1. Our adolescent hypertension study 2006

2. An opportunity to compare apples with apples Saint John study 1978 children grades 7- 12 over 8,000 participants Measured BP and height PI still practicing Great opportunity to look at our community again

3. What did we do differently First we replicated original study (so apples to apples) Second we added weight as a measure and administered a questionnaire (added some oranges) Our population was slightly less 5,000 participants (but definitely significant numbers)

4. What did we find Have to brief the minister first But can let you in on some findings

5. After the study Our purpose was to measure BPs Look at the trends But hey we are health care professionals with a conscience We wanted to have a chance to monitor those who on first blush had an elevated BP Chose high normal as cut off

6. What did we do Anyone with 2 readings over 130/90 Systolic or diastolic or both Sent a letter

7. How many letters Original study with about 8,400 send 84 letters with almost 100% response This study with over 5,000 participants with about 4,900 included for analysis we sent out 250 letters

8. What happened First letter gentle Set aside 4 evening clinics Invited families Set up for crisis counseling on the phone Cardiologist, pediatrician, full blood profile, same measures plus waist circumference

9. Guess what Only 45 showed over 4 nights We did get caught up on gossip Sent out second letter More strongly worded Invited to call let us know, gave phone numbers. email address, and mailing address Got 30 more

10. Just like a dog with the bone Sent out 3 rd letter (actually 3 types) Got a few more In total about 30% show rate

11. What do we think In general would say there is some apathy Only 5 parents called Those that did come with students were only mildly concerned Most indicated that an elevated BP reading would not mean anything

12. What is the lesson As health professionals we need to work on getting the message about high blood pressure out there We should have been getting many anxious calls after each school visit and definitely after each letter

13. The Take Home Message There is ample evidence to suggest that elevated BP readings in adolescents will trend to higher readings as adults We know the risks related to elevated blood pressure results Spread the word