A new index to simplify the screening of hypertension in overweight or obese youth

P. Di Bonito, G. Valerio, L. Pacifico, C. Chiesa, C. Invitti, A. Morandi, C. Maffeis, M. R. Licenziati, M. Manco, E. Miraglia del Giudice, M. G. Baroni, S. Loche, G. Tornese, M. Tomat, G. de Simone, L. Gilardini, E. Sanguigno, F. Franco, A. Grandone, R. Luciano & 3 others M. Incani, M. C. Pellegrin, CARITALY Study Group

Research output: Contribution to journalArticle

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Abstract

Background and aims Hypertension (HTH) is a frequent complication in pediatric obesity. To simplify the screening of HTH in overweight/obese (Ow/Ob) youth, we compared the performance of a new index (High Blood Pressure index, HBPi) with respect to the standard criteria of the IV Report [systolic BP (SBP) and/or diastolic BP (DBP) ≥95th percentile for age, gender and height]. We also compared the performance of HBPi with other simplified indices such as the BP/height ratio and the absolute height-specific BP thresholds. Ten pediatrics' outpatient centers participating in the “CARdiometabolic risk factors in ITALY study” provided medical records of 4225 Ow/Ob children and adolescents (age 6–16 years). Methods and results Centers were divided into two groups: training set (TS) (n = 2204 participants) and validation set (VS) (n = 2021 participants). The simplified HBPi (mmHg) was: (SBP/2 + DBP/10) − age + (1 × female gender). In the TS, a HBPi value ≥57 mmHg in both children and adolescents had high sensitivity (0.89), specificity (0.97), positive (0.89) and negative (0.97) predictive values in classifying youth at high risk of HTN compared with the IV Report. In the VS, the HBPi showed a better performance than high levels of BP/height ratio and height-specific BP thresholds in classifying individuals at risk of HTN: area under curves 0.95 (0.93–0.96), 0.80 (0.78–0.82), 0.76 (0.74–0.79), respectively; specificities 0.95 (0.94–0.96), 0.69 (0.67–0.72), 0.60 (0.57–0.62), respectively. Conclusions HBPi, combining SBP and DBP, gender and age, may help pediatricians to implement HTN screening in Ow/Ob youth.
Original languageEnglish
Pages (from-to)830-835
Number of pages6
JournalNutrition, Metabolism and Cardiovascular Diseases
Volume27
Issue number9
DOIs
Publication statusPublished - Sep 1 2017

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Hypertension
Pediatric Obesity
Area Under Curve
Medical Records
Outpatients
Pediatrics
Sensitivity and Specificity

Keywords

  • Blood pressure to height ratio
  • Diagnostic criteria
  • High blood pressure
  • Pediatric obesity

Cite this

A new index to simplify the screening of hypertension in overweight or obese youth. / Di Bonito, P.; Valerio, G.; Pacifico, L.; Chiesa, C.; Invitti, C.; Morandi, A.; Maffeis, C.; Licenziati, M. R.; Manco, M.; Miraglia del Giudice, E.; Baroni, M. G.; Loche, S.; Tornese, G.; Tomat, M.; de Simone, G.; Gilardini, L.; Sanguigno, E.; Franco, F.; Grandone, A.; Luciano, R.; Incani, M.; Pellegrin, M. C.; Group, CARITALY Study.

In: Nutrition, Metabolism and Cardiovascular Diseases, Vol. 27, No. 9, 01.09.2017, p. 830-835.

Research output: Contribution to journalArticle

Di Bonito, P, Valerio, G, Pacifico, L, Chiesa, C, Invitti, C, Morandi, A, Maffeis, C, Licenziati, MR, Manco, M, Miraglia del Giudice, E, Baroni, MG, Loche, S, Tornese, G, Tomat, M, de Simone, G, Gilardini, L, Sanguigno, E, Franco, F, Grandone, A, Luciano, R, Incani, M, Pellegrin, MC & Group, CARITALYS 2017, 'A new index to simplify the screening of hypertension in overweight or obese youth', Nutrition, Metabolism and Cardiovascular Diseases, vol. 27, no. 9, pp. 830-835. https://doi.org/10.1016/j.numecd.2017.06.013
Di Bonito, P. ; Valerio, G. ; Pacifico, L. ; Chiesa, C. ; Invitti, C. ; Morandi, A. ; Maffeis, C. ; Licenziati, M. R. ; Manco, M. ; Miraglia del Giudice, E. ; Baroni, M. G. ; Loche, S. ; Tornese, G. ; Tomat, M. ; de Simone, G. ; Gilardini, L. ; Sanguigno, E. ; Franco, F. ; Grandone, A. ; Luciano, R. ; Incani, M. ; Pellegrin, M. C. ; Group, CARITALY Study. / A new index to simplify the screening of hypertension in overweight or obese youth. In: Nutrition, Metabolism and Cardiovascular Diseases. 2017 ; Vol. 27, No. 9. pp. 830-835.
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abstract = "Background and aims Hypertension (HTH) is a frequent complication in pediatric obesity. To simplify the screening of HTH in overweight/obese (Ow/Ob) youth, we compared the performance of a new index (High Blood Pressure index, HBPi) with respect to the standard criteria of the IV Report [systolic BP (SBP) and/or diastolic BP (DBP) ≥95th percentile for age, gender and height]. We also compared the performance of HBPi with other simplified indices such as the BP/height ratio and the absolute height-specific BP thresholds. Ten pediatrics' outpatient centers participating in the “CARdiometabolic risk factors in ITALY study” provided medical records of 4225 Ow/Ob children and adolescents (age 6–16 years). Methods and results Centers were divided into two groups: training set (TS) (n = 2204 participants) and validation set (VS) (n = 2021 participants). The simplified HBPi (mmHg) was: (SBP/2 + DBP/10) − age + (1 × female gender). In the TS, a HBPi value ≥57 mmHg in both children and adolescents had high sensitivity (0.89), specificity (0.97), positive (0.89) and negative (0.97) predictive values in classifying youth at high risk of HTN compared with the IV Report. In the VS, the HBPi showed a better performance than high levels of BP/height ratio and height-specific BP thresholds in classifying individuals at risk of HTN: area under curves 0.95 (0.93–0.96), 0.80 (0.78–0.82), 0.76 (0.74–0.79), respectively; specificities 0.95 (0.94–0.96), 0.69 (0.67–0.72), 0.60 (0.57–0.62), respectively. Conclusions HBPi, combining SBP and DBP, gender and age, may help pediatricians to implement HTN screening in Ow/Ob youth.",
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T1 - A new index to simplify the screening of hypertension in overweight or obese youth

AU - Di Bonito, P.

AU - Valerio, G.

AU - Pacifico, L.

AU - Chiesa, C.

AU - Invitti, C.

AU - Morandi, A.

AU - Maffeis, C.

AU - Licenziati, M. R.

AU - Manco, M.

AU - Miraglia del Giudice, E.

AU - Baroni, M. G.

AU - Loche, S.

AU - Tornese, G.

AU - Tomat, M.

AU - de Simone, G.

AU - Gilardini, L.

AU - Sanguigno, E.

AU - Franco, F.

AU - Grandone, A.

AU - Luciano, R.

AU - Incani, M.

AU - Pellegrin, M. C.

AU - Group, CARITALY Study

PY - 2017/9/1

Y1 - 2017/9/1

N2 - Background and aims Hypertension (HTH) is a frequent complication in pediatric obesity. To simplify the screening of HTH in overweight/obese (Ow/Ob) youth, we compared the performance of a new index (High Blood Pressure index, HBPi) with respect to the standard criteria of the IV Report [systolic BP (SBP) and/or diastolic BP (DBP) ≥95th percentile for age, gender and height]. We also compared the performance of HBPi with other simplified indices such as the BP/height ratio and the absolute height-specific BP thresholds. Ten pediatrics' outpatient centers participating in the “CARdiometabolic risk factors in ITALY study” provided medical records of 4225 Ow/Ob children and adolescents (age 6–16 years). Methods and results Centers were divided into two groups: training set (TS) (n = 2204 participants) and validation set (VS) (n = 2021 participants). The simplified HBPi (mmHg) was: (SBP/2 + DBP/10) − age + (1 × female gender). In the TS, a HBPi value ≥57 mmHg in both children and adolescents had high sensitivity (0.89), specificity (0.97), positive (0.89) and negative (0.97) predictive values in classifying youth at high risk of HTN compared with the IV Report. In the VS, the HBPi showed a better performance than high levels of BP/height ratio and height-specific BP thresholds in classifying individuals at risk of HTN: area under curves 0.95 (0.93–0.96), 0.80 (0.78–0.82), 0.76 (0.74–0.79), respectively; specificities 0.95 (0.94–0.96), 0.69 (0.67–0.72), 0.60 (0.57–0.62), respectively. Conclusions HBPi, combining SBP and DBP, gender and age, may help pediatricians to implement HTN screening in Ow/Ob youth.

AB - Background and aims Hypertension (HTH) is a frequent complication in pediatric obesity. To simplify the screening of HTH in overweight/obese (Ow/Ob) youth, we compared the performance of a new index (High Blood Pressure index, HBPi) with respect to the standard criteria of the IV Report [systolic BP (SBP) and/or diastolic BP (DBP) ≥95th percentile for age, gender and height]. We also compared the performance of HBPi with other simplified indices such as the BP/height ratio and the absolute height-specific BP thresholds. Ten pediatrics' outpatient centers participating in the “CARdiometabolic risk factors in ITALY study” provided medical records of 4225 Ow/Ob children and adolescents (age 6–16 years). Methods and results Centers were divided into two groups: training set (TS) (n = 2204 participants) and validation set (VS) (n = 2021 participants). The simplified HBPi (mmHg) was: (SBP/2 + DBP/10) − age + (1 × female gender). In the TS, a HBPi value ≥57 mmHg in both children and adolescents had high sensitivity (0.89), specificity (0.97), positive (0.89) and negative (0.97) predictive values in classifying youth at high risk of HTN compared with the IV Report. In the VS, the HBPi showed a better performance than high levels of BP/height ratio and height-specific BP thresholds in classifying individuals at risk of HTN: area under curves 0.95 (0.93–0.96), 0.80 (0.78–0.82), 0.76 (0.74–0.79), respectively; specificities 0.95 (0.94–0.96), 0.69 (0.67–0.72), 0.60 (0.57–0.62), respectively. Conclusions HBPi, combining SBP and DBP, gender and age, may help pediatricians to implement HTN screening in Ow/Ob youth.

KW - Blood pressure to height ratio

KW - Diagnostic criteria

KW - High blood pressure

KW - Pediatric obesity

U2 - 10.1016/j.numecd.2017.06.013

DO - 10.1016/j.numecd.2017.06.013

M3 - Article

VL - 27

SP - 830

EP - 835

JO - Nutrition, Metabolism and Cardiovascular Diseases

JF - Nutrition, Metabolism and Cardiovascular Diseases

SN - 0939-4753

IS - 9

ER -