Screening and Management of Pediatric High Blood Pressure—Challenges to Implementing the Clinical Practice Guideline

•• Jacobs DR Jr, Woo JG, Sinaiko AR, Daniels SR, Ikonen J, Juonala M, Kartiosuo N, Lehtimäki T, Magnussen CG, Viikari JSA, Zhang N, Bazzano LA, Burns TL, Prineas RJ, Steinberger J, Urbina EM, Venn AJ, Raitakari OT, Dwyer T. Childhood cardiovascular risk factors and adult cardiovascular events. N Engl J Med. 2022;386(20):1877–88. https://doi.org/10.1056/NEJMoa2109191. Epub 2022. PMID: 35373933; PMCID: PMC9563825. This prospective cohort study found that childhood cardiovascular risk factors including systolic BP values in the normal range were associated with incident cardiovascular events in adulthood occurring at ages as young as 40 years.

Article  PubMed  PubMed Central  Google Scholar 

Tirosh A, Afek A, Rudich A, Percik R, Gordon B, Ayalon N, Derazne E, Tzur D, Gershnabel D, Grossman E, Karasik A, Shamiss A, Shai I. Progression of normotensive adolescents to hypertensive adults: a study of 26,980 teenagers. Hypertension. 2010;56(2):203–9. https://doi.org/10.1161/HYPERTENSIONAHA.109.146415. Epub 2010 Jun 14 PMID: 20547973.

Article  CAS  PubMed  Google Scholar 

Moin A, Mohanty N, Tedla YG, Carroll AJ, Padilla R, Langman CB, Smith JD. Under-recognition of pediatric hypertension diagnosis: examination of 1 year of visits to community health centers. J Clin Hypertens (Greenwich). 2021;23(2):257–64. https://doi.org/10.1111/jch.14148. Epub 2020 Dec 29. PMID: 33373088; PMCID: PMC8030016.

Article  PubMed  Google Scholar 

Beacher DR, Chang SZ, Rosen JS, Lipkin GS, McCarville MM, Quadri-Sheriff M, Kwon S, Lane JC, Binns HJ, Ariza AJ. Recognition of elevated blood pressure in an outpatient pediatric tertiary care setting. J Pediatr. 2015;166(5):1233-1239.e1. https://doi.org/10.1016/j.jpeds.2015.02.006. PMID: 25919733.

Article  PubMed  Google Scholar 

Brady TM, Neu AM, Miller ER 3rd, Appel LJ, Siberry GK, Solomon BS. Real-time electronic medical record alerts increase high blood pressure recognition in children. Clin Pediatr (Phila). 2015;54(7):667–75. https://doi.org/10.1177/0009922814559379. Epub 2014 Nov 20. PMID: 25416626; PMCID: PMC4455954. Under diagnosis and failure to follow up.

Article  PubMed  Google Scholar 

Brady TM, Solomon BS, Neu AM, Siberry GK, Parekh RS. Patient-, provider-, and clinic-level predictors of unrecognized elevated blood pressure in children. Pediatrics. 2010;125(6):e1286–93. https://doi.org/10.1542/peds.2009-0555. Epub 2010 May 3 PMID: 20439598.

Article  PubMed  Google Scholar 

Patel ND, Newburn A, Brier ME, Chand DH. Pediatric hypertension: are pediatricians following guidelines? J Clin Hypertens (Greenwich). 2016;18(12):1230–4. https://doi.org/10.1111/jch.12915. Epub 2016 Sep 23. PMID: 27659546; PMCID: PMC8031817.

Article  PubMed  PubMed Central  Google Scholar 

National High Blood Pressure Education Program Working Group on High Blood Pressure in Children and Adolescents. The fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents. Pediatrics. 2004 Aug;114(2 Suppl 4th Report):555–76. PMID: 15286277.

Lo JC, Sinaiko A, Chandra M, Daley MF, Greenspan LC, Parker ED, Kharbanda EO, Margolis KL, Adams K, Prineas R, Magid D, O’Connor PJ. Prehypertension and hypertension in community-based pediatric practice. Pediatrics. 2013;131(2):e415-24. https://doi.org/10.1542/peds.2012-1292. Epub 2013 Jan 28. PMID: 23359583; PMCID: PMC3557407.

Article  PubMed  PubMed Central  Google Scholar 

Daley MF, Sinaiko AR, Reifler LM, Tavel HM, Glanz JM, Margolis KL, Parker E, Trower NK, Chandra M, Sherwood NE, Adams K, Kharbanda EO, Greenspan LC, Lo JC, O’Connor PJ, Magid DJ. Patterns of care and persistence after incident elevated blood pressure. Pediatrics. 2013;132(2):e349-55. https://doi.org/10.1542/peds.2012-2437. Epub 2013. PMID: 23821694; PMCID: PMC3727670.

Article  PubMed  PubMed Central  Google Scholar 

Boneparth A, Flynn JT. Evaluation and treatment of hypertension in general pediatric practice. Clin Pediatr (Phila). 2009;48(1):44–9. https://doi.org/10.1177/0009922808321677. Epub 2008 Oct 2 PMID: 18832551.

Article  PubMed  Google Scholar 

Bello JK, Mohanty N, Bauer V, Rittner SS, Rao G. Pediatric hypertension: provider perspectives. Glob Pediatr Health. 2017;6(4):2333794X17712637. https://doi.org/10.1177/2333794X17712637. PMID: 28620629; PMCID: PMC5464512.

Article  Google Scholar 

Carroll AJ, Mohanty N, Wallace AS, Langman CB, Smith JD. Perspectives of primary care clinicians on the diagnosis and treatment of pediatric hypertension. Fam Community Health. 2023;46(2):123–7. https://doi.org/10.1097/FCH.0000000000000358. PMID: 36799945; PMCID: PMC9942119.

Article  PubMed  PubMed Central  Google Scholar 

Flynn JT, Kaelber DC, Baker-Smith CM, Blowey D, Carroll AE, Daniels SR, de Ferranti SD, Dionne JM, Falkner B, Flinn SK, Gidding SS, Goodwin C, Leu MG, Powers ME, Rea C, Samuels J, Simasek M, Thaker VV, Urbina EM; Subcommittee on screening and management of high blood pressure in children. Clinical practice guideline for screening and management of high blood pressure in children and adolescents. Pediatrics. 2017;140(3):e20171904. https://doi.org/10.1542/peds.2017-1904. Epub 2017 Aug 21. Erratum in: Pediatrics. 2017 Nov 30;: Erratum in: Pediatrics. 2018;142(3): PMID: 28827377.

• Rea CJ, Brady TM, Bundy DG, Heo M, Faro E, Giuliano K, Goilav B, Kelly P, Orringer K, Tarini BA, Twombley K, Rinke ML. Pediatrician adherence to guidelines for diagnosis and management of high blood pressure. J Pediatr. 2022;242:12-17.e1. https://doi.org/10.1016/j.jpeds.2021.11.008. Epub 2021 Nov 10. PMID: 34774574. This report provides the baseline data from the “Boosting Primary Care Awareness and Treatment of Hypertension.” Fifty-nine primary care practices submitted results from chart reviews to document their baseline adherence to the various recommendations in the 2017 AAP Clinical Practice Guidelines for the diagnosis and management of high BP. Results from the intervention are not yet published.

Article  PubMed  Google Scholar 

Carroll AJ, Tedla YG, Padilla R, Jain A, Segovia E, Moin A, Wallace AS, Sanuade OA, Langman CB, Mohanty N, Smith JD. Adherence to the 2017 clinical practice guidelines for pediatric hypertension in safety-net clinics. JAMA Netw Open. 2023;6(4): e237043. https://doi.org/10.1001/jamanetworkopen.2023.7043.PMID:37058305;PMCID:PMC10105315.

Article  PubMed  PubMed Central  Google Scholar 

Goulding M, Ryan G, Frisard C, Stevens E, Person S, Goldberg R, Garg A, Lemon SC. Pediatric high blood pressure follow-up guideline adherence in a Massachusetts health care system. Acad Pediatr. 2023;S1876–2859(23):00271–1. https://doi.org/10.1016/j.acap.2023.07.006. Epub ahead of print. PMID: 37487799.

Article  Google Scholar 

Woods JL, Jacobs MD, Sheeder JL. Improving blood pressure accuracy in the outpatient adolescent setting. Pediatr Qual Saf. 2021;6(4): e416. https://doi.org/10.1097/pq9.0000000000000416.PMID:34179673;PMCID:PMC8225357.

Article  PubMed  PubMed Central  Google Scholar 

WHO technical specifications for automated non-invasive blood pressure monitoring devices with cuff. Geneva: World Health Organization; 2020. License: CC BY-NC-SA 3.0 IGO.

Kallioinen N, Hill A, Horswill MS, Ward HE, Watson MO. Sources of inaccuracy in the measurement of adult patients’ resting blood pressure in clinical settings: a systematic review. J Hypertens. 2017;35(3):421–41. https://doi.org/10.1097/HJH.0000000000001197.PMID:27977471;PMCID:PMC5278896.

Article  CAS  PubMed  Google Scholar 

Brady TM, Charleston J, Ishigami J, Miller ER 3rd, Matsushita K, Appel LJ. Effects of different rest period durations prior to blood pressure measurement: the best rest trial. Hypertension. 2021;78(5):1511–9. https://doi.org/10.1161/HYPERTENSIONAHA.121.17496. Epub 2021 Oct 4 PMID: 34601959.

Article  CAS  PubMed  Google Scholar 

Bijlsma MW, Blufpand HN, Kaspers GJ, Bökenkamp A. Why pediatricians fail to diagnose hypertension: a multicenter survey. J Pediatr. 2014;164(1):173-177.e7. https://doi.org/10.1016/j.jpeds.2013.08.066. Epub 2013 Oct 9 PMID: 24120124.

Article  PubMed  Google Scholar 

Khin EE, Villanos MT, Alvarado JG, Rodriguez D, Arbab B, De Guzman KN. Improved compliance of pediatrics high blood pressure guidelines in well-child clinic visits. Pediatr Qual Saf. 2023;8(4):e670. https://doi.org/10.1097/pq9.0000000000000670.PMID:37551263;PMCID:PMC10403019.

Article  PubMed  PubMed Central  Google Scholar 

Kharbanda EO, Asche SE, Sinaiko AR, Ekstrom HL, Nordin JD, Sherwood NE, Fontaine PL, Dehmer SP, Appana D, O’Connor P. Clinical decision support for recognition and management of hypertension: a randomized trial. Pediatrics. 2018;141(2):e20172954. https://doi.org/10.1542/peds.2017-2954.PMID:29371241;PMCID:PMC5810603.

Article  PubMed  Google Scholar 

Xi B, Zhang T, Li S, Harville E, Bazzano L, He J, Chen W. Can Pediatric Hypertension Criteria Be Simplified? A prediction analysis of subclinical cardiovascular outcomes from the Bogalusa Heart Study. Hypertension. 2017;69(4):691–6. https://doi.org/10.1161/HYPERTENSIONAHA.116.08782. Epub 2017 Feb 21. PMID: 28223474; PMCID: PMC5344730.

Article  CAS  PubMed  Google Scholar 

Koebnick C, Mohan Y, Li X, Porter AH, Daley MF, Luo G, Kuizon BD. Failure to confirm high blood pressures in pediatric care-quantifying the risks of misclassification. J Clin Hypertens (Greenwich). 2018;20(1):174–82. https://doi.org/10.1111/jch.13159. Epub 2018 Jan 12. PMID: 29329492; PMCID: PMC8031137.

Article  PubMed  PubMed Central  Google Scholar 

Araujo-Moura K, Souza LG, Mello GL, De Moraes ACF. Blood pressure measurement in pediatric population: comparison between automated oscillometric devices and mercury sphygmomanometers-a systematic review and meta-analysis. Eur J Pediatr. 2022;181(1):9–22. https://doi.org/10.1007/s00431-021-04171-3. Epub 2021 Jul 17 PMID: 34272985.

Article  PubMed  Google Scholar 

Lurbe E, Agabiti-Rosei E, Cruickshank JK, Dominiczak A, Erdine S, Hirth A, Invitti C, Litwin M, Mancia G, Pall D, Rascher W, Redon J, Schaefer F, Seeman T, Sinha M, Stabouli S, Webb NJ, Wühl E, Zanchetti A. 2016 European Society of Hypertension guidelines for the management of high blood pressure in children and adolescents. J Hypertens. 2016;34(10):1887–920. https://doi.org/10.1097/HJH.0000000000001039. PMID: 27467768.

Article  CAS  PubMed  Google Scholar 

Krmar RT, Holtbäck U, Bergh A, Svensson E, Wühl E. Oscillometric casual blood pressure normative standards for Swedish children using ABPM to exclude casual hypertension. Am J Hypertens. 2015;28(4):459–68. https://doi.org/10.1093/ajh/hpu182. Epub 2014 Nov 10 PMID: 25384408.

Article  PubMed  Google Scholar 

Neuhauser HK, Thamm M, Ellert U, Hense HW, Rosario AS. Blood pressure percentiles by age and height from nonoverweight children and adolescents in Germany. Pediatrics. 2011;127(4):e978–88. https://doi.org/10.1542/peds.2010-1290. Epub 2011 Mar 7 PMID: 21382947.

Article  PubMed  Google Scholar 

Park MK, Menard SW, Schoolfield J. Oscillometric blood pressure standards for children. Pediatr Cardiol. 2005;26(5):601–7. https://doi.org/10.1007/s00246-004-0828-9. PMID: 16151689.

Article  CAS  PubMed  Google Scholar 

Sung RY, Choi KC, So HK, Nelson EA, Li AM, Kwok CW, Tong GN, Mak KH, Ng PC, Fok TF. Oscillometrically measured blood pressure in Hong Kong Chinese children and associations with anthropometric parameters. J Hypertens. 2008;26(4):678–84. https://doi.org/10.1097/HJH.0b013e3282f42270. PMID: 18327076.

Article  CAS  PubMed  Google Scholar 

Chiolero A, Bovet P, Burnier M. Oscillometric blood pressure reference values in children. J Hypertens. 2013;31(2):426. https://doi.org/10.1097/HJH.0b013e32835bdcf2. PMID: 23303360.37. Šuláková T, Šuláková A, Strnadel J, Pavlíček J, Obermannová B, Feber J. Can auscultatory blood pressure normative values be used for evaluation of oscillometric blood pressure in children? J Clin Hypertens (Greenwich). 2017;19(4):381–387. https://doi.org/10.1111/jch.12943. Epub 2016 Nov 7. PMID: 28383188; PMCID: PMC8031177.

Pollack AH, Hanevold C, Onchiri F, Flynn JT. Influence of blood pressure percentile reporting on the recognition of elevated blood pressures. Hosp Pediatr. 2021;11(8):799–807. https://doi.org/10.1542/hpeds.2020-002055. Epub 2021 Jul 2 PMID: 34215652.

Article 

留言 (0)

沒有登入
gif