Comparative analysis of adolescent hypertension definitions for predicting early-adulthood carotid artery intima-media thickness: Tehran lipid and glucose study.

IF 3.2 Q1 PEDIATRICS
Maryam Barzin, Shirin Yaghoobpoor, Maryam Mahdavi, Behnaz Abiri, Majid Valizadeh, Fereidoun Azizi, Pooneh Dehghan, Farhad Hosseinpanah
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Abstract

Background: Definitions of childhood and adolescent hypertension (HTN) do not precisely elucidate the relationship between HTN and cardiovascular outcomes. Carotid intima-media thickness (CIMT), as a substitute for cardiovascular outcomes, enables the early identification of cardiovascular events throughout early adulthood.

Purpose: This study aimed to compare the ability of childhood HTN definitions to predict a high CIMT in early adulthood.

Methods: This prospective cohort study included 921 individuals aged 10-17 years from the Tehran Lipid and Glucose Study (TLGS). The CIMT was measured after 18 years of follow-up. Participants were categorized into normal blood pressure (BP), high-normal BP, HTN stage 1, and HTN stage 2 groups based on the childhood HTN definitions of the 4th report, European Society of Hypertension (ESH), and American Academy of Pediatrics Clinical Practice Guidelines (AAP-CPG). Akaike's information criterion (AIC) and relative efficiencies (RE) were calculated to compare the ability of each to predict a high CIMT (≥95th percentile) during early adulthood.

Results: The highest and lowest prevalence of stage 1 HTN was observed with the AAP-CPG (17.7%) and ESH (8.8%), respectively. Similarly, the highest and lowest prevalence of stage 2 HTN was noted with the AAP-CPG (1.5%) and ESH (0.8%), respectively. According to the RE values, the highest to lowest predictive abilities belonged to the 4th report, ESH, and AAP-CPG, respectively. In all models, the 4th report's pediatric HTN definition had the lowest AIC value and offered the best predictive ability.

Conclusion: Among the various definitions of pediatric HTN, the 4th report offered the best ability to predict a high CIMT during early adulthood, followed by the ESH and AAP-CPG. Because the reference population of the 4th report includes overweight, obese, and normal-weight individuals, our findings suggest that excessive adiposity is among the main predictors of early adulthood atherosclerosis risk.

青少年高血压定义预测成年早期颈动脉内膜中层厚度的比较分析:德黑兰血脂和血糖研究。
背景:儿童和青少年高血压(HTN)的定义并不能准确阐明HTN与心血管后果之间的关系。目的:本研究旨在比较儿童高血压定义预测成年早期高CIMT的能力:这项前瞻性队列研究纳入了德黑兰血脂和血糖研究(TLGS)中年龄在 10-17 岁的 921 人。随访 18 年后测量了 CIMT。根据第 4 次报告、欧洲高血压学会(ESH)和美国儿科学会临床实践指南(AAP-CPG)中的儿童高血压定义,将参与者分为血压(BP)正常组、血压(BP)正常组、高血压(HTN)1 期组和高血压(HTN)2 期组。通过计算阿凯克信息标准(AIC)和相对效率(RE)来比较每种方法预测成年早期高CIMT(≥95百分位数)的能力:结果:AAP-CPG(17.7%)和ESH(8.8%)分别预测出了最高和最低的1期高血压患病率。同样,AAP-CPG(1.5%)和 ESH(0.8%)分别是第二阶段高血压患病率最高和最低的国家。根据 RE 值,预测能力从高到低分别属于第 4 次报告、ESH 和 AAP-CPG。在所有模型中,第 4 次报告的儿科高血压定义的 AIC 值最低,预测能力最强:结论:在儿科高血压的各种定义中,第 4 次报告对成年早期高 CIMT 的预测能力最强,其次是 ESH 和 AAP-CPG。由于第 4 次报告的参考人群包括超重、肥胖和正常体重者,我们的研究结果表明,过度肥胖是成年早期动脉粥样硬化风险的主要预测因素之一。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
8.00
自引率
2.40%
发文量
88
审稿时长
60 weeks
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