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Prevalence of Hypertension in Children

Cynthia S Bell1, Joyce P Samuel1, Joshua A Samuels1

  • 1From the Division of Pediatric Nephrology & Hypertension, McGovern Medical School at UTHealth Houston, TX.

Hypertension (Dallas, Tex. : 1979)
|December 21, 2018
PubMed

Insights

The 2017 American Academy of Pediatrics guideline for pediatric hypertension shows increased elevated blood pressure rates in children. Shorter or younger children and taller, older children are more likely to be diagnosed with hypertension under the new guidelines.

Area of Science:

  • Pediatric Medicine
  • Cardiology
  • Public Health

Background:

  • The American Academy of Pediatrics updated pediatric hypertension guidelines in 2017, replacing the 2004 Fourth Report.
  • Previous guidelines estimated pediatric hypertension prevalence between 2% and 4%.
  • The impact of the new guidelines on prevalence is not yet fully understood.

Purpose of the Study:

  • To estimate the prevalence of elevated blood pressure, stage 1, and stage 2 hypertension in children using the new 2017 American Academy of Pediatrics guideline.
  • To compare new prevalence estimates with those from the Fourth Report guidelines within a school-based screening program.
  • To analyze how sex, age, and height factors influence hypertension classification under the new guidelines.

Main Methods:

  • A school-based blood pressure screening program involving 22,224 students aged 10 to 17 years.
  • Classification of blood pressure categories (elevated, stage 1, stage 2 hypertension) based on the 2017 American Academy of Pediatrics guideline.
  • Comparison of prevalence data with historical data from the Fourth Report guidelines.

Main Results:

  • Prevalence of elevated blood pressure (formerly prehypertension) increased from 14.8% (Fourth Report) to 16.3% (new guideline).
  • This increase is attributed to differential classification changes affecting younger and older children.
  • Confirmed hypertension prevalence remained stable at 2% to 4%, but shorter children (<13 years) and taller, older children (13+ years) are more frequently diagnosed under the new guidelines.

Conclusions:

  • The updated American Academy of Pediatrics guideline has led to an increased prevalence of elevated blood pressure in school-aged children.
  • The new guidelines introduce systematic differences in hypertension diagnosis based on age and height.
  • Continued monitoring and evaluation of pediatric hypertension prevalence and its classification are essential.

Keywords:
blood pressureepidemiologyhypertensionpediatricsprehypertensionprevalence

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