Study shows poor follow up of children with high blood pressure

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1. Only 20.9% of children with an incident of high blood pressure were tested again within a month.

2. A total of 1.4% of participants with an incident of elevated BP met all criteria for hypertension.

Evidence Rating Level: 2 (Good)

Study Rundown: Recent, updated blood pressure (BP) recommendations advise that when a BP measurement occurs in the elevated range (≥ 95th percentile for age, gender, and height) that an additional measurement be taken within 1 to 2 weeks. Regardless of the increased emphasis on this condition, hypertension is consistently unrecognized in many children. In the current study, researchers aimed to determine how children were treated after an incident of high BP. The time in between the incident and follow up measurement, as well as the likelihood of persistent elevated BP were studied. It was determined that 8.4% of the adolescent population had at least one incident of high BP, but only 1.4% of these individuals went on to meet the criteria for hypertension. The large majority of participants with an incident of elevated blood pressure were not retested according to guidelines. This highlights the need for improvement in high BP recognition and monitoring.

Click to read the study, published today in Pediatrics

Relevant Reading: Patient-, Provider-, and Clinic-Level Predictors of Unrecognized Elevated Blood Pressure in Children

In-Depth [retrospective cohort study]: Researchers obtained access to the electronic health records of three healthcare organizations: Health Partners of Minnesota, Kaiser Permanente Colorado, and Kaiser Permanente Northern California. From January 2007 to December 2010, children ages 3-17, with at least two eligible BP measurements were included. A BP was considered eligible if completed in the outpatient setting and height measurements were included 90 days before or after the respective BP measurement. Participants were excluded if they had an initial elevated BP measurement, a previous diagnosis of hypertension, or other co-morbid condition known to cause hypertension. A total of 72,625 children met all study inclusion criteria. Among eligible individuals, 6108 (8.4%) had an incident of elevated BP during study period. Within one month, 20.9% of these children had a follow up BP measurement. Hypertension (defined as a BP ≥ 95th percentile on 3 separate, consecutive occasions) was diagnosed in 84 (1.4%) of the participants with incident high BP.

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