Few Children With Hypertension Appear To Be Diagnosed

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Main Category: Pediatrics / Children's Health
Also Included In: Hypertension;  Cardiovascular / Cardiology;  Obesity / Weight Loss / Fitness
Article Date: 21 Aug 2007 - 13:00 PDT

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A new study found that only about one quarter of all children and adolescents with high blood pressure (hypertension) seem to have been diagnosed with the condition. You can read about this study in the Journal of the American Medical Association (JAMA), August 22/29 issue.

About 2%-5% of children/adolescents suffer from hypertension. Experts believe these figures will rise as the prevalence of obesity among the young rises. As normal and abnormal blood pressure values vary with age, height and sex, proper hypertension diagnosis is more complicated in children compare to adults.

Matthew L. Hansen, M.D., of Case Western Reserve University, Cleveland, and team carried out a study to find out how common undiagnosed hypertension and hypertension in 2-18 year-old children might be. 14,187 children/adolescents were monitored at least three times between June 1999 and September 2006 at outpatient clinics.

The scientists found that 2.7% (507) of children met the criteria for hypertension. Only 26% (131) of the children who had hypertension had been diagnosed as such previously, while 74% (376) had not. 485 (3.4%) of the children met the criteria for prehypertension, 55 (11%) of whom had had elevated blood pressure or hypertension documented in their electronic medical records.

The authors wrote "Identification of elevated blood pressure in children meeting prehypertension or hypertension criteria is important because of the increasing prevalence of pediatric weight problems and because secondary hypertension is more common in children than adults, requiring identification and appropriate work-up. If abnormal blood pressure is not identified by a patient's pediatric clinician, it may be years before the abnormal blood pressure is detected, leading to end-organ damage. Because effective treatments for abnormal blood pressure exist, these long-term sequelae can be avoided with early diagnosis."

"Although this study identifies the problem of undiagnosed hypertension in children, it also points to the potential of electronic medical records to help address this issue. The relatively poor identification of abnormal blood pressure could be remedied by a clinical decision support algorithm built into an electronic medical record that would automatically review current and prior blood pressures, ages, heights, and sex to determine if abnormal blood pressure criteria had been met. The algorithm could indicate if any abnormal blood pressure … already existed and prompt the pediatric clinician that the child appears to have undiagnosed abnormal blood pressure. In addition, the clinical decision support algorithm could provide guideline-based evaluation, treatment, and parent/patient education materials to the clinician."

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Written by: Christian Nordqvist
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