title: Recognition and Management of Elevated Blood Pressure in Pediatric Patients: Challenges and Disparities in Community Health Centers.
abstract: The prevalence of childhood elevated blood pressure (EBP)-a single blood pressure recording above the normal range-is increasing in the United States. Recognizing childhood EBP is difficult because classification is a function of age, sex, and height. We assessed the frequency of clinical recognition of EBP and follow-up care in a sample of pediatric patients seen in 2010 and followed up through September 2013 in a network of 8 urban health centers. Of 754 patients with BP measurements, 261 (35 %) had at least 1 EBP reading during the study period. Of those with an EBP reading, 52 (20 %) had at least 1 EBP reading noted in their medical record. Clinicians were more likely to recognize EBP in overweight/obese [OR 3.27 (95 % confidence interval (CI) 1.64-6.51)] and male [OR 2.83 (95 % CI 1.64-4.42)] children. Strategies to support routine monitoring of BP status could improve identification and management of pediatric EBP.
authors.affiliation: Health Care for the Homeless, 421 Fallsway, Baltimore, MD, 21202, USA.
authors.forename: Rikki L
authors.initials: RL
authors.lastname: Ward
authors.affiliation: Philadelphia Department of Public Health, 500 South Broad Street, Philadelphia, PA, 19146, USA. Jessica.robbins@phila.gov.
authors.forename: Jessica M
authors.initials: JM
authors.lastname: Robbins
authors.affiliation: Human Care Systems, Inc.,, 429 E. 9th St Apartment #3, New York, NY, 10009, USA.
authors.forename: Rebecca N
authors.initials: RN
authors.lastname: Haden
authors.affiliation: UBC-An Express Scripts Company, 920 Harvest Drive Suite 200, Blue Bell, PA, 19422, USA.
authors.forename: Brittany J
authors.initials: BJ
authors.lastname: Benson
authors.affiliation: Philadelphia Department of Public Health, Health Center #2, 1930 South Broad Street, Unit #14, Philadelphia, PA, 19145, USA.
authors.forename: Issy C
authors.initials: IC
authors.lastname: Esangbedo
mesh_terms: D000293:Adolescent; D001795:Blood Pressure Determination / Q000706:statistics & numerical data*; D002648:Child; D002675:Child, Preschool; D003151:Community Health Centers; D005260:Female; D054625:Healthcare Disparities; D006801:Humans; D006973:Hypertension / Q000175:diagnosis*; D008297:Male; D008485:Medical Audit; D011320:Primary Health Care; D012189:Retrospective Studies; D014481:United States
keywords: Blood pressure; Hypertension; Pediatrics; Primary health care; Urban health