Pediatricians generally don't address elevated blood pressures in overweight children during well-child visits. When they do broach the subject, their communication is often unclear, according to preliminary research presented at the American Heart Association's Scientific Sessions 2018.
Researchers analyzed 30 video- and audio-recorded well-child visits of 6- to 12-year-olds with overweight/obesity who had elevated blood pressures at the visit. Visits were recorded from 2013 to 2016. Eighty percent of the children had elevated blood pressures, and 20 percent had blood pressure readings at the recorded visit plus two or more past visits that were high enough to meet criteria for pediatric hypertension. Researchers found pediatricians:
- provided clear and direct information about high blood pressure in 16.6 percent of visits;
- made unclear statements in 16.6 percent of visits—for example: "The biggest reason I worry about this [obesity] is you can start having adult problems like high blood pressure"; and
- frequently didn't address high blood pressure at all (66.7 percent of visits).
Researchers noted that providers were more likely to use more direct communication when children had systolic blood pressures that exceeded the adult high blood pressure threshold.
Researchers also looked at communication themes such as therapeutic lifestyle counseling and follow-up information, each of which they found occurred in 10 percent of visits. Of the 20 percent of children who met criteria for the diagnosis of pediatric hypertension, not one received communication about this diagnosis from pediatricians during the recorded visits.
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