{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T22:07:30Z","timestamp":1768428450026,"version":"3.49.0"},"reference-count":31,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2020,1,1]],"date-time":"2020-01-01T00:00:00Z","timestamp":1577836800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"},{"start":{"date-parts":[[2020,1,1]],"date-time":"2020-01-01T00:00:00Z","timestamp":1577836800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2020,1,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Two different systems for the screening and diagnosis of hypertension (HTN) in children currently coexist, namely, the guidelines of the 2017 American Academy of Pediatrics (AAP) and the 2016 European Society for Hypertension (ESH). The two systems differ in the lowered cut-offs proposed by the AAP versus ESH.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>We evaluated whether the reclassification of hypertension by the AAP guidelines in young people who were defined non-hypertensive by the ESH criteria would classify differently overweight\/obese youth in relation to their cardiovascular risk profile.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>A sample of 2929 overweight\/obese young people (6\u201316 years) defined non-hypertensive by ESH (ESH\u2013) was analysed. Echocardiographic data were available in 438 youth.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Using the AAP criteria, 327\/2929 (11%) young people were categorized as hypertensive (ESH\u2013\/AAP+). These youth were older, exhibited higher body mass index, Homeostatic Model Assessment of Insulin Resistance (HOMA-IR), triglycerides, total cholesterol to high-density lipoprotein cholesterol (TC\/HDL-C) ratio, blood pressure, left ventricular mass index and lower HDL-C (p\u2009&amp;lt;0.025\u20130.0001) compared with ESH\u2013\/AAP\u2013. The ESH\u2013\/AAP+ group showed a higher proportion of insulin resistance (i.e. HOMA-IR\u2009\u22653.9 in boys and 4.2 in girls) 35% vs. 25% (p\u2009&amp;lt;0.0001), high TC\/HDL-C ratio (\u22653.8\u2009mg\/dl) 35% vs. 26% (p\u2009=\u20090.001) and left ventricular hypertrophy (left ventricular mass index \u226545\u2009g\/h2.16) 67% vs. 45% (p\u2009=\u20090.008) as compared with ESH\u2013\/AAP\u2013.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>The reclassification of hypertension by the AAP guidelines in young people overweight\/obese defined non-hypertensive by the ESH criteria identified a significant number of individuals with high blood pressure and abnormal cardiovascular risk. Our data support the need of a revision of the ESH criteria.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1177\/2047487319868326","type":"journal-article","created":{"date-parts":[[2019,8,7]],"date-time":"2019-08-07T00:52:36Z","timestamp":1565139156000},"page":"8-15","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":19,"title":["The American Academy of Pediatrics hypertension guidelines identify obese youth at high cardiovascular risk among individuals non-hypertensive by the European Society of Hypertension guidelines"],"prefix":"10.1093","volume":"27","author":[{"given":"Procolo","family":"Di Bonito","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, \u2018S. Maria delle Grazie\u2019, Pozzuoli Hospital, Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria Rosaria","family":"Licenziati","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, AORN Santobono-Pausilipon, Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marco G","family":"Baroni","sequence":"additional","affiliation":[{"name":"Department of Experimental Medicine, Sapienza University of Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claudio","family":"Maffeis","sequence":"additional","affiliation":[{"name":"Paediatric Diabetes and Metabolic Disorders Unit, University of Verona, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anita","family":"Morandi","sequence":"additional","affiliation":[{"name":"Paediatric Diabetes and Metabolic Disorders Unit, University of Verona, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Melania","family":"Manco","sequence":"additional","affiliation":[{"name":"IRCCS Bambino Ges\u00f9 Children's Hospital, Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emanuele","family":"Miraglia del Giudice","sequence":"additional","affiliation":[{"name":"Department of Woman, Child and General and Specialized Surgery, University of Campania \u2018Luigi Vanvitelli\u2019, Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna","family":"Di Sessa","sequence":"additional","affiliation":[{"name":"Department of Woman, Child and General and Specialized Surgery, University of Campania \u2018Luigi Vanvitelli\u2019, Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giuseppina","family":"Campana","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, AORN Santobono-Pausilipon, Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicola","family":"Moio","sequence":"additional","affiliation":[{"name":"Department of Cardiology, \u2018S. Maria delle Grazie\u2019, Pozzuoli, Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luisa","family":"Gilardini","sequence":"additional","affiliation":[{"name":"IRCCS Istituto Auxologico Italiano, Department of Medical Sciences and Rehabilitation, Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claudio","family":"Chiesa","sequence":"additional","affiliation":[{"name":"Institute of Translational Pharmacology, National Research Council, Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lucia","family":"Pacifico","sequence":"additional","affiliation":[{"name":"Policlinico Umberto I Hospital, Sapienza University of Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giovanni","family":"de Simone","sequence":"additional","affiliation":[{"name":"Hypertension Research Centre and Department of Advanced Biomedical Sciences, Federico II University Hospital, Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giuliana","family":"Valerio","sequence":"additional","affiliation":[{"name":"Department of Movement and Wellbeing Sciences, University of Naples Parthenope, Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"for the CARITALY Study on the behalf of the Childhood Obesity Study Group of the Italian Society of Pediatric Endocrinology and Diabetology","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2020,8,29]]},"reference":[{"issue":"2 Suppl. 4th Report","key":"2021011512042830600_bibr1-2047487319868326","doi-asserted-by":"crossref","first-page":"555","DOI":"10.1542\/peds.114.2.S2.555","article-title":"The fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents","volume":"114","author":"National High Blood Pressure Education Program Working Group 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