A new simple formula built on the American Academy of Pediatrics criteria for the screening of hypertension in overweight/obese children

We evaluated the performance of a new simple formula (NSF) for the screening of hypertension by American Academy of Pediatrics Guidelines 2017 (AAPG₂₀₁₇) in children with overweight/obesity (OW/OB). The performance of the NSF and the modified blood pressure to height ratio (MBPHR3) thresholds against AAPG₂₀₁₇ was evaluated; both methods were also compared to assess the association with concentric left ventricular hypertrophy (cLVH). The study included 3259 OW/OB children (5–13 years). Two centers served as learning sample (LS) (n = 1428), four centers served as validation sample (VS) (n = 1831), and the echocardiographic evaluation was available in 409 children in VS. The NSF was [1.5 × systolic blood pressure (mmHg) + diastolic blood pressure (mmHg)] − [(26 × height (m)] − age (years). A cut-off of the NSF ≥ 193 mmHg showed sensitivity, specificity, positive, and negative predictive values of 0.92, 0.93, 0.83, and 0.97, respectively, versus the standard procedure. Against AAPG₂₀₁₇, the NSF showed higher specificity and positive predictive values than the MBPHR3 thresholds. Among hypertensive children defined by AAPG₂₀₁₇, NSF, or MBPHR3, the odds ratio (95%CI) for cLVH was respectively 1.73 (1.06–2.83), 1.69 (1.05–2.75), and 1.18 (0.75–1.85).

Conclusions: The NSF shows a very high performance for the screening of OW/OB children at risk of hypertension and cLVH.