Initial High Blood Pressure Reading in Children: Approach With Caution
Failing to repeat an initial high blood pressure reading led to a false "hypertensive" result in more than 50% of children.
HealthDay News — Only approximately half of pediatric patients with a blood pressure reading ≥95th percentile would be correctly classified based on their initial blood pressure reading, according to a study published in the Journal of Clinical Hypertension.
Corinna Koebnick, PhD, from Kaiser Permanente Southern California in Pasadena, and colleagues used electronic medical records from 2012 to 2015 to compare the visit results for 186,732 children ages 3 to 17 years with a blood pressure reading ≥95th percentile based on the initial blood pressure and the mean of 2 blood pressure readings.
The researchers found that failing to repeat an initial blood pressure reading ≥95th percentile would lead to a false "hypertensive" visit result in 54.1% of children, who would then require follow-up visits.
During their next visits after the initial result indicating hypertension, hypertension stage I was sustained in 2.3% of youth, and hypertension stage II in 11.3%.
"Our findings suggest that a high initial BP reading in youth is common, while the proportion of youth with sustained hypertension is low," the authors wrote. "Repeating an initial hypertensive BP during the same visit as recommended by current guidelines is important to rule out false-positive results and to avoid unnecessary follow-up visits to confirm whether the hypertensive BP persists."
Koebnick C, Mohan Y, Li X, et al. Failure to confirm high blood pressures in pediatric care-quantifying the risks of misclassification. J Clin Hypertens (Greenwich). 2018;20:174-182.