PEDI HTN Flashcards
What are guidelines for diagnosis of pedi HTN for <12 years of age?
Hypertension in children up to 12 yo is defined as average SBP and/or DBP ≥95th percentile for gender, age, and height on ≥3 occasions
What are guidelines for diagnosis of pedi HTN for >12 years of age?
Adolescents 13 yo + BP levels ≥130/80 mmHg should be considered hypertensive.
Normal BP for <12
<90th percentile age,sex, ht
Elevated BP for <12
90th-95th percentile or 120/80 to < 95th whichever is lower
Stg 1 HTN for <12
> 95th percentile to < 95th + 12 mm HG or 130/80—139/89
Stg 2 HTN for <12
> 95th percentile + 12 mm HG or >140/90
Normal BP for adolescent >12
<120/80
Elevated BP for adolescent >12
120/<80 to 129/<80
Stage 1 HTN for adolescent >12
130/80 to 139/89
Stage 2 HTN for adolescent >12
=>140/90
In young children, what is HTN most often secondary to?
renal problem
In adolescents and teens, HTN is usually due to
a primary disorder due to being overweight, sleep apnea, substance abuse, etc.
What labwork and imaging should be done on all children with persistent BP 95th percentile?
o BUN, creatinine, electrolytes
lipid profile
o Urinalysis +/- urine culture
o CBC
o Renal U/S (usually >8 yo and can cooperate)
o Fasting lipid panel, fasting glucoseWhat is no longer recommended on children with HTN?
EKG
What is recommended ONLY if considering starting medication?
echocardiogram
What labs should be added for the obese child or adolescent?
Hgb A1c
Fatty liver screen
fasting lipid panel
How should therapy for children and adolescents be started?
Therapy should be initiated with a single drug
Acceptable drug classes for pedi HTN include
ACE inhibitors, angiotensin-receptor blockers, β-blockers, calcium channel blockers, and diuretics
Goal for treatment
less than the 90th percentile or <130/80 mm HG
