Texas Health and Human Services / Texas Health Steps

Does This Child Have High Blood Pressure?

High blood pressure has been considered an adult disease but is increasingly seen in young people. High blood pressure during childhood is highly correlated with hypertension in adulthood, making screening, diagnosing and managing pediatric hypertension more important than ever.

Blood pressure screening is a required component of Texas Health Steps preventive medical checkups beginning at age 3 years. Taking accurate measurements for children and adolescents requires proper technique and use of appropriately sized blood pressure cuffs. Taking an accurate reading is just the first step in determining whether a young person needs further evaluation and potential treatment for hypertension.

Pediatric hypertension should not be diagnosed after just one blood pressure reading. Staging of pediatric blood pressure is based on readings taken on at least three different occasions and is based on age, height and sex percentiles from the American Academy of Pediatrics “Clinical Practice Guideline for Screening and Management of High Blood Pressure in Children and Adolescents” (AAP, 2017).

The following table provides a quick screening tool to determine if further evaluation is needed. Review the table and then take the Quick Quiz.

Blood Pressure Screening Values that Require Further Evaluation for Boys and Girls
Age in Years Blood Pressure, mm Hg
Boys Girls
Systolic Diastolic Systolic Diastolic
1 98 52 98 54
2 100 55 101 58
3 101 58 102 60
4 102 60 103 62
5 103 63 104 64
6 105 66 105 67
7 106 68 106 68
8 107 69 107 69
9 107 70 108 71
10 108 72 109 72
11 110 74 111 74
12 113 75 114 75
≥13 120 80 120 80

Source: Used with permission from the AAP’s 2017 “Clinical Practice Guideline for Screening and Management of High Blood Pressure in Children and Adolescents” (Table 6).

Quick Quiz

Your staff routinely takes blood pressure readings as part of medical checkups. You receive the following measurements for three young patients:

Adam, 4-year-old boy, 111/65

Brianna, 9-year-old girl, 107/70

Christina, 12-year-old girl, 118/78

Based on the AAP chart shown above, which of the children require additional evaluation for potential high blood pressure?

Why it matters

Early identification of elevated blood pressure and appropriate management, including lifestyle interventions and medication when indicated, can prevent serious chronic health conditions from developing. Your understanding of blood pressure screening, staging and management can help young people and their families live healthier lives.

Explore more

Pediatric Hypertension: Screening, Diagnosis and Management