Measuring blood pressure in children

• correct cuff size is approximately 2/3 the length of the upper arm
• the 4th Korotkoff sound is used to measure the diastolic blood pressure until adolescence, when the 5th Korotkoff sound can be used
• results should be compared with a graph of normal values for age

In younger children secondary hypertension is the most common cause, with renal parenchymal disease accounting for up to 80%

Causes of hypertension in children

• renal parenchymal disease
• renal vascular disease
• coarctation of the aorta
• phaeochromocytoma
• congenital adrenal hyperplasia
• essential or primary hypertension (becomes more common as children become older)