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Subdiagnóstico de la hipertensión en niños y adolescentes
Matthew L Hansen1, Paul W Gunn, David C Kaelber
1School of Medicine, Case Western Reserve University, Cleveland, Ohio, USA.
JAMA
|August 23, 2007
Resumen
La hipertensión pediátrica y la prehipertensión a menudo no se diagnostican. Factores como la edad, la estatura, la obesidad y lecturas frecuentes de presión arterial alta aumentan la probabilidad de diagnóstico en los niños.
Área de la Ciencia:
- Cardiología Pediátrica Cardiología pediátrica.
- Salud Pública La salud pública.
- Pediatría clínica y pediatría clínica.
Sus antecedentes:
- La prevalencia de la hipertensión pediátrica está aumentando, vinculada a la epidemia de obesidad.
- El diagnóstico de la hipertensión pediátrica es un desafío debido a la edad, el sexo y las normas de presión arterial dependientes de la altura.
Objetivo del estudio:
- Para determinar la frecuencia de la hipertensión no diagnosticada y la prehipertensión en niños.
- Identificar los factores del paciente asociados con el subdiagnóstico de estas afecciones.
Principales métodos:
- Se realizó un estudio de cohorte de 14.187 niños y adolescentes (de 3 a 18 años).
- Se analizaron los registros médicos electrónicos para los diagnósticos documentados de hipertensión o prehipertensión.
- La regresión logística multivariada identificó factores asociados con el diagnóstico correcto.
Principales resultados:
- El 3,6% de los niños tenían hipertensión, pero sólo el 26% fueron diagnosticados.
- El 11% de los niños con prehipertensión (3,4% de la cohorte) tenía un diagnóstico apropiado.
- Los factores que aumentan las probabilidades de diagnóstico incluyen la edad avanzada, la obesidad y las lecturas de presión arterial elevada más frecuentes / graves.
Conclusiones:
- La hipertensión y la prehipertensión con frecuencia no se diagnostican en las poblaciones pediátricas.
- La edad del paciente, la altura, la obesidad y la gravedad / frecuencia de la lectura de la presión arterial son factores clave que influyen en el diagnóstico.
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