Nav: Home

Research shows importance of second pediatric blood-pressure screening

January 12, 2018

Nearly one-quarter of children and teens who had their blood pressure screened at a primary care appointment showed a reading in the hypertensive range, but less than half of those readings could be confirmed after the blood pressure was repeated, according to a new Kaiser Permanente study released today in The Journal of Clinical Hypertension. The research shows the importance of taking a second blood pressure reading for those ages 3 to 17 years when the first reading is elevated.

"Pediatricians don't diagnose hypertension in children very often, but if it is there, we want to find it," said Robert James Riewerts, MD, regional chief of Pediatrics for the Southern California Permanente Medical Group. "This study is important because it demonstrates the best path to accurately diagnose hypertension in a child or teen. Taking a second blood pressure reading is something all clinicians must consider when the initial reading is elevated.

Blood pressure in youth varies considerably and can be affected by factors such as a child's anxiety. Also, determining high blood pressure in children or teens is more difficult to do than in adults because what is considered high varies based on age, gender and height.

Since this study was conducted, Kaiser Permanente in Southern California has put alerts on its electronic health records to alert clinicians when a second blood pressure reading is recommended. Also, decision-support tools were added to help clinicians determine when further evaluation is recommended.

Researchers found that for patients ages 3 to 17 years:
  • 24.7 percent had at least one blood pressure reading in the hypertensive range.
  • Fewer than half of the children who had their blood pressure screened would be correctly classified based solely on their first blood pressure reading of the appointment.
  • 2.3 percent of youth have sustained hypertension over time.
"Because an elevated first blood pressure in youth is common, correct identification of truly elevated blood pressure may be a first step to improve the recognition of hypertension in pediatric care," said Corinna Koebnick, PhD, MSc, of the Kaiser Permanente Southern California Department of Research & Evaluation. "If hypertension is missed, children and teens may not receive the counseling they need for lifestyle changes or medication."

This study is based on the Kaiser Permanente Southern California Children's Health Study, which includes all children and adolescents ages 2 to 19 years in Southern California who are Kaiser Permanente members. The cohort follow-up was conducted through passive surveillance of clinical care information using the electronic health record system.

The final cohort of 755,795 youth was followed during a 4-year study period, January 2012 through December 2015.

Dr. Koebnick suggested that instead of calculating the average of blood pressure readings, using the lower blood pressure reading may be more efficient for most clinicians.

This study adds to previous Kaiser Permanente research aimed at improving hypertension care, including a study that found children who have a first elevated blood pressure at the doctor's office are not likely to receive the recommended follow-up blood-pressure readings. Another study found that expanding blood pressure screenings to non-primary care settings can help identify more adult patients with high blood pressure.
Other authors on the paper include Yasmina D. Mohan, MPH, and Xia Li, MSc, with the Kaiser Permanente Southern California Department of Research & Evaluation in Pasadena, California; Amy H. Porter, MD, Kaiser Permanente Los Angeles Medical Center, Los Angeles; Matthew F. Daley, MD, Kaiser Permanente Institute for Health Research, Denver; Gang Luo, PhD, Department of Biomedical Informatics and Medical Education, University of Washington, Seattle; and Beatriz D. Kuizon, MD, Department of Biomedical Informatics and Medical Education, University of Washington, Seattle.

The study was supported by funds from the Kaiser Permanente Community Benefit Fund and internal operational funding from Kaiser Permanente Southern California.

About the Kaiser Permanente Southern California Department of Research & Evaluation

The Department of Research & Evaluation conducts high-quality, innovative research into disease etiology, prevention, treatment and care delivery. Investigators conduct epidemiologic research, health services research, biostatistics research, and behavioral research as well as clinical trials. Major areas of study include chronic disease, infectious disease, cancer, drug safety and effectiveness, and maternal and child health. Headquartered in Pasadena, California, the department focuses on translating research to practice quickly to benefit the health and lives of Kaiser Permanente Southern California members and the general public. Visit

About Kaiser Permanente

Kaiser Permanente is committed to helping shape the future of health care. We are recognized as one of America's leading health care providers and not-for-profit health plans. Founded in 1945, Kaiser Permanente has a mission to provide high-quality, affordable health care services and to improve the health of our members and the communities we serve. We currently serve more than 11.7 million members in eight states and the District of Columbia. Care for members and patients is focused on their total health and guided by their personal Permanente Medical Group physicians, specialists and team of caregivers. Our expert and caring medical teams are empowered and supported by industry-leading technology advances and tools for health promotion, disease prevention, state-of-the-art care delivery and world-class chronic disease management. Kaiser Permanente is dedicated to care innovations, clinical research, health education and the support of community health. For more information, go to:

Kaiser Permanente

Related Blood Pressure Articles:

Do you really have high blood pressure?
A study by researchers at the University of Montreal Hospital Research Centre (CRCHUM) shows that more than half of family doctors in Canada are still using manual devices to measure blood pressure, a dated technology that often leads to misdiagnosis.
Why do we develop high blood pressure?
Abnormally high blood pressure, or hypertension, may be related to changes in brain activity and blood flow early in life.
For some, high blood pressure associated with better survival
Patients with both type 2 diabetes and acute heart failure face a significantly lower risk of death but a higher risk of heart failure-related hospitalizations if they had high systolic blood pressure on discharge from the hospital compared to those with normal blood pressure, according to a study scheduled for presentation at the American College of Cardiology's 66th Annual Scientific Session.
$9.4 million grant helps scientists explore how cell death from high blood pressure fuels even higher pressure
It's been known for decades that a bacterial infection can raise your blood pressure short term, but now scientists are putting together the pieces of how our own dying cells can fuel chronically high, destructive pressure.
Blood pressure diet improves gout blood marker
A diet rich in fruits, vegetables, low-fat dairy and reduced in fats and saturated fats (the DASH diet), designed decades ago to reduce high blood pressure, also appears to significantly lower uric acid, the causative agent of gout.
New tool to improve blood pressure measurement
Oxford University researchers have developed a prediction model that uses three separate blood pressure readings taken in a single consultation and basic patient characteristics to give an adjusted blood pressure reading that is significantly more accurate than existing models for identifying hypertension.
Blood vessels sprout under pressure
It is blood pressure that drives the opening of small capillaries during angiogenesis.
Better blood pressure control -- by mobile phone
An interactive web system with the help of your mobile phone can be an effective tool for better blood pressure control.
Time to reassess blood-pressure goals
High blood pressure or hypertension is a major health problem that affects more than 70 million people in the US, and over one billion worldwide.
With help from pharmacists, better blood pressure costs $22
A pharmacist-physician collaboration in primary-care offices effectively and inexpensively improved patients' high blood pressure.

Related Blood Pressure Reading:

Lower Your Blood Pressure: A 21-Day DASH Diet Meal Plan to Decrease Blood Pressure Naturally
by Jennifer Koslo PhD RDN CSSD (Author)

Make your healthy heart a habit with the diet and meal plan in Lower Your Blood Pressure.

As 54% of the 75 million Americans who suffer from hypertension know, leading a heart-healthy lifestyle is easier said than done. Recognizing both the rewards and challenges of dieting to lower your blood pressure, Jennifer Koslo, PhD, RD, CSSD, lays out an effective and easy to follow 21-day DASH diet meal plan to help you start and stick to healthy habits. Featuring over 75 low-sodium, high-potassium, and magnesium-filled recipes, Lower Your Blood Pressure is... View Details

Thirty Days to Natural Blood Pressure Control: The "No Pressure" Solution
by MPH, David DeRose MD (Author), MPH, Greg Steinke MD (Author), Trudie Li FNP (Author), Clifford Goldstein (Editor)

High Blood Pressure. Even if you haven’t received the diagnosis yet, as many as three-quarters of the Western world will have to contend with high blood pressure sometime in their lives. However you no longer need to be a victim. Drs. DeRose and Steinke along with Nurse Practitioner Li draw from cutting-edge medical research and their decades of clinical experience to guide you on an amazing 30-day journey. Learn simple natural strategies that have helped many people decrease or eliminate their dependence on medications. Other titles may promise fast results with natural blood pressure... View Details

Blood Pressure Down: The 10-Step Plan to Lower Your Blood Pressure in 4 Weeks--Without Prescription Drugs
by Janet Bond Brill PhD RD (Author)

For the nearly 78 million Americans with hypertension, a safe, effective lifestyle plan—incorporating the DASH diet principles and much more—for lowering blood pressure naturally

If you have high blood pressure, you're not alone: nearly a third of adult Americans have been diagnosed with hypertension, and another quarter are well on their way. Yet a whopping 56 percent of diagnosed patients do not have it under control. The good news? Hypertension is easily treatable (and preventable), and you can take action today to bring your blood pressure down in just four... View Details

The Magnesium Solution for High Blood Pressure (The Square One Health Guides)
by Jay S. Cohen (Author)

Written by health professionals who are well recognized in their respective fields, these concise, easy-to-read books focus on a wide range of important health concerns. From migraine headaches to high cholesterol, each title looks at a specific problem; each provides a clear explanation of the disorder, its causes, and its symptoms; and each offers natural solutions that can either greatly reduce or completely eliminate the problem. Some titles also focus on natural alternatives to drugs with serious side effects―alternatives that in many cases can be used in conjunction with prescription... View Details

Blood Pressure: Blood Pressure Solution : The Ultimate Guide to Naturally Lowering High Blood Pressure and Reducing Hypertension (Blood Pressure Series) (Volume 1)
by Mark Evans (Author)

Blood Pressure Series Book #1

Includes a FREE bonus book “Super Foods for Super Health”

With close to a third of adult Americans have been diagnosed with high blood pressure and hypertension, yet over 50% of diagnosed patients don’t have it under control, high blood pressure and hypertension are a serious problem... The good news is, Blood Pressure and Hypertension is easily treatable! In this book, we will go over the proven process to successfully prevent, control and lower high blood pressure. By implementing the strategies listed within this... View Details

Blood Pressure Solution: The Path to Naturally Lower and Control your Blood Pressure, Without Medication
by Margaret Schmitt (Author)

Do you have high blood pressure?
Do you want to find a solution to it?
Do you want to do it without medication and by using all natural remedies?
More than a billion people worldwide have hypertension. It is a leading cause of hundreds of thousands of deaths every year and most drugs only target the symptoms and are not designed to provide a long-term solution.

Now, with Blood Pressure Solution: The Path to Naturally Lower and Control your Blood Pressure, Without Medication, you have the ideal book to help you develop a comprehensive... View Details

Reversing Hypertension: A Vital New Program to Prevent, Treat, and Reduce High Blood Pressure
by Julian Whitaker (Author)

It Strikes One in Four Americans Without Warning... it triples your risk of dying from a heart increases your risk of stroke can lead to kidney disease, diabetes, and blindness...and to fight it, you may be taking expensive-and dangerous-drugs. Now Dr. Julian Whitaker, a leading champion of nutritional medicine and the author of Reversing Diabetes and Reversing Heart Disease, unleashes a new weapon in the war against hypertension. His simple yet dramatically effective plan offers: * a comprehensive program of diet, exercise, nutritional supplements, and stress... View Details

Blood Pressure: Blood Pressure Solution - Lower Your Blood Pressure With Natural Remedies
by Emily Hoskins (Author)

BLOOD PRESSURE SOLUTION – LOWER YOUR BLOOD PRESSURE USING NATURAL High blood pressure - It’s called ‘The Silent Killer’ and it could strike any of us at any time without warning. There can be absolutely no signs, symptoms or warning. Our highly stressed, busy and sedentary lifestyles are slowly killing us through poor diet and lack of exercise. The Silent Killer has crept into our society and over 29% or 70 million adults in America suffer from high blood pressure. SO WHAT ACTUALLY IS HIGH BLOOD PRESSURE OR HYPERTENSION AND WHAT CAUSES IT? These are great questions that will be... View Details

Blood Pressure Protocol: 42 Simple Blood Pressure Reducing Recipes - The Ultimate Guide To a Healthy Blood Pressure Level
by Kevin Roche (Author)

Blood plays the vital role in controlling the functioning of our body, which is the reason why our bodies’ organ will not be able to work properly if something bad happens to our blood. Some people might underestimate the potential dangers high blood pressure can cause since this condition has such wide media coverage. In contrast, high blood pressure actually leads to various other disorders which are much more challenging to treat, including heart-related diseases and diabetes. Therefore, you should not ever belittle hypertension and its severe consequences. In this book, I have taken... View Details

High Blood Pressure: How to reduce blood pressure quickly and easily, and live a long and healthy life
by Jory Michaels (Author)

High Blood Pressure – How to reduce blood pressure quickly and easily and live a long and healthy life (2nd Edition)

Grab this GREAT physical book now at a limited time discounted price!

Approximately 1 in every 3 Americans suffer from some form of High Blood Pressure, in fact it is one of the most common health problems diagnosed most frequently. Sometimes it can go undiagnosed also, as there are no real visible symptoms, it is only when you have your blood pressure taken at the doctors that the problem can show up.

If you are diagnosed with high... View Details

Best Science Podcasts 2018

We have hand picked the best science podcasts for 2018. Sit back and enjoy new science podcasts updated daily from your favorite science news services and scientists.
Now Playing: TED Radio Hour

The Consequences Of Racism
What does it mean to be judged before you walk through the door? What are the consequences? This week, TED speakers delve into the ways racism impacts our lives, from education, to health, to safety. Guests include poet and writer Clint Smith, writer and activist Miriam Zoila Pérez, educator Dena Simmons, and former prosecutor Adam Foss.
Now Playing: Science for the People

#465 How The Nose Knows
We've all got a nose but how does it work? Why do we like some smells and not others, and why can we all agree that some smells are good and some smells are bad, while others are dependant on personal or cultural preferences? We speak with Asifa Majid, Professor of Language, Communication and Cultural Cognition at Radboud University, about the intersection of culture, language, and smell. And we level up on our olfactory neuroscience with University of Pennsylvania Professor Jay Gottfried.