Obesity-Related Hypertension in Pediatrics, the Impact of American Academy of Pediatrics Guidelines
The prevalence of primary hypertension in pediatric patients is increasing, especially as a result of the increased prevalence of obesity in children. New diagnostic guidelines for blood pressure were published by the American Academy of Pediatrics (AAP) in 2017 to better define classes of hypertens...
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MDPI AG
2021-07-01
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author | Irene Rutigliano Gianpaolo De Filippo Luigi Pastore Giovanni Messina Carlo Agostoni Angelo Campanozzi |
author_facet | Irene Rutigliano Gianpaolo De Filippo Luigi Pastore Giovanni Messina Carlo Agostoni Angelo Campanozzi |
author_sort | Irene Rutigliano |
collection | DOAJ |
description | The prevalence of primary hypertension in pediatric patients is increasing, especially as a result of the increased prevalence of obesity in children. New diagnostic guidelines for blood pressure were published by the American Academy of Pediatrics (AAP) in 2017 to better define classes of hypertension in children. The aim of our study is to evaluate the impact of new guidelines on diagnosis of hypertension in pediatrics and their capacity to identify the presence of cardiovascular and metabolic risk. <b>Methods:</b> Retrospective clinical and laboratory data from 489 overweight and obese children and adolescents were reviewed. Children were classified according to the 2004 and 2017 AAP guidelines for systolic and diastolic blood pressure. Lipid profile and glucose metabolism data were recorded; triglyceride/HDL ratio (TG/HDL) was calculated as an index of endothelial dysfunction. Hepatic steatosis was detected using the ultrasonographic steatosis score. <b>Results:</b> Children with elevated blood pressure increased from 12.5% with the 2004 AAP to 23.1% with the 2017 AAP criteria (<i>p</i> < 0.001). There was a statistically significant increase in children with high blood pressure in all age groups according to the new cut-off values. Notably, the diagnosis of hypertension according to 2017 AAP criteria had a greater positive association with Hepatic Steatosis (rho 0.2, <i>p</i> < 0.001) and TG/HDL ratio (rho 0.125, <i>p</i> = 0.025). <b>Conclusions:</b> The 2017 AAP tables offer the opportunity to better identify overweight and obese children at risk for organ damage, allowing an earlier and more impactful prevention strategy to be designed. |
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issn | 2072-6643 |
language | English |
last_indexed | 2024-03-10T08:30:56Z |
publishDate | 2021-07-01 |
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spelling | doaj.art-1d9a3ef1dbfb4ee89c9716057dbcba882023-11-22T09:02:58ZengMDPI AGNutrients2072-66432021-07-01138258610.3390/nu13082586Obesity-Related Hypertension in Pediatrics, the Impact of American Academy of Pediatrics GuidelinesIrene Rutigliano0Gianpaolo De Filippo1Luigi Pastore2Giovanni Messina3Carlo Agostoni4Angelo Campanozzi5Pediatrics, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, 71013 Foggia, ItalyAssistance Publique—Hôpitaux de Paris, Hôpital Robert-Debré, Service d’Endocrinologie et Diabétologie Pédiatrique, 75019 Paris, FrancePediatrics, Department of Medical and Surgical Sciences, University of Foggia, 71122 Foggia, ItalyDepartment of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, ItalyDepartment of Clinical Sciences and Community Health, University of Milan, 20122 Milan, ItalyPediatrics, Department of Medical and Surgical Sciences, University of Foggia, 71122 Foggia, ItalyThe prevalence of primary hypertension in pediatric patients is increasing, especially as a result of the increased prevalence of obesity in children. New diagnostic guidelines for blood pressure were published by the American Academy of Pediatrics (AAP) in 2017 to better define classes of hypertension in children. The aim of our study is to evaluate the impact of new guidelines on diagnosis of hypertension in pediatrics and their capacity to identify the presence of cardiovascular and metabolic risk. <b>Methods:</b> Retrospective clinical and laboratory data from 489 overweight and obese children and adolescents were reviewed. Children were classified according to the 2004 and 2017 AAP guidelines for systolic and diastolic blood pressure. Lipid profile and glucose metabolism data were recorded; triglyceride/HDL ratio (TG/HDL) was calculated as an index of endothelial dysfunction. Hepatic steatosis was detected using the ultrasonographic steatosis score. <b>Results:</b> Children with elevated blood pressure increased from 12.5% with the 2004 AAP to 23.1% with the 2017 AAP criteria (<i>p</i> < 0.001). There was a statistically significant increase in children with high blood pressure in all age groups according to the new cut-off values. Notably, the diagnosis of hypertension according to 2017 AAP criteria had a greater positive association with Hepatic Steatosis (rho 0.2, <i>p</i> < 0.001) and TG/HDL ratio (rho 0.125, <i>p</i> = 0.025). <b>Conclusions:</b> The 2017 AAP tables offer the opportunity to better identify overweight and obese children at risk for organ damage, allowing an earlier and more impactful prevention strategy to be designed.https://www.mdpi.com/2072-6643/13/8/2586obesityhypertensionchildrencardiovascular risk |
spellingShingle | Irene Rutigliano Gianpaolo De Filippo Luigi Pastore Giovanni Messina Carlo Agostoni Angelo Campanozzi Obesity-Related Hypertension in Pediatrics, the Impact of American Academy of Pediatrics Guidelines Nutrients obesity hypertension children cardiovascular risk |
title | Obesity-Related Hypertension in Pediatrics, the Impact of American Academy of Pediatrics Guidelines |
title_full | Obesity-Related Hypertension in Pediatrics, the Impact of American Academy of Pediatrics Guidelines |
title_fullStr | Obesity-Related Hypertension in Pediatrics, the Impact of American Academy of Pediatrics Guidelines |
title_full_unstemmed | Obesity-Related Hypertension in Pediatrics, the Impact of American Academy of Pediatrics Guidelines |
title_short | Obesity-Related Hypertension in Pediatrics, the Impact of American Academy of Pediatrics Guidelines |
title_sort | obesity related hypertension in pediatrics the impact of american academy of pediatrics guidelines |
topic | obesity hypertension children cardiovascular risk |
url | https://www.mdpi.com/2072-6643/13/8/2586 |
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