ABSTRACT
Measurement of blood pressure less than 5 years is a research exercise requiring special training and experience. The considerable difficulties of guaranteeing accurate and representative measurement of arterial pressure in adults are much greater in childhood. Clinical hypertension in childhood is always secondary hypertension; primary hypertension probably begins in childhood or adolescence, but is not then a clinical problem. A succession of important papers from David Barker has explored connections between prenatal and infant growth and adult blood pressure, glucose tolerance, fibrinogen and Factor VII levels, coronary heart disease and airways obstruction. A further problem complicating clinical measurements of blood pressure in later childhood is that normal blood pressure relates to stature more than to age. Even with a classic history of migraine all children complaining of headache should have a careful examination of both optic fundi, and all should have their blood pressure measured.
