Nj. Horn et al., HYPERTENSIVE ADOLESCENTS DETECTED BY A SCHOOL SURVEILLANCE PROGRAM - A PROBLEM OF OBESITY, Journal of human hypertension, 8(5), 1994, pp. 319-321
BP has been measured in secondary school children in Nottingham as par
t of a routine health appraisal since 1988. School nurses who have rec
eived appropriate training refer children with a BP greater than the 9
5th centile for age and sex (Task Force USA 1987) initially to a commu
nity paediatrician or general practitioner. Of 14,570 children checked
, only 23 patients (14 female) with a mean age of 13.9 years (range 10
-15.8 years) were referred to a paediatric nephrology clinic to be see
n in consultation with a dietitian. In 12 of 23 children there was a f
amily history of hypertension and in seven a family history of other c
ardiovascular disease. No patient with secondary hypertension was iden
tified; 14 patients (61%) were overweight or obese (nine) on the basis
of percentage weight for height at the time of referral. BP values ha
ve tended to normalise on follow-up. Although six of 22 patients lost
weight with dietetic support, eight patients gained weight. The school
surveillance programme for BP is felt by the school nurses to be a va
luable health educational tool and has resulted in few hospital referr
als. Although initial dietetic advice may be of value, obesity remains
a significant problem for the majority of adolescents in this group.