Hypertension in children is a rare disorder with reliable estimates of annual incidence that do not exceed 0.1%. At least one third of these cases have no definable etiology when all of the presently available diagnostic studies are used. Major invasive or expensive evaluations are indicated when hypertension is sustained or severe, and should be directed toward the renal and renovascular areas. Serum potassium and calcium estimates are essential in every case, but the more extensive evaluations of thyroid, parathyroid, adrenal cortical and adrenal medullary hormones should be reserved for patients with specific indications of malfunction in those systems.
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