Thousands of American children have un-diagnosed hypertension, new figures reveal.
The study, backed by the American Academy of Pediatrics, is the first to show a widespread trend of un-investigated abnormal blood pressures in children aged three to 18.
They found that only 23 percent of children with hypertension-style blood pressures were diagnosed with the disease.
Only 10 percent of patients with symptoms of prehypertension were diagnosed.
It means hundreds of thousands of children could unknowingly be at risk of developing heart disease, diabetes, or cancer before they reach adulthood.
Hundreds of thousands of children could unknowingly be at risk of developing heart disease, diabetes, or cancer before they reach adulthood, a new study warns
Lead author Dr David Kaelber, who is also the co-chair of the American Academy of Pediatrics task force that is rewriting the pediatric blood pressure guidelines, warned that the results are a damning indictment of pediatric care in America.
‘Although over 95 percent of children and adolescents are checked for high blood pressure, doctors taking care of children are not putting all of the pieces of the puzzle together in terms of interpreting the results and following the appropriate guidelines for treatment,’ Dr David Kaelber, professor of pediatrics at Case Western, said.
The researchers at Case Western Reserve University analyzed the electronic health records of 400,000 children from nearly 200 pediatric primary care sites across the country, between 1999 and 2014.
Of those children and adolescents with diagnoses of hypertension for at least a year, only six percent of those who needed anti-hypertension medication received a prescription.
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 and/or more frequent blood pressure reads.
The researchers found that underdiagnosis could still occur in these populations.
‘The new reality for pediatricians is that we’re taking care of more and more children who are winding up with chronic conditions, such as hypertension, that were previously seen primarily in adults,’ said senior author Dr Alexander Fiks, a pediatrician at Children’s Hospital of Philadelphia (CHOP).
‘This study shows that many pediatricians are not responding to this new reality – not only are we underdiagnosing hypertension, but we’re often not providing recommended treatment to children with the condition in order to minimize health risks.’
Hypertension (high blood pressure) 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.
In 2007, Dr Kaelber found that within one health care system, studying approximately 15,000 pediatric patients, less than 25 percent with hypertension were diagnosed.
The current study used ‘big data,’ combining electronic health record data from almost 200 practices around the U.S. to show a very similar result at the national level.
The authors said this demonstrates the importance of combining electronic health record data across many practices and health systems to examine treatments and outcomes that rarely occur.