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Pediatric Hypertension: Are Pediatricians Following Guidelines?

The National Heart, Lung, and Blood Institute recommends that children older than 3 years seen in the medical setting have their blood pressure (BP) measured. The authors aimed to determine whether BPs are measured at well‐child visits and whether elevated readings are recognized. A retrospective chart review of 3‐ to 18‐year‐old children seen for well‐child visits was performed. Age, sex, weight, height, BP, extremity measured, and type of intervention were collected. BP was measured in 777 of 805 patients (97%). BP was elevated in 158 patients (20%). A total of 95 patients (60%) did not receive any intervention. Not recognizing elevated BP was associated with increased daily patient load (17.9±6.5 vs 12.6±5.5, P=.001). Higher body mass index was associated with elevated BP (P=.0008) but was not associated with improved recognition. Findings show that BP is almost always measured at well‐child visits but is not being measured appropriately, and general pediatric clinics are not consistently following BP management recommendations.