1. Impact of the 2017 American Academy of Pediatrics Guideline on Hypertension Prevalence Compared With the Fourth Report in an International Cohort
- Author
-
Neha Kajale, Tadeusz Nawarycz, Yajun Liang, Mostafa Qorbani, Shashi Chiplonkar, Alicja Krzyżaniak, Anuradha Khadilkar, Małgorzata Krzywińska-Wiewiorowska, Hajer Aounallah-Skhiri, Pierre Traissac, Young Mi Hong, Min Zhao, Gelayol Ardalan, Hae Soon Kim, Veena Ekbote, Vaman Khadilkar, Emerald G. Heiland, Jalila El Ati, Bo Xi, Roya Kelishadi, Lidia Ostrowska-Nawarycz, Ramin Heshmat, Habiba Ben Romdhane, Barbara Stawińska-Witoszyńska, Mohammad Esmaeil Motlagh, and Liu Yang more...
- Subjects
Male ,China ,Pediatrics ,medicine.medical_specialty ,hypertension ,Internationality ,Tunisia ,pediatrics ,Adolescent ,India ,Iran ,030204 cardiovascular system & hematology ,Severity of Illness Index ,03 medical and health sciences ,Sex Factors ,0302 clinical medicine ,Hypertension prevalence ,Republic of Korea ,Prevalence ,Internal Medicine ,medicine ,Humans ,030212 general & internal medicine ,Child ,Societies, Medical ,child ,Anthropometry ,business.industry ,Age Factors ,blood pressure ,Blood Pressure Determination ,Guideline ,Clinical Practice ,Cross-Sectional Studies ,Blood pressure ,Hypertension ,Practice Guidelines as Topic ,Cohort ,Female ,Poland ,business ,Pediatric population - Abstract
In 2017, the American Academy of Pediatrics (AAP) updated the clinical practice guideline for high blood pressure (BP) in the pediatric population. In this study, we compared the difference in prevalence of elevated and hypertensive BP values defined by the 2017 AAP guideline and the 2004 Fourth Report and estimated the cardiovascular risk associated with the reclassification of BP status defined by the AAP guideline. A total of 47 200 children and adolescents aged 6 to 17 years from 6 countries (China, India, Iran, Korea, Poland, and Tunisia) were included in this study. Elevated BP and hypertension were defined according to 2 guidelines. In addition, 1606 children from China, Iran, and Korea who were reclassified upward by the AAP guideline compared with the Fourth Report and for whom laboratory data were available were 1:1 matched with children from the same countries who were normotensive by both guidelines. Compared with the Fourth Report, the prevalence of elevated BP defined by the AAP guideline was lower (14.9% versus 8.6%), whereas the prevalence of stages 1 and 2 hypertension was higher (stage 1, 6.6% versus 14.5%; stage 2, 0.4% versus 1.7%). Additionally, comparison of laboratory data in the case-control study showed that children who were reclassified upward were more likely to have adverse lipid profiles and high fasting blood glucose compared with normotensive children. In conclusion, the prevalence of elevated BP and hypertension varied significantly between both guidelines. Applying the new AAP guideline could identify more children with hypertension who are at increased cardiovascular risk. more...
- Published
- 2019
- Full Text
- View/download PDF