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Prevention of Adolescent Hypertension

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Dr Kavya Mallikarjun    20 January 2017

The normal BP in children and adolescents is both systolic and diastolic BP <90th percentile. The definition of childhood HT is based upon the normative distribution of BP in healthy children. HT is defined as either systolic and/or diastolic BP ≥95th percentile measured on ≥3 occasions. HT is further delineated into two stages: Stage 1 HT (systolic and/or diastolic BP between the 95th percentile and 5mmHg above the 99th percentile or if in adolescents the BP exceeds 140/90 mmHg even if <95th percentile) and Stage 2 HT (systolic and/or diastolic BP ≥99th percentile plus 5 mmHg). Follow-up: If normal (recheck at next scheduled visit), pre-HT (recheck in 6 months), Stage 1 HT (recheck in 1-2 weeks or earlier if symptoms), Stage 2 HT (evaluate immediately, if symptoms; if not evaluate within the week). Avoid food or stimulant drugs prior to measuring BP in children and adolescents. Measure after 5 min of rest in a quiet environment. Auscultation is the preferred method of BP measurement, with the right arm supported at the level of the heart. Inflate the cuff to 20-30 mmHg above the anticipated systolic BP and then deflate slowly at a rate of 2-3 mmHg per heartbeat.

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