Screening for hypertension in adolescents: the search for normal values

Appropriate control of adult hypertension is currently challenging our health care system. Evaluation of juvenile hypertension may assist in alleviating this massive medical problem by helping to identify potentially remediable risk factors. Assessment of "normal" blood pressure values for children and adolescents must first be accomplished before attempting modification of "abnormals." A hypertension detection and referral surveyed the blood pressures of 7,498 New Orleans high school students aged 14 to 18, to identify youngsters with high blood pressure and to refer them for further evaluation; to demonstrate the range of adolescent blood pressures in this population; to stimulate cooperative blood pressure screening efforts; and to increase the awareness of hypertension and cardiovascular risk factors. Peer group analysis for age, sex, and race showed some variation and divergence to the "tracking" effect. Black boys, for example, showed a sharp increase in diastolic blood pressures at age 16. Blood pressures greater than the 90th percentile are recommended as criteria for referral for further medical evaluation, and were found in this study to be 140-150/84-90 mm Hg for boys and 130-140/84-90 mm Hg for girls.