| name | eso-pediatric-obesity-bp-interpretation |
| description | This skill interprets blood pressure using age-, sex-, and height-specific percentile norms to screen for prehypertension and hypertension in pediatric patients. Trigger phrases include BP ≥90th to <95th percentile = prehypertension and BP ≥95th percentile = stage 1 hypertension (with age‑specific adjustments). |
Interpret blood pressure for prehypertension and hypertension screening
STEP 1 — Gather Information
Collect patient age (years), sex, height (cm or inches), systolic blood pressure (SBP) and diastolic blood pressure (DBP) using an appropriately sized cuff after 5 minutes of rest.
STEP 2 — Rule In / Rule Out
If age <12 years, proceed to percentile‑based interpretation using sex/age/height norms; if age ≥12 years, proceed to adolescent/adult cutoffs.
STEP 3 — Classify or Stratify
For age 3–11 years: compare SBP/DBP to the sex‑, age‑, and height‑specific percentile table (Table 2); for age 12–17 years: use the same percentile table or the adult threshold of ≥120/80 mmHg; for age ≥18 years: apply adult cutoffs. Classify as normal (<90th percentile), prehypertension, stage 1 hypertension, or stage 2 hypertension (stage 3 for ≥18 years).
STEP 4 — Decide
If normal: routine BP check at next visit; if prehypertension: initiate lifestyle counseling and repeat BP in 6 months; if stage 1 hypertension: evaluate for secondary causes, reinforce lifestyle intervention, and repeat BP in 1–2 weeks; if stage 2 hypertension: refer for further evaluation and consider pharmacotherapy per guideline.
Clinical Guardrails / Mimics / Pitfalls
Do not use adult cutoffs for children <18 years, avoid miscuffing (use cuff bladder width ≥40% of arm circumference), ensure measurement after rest, and remember that isolated systolic or diastolic elevation still counts; a single elevated reading requires confirmation on a separate visit.
Concrete Clinical Example
A 10‑year‑old boy (height 50th percentile for age/sex) has SBP 118 mmHg and DBP 76 mmHg. Using the percentile table, his BP falls between the 90th and 95th percentiles → prehypertension. Action: lifestyle counseling and repeat BP in 6 months.
Source: Pediatric Obesity Assessment, Treatment, and Prevention: An Endocrine Society Clinical Practice Guideline, Endocrine Society, 2017, DOI:10.1210/jc.2016-2573
TODO: consider adding scripts/calc.py for the eso-pediatric-obesity-bp-interpretation calculator
