Our adolescent hypertension study 2006

An opportunity to compare apples with apples

• Saint John study 1978 children grades 7-12 over 8,000 participants

• Measured BP and height• PI still practicing• Great opportunity to look at our

community again

What did we do differently

• First we replicated original study (so apples to apples)

• Second we added weight as a measure and administered a questionnaire (added some oranges)

• Our population was slightly less 5,000 participants (but definitely significant numbers)

What did we find

• Have to brief the minister first• But can let you in on some findings

After the study

• Our purpose was to measure BPs• Look at the trends• But hey we are health care professionals

with a conscience• We wanted to have a chance to monitor

those who on first blush had an elevated BP

• Chose high normal as cut off

What did we do

• Anyone with 2 readings over 130/90• Systolic or diastolic or both• Sent a letter

How many letters

• Original study with about 8,400 send 84 letters with almost 100% response

• This study with over 5,000 participants with about 4,900 included for analysis we sent out 250 letters

What happened

• First letter gentle• Set aside 4 evening clinics• Invited families• Set up for crisis counseling on the phone• Cardiologist, pediatrician, full blood

profile, same measures plus waist circumference

Guess what

• Only 45 showed over 4 nights• We did get caught up on gossip• Sent out second letter• More strongly worded• Invited to call let us know, gave phone

numbers. email address, and mailing address

• Got 30 more

Just like a dog with the bone

• Sent out 3rd letter (actually 3 types)• Got a few more• In total about 30% show rate

What do we think

• In general would say there is some apathy

• Only 5 parents called• Those that did come with students were

only mildly concerned• Most indicated that an elevated BP

reading would not mean anything

What is the lesson

• As health professionals we need to work on getting the message about high blood pressure out there

• We should have been getting many anxious calls after each school visit and definitely after each letter

The Take Home Message

• There is ample evidence to suggest that elevated BP readings in adolescents will trend to higher readings as adults

• We know the risks related to elevated blood pressure results

• Spread the word