Static cut-points of hypertension and increased arterial stiffness in children and adolescents: The International Childhood Vascular Function Evaluation Consortium

Min Zhao, Jose G. Mill, Wei Li Yan, Young Mi Hong, Paula Skidmore, Lee Stoner, Ana I. Mora-Urda, Anuradha Khadilkar, Rafael de Oliveira Alvim, Hae Soon Kim, Pilar Montero López, Yi Zhang, Pouya Saeedi, Divanei Zaniqueli, Yuan Jiang, Polyana Romano Oliosa, Eliane Rodrigues de Faria, Kai Mu, Da yan Niu, Costan G. MagnussenBo Xi

Research output: Contribution to journalArticlepeer-review

5 Scopus citations

Abstract

Pediatric elevated blood pressure (BP) and hypertension are usually defined using traditional BP tables at the 90th and 95th percentiles, respectively, based on sex, age, and height, which are cumbersome to use in clinical practice. The authors aimed to assess the performance of the static cut-points (120/80 mm Hg and 130/80 mm Hg for defining elevated BP and hypertension for adolescents, respectively; and 110/70 mm Hg and 120/80 mm Hg for children, respectively) in predicting increased arterial stiffness. Using data from five population-based cross-sectional studies conducted in Brazil, China, Korea, and New Zealand, a total of 2546 children and adolescents aged 6-17 years were included. Increased arterial stiffness was defined as pulse wave velocity ≥sex-specific, age-specific, and study population-specific 90th percentile. Compared to youth with normal BP, those with hypertension defined using the 2017 American Academy of Pediatrics guideline (hereafter referred to as “percentile-based cut-points”) and the static cut-points were at similar risk of increased arterial stiffness, with odds ratios and 95% confidence intervals of 2.35 (1.74-3.17) and 3.07 (2.20-4.28), respectively. Area under the receiver operating characteristic curve and net reclassification improvement methods confirmed the similar performance of static cut-points and percentile-based cut-points (P for difference '.05). In conclusion, the static cut-points performed similarly well when compared with the percentile-based cut-points in predicting childhood increased arterial stiffness. Use of static cut-points to define hypertension in childhood might simplify identification of children with abnormal BP in clinical practice.

Original languageEnglish
Pages (from-to)1335-1342
Number of pages8
JournalJournal of Clinical Hypertension
Volume21
Issue number9
DOIs
StatePublished - 1 Sep 2019

Bibliographical note

Funding Information:
Funding information Dr Bo Xi was supported by the National Natural Science Foundation of China (81673195). Dr Wei-Li Yan was supported by Shanghai Municipal Commission of Health and Family Planning Outstanding Academic Leaders Plan (XBR2013101). Dr Costan G Magnussen was supported by a National Heart Foundation of Australia Future Leader Fellowship (100849). Dr Jose´ G. Mill was supported by FAPES and Fundação VALE.

Publisher Copyright:
©2019 Wiley Periodicals, Inc.

Keywords

  • arterial stiffness
  • blood pressure
  • pediatrics
  • screening

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