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Comparison of ESHG2016 and AAP2017 hypertension guidelines in adolescents between the ages of 13 and 16: effect of body mass index on guidelines

Part of: Basic Science

Published online by Cambridge University Press:  23 August 2021

Gülşah Kaya Aksoy Open the ORCID record for Gülşah Kaya Aksoy [Opens in a new window] ,
Dilek Yapar ,
Nevin Semerci Koyun  and
Çağla Serpil Doğan
Gülşah Kaya Aksoy*
Affiliation:
University of Health Sciences, Antalya Training and Research Hospital, Antalya, Turkey
Dilek Yapar
Affiliation:
Gazi Üniversitesi, Ankara, Turkey
Nevin Semerci Koyun
Affiliation:
University of Health Sciences, Antalya Training and Research Hospital, Antalya, Turkey
Çağla Serpil Doğan
Affiliation:
University of Health Sciences, Antalya Training and Research Hospital, Antalya, Turkey
*
Author for correspondence: Dr G. Kaya Aksoy, University of Health Sciences, Antalya Training and Research Hospital, Antalya, Turkey. E-mail: [email protected]
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Abstract

Objective:

The diagnosis of hypertension in adolescents aged ≥13 and <16 years is based on the percentile according to age, gender, and height in the European Society of Hypertension guidelines guideline; whereas, the American Academy of Pediatrics guideline uses blood pressure above 130/80 mmHg as a single criterion. Therefore, this study aimed to evaluate the compatibility of these two guidelines in adolescents aged ≥13 and <16 years.

Methods:

This study was designed by retrospectively screening the records of 395 adolescents with both office and 24-hour ambulatory blood pressure measurements. Each blood pressure measurement was classified according to both the ESGH2016 and AAP2017 guidelines. Patients were divided into three subgroups according to body mass index. Cohen’s kappa analysis was used to evaluate the agreement between the two guidelines.

Results:

The majority of adolescents were normotensive according to both guidelines, 55.9% by ESHG2016 and 43.1% by AAP2017. For the whole group, the frequency of hypertension was 32.4% with ESHG2016 and 34.4% with AAP2017; while, in obese patients, hypertension frequencies were 38.8% and 43.3%, respectively. The diagnosis of hypertension was demonstrated with the two guidelines, and there was significant agreement at a substantial level, both for the obese subgroup and the whole study group (kappa value = 0.738 and 0.785, respectively). The frequency of white-coat hypertension was higher with the AAP2017 guideline (28.1% versus 16.2%, p < 0.001).

Conclusion:

With our experience in this single-centre study, it seems that both the AAP2017 and the ESHG2016 guidelines can be used in the diagnosis of hypertension in adolescents.

Keywords

HypertensionadolescentsHT guidelineskappa analysis
Type
Original Article
Information
Cardiology in the Young , Volume 32 , Issue 1 , January 2022 , pp. 94 - 100
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Copyright
© The Author(s), 2021. Published by Cambridge University Press

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