Recognition and Management of Elevated Blood Pressure in Pediatric Patients: Challenges and Disparities in Community Health Centers

The prevalence of childhood elevated blood pressure (EBP)—a single blood pressure recording above the normal range—is increasing in the United States. Recognizing childhood EBP is difficult because classification is a function of age, sex, and height. We assessed the frequency of clinical recognition of EBP and follow-up care in a sample of pediatric patients seen in 2010 and followed up through September 2013 in a network of 8 urban health centers. Of 754 patients with BP measurements, 261 (35 %) had at least 1 EBP reading during the study period. Of those with an EBP reading, 52 (20 %) had at least 1 EBP reading noted in their medical record. Clinicians were more likely to recognize EBP in overweight/obese [OR 3.27 (95 % confidence interval (CI) 1.64–6.51)] and male [OR 2.83 (95 % CI 1.64–4.42)] children. Strategies to support routine monitoring of BP status could improve identification and management of pediatric EBP.