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2012, Number 1

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Revista Cubana de Informática Médica 2012; 4 (1)

Toward the prediction of arterial hypertension in adulthood from adolescence

Pérez FGA, Grau AR

Language: Spanish
References: 19
Page: 1-32
PDF size: 280.18 Kb.


ABSTRACT

Introduction: The Hypertension European Society Recommendations under the supervision of The European Cardiology Society for the treatment of high blood pressure (HBP) in children and adolescents recognize that HBP in the pediatric age is an increasing medical problem with current and future negative repercussions. In addition they refer to the lack of strategies or organized health policies dealing with the problem. It is unknown due to the scantiness of following studies from adolescence to adulthood when is possible the conversion from the risk to the disease. Objectives: To determine the interactions among several risk factors in the developing of HBP from adolescence to adulthood. To design a predictive model in order to predict the developing of HBP from adolescence to adulthood. Material and methods: A representative sample of 125 prehypertensive adolescents were followed up through 8 years till year 2009. A predictive model based in a decision tree was done using the CHAID (chi square automatic interaction) technique with the evaluation by areas under the ROC (receiver operating characteristic) curve. Results: A decision tree was designed that was able to classify accurately 80 % of the cases. With this model 67.4 % and 86.6 % of true negative cases and true positive cases, respectfully. Conclusions: The age of the diagnosis of the prehypertension, the birth weight, the familiar obesity and the unfavorable familiar environment were the situations that had the strongest interaction among them in the timing from adolescence to adulthood. The prediction model is an instrumental contribution for predicting HBP in adulthood from adolescence.


REFERENCES

  1. 1- Mancia G, De Backer G, Dominiczak A, Cifkova R, Fagard R, Germano G. 2007 ESH-ESC Guidelines for the management of arterial hypertension: the task force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). J Hypertens. 2007 Jun;25(6):1105-87.

  2. 2- Hedner T, Narkiewicz K, Kjeldsen SE, Oparil S; European Society of Hypertension; European Society of Cardiology. New ESH/ESC guidelines signal progress in hypertension management. Blood Press. 2007;16(3):132-4.

  3. 3- Pérez Fernández G.A, Márquez Espino Y, Aladro I, Santana Santana C. Afectación estructural cardiovascular precoz detectada mediante ecocardiografía bidimensional y doppler en el adolescente hipertenso. Rev Mapfre Medicina. 2005;16: 159-66.The VII Report of the Joint National Committe on detection, evaluation and treatment of high blood pressure Report. JAMA. 2003;289:2560-72.

  4. 4- Chobanian AV. Does It Matter How Hypertension Is Controlled? N Engl J Med. 2008;23:2485-88.

  5. 5- Pérez Fernández GA. Estrés e hipertensión arterial. Resultados del proyecto de investigación PESESCAD-HTA. Med Gen. 2001;38:818-22.

  6. 6- Update on the Task Force (1987) on High Blood Pressure in Children and Adolescents: a working group from the National High Blood Pressure Education Program. Pediatrics. 1996;98:649-58.

  7. 7- National High Blood Pressure Education Program Working Group on High Blood Pressure in Children and Adolescents. The fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents. Pediatrics. 2004;114:555-76.

  8. 8- Lurbe E, Cifkova R, Cruickshank K, Dillon MJ,Ferreira I, Invitti C, et al. Management of high blood pressure in children and adolescents: recommendations of the European Society of Hypertension. J Hypertens. 2009,27:1719-42.

  9. 9- Sun S.S., Grave G.D., Siervogel R.M., Pickoff A.A, Arslanian S.S., Daniels S.R. Systolic blood pressure in childhood predicts hypertension and metabolic syndrome later in life. Pediatrics. 2007; 119:237-46.

  10. 10- Lurbe E, Torró MI. Early vascular phenotypes in the genesis of hypertension.Pediatr Nephrol. 2010 Apr;25(4):763-7.

  11. 11- Berenson GS. Childhood risk factors predict adult risk associated with subclinical cardiovascular disease: the Bogalusa Heart Study. Am J Cardiol. 2002;90:3L–7L.

  12. 12- Mc Niece KL, Poffenbarger TS, Turner JL, Franco KD, Sorof JM, Portman RJ. Prevalence of hypertension and prehipertensión among adolescents. J Pediatr. 2007;150:640-4.

  13. 14- Ministerio de Educación. Resolución Ministerial Nº 291/90. Indicaciones específicas para la aplicación de la Resolución Ministerial Nº 216/89 sobre la evaluación. La Habana: MINED; 1990.

  14. 15- Ministerio de Educación. Resolución Ministerial Nº 216/89 sobre la evaluación. La Habana: MINED; 1989.

  15. 16- Dawson JD, Sonka M, Blecha MB, Lin W, Davis PH. Risk Factors Associated With Aortic and Carotid Intima-Media Thickness in Adolescents and Young Adults. The Muscatine Offspring Study. J Am Coll Cardiol. 2009;53:2273-9.

  16. 17- Falkner B, Gidding SS, Portman R, Rosner B. Blood pressure variability and classification of prehypertension and hypertension in adolescence. Pediatrics. 2009;122:238-42.

  17. 18- Chen X, Wang Y. Tracking of blood pressure from childhood to adulthood: a systematic review and meta-regression analysis. Circulation. 2008. 117:3171- 80.

  18. 19- Fuster V. Are predictive risk scores useful? Nat Rev Cardiol. 2009;6:493.

  19. 20- Harper PR. A review and comparison of classification algorithms for medical decision making. Health Policy. 2005;71:315-31.




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