Aligning Adult and Pediatric Blood Pressure Guidelines

Efforts to align the adult ACC/AHA and pediatric AAP BP guidelines were largely successful. Because there are substantial differences in hypertension evaluation in children and adults, the authors currently favor separate guidelines with efforts at alignment for the transition phase. When pediatric hypertension patients transition to internal medicine care, their BP stage will be the same, the target BP for treatment will be the same, lifestyle management will be emphasized for stage 1 hypertension, and medication choices will be similar. Though for stage 1 hypertension, initiation of medication is more likely in childhood, a patient who transitions from pediatric care, should be followed by the adult follow up criteria rather than the adult medication initiation criteria. Evidence gaps preclude alignment regarding long term risk stratification from childhood through age 40 years.