Hypertension often missed in overweight, obese adolescents

Among overweight and obese adolescents with several documented high BP readings, only 3.8% were diagnosed with hypertension or referred to a subspecialist, according to recently presented data.

“In this large cohort of overweight/obese adolescents with hypertension, the vast majority of patients were undiagnosed and not referred to subspecialists who manage BP monitoring and treatment,” Brian W. Sykes, MD, department of pediatrics, Nemours/Alfred I. DuPont Hospital, Wilmington, Delaware, and colleagues wrote.

Sykes and colleagues analyzed the electronic health records of 6,604 patients, aged 12 to 17 years, in the Nemours Health Care System to assess the how often childhood hypertension goes undiagnosed in obese and overweight adolescents. Included patients had a BMI above the 85^th percentile and at least three BP readings above 120 mm Hg/80 mm Hg.

Results demonstrated that during the 4-year study period, only 3.8% of patients received a hypertension diagnosis.

Patients with lower BMI and BP were less likely to receive a hypertension diagnosis. Undiagnosed patients were also less likely to be black, insured through Medicaid or be seen by a nephrologist, according to the researchers.

Sykes and colleagues noted that pop-up alerts in high-risk patient’s electronic health records may be beneficial in helping to increase hypertension diagnosis in obese and overweight adolescents, as would educational workshops and seminars for clinicians.

“Hypertension in overweight and obese adolescents remains underdiagnosed despite evidence supporting both as independent risk factors for cardiovascular disease. It is crucial that additional resources and future efforts focus on improving detection and early recognition of hypertension in order to reduce cardiovascular morbidity and mortality in this at-risk population,” Sykes said in a press release. – by Casey Hower

Reference:

Sykes BW, et al. Under-Diagnosis of Hypertension in a Large Cohort of Obese/Overweight Adolescents. Abstract SA-PO666. Presented at: ASN Kidney Week 2015; Nov. 3-8; San Diego.

Disclosures: Sykes reports no relevant financial disclosures. Please see abstract for a list of all other authors’ relevant financial disclosures.