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Under‐recognition of pediatric hypertension diagnosis: Examination of 1 year of visits to community health centers
Pediatric hypertension is associated with significant target organ damage in children and cardiovascular morbidity in adulthood. Appropriate diagnosis and management per guideline recommendations are inconsistent. In this study, we determined the proportion of missed diagnosis of hypertension and pr...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8030016/ https://www.ncbi.nlm.nih.gov/pubmed/33373088 http://dx.doi.org/10.1111/jch.14148 |
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author | Moin, Anoosh Mohanty, Nivedita Tedla, Yacob G. Carroll, Allison J. Padilla, Roxane Langman, Craig B. Smith, Justin D. |
author_facet | Moin, Anoosh Mohanty, Nivedita Tedla, Yacob G. Carroll, Allison J. Padilla, Roxane Langman, Craig B. Smith, Justin D. |
author_sort | Moin, Anoosh |
collection | PubMed |
description | Pediatric hypertension is associated with significant target organ damage in children and cardiovascular morbidity in adulthood. Appropriate diagnosis and management per guideline recommendations are inconsistent. In this study, we determined the proportion of missed diagnosis of hypertension and prehypertension and appropriate follow‐up in pediatric patients, stratified by sex, age, race/ethnicity, and weight status. Based on the electronic health record (EHR) data from eight federally qualified health centers, among 62,982 children aged 3 to 18 years, 6233 (10%) had at least one abnormal blood pressure (BP) measurement over twelve months. Among those children whose recorded BPs met the criteria for prehypertension (N = 6178), 14.6% had a diagnosis in the EHR. These children were more likely to be White and have obesity compared with children who met the criteria but were not diagnosed with prehypertension. Among those who met the criteria for hypertension (N = 55), 41.8% had a diagnosis of hypertension in the EHR. Being diagnosed with hypertension was not associated with any examined patient characteristics. Over eleven months, 2837 children had BP ≥ 95th percentile on ≥ 1 visit. Only 13% had guideline‐adherent follow‐up within 1 month and were more likely to be older, female, and of Hispanic ethnicity or “other” race. Over six months, 2902 children had BP ≥ 90th percentile on one visit. 41% had guideline‐adherent follow‐up within 6 months and were more likely to be older, of either White, Hispanic, Asian race, or Hispanic ethnicity. In a community‐based setting, pediatric hypertension and prehypertension were persistently underdiagnosed with low adherence to recommended follow‐up. |
format | Online Article Text |
id | pubmed-8030016 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-80300162021-12-16 Under‐recognition of pediatric hypertension diagnosis: Examination of 1 year of visits to community health centers Moin, Anoosh Mohanty, Nivedita Tedla, Yacob G. Carroll, Allison J. Padilla, Roxane Langman, Craig B. Smith, Justin D. J Clin Hypertens (Greenwich) Children and Adolescents Pediatric hypertension is associated with significant target organ damage in children and cardiovascular morbidity in adulthood. Appropriate diagnosis and management per guideline recommendations are inconsistent. In this study, we determined the proportion of missed diagnosis of hypertension and prehypertension and appropriate follow‐up in pediatric patients, stratified by sex, age, race/ethnicity, and weight status. Based on the electronic health record (EHR) data from eight federally qualified health centers, among 62,982 children aged 3 to 18 years, 6233 (10%) had at least one abnormal blood pressure (BP) measurement over twelve months. Among those children whose recorded BPs met the criteria for prehypertension (N = 6178), 14.6% had a diagnosis in the EHR. These children were more likely to be White and have obesity compared with children who met the criteria but were not diagnosed with prehypertension. Among those who met the criteria for hypertension (N = 55), 41.8% had a diagnosis of hypertension in the EHR. Being diagnosed with hypertension was not associated with any examined patient characteristics. Over eleven months, 2837 children had BP ≥ 95th percentile on ≥ 1 visit. Only 13% had guideline‐adherent follow‐up within 1 month and were more likely to be older, female, and of Hispanic ethnicity or “other” race. Over six months, 2902 children had BP ≥ 90th percentile on one visit. 41% had guideline‐adherent follow‐up within 6 months and were more likely to be older, of either White, Hispanic, Asian race, or Hispanic ethnicity. In a community‐based setting, pediatric hypertension and prehypertension were persistently underdiagnosed with low adherence to recommended follow‐up. John Wiley and Sons Inc. 2020-12-29 /pmc/articles/PMC8030016/ /pubmed/33373088 http://dx.doi.org/10.1111/jch.14148 Text en © 2020 The Authors. The Journal of Clinical Hypertension published by Wiley Periodicals LLC https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made. |
spellingShingle | Children and Adolescents Moin, Anoosh Mohanty, Nivedita Tedla, Yacob G. Carroll, Allison J. Padilla, Roxane Langman, Craig B. Smith, Justin D. Under‐recognition of pediatric hypertension diagnosis: Examination of 1 year of visits to community health centers |
title | Under‐recognition of pediatric hypertension diagnosis: Examination of 1 year of visits to community health centers |
title_full | Under‐recognition of pediatric hypertension diagnosis: Examination of 1 year of visits to community health centers |
title_fullStr | Under‐recognition of pediatric hypertension diagnosis: Examination of 1 year of visits to community health centers |
title_full_unstemmed | Under‐recognition of pediatric hypertension diagnosis: Examination of 1 year of visits to community health centers |
title_short | Under‐recognition of pediatric hypertension diagnosis: Examination of 1 year of visits to community health centers |
title_sort | under‐recognition of pediatric hypertension diagnosis: examination of 1 year of visits to community health centers |
topic | Children and Adolescents |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8030016/ https://www.ncbi.nlm.nih.gov/pubmed/33373088 http://dx.doi.org/10.1111/jch.14148 |
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