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J Pediatr. 2015 Jul;167(1):92-7.e1. doi: 10.1016/j.jpeds.2015.04.016. Epub 2015 May 7.

Hypertension Prevalence, Cardiac Complications, and Antihypertensive Medication Use in Children.

Author information

1
Department of Pediatrics, Tripler Army Medical Center, Honolulu, HI; Department of Pediatrics, Uniformed Services University of the Health Sciences, Bethesda, MD. Electronic address: Craig.p.dobson.mil@mail.mil.
2
Department of Pediatrics, Uniformed Services University of the Health Sciences, Bethesda, MD.

Abstract

OBJECTIVE:

To determine the prevalence of hypertension diagnosis in children of US military members and quantify echocardiography evaluations, cardiac complications, and antihypertensive prescriptions in the post-2004 guideline era.

STUDY DESIGN:

Using billing data from military health insurance (TRICARE) enrollees, hypertension cases were defined as 2 or more visits with a primary or unspecified hypertension diagnosis during any calendar year or 1 such visit if with a cardiologist or nephrologist.

RESULTS:

During 2006-2011, the database contained an average 1.3 million subjects aged 2-18 years per year. A total of 16 322 met the definition of hypertension (2.6/1000). The incidence of hypertension increased by 17% between 2006 and 2011 (from 2.3/1000 to 2.7/1000; P < .001). Hypertension was more common in adolescents aged 12-18 years than in younger children (5.4/1000 vs 0.9/1000). Among patients with hypertension, 5585 (34%) underwent echocardiography. The frequency of annual echocardiograms increased from 22.7% to 27.7% (P < .001). In patients with echocardiography, 8.0% had left ventricular hypertrophy or dysfunction. Among the patients with hypertension, 6353 (38.9%) received an antihypertensive medication.

CONCLUSION:

The prevalence of hypertension in children has increased. Compliance with national guidelines is poor. Of pediatric patients with hypertension who receive an echocardiogram, 1 in 12 had identified cardiac complications, supporting the current recommendations for echocardiography in children with hypertension. Less than one-half of children with hypertension are treated with medication.

PMID:
25957976
DOI:
10.1016/j.jpeds.2015.04.016
[Indexed for MEDLINE]

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