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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...
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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,...
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Parent Needs, Recommendations, and Systemic Challenges Affecting Pediatric Hypertension Detection.

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Summary

Parents and clinicians identified barriers to diagnosing and treating pediatric hypertension (HTN). Parent-recommended strategies, like telehealth and better education, can improve detection but need to align with health system constraints.

Keywords:
gaps in hypertension detectionparent barrierspediatric hypertensionremote blood pressure monitoringsocial determinants of health

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Area of Science:

  • Pediatric Health
  • Implementation Science
  • Public Health

Background:

  • Pediatric hypertension (HTN) affects 3%-5% of US children, with low diagnosis and follow-up rates.
  • Parental and clinical skepticism towards elevated blood pressure (BP) readings and antihypertensive medications necessitates stakeholder-informed strategies.
  • Significant gaps exist in pediatric HTN care, particularly for diagnosed children with prolonged follow-up care interruptions.

Purpose of the Study:

  • To examine parents' perceived needs and recommended strategies for improving pediatric HTN detection.
  • To identify contextual health system challenges impacting pediatric HTN care.
  • To develop stakeholder-informed strategies for enhancing pediatric HTN detection and management.

Main Methods:

  • Qualitative study involving semi-structured interviews with 13 parents and 25 healthcare clinicians from 10 diverse pediatric primary care clinics.
  • Participants included parents of children with stage 2 BP readings and HTN diagnosis, experiencing care gaps of ≥1 year.
  • Thematic analysis guided by the Consolidated Framework for Implementation Research (CFIR) was used to identify key themes and recommendations.

Main Results:

  • Parents reported limited clinical discussions on pediatric HTN, logistical barriers (social determinants of health, finances, insurance), and scheduling conflicts.
  • Clinicians cited systemic constraints: time limits, staffing shortages, and inadequate resources for social determinants of health needs.
  • Parents recommended enhanced education, flexible scheduling, telehealth, remote BP monitoring, and improved care coordination.

Conclusions:

  • Parent-recommended strategies offer potential solutions to pediatric HTN detection challenges.
  • Addressing logistical and systemic barriers is crucial for effective pediatric HTN management.
  • Aligning parent-informed strategies with health system realities is essential for improving pediatric HTN detection and care.