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Antihypertensive Prescribing Patterns for Adolescents With Primary Hypertension
Pediatrics, 01/04/2012
Yoon EY et al. – Adult primary care physicians (PCPs) were the leading prescribers of antihypertensives for adolescents with primary HTN. Race differences exist in physicians’ prescribing of antihypertensives to adolescents with primary HTN. The choice of antihypertensives by physicians of different specialties warrants additional study to understand the underlying rationale for treatment decisions and to determine treatment effectiveness.
Methods- The authors identified adolescents with primary hypertension by International Classification of Diseases, Ninth Revision codes and looked at prescription patterns chronologically for antihypertensive drug class prescribed and the specialty of prescribing physician.
- During 2003–2008, there were 4296 adolescents with primary hypertension (HTN); 66% were boys; 73% were aged 11 to 14 years; 53% were black, 41% white, and 4% Hispanic; and 48% had obesity-related comorbidity.
- Twenty-three percent (977) received antihypertensive prescription.
- White subjects (odds ratio [OR]: 1.61; confidence interval [CI]: 1.39–1.88), older adolescents, and those with comorbidity (OR: 1.57; CI: 1.36–1.82) were more likely to receive antihypertensive prescriptions controlling for gender and years of Medicaid eligibility in logistic regression.
- Angiotensin converting enzyme inhibitors were the most frequently prescribed monotherapy.
- Nearly two-thirds of adolescents received prescriptions from adult primary care physicians (PCPs) only.
- More than one-quarter of adolescents who received a prescription received combination therapy, which was most often prescribed by adult PCPs.
