Increase in Prevalence of Peds HTN With New Definitions

THURSDAY, July 5, 2018 — Incorporation of new pediatric hypertension definitions recently published in a clinical practice guideline (CPG) has increased the prevalence of pediatric hypertension in a population of high-risk youth, according to a study published online July 5 in Pediatrics.

Michael Khoury, M.D., from the Cincinnati Children’s Hospital Medical Center, and colleagues studied participants undergoing an evaluation of the cardiovascular effects of obesity and type 2 diabetes mellitus in youth (aged 10 to 18 years). Blood pressure was classified as normal, elevated, and hypertension, according to two guidelines: the recently published CPG and the previous guideline (Fourth Report on the Diagnosis, Evaluation, and Treatment of High Blood Pressure in Children and Adolescents). Data were available for 364 participants.

The researchers identified hypertension in 8 and 13 percent according to the definitions in the Fourth Report and CPG, respectively (P = 0.007). Similar associations with target organ damage (TOD) were seen for the two guidelines; however, in participants with hypertension, the CPG demonstrated improved sensitivity of TOD detection. There was an increase in the proportion of participants with an abnormal left ventricular mass classified as hypertensive, from 20 percent as defined in the Fourth Report to 31 percent as defined in the CPG (P < 0.001).

“Incorporation of the CPG increased the prevalence of pediatric hypertension in a population of high-risk youth and improved the sensitivity of TOD identification in hypertensive participants,” the authors write.

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Posted: July 2018

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