Abstract P222: Prevalence of Hypotension in Adolescents

Abstract

Background: Hypotension is a widely used but poorly defined clinical entity. Currently accepted definitions of hypotension are the Pediatric Advanced Life Support (PALS) definition, the Brain Trauma Foundation definition, and the International Pediatric Sepsis Consensus Conference. However, its prevalence has not been defined. Objective: To determine the prevalence of hypotension in school aged children. Study Design: This study is a retrospective analysis of data from a series of cross-sectional school-based blood pressure screenings completed by the Houston Pediatric and Adolescent Hypertension Program (HPAHP) at the UTHealth at Houston. Screenings were performed in 21 urban and suburban middle and high schools in the Houston area from 2001 to 2012. We restricted the data set to include subjects with three systolic blood pressure (SBP) measurements performed using a Spacelabs 90217 oscillometric monitor, who did not report taking hypertensive medication, and were not missing demographic information. We defined hypotension based on 2 criteria: average 1 st -3 rd SBP less than the 5 th percentile for height, age and gender. Within these definitions we also restricted the hypotension definition to subjects with average SBP below 90mm Hg. Stata 13 SE was used for all data analysis. Results: Of the total 22, 382 children enrolled, 15,114 children met inclusion criteria: 52% females, mean age 13.6 years (range 10.1-19.9). Racial distribution reflected that of Houston: 35% White, 32% Hispanic, 23% Black, 8% Asian, and 2% other/unknown. Seventy one (0.5%) children had an average SBP reading less than the 5 th percentile and 112 (0.7%) had an average SBP less than the 5 th percentile or 90 mm Hg. Compared to students without hypotension, students with hypotension defined by only the 5 th percentile were older (14.3 vs 13.6 years, t-test p=0.0001); they also tended to be more female, though not significantly (61% vs 39%, Chi 2 p-value=0.134). Conclusion: Although not as prevalent as hypertension in this age group (generally 2-5%), hypotension is a clinically significant entity that is seen in 0.5-0.7% of the general school-aged population.