Skip to main content
Article
Diagnosis of hypertension: Ambulatory pediatric American Heart Association/European Society of Hypertension versus blood pressure load thresholds
Journal of Clinical Hypertension
  • Ajay P. Sharma, Western University
  • Luis Altamirano-Diaz, Western University
  • Mohamed Mohamed Ali, Western University
  • Katryna Stronks, Western University
  • Amrit Kirpalani, Western University
  • Guido Filler, Western University
  • Kambiz Norozi, Western University
Document Type
Article
Publication Date
11-1-2021
URL with Digital Object Identifier
10.1111/jch.14368
Abstract

The agreement between the traditionally-used ambulatory blood pressure (ABP)-load thresholds in children and recently-recommended pediatric American Heart Association (AHA)/European Society of Hypertension (ESH) ABP thresholds for diagnosing ambulatory hypertension (AH), white coat hypertension (WCH), and masked hypertension (MH) has not been evaluated. In this cross-sectional study on 450 outpatient participants, the authors evaluated the agreement between previously used ABP-load 25%, 30%, 40%, 50% thresholds and the AHA/ESH thresholds for diagnosing AH, WCH, and MH. The American Academy of Pediatrics thresholds were used to diagnose office hypertension. The AHA threshold diagnosed ambulatory normotension/hypertension closest to ABP load 50% in 88% (95% CI 0.79, 0.96) participants (k 0.67, 95% CI 0.59, 0.75) and the ESH threshold diagnosed ambulatory normotension/hypertension closest to ABP load 40% in 86% (95% CI 0.77, 0.94) participants (k 0.66, 95% CI 0.59, 0.74). In contrast, the AHA/ESH thresholds had a relatively weaker agreement with ABP load 25%/30%. Therefore, the diagnosis of AH was closest between the AHA threshold and ABP load 50% (difference 3%, 95% CI -2.6%, 8.6%, p =.29) and between the ESH threshold and ABP load 40% (difference 4%, 95% CI -2.1%, 10.1%, p =.19) than between the AHA/ESH and ABP load 25%/30% thresholds. A similar agreement pattern persisted between the AHA/ESH and various ABP load thresholds for diagnosing WCH and MH. The AHA and ESH thresholds diagnosed AH, WCH, and MH closest to ABP load 40%/50% than ABP load 25%/30%. Future outcome-based studies are needed to guide the optimal use of these ABP thresholds in clinical practice.

Citation Information
Ajay P. Sharma, Luis Altamirano-Diaz, Mohamed Mohamed Ali, Katryna Stronks, et al.. "Diagnosis of hypertension: Ambulatory pediatric American Heart Association/European Society of Hypertension versus blood pressure load thresholds" Journal of Clinical Hypertension Vol. 23 Iss. 11 (2021) p. 1947 - 1956
Available at: http://works.bepress.com/luis-altamirano-diaz/16/