SAN FRANCISCO — Children aged 10–19 years in Boston were unlikely to be screened for cardiovascular disease risk factors even if they were overweight, according to a large retrospective chart review.
Of 11,081 children, 33% had no family history recorded in their charts. Of the children with any recorded family history, only 46% had a specific mention of the absence or presence of at least one cardiovascular risk factor in any family member, Dr. Shika G. Anand and Dr. William G. Adams of Boston University reported in a poster presentation at the annual meeting of the Pediatric Academic Societies.
Although more than 95% of the children were screened for hypertension, much smaller percentages were screened for dyslipidemia or abnormal glucose metabolism, even among those who were overweight.
The investigators defined children with a body mass index (BMI) greater than the 95th percentile as being overweight, and children between the 85th and 95th percentile as being at risk for overweight.
Among the 2,795 overweight children, 95% were screened for hypertension, 44% were screened for dyslipidemia, and 36% were screened for abnormal glucose metabolism.
Among the 1,957 children at risk for overweight, 94% were screened for hypertension, 33% were screened for dyslipidemia, and 20% were screened for abnormal glucose metabolism. Overall, 26% of the 10,617 children screened turned out to be positive for hypertension, diabetes, or dyslipidemia.
Subjects in the study included all children aged 10–19 years with at least one primary care visit to Boston Medical Center and at least one recorded BMI during a 2-year period from 2002 to 2004. Pregnant patients were excluded. Of the full sample, 52% were female, 59% were African American, 15% were Hispanic, 6% were white, 2% were Asian American, 1% were Native American, and 17% had an undetermined or other racial classification.
The investigators concluded that there was significant room for improvement in screening for cardiovascular risk factors in pediatric primary care, and that improved screening could be expected to identify a substantial number of overweight children at especially high cardiovascular risk.
The meeting was sponsored by the American Pediatric Society, Society for Pediatric Research, Ambulatory Pediatric Association, and American Academy of Pediatrics.