Related Experiment Videos
Prehypertension and hypertension in community-based pediatric practice
Joan C Lo1, Alan Sinaiko, Malini Chandra
1Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA 94612, USA. joan.c.lo@kp.org
Pediatrics
|January 30, 2013
Summary
This study found lower rates of childhood hypertension in community settings than previously reported. Findings indicate that pediatric hypertension prevalence may be lower than school-based studies suggest.
Area of Science:
- Pediatric Cardiology
- Public Health
- Epidemiology
Background:
- Childhood hypertension is a growing concern with long-term cardiovascular implications.
- Existing data on pediatric hypertension prevalence often comes from school-based screenings, potentially overestimating rates.
- Well-child care visits offer an opportunity to assess blood pressure in a community-based setting.
Purpose of the Study:
- To determine the prevalence of prehypertension and hypertension in children during routine well-child care.
- To compare community-based prevalence rates with previously reported school-based findings.
Main Methods:
- Retrospective cohort study of 199,513 children aged 3-17 years across 3 integrated health systems.
- Blood pressure (BP) classification followed the Fourth Report guidelines: prehypertension (90th-94th percentile), hypertension (≥95th percentile).
- Hypertension was confirmed with at least 3 elevated BP measurements.
Main Results:
- At the initial visit, 12.7% of children had prehypertension and 5.4% had elevated BP.
- Confirmed hypertension was found in an estimated 0.3% of the cohort.
- Increased age and body mass index (BMI) were significantly associated with higher BP, with Black and Asian children showing the highest hypertension prevalence.
Conclusions:
- The prevalence of hypertension identified in this large, diverse community-based cohort is lower than previously reported.
- These findings suggest that childhood hypertension rates may be lower than estimates derived from school-based studies.
- Routine well-child visits are valuable for monitoring pediatric blood pressure trends in community settings.
Related Concept Videos
01:28Hypertension I: Introduction
Hypertension is a widespread, long-term medical condition where blood pressure in the arteries remains elevated. It is characterized by systolic blood pressure readings of 130 mm Hg or above or diastolic blood pressure (DBP) readings of 80 mm Hg or higher. Unmanaged hypertension poses significant health risks, making the distinction between primary (or essential) hypertension and secondary hypertension crucial, as their management and implications vary.Primary HypertensionPrimary hypertension,...
01:30Hypertension III: Clinical Manifestations and Diagnostic Studies
Hypertension is asymptomatic and also referred to as the "silent killer" until it progresses to a severe stage or causes target organ disease. Patients may experience symptoms stemming from the strain on blood vessels and tissues in various organs or the heart's increased workload.Physical exams might show no abnormalities other than high blood pressure. Signs of vascular damage, when present, correspond to the organs supplied by the affected vessels, leading to target organ damage. For...
01:18Hypertension and Regulation of Blood Pressure
Hypertension, the most common cardiovascular disease, is diagnosed through repeated measurements of elevated blood pressure. Its risks, including damage to the kidney, heart, and brain, are directly proportional to blood pressure levels. Starting from 115/75 mm Hg, the risk of cardiovascular disease doubles with each increment of 20/10 mm Hg. The diagnosis relies on blood pressure measurements, not on patient symptoms, as hypertension is often asymptomatic until end-organ damage is imminent or...
01:23Hypertension V: Nursing Management
The nursing management of hypertension involves accurately assessing symptoms, making a comprehensive nursing diagnosis, collaborating with patients to set goals, and implementing targeted interventions to mitigate the condition's impact and improve patient well-being.Comprehensive AssessmentThe initial step in nursing care for hypertension involves a thorough patient assessment. It includes evaluating symptoms such as headaches, dizziness, blurred vision, and previous hypertension episodes.
01:29Hypertension II: Pathophysiology
Hypertension is a chronic condition in which the blood's force against artery walls is excessively high, posing risks such as heart disease. The condition's underlying mechanisms involve complex interactions among the cardiovascular, kidney, and autonomic nervous systems.Renin-Angiotensin-Aldosterone System (RAAS): This system significantly influences blood pressure regulation. When blood pressure decreases, the kidneys secrete renin. This enzyme transforms angiotensinogen, a plasma protein,...
01:30Alterations in Blood Pressure
Alterations in blood pressure, such as hypertension (high blood pressure) and hypotension (low blood pressure), significantly affect human health. Understanding these conditions' classifications, causes, and symptoms is essential for effective management and treatment.
Hypertension (High blood pressure)
Hypertension occurs when blood pressure readings consistently exceed the normal range. It is diagnosed when systolic blood pressure (the top number, indicating pressure while the heart beats)...
Hypertension (High blood pressure)
Hypertension occurs when blood pressure readings consistently exceed the normal range. It is diagnosed when systolic blood pressure (the top number, indicating pressure while the heart beats)...