Screening Adolescents for Hypertension

Prevalence of Hypertension and Pre-Hypertension Among Adolescents

McNiece KL, Poffenbarger TS, Turner JL, Franco KD, Sorof JM, Portman RJ J Pediatr. 2007;150:640-644, 644.e1

The study authors noted that the 2004 guidelines for the diagnosis and classification of hypertension in children increased awareness of the need to screen for elevated blood pressure (BP) at any pediatric visit after age 3 years, and provided guidelines for staging hypertension and how to intervene depending on the staging.^[1]

The concept of "prehypertension" was also defined in that report. This study applied the new guidelines to a population of children attending 9 Houston, Texas, schools in 2003-2005. The study authors wanted to quantitate the proportion of children in a community sample who would be classified as prehypertensive and as hypertensive by the new guidelines.

The investigators collected anthropomorphic data on the subjects as well as serial BP measurements (usually 3 different occasions). All readings were taken with automated BP machines, but the initial reading on each subject was disregarded because automated machines can often read higher on the first measurement than manual BP methods.

After the 3 BP screenings, the study authors classified the subjects as normal (both systolic BP and diastolic BP < 90th percentile for age, height, and sex at first screening); prehypertensive (mean systolic BP or diastolic BP between the 90th and 95th percentiles on 2 of the 3 screens); stage I hypertension (mean systolic BP or mean diastolic BP ≥ 95th percentile but < 99th percentile); and stage II hypertension (mean systolic BP or mean diastolic BP ≥ 95th percentile on all 3 screenings