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2017 American Academy of Pediatrics guidelines for follow-up of high blood pressure levels in children

2017 American Academy of Pediatrics guidelines for follow-up of high blood pressure levels in children
BP screening schedule Lifestyle counseling (weight and nutrition) Check upper and lower extremity BP ABPM* Diagnostic evaluation Initiate treatment Consider subspecialty referral
Normal BP
Annual X
Elevated BP
Initial measurement X
Second measurement (repeat in 6 months) X X
Third measurement (repeat in 6 months) X X X X
Stage 1 HTN
Initial measurement X
Second measurement (repeat in 1 to 2 weeks) X X
Third measurement (repeat in 3 months) X X X X X
Stage 2 HTNΔ
Initial measurement X X
Second measurement (repeat, refer to specialty care within 1 week) X X X X X

BP: blood pressure; ABPM: ambulatory blood pressure monitoring; HTN: hypertension.

* ABPM is done to confirm HTN before initiating a diagnostic evaluation.

¶ Treatment may be initiated by a primary care provider or subspecialist.

Δ If the patient is symptomatic or BP is >30 mmHg above the 95th percentile (or >180/120 mmHg in an adolescent), send to an emergency department.
Reproduced with permission from: Pediatrics, Vol. 140, doi: 10.1542/peds.2017-1904. Copyright © 2017 by the AAP.
Graphic 114575 Version 10.0

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