- Hypertension is defined as blood pressure above the 95th percentile for age, sex and height. It can be primary (essential) or secondary to an underlying condition. - Secondary hypertension is more common in children and is often caused by renal or endocrine diseases. Primary hypertension becomes more prevalent in adolescents. - Evaluation of hypertensive children includes assessing for target organ damage, evaluating comorbidities like obesity, and screening for underlying secondary causes through tests like renal ultrasound. - Lifestyle modifications focusing on diet, exercise and weight loss are the first-line treatment for hypertension in children. Pharmacological treatment is indicated if hypertension persists or there is evidence of end organ damage.