Evaluation and Management of Stage 2 Hypertension in Pediatric Patients.
PURPOSE OF REVIEW
To update the definition and clinical practice of stage 2 hypertension (HTN) in pediatrics.


RECENT FINDINGS
The 2017 American Academy of Pediatrics Clinical Practice Guideline (AAP CPG) for Screening and Management of High Blood Pressure in Children and Adolescent includes new normative blood pressure tables for children and adolescents ages 1 to 17 years and new definitions for stage 2 HTN. This review will highlight these aspects as well as new recommendations in the guideline specific to stage 2 HTN. It will outline how the new guideline differs from the previous 2004 guideline, the implications of these differences, and suggested changes in evaluation and management of stage 2 HTN. Lastly, the review will address topics relevant to daily clinical practice including competitive athletic participation, investigation for secondary HTN and HTN comorbidities, and blood pressure-lowering therapy. With the publication of the new AAP CPG introducing revised normative tables, the prevalence of stage 2 HTN in pediatrics is expected to rise. Based on the new guidelines, there is less emphasis on investigation for secondary HTN and more attention to lifestyle modifications for primary HTN. Future research should address whether there is BP level within the stage 2 HTN range above which the approach to evaluation and management should be altered in this heterogeneous patient population.
['Miyashita|Yosuke|Y|', 'Hanevold|Coral|C|']
D000293:Adolescent D000465:Algorithms D000959:Antihypertensive Agents D002648:Child D006801:Humans D006973:Hypertension D008019:Life Style D010372:Pediatrics D010808:Physical Examination D017410:Practice Guidelines as Topic
Stage 2 hypertension 2017 AAP Clinical Practice Guideline for High Blood Pressure in Children and Adolescents Pediatric hypertension Secondary hypertension