SAN FRANCISCO — Physicians may be failing to address abnormal blood pressure levels among adolescents, according to a study presented at the annual meeting of the American Academy of Family Physicians.
The study analyzed blood pressure levels recorded on preparticipation sports physicals for more than 1,500 adolescents. More than 13% of the adolescents had either a hypertensive systolic or hypertensive diastolic blood pressure level, but few were identified as abnormal or provided with follow-up interventions, according to Kevin E. Burroughs, M.D., of the University of North Carolina, who conducted the study.
“If anything, we should be able to use this information to help us out with trying to help decrease morbidity and mortality for these individuals,” Dr. Burroughs said.
His study looked at the preparticipation exams for 1,547 adolescents from three middle schools and three high schools in Cabarrus County, N.C., during the school years 2003–2004 and 2004–2005. He used guidelines from the National Heart Lung and Blood Institute's Working Task Force on Childhood Hypertension to classify the blood pressure by age and height.
As outlined in those guidelines, blood pressure values of greater than the 95th percentile for age, sex, and height were classified as child and adolescent hypertension. Those in the 90–95th percentile were high normal blood pressure and blood pressure values that fell below the 90th percentile were considered normal.
Overall, 7.4% (114) of the adolescents in the study had systolic blood pressure that would be considered hypertensive and 6.5% (100) of the adolescents had a hypertensive diastolic blood pressure. But only 14 of the adolescents with hypertensive values were labeled as such, Dr. Burroughs said, and only 11 were scheduled for any follow-up.
Though hypertension is not determined by a single reading, it offers physicians an opportunity to identify at-risk individuals in a population that they don't frequently see in the office, Dr. Burroughs said.
“There's an alarmingly low number of abnormal values which have been labeled as such on this examination, possibly due to a lack of awareness among practitioners about these tables and considerations,” he said.
Dr. Burroughs said he's spoken to a number of people who are unfamiliar with the guidelines for classifying blood pressure by age and height. Those familiar with the guidelines might find the process too time consuming, he said.
“We should be able to intervene for these people [by] including them in doing exercise programs, modifying their diet, before we have to get to the point of putting them on medication,” he said.