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Impact of the 2017 American Academy of Pediatrics Guideline on Hypertension Prevalence Compared With the Fourth Report in an International Cohort

Title
Impact of the 2017 American Academy of Pediatrics Guideline on Hypertension Prevalence Compared With the Fourth Report in an International Cohort
Authors
Yang, LiuKelishadi, RoyaHong, Young MiKhadilkar, AnuradhaNawarycz, TadeuszKrzywinska-Wiewiorowska, MalgorzataAounallah-Skhiri, HajerMotlagh, Mohammad EsmaeilKim, Hae SoonKhadilkar, VamanKrzyzaniak, AlicjaBen Romdhane, HabibaHeshmat, RaminChiplonkar, ShashiStawinska-Witoszynska, BarbaraEl Ati, JalilaQorbani, MostafaKajale, NehaTraissac, PierreOstrowska-Nawarycz, LidiaArdalan, GelayolEkbote, VeenaZhao, MinHeiland, Emerald G.Liang, YajunXi, Bo
Ewha Authors
홍영미김혜순
SCOPUS Author ID
홍영미scopus; 김혜순scopus
Issue Date
2019
Journal Title
HYPERTENSION
ISSN
0194-911XJCR Link

1524-4563JCR Link
Citation
HYPERTENSION vol. 74, no. 6, pp. 1343 - 1348
Keywords
blood pressurechildhypertensionpediatrics
Publisher
LIPPINCOTT WILLIAMS &

WILKINS
Indexed
SCIE; SCOPUS WOS scopus
Document Type
Article
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.
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DOI
10.1161/HYPERTENSIONAHA.119.13807
Appears in Collections:
의과대학 > 의학과 > Journal papers
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