Application of the 2017 AAP guidelines increased the estimated prevalence of high blood pressure in Canadian children to 5.8% compared to 4.5% using the 2004 NIH/NHLBI guidelines.
Cohort (n=7,387)
Does the application of the 2017 AAP guidelines increase the estimated prevalence of high blood pressure compared to the 2004 NIH/NHLBI guidelines in Canadian children?
Applying the 2017 AAP guidelines increases the estimated prevalence of high blood pressure in Canadian children compared to previous guidelines, though rates remain lower than in the US, likely reflecting differences in obesity prevalence.
Absolute Event Rate: 5.8% vs 4.5%
BACKGROUND: We assess the impact of the 2017 American Academy of Pediatrics (AAP) guidelines on the prevalence of high blood pressure (BP) in generally healthy Canadian children and identify risk factors associated with high BP (elevated, stage 1, or stage 2 at a single visit). METHODS: A cohort of 7,387 children aged 6 to 18 years in the Canadian Health Measures Survey (CHMS, 2007 to 2015) had BPTru oscillometry with centiles and stages assigned using both the 2017 AAP guidelines and the 2004 Fourth Report from the National Institute of Health/National Heart Lung and Blood Institute (NIH/NHLBI). RESULTS: Although both shifted upwards significantly, mean population systolic BP and diastolic BP percentiles are now 24.2 (95% confidence interval: 23.3 to 25.2) and 46.4 (45.3 to 47.6). As a result, the population prevalence of high BP increased from 4.5% (3.9 to 5.2, NIH/NHLBI) to 5.8% (5.0 to 6.6, AAP), less than in US children measured by auscultation (14.2%, 13.4 to 15.0). Children with high BP were more likely to be overweight/obese, to be exposed to prenatal/household smoking, and to have hypertriglyceridemia, without differences in dietary salt, infant breastfeeding, neonatal hospitalizations, or exercise frequency. CONCLUSION: The 2017 AAP guidelines increase the prevalence of high BP in Canadian children; Canadian prevalence appears lower than in the USA. This may reflect differences in measurement methods or in the prevalence of childhood overweight/obesity between countries, that is, 31.1% (28.9 to 33.3) versus 40.6% (39.5 to 42.0), respectively. Those with high BP were more likely to have other cardiac risk factors, including overweight/obesity, prenatal/household smoking exposure, and hypertriglyceridemia.
Robinson et al. (Mon,) conducted a cohort in High blood pressure (n=7,387). 2017 AAP guidelines vs. 2004 NIH/NHLBI guidelines was evaluated on Population prevalence of high blood pressure. Application of the 2017 AAP guidelines increased the estimated prevalence of high blood pressure in Canadian children to 5.8% compared to 4.5% using the 2004 NIH/NHLBI guidelines.