Hypertension in Children
Hypertension
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 |
95th BP percentiles for girls |
| 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 |
Table 4.6: Diagnosis of high blood pressure in children and adolescents
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
Standard Treatment Guidelines and Essential Medicines List for South Africa, Primary Healthcare, 2020-2024_Version 1.0_1 November 2024
Chapter 4: Cardiovascular Conditions_4.7.3 Hypertension in Children