Stability of Blood Pressure and Diagnosis of Hypertension in Childhood

* Abbreviations: AAP — : American Academy of Pediatrics BP — : blood pressure CPG — : Clinical Practice Guideline for Screening and Management of High Blood Pressure in Children and Adolescents Longitudinal tracking studies as well as multiple long-term cohort studies have demonstrated that blood pressure (BP) in childhood tracks into adulthood and that individuals with high BP levels in childhood are more likely to develop intermediate markers of cardiovascular disease by adulthood than those with normal BP.1 What is less well understood is what happens to childhood BP levels over shorter periods of time: weeks, months, or just a few years? This question is relevant to making a diagnosis of hypertension because the 2017 American Academy of Pediatrics (AAP) Clinical Practice Guideline for Screening and Management of High Blood Pressure in Children and Adolescents (CPG) recommends repeat BP measurements over a period of weeks to months (depending on how high the BP category) before making a diagnosis of hypertension.2 This recommendation is based on the known lability of childhood BP over short time periods, a point that was established by Ogborn and Crocker over 30 years ago.3 In their study reported in this issue of Pediatrics , … Address correspondence to Joseph T. Flynn, MD, MS, Division of Nephrology, Seattle Children’s Hospital, 4800 Sand Point Way NE, M/S OC.9.820, Seattle, WA 98105. E-mail: joseph.flynn{at}seattlechildrens.org