Hypertension
SBP >95centile for age, on 3 visits
Causes:
Obesity (BP increases with BMI)
Ix
BP
Ambulatory BP
Dx
normotension
prehypertension (90-95th)
hypertension (aka Stage 1 = 95th to 5mmHg above 99th)
severe hypertension (aka Stage II = >5mmHg above 99th)
- hypertensive urgency = without symptoms / evidence of end organ damage
- hypertensive emergency = with symptoms / evidence of end organ damage
isolated nocturnal hypertension
non-dippers
INH and NonDipping is due to excess sympathetic drive
Rx
Antihypertensive
treat if >95th centile
UNLESS chronic kidney disease: aim for 50% centile (i.e. treat >50th)
Causes:
Obesity (BP increases with BMI)
Ix
BP
Ambulatory BP
Dx
normotension
prehypertension (90-95th)
hypertension (aka Stage 1 = 95th to 5mmHg above 99th)
severe hypertension (aka Stage II = >5mmHg above 99th)
- hypertensive urgency = without symptoms / evidence of end organ damage
- hypertensive emergency = with symptoms / evidence of end organ damage
isolated nocturnal hypertension
non-dippers
INH and NonDipping is due to excess sympathetic drive
Rx
Antihypertensive
treat if >95th centile
UNLESS chronic kidney disease: aim for 50% centile (i.e. treat >50th)