Impact of different guidelines on the prevalence of hypertension in children and adolescents

Objective: To assess the prevalence of hypertension (HTN) in youth according to the criteria of the European Society of Hypertension (ESH) (Lurbe, 2016), the American Academy of Pediatrics (AAP) (Flynn, 2017), and the Canadian Guidelines (Rabi 2020). Design and method: Four thousand nine hundred and forty evaluations in 2957 Caucasians of both sexes (1459 females), of European origin, from 5 to 18 years of age (mean age 11.0 ±3.2) were included and grouped in 5-12 yr, 13-15 yr and 16-18 yr. Blood pressure (BP) was measured in the non-dominant arm with cuff and bladder size adjusted to upper-arm girth. The three measurements of each office visit were averaged for analysis. Subjects were qualified as hypertensive (SBP and/or DBP) based on the thresholds defined by ESH, AAP and Canadian guidelines and differences among them were calculated. Results: According to the ESH, Canadian and AAP criteria, the percentage of hypertensives was 6.2%, 6% and 9.9%, respectively. The percentages in boys were 7.2%, 8.2% and 12.3%, while in girls were 5.1%, 3.6% and 7.4%. According to age, between 5-12 yr the prevalence of HTN was 6.2%, 5.2% and 10%. In those with 13-15 yr, HTN ranged at 7.3%, 6.8% and 8.6%, while in those with 16-18 yr, HTN was observed in 1.6%, 9.2% and 13.2%. The graphic expression of the different prevalence is shown in the Figures. Significant differences were observed for the total and male prevalence between ESH and Canada with AAP (p<0.05). For girls, differences were observed among the 3 Guidelines. Conclusions: Overall, there are differences in the prevalence of HTN applying different Guidelines. Differences were largely dependent on age and sex.