Key result
2022 AHA pediatric ABPM guidelines increase detected hypertension by ~17 percentage points vs. 2014 criteria.
Why the study?
The American Heart Association launched new 2022 guidelines for diagnosing hypertension by ABPM, but their impact on hypertension prevalence and phenotype in children suspected of hypertension was unknown.
Does applying the 2022 AHA pediatric ABPM guidelines compared to the 2014 AHA guidelines change the prevalence and phenotype classification of hypertension and improve detection of left ventricular hypertrophy in children suspected of hypertension?
Cohort (n=100)
No
Does applying the 2022 AHA pediatric ABPM guidelines compared to the 2014 AHA guidelines change the prevalence and phenotype classification of hypertension and improve detection of left ventricular hypertrophy in children suspected of hypertension?
Applying the 2022 AHA pediatric ABPM guidelines in a Southeast Asian cohort significantly increases the detection of sustained and masked hypertension—particularly among taller adolescents—and better aligns hypertension diagnosis with the presence of left ventricular hypertrophy.
Answers are grounded in this paper and cite their sources.
May increase hypertension detection in taller children; supports LVH alignment but leaves open outcome validation before practice change.
Objective The American Heart Association (AHA) launched the 2022 guidelines for the diagnosis of hypertension (HT) by ambulatory blood pressure monitoring (ABPM). The present study aimed to evaluate the impacts of the 2022 AHA guidelines on the changes in the prevalence and phenotype of HT in children suspected of HT. Methods Consecutive 100 children aged 6 to 20 suspected of HT who underwent 24-hour ABPM were recruited. The patients were separated into 3 groups: escalated, de-escalated, and unchanged. Demographic data were compared between the 3 groups. Logistic regression analysis was performed to evaluate the factors associated with the escalation in the diagnosis of HT. Results The present study revealed that the prevalence of HT, including sustained and masked HT, increased from 48% by the 2014 AHA guidelines to 65% by the 2022 AHA guidelines. Patients in the escalated group tended to have a higher proportion of male gender, with an older age and a taller height compared to those in the de-escalated group. Multivariate analysis showed that height was the only factor associated with the escalation in the diagnosis of HT [OR 1.09 (1.01-1.19), P-value .04]. Five out of 6 (83.3%) patients in the escalated group with available echocardiographic results had left ventricular hypertrophy (LVH). Conclusion Using the 2022 AHA guidelines resulted in more detection of patients with HT, and almost 30% of the escalated group had LVH. This finding supports using the 2022 AHA guidelines to detect children at risk of developing cardiovascular diseases early.
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Nimkarn et al. (2024) conducted a cohort in Suspected pediatric hypertension (n=100). 2022 American Heart Association (AHA) pediatric ABPM guidelines vs. 2014 American Heart Association (AHA) pediatric ABPM guidelines was evaluated on Prevalence of abnormal ABPM (sustained and masked hypertension) (p=<.01). The 2022 AHA pediatric ABPM guidelines increased detected hypertension prevalence from 48% to 65% compared to the 2014 guidelines, with height independently associated with diagnosis escalation.
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