I10
DESCRIPTION
Hypertension is defined as systolic and/or diastolic blood pressure ≥ the 95th percentile for gender, age, and height percentile on at least 3 consecutive occasions. Refer to table below.
The use of appropriate cuff size is important. Too small a cuff for the arm leads to false high BP. The cuff bladder must encircle at least 80% of the upper arm and should cover at least 75% of the distance between the acromion and the olecranon. It is better to use a cuff that is slightly too large than one that is too small. Large cuffs, if covered with linen-like material, can be folded to the appropriate size in smaller infants as long as the bladder encompasses the arm.
Infants and preschool-aged children are almost never diagnosed with essential hypertension and are most likely to have secondary forms of hypertension. With age, the prevalence of essential hypertension increases, and after 10 years of age, it becomes the leading cause of elevated BP. Obesity currently is emerging as a common comorbidity of essential hypertension in paediatric patients, often manifesting during early childhood.
DIAGNOSIS
|
Age years |
95th BP percentiles for boys mmHg |
95th BP percentiles for girls mmHg |
|---|---|---|
| 1 | 103/56 | 104/58 |
| 3 | 109/65 | 107/67 |
| 5 | 112/72 | 110/72 |
| 6 | 114/74 | 111/74 |
| 8 | 116/78 | 115/76 |
| 9 | 118/79 | 117/77 |
| 10 | 119/80 | 119/78 |
| 11 | 121/80 | 121/79 |
| 12 | 123/81 | 123/80 |
Adapted from U.S Department of Health and Human Services. National Institutes of Health (National Heart, Lung, and Blood Institute): The 4th report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents, May 2005 (using the 50th height percentile).
REFERRAL
All cases with BP above the 95th percentile.