Impact of the 2017 AAP clinical guideline on the prevalence of high blood pressure among adolescents in Lagos, Nigeria
IntroductionAdolescent high blood pressure (HBP) can lead to several end-organ complications if it continues into adulthood. The 2017 AAP Guideline has lower blood pressure cut-off points and consequently leads to the identification of more people with high blood pressure. This study evaluated the i...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-06-01
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| Series: | Frontiers in Pediatrics |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fped.2023.1184320/full |
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| author | Ifeoma Atoh Joseph Ezeogu Ekanem Ekure Samuel Ilenre Omokhodion Fidelis Olisamedua Njokanma |
| author_facet | Ifeoma Atoh Joseph Ezeogu Ekanem Ekure Samuel Ilenre Omokhodion Fidelis Olisamedua Njokanma |
| author_sort | Ifeoma Atoh |
| collection | DOAJ |
| description | IntroductionAdolescent high blood pressure (HBP) can lead to several end-organ complications if it continues into adulthood. The 2017 AAP Guideline has lower blood pressure cut-off points and consequently leads to the identification of more people with high blood pressure. This study evaluated the impact of the 2017 American Academy of Pediatrics (AAP) Clinical Guideline on the prevalence of high blood pressure among adolescents when compared to the 2004 Fourth Report.MethodologyA descriptive cross-sectional study was conducted from August 2020 to December 2020. The selection of 1,490 students, 10–19 years old, was by a two-stage sampling technique. Socio-demographic information and relevant clinical data were obtained using a structured questionnaire. Blood pressure was measured according to standard protocol. Categorical and numerical variables were summarized using frequency, percentages, mean, and standard deviation. The McNemar-Bowker test of symmetry was used to compare the blood pressure values in the 2004 Fourth Report and the 2017 AAP Clinical Guideline. The Kappa statistic was used to test for the degree of agreement between the 2004 Fourth Report and the 2017 AAP Clinical Guideline.ResultsThe prevalence rates of high blood pressure, elevated blood pressure, and hypertension among adolescents were 26.7%, 13.8%, and 12.9%, respectively, using the 2017 AAP Clinical Guideline, and 14.5%, 6.1%, and 8.4%, respectively, using the 2004 Fourth Report. The degree of agreement between the 2004 and 2017 guidelines with respect to the classification of blood pressure was 84.8%. The Kappa statistic was 0.71 (CI: 0.67–0.75). The impact of this was a 12.2%, 7.7%, and 4.5% increase in the prevalence of high blood pressure, elevated blood pressure, and hypertension, respectively, using the 2017 AAP Clinical Guideline.ConclusionThe 2017 AAP Clinical Guideline detects a greater proportion of high blood pressure among adolescents. The adoption of this new guideline in clinical practice and its use in the routine screening of high blood pressure among adolescents is recommended. |
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| format | Article |
| id | doaj.art-b3b2ba760b994b4099a66bad9f6f3050 |
| institution | Directory Open Access Journal |
| issn | 2296-2360 |
| language | English |
| last_indexed | 2024-03-13T03:38:45Z |
| publishDate | 2023-06-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Pediatrics |
| spelling | doaj.art-b3b2ba760b994b4099a66bad9f6f30502023-06-23T12:31:51ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602023-06-011110.3389/fped.2023.11843201184320Impact of the 2017 AAP clinical guideline on the prevalence of high blood pressure among adolescents in Lagos, NigeriaIfeoma Atoh0Joseph Ezeogu1Ekanem Ekure2Samuel Ilenre Omokhodion3Fidelis Olisamedua Njokanma4Department of Paediatrics, College of Medicine, University of Lagos, Lagos, NigeriaDepartment of Paediatrics, Federal University Teaching Hospital Owerri, Owerri, NigeriaDepartment of Paediatrics, College of Medicine, University of Lagos, Lagos, NigeriaDepartment of Paediatrics, College of Medicine, University of Ibadan, Ibadan, NigeriaDepartment of Paediatrics, College of Medicine, Lagos State University, Lagos, NigeriaIntroductionAdolescent high blood pressure (HBP) can lead to several end-organ complications if it continues into adulthood. The 2017 AAP Guideline has lower blood pressure cut-off points and consequently leads to the identification of more people with high blood pressure. This study evaluated the impact of the 2017 American Academy of Pediatrics (AAP) Clinical Guideline on the prevalence of high blood pressure among adolescents when compared to the 2004 Fourth Report.MethodologyA descriptive cross-sectional study was conducted from August 2020 to December 2020. The selection of 1,490 students, 10–19 years old, was by a two-stage sampling technique. Socio-demographic information and relevant clinical data were obtained using a structured questionnaire. Blood pressure was measured according to standard protocol. Categorical and numerical variables were summarized using frequency, percentages, mean, and standard deviation. The McNemar-Bowker test of symmetry was used to compare the blood pressure values in the 2004 Fourth Report and the 2017 AAP Clinical Guideline. The Kappa statistic was used to test for the degree of agreement between the 2004 Fourth Report and the 2017 AAP Clinical Guideline.ResultsThe prevalence rates of high blood pressure, elevated blood pressure, and hypertension among adolescents were 26.7%, 13.8%, and 12.9%, respectively, using the 2017 AAP Clinical Guideline, and 14.5%, 6.1%, and 8.4%, respectively, using the 2004 Fourth Report. The degree of agreement between the 2004 and 2017 guidelines with respect to the classification of blood pressure was 84.8%. The Kappa statistic was 0.71 (CI: 0.67–0.75). The impact of this was a 12.2%, 7.7%, and 4.5% increase in the prevalence of high blood pressure, elevated blood pressure, and hypertension, respectively, using the 2017 AAP Clinical Guideline.ConclusionThe 2017 AAP Clinical Guideline detects a greater proportion of high blood pressure among adolescents. The adoption of this new guideline in clinical practice and its use in the routine screening of high blood pressure among adolescents is recommended.https://www.frontiersin.org/articles/10.3389/fped.2023.1184320/fullhigh blood pressureelevated blood pressurehypertensionadolescentsecondary school |
| spellingShingle | Ifeoma Atoh Joseph Ezeogu Ekanem Ekure Samuel Ilenre Omokhodion Fidelis Olisamedua Njokanma Impact of the 2017 AAP clinical guideline on the prevalence of high blood pressure among adolescents in Lagos, Nigeria Frontiers in Pediatrics high blood pressure elevated blood pressure hypertension adolescent secondary school |
| title | Impact of the 2017 AAP clinical guideline on the prevalence of high blood pressure among adolescents in Lagos, Nigeria |
| title_full | Impact of the 2017 AAP clinical guideline on the prevalence of high blood pressure among adolescents in Lagos, Nigeria |
| title_fullStr | Impact of the 2017 AAP clinical guideline on the prevalence of high blood pressure among adolescents in Lagos, Nigeria |
| title_full_unstemmed | Impact of the 2017 AAP clinical guideline on the prevalence of high blood pressure among adolescents in Lagos, Nigeria |
| title_short | Impact of the 2017 AAP clinical guideline on the prevalence of high blood pressure among adolescents in Lagos, Nigeria |
| title_sort | impact of the 2017 aap clinical guideline on the prevalence of high blood pressure among adolescents in lagos nigeria |
| topic | high blood pressure elevated blood pressure hypertension adolescent secondary school |
| url | https://www.frontiersin.org/articles/10.3389/fped.2023.1184320/full |
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