Abstract 048: Impact of New Clinical Practice Guidelines on Cardiovascular Disease Risk Assessment in an Obese Pediatric Population

Abstract

Objectives: Cardiovascular disease (CVD) risk factor prevalence has increased in children. The new clinical practice guidelines (CPG) revised hypertension (HTN) and left ventricular hypertrophy (LVH) definitions. We investigated the impact of the CPG on CVD risk assessment in obese youth. Methods: Cross-sectional study of youth evaluated for high blood pressure at an obesity HTN clinic. Characteristics were compared across historic and current LVH definitions (table 1) using ANOVA. Logistic regression evaluated odds of LVH by HTN status and BMI. Results: Of 54 youth, aged 6-21 yrs, 78% (42 of 54) had class III obesity, 57% (31 of 54) had HTN and 17-74% (9-40 of 54) had LVH. Youth with LVH using CPG definitions were older and more obese (table 1). BMI, not HTN, was predictive of LVH using LVMI > 51g/m 2.7 (table 2). Conclusions: In this at-risk population, LVH was highly prevalent. Adiposity, not HTN, was predictive of LVH when using the adult definition recommended in the CPG. This may have future implications for recommended CVD risk assessment of youth with severe obesity.