{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T01:37:32Z","timestamp":1747186652016,"version":"3.40.5"},"reference-count":22,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2022,11,20]],"date-time":"2022-11-20T00:00:00Z","timestamp":1668902400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001505","name":"Health Research Council of New Zealand","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001505","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001518","name":"Maurice and Phyllis Paykel Trust","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001518","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001232","name":"Royal Australasian College of Physicians","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001232","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Paediatrics Child Health"],"published-print":{"date-parts":[[2023,2]]},"abstract":"<jats:sec><jats:title>Aim<\/jats:title><jats:p>Obesity as a major risk factor for childhood hypertension necessitates careful blood pressure (BP) monitoring of those affected. This study aimed to compare BP classification in a cohort of children affected by obesity using tables versus digital calculations in two sets of guidelines.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This study was a secondary analysis of data collected from a randomised clinical trial of a multidisciplinary life\u2010style assessment and intervention program. Baseline data from 237 children with a body mass index &gt;99th percentile or &gt;91st percentile with weight\u2010related comorbidities and available BP measurements were analysed. We assessed agreement between tables and algorithms in classification of elevated BP\/pre\u2010hypertension and hypertension based on the American Academy of Paediatrics (AAP) clinical practice guidelines (CPG) and the older Fourth Report using Cohen's weighted kappa. The prevalence of hypertensive diagnoses was also compared between the two guidelines.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Agreement between BP tables and algorithmic calculation of percentiles was discordant, though improved in the AAP CPG compared to the Fourth Report (Cohen's kappa\u00a0=\u00a00.70 vs. 0.57, respectively). None (0%) were missed diagnoses, and 59 (24.9%) were false positives for the Fourth Report, and 0 (0%) were missed diagnoses, and 49 (20.9%) were false positives for the AAP CPG. Under the recent guidelines, there was an increase in prevalence of 6.0% (95% confidence interval (CI) 2.5\u20139.4%; <jats:italic>P<\/jats:italic>\u00a0=\u00a00.0001) for BP \u226590th percentile, and of 3.0% (95% CI 0.4\u20135.6%; p\u00a0=\u00a00.016) for hypertension (BP\u2009\u2265\u200995th percentile) in the cohort (18.0% and 6.8%, respectively, increased from 12.0% and 3.8%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Digital calculators over tables in clinical practice are recommended where possible to improve the accuracy of paediatric BP classification. Substantial rates of elevated BP\/Hypertension were found in this cohort of children and adolescents with overweight and obesity.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jpc.16270","type":"journal-article","created":{"date-parts":[[2022,11,21]],"date-time":"2022-11-21T07:25:45Z","timestamp":1669015545000},"page":"242-246","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Comparison of percentile tables and algorithm\u2010based calculators for classification of blood pressures in children and adolescents with obesity: A secondary analysis of a clinical trial"],"prefix":"10.1111","volume":"59","author":[{"given":"William J","family":"Pitts","sequence":"first","affiliation":[{"name":"Liggins Institute, University of Auckland  Auckland New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7532-6441","authenticated-orcid":false,"given":"Tami L","family":"Cave","sequence":"additional","affiliation":[{"name":"Liggins Institute, University of Auckland  Auckland New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5709-367X","authenticated-orcid":false,"given":"Alana","family":"Cavadino","sequence":"additional","affiliation":[{"name":"School of Population Health, Faculty of Medical and Health Sciences University of Auckland  Auckland New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1134-2482","authenticated-orcid":false,"given":"Roman J","family":"Shypailo","sequence":"additional","affiliation":[{"name":"USDA\/ARS Children's Nutrition Research Center, Department of Pediatrics Baylor College of Medicine  Houston Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9234-4887","authenticated-orcid":false,"given":"Sarah E","family":"Maessen","sequence":"additional","affiliation":[{"name":"Department of Paediatrics: Child and Youth Health University of Auckland  Auckland New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8995-8711","authenticated-orcid":false,"given":"Paul L","family":"Hofman","sequence":"additional","affiliation":[{"name":"Liggins Institute, University of Auckland  Auckland New Zealand"},{"name":"Department of Paediatrics: Child and Youth Health University of Auckland  Auckland New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8031-7408","authenticated-orcid":false,"given":"William","family":"Wong","sequence":"additional","affiliation":[{"name":"Department of Paediatric Nephrology Starship Children's Hospital, Auckland District Health Board  Auckland New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2054-338X","authenticated-orcid":false,"given":"Yvonne C","family":"Anderson","sequence":"additional","affiliation":[{"name":"Department of Paediatrics: Child and Youth Health University of Auckland  Auckland New Zealand"},{"name":"enAble Institute, Faculty of Health Sciences Curtin University  Perth Western Australia Australia"},{"name":"Telethon Kids Institute Perth Children's Hospital  Perth Western Australia Australia"},{"name":"Community Health Child and Adolescent Health Service  Perth Western Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,11,20]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2009-2107C"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2017-1904"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2109191"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.114.S2.555"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/HJH.0000000000001972"},{"key":"e_1_2_7_7_1","unstructured":"ShypailoRJ EllisKJ.Age\u2010Based Pediatric Blood Pressure Reference Charts. Baylor College of Medicine; 2011. Available from:https:\/\/www.bcm.edu\/bodycomplab\/Flashapps\/BPVAgeChartpage.html."},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40608-015-0068-y"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/oby.21967"},{"volume-title":"NZDep2006 Index of Deprivation","year":"2007","author":"Salmond C","key":"e_1_2_7_10_1"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1136\/adc.73.1.17"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/jpc.13315"},{"key":"e_1_2_7_13_1","unstructured":"WongW.Starship Clinical Guidelines for Hypertension. 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