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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
PubMed

Insights

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.
Abstract

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