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The prevalence of paediatric hypertension, emphasising the need to use specific population references: the Sardinian Hypertensive Adolescents Research Programme Study

Published online by Cambridge University Press:  10 March 2009

Andrea Raffaele Marras
Affiliation:
Center Study for Cardiac Disease in Pediatric Age, University of Cagliari, Italy
Pier Paolo Bassareo*
Affiliation:
Center Study for Cardiac Disease in Pediatric Age, University of Cagliari, Italy
Massimo Ruscazio
Affiliation:
Clinical Cardiology, Ospedale S.Giovanni di Dio, University of Cagliari, Asl 8, Italy
*
Correspondence to: Pier Paolo Bassareo MD, Center Study for Cardiac Disease in Pediatric Age, University of Cagliari, Via Nizza, 6 – 09129 Cagliari(Italy). Tel: +39070497926; Fax: +39070497926; E-mail: [email protected]

Abstract

The Sardinian Hypertensive Adolescents Research Programme Study, which for the sake of simplicity we will describe as SHARP, was aimed at detecting the prevalence of hypertension in a number of Southern Italian students, using a process of longitudinal screening lasting 3 years, hoping to answer the question whether it is better to use tables charting values established in the United States of America, or to use charts specific for the Italian population.

In all, we studied 839 children, of whom 52.6% were male. We defined hypertension as the average blood pressure exceeding the 95th percentile according to previous tables prepared by the United States Task Force, and previous Italian references.

Use of the American tables identified very high proportions of hypertensive subjects if compared with the distribution curves from our own study (p less than 0.00001), albeit that our findings correlated well with previous Italian charts as reference (no statistical significance).

In short, notwithstanding a little difference in millimetres of mercury about the same percentiles, the tables prepared in the United States of America overestimate the prevalence of hypertension, specific Italian material being more suitable for our needs. Our study emphasises the need to integrate these standards with more up-to-date and representative reports on Italian children, as is done periodically in the United States of America. Even using the Italian specific charts, nonetheless, hypertension was more common in Sardinian children than would be expected from international studies, with one-tenth of the sample being hypertensive.

Type
Original Article
Copyright
Copyright © Cambridge University Press 2009

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References

1. Kilcoyne, MM, Richter, RW, Alsup, PA. Adolescent hypertension. I. Detection and prevalence. Circulation 1974; 50: 758764.CrossRefGoogle ScholarPubMed
2. Ingelfinger, JR. Pediatric antecedents of adult cardiovascular disease – awareness and intervention. N Engl J Med 2004; 350: 21232126.CrossRefGoogle ScholarPubMed
3. Bao, W, Threefoot, SA, Srinivasan, SR, Berenson, GS. Essential hypertension predicted by tracking of elevated blood pressure from childhood to adulthood: the Bogalusa Heart Study. Am J Hypertens 1995; 8: 657665.Google Scholar
4. Report of the Second Task Force on Blood Pressure Control in Children-1987. Task Force on Blood Pressure Control in Children. National Heart, Lung, and Blood Institute, Bethesda, Maryland. Pediatrics 1987; 79: 125.Google Scholar
5. Update on the 1987 Task Force Report on High Blood Pressure in Children and Adolescents: a working group report from the National High Blood Pressure Education Program. National High Blood Pressure Education Program Working Group on Hypertension Control in Children and Adolescents. Pediatrics 1996; 98: 649658.Google Scholar
6. The Fourth Report on the Diagnosis, Evaluation, and Treatment of High Blood Pressure in Children and Adolescents. National High Blood Pressure Education Program Working Group on High Blood Pressure in Children and Adolescents. Pediatrics 2004; 114: 555576.Google Scholar
7. Menghetti, E, Virdis, R, Strambi, M, et al. Blood pressure in childhood and adolescence: the Italian normal standards. Study group on Hypertension of the Italian Society of Pediatrics. J Hypertens 1999; 17: 13631372.Google Scholar
8. Hohn, AR. Guidebook for Pediatric Hypertension. Futura Publishing Company, New York, 1994.Google Scholar
9. Genovesi, S, Giussani, M, Pieruzzi, F, et al. Results of blood pressure screening in a population of school-aged children in the province of Milan: role of overweight. J Hypertens 2005; 23: 493497.Google Scholar
10. Clark, JA, Lieh-Lai, MW, Sarnaik, A, Mattoo, TK. Discrepance between direct and indirect blood pressure measurements using various recommendations for arm cuff selection. Pediatrics 2002; 110: 920923.CrossRefGoogle Scholar
11. Sorof, JM, Lai, D, Turner, J, Poffenbarger, T, Portman, RJ. Overweight, ethnicity, and the prevalence of hypertension in school-aged children. Pediatrics 2004; 113: 475482.CrossRefGoogle ScholarPubMed
12. Fixler, DE, Laird, WP, Fitzgerald, V, Stead, S, Adams, R. Hypertension screening in schools: results of the Dallas study. Pediatrics 1979; 63: 3236.CrossRefGoogle ScholarPubMed
13. Din-Dzietham, R, Liu, Y, Bielo, MV, Shamsa, F. High blood pressure trends in Children and adolescents in national surveys, 1963 to 2002. Circulation 2007; 116: 14881496.Google Scholar
14. Bland, JM, Altman, DG. Regression towards the mean. BMJ 1994; 308: 1499.Google Scholar
15. Lande, MB, Kaczorowski, JM, Auinger, P, Schwartz, GJ, Weitzman, M. Elevated blood pressure and decreased cognitive function among school-age children and adolescents in the United States. J Pediatr 2003; 143: 720724.Google Scholar
16. Sinaiko, AR. Hypertension in children. N Engl J Med 1996; 335: 19681973.CrossRefGoogle ScholarPubMed
17. Remsberg, KE, Demerath, EW, Schubert, CM, Chumlea, WC, Sun, SS, Siervogel, RM. Early menarche and the development of cardiovascular disease risk factors in adolescent girls: the Fels Longitudinal Study. J Clin Endocrinol Metab 2005; 90: 27182724.CrossRefGoogle ScholarPubMed
18. Gilbert, TJ, Percy, CA, White, LL, Romero, FC. Blood pressure and body measurements among Navajo adolescents. Public Health Rep 1996; 111: 4446.Google Scholar
19. De Man, SA, Andrè, JL, Bachmann, H, et al. Blood pressure in childhood: pooled findings of six European studies. J Hypertens 1991; 9: 109114.Google Scholar