Re-evaluating hypertension in children according to different guidelines: a single-center study.
Hypertens Res
; 45(6): 1047-1057, 2022 06.
Article
em En
| MEDLINE
| ID: mdl-35365799
ABSTRACT
We aimed to evaluate the agreements between the guidelines used for both office blood pressure (OBP) and ambulatory blood pressure monitoring (ABPM). Our secondary aim was to define the best threshold to assess children at risk of left ventricular hypertrophy (LVH). Thresholds proposed by the Fourth Report (FR), European Society of Hypertension (ESH), and American Academy of Pediatrics (AAP) for OBP and the Wühl, ESH, and American Heart Association (AHA) for ABPM were used, and nine different BP phenotype combinations were created. The agreements between the thresholds, the sensitivity of the thresholds, and the BP phenotypes used to predict LVH were determined in 949 patients with different ages and body mass indices (BMIs). The agreements between the guidelines for OBP and ABPM were "good" and "very good" (κ = 0.639; 95% CI, 0.638-0.640, κ = 0.986; 95% CI, 0.985-0.988), respectively. To classify OBP and ABPM into BP phenotypes, we obtained nine different combinations, which had "very good" agreement (κ = 0.880; 95% CI, 0.879-0.880). The sensitivity of AAP for detecting LVH was the highest in <12-year-old obese children (S = 75.8, 95% CI, 56.4-89.7). The sensitivity of ABPM in detecting LVH was similar among different age and BMI groups. The sensitivity of different BP phenotypes tended to be higher in the groups where OBP was evaluated according to AAP. The highest sensitivity was detected in the 13- to 15-year-old normal weight group.(S 88.8, 95% CI, 51.7-99.7). The AAP guideline is more sensitive and decisive for BP phenotypes to detect LVH, especially in normal-weight children ≤ 15 years, while ABPM thresholds for children have limited effect.
Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Obesidade Infantil
/
Hipertensão
Tipo de estudo:
Guideline
/
Prognostic_studies
Limite:
Child
/
Humans
País/Região como assunto:
America do norte
Idioma:
En
Revista:
Hypertens Res
Assunto da revista:
ANGIOLOGIA
Ano de publicação:
2022
Tipo de documento:
Article
País de afiliação:
Turquia