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Abstract: TH-PO697

Pediatric Hypertension Screening and Recognition in Primary Care Clinics in Canada

Session Information

Category: Hypertension and CVD

  • 1401 Hypertension and CVD: Epidemiology, Risk Factors, and Prevention

Authors

  • Ding, Linda, University of Manitoba, Winnipeg, Manitoba, Canada
  • Singer, Alexander, University of Manitoba, Winnipeg, Manitoba, Canada
  • Kosowan, Leanne, University of Manitoba, Winnipeg, Manitoba, Canada
  • Dart, Allison, University of Manitoba, Winnipeg, Manitoba, Canada
Background

Pediatric hypertension is becoming increasingly prevalent. Comprehensive guidelines have been developed to guide the diagnosis, evaluation and treatment of hypertension in children. Adherence to these guidelines is unknown in Canada.

Methods

Electronic medical record (EMR) data from the Canadian Primary Care Sentinel Surveillance Network (CPCSSN) was used to determine rates of hypertension screening, follow-up and recognition across Canada for the 2011-2017 period. Data for children aged 3-17 with at least one clinical encounter were extracted. The 2004 guideline by the National Heart, Lung, and Blood Institute was used to define elevated blood pressure (bp=90-95th%ile), hypertension (bp>95th%ile), and screening frequency, as they were pertinent for the study period. Screening rates and follow-ups were evaluated by year. Bivariate analysis was used to compare clinical characteristics of the screened vs non-screened population.

Results

Of the available 378002 children, 22% had at least 1 blood pressure documented. Rates of hypertension screening increased from 18% (n=43387) of all visits in 2011 to 26% (n= 97835) in 2017. Follow-up visits occurred within 6 months for 25% (SD=0.02) of individuals with a normal blood pressure and 26% (SD=0.02) of individuals with elevated blood pressure. For those with hypertension, 57% (SD=0.07) had a follow-up visit within 6 months and 7% (SD=0.01) had a follow-up visit within 1 month. Blood pressure was measured in 76% (SD=0.03) of well child visits (n=42063). The screened cohort included more females (51.6% vs 50.3%, p<0.0001), had higher rates of pediatric diabetes (0.6% vs 0.3%, p<0.0001), and higher BMI (19.9 + 5.2 vs. 17.9 + 4.4kg/m2, p< 0.0001). Overall prevalence of hypertension was 2% (n= 715) based on having 2 documented blood pressures above the hypertension threshold, of those, 5.6% (n=40) had a diagnosis of hypertension or presence of an anti-hypertensive in the EMR.

Conclusion

Across Canada, rates of hypertension screening are low, with higher rates at well child visits. Patients that were screened had more cardiovascular risk factors including higher BMI and rates of diabetes. Recognition of hypertension is also poor suggesting pediatric hypertension should be a priority for knowledge translation interventions.