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Hypertension
- Normative BP values are based on Age, Sex, and Height (check Harriet-Lane).
- BP should be measured in all children >3yrs and in selected children <3yrs.
- The younger the child and the higher the BP, the more likely there is a secondary cause.
- Most common secondary causes:
- 1st year of life: RenoVascular anomalies and aortic coarctation.
- Early childhood/school-aged kids: Renal Parenchymal Disease
- Adolescents: Essential hypertension
- 25% of children that present with HTN requiring emergent management present with hypertensive encephalopathy (ie. it is a more common presentation of HTN in pediatrics than in adults).
- Initial Work-up:
- Upper and Lower Extremity BP measurement
- BMP and U/A – look for renal disease
- CBC – microangiopathic process c/w HUS?
References
Belsha, CW. Pediatric hypertension in the emergency department. Ann Emerg Med. 2008 Mar;51(3 Suppl):S21-3. Epub 2008 Jan 11.