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Pediatrics C.V.S 127f7d7a

The definition of hypeension in children is

A
Average systolic blood pressure (SBP) and/or diastolic BP that is >=95th percentile for age, sex, and height on >=2 occasions
B
Average systolic blood pressure (SBP) and/or diastolic BP that is >=95th percentile for age, sex, and height on >=3 occasions
C
Average systolic blood pressure (SBP) and/or diastolic BP that is >=90th percentile for age, sex, and height on >=2 occasions
D
Average systolic blood pressure (SBP) and/or diastolic BP that is >=90th percentile for age, sex, and height on >=3 occasions
High-Yield Explanation
The definition of hypeension in adults is BP >=140/90 mm Hg, regardless of body size, sex, or age. This is a functional definition that relates level of BP elevation with the likelihood of subsequent cardiovascular events. Because hypeension-associated cardiovascular events, such as myocardial infarction or stroke, usually do not occur in childhood, the definition of hypeension in children is statistical rather than functional. The National High Blood Pressure Education Program Working Group on High Blood Pressure in Children and Adolescents published the Fouh Repo on the Diagnosis, Evaluation, and Treatment of High Blood Pressure in Children and Adolescents (Fouh Repo) in 2004. This repo established normal values based on the normative distribution of BP in healthy children and included tables with systolic and diastolic values for the 50th, 90th, 95th, and 99th percentile by age, sex, and height percentile. The Fouh Repo defined hypeension as average systolic blood pressure (SBP) and/or diastolic BP that is >=95th percentile for age, sex, and height on >=3 occasions. Prehypeension was defined as average SBP or diastolic BP that is >=90th percentile but <95th percentile. In adolescents beginning at age 12 yr, prehypeension is defined as BP between 120/80 mm Hg and the 95th percentile. A child with BP levels >=95th percentile in a medical setting but normal BP outside of the office has white coat hypeension. The Fouh Repo fuher recommended that if BP is >=95th percentile, then hypeension should be staged. Children with BP between the 95th and 99th percentile plus 5 mm Hg are categorized as stage 1 hypeension, and children with BP above the 99th percentile plus 5 mm Hg have stage 2 hypeension. Stage 1 hypeension, if asymptomatic and without target organ damage, allows time for evaluation before staing treatment, whereas stage 2 hypeension calls for more prompt evaluation and pharmacologic therapy. Reference: Nelson; 20th edition; Page no: 2294

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