Clustering of cardiovascular (CV) risk factors in otherwise healthy US children suggests that those whose blood pressure (BP) was reclassified represent a high-risk population whose CV risk may previously have been underestimated. This according to a study that assessed the consequences of the 2017 American Academy of Pediatrics (AAP) clinical practice guidelines for the management of elevated BP in children on the prevalence and severity of elevated BP among children and characterized risk factors for children with new-onset hypertension or a worsening in clinical stage. Researchers found:

• Among the 15,647 children in the study (7,799 girls and 7,848 boys; mean age 13.4 years) based on the AAP guidelines, the estimated population prevalence of elevated BP increased from 11.8% to 14.2%.
• 905 children (5.8%) had newly diagnosed hypertension (n = 381) or a worsening in clinical stage (n = 524).
• Children whose BP was reclassified upward were more likely to be overweight or obese, with adverse lipid profiles and increased hemoglobin A_1c levels.