Table 3.

Suggested Revised Schema for Staging of Ambulatory BP Levels in Children

ClassificationOffice BP*Mean Ambulatory
SBP or DBP
SBP or DBP Load, %§
Normal BP<90th %tile<95th %tile<25
White coat hypertension≥95th %tile<95th %tile<25
Prehypertension≥90th %tile or >120/80 mm Hg<95th %tile≥25
Masked hypertension<95th %tile>95th %tile≥25
Ambulatory hypertension>95th %tile>95th %tile25–50
Severe ambulatory hypertension
(at risk for end-organ damage)
>95th %tile>95th %tile>50
  • %tile indicates percentile; BP, blood pressure; DBP, diastolic blood pressure; and SBP, systolic blood pressure.

  • * Based on National High Blood Pressure Education Program Task Force normative data.101a

  • Based on normative pediatric ABPM values in Appendix Tables A1 through A4.

  • For either the wake or sleep period of the study, or both.

  • § For patients with elevated load but normal mean ambulatory BP and office BP that is either normal (<90th percentile) or hypertensive (≥95th percentile), no specific ambulatory BP classification can be assigned based on current evidence and expert consensus. These “unclassified” patients should be evaluated on a case-by-case basis, taking into account the presence of secondary hypertensiona or multiple cardiovascular risk factors.

  • Some clinicians may prefer the term sustained hypertension rather than ambulatory hypertension.