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Upcoming technical report to supplement AAP blood pressure guidelines :

May 29, 2018

An AAP technical report that supplements the 2017 Clinical Practice Guideline for Screening and Management of High Blood Pressure in Children and Adolescents ( will be published in the coming months to help pediatricians implement the new guidelines. Importantly, the technical report will provide guidance on calculating blood pressure (BP) based on the new normative tables.

The clinical practice guideline (CPG) was the first from the Academy on pediatric hypertension and updated the National Heart, Lung, and Blood Institute’s 2004 Fourth Report on the Diagnosis, Evaluation, and Treatment of High Blood Pressure in Children and Adolescents. The CPG includes new tables for calculating BP in children based on new evidence.

The upcoming technical report, Diagnosis, Evaluation, and Management of High Blood Pressure in Children and Adolescents, will provide a comprehensive overview of the methodological basis for the clinical recommendations iterated in the guideline. The report will include the methodological rigor used to produce the guidelines, corresponding evidence tables and details regarding the critical appraisal of the evidence to support the key action statements and strength of recommendations.

The report also will include an appendix titled “Techniques for the Implementation of 2017 CPG Blood Pressure Definitions into the Electronic Health Record and Computing Blood Pressure Thresholds.” The goal of the appendix is to address barriers to implementation, focusing on computing BP to help clarify the calculations.

The appendix covers recommended cutoffs or thresholds, as they should appear/be identified in the electronic health record (EHR) system. The cutoffs for elevated BP, stage I hypertension (HTN), stage II HTN and critical HTN are provided in the appendix with step-by-step instructions for implementing within an EHR to help providers determine accurate calculations at the point of care.

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