Implications of the 2017 AAP Clinical Practice Guidelines for Management of Hypertension in Children and Adolescents: a Review

Curr Hypertens Rep. 2019 Apr 5;21(5):35. doi: 10.1007/s11906-019-0943-x.

Abstract

Purpose of review: To evaluate the impact of the 2017 American Academy of Pediatrics Clinical Practice Guideline (2017 AAP CPG) for Screening and Management of High Blood Pressure in Children and Adolescents.

Recent findings: The 2017 AAP CPG had several significant changes compared to the 2004 Fourth Report. This review will focus on the emerging evidence from the first studies to apply the 2017 AAP CPG and the simplified table it contains on the overall prevalence of HTN and on recognition among children and adolescents at a higher cardiovascular risk. Recent evidence suggests that use of the 2017 AAP CPG will result in an overall increase in prevalence of HTN, particularly in youth who are obese or who have other cardiovascular risk factors. The change in prevalence likely differs based on sex, age, and height. The ability for the 2017 AAP CPG to detect an association with hypertension and target organ damage requires further study. Continued study is required to assess long-term implications of the 2017 AAP CPG with the goal of a more meaningful HTN definition in the young.

Keywords: 2017 AAP Clinical Practice Guideline for High Blood Pressure in Children and Adolescents; Abnormal left ventricular geometry; Elevated blood pressure; Pediatric hypertension; Prevalence of hypertension; Secondary hypertension; Stage 1 hypertension; Stage 2 hypertension.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Adolescent
  • Blood Pressure / physiology
  • Blood Pressure Determination
  • Child
  • Comorbidity
  • Humans
  • Hypertension / diagnosis*
  • Hypertension / epidemiology
  • Mass Screening
  • Obesity / epidemiology
  • Practice Guidelines as Topic
  • Prevalence
  • Risk Factors
  • United States / epidemiology