Treatment
Blood pressure goals are determined by the etiology of the hypertension, presence of other medical disorders, and evidence of target organ damage. Children with uncomplicated primary hypertension and no target organ damage have a blood pressure goal of less than the 95th percentile. Children with chronic renal disease, diabetes, or evidence of target organ damage have a goal of less than the 90th percentile.9 It is important to note that these blood pressure goals are based on expert opinion, rather than evidence from randomized trials measuring patient-oriented, long-term outcomes. In many cases, the recommendations are extrapolated from adult studies. Children with hypertension need periodic monitoring for target organ damage and development of other CVD risk factors. Children with symptoms of hypertensive urgency or emergency require immediate treatment, typically with intravenous antihypertensive
medications in a setting where they can be