Diagnosis of pediatric hypertension requires ≥3 readings of SBP ≥130 or DBP ≥80. Given the information in the prompt, one reading does not warrant pharmacotherapy.

It never occured to me this guy can have HTN. All i thought we have a Marshal Eriksen in stem

• Children with hypertension (BP > 95th percentile) are primarily treated with lifestyle changes (weight loss, low-sodium diet, regular physical activity)
• Indications for treatment of hypertension in children: (1) Symptomatic hypertension (headaches, etc.) (2) secondary hypertension (3) end-organ damage (4) diabetes (5) hypertension refractory to lifestyle changes
• Key idea: In both children and adults, lifestyle interventions should be thoroughly tried before getting medications on board in setting of hypertension

tx pediatric HTN https://pediatrics.aappublications.org/content/140/3/e20171904#T47 - mostly lifestyle non-pharm interventions as 1st line - pharm tx if: 1)symptomatic HTN 2) stage 2 HTN w/o a clearly modifiable factor 3)any stage HTN a/w CKD or DM}} (see link Table 3 for stages of pediatric HTN)

One moderately elevated reading is insufficient to diagnose HTN, also this is prob white coat HTN