Child blood pressure check: when it is done, how it is measured, and what the numbers mean
The American Academy of Pediatrics (AAP) recommends checking blood pressure in all children once a year from age 3, and at each visit in children at higher risk. The USPSTF found the evidence insufficient to recommend for or against screening children and adolescents (I statement). (USPSTF, 2020) Most children with high blood pressure have no symptoms, and it is often found when a provider checks blood pressure at a checkup. (MedlinePlus, high blood pressure in children)
When it is checked
- Birth to 30 months: the AAP schedule lists a blood pressure risk assessment at each visit, with action if it is positive. (AAP Bright Futures, 2025)
- From age 3: blood pressure is measured at each yearly visit in the AAP schedule. (AAP Bright Futures, 2025) For children at a healthy weight, MedlinePlus says it should be checked every year starting at age 3. (MedlinePlus, high blood pressure in children)
- At every visit: MedlinePlus lists children who are obese, have kidney disease, have problems with the blood vessels leading to the heart, or have diabetes. (MedlinePlus, high blood pressure in children)
- Only at checkups: the AAP 2017 guideline limits routine screening measurements to preventive care visits. (AAP, 2017)
The USPSTF found no good evidence about how often blood pressure should be measured in children and adolescents. (USPSTF, 2020) The other checks at each visit are on well-child checkup screenings by age and teen health screenings.
How the reading is taken
- Cuff and arm: best practice is to measure by auscultation on the upper right arm with an appropriately sized cuff. The right arm is preferred because the standard children's tables reflect right arm readings, and because a low reading in the left arm could be a result of coarctation of the aorta. (USPSTF, 2020) MedlinePlus says the provider uses a cuff that fits the child properly to get an accurate reading. (MedlinePlus, high blood pressure in children)
- Repeat readings: if a child's blood pressure is elevated, the provider should measure it twice and take the average of the 2 measurements. (MedlinePlus, high blood pressure in children)
- More than one visit: best practice is to measure at 3 different visits. (USPSTF, 2020)
- 24-hour monitoring: some organizations suggest confirming the diagnosis with ambulatory blood pressure monitoring, a portable device that records blood pressure usually every 20 to 30 minutes over 12 to 24 hours. (USPSTF, 2020) The AAP 2017 guideline expanded its role in diagnosis. (AAP, 2017)
A reading is written as 2 numbers, such as 120/80: the top number is the systolic pressure and the bottom number is the diastolic pressure. (MedlinePlus, high blood pressure in children)
What the numbers mean under 13
Up to age 13, high blood pressure is defined differently than in adults, because normal blood pressure changes as a child grows. A child's numbers are compared with those of other children of the same age, height and sex. (MedlinePlus, high blood pressure in children) The USPSTF summarises the AAP 2017 definitions for children aged 1 to 13: (USPSTF, 2020)
- Elevated blood pressure (the AAP replaced the term "prehypertension" with this one (AAP, 2017)): 3 measurements between the 90th and 94th percentile for age, height and sex, or 120 to 129/less than 80 mm Hg. (USPSTF, 2020)
- Hypertension: 3 measurements at 3 different visits at or above the 95th percentile for age, height and sex, or above 130/80 mm Hg, whichever is lower. (USPSTF, 2020)
MedlinePlus describes abnormal readings in children as elevated blood pressure, stage 1 high blood pressure and stage 2 high blood pressure, and says your child's provider can tell you what your child's blood pressure should be. (MedlinePlus, high blood pressure in children)
What the numbers mean from 13
From age 13, the AAP 2017 guideline uses a simplified classification that aligns with the adult guideline from the American Heart Association and American College of Cardiology, (AAP, 2017) regardless of sex and height. (USPSTF, 2020) The NHLBI lists these categories, in mm Hg: (NHLBI, 2025)
| Category | Systolic and diastolic (mm Hg) |
|---|---|
| Normal | Less than 120 systolic and less than 80 diastolic |
| Elevated | 120 to 129 systolic and less than 80 diastolic |
| High blood pressure stage 1 | 130 to 139 systolic or 80 to 89 diastolic |
| High blood pressure stage 2 | 140 or higher systolic or 90 or higher diastolic |
The NHLBI says readings higher than 180 systolic or higher than 120 diastolic are a hypertensive crisis: contact your provider immediately. (NHLBI, 2025) More on these categories: blood pressure readings: what they mean.
Why a high reading is rechecked
- One reading is not a diagnosis. The provider will measure a child's blood pressure many times before diagnosing high blood pressure. (MedlinePlus, high blood pressure in children)
- Readings can come back down. The USPSTF notes possible high false-positive rates, meaning elevated measurements that later normalize, and says unnecessary further tests or treatment may be common, particularly with frequent screening. (USPSTF, 2020)
- Follow-up timing: MedlinePlus says that for elevated blood pressure, the reading is checked again at 6 months and, if it is still high, at 12 months; follow-up testing takes place in 1 to 2 weeks for stage 1 and after 1 week for stage 2. (MedlinePlus, high blood pressure in children)
- Looking for a cause: the provider will ask about family history, sleep, risk factors and diet, do a physical exam, and may order tests such as blood and urine tests, a blood sugar test, an echocardiogram, an ultrasound of the kidneys or a sleep study. (MedlinePlus, high blood pressure in children) Younger children (under 6) are more likely than older children to have a cause such as renal disease, coarctation of the aorta or endocrine disease. (USPSTF, 2020)
Risk factors: higher body mass index and a family history of high blood pressure are important risk factors; others include low birth weight, male sex, and African American or Hispanic/Latino race or ethnicity. (USPSTF, 2020) MedlinePlus also lists type 2 diabetes or high blood sugar, high cholesterol, problems breathing during sleep such as snoring or sleep apnea, kidney disease, and preterm birth. (MedlinePlus, high blood pressure in children) High blood pressure affects about 3% to 4% of US children and adolescents in most studies. (USPSTF, 2020)
MedlinePlus, when to contact a medical professional: "Contact your child's provider if home monitoring shows that your child's blood pressure is still high." (MedlinePlus, high blood pressure in children)
Where they differ:
- AAP: screen all children every year from age 3, and children at higher risk at each visit. (USPSTF, 2020) The American Heart Association and the NHLBI also recommend routine screening from age 3. (USPSTF, 2020)
- USPSTF: the evidence is insufficient to weigh benefits and harms of screening (I statement, 2020, consistent with its 2013 statement), and clinicians should stay alert to signs and symptoms of high blood pressure. The American Academy of Family Physicians also says the evidence is insufficient. (USPSTF, 2020)
- UK: the UK National Screening Committee does not recommend screening children for high blood pressure, because it is not known how many children in the UK have it or its long-term effects, an accurate test for screening children and young people is not available, and it is not known how to avoid early signs of ill health and later disease in adults. It also says a specific cause is usually found when children have raised blood pressure. (UK NSC, 2022) The NICE hypertension guideline covers people aged 18 and over. (NICE NG136)
More: USPSTF grades explained.
Your doctor decides what your result means for you.
This page does not give treatment advice, including on diet, exercise or medicines. If your child has a high reading, see after an abnormal screening result for questions to ask.
Questions people ask
At what age should a child have their blood pressure checked?
The AAP recommends checking all children once a year from age 3, and children at higher risk at every visit. The AAP schedule lists a risk assessment at visits from birth to 30 months. The USPSTF found too little evidence to recommend for or against screening children and adolescents (I statement). (USPSTF, 2020) (AAP Bright Futures, 2025)
What is a normal blood pressure for a child?
Under 13, there is no single number: a child's reading is compared with readings of other children of the same age, sex and height, and your child's provider can tell you what your child's blood pressure should be. From 13, the adult categories apply: normal is less than 120 systolic and less than 80 diastolic. (MedlinePlus, high blood pressure in children) (NHLBI, 2025) (AAP, 2017)
What does the 95th percentile mean for a child's blood pressure?
Under the AAP 2017 definitions, for children aged 1 to 13, readings at or above the 95th percentile for age, height and sex, or above 130/80 mm Hg, whichever is lower, on 3 measurements at 3 different visits define hypertension. Readings between the 90th and 94th percentile, or 120 to 129/less than 80 mm Hg, are elevated blood pressure. (USPSTF, 2020)
Why does the size of the cuff matter?
Best practice is to use an appropriately sized cuff on the upper right arm. MedlinePlus says the provider will use a cuff that fits the child properly to get an accurate reading. (USPSTF, 2020) (MedlinePlus, high blood pressure in children)
Does one high reading mean my child has high blood pressure?
No. The provider measures blood pressure many times before diagnosing high blood pressure, and best practice is measurement at 3 different visits. The USPSTF notes possible high false-positive rates, meaning elevated readings that later return to normal. (MedlinePlus, high blood pressure in children) (USPSTF, 2020)