Pediatric hypertension: new guidelines increase prevalence among high-risk youth

  • Khoury M & al.
  • Pediatrics
  • 5 Jul 2018

  • curated by Emily Willingham, PhD
  • Clinical Essentials
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Takeaway

  • In pediatric hypertension, using the most recent guidelines increases hypertension prevalence among high-risk youth.
  • The guidelines also increase sensitivity for target organ damage (TOD) in this population.

Why this matters

Key results

  • Hypertension prevalence was
    • 8% (6% stage I; 2% stage II) with old guidelines,
    • 13% (10% stage I; 3% stage II) with new ones (P=.007).
  • TOD identification (e.g., carotid-intima thickness, diastolic function) was similar, but newer guidelines had increased sensitivity.
  • For example, older and new guidelines respectively pinpointed 20% and 31% with hypertensive left ventricular mass (P<.001>

Study design

  • 364 children (65% female; age, 15.1±2.1 years):
    • 213 were obese.
    • 111 had type 2 diabetes.
  • TOD was measured, BP categorization by guideline (older/newer) was compared.
  • Funding: NIH.

Limitations

  • Causation not established in associations.
  • High-risk population (obesity, diabetes), so generalizability not known.

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