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

IF 3.9 2区医学 Q1 PERIPHERAL VASCULAR DISEASE

Current Hypertension Reports Pub Date : 2024-06-01 Epub Date: 2024-03-09 DOI:10.1007/s11906-024-01298-0

Coral D Hanevold, Tammy M Brady

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

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小儿高血压的筛查和管理--实施《临床实践指南》的挑战。

审查目的：儿童时期的血压（BP）升高和高血压会给成年后的高血压和心血管事件带来风险。早期识别异常血压是预防或降低这种风险的关键。然而，高血压的诊断过程十分复杂，而且对《2017 年美国儿科学会临床实践指南》（CPG）的总体遵守情况较差。我们将回顾遵守《美国儿科学会临床实践指南》的障碍，以及旨在改善儿童高血压诊断和管理的方法：多中心质量改进干预项目 "提高初级保健对高血压的认识和治疗"（BP-CATCH）的基线数据表明，儿童高血压的诊断率仍然偏低。其他研究也证实，儿童对 CPG 中概述的流程缺乏依从性。通过提供电子提示、指导和教育，情况略有改善。将嵌入式病历工具和教育相结合似乎最有希望得到改善。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Current Hypertension Reports 医学-外周血管病

CiteScore

10.50

自引率

0.00%

发文量

审稿时长

6-12 weeks

期刊介绍： This journal intends to provide clear, insightful, balanced contributions by international experts that review the most important, recently published clinical findings related to the diagnosis, treatment, management, and prevention of hypertension. We accomplish this aim by appointing international authorities to serve as Section Editors in key subject areas, such as antihypertensive therapies, associated metabolic disorders, and therapeutic trials. Section Editors, in turn, select topics for which leading experts contribute comprehensive review articles that emphasize new developments and recently published papers of major importance, highlighted by annotated reference lists. An international Editorial Board reviews the annual table of contents, suggests articles of special interest to their country/region, and ensures that topics are current and include emerging research. Commentaries from well-known figures in the field are also provided.