Discrepancies in the diagnosis of hypertension in adolescents according to available office and home high blood pressure criteria

Abstract

This study aimed at comparing the prevalence of abnormal blood pressure (BP) phenotypes among 241 adolescents referred for hypertension (15.4 ± 1.4 years, 62% males, 40% obese) according to mostly used or available criteria for hypertension [AAP or ESH criteria for high office BP (OBP); Arsakeion or Goiânia schools' criteria for high home BP monitoring (HBPM)]. High OBP prevalence was greater when defined by AAP compared with ESH criteria (43.5% vs. 24.5%; p < .001), while high HBPM prevalence was similar between Arsakeion and Goiânia criteria (33.5% and 37.5%; p = .34). Fifty-five percent of the sample fulfilled at least one criterion for high BP, but only 31% of this subsample accomplished all four criteria. Regardless of the HBPM criteria, AAP thresholds were associated with lower prevalence of normotension and masked hypertension and greater prevalence of white-coat and sustained hypertension than ESH thresholds. These findings support the need to standardize the definition of hypertension among adolescents.

Keywords: adolescents; home blood pressure; hypertension; office blood pressure.

FIGURE 1

Venn diagram demonstrating the overlap of abnormal blood pressure prevalence according to the studied criteria. AAP‐OBP ‐ American Academy of Pediatrics high office blood pressure criteria; ESH‐OBP ‐ European Society of Hypertension high office blood pressure criteria; Arsakeion‐HBPM – Arsakeion school study high home blood pressure monitoring criteria; Goiânia‐HBPM – Goiânia schools study high home blood pressure monitoring criteria