Version July 2025
| Clinical features | Primary HTN | Secondary HTN |
| Age | ||
| Prepubertal | Secondary HTN is more likely in younger children, especially those less than 6 years of age | |
| Postpubertal | Older children and adolescents are more likely to have primary HTN | |
| Diastolic HTN* | Diastolic HTN is more likely to be associated with secondary HTN | |
| Nocturnal HTN* | Nocturnal HTN is more likely to be associated with secondary HTN | |
| Overweight/obesity | Overweight or obese children/adolescents are more likely to have primary HTN | |
| Family history of HTN | Children with a positive family history of primary HTN are more likely to have primary HTN | Family history may be positive in some cases of secondary HTN due to a monogenic cause (eg, autosomal dominant polycystic kidney disease) |
| Symptoms of underlying disorder | Patients with primary HTN are typically asymptomatic | Patients with secondary HTN often have other symptoms related to the underlying cause (eg, headache, sweating, and tachycardia due to catecholamine excess in patients with pheochromocytoma) |
HTN: hypertension.
* Nocturnal and diastolic HTN are usually detected by ambulatory blood pressure monitoring.