Hypertension Often Misdiagnosed Among Children: Study

Many children are misdiagnosed with high blood pressure at initial doctor visits, causing unnecessary follow-up appointments and treatments, according to the findings of a new study. 

Kaiser Permanente researchers found that nearly 100,000 pediatric patients were misdiagnosed with hypertension, or high blood pressure. The findings were published in the December issue of the Journal of Clinical Hypertension, and may translate to hundreds of thousands of children receiving a hypertension misdiagnosis for a very serious condition.

Researchers looked at data from 2012 to 2015 on patients ages three to 17 years old enrolled in a Kaiser Permanente Southern California health plan since 2007.

According to the findings, nearly one-quarter of the children included in the study, or about 187,000 children, had a blood pressure reading in the hypertensive range. However, only one-fifth of those patients, or about 30,000 children, were given a repeat blood pressure reading at the same visit.

Among those who had two blood pressure readings with an initial high blood pressure reading above the 99th percentile by 5 mm Hg, 65% had a second reading that was in the normal blood pressure range.

If the first reading had been taken at face value, those children would have received a false positive diagnosis for hypertension.  They may have been required to have additional, maybe multiple, unnecessary follow-up exams or prescribed lifestyle changes or unnecessary medication for a condition they did not have.

The children who were given the second blood pressure tests were able to avoid potentially unnecessary follow-up visits and unnecessary treatment.

Approximately 1.2% of the initial patients had false negatives, or lower final blood pressure readings followed by a higher repeat reading.

Researchers warn that many children classified as having hypertension might be misdiagnosed. They are urging doctors to always use a second blood pressure reading during the same doctors visit to avoid misdiagnoses and unnecessary repeat follow-ups.

Researchers also noted that among asymptomatic children and teens who were screened and  followed up as recommended within 3 months, only a small percentage were confirmed to have an actual hypertension diagnosis.

Roughly 2% of children with an initial visit indicating hypertension stage I readings still have high blood pressure readings at a follow-up visit. Similarly, only 11% of children with hypertension stage II readings at the first visit have a follow-up blood pressure reading that indicates hypertension.

The researchers determined that a second repeat test during the same doctor’s visit should be the standard of practice to help rule out false positive hypertension diagnoses among children.