Public Release: 

What effect do new guidelines have on prevalence of high blood pressure in children?

JAMA Pediatrics

Bottom Line: More U.S. children are considered to have elevated blood pressure under new guidelines from the American Academy of Pediatrics.

Why The Research Is Interesting: The 2017 blood pressure guidelines made two important changes compared to the 2004 fourth report from the National Heart, Lung, and Blood Institute (NHLBI). The first was the exclusion of children who are overweight or obese from the charts used to define normal blood pressures because they tend to have higher blood pressures and worse cardiovascular outcomes later in life. Also, diagnostic thresholds were revised to better align with adult definitions.

Who and When: 15,647 generally healthy, low-risk children (ages 5 to 18) from the National Health and Nutrition Examination Surveys (NHANES from 1999 to 2014) were used to assess the consequences of the new guidelines classifying blood pressure

What (Measures): Blood pressure classification based on either the new 2017 American Academy of Pediatrics guidelines or the 2004 NHLBI report

How (Study Design): This was an observational study. Researchers were not intervening for purposes of the study and cannot control for all other factors that could explain the study findings.

Authors: Celia J. Rodd, M.D., M.Sc., F.R.C.P.C., of the University of Manitoba, Canada, and coauthors

Study Limitations: Insufficient number of children to assess differences by race, sex and age; a lack of information on medical history, family history and co-existing medical problems; and no long-term follow-up

Related Material: The editorial, "What is the Prevalence of Childhood Hypertension: It Depends on the Definition," by Stephen R. Daniels, M.D., Ph.D., of the University of Colorado School of Medicine, Aurora, also is available on the For The Media website.

An editor article review podcast with Aaron E. Carroll, M.D., M.S., JAMA Pediatrics digital media editor, also is available on the For The Media website. The audio transcript is available here.

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For more details and to read the full study, please visit the For The Media website.

(doi:10.1001/jamapediatrics.2018.0223)

Editor's Note: Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

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