title: Use of diagnostic tests in adolescents with essential hypertension.
abstract: OBJECTIVE
  To describe the use of diagnostic tests in adolescents with essential hypertension.
  
  
  METHODS
  Longitudinal analysis of administrative claims data.
  
  
  METHODS
  Michigan Medicaid program during 2003 to 2008.
  
  
  METHODS
  Adolescents with 3 or more years of Medicaid eligibility (≥ 11 months/y) who had a diagnosis of essential hypertension and 1 or more antihypertensive medication pharmacy claims.
  
  
  METHODS
  We examined adolescents' echocardiogram use and compared it with electrocardiogram (EKG) and renal ultrasonography use. We examined timing of the 3 diagnostic tests in relation to the first pharmacy claim. We examined patient demographics and presence of obesity-related comorbidities.
  
  
  RESULTS
  During 2003 to 2008, there were 951 adolescents with essential hypertension who had antihypertensive pharmacy claims; 24% (226) had echocardiograms; 22% (207) had renal ultrasonography; and 50% (478) had EKGs. Males (odds ratio [OR], 1.53; 95% CI, 1.06-2.21), younger adolescents (OR, 1.69; 95% CI, 1.17-2.44), those who had EKGs (OR, 5.79; 95% CI, 4.02-8.36), and those who had renal ultrasonography (OR, 2.22; 95% CI, 1.54-3.20) were more likely to obtain echocardiograms compared with females, older adolescents, and adolescents who did not have EKGs or renal ultrasonography.
  
  
  CONCLUSIONS
  Guideline-recommended diagnostic tests-echocardiograms and renal ultrasonography-were equally poorly used by adolescents with essential hypertension. Sex and age differences exist in the use of echocardiograms by adolescents with essential hypertension. The decision and choice of diagnostic tests to evaluate adolescents with essential hypertension warrant further study to understand the underlying rationale for those decisions and to determine treatment effectiveness.
authors: Division of General Pediatrics, Child Health Evaluation and Research Unit, University of Michigan, Ann Harbor, USA.
authors: Esther Y
authors: EY
authors: Yoon
authors: Lisa
authors: L
authors: Cohn
authors: Albert
authors: A
authors: Rocchini
authors: David
authors: D
authors: Kershaw
authors: Gary
authors: G
authors: Freed
authors: Frank
authors: F
authors: Ascione
authors: Sarah
authors: S
authors: Clark
mesh_terms: D000293:Adolescent; D000959:Antihypertensive Agents / Q000627:therapeutic use; D002648:Child; D004452:Echocardiography / Q000706:statistics & numerical data*; D004562:Electrocardiography / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000188:drug therapy; D017379:Hypertrophy, Left Ventricular / Q000175:diagnosis / Q000000981:diagnostic imaging*; D007674:Kidney Diseases / Q000000981:diagnostic imaging; D008297:Male; D008824:Michigan; D009765:Obesity / Q000150:complications; D012044:Regression Analysis; D013997:Time Factors
chemical_list: D000959:Antihypertensive Agents