In a recent issue of blood pressure monitoring, Maric et al. reported the results of an interesting study in which blood pressure was measured in 780 children between 7 and 17 years of age in two schools of the district of Vozdovac of Belgrade, Serbia. The authors reported a prevalence of elevated blood pressure of 10.5% and concluded that there was a high prevalence of hypertension in (this) sample of schoolchildren'. In this commentary, we would like to stress the importance of distinguishing elevated blood pressure from hypertension.
Hypertension is a state of sustained elevated blood pressure. This means that blood pressure must be elevated on repeated occasions for the diagnosis of hypertension Individuals with high blood pressure at one visit, however, generally have lower blood pressure levels at subsequent visits because of familiarization with the measurement procedure and a regression to the mean effect. Therefore, if blood pressure is high at an initial visit, it is necessary to measure blood pressure at other visits to confirm or exclude hypertension. According to the guidelines of the National High Blood Pressure Education Program Working Group on Children and Adolescents, elevated blood pressure must be confirmed on at least three visits before characterizing a child as having hypertension'. It is also recommended to have blood pressure measured at more than one visit for the diagnosis of hypertension in adults.