Reclassification of adolescent hypertension by ambulatory blood pressure monitoring using adult norms and association with left ventricular hypertrophy

Campbell, J. Fallon; Shah, Sarita R.; Srivaths, Poyyapakkam; Acosta, Alisa A.

doi:10.1111/jch.14156

Cited by 10 publications

(9 citation statements)

References 27 publications

(57 reference statements)

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“…One retrospective single-center study showed better prediction of LVH with the higher ESH cut points versus the ACC/AHA values. 15 In all studies, DBP was not significantly associated with LVH 13–16 or predicted progression to end-stage kidney disease. 14…”

mentioning

confidence: 76%

“…It has also led investigators to explore the impact of using the new adult criteria for diagnosing ambulatory hypertension in children and adolescents. [13][14][15][16] In alignment with the updated BP classification schema recommended in the 2017 AAP CPG, these studies specifically examined the use of adult ABPM thresholds in adolescents ≥13 years of age. Not surprisingly, in all studies, the prevalence of ambulatory hypertension was significantly higher when using the lower ACC/AHA static adult cut points than when using the higher pediatric percentile-based thresholds.…”

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confidence: 99%

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Pediatric Ambulatory Blood Pressure Classification: The Case for a Change

et al. 2021

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In 1997, Soergel et al 1 published the first set of normative values for ambulatory blood pressure monitoring (ABPM) in children. Since then, the clinical utility of ABPM has increased dramatically, and now, ABPM is accepted as the standard method to confirm the diagnosis of hypertension in children. Despite significant progress in the field of pediatric ABPM, many important questions remain unanswered. One of the most controversial issues is how to define ambulatory hypertension in children. The purpose of this review is to discuss the limitations of the current pediatric ABPM classification scheme and to provide the justification and rationale for a new classification.

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confidence: 76%

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confidence: 99%

Pediatric Ambulatory Blood Pressure Classification: The Case for a Change

et al. 2021

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“…To avoid this apparent paradox, due to the higher peripheral amplification of pressure wave in this range of age 28,29 , as well as to the greater physical activity especially during day-time 26 , application of adult ABPM norms has been suggested for pediatric age 27,30 .…”

Section: Ambulatory Blood Pressure Monitoring (Abpm)mentioning

confidence: 99%

Hypertension in children and adolescents

Simone¹,

Mancusi²,

Hanssen

et al. 2022

European Heart Journal

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Definition and management of arterial hypertension in children and adolescents are uncertain, due to different positions of current guidelines. The European Society of Cardiology task-force, constituted by Associations and Councils with interest in arterial hypertension, has reviewed current literature and evidence, to produce a Consensus Document focused on aspects of hypertension in the age range of 6–16 years, including definition, methods of measurement of blood pressure, clinical evaluation, assessment of hypertension-mediated target organ damage, evaluation of possible vascular, renal and hormonal causes, assessment and management of concomitant risk factors with specific attention for obesity, and anti-hypertensive strategies, especially focused on life-style modifications. The Consensus Panel also suggests aspects that should be studied with high priority, including generation of multi-ethnic sex, age and height specific European normative tables, implementation of randomized clinical trials on different diagnostic and therapeutic aspects, and long-term cohort studies to link with adult cardiovascular risk. Finally, suggestions for the successful implementation of the contents of the present Consensus document are also given.

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“…As for office BP, the 95th 24-h mean systolic and diastolic BP percentiles are used as HTN thresholds in children and younger adolescents. However, whether to use percentiles or fixed cut-off BP values to diagnose HTN in adolescents is a matter of debate ( 30 , 31 ). Currently, the 95th percentile is used as a HTN threshold as long as the values are inferior to the accepted criteria for adults ( 10 ).…”

Section: Out Of Office Blood Pressurementioning

confidence: 99%

Joint statement for assessing and managing high blood pressure in children and adolescents: Chapter 1. How to correctly measure blood pressure in children and adolescents

Lurbe

Mancia

Calpe³

et al. 2023

Front. Pediatr.

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The joint statement is a synergistic action between HyperChildNET and the European Academy of Pediatrics about the diagnosis and management of hypertension in youth, based on the European Society of Hypertension Guidelines published in 2016 with the aim to improve its implementation. The first and most important requirement for the diagnosis and management of hypertension is an accurate measurement of office blood pressure that is currently recommended for screening, diagnosis, and management of high blood pressure in children and adolescents. Blood pressure levels should be screened in all children starting from the age of 3 years. In those children with risk factors for high blood pressure, it should be measured at each medical visit and may start before the age of 3 years. Twenty-four-hour ambulatory blood pressure monitoring is increasingly recognized as an important source of information as it can detect alterations in circadian and short-term blood pressure variations and identify specific phenotypes such as nocturnal hypertension or non-dipping pattern, morning blood pressure surge, white coat and masked hypertension with prognostic significance. At present, home BP measurements are generally regarded as useful and complementary to office and 24-h ambulatory blood pressure for the evaluation of the effectiveness and safety of antihypertensive treatment and furthermore remains more accessible in primary care than 24-h ambulatory blood pressure. A grading system of the clinical evidence is included.

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Reclassification of adolescent hypertension by ambulatory blood pressure monitoring using adult norms and association with left ventricular hypertrophy

Cited by 10 publications

References 27 publications

Pediatric Ambulatory Blood Pressure Classification: The Case for a Change

Pediatric Ambulatory Blood Pressure Classification: The Case for a Change

Hypertension in children and adolescents

Joint statement for assessing and managing high blood pressure in children and adolescents: Chapter 1. How to correctly measure blood pressure in children and adolescents

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