Open AccessFailure to confirm high blood pressures in pediatric care—quantifying the risks of misclassification
Author(s) -
Koebnick Corinna,
Mohan Yasmina,
Li Xia,
Porter Amy H.,
Daley Matthew F.,
Luo Gang,
Kuizon Beatriz D.
Publication year - 2018
Publication title -
the journal of clinical hypertension
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.909
H-Index - 67
eISSN - 1751-7176
pISSN - 1524-6175
DOI - 10.1111/jch.13159
Subject(s) - medicine , percentile , blood pressure , medical record , pediatrics , emergency medicine , mathematics , statistics
Pediatric practice guidelines call for repeating an elevated office blood pressure ( BP ) at the same visit, but there are few data available to support this recommendation. We compared the visit results in children aged 3 to 17 years with a BP reading ≥95th percentile (n = 186 732) based on the initial BP and the mean of two BP readings, using electronic medical records from 2012–2015. Failure to repeat an initial BP reading ≥95th percentile would lead to a false “hypertensive” visit result in 54.1% of children who would require follow‐up visits. After an initial visit result indicating hypertension, hypertension stage I or stage II was sustained in 2.3% and 11.3% of youth during their next visits, respectively. In conclusion, only approximately half of the pediatric patients would be correctly classified based on their initial BP . The recommendation to repeat high BP during the same visit needs to be emphasized because it saves unnecessary follow‐up visits.