Abstract P1057: Hypertension Screening in Children and Adolescents: A Global Policy Analysis

Abstract

Introduction: The global prevalence of hypertension (HTN) among children and adolescents is estimated to range from 2% to 5%. However, it ranges from 1% to 22% in lower and middle income countries (LMICs). Differences in demographics, lifestyle and research methodology lead to the varied prevalence. Several high income countries have implemented screening guidelines, but LMICs lack personalised guideline adoption and execution. Methods: We conducted a narrative policy review to examine HTN screening recommendations for children and adolescents. Most recent versions of relevant policy documents (guidelines, policies, practice guides and consensus statements on HTN screening) were identified from countries and regions across the world. Content analysis was used to describe these recommendations qualitatively. Results: 12 policy documents were reviewed and all countries except the United Kingdom recommended regular HTN screening starting at 3 years. Except China and Japan, HTN was defined as systolic or diastolic blood pressure ≥ 95th percentile for age, sex, and height for all countries. Only Japan segregated individuals by school grades. American Heart Association standards for defining HTN were referenced by most guidelines, while India, Africa and Australia replicated them. Both European and American society used the 2004 US Task Force cohort for normal blood pressure values. Conclusion: The rising prevalence of HTN in children and young adults, largely driven by increasing rates of obesity and lifestyle, underscores the need for effective screening and intervention. Further research is needed to study newer cohorts and adapt guidelines to local contexts for optimising screening and intervention programs, particularly in LMICs.