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April 1987

Should Blood Pressure Be Measured Routinely in Children Under 3 Years of Age?

Author Affiliations

Division of Pediatric Cardiology Washington University School of Medicine 400 S Kingshighway Blvd St Louis, MO 63110

Am J Dis Child. 1987;141(4):397-398. doi:10.1001/archpedi.1987.04460040055006

Sir.—I read with great interest the excellent editorial by Dr McNamara1 in the October 1986 issue of AJDC. I heartily agree with the editorial, and I hope it has a favorable reception among physicians.

I would like to call attention to suggestion 6 in section 2: "An annual check of blood pressure of all patients beginning at 3 years of age to detect a consistent blood pressure elevation greater than or equal to the 95th percentile for age." Why exclude infants from birth to 3 years of age? It is true that the incidence of primary hypertension is low in this age group. However, this does not justify omitting the measurement of blood pressure. In the days before the Doppler technique was available, this omission might have been justified because the conventional sphygmomanometric method is difficult to apply in children so young. Even so, the flush blood pressure