Landmark study of Under-diagnosis and Under-treatment of Hypertension in U.S. Kids

By | November 22, 2016

photo_kaelberHypertension is already nicknamed “the silent killer”, and for children and adolescents ages 3 -18, it could easily be called the under-diagnosed disease based on the results of a study published today in Pediatrics. The report’s lead author, Dr. David Kaelber, Chief Medical Informatics Officer at MetroHealth and Director of Health Care Informatics at the Center for Health Care Research and Policy explains the results here. Even though children’s blood pressure is routinely checked during office visits, physicians aren’t interpreting the results and following the appropriate guidelines for treatment.

Between 1999 – 2014, Dr. Kaelber, along with other researchers, analyzed the electronic health records of 400,000 children from nearly 200 pediatric primary care sites across the country. They found that only 23 percent of those who had high blood pressure were diagnosed with the disease, and only 10 percent who were presenting with blood pressures that were prehypertension were properly diagnosed. Among those children and adolescents with diagnosed high blood pressure for a year or more, fewer than 10 percent received antihypertensive medications. Medical guidelines call for medication after diagnosed high blood pressure for at least 6 months.

Watch this video of Dr. Kaelber explaining the results of his research and the implications on medical providers and patients.

Another finding of the study indicates pediatricians were more likely to diagnose hypertension and prehypertension in children who were tall, male, overweight or obese. Additionally, they were more likely to recognize the diseases in children with more abnormal blood pressure values or more frequent blood pressure reads. Yet, researchers found that under-diagnosis could still occur in these populations.

The results of this research affirms the findings of an earlier study Dr. Kaelber conducted in 2007. After studying approximately 15,000 patients, less than 25 percent were diagnosed with hypertension.

Hypertension is one of the ten most common chronic diseases in childhood, and predisposes children to adult hypertension. Children with hypertension can also show early signs of cardiovascular disease that if left untreated can increase long-term morbidity and mortality.

Read the complete article at Pediatrics here.