Abstract 19893: Antihypertensive Utilization Patterns for Children With Primary Hypertension
Background: Prevalence of HTN in children is 2-5% and increasing alongside the childhood obesity epidemic. Little is known about the frequency of antihypertensive prescriptions (Rx), the prescribing physicians, and drug choice for children with primary HTN.
Objective: To characterize antihypertensive utilization patterns for children with primary HTN Design/Methods: Serial cross-sectional analysis of Michigan Medicaid outpatient claims data for children 18 yrs; for each study year, we excluded children with <11 months of Medicaid coverage and those with other health insurance. We identified the number of children with a diagnosis (Dx) of primary HTN and the number with 1 antihypertensive Rx; we calculated the rate of Dx and Rx per 1000 eligible children. Drug class and specialty of prescribing physician were identified.
Results: From 2003-2008, there was a consistent increase in both number and rate of children with 1) primary HTN Dx and 2) primary HTN Dx who received an antihypertensive Rx (Table 1) Across years, overall number of Rx increased for each antihypertensive subclass (Figure 1). Most Rx (54-62%) were generated by adult primary care providers (family physicians, general practitioners, internists, Med-Peds); far fewer Rx were generated by pediatric subspecialists (12-18%) or general pediatricians (10-13%), with little change across years.
Conclusions: Steady increases in antihypertensive Rx reflect the known increase in HTN prevalence. ACE inhibitors were prescribed most often for treatment of children with primary HTN. Adult primary care providers who likely manage HTN in adults generated the majority of antihypertensive Rx for children with primary HTN.
- © 2010 by American Heart Association, Inc.