Kidney Week

Abstract: SA-PO355

Effectiveness, Acceptability, and Feasibility of a School-Based Program for Detecting High Blood Pressure in Children

Session Information

• Hypertension, CVD, and the Kidneys: Clinical Research
  October 26, 2024 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Hypertension and CVD

• 1602 Hypertension and CVD: Clinical

Authors

• Glenning, Jonathan P., Murdoch Children's Research Institute, Parkville, Victoria, Australia

Jonathan P. Glenning

• Sheeran, Freya, Murdoch Children's Research Institute, Parkville, Victoria, Australia

Freya Sheeran, PhD

• Quach, Jon, Murdoch Children's Research Institute, Parkville, Victoria, Australia

Jon Quach, PhD

• Cheung, Michael, Murdoch Children's Research Institute, Parkville, Victoria, Australia

Michael Cheung, MD

• Best, Stephanie, Murdoch Children's Research Institute, Parkville, Victoria, Australia

Stephanie Best

• Quinlan, Catherine, Murdoch Children's Research Institute, Parkville, Victoria, Australia

Catherine Quinlan, MD, MS, MSc, MBA, FASN

• Mynard, Jonathan P., Murdoch Children's Research Institute, Parkville, Victoria, Australia

Jonathan P. Mynard

Background

Childhood high blood pressure (BP) is associated with cardiovascular morbidity and mortality in mid-adulthood. Community-based BP screening may improve equitable access and awareness, but robust methodology is required. Accordingly, our aim was to assess the effectiveness, acceptability and feasibility of a two-stage school-based BP screening program incorporating targeted 24-hour ambulatory blood pressure monitoring (ABPM).

Methods

198 children (59% male, 7.6–12.7 years) were recruited from three primary schools in Melbourne, Australia. Following an education session for all eligible children, auscultatory BP was measured five times, alternating between arms and after an initial five minutes of rest. Those with an average BP ≥85^th percentile (AAP thresholds) or a risk factor for high BP had this repeated two weeks later, along with ABPM. Families and school staff completed a questionnaire about acceptability post-program.

Results

At the first assessment, 5.6% had elevated BP and 5.0% had a hypertensive BP (14.6% combined if using just the first measure). 29.8% were selected for the second assessment (including 10 with obesity, 15 born premature, four with a history of congenital heart disease, and nine with BP ≥85^th percentile, but <90^th percentile), of which 52 attended. ABPM indicated that 5.6% of the total cohort had white coat hypertension based on Assessment 1 and 2.5% based on Assessment 2, with a further 1.5% with sustained hypertension, and 1% with masked hypertension. An additional three participants each had either high BPs during school assessment but did not complete, or had inconclusive, ABPMs. Overall, 5.6% were referred for medical follow-up. The majority of participants (67%) who underwent ABPM reported it was tolerable with a ‘bothersome’ score <8/10 for day and/or night. 96% of families found the program acceptable and 90% welcomed it as part of their child’s schooling.

Conclusion

These data indicate that a school-based BP screening program is effective for detecting high BP, acceptable to families and feasible to run in schools. Measuring BP on multiple occasions, with targeted ABPM, is pivotal for minimising false positives and unnecessary referrals.

Funding

• Private Foundation Support