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Elevated Blood Pressure in Hospitalized Children Predicts True Elevated Blood Pressure Outpatient
Hadassa E Leader1,2,3, Twiza Mambwe4
1K Hovnanian Children's Hospital, Hackensack Meridian Health Network, Neptune City, New Jersey.
Insights
Elevated blood pressure in hospitalized children accurately predicts elevated blood pressure in outpatient settings. This finding supports using inpatient measurements to identify children needing further monitoring for hypertension.
Area of Science:
- Pediatrics
- Cardiology
- Clinical Research
Background:
- Elevated blood pressure (EBP) in children is a growing concern.
- Accurate identification of children with EBP is crucial for timely intervention.
- The utility of inpatient EBP measurements in predicting outpatient EBP is not well-established.
Purpose of the Study:
- To evaluate the predictive accuracy of elevated blood pressure (EBP) identified during hospitalization for subsequent outpatient EBP.
- To determine if American Academy of Pediatrics (AAP) 2017 guidelines for EBP in hospitalized children can predict sustained outpatient hypertension.
Main Methods:
- A multicenter retrospective chart review of 5367 hospitalized children was performed.
- Inpatient mean blood pressures were classified as elevated using AAP 2017 parameters.
- Inpatient EBP was compared with mean blood pressures measured thrice postdischarge.
Main Results:
- 12.2% of hospitalized children (656/5367) had EBP.
- Inpatient EBP demonstrated high predictive accuracy for outpatient EBP.
- Positive predictive value was 96% and negative predictive value was 98%.
Conclusions:
- Hospital-diagnosed elevated blood pressure in children, based on AAP 2017 guidelines, is a strong predictor of persistent outpatient hypertension.
- These findings support the use of inpatient EBP screening to identify children requiring further outpatient blood pressure monitoring.
Objectives:
To determine if elevated blood pressure (EBP) in hospitalized children accurately predicts EBP outpatient.
Methods:
A multicenter retrospective chart review was conducted at a large hospital system in Northeastern United States. Mean blood pressures during hospitalizations were classified as elevated or not elevated, by using the American Academy of Pediatrics (AAP) 2017 parameters. Mean blood pressure was then compared with each patient's mean blood pressure measured 3 times postdischarge. The data were analyzed to determine if inpatient EBP is an accurate predictor of outpatient EBP.
Results:
Of 5367 hospitalized children, 656 (12.2%) had EBP inpatient. Inpatient EBP was highly predictive of outpatient EBP, with a positive predictive value of 96% and negative predictive value of 98%.
Conclusions:
Diagnosing hospitalized children with EBP, as defined by the AAP 2017 guidelines, accurately predicts true EBP outpatient.
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