National Healthcare Quality and Disparities Report
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Search All Research Studies
Topics
- Adverse Drug Events (ADE) (2)
- Adverse Events (1)
- Blood Clots (1)
- (-) Blood Pressure (12)
- Cardiovascular Conditions (2)
- Case Study (2)
- (-) Children/Adolescents (12)
- Chronic Conditions (2)
- Clinical Decision Support (CDS) (1)
- Diabetes (1)
- Diagnostic Safety and Quality (2)
- Electronic Health Records (EHRs) (1)
- Evidence-Based Practice (3)
- Guidelines (2)
- Healthcare Delivery (1)
- Health Information Technology (HIT) (1)
- Medication (2)
- Medication: Safety (2)
- Obesity (2)
- Patient Safety (1)
- Prevention (3)
- Primary Care (1)
- Racial and Ethnic Minorities (1)
- Risk (2)
- Rural/Inner-City Residents (1)
- Rural Health (1)
- Screening (3)
- U.S. Preventive Services Task Force (USPSTF) (3)
AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 12 of 12 Research Studies DisplayedBenziger CP, Suess M, Allen CI
Adapting a clinical decision support system to improve identification of pediatric hypertension in a rural health system: design of a pragmatic trial.
This paper’s objective is to describe the protocol for a study that will adapt an electronic health record linked, web-based clinical decision support (CDS) tool called PedsBP that identifies hypertension (HTN) in children for use in a mostly rural health system and to evaluate the effectiveness of PedsBP for repeat of hypertensive level blood pressure (BP) measurements and HTN recognition among youth 6-17 years of age in primary care settings, comparing low-intensity and high-intensity implementation approaches. A pilot of the tool was conducted in 2 primary care clinics and modified prior to the full trial. Forty community-based primary care clinics (or clusters of clinics) were randomly allocated equally to usual care, low-intensity implementation (CDS only), or high-intensity implementation (CDS plus in-person training, monthly use reports, and ongoing communication between study staff and clinics). Eligible patient recruitment started on August 1, 2022 and will continue for 18 months. Primary outcomes will include repeating hypertensive level BP measurements at office visits and clinical recognition of HTN. Secondary outcomes will include lifestyle counseling, dietician referral, and BP at follow-up.
AHRQ-funded; HS027402.
Citation: Benziger CP, Suess M, Allen CI .
Adapting a clinical decision support system to improve identification of pediatric hypertension in a rural health system: design of a pragmatic trial.
Contemp Clin Trials 2023 Sep; 132:107293. doi: 10.1016/j.cct.2023.107293..
Keywords: Clinical Decision Support (CDS), Children/Adolescents, Rural Health, Rural/Inner-City Residents, Blood Pressure
Brady TM, Goilav B, Tarini BA
Pediatric home blood pressure monitoring: feasibility and concordance with clinic-based manual blood pressure measurements.
The purpose of this feasibility and concordance study was to evaluate pediatric home blood pressure monitoring in an urban, primarily minority population during the SARS-CoV-2 pandemic. Home blood pressure monitoring (HBPM) may lower the number of needed in-person visits prior to receiving a hypertension diagnosis. Given the challenges of bringing children into offices and the increase in of telehealth services, this study examines whether HBPM offers a feasible and accurate adjunct in pediatric hypertension diagnosis. In this study, the authors concluded that only one-third of consenting patients who appeared for an in-clinic BP measurement and HBPM training provided HBPM data, much of it was not completed as instructed, and one-half had HBPM classifications that were discordant from manual BPs obtained in clinic.
AHRQ-funded; HS026239.
Citation: Brady TM, Goilav B, Tarini BA .
Pediatric home blood pressure monitoring: feasibility and concordance with clinic-based manual blood pressure measurements.
Hypertension 2022 Oct; 79(10):e129-e31. doi: 10.1161/hypertensionaha.122.19578..
Keywords: Children/Adolescents, Blood Pressure
Nugent JT, Young C, Funaro MC
Prevalence of secondary hypertension in otherwise healthy youths with a new diagnosis of hypertension: a meta-analysis.
The objective of this meta-analysis was to estimate prevalence of secondary hypertension among otherwise healthy children with hypertension diagnosed in outpatient settings. The authors found that, when stratified by study setting, there were no significant subgroup differences according to study design or quality, country, participant age range, hypertension definition, or blood pressure device. They concluded that the low prevalence of secondary hypertension among children with a new diagnosis of hypertension reinforces clinical practice guidelines to avoid extensive testing in primary care settings for secondary causes in most children with hypertension.
AHRQ-funded; HS027626.
Citation: Nugent JT, Young C, Funaro MC .
Prevalence of secondary hypertension in otherwise healthy youths with a new diagnosis of hypertension: a meta-analysis.
J Pediatr 2022 May; 244:30-37.e10. doi: 10.1016/j.jpeds.2022.01.047..
Keywords: Children/Adolescents, Blood Pressure
Mabry-Hernandez I, Baker SM
AHRQ Author: Mabry-Hernandez I
Screening for high blood pressure in children and adolescents.
This Putting Prevention into Practice case study concerns a 10-year-old boy with obesity and a family history significant for hypertension and hyperlipidemia presenting for a well-child examination. The parents express concern about their child’s risk for hypertension and ask whether they should be monitoring his blood pressure. Three questions are presented, along with answers.
AHRQ-authored.
Citation: Mabry-Hernandez I, Baker SM .
Screening for high blood pressure in children and adolescents.
Am Fam Physician 2021 Mar 15;103(6):371-72..
Keywords: U.S. Preventive Services Task Force (USPSTF), Children/Adolescents, Blood Pressure, Screening, Guidelines, Evidence-Based Practice, Prevention, Case Study
Horton DB, Xie F, Chen L
Oral glucocorticoids and incident treatment of diabetes mellitus, hypertension, and venous thromboembolism in children.
The purpose of this study was to quantify rates of incident treatment for diabetes mellitus, hypertension, and venous thromboembolism (VTE) associated with oral glucocorticoid exposure in children aged 1-18 years. Participants were identified using US Medicaid claims data and included more than 930,000 children diagnosed with autoimmune diseases or a nonimmune comparator condition. Findings showed strong dose-dependent relationships between current glucocorticoid exposure and all outcomes, suggesting strong relative risks, but low absolute risks, of newly-treated VTE, diabetes, and especially hypertension in children taking high-dose oral glucocorticoids.
AHRQ-funded; HS021110.
Citation: Horton DB, Xie F, Chen L .
Oral glucocorticoids and incident treatment of diabetes mellitus, hypertension, and venous thromboembolism in children.
Am J Epidemiol 2021 Feb 1;190(3):403-12. doi: 10.1093/aje/kwaa197..
Keywords: Children/Adolescents, Diabetes, Chronic Conditions, Blood Clots, Medication: Safety, Medication, Adverse Drug Events (ADE), Adverse Events, Risk, Patient Safety, Blood Pressure
Gartlehner G, Vander Schaaf EB, Orr C
Gartlehner G, Vander Schaaf EB, Orr C, Kennedy SM, Clark R, Viswanathan M. Screening for hypertension in children and adolescents: updated evidence report and systematic review for the US Preventive Services Task Force.
This paper is an evidence update that accompanies the final recommendation from the U.S. Preventive Services Task Force (USPSTF) on screening and treatment of hypertension in childhood and adolescence. The update confirmed the previous update that the evidence is inconclusive whether the diagnostic accuracy of blood pressure measurements is adequate for screening asymptomatic children and adolescents in primary care. Forty-two studies from 43 publications were included in the final review.
AHRQ-funded; 290201500011I.
Citation: Gartlehner G, Vander Schaaf EB, Orr C .
Gartlehner G, Vander Schaaf EB, Orr C, Kennedy SM, Clark R, Viswanathan M. Screening for hypertension in children and adolescents: updated evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2020 Nov 10;324(18):1884-95. doi: 10.1001/jama.2020.11119..
Keywords: Children/Adolescents, U.S. Preventive Services Task Force (USPSTF), Blood Pressure, Screening, Evidence-Based Practice, Prevention, Cardiovascular Conditions
Kaelber DC, Localio AR, Ross M
Persistent hypertension in children and adolescents: a 6-year cohort study.
The purpose of this study was to determine the natural history of pediatric hypertension. The study was conducted over a 72-month period among 165 primary care sites; blood pressure measurements from two consecutive 36-month periods were compared. Findings indicated that, in a primary care cohort, most children initially meeting criteria for hypertension or elevated blood pressure had subsequent normal blood pressure levels or did not receive recommended follow-up measurements. These results highlight the need for more nuanced initial blood pressure assessment and systems to promote follow-up of abnormal results.
AHRQ-funded; HS021645.
Citation: Kaelber DC, Localio AR, Ross M .
Persistent hypertension in children and adolescents: a 6-year cohort study.
Pediatrics 2020 Oct;146(4):Oct. doi: 10.1542/peds.2019-3778..
Keywords: Children/Adolescents, Blood Pressure, Cardiovascular Conditions, Chronic Conditions
Rao G, Naureckas S, Datta A
Pediatric hypertension: diagnostic patterns derived from electronic health records.
This study examined the rates of diagnostic for pediatric hypertension using electronic health records (EHRs). The rates of diagnosis were very low (6.1%) among 1478 children identified as hypertensive. Rates of diagnosis improved in children aged 12 and above but was very low for children aged 6 and under. Underdiagnosis can lead to organ failure and increased risk for adult hypertension.
AHRQ-funded; HS024100.
Citation: Rao G, Naureckas S, Datta A .
Pediatric hypertension: diagnostic patterns derived from electronic health records.
Diagnosis 2018 Sep;5(3):157-60. doi: 10.1515/dx-2018-0010..
Keywords: Children/Adolescents, Blood Pressure, Diagnostic Safety and Quality, Electronic Health Records (EHRs), Health Information Technology (HIT)
Bello JK, Mohanty N, Bauer V
Pediatric hypertension: provider perspectives.
The researchers aimed to gain insights into reasons for low rates of diagnosis and treatment from primary care providers. In interviews, providers reflected on numerous barriers to diagnosis, management, and follow-up; recommendations for educational content; and how community health center systems can be improved. Findings informed development of a multifaceted intervention.
AHRQ-funded; HS024100.
Citation: Bello JK, Mohanty N, Bauer V .
Pediatric hypertension: provider perspectives.
Glob Pediatr Health 2017 Jun 6;4:2333794x17712637. doi: 10.1177/2333794x17712637.
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Keywords: Children/Adolescents, Diagnostic Safety and Quality, Healthcare Delivery, Blood Pressure, Obesity, Primary Care
Westover AN, Nakonezny PA, Adinoff B
Impact of stimulant medication use on heart rate and systolic blood pressure during submaximal exercise treadmill testing in adolescents.
In this study of the impact of stimulant medication use on heart rate and systolic blood pressure during submaximal exercise treadmill testing in adolescents, the investigators found that adolescent stimulant medication users, compared to matched nonusers, demonstrated a trend toward decreased heart rate during submaximal exercise (which is potential evidence of chronic adaptation with stimulant exposure). There was no evidence for delayed heart rate recovery in this study, and thus, no evidence for decreased parasympathetic activity during initial exercise recovery.
AHRQ-funded; HS022418.
Citation: Westover AN, Nakonezny PA, Adinoff B .
Impact of stimulant medication use on heart rate and systolic blood pressure during submaximal exercise treadmill testing in adolescents.
J Child Adolesc Psychopharmacol 2016 Dec;26(10):889-99. doi: 10.1089/cap.2016.0064..
Keywords: Adverse Drug Events (ADE), Children/Adolescents, Blood Pressure, Medication, Medication: Safety
Rivera-Soto WT, Rodriguez-Figueroa L
Is waist-to-height ratio a better obesity risk-factor indicator for Puerto Rican children than is BMI or waist circumference?
This study aimed to explore the association of a single blood pressure reading with 3 different obesity indicators (WC, BMI, and WHtR). Its findings suggest the possibility of higher prevalence of high blood pressure in obese Puerto Rican children. The waist-to height ratio could be the best indicator to measure obesity and potential hypertension in Puerto Rican children.
AHRQ-funded; HS014060.
Citation: Rivera-Soto WT, Rodriguez-Figueroa L .
Is waist-to-height ratio a better obesity risk-factor indicator for Puerto Rican children than is BMI or waist circumference?
P R Health Sci J 2016 Mar;35(1):20-5.
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Keywords: Racial and Ethnic Minorities, Obesity, Children/Adolescents, Risk, Blood Pressure
Mabry-Hernandez I, Chu K
AHRQ Author: Mabry-Hernandez I
Screening for primary hypertension in children and adolescents.
This article presents a case study about a 14-year-old black adolescent who presents for a routine school physical examination. Her mother tells you that she and her husband have hypertension, and they worry about their daughter’s blood pressure. She asks you whether her child should be periodically checked for high blood pressure. The case study was coordinated with the AHRQ-administered US Preventive Services Task Force and published online on the American Academy of Family Practice website.
Citation: Mabry-Hernandez I, Chu K .
Screening for primary hypertension in children and adolescents.
Am Fam Physician 2015 Feb 15;91(4):257-8..
Keywords: U.S. Preventive Services Task Force (USPSTF), Children/Adolescents, Blood Pressure, Screening, Evidence-Based Practice, Guidelines, Prevention, Case Study