HIN Health Action e-Bulletin
| December 21, 2007 |
NEW! Pocket Guide to Blood Pressure
Measurement in Children | | This colorful, laminated card takes the scientific information from NHLBI’s The Fourth Report on the Diagnosis, Evaluation, and Treatment of High Blood Pressure in Children and Adolescents (Fourth Report) and converts it into a readily accessible, easy-to-use screening tool. You can go directly from measuring a child’s height and blood pressure to categorizing the blood pressure status for that child. The new Pocket Guide to Blood Pressure Measurement in Children (Pocket Guide) covers ages 3 through 17 with separate tables for boys and girls organized by age and height in centimeters. The Pocket Guide uses the cut points from the Fourth Report for stages of pediatric hypertension for age, sex and height. Categories of hypertension defined in the Fourth Report are given directly in the tables of the Pocket Guide. Category | Normal: | Less than 90 th percentile | | Prehypertension: | > or = 90 th percentile to < 95 th percentile | | Stage I hypertension: | > or = 95 th %tile to < or = 99 th %tile + 5 mmHg | | Stage 2 hypertension: | > 99 th %tile + 5 mmHg | Because diastolic hypertension rarely occurs without systolic hypertension in children, and because the Pocket Guide is a screening tool, it lists systolic pressures only. If, on screening, a child is classified with any stage of hypertension, the diastolic values should be determined from the full tables in the Fourth Report. Order the Pocket Guide (item #07-5268). |
Shorter and Newly Labeled Tables Make Assessment Easier Take a look at the example below for 10 year old boys from the Pocket Guide: 
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Compare the New Pocket Guide to the Tables in the Fourth Report The blood pressure tables on pages 10-13 of the Fourth Report are comprehensive and accurate, but they are somewhat hard to use in a clinical setting. Cut points for stages of hypertension in children and adolescents vary based on sex, age, and height. In the Fourth Report, heights are given literally as percentiles, but are not converted to real world centimeters or inches. Also the BP readouts that define the ranges for prehypertension and stage 1 and stage 2 hypertension are associated with percentiles of the blood pressures seen for each age, sex, and height group, but are not converted to categories of hypertension in the tables themselves. Since stage 2 hypertension is defined as greater than or equal to the 99 th percentile + 5 mm Hg, the clinician has to mentally add 5 to the readouts for the 99 th percentile in the Fourth Report tables. In contrast, this has already been done for you in the Pocket Guide. 
*To reference The Fourth Report on the Diagnosis, Evaluation, and Treatment of High Blood Pressure in Children and Adolescents, Item #05-5267.
HIN1207PEDHBP | 
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Archived page, reproduced from a 2008 copy. It is reference material, not current guidance.
