Doctors often fail to diagnose hypertension in children

Many children in the United States have high blood pressure for years without knowing it, a new study published Wednesday in Journal of the American Medical Association has found.

The recent study, led by Dr. David Kaelber of Case Western Reserve University in Cleveland and Harvard Medical School, suggests that doctors fail to diagnose high blood pressure in more than three-quarters of children with the problem, leaving them at risk for developing heart disease and other organ damage later in life.

In their study, the researchers found that more than 1.5 million U.S. children and teenagers have undiagnosed high blood pressure, a mistake that could have devastating health consequences once these youngsters become adults.

"Hypertension in children is very underdiagnosed," said Dr. Kaelber. Calculating high blood pressure in children is more complex than in adults, and most of the doctors usually ignore the problem because they consider hypertension as an adult problem, said Kaelber.

High blood pressure or hypertension is one of the several 'risk factors' that can increase the chance of developing heart disease, stroke, heart failure, arterial aneurysm in adults, and is the leading cause for chronic renal failure.

Doctors generally suggest patients suffering from high blood pressure to increase their activity levels, cut salt consumption and eat fewer high fat foods to reduce the chances of any complications.

The effects of high blood pressure problem in children are still not known but there is some evidence that it might cause early artery and heart damage in young patients, the researchers said.

Untreated high blood pressure in children can eventually damage the heart, kidneys, eyes and brain. It also puts children at a higher risk for stroke, heart attack, kidney failure and hardening of the arteries, as per told by Dr. Kaelber.

To reach their conclusion, the scientists studied 14,187 children aged between three and 18. The study subjects were seen at least three times during routine checkups between June 1991 and September 2006 in outpatient clinics at a large medical center in the Cleveland area.

Of the total studied children and adolescents, 507 or 3.6 percent had hypertension. But of those cases 376 or 74 percent weren't documented in the electronic medical record with a diagnosis of hypertension or elevated blood pressure, meaning only a quarter (131 children or 26 percent) had been formally diagnosed.

In addition, 485 children, or 3.4 percent, were found to have prehypertension, a term for blood pressure on the high end of the normal range. Of the total prehypertension cases, only 55, or 11 percent, were documented.

“Hypertension in children has been shown to correlate with family history of hypertension, low birth weight, and excess weight. With the increasing prevalence of childhood weight problems, increased attention to weight-related health conditions including hypertension is warranted. Several lines of evidence suggest that blood pressure in US children and adolescents is increasing in parallel with weight,” the researchers said.

Parents should ask their doctors about their children's blood pressure and learn what the readings mean, scientists have cautioned. They also warned that pediatricians and other clinicians need to be more aware of the high blood pressure problem in children.