Hypertension Prevalence, Cardiac Complications, and Antihypertensive Medication Use in Children

Dobson, Craig P; Eide, M; Nylund, Cade M.

doi:10.1016/j.jpeds.2015.04.016

Cited by 32 publications

(37 citation statements)

References 26 publications

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“…[2] Hypertension in children is associated with early vascular aging and left ventricular hypertrophy or dysfunction. [3–6] …”

Section: Introductionmentioning

confidence: 99%

Performance of obesity indices for screening elevated blood pressure in pediatric population

Wang²,

Liu³

et al. 2016

Medicine

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Background:Hypertension is closely related with obesity in pediatric population. Obesity indices were used for screening elevated blood pressure (BP) in children and adolescents. The present study was to perform a meta-analysis to assess the performance of obesity indices, body mass index (BMI), waist circumference (WC), and waist-to-height ratio (WHtR), for identifying elevated BP in children and adolescents.Methods:Data sources were PubMed, EMBASE, Web of Science, Cochrane, and SCOPUS up to May 2016. Studies providing measures of diagnostic performance of obesity indices and using age-, sex-, and height-specific BP 95% as reference standard (the definition of United State Fourth Report) were included. We extracted available data on true-positive, false-positive, true-negative, and false-negative to construct a 2 × 2 contingency table and computed the pooled summary statistics for the sensitivities and specificities to estimate the diagnostic performance.Results:Nine eligible studies that evaluated 25,424 children and adolescents aged 6 to 18 years were included in the meta-analysis. The pooled sensitivities were 42% (BMI), 42% (WC), and 43% (WHtR). The pooled specificities were 80% (BMI), 75% (WC), and 77% (WHtR). The areas under the curve (AUCs) of obesity indices were 0.7780 (BMI), 0.7181 (WC), and 0.6697 (WHtR), respectively. In this meta-analysis, the BP measurements were based on 3 visits in only 1 study. The prevalence of hypertension may be overestimated in these studies.Conclusions:The present meta-analysis showed that the performance of obesity indices for identifying elevated BP was poor. Our findings do not support the performance of WC and WHtR is superior to BMI to help identify children with elevated BP.

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“…[2] Hypertension in children is associated with early vascular aging and left ventricular hypertrophy or dysfunction. [3–6] …”

Section: Introductionmentioning

confidence: 99%

Performance of obesity indices for screening elevated blood pressure in pediatric population

Wang²,

Liu³

et al. 2016

Medicine

View full text Add to dashboard Cite

show abstract

“…The alternative explanation is, of course, that these children's hypertension was more genetically determined (hence, an earlier presentation in childhood) and may represent a different hypertension and hypertension phenotype than adult illness. Nonetheless, the low burden of established hypertension in the parents (approximately 15%, as shown in Table 1 in the paper by Conkar and colleagues) argues against excessive genetic influence in this cohort.…”

mentioning

confidence: 84%

Hypertension and End‐Organ Damage in Children––Is the Picture Less Fuzzy Now?

Fülöp

Dixit

2015

J of Clinical Hypertension

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“…The development of target organ damage, including carotid intima-media thickening, left ventricular hypertrophy, hypertensive nephropathy, and retinopathy are all well-established consequences of childhood hypertension. A recent study of 1.3 million children with military insurance found that 8% of children diagnosed with hypertension had hypertensive target organ damage on echocardiography [29]. In addition, longitudinal studies have shown that childhood hypertension frequently persists into adulthood, and that childhood hypertension is the strongest predictor of adult hypertension [30].…”

Section: Disease Management Overviewmentioning

confidence: 99%

“…The Chronic Kidney Disease in Children study showed that even in children with CKD, who have a 37% prevalence of hypertension, 39% of patients with confirmed hypertension were not receiving antihypertensive drugs [32]. A study of 1.3 million children with military health insurance found that only 34% of children diagnosed with hypertension underwent echocardiography, and only 38.9% of children diagnosed with hypertension received an antihypertensive medication [29]. Blood pressures should be monitored regularly in follow-up to determine if the intervention is resulting in reduction of blood pressures to goal levels.…”

Section: Disease Management Overviewmentioning

confidence: 99%