Hypertension in children and adolescents is often underdiagnosed. Blood pressure should be assessed at every medical encounter in children aged 3 years and older, as well as high-risk children younger than 3 years. Pharmacologic therapy is safe and effective for controlling blood pressure and preventing end-organ changes in this population.

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Danielle is a 16-year-old who presents to your office for a routine health maintenance visit. She has generally been feeling well, except for occasional headaches. They do not localize to a specific location, and they occur weekly and resolve spontaneously. They are not associated with any other neurological symptoms. Her past medical history is unremarkable. She is not taking any medications. Her family history is remarkable for hypertension in both the maternal and paternal grandparents. The review of systems has yielded otherwise negative findings.

The physical examination showed a height at...

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