A1 Refereed original research article in a scientific journal
Use of Static Cutoffs of Hypertension to Determine High cIMT in Children and Adolescents: An International Collaboration Study
Authors: Yang L, Whincup PH, Lopez-Bermejo A, Caserta CA, Medeiros CCM, Kollias A, Pacifico L, Reinehr T, Litwin M, Owen CG, Bassols J, Romeo EL, Ramos TDA, Stergiou GS, Zhao M, Yang LL, Xargay-Torrent S, Amante A, Gusmao TME, Grammatikos E, Wang MM, Prats-Puig A, de Carvalho DF, Carreras-Badosa G, Simoes MD, Mas-Pares B, Shui W, Deanfield JE, Magnussen CG, Xi B
Publisher: ELSEVIER SCIENCE INC
Publication year: 2020
Journal: Canadian Journal of Cardiology
Journal name in source: CANADIAN JOURNAL OF CARDIOLOGY
Journal acronym: CAN J CARDIOL
Volume: 36
Issue: 9
First page : 1467
Last page: 1473
Number of pages: 7
ISSN: 0828-282X
eISSN: 1916-7075
DOI: https://doi.org/10.1016/j.cjca.2020.02.093
Self-archived copy’s web address: http://openaccess.sgul.ac.uk/112019/1/Simplified%20BP%20and%20cIMT%206Feb20.doc
Background: Pediatric hypertension is typically defined as blood pressure >= sex-, age-, and height-specific 95th percentile (high) cutoffs. Given the number of strata, there are hundreds of cutoffs for defining elevated and high blood pressure that make it cumbersome to use in clinical practice. This study aimed to evaluate the utility of the static cutoffs for pediatric hypertension (120/80 mm Hg for children and 130/80 mm Hg for adolescents) in determining high carotid intimamedia thickness (cIMT) in children and adolescents.Methods: Data were from 6 population-based cross-sectional studies in Brazil, China, Greece, Italy, Spain, and the United Kingdom. A total of 4280 children and adolescents, aged 6 to 17 years, were included. High cIMT was defined as cIMT >= sex-, age- and cohort-specific 90th percentile cutoffs.Results: Compared with normal blood pressure, hypertension defined using the percentile-based cutoffs from 2017 American Academy of Pediatrics guideline, and the static cutoffs were associated with similar higher odds for high cIMT (percentile-based cutoffs: odds ratio [OR], 1.46, 95% confidence interval [CI], 1.15-1.86; static cutoffs: OR, 1.65, 95% CI, 1.25-2.17), after adjustment for sex, age, race/ethnicity, body mass index, high-density lipoprotein-cholesterol, triglyceride, and fasting blood glucose. The similar utility of 2 definitions in determining high cIMT was further confirmed by area under the receiver operating characteristic curve and net reclassification improvement methods (P for difference > 0.05).Conclusion: Static cutoffs (120/80 mm Hg for children, 130/80 mm Hg for adolescents) performed similarly compared with percentile-based cutoffs in determining high cIMT, supporting the use of static cutoffs in identifying pediatric hypertension in clinical practice.
