Hypertension screening and follow-up in children and adolescents in a Canadian primary care population sample: a retrospective cohort study

Aliarzadeh, Babak; Meaney, Christopher; Moineddin, Rahim; White, David G.; Birken, Catherine S.; Parkin, Patricia C.; Greiver, Michelle

doi:10.9778/cmajo.20150016

Cited by 18 publications

(18 citation statements)

References 14 publications

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“…These findings are in line with other data from South Africa [31–33]. Previous studies have shown that the strongest risk factor for hypertension in childhood is obesity, male sex, and a family history of hypertension [7, 34]. These findings are supported by our study in which we showed overweight and obese learners to be more likely to be both prehypertensive and hypertensive compared to learners with normal weights as determined by BMI.…”

Section: Discussionsupporting

confidence: 93%

Prevalence of Primary Hypertension and Risk Factors in Grade XII Learners in KwaZulu-Natal, South Africa

Bhimma

Naicker

Gounden

et al. 2018

International Journal of Hypertension

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Hypertension in childhood leads to hypertension in adult life, the strongest risk factor being obesity. This study determined the prevalence of primary hypertension and its risk factors in Grade XII learners in KwaZulu-Natal, South Africa, from March 2016 to June 2017. Weight, height, body mass index (BMI), random finger prick cholesterol and glucose, and spot urine for an albumin : creatinine ratio were measured. An average of three separate blood pressure readings taken was at least 5 minutes apart. Five hundred and sixty-four learners had weight, height, and BMI; 536 had random blood glucose; and 545 had cholesterol and random spot urine albumin : creatinine ratios measured. Prehypertension was detected in 168 (29.7%) and hypertension in 77 (13.7%) of learners. Ninety (15.9%) were overweight and 75 (13,3%) were obese. Hypercholesterolaemia was present in 58 (10.8%) and a high spot random urine albumin : creatinine ratio in 5 (1.0%). None had a high blood glucose level. Both prehypertension and hypertension in all learners showed a significant increase with increasing BMI. Six (1.0%) learners had metabolic syndrome. Female learners in other racial groups (defined as Indian, mixed race, and White learners), overweight, and obese learners showed significantly higher rates of hypercholesterolaemia. We showed overweight and obesity as risk factors for prehypertension and hypertension. This presages the need for an appropriate diet and adequate exercise in a child's school career.

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Section: Discussionsupporting

confidence: 93%

Prevalence of Primary Hypertension and Risk Factors in Grade XII Learners in KwaZulu-Natal, South Africa

Bhimma

Naicker

Gounden

et al. 2018

International Journal of Hypertension

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“…This percentage increased to 87.5 % in a paper by Brady et al (2015), who considered children presenting for both preventative care and acute care visits. These findings have been confirmed in multiple other studies (Stabouli et al 2015;Aliarzadeh et al 2016;Shapiro et al 2012), with recognition rates ranging from 5 % to 67 %. It is clear, then, that a large number of children who meet criteria for hypertension go unrecognized.…”

Section: Recognizing Pediatric Hypertension Can Be Challengingsupporting

confidence: 79%

Value of Routine Screening for Hypertension in Childhood

Semanik¹,

Flynn²

2016

Pediatric Hypertension

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“…Hypertension monitoring after cardiac surgery (as per guidelines, at least yearly and at all health visits in patients at risk) (27) is important. This is relevant because North American data show that BP screening and follow-up by primary care providers is often suboptimal (43,44).…”

Section: Discussionmentioning

confidence: 99%

Acute Kidney Injury and Risk of CKD and Hypertension after Pediatric Cardiac Surgery

Zappitelli¹,

Parikh²,

Kaufman³

et al. 2020

CJASN

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Background and objectivesThe association of AKI after pediatric cardiac surgery with long-term CKD and hypertension development is unclear. The study objectives were to determine whether AKI after pediatric cardiac surgery is associated with incident CKD and hypertension.Design, setting, participants, & measurementsThis was a prospective cohort study of children of 1 month to 18 years old who were undergoing cardiac surgery at two tertiary care centers (Canada, United States). Participants were recruited before cardiac surgery and were followed during hospitalization and at 3, 12, 24, 36, and 48 months after discharge. Exposures were postoperative AKI, based on the Kidney Disease Improving Global Outcomes (KDIGO) definition, and age <2 years old at surgery. Outcomes and measures were CKD (low eGFR or albuminuria for age) and hypertension (per the 2017 American Academy of Pediatrics guidelines) at follow-up, with the composite outcome of CKD or hypertension.ResultsAmong 124 participants, 57 (46%) developed AKI. AKI versus non-AKI participants had a median (interquartile range) age of 8 (4.8–40.8) versus 46 (6.0–158.4) months, respectively, and higher preoperative eGFR. From the 3- to 48-month follow-up, the cohort prevalence of CKD was high (17%–20%); hypertension prevalence was also high (22%–30%). AKI was not significantly associated with the development of CKD throughout follow-up. AKI was associated with hypertension development at 12 months after discharge (adjusted relative risk, 2.16; 95% confidence interval, 1.18 to 3.95), but not at subsequent visits. Children aged <2 years old at surgery had a significantly higher prevalence of hypertension during follow-up than older children (40% versus 21% at 3-month follow-up; 32% versus 13% at 48-month follow-up).ConclusionsCKD and hypertension burden in the 4 years after pediatric cardiac surgery is high. Young age at surgery, but not AKI, is associated with their development.

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Hypertension screening and follow-up in children and adolescents in a Canadian primary care population sample: a retrospective cohort study

Abstract: This screening measure was frequently done and appeared to be incompletely followed up. Clear guidance is needed; guideline developers should consider reviewing this topic.

Cited by 18 publications

References 14 publications

Prevalence of Primary Hypertension and Risk Factors in Grade XII Learners in KwaZulu-Natal, South Africa

Prevalence of Primary Hypertension and Risk Factors in Grade XII Learners in KwaZulu-Natal, South Africa

Value of Routine Screening for Hypertension in Childhood

Acute Kidney Injury and Risk of CKD and Hypertension after Pediatric Cardiac Surgery

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