Key result
The AAP definition identifies elevated BP with ~91% sensitivity versus traditional percentile-based criteria.
Why the study?
The American Academy of Pediatrics recommended 120/80 mm Hg to identify elevated blood pressure in adolescents aged 13-17 years, but its performance compared to the traditional percentile-based definition needed evaluation.
Does the recommended AAP definition (≥120/80 mm Hg) accurately identify elevated blood pressure in adolescents aged 13-17 years compared to the traditional percentile-based definition?
Cross-Sectional (n=7,485)
Does the recommended AAP definition (≥120/80 mm Hg) accurately identify elevated blood pressure in adolescents aged 13-17 years compared to the traditional percentile-based definition?
Answers are grounded in this paper and cite their sources.
The simplified AAP threshold of ≥120/80 mm Hg for elevated blood pressure in adolescents is highly accurate and correlates strongly with the traditional, more complex percentile-based definition.
Recently, the American Academy of Pediatrics (AAP) recommended 120/80 mm Hg as thresholds for identifying elevated blood pressure (BP) in adolescents aged 13-17 years. The authors aimed to compare the performance of the new definition in identifying elevated BP with traditional percentile-based definition. Data were obtained from the National Health and Nutrition Examination Survey 1999-2014, which included 7485 adolescents aged 13-17 years. Elevated BP was defined using the recommended (≥120/80 mm Hg) and traditional definition (≥90th percentile for sex, age, and height or 120/80 mm Hg) presented in AAP guideline. The prevalence of elevated BP was 15.7% and 17.2% using the recommended and traditional definition, respectively (P < .001). The recommended definition had high sensitivity (90.9%), perfect specificity (100.0%), perfect positive predictive value (100.0%), and very high negative predictive value (98.1%) compared with the traditional definition. The Kappa correlation coefficient between two definitions was 0.94 (P < .001). Similar results can be observed in subgroups across sex, age, and sex- and age-specific height percentile except for both sexes with young age and low height percentile. Generally, our results supported the use of the recommended definition for identifying elevated BP in adolescents.
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Fan et al. (2019) conducted a cross-sectional in Elevated blood pressure (n=7,485). Recommended definition (≥120/80 mm Hg) vs. Traditional definition (≥90th percentile for sex, age, and height or 120/80 mm Hg) was evaluated on Prevalence of elevated BP (p=<.001). The recommended AAP definition (≥120/80 mm Hg) identified a 15.7% prevalence of elevated blood pressure versus 17.2% with the traditional definition (P<.001), demonstrating 90.9% sensitivity.
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