HYPERTENSION

In children and adolescents, primary or essential hypertension is diagnosed when persistently elevated blood pressure cannot be explained by any underlying organic cause. According to the recommendations of the Task Force on Blood Pressure Control in Children, children and adolescents 1 to 17 years of age are considered hypertensive if their average systolic and/or diastolic blood pressure readings are at or above the 95th percentile (based on age, sex, and height) on at least three separate occasions.1 Definitions of normal blood pressure and hypertension are as follows:

In 1987 the Second Task Force on Blood Pressure Control in Children reported that children and adolescents with frequent blood pressure readings between the 90th and 95th percentiles for their age, sex, and height (unless tall for their age) are at risk for developing hypertension.2 The task force advised that these children and adolescents with high-normal blood pressure should be followed regularly for early detection of further elevation in blood pressure. Tables 16 and 17 present the current blood pressure standards for the 90th and 95th percentiles for males and females ages 1 to 17 years, by percentile of height.3

 

Table 16. Blood Pressure Levels for the 90th and 95th Percentiles of Blood Pressure for Boys Ages 1 to 17 Years

 

Systolic BP (mm Hg), by Height
Percentile from Standard Growth Curves

Diastolic BP (mm Hg), by Height
Percentile from Standard Growth Curves
Age BP
Percentilea		 5% 10% 25% 50% 75% 90% 95% 5% 10% 25% 50% 75% 90% 95%
1 90th  94 95  97 98 100 102 102 50 51 52 53 54 54 55
  95th 98  99  101 102 104 106 106 55 55 56 57 58 59 59
2 90th 98 99 100 102 104 105 106 55 55 56 57 58 59 59
  95th 101 102 104 106 108 109 110 59 59 60 61 62 63 63
3 90th 100 101 103 105 107 108 109 59 59 60 61 62 63 63
  95th 104 105 107 109 111 112 113 63 63 64 65 66 67 67
4 90th 102 103 105 107 109 110 111 62 62 63 64 65 66 66
  95th 106 107 109 111 113 114 115 66  67 67 68 69 70 71
5 90th 104 105 106 108 110 112 112 65 65 66 67 68 69 69
  95th 108 109 110 112 114 115 116 69 70 70 71 72 73 74
6 90th 105 106 108 110 111 113 114 67 68 69 70 70 71 72
  95th 109 110 112 114 115  117 117 72 72 73 74 75  76  76
7 90th 106 107 109 111 113 114 115 69 70 71 72 72 73 74
  95th 110 111 113 115 116 118 119 74 74 75 76 77 78 78
8 90th 107 108 110 112 114 115 116 71 71 72 73 74 75 75
  95th 111 112 114 116 118 119 120 75  76 76 77 78 79 80
9 90th 109 110 112 113 115 117 117 72 73 73 74 75 76 77
  95th 113 114 116 117 119 121 121 76 77 78 79 80 80 81
10 90th 110 112 113 115 117 118 119 73 74 74 75 76 77 78
  95th 114  115  117 119 121 122 123 77 78 79 80 80 81 82
11 90th 112 113 115 117 119 120 121 74 74 75 76 77 78 78
  95th 116 117 119 121 123 124 125 78 79 79 80 81 82 83
12 90th 115 116 117 119 121 123 123 75 75 76 77 78 78 79
  95th 119 120 121 123 125 126 127 79 79 80 81 82 83 83
13 90th 117 118 120 122 124 125 126 75 76 76 77 78 79 80
  95th 121 122 124 126 128 129 130 79 80 81 82  83 83 84
14 90th 120 121 123 125 126 128 128 76 76 77 78 79 80 80
  95th 124 125  127  128 130 132 132 80  81 81 82 83  84 85
15 90th 123 124 125 127 129 131 131 77 77 78 79 80 81 81
  95th 127 128 129 131 133 134 135 81 82 83 83 84 85 86
16 90th 125 126 128 130 132 133 134 79 79 80 81 82 82 83
  95th 129 130 132 134 136 137 138 83 83 84 85 86 87 87
17 90th 128 129 131 133 134 136 136 81 81 82 83 84 85 85
  95th 132 133 135 136 138 140  140  85 85 86 87 88 89 89

Source: Reprinted from National High Blood Pressure Education Program Working Group on Hypertension Control in Children and Adolescents.3
aBlood pressure percentile determined by a single measurement.

Table 17. Blood Pressure Levels for the 90th and 95th Percentiles of Blood Pressure for Girls Ages 1 to 17 Years

 

Systolic BP (mm Hg), by Height
Percentile from Standard Growth Curves

Diastolic BP (mm Hg), by Height
Percentile from Standard Growth Curves
Age BP
Percentilea		 5% 10% 25% 50% 75% 90% 95% 5% 10% 25% 50% 75% 90% 95%
1 90th 97 98 99 100 102 103 104 53 53 53 54 55 56 56
  95th 101 102 103 104 105 107 107 57 57 57 58 59 60 60
2 90th 99 99 100 102 103 104 105 57 57 58 58 59 60 61
  95th 102 103 104 105 107 108 109 61 61 62 62 63 64 65
3 90th 100 100 102 103 104 105 106 61 61 61 62 63 63 64
  95th 104 104 105 107 108 109 110 65 65 65 66 67 67 68
4 90th 101 102 103 104 106 107 108 63 63 64 65 65 66 67
  95th 105 106 107 108 109 111 111 67 67 68 69 69 70 71
5 90th 103 103 104 106 107 108 109 65 66 66 67 68 68 69
  95th 107 107 108 110 111 112 113 69 70 70 71 72 72 73
6 90th 104 105 106 107 109 110 111 67 67 68 69 69 70 71
  95th 108 109 110 111 112 114 114 71 71 72 73 73 74 75
7 90th 106 107 108 109 110 112 112 69 69 69 70 71 72 72
  95th 110 110 112 113 114 115 116 73 73 73 74 75 76 76
8 90th 108 109 110 111 112 113 114 70 70 71 71 72 73 74
  95th 112 112 113 115 116 117 118 74 74 75 75 76 77 78
9 90th 110 110 112 113 114 115 116 71 72 72 73 74 74 75
  95th 114 114 115 117 118 119 120 75 76 76 77 78 78 79
10 90th 112 112 114 115 116 117 118 73 73 73 74 75 76 76
  95th 116 116 117 119 120 121 122 77 77 77 78 79 80 80
11 90th 114 114 116 117 118 119 120 74 74 75 75 76 77 77
  95th 118 118 119 121 122 123 124 78 78 79 79 80 81 81
12 90th 116 116 118 119 120 121 122 75 75 76 76 77 78 78
  95th 120 120 121 123 124 125 126 79 79 80 80 81 82 82
13 90th 118 118 119 121 122 123 124 76 76 77 78 78 79 80
  95th 121 122 123 125 126 127 128 80 80 81 82 82 83 84
14 90th 119 120 121 122 124 125 126 77 77 78 79 79 80 81
  95th 123 124 125 126 128 129 130 81 81 82 83 83 84 85
15 90th 121 121 122 124 125 126 127 78 78 79 79 80 81 82
  95th 124 125 126 128 129 130 131 82 82 83 83 84 85 86
16 90th 122 122 123 125 126 127 128 79 79 79 80 81 82 82
  95th 125 126 127 128 130 131 132 83 83 83 84 85 86 86
17 90th 122 123 124 125 126 128 128 79 79 79 80 81 82 82
  95th 126 126 127 129 130 131 132 83 83 83 84 85 86 86

Source: Reprinted from National High Blood Pressure Education Program Working Group on Hypertension Control in Children and Adolescents.3
aBlood pressure percentile determined by a single measurement.