Estimated Change in Prevalence and Trends of Childhood Blood Pressure Levels in the United States After Application of the 2017 AAP Guideline

Abstract

IntroductionChildhood hypertension is associated with higher risks of cardiovascular disease during adulthood. This study estimated the prevalence of hypertension and high blood pressure among children aged 8 to 17 years in the United States per the 2017 American Academy of Pediatrics (AAP) guideline and compared that with the 2004 National Institutes of Health/National Heart, Lung, and Blood Institute (NIH/NHLBI) guideline’s prevalence estimate during 2005–2008 and 2013–2016.MethodsThis cross-sectional study analyzed the National Health and Nutrition Examination Survey data. High blood pressure included hypertension and elevated blood pressure (per the 2017 AAP guideline)/prehypertension (per the 2004 NIH/NHLBI guideline).ResultsThe analysis included 3,633 children in 2005–2008 and 3,471 children in 2013–2016. Per the 2004 NIH/NHLBI guideline, 3.1% (95% confidence interval [CI], 2.3%–4.3%) had hypertension in 2005–2008 and 1.9% (95% CI, 1.4%–2.6%) had hypertension in 2013–2016. Per the 2017 AAP guideline, prevalence was 5.7% (95% CI, 4.6%–7.1%) in 2005–2008 and 3.5% (95% CI, 2.7%–4.5%) in 2013–2016. About 2.5% (95% CI, 2.0%–3.1%) children in 2005–2008 and 1.5% (95% CI, 0.9%–2.0%) children in 2013–2016 were reclassified as hypertensive. We observed a similar change in prevalence for high blood pressure after application of the new guideline. The prevalence of high blood pressure also declined from 2005–2008 to 2013–2016 per both guidelines.ConclusionAlthough the new guideline would reclassify a small proportion of children as having hypertension or high blood pressure, the prevalence declined from 2005–2008 to 2013–2016.

Are My Pediatric Patients at Increased Risk of Developing Chronic Kidney Disease?

“…6 Pediatric guidelines are well established for screening, diagnosis, and evaluation of the estimated 4% of children worldwide who are hypertensive. [44][45][46][47] Longitudinal data support a strong tendency for hypertension to track from the pediatric age group into adulthood. 48 Hypertension in teenagers has been shown to increase the risk of end-stage renal disease (ESRD) in middleaged adults in large studies in Sweden and Israel.…”

Importância Do Reconhecimento Precoce Da Hipertensão Arterial Em Crianças E Adolescentes

“…Os resultados das publicações selecionadas nesta revisão estão descritos no Quadro 1. A HA é um importante fator de risco modificável para a morbimortalidade cardiovascular, tanto em adolescentes como em adultos jovens, estando associada a efeitos negativos a longo prazo sobre a saúde 1,4 . Trata-se de uma condição clínica multifatorial, frequentemente associada aos distúrbios metabólicos, alterações funcionais e/ou estruturais de órgãos-alvo.…”

“…Trata-se de uma condição clínica multifatorial, frequentemente associada aos distúrbios metabólicos, alterações funcionais e/ou estruturais de órgãos-alvo. Embora não tenha relação direta conhecida de hipertensão com a doença cardiovascular em crianças ou adolescentes, a hipertensão está associada à aterosclerose, hipertrofia ventricular e complicações renais nessa população4.Além disso, a hipertensão na infância é associada a riscos mais elevados de doença cardiovascular durante a vida adulta 1,4 .…”

The effects of obesity on kidney function: a challenge for nephrologists

“…The categorization proposed in this report was recently updated30 with relevant changes in the parameters used to define hypertension in children and adolescents. The new definitions may potentially redefine the prevalence of hypertension in the general pediatric population,31 as well as in overweight and obese individuals 32…”