Research Article| October 01 2020 Identifying the Hypertensive Adolescent AAP Grand Rounds (2020) 44 (4): 47. https://doi.org/10.1542/gr.44-4-47 Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Facebook Twitter LinkedIn MailTo Tools Icon Tools Get Permissions Cite Icon Cite Search Site Citation Identifying the Hypertensive Adolescent. AAP Grand Rounds October 2020; 44 (4): 47. https://doi.org/10.1542/gr.44-4-47 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search toolbar search search input Search input auto suggest filter your search All PublicationsAll JournalsAAP Grand RoundsPediatricsHospital PediatricsPediatrics In ReviewNeoReviewsAAP NewsAll AAP Sites Search Advanced Search Topics: hypertension Source: Wieniawski P, Werner B. Prediction of the hypertension risk in teenagers [published online ahead of print June 9, 2020]. Cardiol J. 2020. doi: https://doi.org/10.5603/CJ.a2020.0079Google Scholar Investigators from the Medical University of Warsaw, Poland, conducted a cross-sectional study to create a hypertension risk stratification model and algorithm to detect hypertension in adolescents. Eligible participants were middle and high school students aged 15–17 years from schools in and around Warsaw who never had been diagnosed or suspected of having hypertension previously. Participants completed a questionnaire regarding their family history and risk factors for cardiovascular disease. Blood pressure measurements were taken 3 times on at least 2 separate visits at least a week apart. Anthropometric measurements, including weight; height; BMI; and hip, arm, and abdominal circumference, also were obtained. The primary outcome was hypertension, defined as systolic and/or diastolic blood pressure ≥95th percentile according to norms for gender, age, and/or height. Among those with hypertension after initial blood pressure measurement, 24-hour ambulatory blood pressure monitoring was performed for confirmation. Investigators used logistic regression to identify anthropometric and family history variables associated with hypertension, then developed a model including significant variables to predict the risk of hypertension. This model was tested by administering a questionnaire that included these variables to a separate sample of students to determine its sensitivity and specificity for estimating an individual as having a > 50% or > 75% risk of hypertension. There were 690 student participants included in the initial sample, 5.8% (N = 40) of whom were found to have hypertension. Variables significantly associated with hypertension included a high BMI and having at least one parent who had hypertension. In the predictive model, height, weight, waist-to-hip circumference, and family history of hypertension were included. There were 108 participants who completed the predictive model questionnaire. The sensitivity and specificity of the predictive model for estimating a > 50% risk of hypertension were 91% and 97%, respectively; for estimating a > 75% risk, the sensitivity and specificity were 54% and 100%, respectively. The authors conclude that an algorithm including height, weight, waist-to-hip circumference, and family history of hypertension can predict hypertension in adolescents. Dr Sanchez-Kazi has disclosed no financial relationship relevant to this commentary. This commentary does not contain a discussion of an unapproved/investigative use of a commercial product/device. Hypertension in children is an increasing worldwide health problem (See AAP Grand Rounds. 2020;43[5];591 .) There is increased risk of chronic kidney disease and cardiovascular health problems in adults who were hypertensive as children (See AAP Grand Rounds. 2019;41[6];632,3 ), so identifying children who are at risk is important. In the current study, the authors proposed a risk stratification formula to identify adolescents who are at risk of developing hypertension using anthropometric measurements and family history. Multiple worldwide investigators have demonstrated in prospective, observational, and cross-sectional studies that increased weight, high waist-to-hip ratio, and elevated BMI raise the risk of hypertension significantly.3,4 The risk of... You do not currently have access to this content.
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