TY  - JOUR
T1  - USe of diagnostic tests in adolescents with essential hypertension
AU  - Yoon EY, Cohn L, Rocchini A, et al
Y1  - 2012/09/01
N1  - 10.1001/archpediatrics.2012.1173
JO  - Archives of Pediatrics & Adolescent Medicine
SP  - 857
EP  - 862
VL  - 166
IS  - 9
N2  - Objective 
                  To describe the use of diagnostic tests in adolescents with essential hypertension.Design 
                  Longitudinal analysis of administrative claims data.Setting 
                  Michigan Medicaid program during 2003 to 2008.Participants 
                  Adolescents with 3 or more years of Medicaid eligibility (≥11 months/y) who had a diagnosis of essential hypertension and 1 or more antihypertensive medication pharmacy claims.Main Outcome Measures 
                  We examined adolescents' echocardiogram use and compared it with electrocardiogram (EKG) and renal ultrasonography use. We examined timing of the 3 diagnostic tests in relation to the first pharmacy claim. We examined patient demographics and presence of obesity-related comorbidities.Results 
                  During 2003 to 2008, there were 951 adolescents with essential hypertension who had antihypertensive pharmacy claims; 24% (226) had echocardiograms; 22% (207) had renal ultrasonography; and 50% (478) had EKGs. Males (odds ratio [OR], 1.53; 95% CI, 1.06-2.21), younger adolescents (OR, 1.69; 95% CI, 1.17-2.44), those who had EKGs (OR, 5.79; 95% CI, 4.02-8.36), and those who had renal ultrasonography (OR, 2.22; 95% CI, 1.54-3.20) were more likely to obtain echocardiograms compared with females, older adolescents, and adolescents who did not have EKGs or renal ultrasonography.Conclusions 
                  Guideline-recommended diagnostic tests—echocardiograms and renal ultrasonography—were equally poorly used by adolescents with essential hypertension. Sex and age differences exist in the use of echocardiograms by adolescents with essential hypertension. The decision and choice of diagnostic tests to evaluate adolescents with essential hypertension warrant further study to understand the underlying rationale for those decisions and to determine treatment effectiveness.
SN  - 1072-4710
M3  - doi: 10.1001/archpediatrics.2012.1173
UR  - http://dx.doi.org/10.1001/archpediatrics.2012.1173
ER  -