The Experts below are selected from a list of 327 Experts worldwide ranked by ideXlab platform
Sarah Clark - One of the best experts on this subject based on the ideXlab platform.
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use of antihypertensive medications and diagnostic tests among privately insured adolescents and young adults with primary versus Secondary Hypertension
Journal of Adolescent Health, 2014Co-Authors: Esther Y Yoon, Lisa M Cohn, Gary L Freed, Albert P Rocchini, David B Kershaw, Frank J Ascione, Sarah ClarkAbstract:Abstract Purpose To compare the use of antihypertensive medications and diagnostic tests among adolescents and young adults with primary versus Secondary Hypertension. Methods We conducted retrospective cohort analysis of claims data for adolescents and young adults (12–21 years of age) with ≥3 years of insurance coverage (≥11 months/year) in a large private managed care plan during 2003–2009 with diagnosis of primary Hypertension or Secondary Hypertension. We examined their use of antihypertensive medications and identified demographic characteristics and the presence of obesity-related comorbidities. For the subset receiving antihypertensive medications, we examined their diagnostic test use (echocardiograms, renal ultrasounds, and electrocardiograms). Results The study sample included 1,232 adolescents and young adults; 84% had primary Hypertension and 16% had Secondary Hypertension. The overall prevalence rate of Hypertension was 2.6%. One quarter (28%) with primary Hypertension had one or more antihypertensive medications, whereas 65% with Secondary Hypertension had one or more antihypertensive medications. Leading prescribers of antihypertensives for subjects with primary Hypertension were primary care physicians (80%), whereas antihypertensive medications were equally prescribed by primary care physicians (43%) and sub-specialists (37%) for subjects with Secondary Hypertension. Conclusions The predominant Hypertension diagnosis among adolescents and young adults is primary Hypertension. Antihypertensive medication use was higher among those with Secondary Hypertension compared with those with primary Hypertension. Further study is needed to determine treatment effectiveness and patient outcomes associated with differential treatment patterns used for adolescents and young adults with primary versus Secondary Hypertension.
Esther Y Yoon - One of the best experts on this subject based on the ideXlab platform.
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use of antihypertensive medications and diagnostic tests among privately insured adolescents and young adults with primary versus Secondary Hypertension
Journal of Adolescent Health, 2014Co-Authors: Esther Y Yoon, Lisa M Cohn, Gary L Freed, Albert P Rocchini, David B Kershaw, Frank J Ascione, Sarah ClarkAbstract:Abstract Purpose To compare the use of antihypertensive medications and diagnostic tests among adolescents and young adults with primary versus Secondary Hypertension. Methods We conducted retrospective cohort analysis of claims data for adolescents and young adults (12–21 years of age) with ≥3 years of insurance coverage (≥11 months/year) in a large private managed care plan during 2003–2009 with diagnosis of primary Hypertension or Secondary Hypertension. We examined their use of antihypertensive medications and identified demographic characteristics and the presence of obesity-related comorbidities. For the subset receiving antihypertensive medications, we examined their diagnostic test use (echocardiograms, renal ultrasounds, and electrocardiograms). Results The study sample included 1,232 adolescents and young adults; 84% had primary Hypertension and 16% had Secondary Hypertension. The overall prevalence rate of Hypertension was 2.6%. One quarter (28%) with primary Hypertension had one or more antihypertensive medications, whereas 65% with Secondary Hypertension had one or more antihypertensive medications. Leading prescribers of antihypertensives for subjects with primary Hypertension were primary care physicians (80%), whereas antihypertensive medications were equally prescribed by primary care physicians (43%) and sub-specialists (37%) for subjects with Secondary Hypertension. Conclusions The predominant Hypertension diagnosis among adolescents and young adults is primary Hypertension. Antihypertensive medication use was higher among those with Secondary Hypertension compared with those with primary Hypertension. Further study is needed to determine treatment effectiveness and patient outcomes associated with differential treatment patterns used for adolescents and young adults with primary versus Secondary Hypertension.
Joseph T Flynn - One of the best experts on this subject based on the ideXlab platform.
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differentiation between primary and Secondary Hypertension in children using ambulatory blood pressure monitoring
Pediatrics, 2002Co-Authors: Joseph T FlynnAbstract:OBJECTIVE: To determine whether ambulatory blood pressure monitoring (ABPM) can help differentiate children with Secondary Hypertension from those with primary Hypertension. METHODS: Ninety-seven ABPM studies obtained from 85 children followed in a pediatric Hypertension clinic were analyzed. Forty studies were performed in patients with primary Hypertension, and 57 studies were performed in patients with Secondary Hypertension. Mean patient age was 13.8 +/- 3.5 [mean +/- standard deviation] years, range 4 to 19.7 years; patients with Secondary Hypertension were younger and had lower body mass index than patients with primary Hypertension. RESULTS: Daytime diastolic and nocturnal systolic blood pressure (BP) loads, defined as the percentage of readings greater than a threshold value, were significantly greater in patients with Secondary Hypertension compared with patients with primary Hypertension. A daytime diastolic BP load of > or =25% and/or a nocturnal systolic BP load of > or =50% was highly specific for Secondary Hypertension. CONCLUSIONS: Secondary Hypertension in childhood is characterized by daytime diastolic BP elevation and nocturnal systolic BP elevation. This pattern of Hypertension on ABPM may be a clue to underlying renal or other organ system pathology in children being evaluated for suspected Hypertension and could help to identify children who require more detailed evaluation to determine the cause of their Hypertension.
Ana Cristina Simoes E Silva - One of the best experts on this subject based on the ideXlab platform.
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primary versus Secondary Hypertension in children followed up at an outpatient tertiary unit
Pediatric Nephrology, 2011Co-Authors: Romina S Gomes, Isabel Gomes Quirino, Regina Maria Pereira, Breno M Vitor, Alysson F Leite, Eduardo A Oliveira, Ana Cristina Simoes E SilvaAbstract:Childhood Hypertension has classically been recognized as a Secondary disease. However, primary Hypertension also occurs in children. The aim of this study was to compare clinical features of pediatric patients with elevated blood pressure, which were referred to an outpatient tertiary unit, and to detect variables associated with the identification of primary Hypertension. The records of 220 patients with Hypertension followed between 1996 and 2006 were analyzed. The variable of interest was primary Hypertension. Logistic regression analysis was applied to identify clinical variables that were independently associated with primary Hypertension. Of 220 patients, 33 (15%) had primary Hypertension, and 187 (85%) exhibited Secondary Hypertension. No statistically significant differences were detected in gender, race, age at diagnosis, and systolic/diastolic blood pressure levels between both groups. After adjustment, four variables at baseline remained independently associated with primary Hypertension: absence of signs/symptoms (OR 18.87, 95% CI 6.32–56.29), normal serum creatinine (OR 0.02, 95% CI 0.00–0.27), family history of Hypertension (OR 3.03, 95% CI 1.04–8.79), and elevated body weight (OR 1.06, 95% CI 1.02–1.10). The absence of signs/symptoms, normal serum creatinine, family history of Hypertension, and overweight/obesity at admission are clues to diagnose primary Hypertension in childhood.
David B Kershaw - One of the best experts on this subject based on the ideXlab platform.
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use of antihypertensive medications and diagnostic tests among privately insured adolescents and young adults with primary versus Secondary Hypertension
Journal of Adolescent Health, 2014Co-Authors: Esther Y Yoon, Lisa M Cohn, Gary L Freed, Albert P Rocchini, David B Kershaw, Frank J Ascione, Sarah ClarkAbstract:Abstract Purpose To compare the use of antihypertensive medications and diagnostic tests among adolescents and young adults with primary versus Secondary Hypertension. Methods We conducted retrospective cohort analysis of claims data for adolescents and young adults (12–21 years of age) with ≥3 years of insurance coverage (≥11 months/year) in a large private managed care plan during 2003–2009 with diagnosis of primary Hypertension or Secondary Hypertension. We examined their use of antihypertensive medications and identified demographic characteristics and the presence of obesity-related comorbidities. For the subset receiving antihypertensive medications, we examined their diagnostic test use (echocardiograms, renal ultrasounds, and electrocardiograms). Results The study sample included 1,232 adolescents and young adults; 84% had primary Hypertension and 16% had Secondary Hypertension. The overall prevalence rate of Hypertension was 2.6%. One quarter (28%) with primary Hypertension had one or more antihypertensive medications, whereas 65% with Secondary Hypertension had one or more antihypertensive medications. Leading prescribers of antihypertensives for subjects with primary Hypertension were primary care physicians (80%), whereas antihypertensive medications were equally prescribed by primary care physicians (43%) and sub-specialists (37%) for subjects with Secondary Hypertension. Conclusions The predominant Hypertension diagnosis among adolescents and young adults is primary Hypertension. Antihypertensive medication use was higher among those with Secondary Hypertension compared with those with primary Hypertension. Further study is needed to determine treatment effectiveness and patient outcomes associated with differential treatment patterns used for adolescents and young adults with primary versus Secondary Hypertension.
