Vecchiola, A., C. F. Lagos, C. A. Carvajal, R. Baudrand and C. E. Fardella (2016). "Aldosterone Production and Signaling Dysregulation in Obesity." Curr Hypertens Rep 18(3): 20.

Parker, E. D., A. R. Sinaiko, E. O. Kharbanda, K. L. Margolis, M. F. Daley, N. K. Trower, N. E. Sherwood, L. C. Greenspan, J. C. Lo, D. J. Magid and P. J. O'Connor (2016). "Change in Weight Status and Development of Hypertension." Pediatrics 137(3): e20151662.

Ostchega, Y., J. P. Hughes, T. Nwankwo and G. Zhang (2018). "Mean mid-arm circumference and blood pressure cuff sizes for US children, adolescents and adults: National Health and Nutrition Examination Survey, 2011-2016." Blood Press Monit 23(6): 305-311.

(National High Blood Pressure Education Program Working Group on High Blood Pressure in and Adolescents 2004, Chen and Wang 2008, Banker, Bell et al. 2016, Flynn, Kaelber et al. 2017, Weaver 2017, Weaver 2019)

Dionne, J. M., et al. (2017). "Hypertension Canada's 2017 Guidelines for the Diagnosis, Assessment, Prevention, and Treatment of Pediatric Hypertension." Can J Cardiol 33(5): 577-585.

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do Carmo, J. M., A. A. da Silva, Z. Cai, S. Lin, J. H. Dubinion and J. E. Hall (2011). "Control of blood pressure, appetite, and glucose by leptin in mice lacking leptin receptors in proopiomelanocortin neurons." Hypertension 57(5): 918-926.

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Pickering, T. G., J. E. Hall, L. J. Appel, B. E. Falkner, J. W. Graves, M. N. Hill, D. H. Jones, T. Kurtz, S. G. Sheps, E. J. Roccella, P. Council on High Blood Pressure Research and A. H. A. Public Education Subcommittee (2005). "Recommendations for blood pressure measurement in humans: an AHA scientific statement from the Council on High Blood Pressure Research Professional and Public Education Subcommittee." J Clin Hypertens (Greenwich) 7(2): 102-109.

Xi, B., X. Zong, R. Kelishadi, Y. M. Hong, A. Khadilkar, L. M. Steffen, T. Nawarycz, M. Krzywinska-Wiewiorowska, H. Aounallah-Skhiri, P. Bovet, A. Chiolero, H. Pan, M. Litwin, B. K. Poh, R. Y. Sung, H. K. So, P. Schwandt, G. M. Haas, H. K. Neuhauser, L. Marinov, S. V. Galcheva, M. E. Motlagh, H. S. Kim, V. Khadilkar, A. Krzyzaniak, H. B. Romdhane, R. Heshmat, S. Chiplonkar, B. Stawinska-Witoszynska, J. El Ati, M. Qorbani, N. Kajale, P. Traissac, L. Ostrowska-Nawarycz, G. Ardalan, L. Parthasarathy, M. Zhao, T. Zhang and C. International Child Blood Pressure References Establishment (2016). "Establishing International Blood Pressure References Among Nonoverweight Children and Adolescents Aged 6 to 17 Years." Circulation 133(4): 398-408.

Flynn, J. T., D. C. Kaelber, C. M. Baker-Smith, D. Blowey, A. E. Carroll, S. R. Daniels, S. D. de Ferranti, J. M. Dionne, B. Falkner, S. K. Flinn, S. S. Gidding, C. Goodwin, M. G. Leu, M. E. Powers, C. Rea, J. Samuels, M. Simasek, V. V. Thaker, E. M. Urbina, S. Subcommittee On and C. Management Of High Blood Pressure In (2017). "Clinical Practice Guideline for Screening and Management of High Blood Pressure in Children and Adolescents." Pediatrics 140(3).

Brambilla, P., L. Antolini, M. E. Street, M. Giussani, S. Galbiati, M. G. Valsecchi, A. Stella, G. V. Zuccotti, S. Bernasconi and S. Genovesi (2013). "Adiponectin and hypertension in normal-weight and obese children." Am J Hypertens 26(2): 257-264.

University of Iowa Roy J. and Lucille A. Carver College of Medicine Department of Otolaryngology 200 Hawkins Drive 21151 Pomerantz Family Pavilion Iowa City, IA 52242-1089

National High Blood Pressure Education Program Working Group on High Blood Pressure in, C. and Adolescents (2004). "The fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents." Pediatrics 114(2 Suppl 4th Report): 555-576.

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Kalil, G. Z. and W. G. Haynes (2012). "Sympathetic nervous system in obesity-related hypertension: mechanisms and clinical implications." Hypertens Res 35(1): 4-16.

Rasouli, N. and P. A. Kern (2008). "Adipocytokines and the metabolic complications of obesity." J Clin Endocrinol Metab 93(11 Suppl 1): S64-73.

Prineas, R. J., Y. Ostchega, M. Carroll, C. Dillon and M. McDowell (2007). "US demographic trends in mid-arm circumference and recommended blood pressure cuffs for children and adolescents: data from the National Health and Nutrition Examination Survey 1988-2004." Blood Press Monit 12(2): 75-80.

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Values were derived from numerous sources (listed below) and reflect the guidelines determined to be up-to-date as of May 20, 2020. Normal ranges may include measurements that deviate from these values. Note that the patient's normal range and clinical condition should always be considered.

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McNiece, K. L., T. S. Poffenbarger, J. L. Turner, K. D. Franco, J. M. Sorof and R. J. Portman (2007). "Prevalence of hypertension and pre-hypertension among adolescents." The Journal of pediatrics 150(6): 640-644. e641.

Ogden, C. L., M. D. Carroll, C. D. Fryar and K. M. Flegal (2015). "Prevalence of Obesity Among Adults and Youth: United States, 2011-2014." NCHS Data Brief(219): 1-8.

"Report of the Second Task Force on Blood Pressure Control in Children--1987. Task Force on Blood Pressure Control in Children. National Heart, Lung, and Blood Institute, Bethesda, Maryland." Pediatrics 79(1): 1-25.

Scott, W. A., A. P. Rocchini, E. L. Bove, D. M. Behrendt, R. H. Beekman, M. Dick, 2nd, G. Serwer, R. Snider and A. Rosenthal (1988). "Repair of interrupted aortic arch in infancy." J Thorac Cardiovasc Surg 96(4): 564-568.

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Chiolero, A., F. Cachat, M. Burnier, F. Paccaud and P. Bovet (2007). "Prevalence of hypertension in schoolchildren based on repeated measurements and association with overweight." Journal of hypertension 25(11): 2209-2217.

(Flynn, Kaelber et al. 2017, National High Blood Pressure Education Program Working Group on High Blood Pressure in and Adolescents 2004, Xi, Zong et al. 2016, Morgan & Mikhail's Clinical Anesthesiology,  Chapter 42. Pediatric Anesthesia)

(Chen and Wang 2008, Chiolero, Cachat et al. 2007, McNiece, Poffenbarger et al. 2007, National High Blood Pressure Education Program Working Group on High Blood Pressure in and Adolescents 2004, Weaver 2019)

* For Newborn infants, BP values vary considerably during the first few weeks of life and the definition of HTN in preterm and term neonates also varies. Data have been compiled on neonatal BP values and the summary table is available. Please note that no alternative data have been developed recently. For further information, please see the following articles:

Chen, X. and Y. Wang (2008). "Tracking of blood pressure from childhood to adulthood: a systematic review and meta-regression analysis." Circulation 117(25): 3171-3180.

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Dionne, J. M., et al. (2012). "Hypertension in infancy: diagnosis, management, and outcome." Pediatr Nephrol 27(1): 17-32.

Coulthard, M. G. (2020). "Single blood pressure chart for children up to 13 years to improve the recognition of hypertension based on existing normative data." Arch Dis Child.

Pickering, T. G., J. E. Hall, L. J. Appel, B. E. Falkner, J. Graves, M. N. Hill, D. W. Jones, T. Kurtz, S. G. Sheps and E. J. Roccella (2005). "Recommendations for blood pressure measurement in humans and experimental animals: part 1: blood pressure measurement in humans: a statement for professionals from the Subcommittee of Professional and Public Education of the American Heart Association Council on High Blood Pressure Research." Circulation 111(5): 697-716.

The Department of Otolaryngology and the University of Iowa wish to acknowledge the support of those who share our goal in improving the care of patients we serve. The University of Iowa appreciates that supporting benefactors recognize the University of Iowa's need for autonomy in the development of the content of the Iowa Head and Neck Protocols.

Palatini, P. and G. N. Frick (2012). "Cuff and bladder: overlooked components of BP measurement devices in the modern era?" Am J Hypertens 25(2): 136-138.

Editor: Henry Hoffman, MD Managing Editors: Sarah Elliott, Kay Klein, Claire Davis Illustrated by: Timothy McCulloch, MD

The contents of this web site are for information purposes only, and are not intended to be a substitute for professional medical advice, diagnosis, or treatment. The University of Iowa does not recommend or endorse any specific tests, physicians, products, procedures, opinions, or other information that may be mentioned on this web site. Although the standards discussed herein reflect the University of Iowa's head and neck protocols, reliance on any information provided herein is solely at your own risk.

Ostchega, Y., J. P. Hughes, R. J. Prineas, G. Zhang, T. Nwankwo and M. M. Chiappa (2014). "Mid-arm circumference and recommended blood pressure cuffs for children and adolescents aged between 3 and 19 years: data from the National Health and Nutrition Examination Survey, 1999-2010." Blood Press Monit 19(1): 26-31.

Stefan, N., B. Vozarova, T. Funahashi, Y. Matsuzawa, C. Weyer, R. S. Lindsay, J. F. Youngren, P. J. Havel, R. E. Pratley, C. Bogardus and P. A. Tataranni (2002). "Plasma adiponectin concentration is associated with skeletal muscle insulin receptor tyrosine phosphorylation, and low plasma concentration precedes a decrease in whole-body insulin sensitivity in humans." Diabetes 51(6): 1884-1888.

Banker, A., C. Bell, M. Gupta-Malhotra and J. Samuels (2016). "Blood pressure percentile charts to identify high or low blood pressure in children." BMC Pediatr 16: 98.