儿科动态血压监测,高血压表型解释和分类的最新进展。

IF 3.9 2区 医学 Q1 PERIPHERAL VASCULAR DISEASE
Abby Basalely, Taylor Hill-Horowitz, Christine B Sethna
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引用次数: 2

摘要

综述目的:本综述强调了2022年美国心脏协会(AHA)关于儿童和青少年动态血压监测(ABPM)的科学声明中反映的主要变化,特别关注了新定义的高血压表型及其流行病学和相关结果。最新发现:2022年AHA指南最显著的变化包括:(1)血压(BP)阈值与2017年美国儿科学会(AAP)临床实践指南、2017年美国心脏病学会(ACC)/AHA高血压指南和2016年欧洲高血压学会(ESH)儿科建议一致;(2)在所有儿科患者中扩大使用ABPM诊断和分型儿科高血压;(3)从诊断标准中去除血压负荷;(4)简化新发高血压表型分类,预测风险,指导临床管理。最近的研究表明,使用2022年美国心脏协会儿科ABPM指南将增加儿科动态高血压的患病率,特别是老年、高个子男性的尾流动态高血压和8岁以上男性和女性的夜间高血压。新的定义简化了动态高血压标准,只包括最能预测未来健康结果的因素,根据最近的数据和其他指南,提高了血压阈值的敏感性,从而使高血压诊断更具临床意义。该指南还将有助于青少年和年轻人向成人医疗保健过渡。进一步的研究需要在更多样化的儿科人群中研究动态血压标准,并评估这些指南对患病率和未来结局的影响。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Ambulatory Blood Pressure Monitoring in Pediatrics, an Update on Interpretation and Classification of Hypertension Phenotypes.

Purpose of review: This review highlights the major changes reflected in the 2022 American Heart Association (AHA) Scientific Statement on Ambulatory Blood Pressure Monitoring (ABPM) in Children and Adolescents with a specific focus on the newly defined phenotypes of hypertension and their epidemiology and associated outcomes.

Recent findings: The 2022 AHA guidelines' most notable changes include the following: (1) alignment of blood pressure (BP) thresholds with the 2017 American Academy of Pediatrics (AAP) clinical practice guidelines, 2017 American College of Cardiology (ACC)/AHA hypertension guidelines, and 2016 European Society of Hypertension (ESH) pediatric recommendations; (2) expansion of the use of ABPM to diagnose and phenotype pediatric hypertension in all pediatric patients; (3) removal of BP loads from diagnostic criteria; and (4) simplified classification of new hypertension phenotypes to prognosticate risks and guide clinical management. Recent studies suggest that utilizing the 2022 AHA pediatric ABPM guidelines will increase the prevalence of pediatric ambulatory hypertension, especially for wake ambulatory hypertension in older, taller males and for nocturnal hypertension in both males and females ≥ 8 years of age. The new definitions simplify the ambulatory hypertension criteria to include only the elements most predictive of future health outcomes, increase the sensitivity of BP thresholds in alignment with recent data and other guidelines, and thus make hypertension diagnoses more clinically meaningful. This guideline will also aid in the transition of adolescents and young adults to adult medical care. Further studies will be necessary to study ambulatory BP norms in a more diverse pediatric population and evaluate the impact of these guidelines on prevalence and future outcomes.

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来源期刊
Current Hypertension Reports
Current Hypertension Reports 医学-外周血管病
CiteScore
10.50
自引率
0.00%
发文量
65
审稿时长
6-12 weeks
期刊介绍: This journal intends to provide clear, insightful, balanced contributions by international experts that review the most important, recently published clinical findings related to the diagnosis, treatment, management, and prevention of hypertension. We accomplish this aim by appointing international authorities to serve as Section Editors in key subject areas, such as antihypertensive therapies, associated metabolic disorders, and therapeutic trials. Section Editors, in turn, select topics for which leading experts contribute comprehensive review articles that emphasize new developments and recently published papers of major importance, highlighted by annotated reference lists. An international Editorial Board reviews the annual table of contents, suggests articles of special interest to their country/region, and ensures that topics are current and include emerging research. Commentaries from well-known figures in the field are also provided.
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