About 5% of children have hypertension, and prevalence is increasing due to rising rates of obesity. Presently, only about 1 in 4 children with hypertension are diagnosed, leaving many at risk of damage to the heart, kidneys, or brain. This study provides a helpful roadmap to operationalize screening and help more kids.
WILMINGTON, Delaware (July 14, 2026) — A study by Nemours Children’s Health that was published in JAMA Network Open identifies the most common barriers to screening children for hypertension and suggests actionable strategies for improvement. Pediatric hypertension often goes undiagnosed, setting the stage for long-term health complications like cardiovascular disease.
“About 5% of children have hypertension, and prevalence is increasing due to rising rates of obesity,” explained the study’s lead author, Abbas Zaidi, MD, Pediatric Cardiologist, Nemours Children’s Health, Delaware Valley. “Presently, only about 1 in 4 children with hypertension are diagnosed, leaving many at risk of damage to the heart, kidneys, or brain. This study provides a helpful roadmap to operationalize screening and help more kids.”
The American Academy of Pediatrics recommends annual blood pressure screening for children age 3 and up, with additional screening for children at higher risk. Patients with high blood pressure readings should be referred for follow-up readings to assess whether the pattern is consistent, however, previous research has shown that as many as 60% of patients do not receive the recommended follow-up.
Dr. Zaidi and team interviewed 25 clinicians at multiple Nemours Children’s Health locations to identify barriers to screening kids for hypertension. The interviewees, comprised of physicians, nurses, nurse managers, and medical assistants, identified five primary obstacles:
- Lack of a clinical pathway
- Insufficient education and training resources
- Inconsistent reflections of blood pressure history in electronic health records (EHR)
- Availability of well-maintained and correctly sized equipment
- Communication between primary care physicians and specialists
The study recommended concrete measures to help eliminate each of those barriers, including:
- Clearly delineate roles and procedures for conducting blood pressure readings at office visits; use supportive tools such as decision trees
- Provide regular training for medical assistants, nurses, and physicians; equip exam rooms with quick reference materials
- Enhance EHR tools, such as trend visualizations and automatic alerts
- Standardize equipment availability and create systems for organizing and maintaining it
- Develop clear referral guidelines and improved messaging technology between primary care teams and specialists
Dr. Zaidi explained that the study findings and recommendations are likely generalizable to other health systems and could be scaled to most settings.
“The diversity of health care settings means that solutions are unlikely to be one-size-fits-all,” he noted. “However, many strategies identified in our study are broadly applicable and shed a light on common implementation challenges.”
###
About Nemours Children's Health
Nemours Children’s Health is one of the nation’s largest multistate pediatric health systems, which includes two free-standing children's hospitals and a network of 80 primary and specialty care practices. Nemours Children's seeks to transform the health of children by adopting a holistic health model that utilizes innovative, safe, and high-quality care, while also addressing children’s needs well beyond medicine. In producing the highly acclaimed, award-winning pediatric medicine podcast Well Beyond Medicine, Nemours underscores that commitment by featuring the people, programs and partnerships addressing Whole Child Health. Nemours Children's also powers the world’s most-visited website for information on the health of children and teens, Nemours KidsHealth.org.
The Nemours Foundation, established through the legacy and philanthropy of Alfred I. duPont, provides pediatric clinical care, research, education, advocacy, and prevention programs to the children, families and communities it serves. For more information, visit Nemours.org.
Nemours has a number of service regions. Selecting your region will help us show you the right contact information and the most relevant content for you.