Reclassifying hypertension phenotypes in adolescents by ambulatory blood pressure monitoring: implications of the 2022 AHA guidelines in a Brazilian birth cohort.
Background: Hypertension in adolescents is a growing public health concern, with ambulatory blood pressure monitoring (ABPM) playing a key role in diagnosis. The 2022 American Heart Association (AHA) guidelines introduced substantial changes to ABPM classification criteria, with the exclusion of the...
| Publicado en: | Pediatric Nephrology Vol. 40; no. 12; pp. 3717 - 3724 |
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| Autores principales: | , , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Springer Nature
Dec2025
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=188853877&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 188853877 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 0931041X EF1 jtl: Pediatric Nephrology issn: 0931041X maglogo: N pubinfo: dt: Dec2025 vid: 40 iid: 12 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 188853877 187276471 188853877 188853877 10.1007/s00467-025-06917-9 188853877 ppf: 3717 ppct: 7 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Reclassifying hypertension phenotypes in adolescents by ambulatory blood pressure monitoring: implications of the 2022 AHA guidelines in a Brazilian birth cohort. aug: au: Machado, Ivan Coelho Facincani, Inalda Lino, Mariana Cachero Pap, Gabriela Coelho, Eduardo Barbosa Cardoso, Viviane Cunha Carmona, Fabio affil: https://ror.org/036rp1748 Division of Pediatric Nephrology, Ribeirão Preto Medical School, University of São Paulo (USP), São Paulo, SP, Brazil sug: subj: Hypertension Epidemiology Hypertension Classification Blood Pressure Monitoring, Ambulatory American Heart Association Practice Guidelines Phenotype Evaluation Community Living Human Funding Source Brazil Prospective Studies Male Female Child Adolescence Cross Sectional Studies Chi Square Test Prevalence Confidence Intervals Descriptive Statistics Blood Pressure Devices Utilization Blood Pressure Determination Body Mass Index Gestational Age Birth Weight Software Masked Hypertension Diagnosis Childbirth, Premature Child: 6-12 years Adolescent: 13-18 years Male Female ab: Background: Hypertension in adolescents is a growing public health concern, with ambulatory blood pressure monitoring (ABPM) playing a key role in diagnosis. The 2022 American Heart Association (AHA) guidelines introduced substantial changes to ABPM classification criteria, with the exclusion of the blood pressure (BP) load criterion and the alignment of diagnostic thresholds with adult values. This study aimed to assess the impact of guideline revisions on the prevalence of hypertension phenotypes among Brazilian adolescents. Methods: We conducted a cross-sectional study of 1006 adolescents (aged 11–13 years) from the BRISA cohort in Ribeirão Preto, Brazil. Participants underwent 24-h ABPM and clinic BP (cBP) assessment. Hypertension phenotypes were classified according to both the 2014 and 2022 AHA guidelines. Statistical analysis included prevalence comparisons, reclassification patterns, and centroid-based phenotypic analysis. Results: The prevalence of cBP hypertension was 3.4%. Using either the 2014 or 2022 AHA criteria, around 13% of adolescents were classified as hypertensive. However, under the 2014 guidelines, nearly 20% of the cohort remained unclassified, primarily due to elevated BP load alone. These individuals were reclassified as normotensive under the 2022 criteria, leading to a 20% increase in this group. One in ten adolescents was diagnosed with masked hypertension. Among hypertensive individuals, half had elevated nighttime BP only. Conclusions: The 2022 AHA guideline revisions improved the clarity of hypertension classification in this prenatal cohort. These findings support the clinical utility of the updated criteria and highlight the importance of adapting ABPM interpretation to current standards. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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