Persistent Hypertension in Children and Adolescents: A 6-Year Cohort Study
To determine the natural history of pediatric hypertension. We conducted a 72-month retrospective cohort study among 165 primary care sites. Blood pressure measurements from two consecutive 36 month periods were compared. Among 398 079 primary care pediatric patients ages 3 to 18, 89 347 had ≥3 bloo...
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| Veröffentlicht in: | Pediatrics (Evanston) 2020-10, Vol.146 (4) |
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| creator | Kaelber, David C Localio, A Russell Ross, Michelle Leon, Janeen B Pace, Wilson D Wasserman, Richard C Grundmeier, Robert W Steffes, Jennifer Fiks, Alexander G |
| description | To determine the natural history of pediatric hypertension.
We conducted a 72-month retrospective cohort study among 165 primary care sites. Blood pressure measurements from two consecutive 36 month periods were compared.
Among 398 079 primary care pediatric patients ages 3 to 18, 89 347 had ≥3 blood pressure levels recorded during a 36-month period, and 43 825 children had ≥3 blood pressure levels for 2 consecutive 36-month periods. Among these 43 825 children, 4.3% (1881) met criteria for hypertension (3.5% [1515] stage 1, 0.8% [366] stage 2) and 4.9% (2144) met criteria for elevated blood pressure in the first 36 months. During the second 36 months, 50% (933) of hypertensive patients had no abnormal blood pressure levels, 22% (406) had elevated blood pressure levels or |
| doi_str_mv | 10.1542/peds.2019-3778 |
| format | Article |
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We conducted a 72-month retrospective cohort study among 165 primary care sites. Blood pressure measurements from two consecutive 36 month periods were compared.
Among 398 079 primary care pediatric patients ages 3 to 18, 89 347 had ≥3 blood pressure levels recorded during a 36-month period, and 43 825 children had ≥3 blood pressure levels for 2 consecutive 36-month periods. Among these 43 825 children, 4.3% (1881) met criteria for hypertension (3.5% [1515] stage 1, 0.8% [366] stage 2) and 4.9% (2144) met criteria for elevated blood pressure in the first 36 months. During the second 36 months, 50% (933) of hypertensive patients had no abnormal blood pressure levels, 22% (406) had elevated blood pressure levels or <3 hypertensive blood pressure levels, and 29% (542) had ≥3 hypertensive blood pressure levels. Of 2144 patients with elevated blood pressure in the first 36 months, 70% (1492) had no abnormal blood pressure levels, 18% (378) had persistent elevated blood pressure levels, and 13% (274) developed hypertension in the second 36-months. Among the 7775 patients with abnormal blood pressure levels in the first 36-months, only 52% (4025) had ≥3 blood pressure levels recorded during the second 36-months.
In a primary care cohort, most children initially meeting criteria for hypertension or elevated blood pressure had subsequent normal blood pressure levels or did not receive recommended follow-up measurements. These results highlight the need for more nuanced initial blood pressure assessment and systems to promote follow-up of abnormal results.</description><identifier>ISSN: 0031-4005</identifier><identifier>EISSN: 1098-4275</identifier><identifier>DOI: 10.1542/peds.2019-3778</identifier><identifier>PMID: 32948657</identifier><language>eng</language><publisher>United States: American Academy of Pediatrics</publisher><subject>Adolescent ; Age Factors ; Blood pressure ; Blood Pressure Determination - statistics & numerical data ; Body Height ; Child ; Child, Preschool ; Children ; Cohort analysis ; Confidence Intervals ; Female ; Humans ; Hypertension ; Hypertension - diagnosis ; Hypertension - epidemiology ; Male ; Pediatrics ; Primary care ; Reference Values ; Regression Analysis ; Retrospective Studies ; Sex Factors ; Teenagers ; Time Factors</subject><ispartof>Pediatrics (Evanston), 2020-10, Vol.146 (4)</ispartof><rights>Copyright © 2020 by the American Academy of Pediatrics.</rights><rights>Copyright American Academy of Pediatrics Oct 1, 2020</rights><rights>Copyright © 2020 by the American Academy of Pediatrics 2020</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c418t-272b362dcdfd7576817d0a9d720304df23669834ddb210dcb47631cf36e765203</citedby><cites>FETCH-LOGICAL-c418t-272b362dcdfd7576817d0a9d720304df23669834ddb210dcb47631cf36e765203</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,776,780,881,27903,27904</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32948657$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kaelber, David C</creatorcontrib><creatorcontrib>Localio, A Russell</creatorcontrib><creatorcontrib>Ross, Michelle</creatorcontrib><creatorcontrib>Leon, Janeen B</creatorcontrib><creatorcontrib>Pace, Wilson D</creatorcontrib><creatorcontrib>Wasserman, Richard C</creatorcontrib><creatorcontrib>Grundmeier, Robert W</creatorcontrib><creatorcontrib>Steffes, Jennifer</creatorcontrib><creatorcontrib>Fiks, Alexander G</creatorcontrib><title>Persistent Hypertension in Children and Adolescents: A 6-Year Cohort Study</title><title>Pediatrics (Evanston)</title><addtitle>Pediatrics</addtitle><description>To determine the natural history of pediatric hypertension.
We conducted a 72-month retrospective cohort study among 165 primary care sites. Blood pressure measurements from two consecutive 36 month periods were compared.
Among 398 079 primary care pediatric patients ages 3 to 18, 89 347 had ≥3 blood pressure levels recorded during a 36-month period, and 43 825 children had ≥3 blood pressure levels for 2 consecutive 36-month periods. Among these 43 825 children, 4.3% (1881) met criteria for hypertension (3.5% [1515] stage 1, 0.8% [366] stage 2) and 4.9% (2144) met criteria for elevated blood pressure in the first 36 months. During the second 36 months, 50% (933) of hypertensive patients had no abnormal blood pressure levels, 22% (406) had elevated blood pressure levels or <3 hypertensive blood pressure levels, and 29% (542) had ≥3 hypertensive blood pressure levels. Of 2144 patients with elevated blood pressure in the first 36 months, 70% (1492) had no abnormal blood pressure levels, 18% (378) had persistent elevated blood pressure levels, and 13% (274) developed hypertension in the second 36-months. Among the 7775 patients with abnormal blood pressure levels in the first 36-months, only 52% (4025) had ≥3 blood pressure levels recorded during the second 36-months.
In a primary care cohort, most children initially meeting criteria for hypertension or elevated blood pressure had subsequent normal blood pressure levels or did not receive recommended follow-up measurements. These results highlight the need for more nuanced initial blood pressure assessment and systems to promote follow-up of abnormal results.</description><subject>Adolescent</subject><subject>Age Factors</subject><subject>Blood pressure</subject><subject>Blood Pressure Determination - statistics & numerical data</subject><subject>Body Height</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Children</subject><subject>Cohort analysis</subject><subject>Confidence Intervals</subject><subject>Female</subject><subject>Humans</subject><subject>Hypertension</subject><subject>Hypertension - diagnosis</subject><subject>Hypertension - epidemiology</subject><subject>Male</subject><subject>Pediatrics</subject><subject>Primary care</subject><subject>Reference Values</subject><subject>Regression Analysis</subject><subject>Retrospective Studies</subject><subject>Sex Factors</subject><subject>Teenagers</subject><subject>Time Factors</subject><issn>0031-4005</issn><issn>1098-4275</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkc1LwzAYh4Mobn5cPUrAi5fOfKf1IIyiThkoqAdPoW1S19E1NWmF_fembA71lECe_Hh_7wPAGUYTzBm5ao32E4JwElEp4z0wxiiJI0Yk3wdjhCiOGEJ8BI68XyKEGJfkEIwoSVgsuByDx2fjfOU703Rwtm6NCzdf2QZWDUwXVa2daWDWaDjVtja-CJy_hlMooneTOZjahXUdfOl6vT4BB2VWe3O6PY_B293tazqL5k_3D-l0HhUMx11EJMmpILrQpZZcihhLjbJES4IoYrokVIgkpkzrnGCki5xJQXFRUmGk4AE6Bjeb3LbPV0YPI7msVq2rVplbK5tV6u9LUy3Uh_1SYUEiJiwEXG4DnP3sje_UqgrN6jprjO29IowxKhMu4oBe_EOXtndNqBcojjmnEotATTZU4az3zpS7YTBSgyY1aFKDJjVoCh_Of1fY4T9e6De6cY16</recordid><startdate>202010</startdate><enddate>202010</enddate><creator>Kaelber, David C</creator><creator>Localio, A Russell</creator><creator>Ross, Michelle</creator><creator>Leon, Janeen B</creator><creator>Pace, Wilson D</creator><creator>Wasserman, Richard C</creator><creator>Grundmeier, Robert W</creator><creator>Steffes, Jennifer</creator><creator>Fiks, Alexander G</creator><general>American Academy of Pediatrics</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TS</scope><scope>7U9</scope><scope>H94</scope><scope>K9.</scope><scope>M7N</scope><scope>NAPCQ</scope><scope>U9A</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>202010</creationdate><title>Persistent Hypertension in Children and Adolescents: A 6-Year Cohort Study</title><author>Kaelber, David C ; Localio, A Russell ; Ross, Michelle ; Leon, Janeen B ; Pace, Wilson D ; Wasserman, Richard C ; Grundmeier, Robert W ; Steffes, Jennifer ; Fiks, Alexander G</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c418t-272b362dcdfd7576817d0a9d720304df23669834ddb210dcb47631cf36e765203</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Adolescent</topic><topic>Age Factors</topic><topic>Blood pressure</topic><topic>Blood Pressure Determination - statistics & numerical data</topic><topic>Body Height</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Children</topic><topic>Cohort analysis</topic><topic>Confidence Intervals</topic><topic>Female</topic><topic>Humans</topic><topic>Hypertension</topic><topic>Hypertension - diagnosis</topic><topic>Hypertension - epidemiology</topic><topic>Male</topic><topic>Pediatrics</topic><topic>Primary care</topic><topic>Reference Values</topic><topic>Regression Analysis</topic><topic>Retrospective Studies</topic><topic>Sex Factors</topic><topic>Teenagers</topic><topic>Time Factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kaelber, David C</creatorcontrib><creatorcontrib>Localio, A Russell</creatorcontrib><creatorcontrib>Ross, Michelle</creatorcontrib><creatorcontrib>Leon, Janeen B</creatorcontrib><creatorcontrib>Pace, Wilson D</creatorcontrib><creatorcontrib>Wasserman, Richard C</creatorcontrib><creatorcontrib>Grundmeier, Robert W</creatorcontrib><creatorcontrib>Steffes, Jennifer</creatorcontrib><creatorcontrib>Fiks, Alexander G</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Physical Education Index</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Pediatrics (Evanston)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kaelber, David C</au><au>Localio, A Russell</au><au>Ross, Michelle</au><au>Leon, Janeen B</au><au>Pace, Wilson D</au><au>Wasserman, Richard C</au><au>Grundmeier, Robert W</au><au>Steffes, Jennifer</au><au>Fiks, Alexander G</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Persistent Hypertension in Children and Adolescents: A 6-Year Cohort Study</atitle><jtitle>Pediatrics (Evanston)</jtitle><addtitle>Pediatrics</addtitle><date>2020-10</date><risdate>2020</risdate><volume>146</volume><issue>4</issue><issn>0031-4005</issn><eissn>1098-4275</eissn><abstract>To determine the natural history of pediatric hypertension.
We conducted a 72-month retrospective cohort study among 165 primary care sites. Blood pressure measurements from two consecutive 36 month periods were compared.
Among 398 079 primary care pediatric patients ages 3 to 18, 89 347 had ≥3 blood pressure levels recorded during a 36-month period, and 43 825 children had ≥3 blood pressure levels for 2 consecutive 36-month periods. Among these 43 825 children, 4.3% (1881) met criteria for hypertension (3.5% [1515] stage 1, 0.8% [366] stage 2) and 4.9% (2144) met criteria for elevated blood pressure in the first 36 months. During the second 36 months, 50% (933) of hypertensive patients had no abnormal blood pressure levels, 22% (406) had elevated blood pressure levels or <3 hypertensive blood pressure levels, and 29% (542) had ≥3 hypertensive blood pressure levels. Of 2144 patients with elevated blood pressure in the first 36 months, 70% (1492) had no abnormal blood pressure levels, 18% (378) had persistent elevated blood pressure levels, and 13% (274) developed hypertension in the second 36-months. Among the 7775 patients with abnormal blood pressure levels in the first 36-months, only 52% (4025) had ≥3 blood pressure levels recorded during the second 36-months.
In a primary care cohort, most children initially meeting criteria for hypertension or elevated blood pressure had subsequent normal blood pressure levels or did not receive recommended follow-up measurements. These results highlight the need for more nuanced initial blood pressure assessment and systems to promote follow-up of abnormal results.</abstract><cop>United States</cop><pub>American Academy of Pediatrics</pub><pmid>32948657</pmid><doi>10.1542/peds.2019-3778</doi><oa>free_for_read</oa></addata></record> |
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| subjects | Adolescent Age Factors Blood pressure Blood Pressure Determination - statistics & numerical data Body Height Child Child, Preschool Children Cohort analysis Confidence Intervals Female Humans Hypertension Hypertension - diagnosis Hypertension - epidemiology Male Pediatrics Primary care Reference Values Regression Analysis Retrospective Studies Sex Factors Teenagers Time Factors |
| title | Persistent Hypertension in Children and Adolescents: A 6-Year Cohort Study |
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