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

Abbas H Zaidi1,2, Erica Sood1,2,3, Sarah De Ferranti4,5

  • 1Nemours Children's Health Cardiac Center, Wilmington, Delaware, USA.

Journal of Clinical Hypertension (Greenwich, Conn.)
|September 24, 2025
PubMed

Insights

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.

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.

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

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