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Screening and Management of Pediatric High Blood Pressure—Challenges to Implementing the Clinical Practice Guideline

  • Pediatric Hypertension (C Hanevold, Section Editor)
  • Published:
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Abstract

Purpose of Review

Elevated blood pressure (BP) and hypertension in childhood convey risk for hypertension and cardiovascular events in adulthood. Early recognition of abnormal BPs is key to preventing or lessening this risk. However, the process for making the diagnosis of hypertension is complex, and overall adherence to the 2017 American Academy of Pediatrics Clinical Practice Guidelines (CPG) is poor. We will review obstacles to adherence to the CPG and approaches designed to improve the diagnosis and management of hypertension in children.

Recent Findings

Baseline data from the multi-center quality improvement intervention, “Boosting Primary Care Awareness and Treatment of Hypertension” (BP-CATCH), demonstrate that childhood hypertension remains underdiagnosed. Other studies confirm a lack of compliance with the process outlined in the CPG. The provision of electronic prompts, coaching, and education results in modest improvements.

Summary

The combination of embedded medical record tools and education seems to offer the most hope for improvement.

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Data Availability

No datasets were generated or analysed during the current study.

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Acknowledgements

We would like to express our gratitude to Ms. Katherine Gannon for creating the figures included in this paper, which have greatly enhanced the visual representation of key steps needed for BP screening and to ensure device accuracy. We are also appreciative of the manuscript critiques provided by Dr. Elyse Kharbanda and Dr. Bonita Falkner.

Author information

Authors and Affiliations

  1. Department of Pediatrics, University of Washington School of Medicine, Seattle, WA, USA

    Coral D. Hanevold

  2. Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Tammy M. Brady

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  1. Coral D. Hanevold
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  2. Tammy M. Brady
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CH prepared the main manuscript text, tables, and outlines for figures. TB contributed to manuscript preparation and editing of the manuscript, tables, and figure outlines.

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Correspondence to Coral D. Hanevold.

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Hanevold, C.D., Brady, T.M. Screening and Management of Pediatric High Blood Pressure—Challenges to Implementing the Clinical Practice Guideline. Curr Hypertens Rep (2024). https://doi.org/10.1007/s11906-024-01298-0

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