Roughly 25 percent of pediatric patients with hypertension were diagnosed with the condition, according to a retrospective cohort study. In addition, only 10 percent of children with prehypertension were diagnosed.

Lead researcher David C. Kaelber, MD, of Case Western Reserve University in Cleveland, and colleagues published their results online Nov. 22 in Pediatrics.

The researchers analyzed electronic health record data between 1999 and 2014 on 398,079 children who were 3 to 18 years old and had their blood pressure measured at least three times.

Of the children, 48.9 percent were girls and 58.6 percent were younger than 10 years old. They were from nearly 200 pediatric primary care sites in the U.S.

Among the practices with at least 50 eligible patients, 23.2 percent of those with hypertension and 10.2 percent of those with prehypertension were diagnosed.

Of the patients diagnosed with hypertension, only 5.6 percent were prescribed hypertensive medications within 12 months of diagnosis. The most common medications were ACE inhibitors/ARBs (35 percent), diuretics (22 percent), calcium channel blockers (17 percent) and beta-blockers (10 percent).

Pediatricians were more likely to diagnose hypertension and prehypertension in children who were tall, male, overweight or obese and those who had more abnormal blood pressure values and/or had their blood pressure tested more often, according to a news release.

“The new reality for pediatricians is that we’re taking care of more and more children who are winding up with chronic conditions, such as hypertension, that were previously seen primarily in adults,” Alexander Fiks, MD, MSCE, a pediatrician at Children's Hospital of Philadelphia and the senior study author, said in a news release. “This study shows that many pediatricians are not responding to this new reality—not only are we underdiagnosing hypertension, but we’re often not providing recommended treatment to children with the condition in order to minimize health risks.”