High blood pressure often missed in kids
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Most cases of high blood pressure in children and teenagers are not recognized or treated, investigators report in the Journal of the American Medical Association.
Dr. David C. Kaelber and associates reviewed medical records for patients 3 to 18 years of age treated in clinics affiliated with Case Western Reserve University in Cleveland, and identified 14,187 patients who had three or more well-child care visits between 1999 and 2006.
Overall, 507 patients (3.6 percent) had high blood pressure. However, only a quarter of these patients were diagnosed with high blood pressure, even though there was enough information to make the diagnosis the patients’ records, the researchers found.
Among 485 other patients classified as having blood pressure in the upper range of normal, the condition was documented in only 55 patients (11 percent), the investigators report.
Kaelber, at Harvard Medical School in Boston, and his associates attribute the underrecognition of high blood pressure in children to a “lack of knowledge of normal blood pressure ranges,” and “lack of awareness of a patient’s previous blood pressure readings.”
One remedy, Kaelber and his team suggest, is to build a program into the “electronic medical record that would automatically review current and prior blood pressures, ages, heights, and sex to determine if abnormal blood pressure criteria had been met,” which would then prompt the doctor to take a closer look at that patient.
If high blood pressure in children is not identified by their pediatricians, the investigators conclude, “it may be years before the abnormal blood pressure is detected,” by which time damage to vital organs has already occurred.
SOURCE: Journal of the American Medical Association, August 22/29, 2007.
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