Key result
Among US children aged 8 to 17 years, the prevalence of elevated blood pressure was 7.2% and hypertensive blood pressure was 3.8%, with disparities persisting across age, sex, and race/ethnicity after adjusting for weight status.
Why the study?
Following the 2017 American Academy of Pediatrics blood pressure screening guideline updates, contemporary nationally representative estimates of elevated and hypertensive blood pressure among US children across sociodemographic groups, accounting for weight, were needed.
Cross-Sectional (n=5,971)
Elevated and hypertensive blood pressure affect a significant proportion of US children, with disparities by age, sex, and race/ethnicity persisting even after adjusting for body weight.
Prevalence data support sustained pediatric BP surveillance; leaves open questions on trends, causality, and interventions.
INTRODUCTION: The American Academy of Pediatrics (AAP) updated its blood pressure (BP) screening guidelines in 2017 to emphasize body weight as a risk factor. We provide contemporary, nationally representative estimates of prevalence of elevated and hypertensive BP among US children and examine sociodemographic prevalence differences, accounting for the influence of weight. METHODS: We used cross-sectional data from children aged 8 to 17 years (N = 5,971; weighted N = 36,612,323) collected from 2011 through 2018 in 4 biennial cycles of the National Health and Nutrition Examination Survey (NHANES). Children's BP was categorized as normal, elevated, or hypertensive. Sociodemographic characteristics included were sex, age, race/ethnicity, family income, and education. Log binomial regression, with and without adjustment for weight (dichotomized at the 85th body mass index percentile), determined prevalence estimates and differences for elevated and hypertensive BPs with 95% CIs. RESULTS: In NHANES data collected from 2011 through 2018, 7.2% (95% CI, 6.3%-8.3%) of US children had elevated BP, and 3.8% (95% CI, 3.3%-4.5%) had hypertensive BP according to 2017 AAP guidelines. Differences in prevalence of weight-adjusted elevated BP indicated higher prevalence among children aged 16 to 17 years compared with children aged 8 to 9 years (prevalence difference, +6.3%; 95% CI, 3.2%-9.4%), among males compared with females (+4.6%; 95% CI, 2.7%-6.4%), and among non-Latino Black children compared with non-Latino White children (+4.0%; 95% CI, 2.2%-5.8%). Crude hypertensive BP prevalence was highest among children aged 8 to 9 years, male children, and Mexican American children. The only difference remaining after weight adjustment was among children aged 8 to 9 years and 13 to 15 years. CONCLUSION: Elevated BP was most prevalent among US children who were older, male, or non-Latino Black. Factors beyond inequalities in body weight may contribute to disparities in elevated BP.
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Goulding et al. (2021) conducted a cross-sectional in Elevated and hypertensive blood pressure (n=5,971). Sociodemographic factors and weight status vs. Reference sociodemographic groups and healthy weight was evaluated on Prevalence of elevated blood pressure (95% CI 6.3-8.3). Among US children aged 8 to 17 years, the prevalence of elevated blood pressure was 7.2% and hypertensive blood pressure was 3.8%, with disparities persisting across age, sex, and race/ethnicity after adjusting for weight status.
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