CE Credit

Pediatric Hypertension: Screening, Diagnosis and Management

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Welcome to the training on Pediatric Hypertension: Screening, Diagnosis and Management provided by the Texas Health and Human Services Commission (HHSC) and the Texas Department of State Health Services (DSHS).

Credit hours: 1.25 CE

Goal

The goal of this module is to equip Texas Health Steps providers and others to monitor blood pressure (BP) in children and adolescents, evaluate and follow up on elevated BP readings, and manage pediatric hypertension in collaboration with families.

Target Audience

Texas Health Steps providers and other interested health-care professionals.

Specific Learning Objectives

After completing the activities of this module, you will be able to:

  1. Apply Texas Health Steps guidelines for routine blood pressure monitoring and age-based anticipatory guidance.
  2. Apply clinical best practices to evaluate all elevated blood pressure readings and to diagnose and manage pediatric hypertension.
  3. Integrate recommended prevention and intervention strategies and connect families with helpful resources.

NOTE: This module is based on the American Academy of Pediatrics (AAP) “Clinical Practice Guideline for Screening and Management of High Blood Pressure in Children and Adolescents” (2017), the first set of guidelines for high blood pressure in children and adolescents developed by the AAP and still in use today. The module refers to the guidelines as the AAP Guideline.

Please note this module expires on 8/22/2025.

This module was released on 8/22/2022.

Accreditation Statement

Disclosures

Browser Requirements

American Academy of Pediatrics. (2017). Clinical Practice Guideline for Screening and Management of High Blood Pressure in Children and Adolescents. Pediatrics, 140(3).

Tables from the AAP Guideline (2017):

  • Table 3: Updated Definitions of BP Categories and Stages
  • Table 4: BP Levels for Boys by Age and Height Percentile
  • Table 5: BP Levels for Girls by Age and Height Percentile
  • Table 6: Screening BP Values Requiring Further Evaluation
  • Table 14: Examples of Physical Examination Findings and History Suggestive of Secondary HTN or Related to End Organ Damage Secondary to HTN
  • Table 16: DASH Diet Recommendations
  • Table 17: Dosing Recommendations for the Initial Prescription of Antihypertensive Drugs for Outpatient Management of Chronic HTN

Comprehensive Care Program (CCP), a package of Texas Medicaid services available to individuals based on medical necessity that goes beyond regular Medicaid services for all ages and is part of the Texas Health Steps benefit for individuals ages 20 and younger. Find information about the CCP in the Children’s Services Handbook of the Texas Medicaid Provider Procedures Manual (TMPPM).

CCP Prior Authorization Request for Non-Face-to-Face Clinician-Directed Care Coordination Services.

DASH eating plan. National Library of Medicine web page with information about a diet developed to help lower high blood pressure and lose weight.

Goulding, M., Goldberg, R., & Lemon,  S. C. (2021). Differences in Blood Pressure Levels Among Children by Sociodemographic Status. Preventing Chronic Disease, 18:210058. Centers for Disease Control and Prevention. See Table 3: Prevalence of Elevated and Hypertensive Blood Pressures by Sociodemographic Characteristics in U.S. Children Ages 8 to 17 years, (NHANES) 2011-2018.

GotTransition.org. Resources are available to help youth, parents and providers plan for transitioning from pediatric to adult care.

Texas Health and Human Services Commission. Medicaid for Transitioning Foster Care Youth, allows young adults through age 20 years who are leaving foster care and enrolled in Medicaid to receive services through the Comprehensive Care Program.

Texas Health and Human Services Commission. Medical Transportation Program.

Texas Health and Human Services Commission. Star Health, a Texas Medicaid health plan for children in foster care through the Texas Department of Family and Protected Services. In Spanish.

  • For more information, caretakers and guardians can call STAR Health at 866-912-6283.

Texas Health Steps, Anticipatory Guidance Provider Guide. A helpful flip chart designed to be used during medical checkups to review age-appropriate topics, elicit parent and patient concerns, and guide discussion of individualized anticipatory guidance.

Texas Health Steps, Periodicity Schedule.

Texas Medicaid & Healthcare Partnership. Online Provider Search offers a streamlined search process for finding Medicaid providers. The online search tool also enables providers to update their contact information. This lookup tool allows providers to:

  • Designate specialties and subspecialties that are not captured at enrollment
  • Search using provider-designated specialties and subspecialties

In addition, primary care providers in need of a specialist or subspecialist can call the Texas Health Steps toll-free help line at 877-847-8377 (877-THSTEPS) Monday through Friday, 8 a.m. to 6 p.m., Central Time.

Texas Medicaid & Healthcare Partnership. Texas Medicaid Provider Procedures Manual.

American Academy of Pediatrics, healthychildren.org. Screening & Treating Kids for High Blood Pressure: AAP Report Explained.

American Heart Association. High Blood Pressure web page, which includes fact sheets and tips on how to measure blood pressure at home.

American Heart Association. Healthy Living web page, which includes recipes, exercise and fitness tips, and wellness and self-care.

Children’sHealth. High Blood Pressure in Kids.

DASH eating plan. National Library of Medicine web page with information about a diet developed to help lower high blood pressure and lose weight.

DASH eating plan, National Heart, Lung, and Blood Institute.

GotTransition.org. Resources are available to help youth, parents and providers plan for transitioning from pediatric to adult care.

Nemours Children’s Health. (2022). Hypertension (High Blood Pressure), a web page with information for parents, children and adolescents.

Medical definitions in this module were obtained or adapted from American Academy of Pediatrics, Mayo Clinic, Merriam-Webster, National Organization for Rare Disorders, Stanford Medicine, U.S. National Library of Medicine and WebMD.