Key result
Anthropometric indicators of obesity generally demonstrated low diagnostic accuracy for screening high blood pressure in adolescents, with only one of ten included studies showing moderate to high precision.
Why the study?
Anthropometric indicators of obesity associate with blood pressure in adolescents, but their accuracy for screening for high blood pressure is not known.
Do anthropometric indicators of obesity accurately identify high blood pressure in adolescents?
Systematic Review (n=17,764)
Do anthropometric indicators of obesity accurately identify high blood pressure in adolescents?
Anthropometric indicators of obesity should be used with caution for screening high blood pressure in adolescents due to limited evidence of high diagnostic accuracy.
Answers are grounded in this paper and cite their sources.
Anthropometric indicators warrant caution for hypertension screening in adolescents; challenges their routine adoption and calls for better-validated diagnostics in research.
Background: Anthropometric indicators of obesity have been associated with blood pressure in adolescents. However, the accuracy of anthropometric indicators of obesity for screening for high blood pressure (HBP) in adolescents is not known. Thus, the aim of the present study was to summarize the set of evidence regarding the predictive ability of anthropometric indicators of obesity to identify HBP in adolescents. Methods: Searches were performed in five databases: MEDLINE, Web of Knowledge, Scopus, Scientific Electronic online (SciELO) and SportDiscus. The inclusion criteria for studies were: adolescents aged 10-19 years or mean age included in this range, observational and intervention studies, studies that proposed cutoff points for anthropometric indicators of obesity, and studies in English, Portuguese and Spanish. The methodological quality of studies was assessed using the QUADAS-2 instrument. Results: Ten studies met the inclusion criteria and had their information summarized. Based on the information described in these studies, the anthropometric indicators body mass index (BMI), waist circumference (WC), waist-to-height-ratio (WHtR), triceps skinfold thickness, body adiposity index, C index, body mass, waist-to-arm span ratio, arm fat area, average arm perimeter, fat percentage and arm span were likely to be used in high blood pressure (HBP) screening among adolescents. However, only one study showed acceptable values (moderate to high precision) in relation to the accuracy measurements of described cutoffs. Conclusion: Caution is suggested in the use of anthropometric indicators of obesity for HBP screening in adolescents, in which a greater number of studies with accurate diagnostic tools are necessary.
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Borges et al. (2022) conducted a systematic review in High blood pressure and obesity (n=17,764). Anthropometric indicators of obesity (BMI, waist circumference, waist-to-height ratio, etc.) vs. Standard blood pressure measurement was evaluated on Diagnostic accuracy (Area Under the Curve) for identifying high blood pressure. Anthropometric indicators of obesity generally demonstrated low diagnostic accuracy for screening high blood pressure in adolescents, with only one of ten included studies showing moderate to high precision.
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