scholarly journals Blood pressure-to-height ratio for diagnosing hypertension in adolescents

2017 ◽  
Vol 57 (2) ◽  
pp. 84
Author(s):  
Kristina Ambarita ◽  
Oke Rina Ramayani ◽  
Munar Lubis ◽  
Isti Ilmiati Fujiati ◽  
Rafita Ramayati ◽  
...  

Background Diagnosing hypertension in children and adolescents is not always straightforward. The blood pressure-to-height ratio (BPHR) has been reported as a screening tool for diagnosing hypertension.Objective To evaluate the diagnostic value of blood pressure-to-height ratio for evaluating hypertension in adolescents.Methods A cross-sectional study was conducted among 432 healthy adolescents aged 12-17 years in Singkuang, North Sumatera from April to May 2016. Blood pressure tables from the National High Blood Pressure Education Program (NHBPEP) Working Group on High Blood Pressure in Children and Adolescents were used as our standard of comparison. Sex-specific systolic and diastolic blood pressure-to-height ratios (SBPHR and DBPHR) were calculated. ROC curve analyses were performed to assess the accuracy of BPHR for discriminating between hypertensive and non-hypertensive adolescents. Optimal thresholds of BPHR were determined and validated using 2x2 table analyses.Results The accuracies of BPHR for diagnosing hypertension were > 90% (P<0.001), for both males and females. Optimal SBPHR and DBPHR thresholds for defining hypertension were 0.787 and 0.507 in boys, respectively, and 0.836 and 0.541 in girls, respectively. The sensitivities of SBPHR and DBPHR in both sexes were all >93%, and specificities in both sexes were all >81%. Positive predictive values for SBPHR and DBPHR were 38.7% and 45.2% in boys, respectively; and 55.9% and 42.4% in girls, respectively; negative predictive values in both sexes were all >97%, positive likelihood ratios in both sexes were all >5, and negative likelihood ratios in both sexes were all <1.Conclusion Blood pressure-to-height ratio is a simple screening tool with high sensitivity and specificity for diagnosing hypertension in adolescents.

Gastrohnup ◽  
2016 ◽  
Vol 17 (3S3) ◽  
Author(s):  
LINA JOHANNA MORENO GIRALDO ◽  
ADELA HERRERA GENES

La Hipertensión Arterial (HTA) en niños es un problema creciente en salud. Con una frecuencia estimada en niños del 1-13%, dependiendo de la metodología usada, es uno de los factores de riesgo más importantes para el desarrollo de enfermedad cardiovascular y renal crónica. En 2004, el Cuarto Informe, establece que los valores normales de la presión arterial en niños dependen del género, edad, percentil de talla y para su clasificación se utilizan actualmente las tablas de la National High Blood Pressure Education Program Working Group on High Blood Pressure Children and Adolescents, con los percentiles 50, 90, 95 y 99 de presión arterial sistólica y diastólica. Entre los factores en la patogenia de la HTA primaria ó esencial en pediatría está la obesidad, relacionada con el aumento del gasto cardíaco y del volumen intravascular, aumento de la actividad del sistema simpático, lesión endotelial por radicales libres, aumento de la generación de angiotensina a partir del tejido adiposo, hiperinsulinemia con aumento en la reabsorción de sodio y del tono simpático, de la leptina, además de aterosclerosis temprana, trastornos del sueño relacionados con síndromes de apnea e hipopnea. En los niños, las diferentes guías de manejo incluyendo las de la Organización Mundial de la Salud y de la Sociedad Internacional de Hipertensión (OMS/ISH), se plantean como objetivo terapéutico reconocido ampliamente, que una disminución en el consumo de sodio en niños y adolescentes se ha asociado con reducción en la PA, entre 1 a 3 mmHg. Por lo anterior, teniendo en cuenta las complicaciones en edades tardías de consumo de sal de la dieta desde la infancia y la aparición más frecuente de niños pequeños se debe determinar las necesidades de sodio en la dieta y dentro de las recomendaciones se debe preferir alimentos de origen natural y en lo posible no se debe agregar sal a las preparaciones en el niño menor de 2 años.


2020 ◽  
Author(s):  
Lei Cao ◽  
Ge Li ◽  
Changhong Zhang ◽  
Xiaohua Tang

Abstract Background In order to study the high blood pressure of children and adolescents and its influencing factors, it provides evidence-based evidence for the high blood pressure prevention of primary and secondary school students. Methods This study is a cross-sectional survey, which uses stratified cluster sampling method to select students from 7 schools to participate in questionnaire survey and physical examination. The correlation between single factor and high blood pressure was analyzed by chi-square test, and multivariate logistic regression analysis was used for multivariate analysis. Results A total of 1,814 subjects, including 512 primary school students (28.22%), 499 junior high school students (27.51%), 563 senior high school (31.04%), and 240 vocational high school (13.23%). There were 1000 males (55.13%) and 814 females (44.70%). The average age was 13.64±2.65 years. The detection rate of high blood pressure was 9.76%. Multivariate logistic regression analysis showed that the age groups were 10~ and 14~ (OR=20.870, 95%CI=2.372-183.666; OR=10.049, 95%CI=1.306-77.353) , sleep duration < 7h (OR=4.136, 95%CI=4.136), and physical education class times ≤2 times per week (OR=5.073, 95%CI=2.497-10.306), which were risk factors for high blood pressure in children and adolescents. Normal weight and overweight group were protective factors compared to the obesity group (OR=0.094, 95%CI=0.061-0.146; OR=0.225, 95%CI=0.134-0.378). Conclusion The age groups of 14~ and 16~ years old, physical education classes ≤ 2 times per week, and sleep duration <7h were risk factors for primary and secondary school students, and BMI of Normal weight and overweight group were protective factors compared to the obesity group students.


BMJ Open ◽  
2020 ◽  
Vol 10 (1) ◽  
pp. e032874 ◽  
Author(s):  
Joyce Ying Hui Tee ◽  
Wan Ying Gan ◽  
Poh Ying Lim

ObjectiveTo compare the performance of different anthropometric indices including body mass index (BMI), waist circumference (WC), waist-to-height ratio (WHtR) and a body shape index to predict high blood pressure (BP) in adolescents using the 90th and 95th percentiles as two different thresholds.DesignCross-sectional study.SettingProbability proportionate to size was used to randomly select two schools in Selangor state, Malaysia.ParticipantsA total of 513 adolescents (58.9% women and 41.1% men) aged 12–16 years were recruited.Primary and secondary outcome measuresWeight, height, WC and BP of the adolescents were measured. The predictive power of anthropometric indices was analysed by sex using the receiver operating characteristic curve.ResultsBMI and WHtR were the indices with higher areas under the curve (AUCs), yet the optimal cut-offs to predict high BP using the 95th percentile were higher than the threshold for overweight/obesity. Most indices showed poor sensitivity under the suggested cut-offs. In contrast, the optimal BMI and WHtR cut-offs to predict high BP using the 90th percentile were lower (men: BMI-for-age=0.79, WHtR=0.46; women: BMI-for-age=0.92, WHtR=0.45). BMI showed the highest AUC in both sexes but had poor sensitivity among women. WHtR presented good sensitivity and specificity in both sexes.ConclusionsThese findings suggested that WHtR might be a useful indicator for screening high blood pressure risk in the routine primary-level health services for adolescents. Future studies are warranted to involve a larger sample size to confirm these findings.


BMJ Open ◽  
2018 ◽  
Vol 8 (7) ◽  
pp. e019902 ◽  
Author(s):  
Sandrita Simonyte ◽  
Renata Kuciene ◽  
Virginija Dulskiene ◽  
Vaiva Lesauskaite

ObjectivesRecently, genome-wide associated studies have identified several genetic loci that are associated with elevated blood pressure and could play a critical role in intracellular calcium homeostasis. The aim of this study was to assess the associations ofATP2B1rs2681472 andCACNB2rs12258967 gene polymorphisms with high blood pressure (HBP) among Lithuanian children and adolescents aged 12–15 years.Study design and participantsThis was a cross-sectional study of a randomly selected sample of 646 12–15-year-old adolescents who participated in the survey ‘The Prevalence and Risk Factors of HBP in 12–15 Year-Old Lithuanian Children and Adolescents (from November 2010 to April 2012)’. Anthropometric parameters and BP were measured. The participants with HBP were screened on two separate occasions. Subjects were genotypedATP2B1rs2681472 andCACNB2rs12258967 gene polymorphisms using real-time PCR method.ResultsThe prevalence of HBP was 36.7%, significantly higher for boys than for girls. In the multivariate analysis, after adjustment for body mass index and waist circumference, boys withCACNB2CG genotype,CACNB2GG genotype andCACNB2CG +GG genotype had higher odds of having HBP in codominant (adjusted OR (aOR)=1.92; 95% CI 1.16 to 3.18, p=0.011; and aOR=2.64; 95% CI 1.19 to 5.90, p=0.018) and in dominant (aOR=2.05; 95% CI 1.27 to 3.30, p=0.003) inheritance models. Girls carryingCACNB2CG genotype andCACNB2CG +GG genotype had increased odds of HBP in codominant (aOR=1.82; 95% CI 1.02 to 3.24, p=0.044) and in dominant (aOR=1.89; 95% CI 1.09 to 3.28, p=0.023) inheritance models. Furthermore, significant associations were found in additive models separately for boys (aOR=1.72; 95% CI 1.20 to 2.46, p=0.003) and girls (aOR=1.52; 95% CI 1.05 to 2.20, p=0.027). No significant association was found betweenATP2B1gene polymorphism and the odds of HBP.ConclusionsOur results indicate thatCACNB2gene polymorphism was significantly associated with higher odds of HBP in Lithuanian adolescents aged 12–15 years.


2015 ◽  
Vol 24 (1) ◽  
pp. 30-5 ◽  
Author(s):  
Kurnia Febriana ◽  
Neti Nurani ◽  
Madarina Julia

Background: Obesity is associated with increased risk for high blood pressure (BP). Although a routine BP measurement is indicated for all children visiting pediatric practice, recognition of children particularly at risk may save times. The aim of this study was to assess the cut-off point for body mass index (BMI) and waist-to-height ratio (WHtR) to predict high BP in adolescents. Methods: We conducted a cross-sectional study on 928 children aged 11 to 16 years in Yogyakarta. BP were measured using standard technique described by The Fourth Report on The Diagnosis, Evaluation, and Treatment of High Blood Pressure in Children and Adolescents. BMI was adjusted for age and sex using the WHO 2007 growth reference. WHtR was ratio of waist circumference related to height in centimeters. Receiver operating characteristic (ROC) curves were used to estimate the best cut-offs. Results: The best cut-off point for BMI-for-age Z-score (BMIZ) to predict high BP was 0.51 with sensitivity and specificity of 82% (95% CI = 78-86) and 76% (95% CI = 67-78) for systolic BP and sensitivity and specificity of 82% (95% CI = 78-86) and 72% (95% CI = 68-76) for diastolic BP. The best cut-off point for WHtR was 0.45, with sensitivity of 76% (95% CI = 67-78) and specificity of 74% (95% CI = 71-79) for systolic BP and sensitivity of 76% (95% CI = 72-80) and specificity of 70% (95% CI = 61-75) for diastolic BP.Conclusion: BMIZ of 0.51 and WHtR of 0.45 are the best cut-off point to predict high BP in adolescents.


2020 ◽  
Vol 41 (Supplement_1) ◽  
Author(s):  
A Kerimkulova ◽  
A S Ospanova ◽  
R G Nurpeissova ◽  
G M Kamalbekova ◽  
T H Rymbaeva

Abstract Introduction The obesity and overweight epidemic, together with increasing cardiovascular disease, represent a major health problem worldwide, and their occurrence in childhood and adolescence has increased in recent time. Purpose to assess the association of  waist circumference (WC) and waist-to-height ratio (WHtR) coefficient with occurrence rate in adolescents with high blood pressure. Materials and methods The results of a single-step cross-sectional study of teenagers aged 12-13 years studied in 12 secondary schools in our city (Kazakhstan) are presented. The study included adolescents in the amount of 1519 (average age, standard deviation 12.3 + 0.46 years). For representing the outcomes there were used  the measurement of weight, height, BMI, WC, WHtR and the blood pressure of adolescents. Criteria for BP: normal BP (SBP and DBP &lt;89th percentile); high normal BP (SBP and DBP ≤90 and 94th percentile); arterial hypertension (SBP and DBP &gt; 95th percentile). ROC analysis was used to study the relationship between WC, WHtR and BMI. The distinctive impact of  WC or WHtR on the development of these states was expressed as the area under the curve (AUC 95% CI). Results From 1519 studied teenagers of 12-13 years, boys were 49.1% (n = 745), girls 50.9% (n = 774). Population with normal BP composed 62.7%, normal raised BP - 24.8%, hypertension - 12.4%, WC˂90th percentile at 98.5% (n = 939). The distribution by sex was: girls are more likely to have abdominal obesity than boys, (χ²=19.940, df = 1, р˂0.001). An elevated level of  WHtR was detected in 7.6% (n = 115) of adolescents. Among boys were 7.7% (n = 57) and girls 7.5% (n = 58), χ²=0.013, df = 1, p = 0.908. ). Girls (10.8%) with high blood pressure have increase WC than boys (2.1%), χ²=26.689, df = 1, р˂0.001. Adolescents with high blood pressure have enhanced WHtR - 12.2% than adolescents with normal blood pressure (2.7%), χ²=27.518, df = 1, р˂0.001. Increase of WC &gt; 90th percentile enhances with 4.5 times (95% CI: 2.44-8.53) and WHtR with 2.7 times (95% CI: 1.85-4.04) in adolescents with high blood pressure. WC (AUC = 832; 95% CI: 0.792-0.872) and WHtR (AUC = 0.812; 95% CI: 0.770-0.854was a better predictor of abdominal obesity than BMI. Conclusions. Indicators of  WC, WHtR indicating to the presence of abdominal obesity to identify risk factors for the development of high blood pressure. Participants with increase of  WC &gt; 90th percentile were 4.5 times and WHtR were 2.7 times more likely to have high blood pressure.


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