Study suggests poor usage of diagnostic tests<br> in adolescents with hypertension

CHICAGO, IL – A study suggests that recommended diagnostic tests for hypertension in adolescents are poorly used.

Esther Y. Yoon, M.D., M.P.H., and colleagues of the University of Michigan, Ann Arbor, examined echocardiogram use in adolescents with hypertension and compared it with EKG and renal ultrasonography use in an analysis of administrative claims data from the Michigan Medicaid program from 2003 to 2008, in a report published Online First by Archives of Pediatrics & Adolescent Medicine, a JAMA Network publication.

Results indicate that 951 adolescents with “essential” hypertension (i.e., the cause is unknown) had antihypertensive pharmacy claims: 24 percent (226) had echocardiograms; 22 per cent (207) had renal ultrasonography; and 50 per cent (478) had EKGs.

Hypertension is a growing problem for adolescents due to the association between obesity and hypertension. Current guidelines recommend renal ultrasonography for all patients with hypertension to rule out renal (kidney) disease and echocardiograms to assess target organ damage.

Little is known about echocardiogram use among adolescents, however, compared to other recommended diagnostic tests (renal ultrasonography) and non-recommended but more readily available tests such as electrocardiograms (EKGs), according to the study background.

 The study results show equally low levels of obtaining echocardiograms and renal ultrasonography, both recommended tests. In contrast, one-half of adolescents had at least one EKG during the study period, a diagnostic test that is not recommended by pediatric guidelines but one that is recommended for adults with hypertension.

Boys, younger adolescents, those who had EKGs, and those who had renal ultrasonography were more likely to receive echocardiograms than girls, older adolescents, and those who did not have EKGs or renal ultrasonography.

Nike Schuhe