Evaluation and diagnosis of hypertension in infants between one month and one year of age
- Tej K Mattoo, MD, DCH, FRCP
Tej K Mattoo, MD, DCH, FRCP
- Section Editor — Pediatric Nephrology
- Professor of Pediatrics
- Wayne State University School of Medicine
The diagnosis of hypertension is typically made by comparing blood pressure (BP) with normative BP values. However, it is challenging to make the diagnosis of hypertension in infants because of the lack of robust normative data and because BP is not routinely measured in healthy infants.
The definition of hypertension based on available data, risk factors, and etiology for hypertension in infants between one month and one year of age will be reviewed here. The etiology and risk factors of hypertension in neonates, and the management of hypertension in infants are discussed separately. (See "Etiology, clinical features, and diagnosis of neonatal hypertension" and "Management of hypertension in infants".)
As in older children, the definition of hypertension in infants is based upon blood pressure (BP) percentiles. The systolic and diastolic BPs are of equal importance in determining the following BP categories (see "Definition and diagnosis of hypertension in children and adolescents"):
●Normal BP – Both systolic and diastolic BP <90th percentile.
●Elevated BP – Systolic and/or diastolic BP ≥90th percentile but <95th percentile.To continue reading this article, you must log in with your personal, hospital, or group practice subscription. For more information on subscription options, click below on the option that best describes you:
- National High Blood Pressure Education Program Working Group on High Blood Pressure in Children and Adolescents. The fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents. Pediatrics 2004; 114:555.
- de Swiet M, Fayers P, Shinebourne EA. Systolic blood pressure in a population of infants in the first year of life: the Brompton study. Pediatrics 1980; 65:1028.
- Kent AL, Kecskes Z, Shadbolt B, Falk MC. Blood pressure in the first year of life in healthy infants born at term. Pediatr Nephrol 2007; 22:1743.
- Whincup PH, Bredow M, Payne F, et al. Size at birth and blood pressure at 3 years of age. The Avon Longitudinal Study of Pregnancy and Childhood (ALSPAC). Am J Epidemiol 1999; 149:730.
- Bansal N, Ayoola OO, Gemmell I, et al. Effects of early growth on blood pressure of infants of British European and South Asian origin at one year of age: the Manchester children's growth and vascular health study. J Hypertens 2008; 26:412.
- Heij HA, Ekkelkamp S, Vos A. Hypertension associated with skeletal traction in children. Eur J Pediatr 1992; 151:543.
- Flynn JT, Kaelber DC, Baker-Smith CM, et al. Clinical Practice Guideline for Screening and Management of High Blood Pressure in Children and Adolescents. Pediatrics 2017; 140.
- Friedman AL, Hustead VA. Hypertension in babies following discharge from a neonatal intensive care unit. A 3-year follow-up. Pediatr Nephrol 1987; 1:30.
- Abman SH, Warady BA, Lum GM, Koops BL. Systemic hypertension in infants with bronchopulmonary dysplasia. J Pediatr 1984; 104:928.
- Alagappan A, Malloy MH. Systemic hypertension in very low-birth weight infants with bronchopulmonary dysplasia: incidence and risk factors. Am J Perinatol 1998; 15:3.
- Duncan AF, Rosenfeld CR, Morgan JS, et al. Interrater reliability and effect of state on blood pressure measurements in infants 1 to 3 years of age. Pediatrics 2008; 122:e590.
- Menghetti E, Cellitti R, Marsili D, et al. 24 hour monitoring of blood pressure in premature and full-term new born babies. Eur Rev Med Pharmacol Sci 1997; 1:189.
- Varda NM, Gregoric A. Twenty-four-hour ambulatory blood pressure monitoring in infants and toddlers. Pediatr Nephrol 2005; 20:798.
- Gellermann J, Kraft S, Ehrich JH. Twenty-four-hour ambulatory blood pressure monitoring in young children. Pediatr Nephrol 1997; 11:707.
- Gimpel C, Wühl E, Arbeiter K, et al. Superior consistency of ambulatory blood pressure monitoring in children: implications for clinical trials. J Hypertens 2009; 27:1568.