Height‐based equations as screening tools for high blood pressure in pediatric practice, the GENOBOX study
Abstract Due to the absence of easily applicable cut‐off points to determine high blood pressure or hypertension in children, as in the adult population, blood pressure is rarely measured in the pediatrician's clinical routine. This has led to an underdiagnosis of high blood pressure or hyperte...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2022-06-01
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| Series: | The Journal of Clinical Hypertension |
| Subjects: | |
| Online Access: | https://doi.org/10.1111/jch.14489 |
| _version_ | 1827778934660399104 |
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| author | Gloria Pérez‐Gimeno Azahara I. Ruperez Mercedes Gil‐Campos Concepción M. Aguilera Augusto Anguita Rocío Vázquez‐Cobela Estela Skapino Luis A. Moreno Rosaura Leis Gloria Bueno‐Lozano |
| author_facet | Gloria Pérez‐Gimeno Azahara I. Ruperez Mercedes Gil‐Campos Concepción M. Aguilera Augusto Anguita Rocío Vázquez‐Cobela Estela Skapino Luis A. Moreno Rosaura Leis Gloria Bueno‐Lozano |
| author_sort | Gloria Pérez‐Gimeno |
| collection | DOAJ |
| description | Abstract Due to the absence of easily applicable cut‐off points to determine high blood pressure or hypertension in children, as in the adult population, blood pressure is rarely measured in the pediatrician's clinical routine. This has led to an underdiagnosis of high blood pressure or hypertension in children. For this reason, the present study evaluate the utility of five equations for the screening of high blood pressure in children: blood pressure to height ratio, modified blood pressure to height ratio, new modified blood pressure to height ratio, new simple formula and height‐based equations. The authors evaluated 1599 children between 5 and 18 years. The performance of the five equations was analyzed using the receiver‐operating characteristics curves for identifying blood pressure above P90th according to the American Academy of Pediatrics Clinical Practice Guideline 2017. All equations showed an area under the curve above 0.882. The new modified blood pressure to height ratio revealed a high sensitivity whereas the height‐based equations showed the best performance, with a positive predictive value above 88.2%. Finally, all equations showed higher positive predictive values in children with overweight or obesity. The height‐based equation obtained the highest PPV values above 71.1% in children with normal weight and above 90.2% in children with overweight or obesity. In conclusions, the authors recommend the use of the height‐based equations equation because it showed the best positive predictive values to identify children with elevated blood pressure, independently of their sex, pubertal and weight status. |
| first_indexed | 2024-03-11T14:43:04Z |
| format | Article |
| id | doaj.art-200f9ef4f0be40059ad60c082ff070ea |
| institution | Directory Open Access Journal |
| issn | 1524-6175 1751-7176 |
| language | English |
| last_indexed | 2024-03-11T14:43:04Z |
| publishDate | 2022-06-01 |
| publisher | Wiley |
| record_format | Article |
| series | The Journal of Clinical Hypertension |
| spelling | doaj.art-200f9ef4f0be40059ad60c082ff070ea2023-10-30T13:26:02ZengWileyThe Journal of Clinical Hypertension1524-61751751-71762022-06-0124671372210.1111/jch.14489Height‐based equations as screening tools for high blood pressure in pediatric practice, the GENOBOX studyGloria Pérez‐Gimeno0Azahara I. Ruperez1Mercedes Gil‐Campos2Concepción M. Aguilera3Augusto Anguita4Rocío Vázquez‐Cobela5Estela Skapino6Luis A. Moreno7Rosaura Leis8Gloria Bueno‐Lozano9Growth Exercise Nutrition and Development (GENUD) Research group Universidad de Zaragoza Instituto de Investigación Sanitartia de Aragón (IIS Aragón) Instituto Agroalimentario de Aragón‐IA2 (Universidad de Zaragoza‐CITA) Zaragoza SpainGrowth Exercise Nutrition and Development (GENUD) Research group Universidad de Zaragoza Instituto de Investigación Sanitartia de Aragón (IIS Aragón) Instituto Agroalimentario de Aragón‐IA2 (Universidad de Zaragoza‐CITA) Zaragoza SpainMetabolic Pediatric and Investigation Unit Reina Sofía University Hospital Maimónides Insitute of Biomedicine Research of Córdoba (IMIBIC) University of Córdoba Córdoba SpainCIBEROBN (Physiopathology of Obesity and Nutrition) Institute of Health Carlos III (ISCIII) Madrid SpainCIBEROBN (Physiopathology of Obesity and Nutrition) Institute of Health Carlos III (ISCIII) Madrid SpainCIBEROBN (Physiopathology of Obesity and Nutrition) Institute of Health Carlos III (ISCIII) Madrid SpainGrowth Exercise Nutrition and Development (GENUD) Research group Universidad de Zaragoza Instituto de Investigación Sanitartia de Aragón (IIS Aragón) Instituto Agroalimentario de Aragón‐IA2 (Universidad de Zaragoza‐CITA) Zaragoza SpainGrowth Exercise Nutrition and Development (GENUD) Research group Universidad de Zaragoza Instituto de Investigación Sanitartia de Aragón (IIS Aragón) Instituto Agroalimentario de Aragón‐IA2 (Universidad de Zaragoza‐CITA) Zaragoza SpainCIBEROBN (Physiopathology of Obesity and Nutrition) Institute of Health Carlos III (ISCIII) Madrid SpainGrowth Exercise Nutrition and Development (GENUD) Research group Universidad de Zaragoza Instituto de Investigación Sanitartia de Aragón (IIS Aragón) Instituto Agroalimentario de Aragón‐IA2 (Universidad de Zaragoza‐CITA) Zaragoza SpainAbstract Due to the absence of easily applicable cut‐off points to determine high blood pressure or hypertension in children, as in the adult population, blood pressure is rarely measured in the pediatrician's clinical routine. This has led to an underdiagnosis of high blood pressure or hypertension in children. For this reason, the present study evaluate the utility of five equations for the screening of high blood pressure in children: blood pressure to height ratio, modified blood pressure to height ratio, new modified blood pressure to height ratio, new simple formula and height‐based equations. The authors evaluated 1599 children between 5 and 18 years. The performance of the five equations was analyzed using the receiver‐operating characteristics curves for identifying blood pressure above P90th according to the American Academy of Pediatrics Clinical Practice Guideline 2017. All equations showed an area under the curve above 0.882. The new modified blood pressure to height ratio revealed a high sensitivity whereas the height‐based equations showed the best performance, with a positive predictive value above 88.2%. Finally, all equations showed higher positive predictive values in children with overweight or obesity. The height‐based equation obtained the highest PPV values above 71.1% in children with normal weight and above 90.2% in children with overweight or obesity. In conclusions, the authors recommend the use of the height‐based equations equation because it showed the best positive predictive values to identify children with elevated blood pressure, independently of their sex, pubertal and weight status.https://doi.org/10.1111/jch.14489childrenheight‐based equationshigh blood pressurepediatricianscreening |
| spellingShingle | Gloria Pérez‐Gimeno Azahara I. Ruperez Mercedes Gil‐Campos Concepción M. Aguilera Augusto Anguita Rocío Vázquez‐Cobela Estela Skapino Luis A. Moreno Rosaura Leis Gloria Bueno‐Lozano Height‐based equations as screening tools for high blood pressure in pediatric practice, the GENOBOX study The Journal of Clinical Hypertension children height‐based equations high blood pressure pediatrician screening |
| title | Height‐based equations as screening tools for high blood pressure in pediatric practice, the GENOBOX study |
| title_full | Height‐based equations as screening tools for high blood pressure in pediatric practice, the GENOBOX study |
| title_fullStr | Height‐based equations as screening tools for high blood pressure in pediatric practice, the GENOBOX study |
| title_full_unstemmed | Height‐based equations as screening tools for high blood pressure in pediatric practice, the GENOBOX study |
| title_short | Height‐based equations as screening tools for high blood pressure in pediatric practice, the GENOBOX study |
| title_sort | height based equations as screening tools for high blood pressure in pediatric practice the genobox study |
| topic | children height‐based equations high blood pressure pediatrician screening |
| url | https://doi.org/10.1111/jch.14489 |
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