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PEDIATRIC HYPERTENSION
PEDIATRIC HYPERTENSION
RANGE OF
RANGE OF
HYPERTENSION
HYPERTENSION
The Fourth Report on the Diagnosis, Evaluation, and
The Fourth Report on the Diagnosis, Evaluation, and
Treatment of High Blood Pressure in Children and Adolescent
Treatment of High Blood Pressure in Children and Adolescent
Hypertension
Hypertensionisisdefined
definedasasaverage
averageSystolic
Systolic
Blood Pressure and Diastolic Blood Pressure
Blood Pressure and Diastolic Blood Pressure
that is greater than or equal
that is greater than or equal to 95th to 95 th
percentile
percentilefor
forsex,
sex,age,
age,and
andheight
heighton
onthree
three
or
ormore
moreoccasions.
occasions.
THE CLASSIIFICATION OF
THEHYPERTENSION
CLASSIIFICATION OF
HYPERTENSION
CLASSIFICATION RANGE
Normal Blood Pressure Systolic and Diastolic less
than 90th Percentile
Pre-Hypertension Systolic or Diastolic 90th
percentile but < 95th
Percentile
Hypertension Systolic or Diastolic 95th
percentile
Hypertension grade 1 Systolic or Diastolic between
95th and 99th percentile plus
5 mmHg
Hypertension grade 2 Systolic or diastolic < 99th
plus 5 mmHg
EVALUATION
EVALUATION
Symptomatic
Diabetes Mellitus Indication Symptomatic
Diabetes Mellitus Indication hypertension
hypertension
FDA approvak
for ARBs is
limited to
children 6
years old with
creatinine
clearance 30
mL/min per 1,73
m2
Drug Type Dose and Side Effect
classification interval
Furosemide may
be useful as
Adrenergic blockers
Start minimal Adrenergic blockers
Step Start minimal (Alpha or beta) start
dose of Diuretic
1 Step dose of Diuretic Or
(Alpha or beta)
with minimal dosestart
1 Or with minimal dose
Adds on
Step Adds on Refer toPediatric of
vasodilator ckass Refer toPediatric of
3Step vasodilator ckass Or
Or nephrology
3 (hidralazin) nephrology
(hidralazin)
Management of Hypertensive
Management of Hypertensive
Emergency
Emergency
Hypertensive emergency is a condition which is blood
Hypertensive emergency is a condition which is blood
pressure should be reduced in one hour, because of the
pressure should be reduced in one hour, because of the
symptoms like seizures, headache, blur vision, or heart
symptoms like seizures, headache, blur vision, or heart
failure.
failure.
Primary
Primary Secondary
Secondary
Tertiary
Tertiary
THANKS
THANKS