A simplified table improves the recognition of paediatric hypertension
Article first published online: 26 OCT 2010
© 2010 The Authors. Journal of Paediatrics and Child Health © 2010 Paediatrics and Child Health Division (Royal Australasian College of Physicians)
Journal of Paediatrics and Child Health
Volume 47, Issue 1-2, pages 22–26, January/February 2011
How to Cite
Mitchell, C. K., Theriot, J. A., Sayat, J. G., Muchant, D. G. and Franco, S. M. (2011), A simplified table improves the recognition of paediatric hypertension. Journal of Paediatrics and Child Health, 47: 22–26. doi: 10.1111/j.1440-1754.2010.01885.x
- Issue published online: 23 JAN 2011
- Article first published online: 26 OCT 2010
- Accepted for publication 8 April 2010.
- blood pressure;
Aim: Unrecognised and untreated hypertension can lead to significant morbidity and mortality over time. In a 2003 chart review, we found that our providers only recognised 15% of hypertensive blood pressure (BP). Our objective was to determine whether a simplified BP table improves the recognition of elevated BP in children.
Methods: We developed a simplified BP table for children 3–18 years and posted it in provider work areas beginning August 2006. We reviewed a retrospective sample of well visits for children aged 3–18 years, with equal numbers by sex and year of age, presenting at a university-based paediatric clinic between January and August 2007. Visit notes for all children with elevated BP values ≥90th percentile were reviewed to identify whether the provider recognised that the BP was elevated.
Results: In 493 well visits, 85 (17.2%) children had pre-hypertensive (90th to <95th percentile) and 100 (20.3%) had hypertensive (≥95th percentile) BP values. Providers recognised elevations in 34 (40%) pre-hypertensive and 77 (77%) hypertensive measurements. Recognition was significantly more common for those in the hypertensive than the pre-hypertensive range (χ2 = 24.9, degrees of freedom = 1, P < 0.001). Compared with our 2003 data, recognition of hypertensive BP values was significantly greater (77% vs. 15%) (t = 14.479, degrees of freedom = 98, P < 0.001) after introduction of the simplified BP table.
Conclusions: Use of a simplified BP table can lead to significantly improved recognition of elevated BP in children.