Dear Doctor: How important is it to keep track of a child's blood pressure? I read that the American Academy of Pediatrics just updated its guidelines for screening and managing high blood pressure in kids. Is this really a problem that I need to worry about?

Dear Reader: We're so glad you brought up this very important topic. Blood pressure is a diagnostic tool that's as important in children as it is in adults. However, because blood pressure readings in children are evaluated by a different set of metrics than those of adults, the subject has often been confusing.

By now, the significance of high blood pressure, or hypertension, is well known to most of us. It's not a condition that you can readily feel, but when left untreated it can cause significant damage to your body. By the time symptoms appear, you can be dealing with a host of problems, including damage to your heart, kidneys, eyes, bones and cognitive function.

High blood pressure in children can be a predictor of the condition later in life. It can cause certain types of damage to the structures and blood vessels of a child's heart. And it can be a symptom of other serious underlying conditions, including heart or kidney problems. Between 2.2 to 3.5 percent of children have high blood pressure, according to the new guidelines. The number jumps up to 24 percent among children who are obese or overweight. Children who were born prematurely and those with sleep-disordered breathing are also at risk of high blood pressure.

That's why establishing a baseline blood pressure reading beginning as early as the age of 3 is important. After that, a child's blood pressure should be measured during annual physical exams, and the trajectory of those readings over time should be noted and used as a diagnostic tool.

Thanks to the new blood pressure guidelines, released in August 2017 by the American Academy of Pediatrics, this should be much more easily accomplished. Unlike in adults, whose blood pressure readings fall into uniform parameters, readings in children must be interpreted based on gender, age and height. It's no surprise that, with so many variables to deal with, repeated studies show that up to 75 percent of children with high blood pressure have gone undiagnosed.

Before, health care professionals had to delve into multiple pages of charts to assemble the numbers and come up with a reading. The updated guidelines have simplified this pile of data into a single table. It's easy to use and easy for everyone, including parents, to understand.

For a child to be diagnosed with high blood pressure requires three separate readings that fall above the established guidelines. A single high reading, while not a diagnosis, does indicate the need for subsequent evaluations to rule out hypertension.

If your pediatrician or family physician doesn't routinely check your children's blood pressure, don't be afraid to ask. With one-third of adults in the United States now diagnosed with hypertension, it's clear that it's never too soon to get ahead of this serious condition.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o Media Relations, UCLA Health, 924 Westwood Blvd., Suite 350, Los Angeles, CA, 90095. Owing to the volume of mail, personal replies cannot be provided.)

Dear Doctor: I am a senior citizen on Medicare. I don't have a "regular" doctor, but rather, I go to a clinic when I have a problem. What is covered in the annual Medicare physical? What should I, as a patient, know and do?

Dear Reader: Let's face it -- health insurance can be complicated and confusing, and Medicare is no different. We hope we can offer a bit of clarity regarding Medicare's annual physical exams, the details of which often leave our own senior patients with plenty of questions.

In the 12 months after you enroll in Medicare Part B, you're eligible for something known as a "preventive care" visit. During this appointment, you'll tell your doctor your personal medical history as well as your family history. She or he will record your height, weight and blood pressure, and will calculate your BMI, or body mass index. You'll get a vision test, and you'll be evaluated for risk of depression and any other potential safety issues.

Certain screening tests and vaccinations may be ordered at this time. Because details vary depending on each specific case, be sure to ask your doctor whether additional costs will be incurred. You may have to pay coinsurance, and the Medicare Part B deductible may apply.

During this initial visit, you'll also have a chance to discuss advanced health directives, sometimes known as a living will. You will receive a written plan that details a future schedule of screenings, vaccines and any other preventive services your medical history has indicated may be necessary.

Each subsequent year, Medicare entitles you to an annual physical evaluation that is less comprehensive than what we think of as a full physical. Known as a yearly wellness exam, it focuses on what a physician can see, hear and feel during an exam, such as heart rate, blood pressure, weight, BMI, heart and lung sounds and visible symptoms. However, the wellness exam does not include blood tests like complete blood count, kidney, liver and thyroid function, diabetes and cholesterol screenings, or a check of vitamin D levels, which we include in annual physical exams in our practices. These can be ordered, but depending on the test, there can be additional costs.

To get the most out of any physical exam, we recommend that patients bring the following:

-- Complete medical records, including immunization records, results of recent screening tests and information on any surgeries.

-- A list of all medications and supplements you are currently taking, including dosage, history of use and any side effects you may have experienced.

-- Comprehensive medical family history, including diseases like cancer, asthma, diabetes, memory disorders or dementia.

This last part is important because if your doctor determines that you are at particular risk of a certain disease or condition, you may be eligible for additional screenings and more frequent screenings. However, this typically requires a referral.

Lastly, we would encourage you to find and build a relationship with a primary care physician. This will give you a medical "home base," a doctor who knows you and your medical needs, as well as a partner in your ongoing care and an advocate for your best quality of life.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o Media Relations, UCLA Health, 924 Westwood Blvd., Suite 350, Los Angeles, CA, 90095. Owing to the volume of mail, personal replies cannot be provided.)

Hello, dear readers! We hope that you're settling into 2018. (It still sounds odd to say it!) We love that you're keeping our inbox full, and, as ever, we remain grateful for your interest and engagement in our columns.

Quite a few of your letters delve deeper into topics we have tackled and are slated to become the subjects of follow-up columns. To those who have written to thank us, we say thank you. And now, onward, as we address a few of your questions, thoughts and concerns.

-- A recent column about headaches and their causes prompted a reader from Madison, Wisconsin, to write in with an addition to the list:

"There is one more possibility that is often ignored," she wrote. "My son had headaches on and off between the ages of 12 and 17. At age 17, he had his wisdom teeth out, and the headaches were gone. People with headaches that start in their teens may want to check with a dentist to see if their wisdom teeth are impacted."

While not nearly as common as the causes discussed in the column, impacted wisdom teeth can trigger painful and repeated headaches in some people. These teeth, which are the third molars at the back of the mouth, often lack adequate room to emerge. Whether due to infection, pressure or misalignment of the jaw, the result can be recurring headaches. If the onset (or increase) in headaches coincides with the typical age range for wisdom tooth eruption -- 17 to 24 -- it's a good idea to check with your dentist.

-- The dental angle on headaches got a thumbs-up from another reader, who says she was initially a skeptic:

"The 'dental problem' was a cause that I didn't buy into," she wrote. "My dentist told me I was grinding my teeth, and though he made me a tooth guard, I didn't wear it for years. I finally gave it a try because my headaches persisted and pain meds were hurting my stomach. No more daily headaches!"

-- We loved this story from a reader from Naples, Florida, in response to our column about the importance of the annual physical exam.

"A friend of mine, who was feeling fine, went to her annual physical," she wrote. "Routine blood tests revealed that she had leukemia. She immediately sought treatment and today, 20 years later, she's fine. I can't think of a more powerful argument in favor of having an annual physical."

Needless to say, we heartily agree that an annual physical exam can be a lifesaver. Whether it's identifying "silent" problems like hypertension or the early stages of serious illness, or enlisting your primary care physician as your partner in long-term health and wellness goals, a yearly physical is a powerful -- and empowering -- tool.

-- Finally, we just learned of an interesting advance in cochlear implants, which we addressed in a column recently. New programming software that was just approved by the FDA will allow audiologists to evaluate and adjust a patient's implants from afar via remote programming software.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o Media Relations, UCLA Health, 924 Westwood Blvd., Suite 350, Los Angeles, CA, 90095. Owing to the volume of mail, personal replies cannot be provided.)