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Hypertension in kids often goes
unnoticed
23 August, 2007:
Hypertension or high blood pressure
may be affecting the long-term health
of as many as 1.5 million children in
the United States.
A new study, to appear in the upcoming
issue of the Journal of the American
Medical Association, examined existing
medical records of over 14,000
children aged 3 to 18.
Researchers found that, while 507 of
these children and adolescents had
high blood pressure, such a diagnosis
had only been made in 131 of them,
which suggests that nearly 3 out of 4
cases of hypertension went
undiagnosed. This could have huge
implications if they are reflected in
the general population, the
researchers believe.
Dr David Kaelber, of the Boston
Children’s Hospital, and lead author
of the study, said only about 500,000
of these cases will be detected. This
means
that there are 1.5 million of these
children that neither they, nor their
parents, nor their clinicians know
they have high blood pressure. Doctors
not affiliated with the study said the
research underscores a significant
problem.
Dr Tom Edwards, a paediatric
cardiologist at the Cleveland Clinic,
remarked: “I think this article
emphasizes the importance of doing
blood pressure monitoring in children.
There seems to be a significant
difference between what we think the
incidence of hypertension is and its
correct incidence.”
According to Dr Goutham Rao, clinical
director of the Weight Management and
Wellness Center at the Children’s
Hospital, Pittsburgh, “the epidemic of
childhood obesity has made
hypertension much more common. Roughly
30% of overweight and obese children
are hypertensive. As more and more
children become obese, hypertension
will become an increasingly common
problem.”
Why are pediatricians missing so many
cases of high blood pressure? Even
though a blood pressure check is a
routine part of any pediatric
examination, the recent study shows
that the data obtained through these
checks is not always used in the best
way possible to determine whether or
not a child has high blood pressure.
This is partly because of the fact
that ‘normal’ blood pressure ranges
for children vary greatly according to
height, age and sex of the child – far
too many values for doctors to know by
heart.
Moreover, even if the doctor notes an
abnormally high blood pressure reading
at a single check-up, it takes three
of these high readings on separate
doctor visits to make a diagnosis of
pediatric hypertension.
Doctors say that an increased reliance
on computerized records could be part
of the solution to this problem, as
electronic databases may offer a much
easier and more reliable way to keep
track of pediatric patients from visit
to visit.
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