About 795,000 more teens whose blood pressure was taken in 2013-’16 would be classified as having hypertension under new AAP guidelines, according to a new study.
Centers for Disease Control and Prevention researchers set out to look at the impact of the 2017 AAP Clinical Practice Guideline for Screening and Management of High Blood Pressure in Children and Adolescents, which included new normative blood pressure tables.
Using 2001-’16 data from the National Health and Nutrition Examination Survey, they analyzed the status of just over 12,000 12- to 19-year-olds and published the findings today in Morbidity and Mortality Weekly Report.
Under the new guidelines, prevalence of hypertension from 2013-’16 ranged from 1.88% in healthy children to 14.7% of those with severe obesity. About 2.6% of teens would be reclassified as having hypertension, and those youths often were male, 18-19 years old or have obesity.
“Clinicians and public health professionals transitioning to the new guideline might expect more youths to be classified as having hypertension,” authors wrote. “Efforts to address hypertension in youths include lifestyle and environmental strategies that promote cardiovascular health.”
When applying either set of guidelines consistently over previous years, the hypertension rate has declined. Under the old standards, it dropped from 3.2% in 2001 to 1.5% in 2016. New guidelines showed rates dropping during that time from 7.7% to 4.2%. These improvements came even as obesity increased from 17.8% in 2001-’04 to 21.8% from 2013-’16.
Early interventions, improvements in diet and increases in medication use may have contributed to the hypertension declines, according to the report. However, authors said because the causes are uncertain, the declining hypertension prevalence should be interpreted cautiously.
Pediatricians will be able to get more guidance from an upcoming AAP technical report that supplements the 2017 guidelines.