CURRENT TOPIC Investigation of hypertension and the recognition of monogenic hypertension

Hypertension in childhood is rare and is more likely to be secondary to a medical disorder in the very young and in those with severe hypertension. Essential hypertension is rarely diagnosed in children less than 5 years of age but is diagnosed with increasing frequency from the age of 10 years. These observations justify the aggressive investigation of preschool children with persistent hypertension (blood pressure> 97th centile for height1) and school aged chil-dren with severe hypertension, because of the high probability of making a diagnosis. The assessment of a child with hypertension should begin with a careful medical history, family medical history, and a thorough physical examination, which might provide clues to th