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Persistent Hypertension in Children and Adolescents: A 6-Year Cohort Study

David C Kaelber1,2,3, A Russell Localio4,5, Michelle Ross4,5

  • 1Comparative Effectiveness Research through Collaborative Electronic Reporting Consortium Research Team, Elk Grove Village, Illinois; david.kaelber@case.edu.

Pediatrics
|September 19, 2020
PubMed

Insights

Most children diagnosed with pediatric hypertension or elevated blood pressure in primary care settings did not maintain abnormal readings or receive recommended follow-up. This highlights a need for improved blood pressure assessment and monitoring systems.

Area of Science:

  • Pediatric Health
  • Cardiovascular Health
  • Public Health

Background:

  • Pediatric hypertension is a growing concern in primary care.
  • Understanding the natural history of elevated blood pressure in children is crucial for effective management.
  • Current diagnostic and follow-up protocols may require refinement.

Purpose of the Study:

  • To determine the natural history of pediatric hypertension.
  • To analyze blood pressure trends in children over a 72-month period.
  • To identify patterns in the progression and resolution of elevated blood pressure in pediatric populations.

Main Methods:

  • Retrospective cohort study involving 165 primary care sites.
  • Analysis of blood pressure measurements from 43,825 pediatric patients (ages 3-18) over two consecutive 36-month periods.
  • Comparison of blood pressure levels at baseline and follow-up to assess hypertension and elevated blood pressure criteria.

Main Results:

  • Of 43,825 children, 4.3% initially met hypertension criteria and 4.9% met elevated blood pressure criteria.
  • In the second 36-month period, 50% of initially hypertensive children had normal blood pressure, and 22% had less severe abnormalities.
  • Among those with elevated blood pressure initially, 70% normalized, while 13% developed hypertension in the second period.

Conclusions:

  • Most children initially diagnosed with pediatric hypertension or elevated blood pressure showed normal readings later or lacked adequate follow-up.
  • Findings underscore the need for more precise initial blood pressure assessments in children.
  • Improved systems are required to ensure consistent follow-up for abnormal pediatric blood pressure readings.
Abstract

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