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Pediatrics. 2013 Aug;132(2):e349-55. doi: 10.1542/peds.2012-2437. Epub 2013 Jul 1.

Patterns of care and persistence after incident elevated blood pressure.

Author information

  • 1Institute for Health Research, Kaiser Permanente Colorado, Denver, Colorado 80231, USA. matthew.f.daley@kp.org

Abstract

BACKGROUND AND OBJECTIVE:

Screening for hypertension in children occurs during routine care. When blood pressure (BP) is elevated in the hypertensive range, a repeat measurement within 1 to 2 weeks is recommended. The objective was to assess patterns of care after an incident elevated BP, including timing of repeat BP measurement and likelihood of persistently elevated BP.

METHODS:

This retrospective study was conducted in 3 health care organizations. All children aged 3 through 17 years with an incident elevated BP at an outpatient visit during 2007 through 2010 were identified. Within this group, we assessed the proportion who had a repeat BP measured within 1 month of their incident elevated BP and the proportion who subsequently met the definition of hypertension. Multivariate analyses were used to identify factors associated with follow-up BP within 1 month of initial elevated BP.

RESULTS:

Among 72,625 children and adolescents in the population, 6108 (8.4%) had an incident elevated BP during the study period. Among 6108 with an incident elevated BP, 20.9% had a repeat BP measured within 1 month. In multivariate analyses, having a follow-up BP within 1 month was not significantly more likely among individuals with obesity or stage 2 systolic elevation. Among 6108 individuals with an incident elevated BP, 84 (1.4%) had a second and third consecutive elevated BP within 12 months.

CONCLUSIONS:

Whereas >8% of children and adolescents had an incident elevated BP, the great majority of BPs were not repeated within 1 month. However, relatively few individuals subsequently met the definition of hypertension.

KEYWORDS:

adolescent; blood pressure; child; electronic health records; hypertension; screening

PMID:
23821694
[PubMed - indexed for MEDLINE]
PMCID:
PMC3727670
Free PMC Article
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