High Prevalence and Lack of Parental Awareness of Pediatric Hypertension Among a Low-income Sample in Worcester, MA

Objectives: To identify frequency and correlates of hypertension in a low income, ethnically diverse, sample of children as well as to assess parental awareness of hypertension. Methods: This cross-sectional study included parent-child dyads (n = 228), from which physical measurements of the child, and parent reported survey measures were collected. Child’s blood pressure percentile was determined via 2017 American Academy of Pediatrics (AAP) clinical practice guidelines and categorized as normal (< 90th percentile), elevated (≥ 90th percentile to < 95th percentile), or hypertensive (≥ 95th percentile). Bivariate multinomial logistic regression models assessed the relative risk ratio for potential correlates of blood pressure categorization and frequency distribution of parental awareness of blood pressure status was examined. Results: Median child age was 8.1 years (IQR 6.5–9.9). Half were female, 61.8% were Latino and 15.8% were Non-Latino Black. Median body mass index (BMI) percentile was 83.6 (IQR 58.4–97.1) and 31.6% exceeded the 95th percentile. AAP criteria for hypertension and elevated blood pressure were met by 30.7% and 14.3% of children respectively. After full adjustment, the relative risk of categorization as hypertensive versus normal increased by a factor of 1.16 (95% CI 1.02–1.3) per 10-unit increase in BMI percentile, and 0.86 (95% CI 0.74–1.0) per one-year increase in age. Less than five parents (redacted due to low sample size) reported their child having a history of high blood pressure. Conclusions: In this low income, racially/ethnically diverse sample, we observed levels of hypertension and elevated blood pressure considerably higher than national estimates. However, in contrast, extremely low parental awareness was observed.