New clinical guidelines for pediatric
hypertension resulted in increased prevalence of hypertension and improved
sensitivity in detecting target organ damage among at-risk
youth.
A revised classification table for pediatric hypertension has increased the estimated prevalence of elevated blood pressure (BP) in children and adolescents by 20%, new data show.
Further analysis indicate
there is a clustering of other risk factors, such as obesity and dyslipidemia,
among the youth whose risk is upgraded under the new guidelines, which one
expert says is "somewhat reassuring."
Moreover, nearly 6% of children in the study (905 of 15,584) were reclassified upward under the revised guidelines, including 381 who had been considered normotensive by National Heart, Lung, and Blood Institute standards but are now considered to have elevated BP (368 children) or stage 1 levels (13 children) by American Academy of Pediatrics criteria. Further, 470 children previously classified as prehypertensive were reclassified as having stage 1 hypertension, and 54 who had been deemed stage 1 hypertensive were reclassified as stage 2, the authors report.
Patients fasted overnight for a minimum of 10 hours, after which body mass index was calculated, blood pressure was taken, and anthropometric, laboratory, echocardiography, and carotid assessments were performed.
Primary Hypertension
·
Predominant cause of HTN in US children
·
Characteristics include:
o
≥6 years of age; positive family history of HTN;
obesity/overweight
·
Severity of BP elevation is similar
between primary and secondary HTN
o
Diastolic HTN predictive of secondary
cause
o
Systolic HTN predictive of primary HTN
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