Journal article
Prevalence Implications of the 2017 American Academy of Pediatrics Hypertension Guideline and Associations with Adult Hypertension
The Journal of pediatrics, Vol.241, pp.22-28.e4
02/2022
DOI: 10.1016/j.jpeds.2021.09.056
PMCID: PMC8924915
PMID: 34619113
Abstract
To evaluate the impact of the 2017 American Academy of Pediatrics hypertension Clinical Practice Guideline (CPG), compared with the previous guideline (“Fourth Report”), on the frequency of hypertensive blood pressure (BP) measurements in childhood and associations with hypertension in adulthood using data from the International Childhood Cardiovascular Cohort Consortium.
Childhood BPs were categorized in normal, prehypertensive/elevated, and hypertensive (stage 1 and 2) ranges using the Fourth Report and the CPG. Participants were contacted in adulthood to assess self-reported hypertension. The associations between childhood hypertensive range BPs and self-reported adult hypertension were evaluated.
Data were available for 34 014 youth (10.4 ± 3.1 years, 50.6% female) with 92 751 BP assessments. Compared with the Fourth Report, the CPG increased hypertensive readings from 7.6% to 13.5% and from 1.3% to 2.5% for stage 1 and 2 hypertensive range, respectively (P < .0001). Of 12 761 adults (48.8 ± 7.9 years, 43% male), 3839 (30.1%) had self-reported hypertension. The sensitivity for predicting adult hypertension among those with hypertensive range BPs at any point in childhood, as defined by the Fourth Report and the CPG, respectively, was 13.4% and 22.4% (specificity 92.3% and 85.9%, P < .001), with no significant impact on positive and negative predictive values. Associations with self-reported adult hypertension were similar and weak (c-statistic range 0.61-0.68) for hypertensive range BPs as defined by the Fourth Report and CPG.
The CPG significantly increased the prevalence of childhood BPs in hypertensive ranges and improved the sensitivity, without an overall strengthened association, of predicting self-reported adult hypertension.
Details
- Title: Subtitle
- Prevalence Implications of the 2017 American Academy of Pediatrics Hypertension Guideline and Associations with Adult Hypertension
- Creators
- Michael Khoury - University of AlbertaPhilip Khoury - Cincinnati Children's Hospital Medical CenterLydia Bazzano - Tulane UniversityTrudy L. Burns - University of IowaStephen Daniels - University of Colorado DenverTerence Dwyer - Oxford Martin Sch, Oxford Univ, Oxford, United KingdomJohanna Ikonen - Turku University HospitalDavid R. Jacobs - University of MinnesotaMarkus Juonala - Turku University HospitalMika Kähönen - Tampere University HospitalRonald Prineas - Wake Forest UniversityOlli T. Raitakari - Turku University HospitalJulia Steinberger - University of MinnesotaAlison Venn - University of TasmaniaJorma Viikari - Turku University HospitalJessica G. Woo - Cincinnati Children's Hospital Medical CenterAlan Sinaiko - University of MinnesotaElaine M. Urbina - Cincinnati Children's Hospital Medical Center
- Resource Type
- Journal article
- Publication Details
- The Journal of pediatrics, Vol.241, pp.22-28.e4
- DOI
- 10.1016/j.jpeds.2021.09.056
- PMID
- 34619113
- PMCID
- PMC8924915
- NLM abbreviation
- J Pediatr
- ISSN
- 0022-3476
- eISSN
- 1097-6833
- Publisher
- Elsevier Inc
- Grant note
- DOI: 10.13039/100000050, name: NHLBI
- Language
- English
- Date published
- 02/2022
- Academic Unit
- Epidemiology; Fraternal Order of Eagles Diabetes Research Center
- Record Identifier
- 9984363577302771
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