A Pocket Guide to

Blood Pressure
Measurement
in Children
From the National High Blood Pressure
Education Program Working Group on
High Blood Pressure in Children and
Adolescents.

Measurement

Begin routine blood pressure (BP) measurement at 3 years

of age.
Correct cuff size depends on arm size. Practically speaking,
correct cuff size equals largest cuff that will fit on the upper
arm with room below for the stethoscope head.
BP should be measured in the right arm of a relaxed,
seated child.
BP measurement by auscultation is the Gold Standard.
BP by automated device correlates reasonably well
with auscultation, with practical advantages of rapid
measurement remote from child and elimination of
reader error.
If BP is high by automated device, repeat by auscultation.

BP Classification/Interpretation
BP is classified by systolic BP (SBP) and diastolic BP (DBP)
percentiles for age/sex/height. If SBP or DBP >90th percentile,
repeat twice at same office visit before interpreting result.
Normal BP: SBP and DBP <90th percentile
Recheck in 1 year.
Prehypertension: SBP or DBP > 90th percentile to <95th
percentile or BP >120/80 mmHg to <95th percentile
Recheck in 6 months.
Begin weight management (as appropriate).
Stage 1 Hypertension (HTN): SBP and/or DBP > 95th
percentile to < 99th percentile plus 5 mmHg
Recheck in 1 to 2 weeks.
If BP remains at this level on recheck, begin evaluation
and treatment including weight management if appropriate.
Stage 2 HTN: SBP and/or DBP >99th percentile plus 5 mmHg
Begin evaluation and treatment within 1 week,
immediately if symptomatic.

Systolic BP Percentile Tables

Since diastolic HTN rarely occurs without systolic HTN in
children, the SBP percentile tables on the next page can
be used for HTN screening. If a childs SBP on screening is
classified as prehypertension or HTN, then both SBP and DBP
percentiles should be determined using the tables in the complete
report: The Fourth Report on the Diagnosis, Evaluation, and
Treatment of High Blood Pressure in Children and Adolescents.
Pediatrics 2004 Aug;114(Suppl 2:)555-76; or http://www.nhlbi.
nih.gov/health/prof/heart/hbp/hbp_ped.htm.

Directions for Use of Tables

1.Heights in the table are given for age at midyear. Use closest
height to interpret BP.
2. Prehypertension SBP > value from table (90th percentile)
to < Stage 1 HTN value; or SBP >120 mmHg to < Stage 1 HTN
value.
SBP > value from the table (95th
Stage 1 HTN
<
percentile) to Stage 2 HTN.
SBP >value from table (99th percentile
Stage 2 HTN
plus 5 mmHg).
For more information go to: www.nhlbi.nih.gov.

Girls SBP by Age and Height

(Normal SBP is less than the prehypertensive result.)
Age

BP
Classification

Systolic BP (mmHg)

Height (cm)
Prehypertension
Stage 1 HTN
Stage 2 HTN

91
100
104
116

92
100
104
116

95
102
105
118

98
103
107
119

100
104
108
120

103
106
109
121

105
106
110
122

Height (cm)
Prehypertension
Stage 1 HTN
Stage 2 HTN

97
101
105
117

99
102
106
118

101
103
107
119

104
104
108
120

108
106
110
122

110
107
111
123

112
108
112
124

Height (cm)
Prehypertension
Stage 1 HTN
Stage 2 HTN

104
103
107
119

105
103
107
119

108
105
108
121

111
106
110
122

115
107
111
123

118
109
112
125

120
109
113
125

Height (cm)
Prehypertension
Stage 1 HTN
Stage 2 HTN

110
104
108
120

112
105
109
121

115
106
110
122

118
108
111
124

122
109
113
125

126
110
114
126

128
111
115
127

Height (cm)
Prehypertension
Stage 1 HTN
Stage 2 HTN

116
106
110
122

118
107
111
123

121
108
112
124

125
109
113
125

129
111
115
127

132
112
116
128

135
113
116
129

Height (cm)
Prehypertension
Stage 1 HTN
Stage 2 HTN

121
108
112
124

123
109
112
125

127
110
114
126

131
111
115
127

135
113
116
128

139
114
118
130

141
114
118
130

Height (cm)
Prehypertension
Stage 1 HTN
Stage 2 HTN

125
110
114
126

128
110
114
126

131
112
115
128

136
113
117
129

140
114
118
130

144
116
119
132

147
116
120
132

10

Height (cm)
Prehypertension
Stage 1 HTN
Stage 2 HTN

130
112
116
128

132
112
116
128

136
114
117
130

141
115
119
131

146
116
120
132

150
118
121
134

153
118
122
134

11

Height (cm)
Prehypertension
Stage 1 HTN
Stage 2 HTN

136
114
118
130

138
114
118
130

143
116
119
131

148
117
121
133

153
118
122
134

157
119
123
135

160
120
124
136

12

Height (cm)
Prehypertension
Stage 1 HTN
Stage 2 HTN

143
116
119
132

146
116
120
132

150
117
121
133

155
119
123
135

160
120
124
136

164
120
125
137

166
120
126
138

13

Height (cm)
Prehypertension
Stage 1 HTN
Stage 2 HTN

148
117
121
133

151
118
122
134

155
119
123
135

159
120
124
137

164
120
126
138

168
120
127
139

170
120
128
140

14

Height (cm)
Prehypertension
Stage 1 HTN
Stage 2 HTN--

151
119
123
135

153
120
123
136

157
120
125
137

161
120
126
138

166
120
127
140

170
120
129
141

172
120
129
141

15

Height (cm)
Prehypertension
Stage 1 HTN
Stage 2 HTN

152
120
124
136

154
120
125
137

158
120
126
138

162
120
127
139

167
120
129
141

171
120
130
142

173
120
131
143

16

Height (cm)
Prehypertension
Stage 1 HTN
Stage 2 HTN

152
120
125
137

154
120
126
138

158
120
127
139

163
120
128
140

167
120
130
142

171
120
131
143

173
120
132
144

17

Height (cm)
Prehypertension
Stage 1 HTN
Stage 2 HTN

152
120
125
138

155
120
126
138

159
120
127
139

163
120
129
141

167
120
130
142

171
120
131
143

174
120
132
144

Boys SBP by Age and Height

(Normal SBP is less than the prehypertensive result.)
Age

BP
Classification

Systolic BP (mmHg)

Height (cm)
Prehypertension
Stage 1 HTN
Stage 2 HTN

92
100
104
116

94
101
105
117

96
103
107
119

99
105
109
121

102
107
110
123

104
108
112
124

106
109
113
125

Height (cm)
Prehypertension
Stage 1 HTN
Stage 2 HTN

99
102
106
118

100
103
107
119

103
105
109
121

106
107
111
123

109
109
112
125

112
110
114
126

113
111
115
127

Height (cm)
Prehypertension
Stage 1 HTN
Stage 2 HTN

104
104
108
120

106
105
109
121

109
106
110
123

112
108
112
125

116
110
114
126

119
111
115
128

120
112
116
128

Height (cm)
Prehypertension
Stage 1 HTN
Stage 2 HTN

110
105
109
121

112
106
110
122

115
108
112
124

119
110
114
126

122
111
115
128

126
113
117
129

127
113
117
130

Height (cm)
Prehypertension
Stage 1 HTN
Stage 2 HTN

116
106
110
122

118
107
111
123

121
109
113
125

125
111
115
127

129
113
117
129

132
114
118
130

134
115
119
131

Height (cm)
Prehypertension
Stage 1 HTN
Stage 2 HTN

121
107
111
124

123
109
112
125

127
110
114
127

131
112
116
128

135
114
118
130

139
115
119
132

141
116
120
132

Height (cm)
Prehypertension
Stage 1 HTN
Stage 2 HTN

126
109
113
125

128
110
114
126

132
112
116
128

136
114
118
130

141
115
119
132

145
117
121
133

147
118
121
134

10

Height (cm)
Prehypertension
Stage 1 HTN
Stage 2 HTN

130
111
115
127

133
112
116
128

137
114
117
130

141
115
119
132

146
117
121
133

150
119
122
135

153
119
123
135

11

Height (cm)
Prehypertension
Stage 1 HTN
Stage 2 HTN

135
113
117
129

137
114
118
130

142
115
119
132

146
117
121
134

151
119
123
135

156
120
124
137

159
120
125
137

12

Height (cm)
Prehypertension
Stage 1 HTN
Stage 2 HTN

140
115
119
131

143
116
120
132

148
118
122
134

153
120
123
136

158
120
125
138

163
120
127
139

166
120
127
140

13

Height (cm)
Prehypertension
Stage 1 HTN
Stage 2 HTN

147
117
121
133

150
118
122
135

155
120
124
136

160
120
126
138

166
120
128
140

171
120
129
141

173
120
130
142

14

Height (cm)
Prehypertension
Stage 1 HTN
Stage 2 HTN

154
120
124
136

157
120
125
137

162
120
127
139

167
120
128
141

173
120
130
143

177
120
132
144

180
120
132
145

15

Height (cm)
Prehypertension
Stage 1 HTN
Stage 2 HTN

159
120
126
139

162
120
127
140

167
120
129
141

172
120
131
143

177
120
133
145

182
120
134
147

184
120
135
147

16

Height (cm)
Prehypertension
Stage 1 HTN
Stage 2 HTN

162
120
129
141

165
120
130
142

170
120
132
144

175
120
134
146

180
120
135
148

184
120
137
149

186
120
137
150

17

Height (cm)
Prehypertension
Stage 1 HTN
Stage 2 HTN

164
120
131
144

166
120
132
145

171
120
134
146

176
120
136
148

181
120
138
150

185
120
139
151

187
120
140
152

NIH Publication 07-5268

May 2007