Development of a simple tool for diagnosis and initial approach to hypertension and pre-hypertension in children and youth

Abstract

Background: Hypertension and pre-hypertension in children and adolescents are frequently missed despite current screening recommendations and the potential benefit for early diagnosis and intervention. Difficulty in interpretation of office blood pressure readings in children has been partially blamed for the significant under-diagnosis of childhood hypertension. The objective of our group was to develop and evaluate a simple tool designed to assist primary health care physicians to interpret office blood pressure readings in children and adolescents. Methods: A multi-disciplinary advisory group in our institution undertook the development of a diagnostic tool based on currently accepted gold standard parameters. Input from Family Physicians and Pediatricians was used in the design process. The tool was then distributed among Family Physicians in our catchment area and evaluated with a post-distribution survey. Results: A laminated one page summary of pediatric blood pressure parameters and initial approach to pediatric hypertension was created and distributed. Feedback from primary care physicians was mostly positive and supportive of this initiative. Conclusions: Innovating and simplifying the screening process for hypertension and pre-hypertension in childhood may promote early detection and intervention however the effect of such initiatives on the rate of diagnosis of pediatric hypertension will need to be tested prospectively by appropriately designed studies.