In Reply.—Dr Goldring urges pediatricians to measure blood pressure routinely from birth on rather than starting at about 3 years of age as I recommended in my editorial. This would indeed be ideal if the practical limitations can be worked out. In fact, it is always ideal for physicians to carry out a complete physical examination routinely in every patient. But in each physical examination we have to weigh the chance of positive yield against those aspects of the examination that are likely to be an agitation to the patient, that are inordinately time consuming, or that carry a high percentage of false-negative or false-positive results. The process of measuring the blood pressure in the healthy infant has an element of each of these limitations.
First, the positive yield of abnormal blood pressure in a well-infant examination is extremely low. Also, the mechanics of blood-pressure recording often make the