Prehypertension and hypertension in community-based pediatric practice

Joan C. Lo, Alan Sinaiko, Malini Chandra, Matthew F. Daley, Louise C. Greenspan, Emily D. Parker, Elyse O. Kharbanda, Karen L. Margolis, Kenneth Adams, Ronald Prineas, David Magid, Patrick J. O'Connor

Research output: Contribution to journalArticlepeer-review

113 Scopus citations


To examine the prevalence of prehypertension and hypertension among children receiving well-child care in community-based practices. METHODS: Children aged 3 to 17 years with measurements of height, weight, and blood pressure (BP) obtained at an initial (index) well-child visit between July 2007 and December 2009 were included in this retrospective cohort study across 3 large, integrated health care delivery systems. Index BP classification was based on the Fourth Report on the Diagnosis, Evaluation, and Treatment of High Blood Pressure in Children and Adolescents: normal BP, ,90th percentile; prehypertension, 90th to 94th percentile; hypertension, 3 BP measurements <95th percentile (index and 2 subsequent consecutive visits). RESULTS: The cohort included 199 513 children (24.3% aged 3-5 years, 34.5% aged 6-11 years, and 41.2% aged 12-17 years) with substantial racial/ethnic diversity (35.9% white, 7.8% black, 17.6% Hispanic, 11.7% Asian/Pacific Islander, and 27.0% other/unknown race). At the index visit, 81.9% of participants were normotensive, 12.7% had prehypertension, and 5.4% had a BP in the hypertension range (<95th percentile). Of the 10 848 children with an index hypertensive BP level, 3.8% of those with a follow-up BP measurement had confirmed hypertension (estimated 0.3% prevalence). Increasing age and BMI were significantly associated with prehypertension and confirmed hypertension (P , .001 for trend). Among racial/ethnic groups, blacks and Asians had the highest prevalence of hypertension.

Original languageEnglish (US)
Pages (from-to)e415-e424
Issue number2
StatePublished - Feb 2013


  • Blood pressure
  • Databases
  • Electronic health records
  • Health information technology
  • Hypertension
  • Pediatrics
  • Prehypertension


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