The Importance of Office Blood Pressure Measurement Frequency and Methodology in Evaluating the Prevalence of Hypertension in Children and Adolescents With Type 1 Diabetes: The SWEET International Database

Abstract

<b>Objective: </b>The prevalence of hypertension is higher in children and adolescents with type 1 diabetes (T1D) compared to those without. This retrospective analysis of a large cohort of children and adolescents with T1D from the SWEET international consortium of pediatric diabetes centers aimed to (i) estimate the prevalence of elevated office blood pressure (BP) and hypertension and (ii) investigate the influence of BP measurement methodology on the prevalence of hypertension. <p><b>Research design and methods</b>: A total of 27,120 individuals with T1D, aged 5-18 years were analyzed. Participants were grouped into those with BP measurements at ≥3 visits (n=10,440) and <3 visits, (n=16,680) per year, and stratified by age and sex. A subgroup analysis was performed on 15,742 individuals from centers providing a score indicating BP measurement accuracy.</p> <p><b>Results: </b>Among participants with BP measurement at ≥3 visits, the prevalence of hypertension was lower compared with those with <3 visits (10.8% vs 17.5% p<0.001), whereas elevated BP and normotension was higher (17.5% and 71.7% vs 15.3% and 67.1% respectively; both p<0.001). The prevalence of hypertension and elevated BP was higher in individuals aged ≥13 years than in younger ones (p<0.001) and in males than females (p<0.001). In linear regression models, systolic and diastolic BP were independently determined by the BP measurement methodology.</p> <p><b>Conclusions: </b>The estimated prevalence of elevated BP and hypertension in children and adolescents with T1D is almost 30% and depends on the BP measurement methodology. Less frequent BP evaluation may overestimate the prevalence of hypertension.</p>