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Paediatric Clinical Practice Guideline

Paediatric Clinical Practice Guideline Paediatric Clinical Practice Guideline Hypertension Page 1 of 8 Hypertension Author: Dr P Hildick-Smith, Dr M Lazner, Mr C Chadwick Approved by the Medicines Governance Group October 2019 Publication date: October 2019 Review date: October 2021 Definitions (all on the basis of age, sex and height tables): In children with known renal problems the blood pressure should be maintained around the 50th percentile. Assessment Measurement of Blood Pressure in Children - Use the right side upper arm - Use a cuff that is appropriate to the size of the child s arm. If a cuff is too small, the next largest cuff should be used, even if it appears large. Bladder length should be 80 100% of the upper arm circumference Bladder width should be at least 40% of the upper arm length - Manual measurements will always be more accurate than machine measurements.

Record weight, height and BMI. Always consider an undiagnosed coarctation of the aorta - feel for femoral pulses and perform BP in upper and lower limbs. BP usually 10-20 mmHg higher in legs than arms, in coarctation this is reversed. Initial screening investigations: Second line investigations: Complement & auto-antibody screen

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