Hypertension Underdiagnosed in Overweight, Obese Teens

Despite evidence supporting hypertension in overweight and obese adolescents as risk factors for heart disease, high blood pressure is underdiagnosed in these teenagers. New research presented at Kidney Week examined the extent of the underdiagnosis.

Brian Sykes, MD, a pediatrician with Nemours/A.I. duPont Hospital in Wilmington, DE, and his colleagues looked at hypertension diagnoses in overweight and obese adolescents cared for by Nemours Health Care System. They examined electronic medical records within Nemours and identified 6604 youth 12 to 17 years old with a BMI above the 85th percentile and with more than 3 documented blood pressure readings >120/80 mm Hg between 2010 and 2014. Only 3.8% (255) of these adolescents received a diagnosis of hypertension during the study period, while 96.2% (6349) were undiagnosed. Adolescents who were undiagnosed had lower BMIs and blood pressure readings. They were also less likely to be African American, have Medicaid, or be seen by subspecialists who manage blood pressure monitoring and treatment.

“In a large pediatric health care system, hypertension in overweight and obese adolescents remains underdiagnosed despite evidence supporting both as independent risk factors for cardiovascular disease,” said Dr. Sykes. “It is crucial that additional resources and future efforts focus on improving detection and early recognition of hypertension in order to reduce cardiovascular morbidity and mortality in this at-risk population.”

Potential initiatives might include alert flags in electronic medical records for this at-risk population and additional educational workshops or seminars for clinicians.

“Under-Diagnosis of Hypertension in a Large Cohort of Overweight/Obese Adolescents” (Abstract SA-PO666).