Abstract

The Fourth Report on the Diagnosis, Evaluation, and Treatment of High Blood Pressure in Children and Adolescents (Fourth Report) was published in 2004. [1] These guidelines recommended an evaluation of confirmed childhood hypertension that was not limited to a secondary cause of hypertension, but also included recommendations to test for associated risk factors and target organ damage (TOD). Subsequent research on blood pressure (BP) in children led to many reports on the increasing prevalence of abnormal BP in children, and on factors associated with abnormal BP that contributed to heightened risk for cardiovascular disease in early adulthood. Based on an expanded body of findings, the American Academy of Pediatrics sponsored an update of the pediatric BP guidelines.