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Abstract: TH-PO589

Temporal Trends in Prevalence of Blood Pressure Screening and Hypertension After Introduction of Clinical Practice Guidelines on Hypertension in Canadian Children: A Time-Series Analysis

Session Information

Category: Hypertension and CVD

  • 1501 Hypertension and CVD: Epidemiology‚ Risk Factors‚ and Prevention


  • Wu, Michael, McMaster University, Hamilton, Ontario, Canada
  • Dart, Allison, University of Manitoba, Winnipeg, Manitoba, Canada
  • Kosowan, Leanne, University of Manitoba, Winnipeg, Manitoba, Canada
  • Roychoudhury, Smita, McMaster University, Hamilton, Ontario, Canada
  • Singer, Alexander, University of Manitoba, Winnipeg, Manitoba, Canada
  • Chanchlani, Rahul, McMaster University, Hamilton, Ontario, Canada

In 2016 & 2017 respectively, new Canadian & American guidelines for assessing pediatric hypertension (HTN) were introduced. It is unknown whether these guidelines have impacted blood pressure (BP) screening & HTN prevalence in primary care settings.


The study included 438,297 children (3-18 years) from seven Canadian provinces with 1+ encounter in the Canadian Primary Care Sentinel Surveillance Network (CPCSSN) database between January 1, 2011 & December 31, 2019. The study cohort had 3 phases: Jan 1, 2011-Dec 31, 2015 (era 1), Jan 1, 2016 – Dec 31, 2017 (wash out) & Jan 1, 2018- Dec 31, 2019 (era 2). HTN was defined by NHLBI guideline up to December 31, 2017 & AAP 2017 guideline thereafter. We performed an interrupted time series analysis to assess impact of the guideline recommendations on BP screening and HTN prevalence.


264,635 children in era 1 & 193,654 children in era 2 were evaluated. In era 1 and 2, there were 66,653 (25.2%) & 45,050 (23.3%) children, respectively with at least 1 BP measurement. Annual BP screening generally increased each year from 13.3% in 2011 to 20.2% in 2019. In Era 1, a total of 1.1% of children met HTN criteria with a mean onset age of 12.6 years (SD 4.1). In Era 2, a total of 2.0% of children met HTN criteria with a mean onset age of 14.1 years (SD 4.1). Time series analysis revealed a significant increase in BP screening and HTN after the guidelines’ introduction (p=0.04 and p=<0.0001 respectively).


BP screening and HTN prevalence generally increased between 2011 and 2019, with a significant increase in post-guideline BP documentation and children meeting HTN criteria following guideline implementation.

Proportion of children who received BP screening or who met HTN criteria from Jan 1, 2011 to Dec 31, 2019