Circadian rhythms of BP are established early in life. The ABPM coupled with an objective measure of activity is a powerful tool for the management of hypertension and is a sensitive tool for the dissection of the determinants of hypertension. The challenge for pediatricians in the future includes such important goals as establishing normal values for the circadian assessment of BP for a growing child, coupling of BP determinations with activity, using the ABPM to better understand BP tracking, studying the rhythms of families using the ABPM, educating the medical and lay communities of the importance of rhythmic phenomena, studying longitudinally patients with varying forms of hypertension, using the ABPM to test and optimize antihypertensive medications, and determining the proper diagnosis of hypertension in children based on end-organ damage rather than surrogate measures.