Hypertension in infancy and childhood is characterized by prolonged elevated blood pressure that may be due to either primary or secondary causes. Because many children suffering from hypertension remain asymptomatic, care must be taken to identify the at-risk child by investigating family medical history, accurately measuring blood pressure, and conducting a thorough physical examination. This issue of Pediatric Annals examines pediatric hypertension and offers methods of evaluation and management. Topics include: pediatric hypertension, a pediatrician's approach to the evaluation of hypertension, the role of noninvasive evaluation of pediatric hypertension, hypertension in infants, the hypertensive adolescent, and new classes of antihypertensive medications.
HOW TO OBTAIN CME CREDITS BY READING THIS ISSUE
Pediatricians can receive Category I credits for the Physician's Recognition Award of the American Medical Association by reading the following articles and successfully completing the quiz at the end of the issue. Complete instructions are given on the quiz pages.
The Pre-Test below has been prepared to assist you in studying the following material. It indicates some of the areas to be covered, and will make it possible for you to challenge your present knowledge of the material before reading further.
1 . A factitious observation of high blood pressure frequently results from which of the following:
A. A blood pressure cuff the bladder of which is > 75% of the upper arm length.
B. Excessive pressure with the stethoscope head.
C. Use of single measurements.
D. Home measurements of blood pressure.
2. Measuring and Interpreting blood pressure in infants and children may be diff icult because of all the following EXCEPT:
A. Readings are often spurious in anxious children.
B. Errors may be obtained by too heavy pressure of the stethoscope held in the antecubital fossa.
C. Blood pressure in children is a changing variable with their growth.
D. High blood pressure readings are usually due to an oversized cuff.
3. All of the following are true concerning the diagnosis of primary hypertension EXCEPT:
A. Suspected if family history is positive for hypertension.
B. More common in adolescents than in young children.
C. Associated with salt sensitivity.
D. Straightforward to diagnose.
4. Hypertension in the newborn is NOT due to:
A. Renal artery thrombosis
B. Maternal stress
C. Bronchopulmonary dysplasia
D. Acute renal failure