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 (AAPG(2017)) in children with overweight/obesity (OW/OB). The performance of the NSF and the modified blood pressure to height ratio (MBPHR3) thresholds against AAPG(2017) was evaluated; both methods were also compared to assess the association with concentric left ventricular hypertrophy (cLVH). The study included 3259 OW/OB children (5-13years). 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 [1.5xsystolic blood pressure (mmHg)+diastolic blood pressure (mmHg)]-[(26 x height (m)]-age (years). A cut-off of the NSF >= 193mmHg showed sensitivity, specificity, positive, and negative predictive values of 0.92, 0.93, 0.83, and 0.97, respectively, versus the standard procedure. Against AAPG(2017), the NSF showed higher specificity and positive predictive values than the MBPHR3 thresholds. Among hypertensive children defined by AAPG(2017), 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.