Changes in the 2017 Pediatric Hypertension Clinical Guidelines

The clinical practice guidelines (CPGs) on diagnosis and management of high blood pressure (BP) in children and adolescents have been periodically modified and updated since the original publication in 1977.¹ Since the last pediatric BP guideline was published in 2004, known as the Fourth Report,² the literature on child BP and hypertension has expanded considerably. There has been a recognized need to update the Fourth Report for several years. However, the National Heart, Lung, and Blood Institute (NHLBI) who sponsored previous pediatric BP guidelines announced that NHLBI would no longer sponsor development of new clinical guidelines.³ Subsequently, in 2014, the American Academy of Pediatrics (AAP) agreed to sponsor development of a new pediatric BP CPG. The new CPG for screening and management of high BP in children and adolescents was recently published in Pediatrics.⁴ This CPG was developed using the rigorous evidence-based approach recommended by the Institute of Medicine in 2011.⁵ This methodology was consistent with recent NHLBI recommendations on development of CPGs for cardiovascular disease.³ The new pediatric hypertension CPG contains several modifications from the previous guideline to guide clinicians in diagnosis and management of elevated BP and hypertension in children and adolescents. This summary describes those changes made since the 2004 Fourth Report.

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