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(Hypertension. 2004;44:387.)
© 2004 American Heart Association, Inc.

Special Report

Summary of the Fourth Report on the Diagnosis, Evaluation, and Treatment of High Blood Pressure in Children and Adolescents

From the Department of Medicine (B.F.), Thomas Jefferson University, Philadelphia, Pa, and Cincinnati Children’s Hospital Medical Center (S.R.D.), Cincinnati, Ohio.

Correspondence to Bonita Falkner, MD, 833 Chestnut St, Suite 700, Philadelphia, PA 19107. E-mail Bonita.Falkner@jefferson.edu

An extract of the first 250 words of the full text is provided, because this article has no abstract.

	Introduction

 
The Working Group on High Blood Pressure in Children and Adolescents has published the Fourth Report on the Diagnosis, Evaluation, and Treatment of High Blood Pressure in Children and Adolescents¹ (www.nhlbi.nih.gov/guidelines/hypertension/child_tbl.htm). This publication, from the National High Blood Pressure Education Program, updates the previous 1996 publication.² The purpose of the Fourth Report is to inform clinicians on the latest scientific evidence regarding blood pressure in children and to provide recommendations for evaluation and treatment of hypertension in the young. The Working Group reexamined the childhood blood pressure database with the addition of new data from the 1999 to 2000 National Health and Nutrition Examination Survey (NHANES). The Working Group also evaluated the recent information on instrumentation for blood pressure measurement in the young, the evidence of target-organ damage in children and adolescents with hypertension, and the results of recent studies on antihypertensive therapy in the young. The fourth report provides new guidelines to clinicians on evaluation and management of children with hypertension and also for children with significant risk for hypertension.

	Definition of Hypertension

 
The definition of hypertension in children and adolescents remains unchanged and is based on blood pressure percentile. Hypertension is defined as average systolic and/or diastolic blood pressure that is 95th percentile for gender, age, and height on 3 or more separate occasions. Blood pressure levels that are 90th percentile but <95th percentile is now termed "prehypertension." The adult definition of prehypertension is used for adolescents because the 90th percentile for systolic blood pressure is >120 mm Hg by age . . . [Full Text of this Article]

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