Improving Outcomes for Hypertensive Children
| Status: | Completed |
|---|---|
| Conditions: | High Blood Pressure (Hypertension) |
| Therapuetic Areas: | Cardiology / Vascular Diseases |
| Healthy: | No |
| Age Range: | 6 - 17 |
| Updated: | 4/21/2016 |
| Start Date: | November 2011 |
| End Date: | May 2015 |
Approximately 200 children age 6 - <18 years receiving medications for essential
hypertension (HTN) will be recruited from the Pediatric Hypertension Clinic at the time of a
routine clinic visit. Participating subjects will be asked to wear the ambulatory blood
pressure monitor (ABPM) for 24 hours within 2 weeks of the qualifying visit. Measurements
obtained with the ABPM will be compared to measurements obtained by routine clinical
procedures documented in the subject's clinical chart. Kappa statistic will be utilized to
compare differences in documented BP control between the two measures as well as changes in
therapeutic management decisions by treating physicians with the addition of the ABPM
readings. The overall goal is to confirm that ABPM leads to an increased detection of
uncontrolled HTN along with a similar increase in adjustments increasing anti-hypertensive
medication regimens.
hypertension (HTN) will be recruited from the Pediatric Hypertension Clinic at the time of a
routine clinic visit. Participating subjects will be asked to wear the ambulatory blood
pressure monitor (ABPM) for 24 hours within 2 weeks of the qualifying visit. Measurements
obtained with the ABPM will be compared to measurements obtained by routine clinical
procedures documented in the subject's clinical chart. Kappa statistic will be utilized to
compare differences in documented BP control between the two measures as well as changes in
therapeutic management decisions by treating physicians with the addition of the ABPM
readings. The overall goal is to confirm that ABPM leads to an increased detection of
uncontrolled HTN along with a similar increase in adjustments increasing anti-hypertensive
medication regimens.
Inclusion Criteria:
1. Age 6-17 years (up to 18th birthday) receiving anti-hypertensive medication(s) by
subject history at presentation for the qualifying clinic visit
2. Arm circumference measurement of 15-50 cm (limits of SpaceLabs ABPM cuffs).
Exclusion Criteria:
1. Severe HTN which in the opinion of the treating physician would prevent the subject
from delaying changes in therapy to complete the study.
2. Secondary HTN from all causes (excluding obesity-related HTN). This includes but is
not limited to renovascular HTN, chronic kidney disease, coarctation of the aorta,
and monogenic forms of HTN.
3. Physical limitations prohibiting placement of the ABPM monitor.
4. Significant arrhythmias or known disruptions in cardiac output which may interfere
with the monitor's ability to detect BP accurately.
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Arkansas Children's Hospital Arkansas Children's Hospital (ACH) is the only pediatric medical center in Arkansas...
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