TY - JOUR
T1 - Blood pressure in 57,915 pediatric patients who are overweight or obese based on five reference systems
AU - APV initiative and the BMBF Competence Network Obesity
AU - Flechtner-Mors, Marion
AU - Neuhauser, Hannelore
AU - Reinehr, Thomas
AU - Roost, Hans-Peter
AU - Wiegand, Susanna
AU - Siegfried, Wolfgang
AU - Zwiauer, Karl
AU - Molz, Esther
AU - Holl, Reinhard W
N1 - Publisher Copyright:
© 2015 Elsevier Inc.
PY - 2015/6/1
Y1 - 2015/6/1
N2 - The aim of this study was to determine the prevalence of hypertension in overweight or obese pediatric subjects using different national or international references, which are based either on the entire population or on normal weight children only: 188 centers from Germany, Austria, and Switzerland participated in the Adipositas Patienten Verlaufsbeobachtung initiative. Data from 57,915 children aged 6 to 18 years who are overweight or obese were used to determine the prevalence of prehypertension and hypertension based on Second Task Force, European pooled data, Fourth Report all and Fourth Report nonoverweight, or German Health Interview and Examination Survey for Children and Adolescents (KiGGS) references. Three references included overweight children, whereas 2 (Fourth Report nonoverweight and KiGGS) were based on nonoverweight children only. Based on KiGGS, Fourth Report nonoverweight, Fourth Report all, European pooled data, or Second Task Force, the prevalence of hypertension was 47%, 42%, 36%, 32%, and 27%, respectively. Recent references classified more children as hypertensive, whereas fewer children fell into the prehypertensive group. Only 22% of children were classified as hypertensive by each of the 5 references (8% as prehypertensive). The prevalence of normal blood pressure was independent of the reference applied. Hypertension as defined by the different reference systems was significantly correlated, and all methods were significantly associated with impaired glucose metabolism or dyslipidemia, without significant differences in methods. In conclusion, the diagnosis of elevated blood pressure depends on the reference population used. A nonoverweight reference population substantially increases the prevalence of hypertension in children and adolescents who are overweight or obese. The choice of the reference has significant implications for risk stratification and treatment decisions.
AB - The aim of this study was to determine the prevalence of hypertension in overweight or obese pediatric subjects using different national or international references, which are based either on the entire population or on normal weight children only: 188 centers from Germany, Austria, and Switzerland participated in the Adipositas Patienten Verlaufsbeobachtung initiative. Data from 57,915 children aged 6 to 18 years who are overweight or obese were used to determine the prevalence of prehypertension and hypertension based on Second Task Force, European pooled data, Fourth Report all and Fourth Report nonoverweight, or German Health Interview and Examination Survey for Children and Adolescents (KiGGS) references. Three references included overweight children, whereas 2 (Fourth Report nonoverweight and KiGGS) were based on nonoverweight children only. Based on KiGGS, Fourth Report nonoverweight, Fourth Report all, European pooled data, or Second Task Force, the prevalence of hypertension was 47%, 42%, 36%, 32%, and 27%, respectively. Recent references classified more children as hypertensive, whereas fewer children fell into the prehypertensive group. Only 22% of children were classified as hypertensive by each of the 5 references (8% as prehypertensive). The prevalence of normal blood pressure was independent of the reference applied. Hypertension as defined by the different reference systems was significantly correlated, and all methods were significantly associated with impaired glucose metabolism or dyslipidemia, without significant differences in methods. In conclusion, the diagnosis of elevated blood pressure depends on the reference population used. A nonoverweight reference population substantially increases the prevalence of hypertension in children and adolescents who are overweight or obese. The choice of the reference has significant implications for risk stratification and treatment decisions.
KW - Adolescent
KW - Blood Pressure
KW - Child
KW - Female
KW - Humans
KW - Hypertension/complications
KW - Male
KW - Obesity/complications
KW - Overweight/complications
KW - Reference Values
UR - http://www.scopus.com/inward/record.url?scp=84929280501&partnerID=8YFLogxK
U2 - 10.1016/j.amjcard.2015.02.063
DO - 10.1016/j.amjcard.2015.02.063
M3 - Journal article
C2 - 25862158
SN - 0002-9149
VL - 115
SP - 1587
EP - 1594
JO - American Journal of Cardiology
JF - American Journal of Cardiology
IS - 11
ER -