{"id":136,"date":"2018-04-23T11:33:04","date_gmt":"2018-04-23T11:33:04","guid":{"rendered":"http:\/\/edren.org\/ren\/?page_id=136"},"modified":"2021-01-29T12:44:26","modified_gmt":"2021-01-29T12:44:26","slug":"blood-pressures-in-children","status":"publish","type":"page","link":"https:\/\/edren.org\/ren\/handbook\/unithdbk\/blood-pressure-and-cardiovascular-disease\/blood-pressures-in-children\/","title":{"rendered":"Blood pressures in children"},"content":{"rendered":"<p>Blood pressure measurements tend to be omitted in routine assessments of children.\u00a0\u00a0 When it is measured, the variation of normal BP with age can lead to missing the diagnosis of hypertension.\u00a0 Normal ranges are shown below. \u00a0Taller children have slightly higher average BPs. Centile values shown are for 50th height centile:\u00a0 average BPs vary by \u00b13-5mmHg for 5th-95th height centiles (so range typically varies 6-10mmHg for height at any age).<\/p>\n<p>The <a href=\"http:\/\/content.nejm.org\/cgi\/content\/full\/361\/17\/1639\">ESCAPE trial<\/a> (2009)\u00a0showed that controlling blood pressure to below the 50th centile was more effective than a target of 50-90th centile in reducing renal endpoints in 385 children with renal disease followed for 5 years (30% versus 42%).\u00a0 All were also treated with an ACE\u00a0inhibitor.\u00a0 As in adults, proteinuria and lower GFR predicted higher risk of progression.<\/p>\n<p><strong><span style=\"color: #993300;\">Blood pressure charts:<\/span><\/strong> \u00a0 The charts on this page were constructed from US data linked below.\u00a0 UK\u00a0children&#8217;s blood pressures are slightly higher, particularly pre-pubertally, and we thought the US data already high enough (e.g. systolic 50th centile boys and girls aged 8 is about 107 in UK\u00a0versus 99 in US; age 4, 101 vs 93.\u00a0 Age 16 boys 50th centile 116 US, 120 UK; girls 109 US, 106 UK. However differences are substantially smaller at upper centiles). \u00a0<em>Click to enlarge individual figures; download a pdf with larger charts for printing at foot of page.<\/em><\/p>\n<table style=\"border-collapse: collapse; width: 100%;\" border=\"1\">\n<tbody>\n<tr>\n<td style=\"width: 50%;\"><a href=\"http:\/\/edren.org\/ren\/wp-content\/uploads\/2018\/10\/Boys2sm.gif\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-medium wp-image-1787\" src=\"http:\/\/edren.org\/ren\/wp-content\/uploads\/2018\/10\/Boys2sm-300x225.gif\" alt=\"\" width=\"300\" height=\"225\" srcset=\"https:\/\/edren.org\/ren\/wp-content\/uploads\/2018\/10\/Boys2sm-300x225.gif 300w, https:\/\/edren.org\/ren\/wp-content\/uploads\/2018\/10\/Boys2sm-150x113.gif 150w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><\/td>\n<td style=\"width: 50%;\"><a href=\"http:\/\/edren.org\/ren\/wp-content\/uploads\/2018\/10\/Girls2sm.gif\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-medium wp-image-1788\" src=\"http:\/\/edren.org\/ren\/wp-content\/uploads\/2018\/10\/Girls2sm-300x225.gif\" alt=\"\" width=\"300\" height=\"225\" srcset=\"https:\/\/edren.org\/ren\/wp-content\/uploads\/2018\/10\/Girls2sm-300x225.gif 300w, https:\/\/edren.org\/ren\/wp-content\/uploads\/2018\/10\/Girls2sm-150x113.gif 150w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p>The <a href=\"http:\/\/www.pediatrichypertension.org\/\" data-cke-saved-href=\"http:\/\/www.pediatrichypertension.org\/\">International Paediatric Hypertension Association<\/a> categorises blood pressure into three stages.\u00a0 The value of doing this, rather than simply reporting the centile as you might for height or weight, isn&#8217;t certain:<\/p>\n<ul style=\"list-style-type: disc;\">\n<li><strong><span style=\"color: #993300;\">Prehypertensive<\/span><\/strong> = 90<sup>th<\/sup> centile to 120 mmHg<\/li>\n<li><strong><span style=\"color: #993300;\">Stage 1 hypertension<\/span><\/strong> = 95<sup>th<\/sup> centile upwards<\/li>\n<li><strong><span style=\"color: #993300;\">Stage 2 hypertension<\/span><\/strong> = 99<sup>th<\/sup> centile + 5mmHg<\/li>\n<\/ul>\n<p>A UK\u00a0recommendation is to consider anything over the 98th centile as hypertension, and 91-98th as high-normal.<\/p>\n<h5><strong><span style=\"color: #993300;\">Patient information<\/span><\/strong><\/h5>\n<p><a href=\"http:\/\/edren.org\/ren\/edren-info\/high-blood-pressure-hypertension\/\" data-cke-saved-href=\"..\/..\/..\/..\/pages\/edreninfo\/high-blood-pressure-hypertension.php\">High blood pressure and kidney disease<\/a> (in adults)\u00a0from <a href=\"http:\/\/edren.org\/ren\/edren-info\/\" data-cke-saved-href=\"..\/..\/..\/..\/pages\/edreninfo.php\">EdRen<\/a><a href=\"http:\/\/edren.org\/ren\/edren-info\/\" data-cke-saved-href=\"..\/..\/..\/..\/pages\/edreninfo.php\">INFO<\/a><\/p>\n<p><span style=\"font-size: 12pt; color: #808080;\"><strong>Acknowledgements:\u00a0<\/strong>\u00a0 Neil Turner was the main author for this page. It was created in May 2010 and significantly revised in July 2010. The last amended date is shown in the footer.\u00a0<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Blood pressure measurements tend to be omitted in routine assessments of children.\u00a0\u00a0 When it is measured, the variation of normal BP with age can lead to missing the diagnosis of hypertension.\u00a0 Normal ranges are shown below. \u00a0Taller children have slightly higher average BPs. Centile values shown are for 50th height\u2026<\/p>\n<p> <a class=\"continue-reading-link\" href=\"https:\/\/edren.org\/ren\/handbook\/unithdbk\/blood-pressure-and-cardiovascular-disease\/blood-pressures-in-children\/\"><span>Continue reading<\/span><i class=\"crycon-right-dir\"><\/i><\/a> <\/p>\n","protected":false},"author":2,"featured_media":0,"parent":5376,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_lmt_disableupdate":"","_lmt_disable":"","footnotes":""},"class_list":["post-136","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/edren.org\/ren\/wp-json\/wp\/v2\/pages\/136","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/edren.org\/ren\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/edren.org\/ren\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/edren.org\/ren\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/edren.org\/ren\/wp-json\/wp\/v2\/comments?post=136"}],"version-history":[{"count":5,"href":"https:\/\/edren.org\/ren\/wp-json\/wp\/v2\/pages\/136\/revisions"}],"predecessor-version":[{"id":1785,"href":"https:\/\/edren.org\/ren\/wp-json\/wp\/v2\/pages\/136\/revisions\/1785"}],"up":[{"embeddable":true,"href":"https:\/\/edren.org\/ren\/wp-json\/wp\/v2\/pages\/5376"}],"wp:attachment":[{"href":"https:\/\/edren.org\/ren\/wp-json\/wp\/v2\/media?parent=136"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}