The importance of hypertension in the pediatric population has not been as well-appreciated as in adults. This may be due in part to the much lower prevalence of hypertension in children. Nevertheless, hypertension is an important clinical problem in pediatrics, and the approach to its management differs from that in adults in several major respects. Compared with adults, a much greater percentage of hypertension in childhood is caused by secondary, potentially correctable, disease states. Elevated blood pressure in children may also represent the early expression of primary or essential hypertension. In addition, the technique of blood pressure measurement, the definitions of high blood pressure, and the classifications of blood pressure values in children are different than in adults. These factors dictate a pediatric approach to the detection, evaluation, and management of hypertension in children and adolescents. (C) 1996 by the National Kidney Foundation, Inc.