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Appropriate diagnosis and management per guideline recommendations are inconsistent. In this study, we determined the proportion of missed diagnosis of hypertension and prehypertension and appropriate follow\u2010up in pediatric patients, stratified by sex, age, race\/ethnicity, and weight status. Based on the electronic health record (EHR) data from eight federally qualified health centers, among 62,982 children aged 3 to 18\u00a0years, 6233 (10%) had at least one abnormal blood pressure (BP) measurement over twelve months. Among those children whose recorded BPs met the criteria for prehypertension (<jats:italic>N<\/jats:italic>\u00a0=\u00a06178), 14.6% had a diagnosis in the EHR. These children were more likely to be White and have obesity compared with children who met the criteria but were not diagnosed with prehypertension. Among those who met the criteria for hypertension (<jats:italic>N<\/jats:italic>\u00a0=\u00a055), 41.8% had a diagnosis of hypertension in the EHR. Being diagnosed with hypertension was not associated with any examined patient characteristics. Over eleven months, 2837 children had BP\u00a0\u2265\u00a095th percentile on\u00a0\u2265\u00a01 visit. Only 13% had guideline\u2010adherent follow\u2010up within 1\u00a0month and were more likely to be older, female, and of Hispanic ethnicity or \u201cother\u201d race. Over six months, 2902 children had BP\u00a0\u2265\u00a090th percentile on one visit. 41% had guideline\u2010adherent follow\u2010up within 6\u00a0months and were more likely to be older, of either White, Hispanic, Asian race, or Hispanic ethnicity. In a community\u2010based setting, pediatric hypertension and prehypertension were persistently underdiagnosed with low adherence to recommended follow\u2010up.<\/jats:p>","DOI":"10.1111\/jch.14148","type":"journal-article","created":{"date-parts":[[2020,12,29]],"date-time":"2020-12-29T21:55:03Z","timestamp":1609278903000},"page":"257-264","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":31,"title":["Under\u2010recognition of pediatric hypertension diagnosis: Examination of 1 year of visits to community health centers"],"prefix":"10.1111","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7587-5472","authenticated-orcid":false,"given":"Anoosh","family":"Moin","sequence":"first","affiliation":[{"name":"Ann &amp; Robert H. 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Lurie Children\u2019s Hospital of Chicago and Northwestern University Feinberg School of Medicine Chicago IL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justin D.","family":"Smith","sequence":"additional","affiliation":[{"name":"Departments of Psychiatry and Behavioral Sciences Preventive Medicine Medical Social Sciences, and Pediatrics Northwestern University Feinberg School of Medicine Chicago IL USA"},{"name":"Department of Population Health Sciences University of Utah School of Medicine Salt Lake City UT USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,12,29]]},"reference":[{"key":"e_1_2_10_2_1","first-page":"1","article-title":"Global prevalence of hypertension in children: A systematic review and Meta\u2010analysis","author":"Song P","year":"2019","journal-title":"JAMA Pediatr"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6727a2"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2015.07.055"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2006-2543"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2011.03.021"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11906-013-0370-3"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.113.001614"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00246-006-1390-4"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1177\/0883073813494264"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.114.2.S2.555"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1161\/HYP.0000000000000066"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2017-1904"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.298.8.874"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1177\/2333794X17712637"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapediatrics.2014.3216"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.113.3.475"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.111.00831"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.3928\/19382359-20181119-01"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2012-1292"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2009-0555"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/jch.12915"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2012-2437"},{"key":"e_1_2_10_24_1","unstructured":"CDC\/NCHS.CDC growth charts: United States.http:\/\/www.cdc.gov\/growthcharts. 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