Hypertension may not be common in children, but if present, it could be a problem in children of any age. It is often not measured because medical professionals fail to measure blood pressure in a child or the technique the doctor uses to measure blood pressure is incorrect.[7]In adults, high blood pressure is defined as a blood pressure of 140/90 and higher but in children, to determine whether blood pressure is elevated, it is necessary to take into account the child's age, weight and height. A child is said to have hypertension when his or her blood pressure exceeds the 95th percentile, measured on at least three occasions.[7] Three categories of hypertension can be defined in children:[7] • Prehypertension: when systolic/diastolic measurements are between the 90th and 95th percentile or if blood pressure exceeds 120/80 mmHg. • Stage 1 hypertension: when the systolic/diastolic measurement falls between the 95th and 99th percentile plus 5 mmHg.• Stage 2 hypertension: when the systolic/diastolic measurement exceeds the 99th percentile plus 5 mmHg. A simple formula can be used that provides a correlation of the 95th percentile of blood pressure to the 50th percentile of height up to 16 years of age.[7] • Systolic pressure: 100+ (2.5 x age of patients in years) • Diastolic pressure: 60+2 for each year up to 11 years, then +1 for each subsequent year. Common Causes of Hypertension in Children The causes of hypertension can be divided into essential and secondary causes of hypertension in children. Secondary causes are more common in all age groups except adolescents. [7]Most secondary causes of hypertension are renal or kidney-related. 90% of cases of sustained hypertension in children are caused by kidney disease, renovascular hypertension, and coarctation of the aorta.[7]Causes of secondary hypertension... ... middle of paper ...... fluid retention or ure. The onset of action is slow, so diuretics are often used adjunctively rather than alone. [8 and 9] Acute renal failure and pulmonary edema are associated with the use of this drug. [7]Nicarpidine: long-acting calcium channel blocker and causes arterial vasodilation. Used in combination with a beta blocker if the patient has coronary artery disease. Easy to prepare and administer as an intravenous infusion. [8 and 9] In patients with less severe acute hypertension in whom an abrupt lowering of blood pressure is not necessary, oral antihypertensives can be used. [7]• Amlodipine: takes up to 2 hours to have an effect on blood pressure, but has a long half-life.• Nifedipine: rapid onset of action, but has a short half-life. It should only be used in uncomplicated situations without possible risks to end organs due to its ability to lower blood pressure very quickly.