title: Hypertension Prevalence, Cardiac Complications, and Antihypertensive Medication Use in Children.
abstract: OBJECTIVE
  To determine the prevalence of hypertension diagnosis in children of US military members and quantify echocardiography evaluations, cardiac complications, and antihypertensive prescriptions in the post-2004 guideline era.
  
  
  METHODS
  Using billing data from military health insurance (TRICARE) enrollees, hypertension cases were defined as 2 or more visits with a primary or unspecified hypertension diagnosis during any calendar year or 1 such visit if with a cardiologist or nephrologist.
  
  
  RESULTS
  During 2006-2011, the database contained an average 1.3 million subjects aged 2-18 years per year. A total of 16 322 met the definition of hypertension (2.6/1000). The incidence of hypertension increased by 17% between 2006 and 2011 (from 2.3/1000 to 2.7/1000; P < .001). Hypertension was more common in adolescents aged 12-18 years than in younger children (5.4/1000 vs 0.9/1000). Among patients with hypertension, 5585 (34%) underwent echocardiography. The frequency of annual echocardiograms increased from 22.7% to 27.7% (P < .001). In patients with echocardiography, 8.0% had left ventricular hypertrophy or dysfunction. Among the patients with hypertension, 6353 (38.9%) received an antihypertensive medication.
  
  
  CONCLUSIONS
  The prevalence of hypertension in children has increased. Compliance with national guidelines is poor. Of pediatric patients with hypertension who receive an echocardiogram, 1 in 12 had identified cardiac complications, supporting the current recommendations for echocardiography in children with hypertension. Less than one-half of children with hypertension are treated with medication.
authors.affiliation: Department of Pediatrics, Tripler Army Medical Center, Honolulu, HI; Department of Pediatrics, Uniformed Services University of the Health Sciences, Bethesda, MD. Electronic address: Craig.p.dobson.mil@mail.mil.
authors.forename: Craig P
authors.initials: CP
authors.lastname: Dobson
authors.affiliation: Department of Pediatrics, Uniformed Services University of the Health Sciences, Bethesda, MD.
authors.forename: Matilda
authors.initials: M
authors.lastname: Eide
authors.affiliation: Department of Pediatrics, Uniformed Services University of the Health Sciences, Bethesda, MD.
authors.forename: Cade M
authors.initials: CM
authors.lastname: Nylund
mesh_terms: D000293:Adolescent; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D004452:Echocardiography / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000453:epidemiology*; D017379:Hypertrophy, Left Ventricular / Q000175:diagnosis / Q000453:epidemiology*; D015994:Incidence; D008297:Male; D015995:Prevalence; D012189:Retrospective Studies; D014481:United States / Q000453:epidemiology; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis / Q000453:epidemiology*
chemical_list: D000959:Antihypertensive Agents