Pediatric Hypertension

Purpose of Review: Pediatric hypertension is an increasingly prevalent, yet underdiagnosed, problem associated with increased cardiovascular risk in adulthood. This article aims to review the diagnosis, evaluation, and management of pediatric hypertension and will include data from literature published after the new pediatric hypertension guidelines, when available. Recent Findings: The 2017 American Academy of Pediatrics’ Clinical Practice Guidelines (CPG) for the diagnosis and management of pediatric hypertension significantly updated the approach to hypertension screening and management in youth. Many of these changes are reflective of the greater role certain conditions such as obesity, prematurity, and sleep-disordered breathing have on pediatric blood pressure. These changes, along with the expanded focus on 24-h ambulatory blood pressure monitoring (24-h ABPM) in the new guidelines, will be highlighted in this review. Summary: Proper blood pressure measurement, including the use of 24-h ABPM, is critical for the diagnosis of hypertension in children. Treatment efforts for all children should focus on lifestyle modifications, with pharmacotherapy initiated for those who fail lifestyle modification, or for those with stage II, secondary, or symptomatic hypertension.