14 Retrospective Screening for Hypertension/Pre-Hypertension in a Pediatric Sub-Specialty Clinic.

Abstract

The 2004 NHBPEP report provided updated normative data for systolic and diastolic blood pressure (SBP/DBP) in children. These data now define pre-hypertension (Pre-HTN) as well as HTN for gender, age, & height. Pediatric Endocrinologists see many diagnoses that may impact BP. Purpose: To retrospectively review and screen BP measurements, using 2004 NHBPEP data, for patients (pts) attending an out-pt, University-based, Pediatric Endocrinology Clinic. Methods: Chart review of visits (7/1/04–12/31/04) by the MD or NP for pts between 1–20 years of age. BP typically was obtained from the right arm manually or using a Critikon Dinamap™ 8100T monitor. Recorded gender/age/height/weight values subsequently were entered onto a PDA with the Stat Growth-BP™ program where pts' BPs then were noted as NL, Pre-HTN, or HTN. Pre-HTN = SBP +/or DBP between 90–95%; HTN = SBP +/or DBP ≤95%. Results: (Table 1). *30 pts had NL BP on another visit; 17 pts were diagnosed previously with HTN; 5 pts were noted as agitated or upset during BP measurement. Summary: Initial review of retrospectively collected data found 164 [(181–17) of 642; 25.5%] previously undiagnosed pts who screened positive for HTN onG 1 occasion; 80 of 642 pts (12.5%) fulfilled new criteria for Pre-HTN. Discussion: The origins of adult cardiovascular disease often lay in childhood; pts frequently seen in an Endocrinology clinic (e.g. For diabetes mellitus, obesity, dysmetabolic syndrome, sexual precocity, adrenal & thyroid disorders) may be especially at risk. By definition, HTN is confirmed withG 3 elevated SBP +/or DBP readings. Conclusions/Speculations: In a single University-based Pediatric Endocrine clinic, many patients with borderline or elevated BP are under-appreciated. A general pediatric clinic may be much busier. Clinicians must employ an efficient method to correctly identify HTN & Pre-HTN in children, relative to gender, age, and height.