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Screening for hypertension in young people with obesity: Feasibility in the real life |
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| Institution: | 1. Department of Internal Medicine, “S. Maria Delle Grazie”, Pozzuoli Hospital, Naples, Italy;2. Obesity and Endocrine Disease Unit, Department of Neuroscience, Santobono-Pausilipon Children''s Hospital, Naples, Italy;3. Department of Surgery, Dentistry, Pediatrics and Gynecology, Section of Pediatric Diabetes and Metabolism, University of Verona, Italy;4. Department of Woman, Child and General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, Naples, Italy;5. Department of Human Pathology in Adulthood and Childhood, University of Messina, Messina, Italy;6. Department of Movement Sciences and Wellbeing, University of Naples Parthenope, Naples, Italy;1. Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia;2. Department of Kinesiology, University of Georgia, Athens, USA;3. The Nuffield Department of Women''s & Reproductive Health, University of Oxford, Oxford, UK;4. Murdoch Children''s Research Institute, Melbourne, Australia;5. Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia;6. Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland;7. Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland;1. Facultad de Ciencias Químicas, Universidad Autónoma de San Luis Potosí, Mexico;2. Facultad de Medicina, Universidad Autónoma de San Luis Potosí, Mexico;1. Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy;2. Department of Biomedicine, Neurosciences and Advanced Diagnostics, University of Palermo, Palermo, Italy;3. Istituto di Biofisica, Consiglio Nazionale delle Ricerche, Palermo, Italy;1. Department of Pathology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China;2. Department of Biostatistics and Medical Record, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China;3. NAFLD Research Center, Department of Hepatology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China;4. Department of Clinical Laboratory, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China;5. Southampton National Institute for Health Research Biomedical Research Centre, University Hospital Southampton, Southampton General Hospital, Southampton, UK;6. Section of Endocrinology, Diabetes, and Metabolism, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy;7. Institute of Hepatology, Wenzhou Medical University, Wenzhou, China;8. Key Laboratory of Diagnosis and Treatment for the Development of Chronic Liver Disease in Zhejiang Province, Wenzhou, China |
| Abstract: | Background and aimScreening for pediatric hypertension (HTN) is based on several measurements of blood pressure (BP) in different visits. We aimed to assess its feasibility in outpatient youths with overweight/obesity (OW/OB) in terms of adherence to two-repeated measurements of BP and to show the features of youths who missed the follow-up and the predictive role of clinical and/or anamnestic features on confirmed HTN.Methods and resultsSix hundred, eighty-eight youths (9–17 years) with OW/OB, consecutively recruited, underwent a first measurement of BP. Those exhibiting BP levels within the hypertensive range were invited to repeat a second measurement within 1–2 weeks. Confirmed HTN was diagnosed when BP in the hypertensive range was confirmed at the second measurement. At entry, 174 youths (25.1%) were classified as hypertensive. At the second visit, 66 youths (37.9%) were lost to follow-up. In the remaining 108 participants, HTN was confirmed in 59, so that the prevalence of confirmed HTN was 9.5% in the overall sample; it was higher in adolescents than children (15.9% vs 6.8%, P = 0.001). HTN at first visit showed the best sensitivity (100%) and a good specificity (91%) for confirmed HTN. The association of HTN at first visit plus familial HTN showed high specificity (98%) and positive predictive value of 70%.ConclusionThe high drop-out rate confirms the real difficulty to obtain a complete diagnostic follow up in the obese population. Information about family history of HTN may assist pediatricians in identifying those children who are at higher risk of confirmed HTN. |
| Keywords: | Adolescents Children Blood pressure Hypertension Obesity Overweight Familial hypertension BP"} {"#name":"keyword" "$":{"id":"kwrd0050"} "$$":[{"#name":"text" "_":"Blood pressure BMI"} {"#name":"keyword" "$":{"id":"kwrd0060"} "$$":[{"#name":"text" "_":"Body mass index CV"} {"#name":"keyword" "$":{"id":"kwrd0070"} "$$":[{"#name":"text" "_":"Cardiovascula DBP"} {"#name":"keyword" "$":{"id":"kwrd0080"} "$$":[{"#name":"text" "_":"Diastolic blood pressure HTN"} {"#name":"keyword" "$":{"id":"kwrd0090"} "$$":[{"#name":"text" "_":"Hypertension NPV"} {"#name":"keyword" "$":{"id":"kwrd0100"} "$$":[{"#name":"text" "_":"Negative predictive value OB"} {"#name":"keyword" "$":{"id":"kwrd0110"} "$$":[{"#name":"text" "_":"Obesity OW"} {"#name":"keyword" "$":{"id":"kwrd0120"} "$$":[{"#name":"text" "_":"Overweight PPV"} {"#name":"keyword" "$":{"id":"kwrd0130"} "$$":[{"#name":"text" "_":"Positive predictive value SDS"} {"#name":"keyword" "$":{"id":"kwrd0140"} "$$":[{"#name":"text" "_":"Standard deviation score SBP"} {"#name":"keyword" "$":{"id":"kwrd0150"} "$$":[{"#name":"text" "_":"Systolic blood pressure |
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