Kidney Week

Abstract: FR-PO547

Prevalence of Elevated Blood Pressure in Multiethnic School-Aged Children in New York City

Session Information

• Hypertension: Clinical and Translational
  November 03, 2017 | Location: Hall H, Morial Convention Center
  Abstract Time: 10:00 AM - 10:00 AM

Category: Hypertension

• 1106 Hypertension: Clinical and Translational - Secondary Causes

Authors

• Viteri Baquerizo, Bernarda, Mount Sinai School of Medicine, New York, New York, United States

Bernarda Viteri Baquerizo,

• Saland, Jeffrey M., Mount Sinai School of Medicine, New York, New York, United States

Jeffrey M. Saland,

• Ceballos, Clare, Mount Sinai School of Medicine, New York, New York, United States

Clare Ceballos,

Background

Pediatric hypertension (HTN) is a public health problem defined by blood pressure (BP) > 95th percentile relative to age, gender, and height on > 3 occasions. Overweight increases the likelihood of elevated BP and HTN and is more common among minority, poor, and male children. These findings (28% overweight with 12% pre-hypertensive / 15% hypertensive range BP) were noted in School Based Health (SBH) centers by a team from this medical center 15 years ago. Our goal was to revisit these centers and a tertiary care hospital-based clinic to assess the quality of BP screening and follow-up and if needed to begin iterative quality improvement (QI) toward reducing consequences of HTN on childhood development and early-onset end organ damage.

Methods

Retrospective cross-section cohort, age 4-21 years, with at least one outpatient visit (SBH or hospital-based) between July 2015-June 2016.

Results

5739 patients had 8225 encounters. 215 (3.74%) patients had at least one visit with elevated BP, out of which only 16 (7%) had follow-up within the period described. About 3/4 of the visits were at the hospital-based clinics and 2.65% of patients with elevated BP were seen in this setting vs. 4.39% seen at SBH clinics (p-value = 0.003). Appropriate follow-up in patients with elevated BP was noted in 14/126 seen at hospital-based clinics vs. 2/44 seen at SBH clinics. The children with or without elevated BP did not differ with respect to sex (female 52% and 48%, respectively), or AA race (40%), while Latinos were found in 46% patients with normal BP vs. 40% with elevated BP. Median age was 10 for the entire cohort. Obesity was noted in 63% of patients with elevated BP (median BMI 99^th percentile.), vs. 34% in patients with normal BP (median BMI 82^nd percentile (p-value 0.001;CI -13.65 to -13.56), despite a slightly higher prevalence of patients classified overweight (BMI > 85^th percentile) in the latter group.

Conclusion

Although the rate of elevated BP in this population was somewhat lower than other reports of general screening programs, there is nonetheless a significant population of children with elevated BP and overweight as a risk factor for elevated BP. The lack of follow-up among this group of patients with elevated BP highlights the need of quality improvement in the systematic screening and treatment of children in the East Harlem area of New York.