At what level of blood pressure should hypertension be defined in children?

• Published in: Cardiology in the young Vol. 19; no. 5; pp. 428 - 430
• Main Authors: Sinha, Manish D., Reid, Christopher J. D.
• Format: Journal Article
• Language: English
• Published: Cambridge, UK Cambridge University Press 01.10.2009
• Subjects: ambulatory blood pressure monitoring; Blood pressure; Blood Pressure Determination - standards; Changes; Child; Definition; end organ damage; Humans; Hypertension - diagnosis; left ventricular hypertrophy; paediatric; Population; Studies
• ISSN: 1047-9511; 1467-1107
• DOI: 10.1017/S1047951109990667

[...] different populations would have different values for their blood pressure percentiles. Studies in children that have assessed the association of hypertension with left ventricular hypertrophy as a marker of end-organ damage have found up to two-fifths of hypertensive patients to have left ventricular hypertrophy,20,21 with better correlation of elevated measurements with left ventricular hypertrophy when using ambulatory monitoring.22 As detection of left ventricular hypertrophy in children with hypertension by measuring blood pressure in the clinic is found in less than half of patients, there is a need to evaluate other intermediate markers of the effect of hypertension.19 These could include changes in the peripheral arterial beds by measuring retinal vascular narrowing, looking for changes in arterial structure and function in large vessels by measuring carotid intimal medial thickness and measures of arterial stiffness, examining left ventricular function, and assessing cardiovascular biomarkers such as inactive amino terminal Pro-B-type-natriuretic peptide.