Alan H. Jobe, MD, PhDThis issue of The Journal includes a fascinating report by Bijlsma et al in theNetherlands. These authors questioned nearly 200 pediatricians in regard to theirpractice in assessing blood pressure. Approximately two-thirds of those respondingindicated that they only consulted reference tables if they suspected that a blood pres-sure measurement was elevated. These physicians were then queried about specificmeasurements in hypothetical children; nearly one-half of them missed at least oneof the cases as having hypertension or prehypertension.
So, if we only consult reference tables if we suspect that hypertension is present, butif our ability to recognize the child in whom we should be suspect is not good, whatshould we do? Consulting reference tables for virtually every child one sees is probablythe only sure fire way to address this issue. Of course, a better solution would be med-ical informatics support that would regularly identify and flag blood pressures that areabnormal.