Hypertension is a major risk factor for stroke, coronary artery disease and kidney damage in adults and children. There is a paucity of data on the long-term sequelae of persistent hypertension in children, but it is already known that children with hypertension have evidence of end organ damage and are at risk of hypertension into adulthood. The prevalence of hypertension in children is rising, most likely due to a concurrent rise in obesity rates. In children with hypertension, non-pharmacological measures are often recommended as first-line therapy, but a significant proportion of children will eventually require pharmacological treatment to reduce blood pressure, especially those with evidence of end organ damage at presentation or during follow-up. Twenty-four-hour ambulatory blood pressure monitoring (ABPM) is an essential tool in the diagnosis and therapeutic monitoring of arterial hypertension in children. In this review I will describe and discuss current methods to evaluate of BP level, the distribution of ABPM, outline available methods for BP assessment and discuss the clinical consequences of BP variability.
