Primary hypertension in childhood and adolescence

Hypertension is a major public health problem in the adult population. The focus in children should be on identifying those children in the highest percentiles of systolic and diastolic blood pressure. In order to do this, blood pressure must be measured routinely in children aged 3 years and older during well-child examinations. Blood pressure must be measured accurately and interpreted correctly. Once such children with elevated blood pressures are identified, appropriate nonpharmacologic measures should be instituted. For those children with marked elevation of blood pressure or who are at risk for target-organ damage, it is reasonable to consider antihypertensive medication after weighing the potential risks and benefits. The hope is that this strategy will ultimately lead to decreased morbidity and mortality from hypertension in the adult population.