Categories for children 1 to 12 years
For children under 13, find the 90th and 95th percentiles for the child's sex, age and height percentile in the AAP tables, then classify the systolic and diastolic readings separately. The higher category wins.
| Category | Children under 13 |
|---|---|
| Normal | Under the 90th percentile |
| Elevated | 90th percentile or more, but under the 95th (or 120/80 if lower) |
| Stage 1 hypertension | 95th percentile or more, but under the 95th + 12 mm Hg (or 130/80 if lower) |
| Stage 2 hypertension | 95th percentile + 12 mm Hg or more (or 140/90 if lower) |
Categories for adolescents 13 years and older
From 13 years, percentiles are no longer needed. The same adult-style cut-offs apply to all adolescents, and the higher of the systolic and diastolic category is used.
| Category | 13 years and older |
|---|---|
| Normal | Under 120/80 |
| Elevated | Systolic 120–129 with diastolic under 80 |
| Stage 1 hypertension | Systolic 130–139 or diastolic 80–89 |
| Stage 2 hypertension | Systolic 140 or more or diastolic 90 or more |
Example percentile values at the 50th height percentile
These values (mm Hg) come from the AAP 2017 tables built into the calculator, for a child at the 50th height percentile. Shorter or taller children have different cut-offs, so use the calculator for an individual child.
| Age | Boys 90th (SBP/DBP) | Boys 95th (SBP/DBP) | Girls 90th (SBP/DBP) | Girls 95th (SBP/DBP) |
|---|---|---|---|---|
| 1 year | 100/53 | 103/55 | 100/56 | 103/60 |
| 3 years | 103/59 | 107/62 | 104/62 | 108/66 |
| 5 years | 106/65 | 109/69 | 107/67 | 110/71 |
| 8 years | 110/71 | 114/74 | 110/72 | 113/74 |
| 10 years | 112/74 | 116/77 | 112/73 | 116/76 |
| 12 years | 117/75 | 121/78 | 118/75 | 122/78 |
When to measure and when to repeat
Check blood pressure yearly from age 3, and at every visit in children with obesity, kidney disease, coarctation, diabetes or medicines that raise blood pressure. Confirm high oscillometric readings by auscultation.
- Normal: recheck at the next routine visit
- Elevated: lifestyle counseling and repeat in 6 months, checking upper and lower limb pressures if still elevated; still elevated at 12 months means ABPM, diagnostic evaluation and considering referral
- Stage 1: lifestyle counseling and repeat in 1–2 weeks, with upper and lower limb pressures if still stage 1; still stage 1 at 3 months means ABPM, diagnostic evaluation, starting treatment and considering referral
- Stage 2: lifestyle counseling, upper and lower limb pressures, and repeat or refer to specialty care within 1 week; if confirmed, evaluation, ABPM and treatment
Emergencies
Symptoms such as severe headache, vision change, seizure, chest pain or heart failure with stage 2 hypertension, or a blood pressure more than 30 mm Hg above the 95th percentile (over 180/120 in adolescents), need the emergency department now.
Evaluation and first-line treatment
Once hypertension is confirmed, check urinalysis, chemistry and lipids. Get a renal ultrasound in children under 6 years or if the urinalysis or creatinine is abnormal, and an echocardiogram before starting medicine. The treatment goal is under the 90th percentile and under 130/80.
First-line medicines listed in the guideline include lisinopril or losartan (from 6 years), amlodipine and hydrochlorothiazide. The calculator shows weight-based starting doses and maximums.
Use the free tool
Percentiles by age, sex and height, category, follow-up and medication doses.
Open Blood Pressure →Common questions
What blood pressure is high for a 10-year-old?
For a 10-year-old at the 50th height percentile, the 95th percentile (stage 1 threshold) is 116/77 for boys and 116/76 for girls. Readings at or above it on 3 separate visits mean hypertension. Height changes the cut-offs, so use the calculator.
Do teenagers use percentiles for blood pressure?
No. From 13 years, the AAP 2017 guideline uses fixed cut-offs: 120–129/under 80 is elevated, 130–139 or 80–89 is stage 1, and 140 or more or 90 or more is stage 2.
When is ambulatory blood pressure monitoring (ABPM) needed?
ABPM is advised when elevated blood pressure persists at 12 months, when stage 1 persists at 3 months, and when stage 2 hypertension is confirmed.
How many readings confirm hypertension in a child?
High readings on 3 separate visits are needed, and high oscillometric readings should be confirmed by auscultation.
Sources
Flynn JT, Kaelber DC, Baker-Smith CM, et al. Clinical practice guideline for screening and management of high blood pressure in children and adolescents. Pediatrics 2017;140(3):e20171904 — Tables 3, 4, 5, 11 and 18.
For education only, not medical advice. Always confirm against current guidelines and your local protocols. Pedemy is independent and not affiliated with or endorsed by the organizations cited.