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Comparative Study
. 2025 May 8;25(1):364.
doi: 10.1186/s12887-025-05713-6.

Assessment of cardiovascular disease risk factors in Korean children: impact of various pediatric hypertension guidelines and application of the Korean blood pressure reference

Jeong Yeon Kim  1 , Sangshin Park  2   3 , Heeyeon Cho  4
Affiliations
Comparative Study

Assessment of cardiovascular disease risk factors in Korean children: impact of various pediatric hypertension guidelines and application of the Korean blood pressure reference

Jeong Yeon Kim et al. BMC Pediatr. .

Abstract

Background: The global rise in pediatric hypertension (HTN) is a significant concern as it serves as a precursor to cardiovascular disease (CVD). To address this, we performed a comparative analysis of two guidelines for pediatric HTN: the 2017 American Academy of Pediatrics (AAP) and the 2016 European Society for Hypertension (ESH), applying the Korean blood pressure (BP) reference specifically to the Korean pediatric population.

Methods: Data from 2,060 children and adolescents aged 10-18 years from the Korean National Health and Nutrition Examination Survey (2016-2018) were analyzed. BP was classified according to the AAP, the ESH, and the Korea Regional BP Classification (KRC). High BP was defined as BP exceeding the normotensive range.

Results: The prevalence of high BP in Korean youth was significantly higher according to the AAP group than that in the ESH group (19.5% vs. 10.6%, P < 0.0001). Variations in prevalence were noted based on age, sex, and obesity. No significant differences were observed between the AAP and KRC groups in terms of high BP prevalence. The application of the AAP and KRC provided a more comprehensive reflection of CVD risk factors, including obesity and metabolic profiles, compared to the ESH. The KRC showed a tendency to classify more non-obese individuals as having elevated BP, although this difference was not statistically significant.

Conclusions: In comparing the AAP, ESH, and KRC criteria in the Korean pediatric population, the KRC demonstrated a tendency to identify individuals with CVD risk factors as having high BP. This finding suggests that using the KRC as the criterion for high BP may facilitate earlier intervention in the management of CVD risk.

Keywords: Cardiovascular disease; Korean population; Pediatric hypertension.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: The present study was approved by the Institutional Review Board (IRB) of Samsung Medical Center (IRB number 21-10-074). The informed consent was waived by IRB of Samsung Medical Center. All the data were obtained in accordance with the ethical principles for medical research involving human subjects established in the Declaration of Helsinki 1975 (revised in 2000). Consent for publication: Not applicable. Competing interests: The authors declare no competing interests. Clinical trial number: Not applicable.

Figures

Fig. 1
Fig. 1
Prevalence of BP elevation in Korean children according to (A) each guideline, (B) sex, (C) obesity, weighted. AAP American Academy of Pediatrics, BP blood pressure, ESH European Society for Hypertension, HTN hypertension, KRC Korea Regional Blood Pressure Classification
Fig. 2
Fig. 2
Difference in prevalence of high BP according to age group as classified by (A) AAP versus ESH and (B) ESH versus KRC. All weighted. AAP American Academy of Pediatrics, BP blood pressure, ESH European Society for Hypertension, HTN hypertension, KRC Korea Regional Blood Pressure Classification
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References

    1. Song P, Zhang Y, Yu J, Zha M, Zhu Y, Rahimi K, et al. Global prevalence of hypertension in children: A systematic review and Meta-analysis. JAMA Pediatr. 2019;173(12):1154–63. 10.1001/jamapediatrics.2019.3310. - PMC - PubMed
    1. Xi B, Bovet P, Hong YM, Zong X, Chiolero A, Kim HS, et al. Recent blood pressure trends in adolescents from China, Korea, Seychelles and the united States of America, 1997–2012. J Hypertens. 2016;34(10):1948–58. 10.1097/hjh.0000000000001058. - PubMed
    1. Hardy ST, Urbina EM. Blood pressure in childhood and adolescence. Am J Hypertens. 2021;34(3):242–9. 10.1093/ajh/hpab004. - PMC - PubMed
    1. Khoury M, Urbina EM. Cardiac and vascular target organ damage in pediatric hypertension. Front Pediatr. 2018;6:148. 10.3389/fped.2018.00148. - PMC - PubMed
    1. Daniels SR, Loggie JM, Khoury P, Kimball TR. Left ventricular geometry and severe left ventricular hypertrophy in children and adolescents with essential hypertension. Circulation. 1998;97(19):1907–11. 10.1161/01.cir.97.19.1907. - PubMed

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