SCHOOL-BASED SCREENING FOR HIGH BLOOD PRESSURE IN CHILDREN IS EFFECTIVE, ACCEPTABLE AND FEASIBLE
Mr Jonathan Glenning1,2,3, Dr Freya Sheeran1,2,3, A/Prof. Jon Quach1,2, Prof. Michael Cheung1,2,3, A/Prof. Stephanie Best1,2, A/Prof. Catherine Quinlan1,2,3, A/Prof. Jonathan Mynard1,2,3
1Murdoch Children’s Research Institute, Parkville, Australia, 2University of Melbourne, Parkville, Australia, 3Royal Children’s Hospital, Melbourne, Parkville, Australia
Aim: To assess the feasibility of conducting a BP screening program.
Background: Elevated blood pressure (BP) or hypertension affects ~15% of children globally and has a significant association with cardiovascular morbidity and mortality in mid-adulthood. However, there is no established pathway for hypertension screening in childhood in Australia.
Methods: One-hundred-ninety-eight children (59% male) in grades 3–6 were recruited from three Melbourne primary schools. BP was manually measured five times in those for whom parental consent was obtained. Those with an average BP >85th percentile or risk factors for high BP had these measurements repeated two weeks later, along with 24-hour ambulatory blood pressure monitoring (ABPM). Families and school staff also provided impressions and feedback before and after the program.
Results: Initially, 5.6% and 5.0% had an elevated (>90th percentile) or hypertensive (>95th percentile) BP respectively. Fifty-nine participants (29.8%) were asked to return for the second screening (including 29 with risk factors such as obesity or prematurity, and nine with a BP>85th percentile but <90th percentile). Fifty-two then completed the second screening and ABPM where five had hypertensive BPs. They, along with three others with inconclusive ABPMs, and three who had elevated/high BPs initially but did not undergo ABPM were referred to a GP. 67% reported that ABPM was tolerable (‘bothersome’ score <8/10 for day and/or night). Finally, 96% of families approved of the program and 90% welcomed it as part of their child’s schooling.
Conclusions: These preliminary data indicate that a school BP screening program is effective, acceptable and feasible and that measuring BP across multiple occasions, including ABPM, can minimise false positives and therefore burden on individuals and the healthcare system via unnecessary referrals.
Presentation Slides PDF – Click here
Biography:
Jonathan Glenning is an MD/PhD Candidate within the Melbourne Medical School and Department of Paediatrics at the University of Melbourne, the Kidney Flagship and Heart Research at the Murdoch Children’s Research Institute and is an Honorary Researcher within the Department of Cardiology at the Royal Children’s Hospital, Melbourne. His research is all about improving the accuracy of blood pressure measurement as well as establishing, expanding, and improving both new and existing approaches for blood pressure screening in children and adolescents.