Title: Pediatric Cardiology / Hypertension
Tags: hypertension peds-cardio high-yield treatment abpm etiology definition staging workup coarctation diabetes emergency endocrine medications renovascular screening target

Q: What defines elevated blood pressure in children (2017 AAP)?
A: SBP or DBP ≥90th but <95th percentile (or 120/80 in adolescents)

Q: What defines Stage 1 hypertension in children?
A: SBP or DBP ≥95th to <95th + 12 mmHg (or 130/80-139/89 in adolescents)

Q: What defines Stage 2 hypertension in children?
A: SBP or DBP ≥95th + 12 mmHg (or ≥140/90 in adolescents)

Q: At what age do adult BP cutoffs apply?
A: Age ≥13 years

Q: What is the screening recommendation for BP in children?
A: Annual BP screening starting at age 3 years (or earlier if risk factors)

Q: What is the most common cause of secondary hypertension in children?
A: Renal parenchymal disease

Q: What percentage of hypertension in children is primary (essential)?
A: Increasing - now majority in adolescents; less common in younger children

Q: What vascular cause of hypertension should be considered with upper/lower extremity BP discrepancy?
A: Coarctation of the aorta

Q: What endocrine causes should be considered in pediatric hypertension?
A: Pheochromocytoma, hyperthyroidism, Cushing syndrome, primary aldosteronism

Q: What medications can cause hypertension in children?
A: Stimulants (ADHD meds), steroids, NSAIDs, oral contraceptives, decongestants

Q: What is the first-line confirmatory test for hypertension?
A: Ambulatory Blood Pressure Monitoring (ABPM)

Q: What ABPM finding confirms hypertension?
A: Mean SBP or DBP ≥95th percentile

Q: What is "masked hypertension" on ABPM?
A: Normal office BP but elevated ambulatory BP

Q: What is "white coat hypertension" on ABPM?
A: Elevated office BP but normal ambulatory BP (no treatment needed, monitor)

Q: What initial workup is indicated for confirmed hypertension?
A: BMP (renal function), UA, lipid panel, fasting glucose, echo (if Stage 2)

Q: When is renal artery imaging indicated?
A: Stage 2 HTN, young child with HTN, poor response to treatment

Q: What is first-line treatment for Stage 1 hypertension without target organ damage?
A: Lifestyle modifications (DASH diet, weight loss, exercise, reduce sodium)

Q: What BP target is recommended for treatment in children?
A: <90th percentile (or <130/80 in adolescents)

Q: What is first-line antihypertensive for children with CKD or proteinuria?
A: ACE inhibitor or ARB

Q: What antihypertensive class is first-line for children with diabetes?
A: ACE inhibitor or ARB

Q: What antihypertensive is useful for children with migraine comorbidity?
A: Beta-blocker (propranolol) or calcium channel blocker

Q: What defines hypertensive urgency vs emergency?
A: Emergency = severe HTN with target organ damage; Urgency = severe HTN without TOD