Screening for High Blood Pressure in Children and Adolescents

Force, US Preventive Services Task; Krist, Alex H.; Davidson, Karina W.; Mangione, Carol M.; Barry, Michael J.; Cabana, Michael D.; Caughey, Aaron B.; Donahue, Katrina E; Doubeni, Chyke A.; Epling, John W.; Kubik, Martha; Ogedegbe, Gbenga; Pbert, Lori; Silverstein, Michael; Simon, Melissa A.; Tseng, Chien-Wen; Wong, John B.

doi:10.1001/jama.2020.20122

Cited by 58 publications

(25 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Despite the latest guidelines of the American Pediatric Association to screen for hypertension among all adolescents, 23 a recent review by the US Preventive Task Force concluded that such a recommendation is not justified due to the lack of evidence regarding long-term clinical outcomes. 24 Our study suggests neurological sequela of established late-adolescent hypertension, in the form of stroke in young adulthood. This observation adds to the cumulative evidence of the potentially harmful effects of adolescent hypertension, 3,[6][7][8] even when controlling for such central risk factors as adolescent BMI and diabetes during adult life.…”

Section: Discussionmentioning

confidence: 59%

Adolescent Hypertension Is Associated With Stroke in Young Adulthood: A Nationwide Cohort of 1.9 Million Adolescents

Fishman

Bardugo

Zloof

et al. 2023

Stroke

View full text Add to dashboard Cite

BACKGROUND: Adult hypertension is a well-established risk factor for stroke in young adults (aged <55 years), and the effects are even more deleterious than at an older age. However, data are limited regarding the association between adolescent hypertension and the risk of stroke in young adulthood. METHODS: A nationwide, retrospective cohort study of adolescents (aged 16–19 years) who were medically evaluated before compulsory military service in Israel during 1985 to 2013. For each candidate for service, hypertension was designated after constructed screening, and the diagnosis was confirmed through a comprehensive workup process. The primary outcome was ischemic and hemorrhagic stroke incidence as registered at the national stroke registry. Cox proportional-hazards models were used. We conducted sensitivity analyses by excluding people with a diabetes diagnosis at adolescence or a new diabetes diagnosis during the follow-up period, analysis of adolescents with overweight, and adolescents with baseline unimpaired health status. RESULTS: The final sample included 1 900 384 adolescents (58% men; median age, 17.3 years). In total, 1474 (0.08%) incidences of stroke (1236 [84%] ischemic) were recorded, at a median age of 43 (interquartile range, 38–47) years. Of these, 18 (0.35%) occurred among the 5221 people with a history of adolescent hypertension. The latter population had a hazard ratio of 2.4 (95% CI, 1.5–3.9) for incident stroke after adjustment for body mass index and baseline sociodemographic factors. Further adjustment for diabetes status yielded a hazard ratio of 2.1 (1.3–3.5). We found similar results when the outcome was ischemic stroke with a hazard ratio of 2.0 (1.2–3.5). Sensitivity analyses for overall stroke, and ischemic stroke only, yielded consistent findings. CONCLUSIONS: Adolescent hypertension is associated with an increased risk of stroke, particularly ischemic stroke, in young adulthood.

show abstract

Section: Discussionmentioning

confidence: 59%

Adolescent Hypertension Is Associated With Stroke in Young Adulthood: A Nationwide Cohort of 1.9 Million Adolescents

Fishman

Bardugo

Zloof

et al. 2023

Stroke

View full text Add to dashboard Cite

show abstract

“…Only a weak relation of diastolic blood pressure to RFMp (r = 0 .206, p < 0.001) appeared in the All group. Despite well-established policies for BP measurement in the clinical area of this Unit, results are not as consistent as other clinical parameters, and probably the doubts about BP screening (49,50) not only apply to these data but lead to reconsidering these policies.…”

Section: Discussionmentioning

confidence: 87%

Trunk Fat Estimation According To Gender In Childhood Through Basic Somatic Readings. An Opportunity for Improving Girl’S Evaluation

Moya

Pérez‐Fernández

2021

Preprint

View full text Add to dashboard Cite

Background: Easy appraisal of trunk fat and the eventual cardiometabolic risk of pediatric obesity is a present requirement. Its estimators Waist-to-Height Ratio (WHtR) and Relative Fat Mass pediatric (RFMp, expressed as % of total fat content), can be a complement of widely accepted BMI.Methods: 472 children (39% boys), classified as underweight, normal weight, overweight and obese (Nutritional groups, NG) according to BMI Z-score after their strictly obtained anthropometric initial data, with ad hoc exclusion criteria. Calculation of WHtR and RFMp was done for each nutritional group and sex, as associations through multiple linear regression (MLR) and differences among sexes (medians, IQR).Results: Age (mean (95% CI)), 10.8 y (10.1- 11.1). Estimators values in: All group WHtR 0.5 (0.49 – 0.51), RFMp% 32.3 (31.7 – 33.0); Underweight, WHtR 0.41 (0.40 – 0.41), RFMp (%) 22.8 (21.2 – 24.4); Normal weight, WHtR 0.46 (0.45 – 0.47), RFMp(%) 28.9 (28.1 – 29.7); Overweight, WHtR 0.51 (0.50 – 0.52), RFMp(%) 34.2 (33.3 – 35.1) and Obese WHtR 0.56 (0.55 – 0.57), RFMp(%) 37.8 (36.9 – 38.6). Associations (NG; independent variables): In NG adjusted R² values were between 0.74-0.78. In All group Beta coefficients were for RFMp 3.36 (P< 0.001) for girls; for waist circumference (WC 2.97 (P< 0.001) and for WHtR were respectively -0.01 (p< 0.001) and 0.03 (p< 0.001) Sex differences: BMI were in NG without gender differences (Mann-W’s U). Whereas WHtR (median IQR) differ (M vs F) respectively in: All group 0.49 (0.45 - 0.54) vs 0.52 (0.45 - 0.56), p<0.004; in Overweight 0.51 (0.48 – 0.53) vs 0.54 (0.51 – 0.55), p< 0.001; in Obese 0.55 (0.52 – 0.57) vs 0.57 (0.54 – 0.60), p< 0.004. RFMp (%): in All 29.21 (24.27 – 32.92) vs 36.63 (30.2 – 39.51), p< 0.001; in Overweight 31.24 (28.35 – 32.35) vs 37.95 (35.75 – 38.82), p<0.001 and in Obese 35.89 (32.05 – 36.15) vs 40.63 (38.27 – 42.42), p<0.001.Conclusions: WHtR and RFMp are simple and reliable indexes not requiring centile charts. Their values, including waist circumference, can estimate the different trunk fat component in boys and girls better than BMI, especially if overweight and obese. RFMp proved to be more reliable as it considers gender. Reasonably, both should be included in routine anthropometric readings.

show abstract

“…Only a weak relationship of diastolic blood pressure with RFMp (r = 0 .206, p < 0.001) appeared in the total sample. Despite well-established policies for BP measurement in the clinical area of this unit with an elevated blood pressure section [56], the results are not as consistent as those of other clinical parameters, and doubts about BP screening [57,58] probably not only apply to these data but also lead to reconsidering these policies.…”

Section: Blood Pressurementioning

confidence: 82%

Estimating trunk fat in children according to sex using basic somatic readings: an opportunity for improving evaluation among girls

Benavent

Pérez‐Fernández

2021

BMC Pediatr

View full text Add to dashboard Cite

Background The fat mass estimators waist-to-height ratio (WHtR) and relative fat mass—pediatric (RFMp) complement the widely accepted body mass index (BMI) in obesity evaluation. Aims of the Study: Conduct an easy appraisal of trunk fat and the cardiometabolic risk associated with pediatric obesity. Methods A total of 472 children (39% boys in the total sample) were classified as underweight, normal weight, overweight or obese (nutritional groups, NGs) according to BMI Z-score after initial anthropometric data were obtained and ad hoc exclusion criteria were applied. WHtR and RFMp (% of total fat) were calculated for each group, associations were assessed through multiple linear regression (MLR), and differences between sexes were evaluated (medians, IQR). Results The mean age (mean (95% CI)) was 10.8 y (10.1–11.1). The values in the total sample were as follows: WHtR, 0.5 (0.49–0.51) and RFMp%, 32.3 (31.7–33.0). In the overweight group, the values were as follows: WHtR, 0.51 (0.50–0.52) and RFMp(%), 34.2 (33.3–35.1). In the obese group, the values were as follows: WHtR, 0.56 (0.55–0.57) and RFMp(%), 37.8 (36.9–38.6). The associations were as follows (NG; independent variables): In the NG, adjusted R2 values were between 0.74 and 0.78. In the total sample, the beta coefficient was 3.36 (P < 0.001) for RFMp for girls; for waist circumference (WC), the beta coefficient was 2.97 (P < 0.001), and for WHtR the beta coefficients were − 0.01 (p < 0.001) and 0.03 (p < 0.001),for girls and for WC respectively. The sex differences were as follows: BMI exhibited no differences in the NG (Mann-Whitney U). WHtR (median (IQR)) differed (M vs. F) in the total sample (0.49 (0.45–0.54) vs. 0.52 (0.45–0.56), p < 0.004); in the overweight group (0.51 (0.48–0.53) vs. 0.54 (0.51–0.55), p < 0.001); and in the obese group (0.55 (0.52–0.57) vs. 0.57 (0.54–0.60), p < 0.004). RFMp (%) differed in the total group (29.21 (24.27–32.92) vs. 36.63 (30.2–39.51), p < 0.001); in the overweight group (31.24 (28.35–32.35) vs. 37.95 (35.75–38.82), p < 0.001) and in the obese group (35.89 (32.05–36.15) vs. 40.63 (38.27–42.42), p < 0.001). Conclusions WHtR and RFMp are simple and reliable indices that do not require centile charts. Their values, including waist circumference, can be used to estimate the different trunk fat components in boys and girls better than BMI, especially if individuals are overweight or obese. RFMp proved to be more reliable as it considers sex. Both should be included in routine anthropometric readings.

show abstract

Screening for High Blood Pressure in Children and Adolescents

Cited by 58 publications

References 24 publications

Adolescent Hypertension Is Associated With Stroke in Young Adulthood: A Nationwide Cohort of 1.9 Million Adolescents

Adolescent Hypertension Is Associated With Stroke in Young Adulthood: A Nationwide Cohort of 1.9 Million Adolescents

Trunk Fat Estimation According To Gender In Childhood Through Basic Somatic Readings. An Opportunity for Improving Girl’S Evaluation

Estimating trunk fat in children according to sex using basic somatic readings: an opportunity for improving evaluation among girls

Contact Info

Product

Resources

About