Related Experiment Video
Updated: May 20, 2026

Testing Acetylcholine Followed by Adenosine for Invasive Diagnosis of Coronary Vasomotor Disorders
Published on: February 3, 2021
Use of diagnostic tests in adolescents with essential hypertension
Esther Y Yoon1, Lisa Cohn, Albert Rocchini
1Division of General Pediatrics, Child Health Evaluation and Research Unit, University of Michigan, Ann Harbor, USA.
Objective:
To describe the use of diagnostic tests in adolescents with essential hypertension.
Design:
Longitudinal analysis of administrative claims data.
Setting:
Michigan Medicaid program during 2003 to 2008.
Participants:
Adolescents with 3 or more years of Medicaid eligibility (≥ 11 months/y) who had a diagnosis of essential hypertension and 1 or more antihypertensive medication pharmacy claims.
Main Outcome Measures:
We examined adolescents' echocardiogram use and compared it with electrocardiogram (EKG) and renal ultrasonography use. We examined timing of the 3 diagnostic tests in relation to the first pharmacy claim. We examined patient demographics and presence of obesity-related comorbidities.
Results:
During 2003 to 2008, there were 951 adolescents with essential hypertension who had antihypertensive pharmacy claims; 24% (226) had echocardiograms; 22% (207) had renal ultrasonography; and 50% (478) had EKGs. Males (odds ratio [OR], 1.53; 95% CI, 1.06-2.21), younger adolescents (OR, 1.69; 95% CI, 1.17-2.44), those who had EKGs (OR, 5.79; 95% CI, 4.02-8.36), and those who had renal ultrasonography (OR, 2.22; 95% CI, 1.54-3.20) were more likely to obtain echocardiograms compared with females, older adolescents, and adolescents who did not have EKGs or renal ultrasonography.
Conclusions:
Guideline-recommended diagnostic tests-echocardiograms and renal ultrasonography-were equally poorly used by adolescents with essential hypertension. Sex and age differences exist in the use of echocardiograms by adolescents with essential hypertension. The decision and choice of diagnostic tests to evaluate adolescents with essential hypertension warrant further study to understand the underlying rationale for those decisions and to determine treatment effectiveness.
Related Concept Videos
Hypertension III: Clinical Manifestations and Diagnostic Studies
Hypertension I: Introduction
Dysrhythmias V: Evaluating Dysrhythmias
Hypertension V: Nursing Management
Special considerations while measuring blood pressure
Monitoring Both Arms:
Monitoring BP in both arms during the initial assessment is advisable, as the systolic value may differ by five to ten mm Hg between arms. For subsequent BP assessments, use the arm with the higher reading.
Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies