Abstract: The rising prevalence of elevated BP in children and adolescents is a clinical and public health problem of increasing importance but little is known about patterns of care or the resource use implications of elevated BP in this population. The objective of this four year NIH-funded study is to improve care provided to children and adolescents with elevated blood pressure(BP) by (a) identifying subjects aged 0-17 with elevated BP across three large medical groups in MN, CO, and CA, (b) assessing the relationship of BMI and change in BMI to BP and change in BP, (c) assessing patterns of care provided to those with elevated BP, and (d) assessing the relationship of BP to resource use, controlling for BMI and other factors. We have developed a comprehensive analytic database using a common electronic medical record system across three sites to collect and classify subjects as normotensive, pre-hypertensive or hypertensive using age-, gender-, and height-specific BP percentile ranks established by the 2004 Fourth Report on the Diagnosis, Evaluation, and Treatment of High Blood Pressure in Children and Adolescents. This poster will present the study design and preliminary results from 2007-2009 using this database.