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Hypertension in Children
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Age | SBP* | DBP* |
---|---|---|
Normal BP | ||
< 13 years | < 90th percentile | < 90th percentile |
≥ 13 years | < 120 | < 80 |
Elevated BP | ||
< 13 years | Between 90th and 95th percentile | Between 90th and 95th percentile |
≥ 13 years | ≥ 120-129 | < 80 |
Stage 1 hypertension | ||
< 13 years | 95th percentile to 95th percentile + 12 mm Hg | 95th percentile to 95th percentile + 12 mm Hg |
≥ 13 years | > 130-139 | > 80-89 |
Stage 2 hypertension | ||
< 13 years | > 95th percentile + 12 mm Hg | > 95th percentile + 12 mm Hg |
≥ 13 years | > 140 | > 90 |
Age (years) | SBP (mm Hg) | DBP (mm Hg) |
---|---|---|
Boys | ||
1 | 98 | 52 |
2 | 100 | 55 |
3 | 101 | 58 |
4 | 102 | 60 |
5 | 103 | 63 |
6 | 105 | 66 |
7 | 106 | 68 |
8 | 107 | 69 |
9 | 107 | 70 |
10 | 108 | 72 |
11 | 110 | 74 |
12 | 113 | 75 |
≥ 13 | 120 | 80 |
Girls | ||
1 | 98 | 54 |
2 | 101 | 58 |
3 | 102 | 60 |
4 | 103 | 62 |
5 | 104 | 64 |
6 | 105 | 67 |
7 | 106 | 68 |
8 | 107 | 69 |
9 | 108 | 71 |
10 | 109 | 72 |
11 | 111 | 74 |
12 | 114 | 75 |
≥ 13 | 120 | 80 |
Age (years) | BP percentile | Height percentile or measured height | ||||||
---|---|---|---|---|---|---|---|---|
5% | 10% | 25% | 50% | 75% | 90% | 95% | ||
1 | Height (in) | 30.4 | 30.8 | 31.6 | 32.4 | 33.3 | 34.1 | 34.6 |
Height (cm) | 77.2 | 78.3 | 80.2 | 82.4 | 84.6 | 86.7 | 87.9 | |
SBP (mm Hg) | ||||||||
50th | 85 | 85 | 86 | 86 | 87 | 88 | 88 | |
90th | 98 | 99 | 99 | 100 | 100 | 101 | 101 | |
95th | 102 | 102 | 103 | 103 | 104 | 105 | 105 | |
95th + 12 mm Hg | 114 | 114 | 115 | 115 | 116 | 117 | 117 | |
DBP (mm Hg) | ||||||||
50th | 40 | 40 | 40 | 41 | 41 | 42 | 42 | |
90th | 52 | 52 | 53 | 53 | 54 | 54 | 54 | |
95th | 54 | 54 | 55 | 55 | 56 | 57 | 57 | |
95th + 12 mm Hg | 66 | 66 | 67 | 67 | 68 | 69 | 69 | |
2 | Height (in) | 33.9 | 34.4 | 35.3 | 36.3 | 37.3 | 38.2 | 38.8 |
Height (cm) | 86.1 | 87.4 | 89.6 | 92.1 | 94.7 | 97.1 | 98.5 | |
SBP (mm Hg) | ||||||||
50th | 87 | 87 | 88 | 89 | 89 | 90 | 91 | |
90th | 100 | 100 | 101 | 102 | 103 | 103 | 104 | |
95th | 104 | 105 | 105 | 106 | 107 | 107 | 108 | |
95th + 12 mm Hg | 116 | 117 | 117 | 118 | 119 | 119 | 120 | |
DBP (mm Hg) | ||||||||
50th | 43 | 43 | 44 | 44 | 45 | 46 | 46 | |
90th | 55 | 55 | 56 | 56 | 57 | 58 | 58 | |
95th | 57 | 58 | 58 | 59 | 60 | 61 | 61 | |
95th + 12 mm Hg | 69 | 70 | 70 | 71 | 72 | 73 | 73 | |
3 | Height (in) | 36.4 | 37 | 37.9 | 39 | 40.1 | 41.1 | 41.7 |
Height (cm) | 92.5 | 93.9 | 96.3 | 99 | 101.8 | 104.3 | 105.8 | |
SBP (mm Hg) | ||||||||
50th | 88 | 89 | 89 | 90 | 91 | 92 | 92 | |
90th | 101 | 102 | 102 | 103 | 104 | 105 | 105 | |
95th | 106 | 106 | 107 | 107 | 108 | 109 | 109 | |
95th + 12 mm Hg | 118 | 118 | 119 | 119 | 120 | 121 | 121 | |
DBP (mm Hg) | ||||||||
50th | 45 | 46 | 46 | 47 | 48 | 49 | 49 | |
90th | 58 | 58 | 59 | 59 | 60 | 61 | 61 | |
95th | 60 | 61 | 61 | 62 | 63 | 64 | 64 | |
95th + 12 mm Hg | 72 | 73 | 73 | 74 | 75 | 76 | 76 | |
4 | Height (in) | 38.8 | 39.4 | 40.5 | 41.7 | 42.9 | 43.9 | 44.5 |
Height (cm) | 98.5 | 100.2 | 102.9 | 105.9 | 108.9 | 111.5 | 113.2 | |
SBP (mm Hg) | ||||||||
50th | 90 | 90 | 91 | 92 | 93 | 94 | 94 | |
90th | 102 | 103 | 104 | 105 | 105 | 106 | 107 | |
95th | 107 | 107 | 108 | 108 | 109 | 110 | 110 | |
95th + 12 mm Hg | 119 | 119 | 120 | 120 | 121 | 122 | 122 | |
DBP (mm Hg) | ||||||||
50th | 48 | 49 | 49 | 50 | 51 | 52 | 52 | |
90th | 60 | 61 | 62 | 62 | 63 | 64 | 64 | |
95th | 63 | 64 | 65 | 66 | 67 | 67 | 68 | |
95th + 12 mm Hg | 75 | 76 | 77 | 78 | 79 | 79 | 80 | |
5 | Height (in) | 41.1 | 41.8 | 43.0 | 44.3 | 45.5 | 46.7 | 47.4 |
Height (cm) | 104.4 | 106.2 | 109.1 | 112.4 | 115.7 | 118.6 | 120.3 | |
SBP (mm Hg) | ||||||||
50th | 91 | 92 | 93 | 94 | 95 | 96 | 96 | |
90th | 103 | 104 | 105 | 106 | 107 | 108 | 108 | |
95th | 107 | 108 | 109 | 109 | 110 | 111 | 112 | |
95th + 12 mm Hg | 119 | 120 | 121 | 121 | 122 | 123 | 124 | |
DBP (mm Hg) | ||||||||
50th | 51 | 51 | 52 | 53 | 54 | 55 | 55 | |
90th | 63 | 64 | 65 | 65 | 66 | 67 | 67 | |
95th | 66 | 67 | 68 | 69 | 70 | 70 | 71 | |
95th + 12 mm Hg | 78 | 79 | 80 | 81 | 82 | 82 | 83 | |
6 | Height (in) | 43.4 | 44.2 | 45.4 | 46.8 | 48.2 | 49.4 | 50.2 |
Height (cm) | 110.3 | 112.2 | 115.3 | 118.9 | 122.4 | 125.6 | 127.5 | |
SBP (mm Hg) | ||||||||
50th | 93 | 93 | 94 | 95 | 96 | 97 | 98 | |
90th | 105 | 105 | 106 | 107 | 109 | 110 | 110 | |
95th | 108 | 109 | 110 | 111 | 112 | 113 | 114 | |
95th + 12 mm Hg | 120 | 121 | 122 | 123 | 124 | 125 | 126 | |
DBP (mm Hg) | ||||||||
50th | 54 | 54 | 55 | 56 | 57 | 57 | 58 | |
90th | 66 | 66 | 67 | 68 | 68 | 69 | 69 | |
95th | 69 | 70 | 70 | 71 | 72 | 72 | 73 | |
95th + 12 mm Hg | 81 | 82 | 82 | 83 | 84 | 84 | 85 | |
7 | Height (in) | 45.7 | 46.5 | 47.8 | 49.3 | 50.8 | 52.1 | 52.9 |
Height (cm) | 116.1 | 118 | 121.4 | 125.1 | 128.9 | 132.4 | 134.5 | |
SBP (mm Hg) | ||||||||
50th | 94 | 94 | 95 | 97 | 98 | 98 | 99 | |
90th | 106 | 107 | 108 | 109 | 110 | 111 | 111 | |
95th | 110 | 110 | 111 | 112 | 114 | 115 | 116 | |
95th + 12 mm Hg | 122 | 122 | 123 | 124 | 126 | 127 | 128 | |
DBP (mm Hg) | ||||||||
50th | 56 | 56 | 57 | 58 | 58 | 59 | 59 | |
90th | 68 | 68 | 69 | 70 | 70 | 71 | 71 | |
95th | 71 | 71 | 72 | 73 | 73 | 74 | 74 | |
95th + 12 mm Hg | 83 | 83 | 84 | 85 | 85 | 86 | 86 | |
8 | Height (in) | 47.8 | 48.6 | 50 | 51.6 | 53.2 | 54.6 | 55.5 |
Height (cm) | 121.4 | 123.5 | 127 | 131 | 135.1 | 138.8 | 141 | |
SBP (mm Hg) | ||||||||
50th | 95 | 96 | 97 | 98 | 99 | 99 | 100 | |
90th | 107 | 108 | 109 | 110 | 111 | 112 | 112 | |
95th | 111 | 112 | 112 | 114 | 115 | 116 | 117 | |
95th + 12 mm Hg | 123 | 124 | 124 | 126 | 127 | 128 | 129 | |
DBP (mm Hg) | ||||||||
50th | 57 | 57 | 58 | 59 | 59 | 60 | 60 | |
90th | 69 | 70 | 70 | 71 | 72 | 72 | 73 | |
95th | 72 | 73 | 73 | 74 | 75 | 75 | 75 | |
95th + 12 mm Hg | 84 | 85 | 85 | 86 | 87 | 87 | 87 | |
9 | Height (in) | 49.6 | 50.5 | 52 | 53.7 | 55.4 | 56.9 | 57.9 |
Height (cm) | 126 | 128.3 | 132.1 | 136.3 | 140.7 | 144.7 | 147.1 | |
SBP (mm Hg) | ||||||||
50th | 96 | 97 | 98 | 99 | 100 | 101 | 101 | |
90th | 107 | 108 | 109 | 110 | 112 | 113 | 114 | |
95th | 112 | 112 | 113 | 115 | 116 | 118 | 119 | |
95th + 12 mm Hg | 124 | 124 | 125 | 127 | 128 | 130 | 131 | |
DBP (mm Hg) | ||||||||
50th | 57 | 58 | 59 | 60 | 61 | 62 | 62 | |
90th | 70 | 71 | 72 | 73 | 74 | 74 | 74 | |
95th | 74 | 74 | 75 | 76 | 76 | 77 | 77 | |
95th + 12 mm Hg | 86 | 86 | 87 | 88 | 88 | 89 | 89 | |
10 | Height (in) | 51.3 | 52.2 | 53.8 | 55.6 | 57.4 | 59.1 | 60.1 |
Height (cm) | 130.2 | 132.7 | 136.7 | 141.3 | 145.9 | 150.1 | 152.7 | |
SBP (mm Hg) | ||||||||
50th | 97 | 98 | 99 | 100 | 101 | 102 | 103 | |
90th | 108 | 109 | 111 | 112 | 113 | 115 | 116 | |
95th | 112 | 113 | 114 | 116 | 118 | 120 | 121 | |
95th + 12 mm Hg | 124 | 125 | 126 | 128 | 130 | 132 | 133 | |
DBP (mm Hg) | ||||||||
50th | 59 | 60 | 61 | 62 | 63 | 63 | 64 | |
90th | 72 | 73 | 74 | 74 | 75 | 75 | 76 | |
95th | 76 | 76 | 77 | 77 | 78 | 78 | 78 | |
95th + 12 mm Hg | 88 | 88 | 89 | 89 | 90 | 90 | 90 | |
11 | Height (in) | 53 | 54 | 55.7 | 57.6 | 59.6 | 61.3 | 62.4 |
Height (cm) | 134.7 | 137.3 | 141.5 | 146.4 | 151.3 | 155.8 | 158.6 | |
SBP (mm Hg) | ||||||||
50th | 99 | 99 | 101 | 102 | 103 | 104 | 106 | |
90th | 110 | 111 | 112 | 114 | 116 | 117 | 118 | |
95th | 114 | 114 | 116 | 118 | 120 | 123 | 124 | |
95th + 12 mm Hg | 126 | 126 | 128 | 130 | 132 | 135 | 136 | |
DBP (mm Hg) | ||||||||
50th | 61 | 61 | 62 | 63 | 63 | 63 | 63 | |
90th | 74 | 74 | 75 | 75 | 75 | 76 | 76 | |
95th | 77 | 78 | 78 | 78 | 78 | 78 | 78 | |
95th + 12 mm Hg | 89 | 90 | 90 | 90 | 90 | 90 | 90 | |
12 | Height (in) | 55.2 | 56.3 | 58.1 | 60.1 | 62.2 | 64 | 65.2 |
Height (cm) | 140.3 | 143 | 147.5 | 152.7 | 157.9 | 162.6 | 165.5 | |
SBP (mm Hg) | ||||||||
50th | 101 | 101 | 102 | 104 | 106 | 108 | 109 | |
90th | 113 | 114 | 115 | 117 | 119 | 121 | 122 | |
95th | 116 | 117 | 118 | 121 | 124 | 126 | 128 | |
95th + 12 mm Hg | 128 | 129 | 130 | 133 | 136 | 138 | 140 | |
DBP (mm Hg) | ||||||||
50th | 61 | 62 | 62 | 62 | 62 | 63 | 63 | |
90th | 75 | 75 | 75 | 75 | 75 | 76 | 76 | |
95th | 78 | 78 | 78 | 78 | 78 | 79 | 79 | |
95th + 12 mm Hg | 90 | 90 | 90 | 90 | 90 | 91 | 91 | |
13 | Height (in) | 57.9 | 59.1 | 61 | 63.1 | 65.2 | 67.1 | 68.3 |
Height (cm) | 147 | 150 | 154.9 | 160.3 | 165.7 | 170.5 | 173.4 | |
SBP (mm Hg) | ||||||||
50th | 103 | 104 | 105 | 108 | 110 | 111 | 112 | |
90th | 115 | 116 | 118 | 121 | 124 | 126 | 126 | |
95th | 119 | 120 | 122 | 125 | 128 | 130 | 131 | |
95th + 12 mm Hg | 131 | 132 | 134 | 137 | 140 | 142 | 143 | |
DBP (mm Hg) | ||||||||
50th | 61 | 60 | 61 | 62 | 63 | 64 | 65 | |
90th | 74 | 74 | 74 | 75 | 76 | 77 | 77 | |
95th | 78 | 78 | 78 | 78 | 80 | 81 | 81 | |
95th + 12 mm Hg | 90 | 90 | 90 | 90 | 92 | 93 | 93 | |
14 | Height (in) | 60.6 | 61.8 | 63.8 | 65.9 | 68.0 | 69.8 | 70.9 |
Height (cm) | 153.8 | 156.9 | 162 | 167.5 | 172.7 | 177.4 | 180.1 | |
SBP (mm Hg) | ||||||||
50th | 105 | 106 | 109 | 111 | 112 | 113 | 113 | |
90th | 119 | 120 | 123 | 126 | 127 | 128 | 129 | |
95th | 123 | 125 | 127 | 130 | 132 | 133 | 134 | |
95th + 12 mm Hg | 135 | 137 | 139 | 142 | 144 | 145 | 146 | |
DBP (mm Hg) | ||||||||
50th | 60 | 60 | 62 | 64 | 65 | 66 | 67 | |
90th | 74 | 74 | 75 | 77 | 78 | 79 | 80 | |
95th | 77 | 78 | 79 | 81 | 82 | 83 | 84 | |
95th + 12 mm Hg | 89 | 90 | 91 | 93 | 94 | 95 | 96 | |
15 | Height (in) | 62.6 | 63.8 | 65.7 | 67.8 | 69.8 | 71.5 | 72.5 |
Height (cm) | 159 | 162 | 166.9 | 172.2 | 177.2 | 181.6 | 184.2 | |
SBP (mm Hg) | ||||||||
50th | 108 | 110 | 112 | 113 | 114 | 114 | 114 | |
90th | 123 | 124 | 126 | 128 | 129 | 130 | 130 | |
95th | 127 | 129 | 131 | 132 | 134 | 135 | 135 | |
95th + 12 mm Hg | 139 | 141 | 143 | 144 | 146 | 147 | 147 | |
DBP (mm Hg) | ||||||||
50th | 61 | 62 | 64 | 65 | 66 | 67 | 68 | |
90th | 75 | 76 | 78 | 79 | 80 | 81 | 81 | |
95th | 78 | 79 | 81 | 83 | 84 | 85 | 85 | |
95th + 12 mm Hg | 90 | 91 | 93 | 95 | 96 | 97 | 97 | |
16 | Height (in) | 63.8 | 64.9 | 66.8 | 68.8 | 70.7 | 72.4 | 73.4 |
Height (cm) | 162.1 | 165 | 169.6 | 174.6 | 179.5 | 183.8 | 186.4 | |
SBP (mm Hg) | ||||||||
50th | 111 | 112 | 114 | 115 | 115 | 116 | 116 | |
90th | 126 | 127 | 128 | 129 | 131 | 131 | 132 | |
95th | 130 | 131 | 133 | 134 | 135 | 136 | 137 | |
95th + 12 mm Hg | 142 | 143 | 145 | 146 | 147 | 148 | 149 | |
DBP (mm Hg) | ||||||||
50th | 63 | 64 | 66 | 67 | 68 | 69 | 69 | |
90th | 77 | 78 | 79 | 80 | 81 | 82 | 82 | |
95th | 80 | 81 | 83 | 84 | 85 | 86 | 86 | |
95th + 12 mm Hg | 92 | 93 | 95 | 96 | 97 | 98 | 98 | |
17 | Height (in) | 64.5 | 65.5 | 67.3 | 69.2 | 71.1 | 72.8 | 73.8 |
Height (cm) | 163.8 | 166.5 | 170.9 | 175.8 | 180.7 | 184.9 | 187.5 | |
SBP (mm Hg) | ||||||||
50th | 114 | 115 | 116 | 117 | 117 | 118 | 118 | |
90th | 128 | 129 | 130 | 131 | 132 | 133 | 134 | |
95th | 132 | 133 | 134 | 135 | 137 | 138 | 138 | |
95th + 12 mm Hg | 144 | 145 | 146 | 147 | 149 | 150 | 150 | |
DBP (mm Hg) | ||||||||
50th | 65 | 66 | 67 | 68 | 69 | 70 | 70 | |
90th | 78 | 79 | 80 | 81 | 82 | 82 | 83 | |
95th | 81 | 82 | 84 | 85 | 86 | 86 | 87 | |
95th + 12 mm Hg | 93 | 94 | 96 | 97 | 98 | 98 | 99 |
Age (years) | BP percentile | Height percentile or measured height | ||||||
---|---|---|---|---|---|---|---|---|
5% | 10% | 25% | 50% | 75% | 90% | 95% | ||
1 | Height (in) | 29.7 | 30.2 | 30.9 | 31.8 | 32.7 | 33.4 | 33.9 |
Height (cm) | 75.4 | 76.6 | 78.6 | 80.8 | 83 | 84.9 | 86.1 | |
SBP (mm Hg) | ||||||||
50th | 84 | 85 | 86 | 86 | 87 | 88 | 88 | |
90th | 98 | 99 | 99 | 100 | 101 | 102 | 102 | |
95th | 101 | 102 | 102 | 103 | 104 | 105 | 105 | |
95th + 12 mm Hg | 113 | 114 | 114 | 115 | 116 | 117 | 117 | |
DBP (mm Hg) | ||||||||
50th | 41 | 42 | 42 | 43 | 44 | 45 | 46 | |
90th | 54 | 55 | 56 | 56 | 57 | 58 | 58 | |
95th | 59 | 59 | 60 | 60 | 61 | 62 | 62 | |
95th + 12 mm Hg | 71 | 71 | 72 | 72 | 73 | 74 | 74 | |
2 | Height (in) | 33.4 | 34 | 34.9 | 35.9 | 36.9 | 37.8 | 38.4 |
Height (cm) | 84.9 | 86.3 | 88.6 | 91.1 | 93.7 | 96 | 97.4 | |
SBP (mm Hg) | ||||||||
50th | 87 | 87 | 88 | 89 | 90 | 91 | 91 | |
90th | 101 | 101 | 102 | 103 | 104 | 105 | 106 | |
95th | 104 | 105 | 106 | 106 | 107 | 108 | 109 | |
95th + 12 mm Hg | 116 | 117 | 118 | 118 | 119 | 120 | 121 | |
DBP (mm Hg) | ||||||||
50th | 45 | 46 | 47 | 48 | 49 | 50 | 51 | |
90th | 58 | 58 | 59 | 60 | 61 | 62 | 62 | |
95th | 62 | 63 | 63 | 64 | 65 | 66 | 66 | |
95th + 12 mm Hg | 74 | 75 | 75 | 76 | 77 | 78 | 78 | |
3 | Height (in) | 35.8 | 36.4 | 37.3 | 38.4 | 39.6 | 40.6 | 41.2 |
Height (cm) | 91 | 92.4 | 94.9 | 97.6 | 100.5 | 103.1 | 104.6 | |
SBP (mm Hg) | ||||||||
50th | 88 | 89 | 89 | 90 | 91 | 92 | 93 | |
90th | 102 | 103 | 104 | 104 | 105 | 106 | 107 | |
95th | 106 | 106 | 107 | 108 | 109 | 110 | 110 | |
95th + 12 mm Hg | 118 | 118 | 119 | 120 | 121 | 122 | 122 | |
DBP (mm Hg) | ||||||||
50th | 48 | 48 | 49 | 50 | 51 | 53 | 53 | |
90th | 60 | 61 | 61 | 62 | 63 | 64 | 65 | |
95th | 64 | 65 | 65 | 66 | 67 | 68 | 69 | |
95th + 12 mm Hg | 76 | 77 | 77 | 78 | 79 | 80 | 81 | |
4 | Height (in) | 38.3 | 38.9 | 39.9 | 41.1 | 42.4 | 43.5 | 44.2 |
Height (cm) | 97.2 | 98.8 | 101.4 | 104.5 | 107.6 | 110.5 | 112.2 | |
SBP (mm Hg) | ||||||||
50th | 89 | 90 | 91 | 92 | 93 | 94 | 94 | |
90th | 103 | 104 | 105 | 106 | 107 | 108 | 108 | |
95th | 107 | 108 | 109 | 109 | 110 | 111 | 112 | |
95th + 12 mm Hg | 119 | 120 | 121 | 121 | 122 | 123 | 124 | |
DBP (mm Hg) | ||||||||
50th | 50 | 51 | 51 | 53 | 54 | 55 | 55 | |
90th | 62 | 63 | 64 | 65 | 66 | 67 | 67 | |
95th | 66 | 67 | 68 | 69 | 70 | 70 | 71 | |
95th + 12 mm Hg | 78 | 79 | 80 | 81 | 82 | 82 | 83 | |
5 | Height (in) | 40.8 | 41.5 | 42.6 | 43.9 | 45.2 | 46.5 | 47.3 |
Height (cm) | 103.6 | 105.3 | 108.2 | 111.5 | 114.9 | 118.1 | 120 | |
SBP (mm Hg) | ||||||||
50th | 90 | 91 | 92 | 93 | 94 | 95 | 96 | |
90th | 104 | 105 | 106 | 107 | 108 | 109 | 110 | |
95th | 108 | 109 | 109 | 110 | 111 | 112 | 113 | |
95th + 12 mm Hg | 120 | 121 | 121 | 122 | 123 | 124 | 125 | |
DBP (mm Hg) | ||||||||
50th | 52 | 52 | 53 | 55 | 56 | 57 | 57 | |
90th | 64 | 65 | 66 | 67 | 68 | 69 | 70 | |
95th | 68 | 69 | 70 | 71 | 72 | 73 | 73 | |
95th + 12 mm Hg | 80 | 81 | 82 | 83 | 84 | 85 | 85 | |
6 | Height (in) | 43.3 | 44 | 45.2 | 46.6 | 48.1 | 49.4 | 50.3 |
Height (cm) | 110 | 111.8 | 114.9 | 118.4 | 122.1 | 125.6 | 127.7 | |
SBP (mm Hg) | ||||||||
50th | 92 | 92 | 93 | 94 | 96 | 97 | 97 | |
90th | 105 | 106 | 107 | 108 | 109 | 110 | 111 | |
95th | 109 | 109 | 110 | 111 | 112 | 113 | 114 | |
95th + 12 mm Hg | 121 | 121 | 122 | 123 | 124 | 125 | 126 | |
DBP (mm Hg) | ||||||||
50th | 54 | 54 | 55 | 56 | 57 | 58 | 59 | |
90th | 67 | 67 | 68 | 69 | 70 | 71 | 71 | |
95th | 70 | 71 | 72 | 72 | 73 | 74 | 74 | |
95th + 12 mm Hg | 82 | 83 | 84 | 84 | 85 | 86 | 86 | |
7 | Height (in) | 45.6 | 46.4 | 47.7 | 49.2 | 50.7 | 52.1 | 53 |
Height (cm) | 115.9 | 117.8 | 121.1 | 124.9 | 128.8 | 132.5 | 134.7 | |
SBP (mm Hg) | ||||||||
50th | 92 | 93 | 94 | 95 | 97 | 98 | 99 | |
90th | 106 | 106 | 107 | 109 | 110 | 111 | 112 | |
95th | 109 | 110 | 111 | 112 | 113 | 114 | 115 | |
95th + 12 mm Hg | 121 | 122 | 123 | 124 | 125 | 126 | 127 | |
DBP (mm Hg) | ||||||||
50th | 55 | 55 | 56 | 57 | 58 | 59 | 60 | |
90th | 68 | 68 | 69 | 70 | 71 | 72 | 72 | |
95th | 72 | 72 | 73 | 73 | 74 | 74 | 75 | |
95th + 12 mm Hg | 84 | 84 | 85 | 85 | 86 | 86 | 87 | |
8 | Height (in) | 47.6 | 48.4 | 49.8 | 51.4 | 53 | 54.5 | 55.5 |
Height (cm) | 121 | 123 | 126.5 | 130.6 | 134.7 | 138.5 | 140.9 | |
SBP (mm Hg) | ||||||||
50th | 93 | 94 | 95 | 97 | 98 | 99 | 100 | |
90th | 107 | 107 | 108 | 110 | 111 | 112 | 113 | |
95th | 110 | 111 | 112 | 113 | 115 | 116 | 117 | |
95th + 12 mm Hg | 122 | 123 | 124 | 125 | 127 | 128 | 129 | |
DBP (mm Hg) | ||||||||
50th | 56 | 56 | 57 | 59 | 60 | 61 | 61 | |
90th | 69 | 70 | 71 | 72 | 72 | 73 | 73 | |
95th | 72 | 73 | 74 | 74 | 75 | 75 | 75 | |
95th + 12 mm Hg | 84 | 85 | 86 | 86 | 87 | 87 | 87 | |
9 | Height (in) | 49.3 | 50.2 | 51.7 | 53.4 | 55.1 | 56.7 | 57.7 |
Height (cm) | 125.3 | 127.6 | 131.3 | 135.6 | 140.1 | 144.1 | 146.6 | |
SBP (mm Hg) | ||||||||
50th | 95 | 95 | 97 | 98 | 99 | 100 | 101 | |
90th | 108 | 108 | 109 | 111 | 112 | 113 | 114 | |
95th | 112 | 112 | 113 | 114 | 116 | 117 | 118 | |
95th + 12 mm Hg | 124 | 124 | 125 | 126 | 128 | 129 | 130 | |
DBP (mm Hg) | ||||||||
50th | 57 | 58 | 59 | 60 | 60 | 61 | 61 | |
90th | 71 | 71 | 72 | 73 | 73 | 73 | 73 | |
95th | 74 | 74 | 75 | 75 | 75 | 75 | 75 | |
95th + 12 mm Hg | 86 | 86 | 87 | 87 | 87 | 87 | 87 | |
10 | Height (in) | 51.1 | 52 | 53.7 | 55.5 | 57.4 | 59.1 | 60.2 |
Height (cm) | 129.7 | 132.2 | 136.3 | 141 | 145.8 | 150.2 | 152.8 | |
SBP (mm Hg) | ||||||||
50th | 96 | 97 | 98 | 99 | 101 | 102 | 103 | |
90th | 109 | 110 | 111 | 112 | 113 | 115 | 116 | |
95th | 113 | 114 | 114 | 116 | 117 | 119 | 120 | |
95th + 12 mm Hg | 125 | 126 | 126 | 128 | 129 | 131 | 132 | |
DBP (mm Hg) | ||||||||
50th | 58 | 59 | 59 | 60 | 61 | 61 | 62 | |
90th | 72 | 73 | 73 | 73 | 73 | 73 | 73 | |
95th | 75 | 75 | 76 | 76 | 76 | 76 | 76 | |
95th + 12 mm Hg | 87 | 87 | 88 | 88 | 88 | 88 | 88 | |
11 | Height (in) | 53.4 | 54.5 | 56.2 | 58.2 | 60.2 | 61.9 | 63 |
Height (cm) | 135.6 | 138.3 | 142.8 | 147.8 | 152.8 | 157.3 | 160 | |
SBP (mm Hg) | ||||||||
50th | 98 | 99 | 101 | 102 | 104 | 105 | 106 | |
90th | 111 | 112 | 113 | 114 | 116 | 118 | 120 | |
95th | 115 | 116 | 117 | 118 | 120 | 123 | 124 | |
95th + 12 mm Hg | 127 | 128 | 129 | 130 | 132 | 135 | 136 | |
DBP (mm Hg) | ||||||||
50th | 60 | 60 | 60 | 61 | 62 | 63 | 64 | |
90th | 74 | 74 | 74 | 74 | 74 | 75 | 75 | |
95th | 76 | 77 | 77 | 77 | 77 | 77 | 77 | |
95th + 12 mm Hg | 88 | 89 | 89 | 89 | 89 | 89 | 89 | |
12 | Height (in) | 56.2 | 57.3 | 59 | 60.9 | 62.8 | 64.5 | 65.5 |
Height (cm) | 142.8 | 145.5 | 149.9 | 154.8 | 159.6 | 163.8 | 166.4 | |
SBP (mm Hg) | ||||||||
50th | 102 | 102 | 104 | 105 | 107 | 108 | 108 | |
90th | 114 | 115 | 116 | 118 | 120 | 122 | 122 | |
95th | 118 | 119 | 120 | 122 | 124 | 125 | 126 | |
95th + 12 mm Hg | 130 | 131 | 132 | 134 | 136 | 137 | 138 | |
DBP (mm Hg) | ||||||||
50th | 61 | 61 | 61 | 62 | 64 | 65 | 65 | |
90th | 75 | 75 | 75 | 75 | 76 | 76 | 76 | |
95th | 78 | 78 | 78 | 78 | 79 | 79 | 79 | |
95th + 12 mm Hg | 90 | 90 | 90 | 90 | 91 | 91 | 91 | |
13 | Height (in) | 58.3 | 59.3 | 60.9 | 62.7 | 64.5 | 66.1 | 67 |
Height (cm) | 148.1 | 150.6 | 154.7 | 159.2 | 163.7 | 167.8 | 170.2 | |
SBP (mm Hg) | ||||||||
50th | 104 | 105 | 106 | 107 | 108 | 108 | 109 | |
90th | 116 | 117 | 119 | 121 | 122 | 123 | 123 | |
95th | 121 | 122 | 123 | 124 | 126 | 126 | 127 | |
95th + 12 mm Hg | 133 | 134 | 135 | 136 | 138 | 138 | 139 | |
DBP (mm Hg) | ||||||||
50th | 62 | 62 | 63 | 64 | 65 | 65 | 66 | |
90th | 75 | 75 | 75 | 76 | 76 | 76 | 76 | |
95th | 79 | 79 | 79 | 79 | 80 | 80 | 81 | |
95th + 12 mm Hg | 91 | 91 | 91 | 91 | 92 | 92 | 93 | |
14 | Height (in) | 59.3 | 60.2 | 61.8 | 63.5 | 65.2 | 66.8 | 67.7 |
Height (cm) | 150.6 | 153 | 156.9 | 161.3 | 165.7 | 169.7 | 172.1 | |
SBP (mm Hg) | ||||||||
50th | 105 | 106 | 107 | 108 | 109 | 109 | 109 | |
90th | 118 | 118 | 120 | 122 | 123 | 123 | 123 | |
95th | 123 | 123 | 124 | 125 | 126 | 127 | 127 | |
95th + 12 mm Hg | 135 | 135 | 136 | 137 | 138 | 139 | 139 | |
DBP (mm Hg) | ||||||||
50th | 63 | 63 | 64 | 65 | 66 | 66 | 66 | |
90th | 76 | 76 | 76 | 76 | 77 | 77 | 77 | |
95th | 80 | 80 | 80 | 80 | 81 | 81 | 82 | |
95th + 12 mm Hg | 92 | 92 | 92 | 92 | 93 | 93 | 94 | |
15 | Height (in) | 59.7 | 60.6 | 62.2 | 63.9 | 65.6 | 67.2 | 68.1 |
Height (cm) | 151.7 | 154 | 157.9 | 162.3 | 166.7 | 170.6 | 173 | |
SBP (mm Hg) | ||||||||
50th | 105 | 106 | 107 | 108 | 109 | 109 | 109 | |
90th | 118 | 119 | 121 | 122 | 123 | 123 | 124 | |
95th | 124 | 124 | 125 | 126 | 127 | 127 | 128 | |
95th + 12 mm Hg | 136 | 136 | 137 | 138 | 139 | 139 | 140 | |
DBP (mm Hg) | ||||||||
50th | 64 | 64 | 64 | 65 | 66 | 67 | 67 | |
90th | 76 | 76 | 76 | 77 | 77 | 78 | 78 | |
95th | 80 | 80 | 80 | 81 | 82 | 82 | 82 | |
95th + 12 mm Hg | 92 | 92 | 92 | 93 | 94 | 94 | 94 | |
16 | Height (in) | 59.9 | 60.8 | 62.4 | 64.1 | 65.8 | 67.3 | 68.3 |
Height (cm) | 152.1 | 154.5 | 158.4 | 162.8 | 167.1 | 171.1 | 173.4 | |
SBP (mm Hg) | ||||||||
50th | 106 | 107 | 108 | 109 | 109 | 110 | 110 | |
90th | 119 | 120 | 122 | 123 | 124 | 124 | 124 | |
95th | 124 | 125 | 125 | 127 | 127 | 128 | 128 | |
95th + 12 mm Hg | 136 | 137 | 137 | 139 | 139 | 140 | 140 | |
DBP (mm Hg) | ||||||||
50th | 64 | 64 | 65 | 66 | 66 | 67 | 67 | |
90th | 76 | 76 | 76 | 77 | 78 | 78 | 78 | |
95th | 80 | 80 | 80 | 81 | 82 | 82 | 82 | |
95th + 12 mm Hg | 92 | 92 | 92 | 93 | 94 | 94 | 94 | |
17 | Height (in) | 60.0 | 60.9 | 62.5 | 64.2 | 65.9 | 67.4 | 68.4 |
Height (cm) | 152.4 | 154.7 | 158.7 | 163.0 | 167.4 | 171.3 | 173.7 | |
SBP (mm Hg) | ||||||||
50th | 107 | 108 | 109 | 110 | 110 | 110 | 111 | |
90th | 120 | 121 | 123 | 124 | 124 | 125 | 125 | |
95th | 125 | 125 | 126 | 127 | 128 | 128 | 128 | |
95th + 12 mm Hg | 137 | 137 | 138 | 139 | 140 | 140 | 140 | |
DBP (mm Hg) | ||||||||
50th | 64 | 64 | 65 | 66 | 66 | 66 | 67 | |
90th | 76 | 76 | 77 | 77 | 78 | 78 | 78 | |
95th | 80 | 80 | 80 | 81 | 82 | 82 | 82 | |
95th + 12 mm Hg | 92 | 92 | 92 | 93 | 94 | 94 | 94 |
Category | Clinic SBP or DBP* | Mean ambulatory SBP or DBP | ||
---|---|---|---|---|
< 13 years of age | ≥ 13 years of age | < 13 years of age | ≥ 13 years of age | |
Normal BP | < 95th percentile | < 130/80 mm Hg | < 95th percentile OR adolescent cut points* | < 125/75 mm Hg 24-h AND < 130/80 mm Hg wake AND < 110/65 mm Hg sleep |
WCH | ≥ 95th percentile | ≥ 130/80 mm Hg | ||
Masked hypertension | < 95th percentile | < 130/80 mm Hg | ≥ 95th percentile OR adolescent cut points* | ≥ 125/75 mm Hg 24-h OR ≥ 130/80 mm Hg wake OR ≥ 110/65 mm Hg sleep |
Ambulatory hypertension | ≥ 95th percentile | ≥ 130/80 mm Hg |
Condition | Description | Differentiated by |
---|---|---|
WCH | BP ≥ 95th percentile in office or clinical setting but < 95th percentile outside office or clinical setting | Home BPs are different than clinic BPs |
Primary | Hypertension without a specific underlying etiology | Patients are usually older than 6 years, have family history of hypertension, are overweight or obese |
Secondary | Hypertension due to a specific etiology | Patients are usually younger than 6 years and/or have symptoms and signs of underlying condition |
Condition | Description | Differentiated by |
---|---|---|
Renal | ||
Postinfectious glomerulonephritis | Hematuria and edema several weeks following infection, often streptococcal18 | Hematuria Recent infection |
Henoch-Schönlein purpura | Purpuric rash, abdominal pain and joint pain usually developing weeks following URI19 | Purpuric lesions |
Pyelonephritis | Kidney infection with flank pain, fever | Urine with white cells, growth on culture |
Hemolytic uremic syndrome | Hemolytic anemia, thrombocytopenia, renal thrombi following a bloody diarrheal illness20 | Hemolytic anemia, thrombocytopenia Renal injury |
Wilms tumor21 | Malignant tumor of kidney in children | Biopsy of mass |
Polycystic kidney disease22 | Genetic disease with multiple renal cysts | Bilateral kidney cysts on US |
Vascular | ||
Renal artery stenosis23 | Narrowing of renal artery associated with fibromuscular dysplasia, Williams syndrome, and neurofibromatosis | Imaging, usually CTA, MRA, or angiography |
Aortic coarctation24 | Congenital narrowing with diminished femoral pulses, murmur | Echocardiography |
Vasculitis25 | Group of disorders resulting from inflammation of blood vessel wall including Takayasu, polyarteritis nodosa, Kawasaki | Specific criteria for each disease often with rash, inflammatory markers |
Umbilical artery catheterization26 | Thrombus to renal artery, postulated embolization to kidney causing increase in renin secretion | History of umbilical artery catheterization and neonatal hypertension |
Endocrine | ||
Congenital adrenal hyperplasia27 | Group of inherited recessive disorders that results in insufficient cortisol and aldosterone | Neonatal screening Elevated ACTH |
Hyperthyroidism28 | Excess thyroid hormone resulting in elevated heart rate/BP, proptosis, weight loss, fatigue | Decreased TSH, elevated T3, T4 Goiter |
Pheochromocytoma29 | Tumors that release catecholamines resulting in tachycardia/hypertension, flushing | Plasma free and urinary metanephrines CT/MRI of abdomen/pelvis |
Cushing syndrome30 | Moon facies, truncal obesity, abdominal striae, hirsutism | Midnight cortisol Low-dose dexamethasone suppression test |
Neuroblastoma | Abdominal mass with tachycardia, hypertension | Biopsy |
Primary aldosteronism31 | Adrenal disorder characterized by hypertension, hypokalemia, and metabolic alkalosis | Hypokalemia, metabolic alkalosis Elevated aldosterone Decreased renin |
Drugs/medications | ||
Corticosteroids | Used in inflammatory conditions including asthma, rheumatologic disease | History Improvement in BPs following cessation |
Sympathomimetics29 | Tachycardia, hypertension from drugs such as decongestants, amphetamines, cocaine | History and drug testing |
Oral contraceptives | ||
Genetic | ||
Liddle syndrome10 | Early-onset hypertension Autosomal dominant Hypokalemia, metabolic alkalosis | Genetic testing |
Gordon syndrome32 | Inherited Hyperkalemia, metabolic acidosis | Genetic testing |
Williams syndrome | Elfin facies with hypercalcemia | Genetic testing |
Category | Mechanism | Indication | Contraindication | Adverse effects | Examples |
---|---|---|---|---|---|
First line therapies | |||||
CCBs DHP subclass | Vasodilation of peripheral arteries by relaxation of vascular smooth muscle | Primary or secondary hypertension | Hypersensitivity to CCB | Flushing Dizziness Peripheral edema | Amlodipine Isradipine Extended-release nifedipine |
ARBs | Blocks angiotensin II receptor Inhibits vasoconstriction Inhibits salt and water retention in kidney | CKD Diabetes mellitus Proteinuria | Pregnancy Patients taking ACE inhibitor | Reduced GFR can impair renal function Hyperkalemia Acute kidney injury | Losartan Candesartan Valsartan Irbesartan Olmesartan |
ACE inhibitors | Inhibits conversion of angiotensin I to angiotensin II, preventing vasoconstriction | CKD Proteinuria Diabetes mellitus | Pregnancy Angioedema Patients taking ARBs | Reduced GFR can impair renal function Headache, cough, dizziness Severe: hyperkalemia, angioedema, acute kidney injury | Enalapril Captopril Lisinopril Ramipril Fosinopril Quinapril Benazepril |
Thiazides | Induces sodium and fluid loss | Edema Osteoporosis Calcium nephrolithiasis | Anuric | Dizziness Hypokalemia Severe: arrhythmias, cholestatic jaundice, pancreatitis | Chlorthalidone Indapamide Hydrochlorothiazide |
Second line therapies | |||||
β-Blockers | Decreased renin Decreased cardiac output | Use in patients whose hypertension does not respond to 2 or more first line agents | Asthmatics | Dizziness Severe: chest pain, shortness of breath | Atenolol Metoprolol Bisoprolol |
Vasodilators | Relaxes arteriolar smooth muscle | Use in refractory hypertension | Pericardial effusion | Palpitations Nausea Headache Nausea/vomiting | Minoxidil Hydralazine |
Kimberly Reidy, MD
Associate Professor and Chief
Department of Pediatrics
Division of Pediatric Nephrology
Children’s Hospital at Montefiore/Albert Einstein College of Medicine
Mohammed Amin, MD
Fellow
Department of Pediatrics
Division of Pediatric Nephrology
Children’s Hospital at Montefiore/Albert Einstein College of Medicine
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