Question: How Is High Blood Pressure Diagnosed in Children?
Answer:
Diagnosing high blood pressure in children follows a different set of guidelines compared to diagnosing high blood pressure in adults. In adults, the measured blood pressure is compared to a set of standard numbers that serve as a "diagnosis chart." If the measured blood pressure is above a certain cutoff number, the adult is diagnosed with high blood pressure.
The charts and numbers used to diagnose high blood pressure in adults come from a large body of scientific evidence gathered over time. Research studies have examined the relationships between different levels of blood pressure and the resulting risk of problems such as heart attack or kidney damage. Because these risk profiles are well understood, it is possible to say with some certainty that a given blood pressure value is safe (normal), unsafe (Stage I), or dangerous (Stage II).
Because children with high blood pressure generally don't experience heart problems or other organ damage until they reach adulthood, making the same kind of standard diagnosis charts is not possible - there isn't enough evidence to formulate rules about safe, unsafe, and dangerous blood pressure ranges. Instead, high blood pressure in children is diagnosed using a statistical scale that adjusts the measured blood pressure for factors like height, weight, and age, and compares the adjusted number to a set of averages.
Using this modified system, high blood pressure in children is diagnosed according to the following rules:
- Normal Blood Pressure: Systolic and Diastolic Pressures <90th percentile
- Prehypertension: Systolic and/or diastolic pressure >90th percentile but <95th percentile OR a combined blood pressure of >120/80 if the child is younger than 16
- Stage 1 Hypertension: Systolic and/or diastolic BP >95th percentile but <5 mmHg above the 99th percentile
- Stage 2 Hypertension: Systolic and/or diastolic BP >99th percentile +5 mmHg
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