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Many children with high BP don’t get follow-up

Children who have a first elevated blood pressure at the doctor’s office are not likely to receive the recommended follow-up blood pressure readings within a month, according to a study.

However, most children’s blood pressure subsequently returned to normal for their age, sex and height, according to the study, which was published in the August issue of the journal Pediatrics.

Researchers examined the electronic health records of 72,625 children and adolescents ages 3 to 17 over a three-year period at Kaiser Permanente in Colorado and Northern California and HealthPartners of Minnesota. Members of the study cohort received blood pressure checks as part of their routine clinical care. While 8.4% of children in the study had at least one visit with elevated blood pressure, only 20.9% of those children received another blood pressure screening within a month.

Of those with an elevated blood pressure reading, only 1.4% went on to develop childhood hypertension, defined as three consecutive high blood pressure readings on three separate days.

“Diagnosing hypertension during childhood is difficult because normal blood pressure for children changes as they age,” Matthew F. Daley, MD, of the Institute for Health Research at Kaiser Permanente Colorado, said in a news release. “It’s fairly common for children to have a single elevated blood pressure reading, but when their doctors repeat the test, it appears that most children won’t actually have hypertension.

“This tells us that parents should have their children’s blood pressure checked and, if it’s high, rechecked at the same visit.”

The researchers also found that factors such as obesity or stage 2 hypertension did not significantly affect whether children received follow-up blood pressure checks within a month of a first elevated blood pressure.

Children’s blood pressure can be quite variable, and excitement and nervousness at the doctor’s office can result in elevated blood pressure readings for children, according to the authors, so children and adolescents are diagnosed as hypertensive only after three consecutive readings that are at or above the 95th percentile for their age, sex and height.

Screening for hypertension in children and adolescents who do not exhibit symptoms occurs during routine clinical care, but little is known about patterns of care after a first elevated blood pressure. Guidelines from the National Heart, Lung and Blood Institute recommend repeating the blood pressure one to two weeks after the first elevated blood pressure.

Study abstract: http://pediatrics.aappublications.org/content/132/2/e349.abstract.

By | 2013-08-02T00:00:00-04:00 August 2nd, 2013|Categories: National|0 Comments

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