ArticlePediatric research2021
Isolated diastolic high blood pressure: a distinct clinical phenotype in US children.
Article in Pediatric research, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
11 citing papers in PubMed.
- Childhood isolated systolic hypertension is not benign: adult hypertension and cardiovascular remodeling.Hypertension research : official journal of the Japanese Society of Hypertension · 2026Article
- Precision approaches to paediatric hypertension: linking pathophysiology to therapy.Pediatric nephrology (Berlin, Germany) · 2026Review
- Isolated diastolic hypertension and incident cardio-renal-metabolic multimorbidity in the Tehran Lipid and Glucose Study: comparison of ACC/AHA and ESC/NICE guideline definitions.Hypertension research : official journal of the Japanese Society of Hypertension · 2025Article
- Utility of home doppler blood pressure measurement to minimise unnecessary investigations in children with suspected hypertension.Journal of human hypertension · 2025Article
- Ambulatory isolated diastolic hypertension and risk of left ventricular hypertrophy in children with primary and secondary hypertension.Pediatric nephrology (Berlin, Germany) · 2024Article
- Variation in paediatric 24-h ambulatory blood pressure monitoring interpretation by Canadian and UK physicians.Journal of human hypertension · 2023Article
- Association of Childhood Blood Pressure with Left Atrial Size and Function: Study of High Blood Pressure in Pediatrics-Adult Hypertension in Youth (SHIP AHOY).The Journal of pediatrics · 2023Article
- Change in Prevalence of Hypertension among Korean Children and Adolescents during the Coronavirus Disease 2019 (COVID-19) Outbreak: A Population-Based Study.Children (Basel, Switzerland) · 2023Article
- Subjective sleep score is associated with central and peripheral blood pressure values in children aged 7-12 years.Journal of sleep research · 2022Article
- Prevalence of hypertension and related risk factors among children and adolescents at three separate visits: A large school-based study in China.Frontiers in pediatrics · 2022Article
- Is Isolated Diastolic Hypertension an Important Phenotype?Current cardiology reports · 2021Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundScreening studies have shown that 0.7-4.5% of generally healthy children have isolated diastolic high BP. We therefore studied the characteristics of children with diastolic BP in the elevated and hypertensive ranges according to current guidelines in US children from the National Health and Nutrition Examination Survey (NHANES, 1999-2016).
methodsWe studied 17,362 children (8-18 years) with BP measured by sphygmomanometry. High BP was categorized as isolated systolic (iSH), isolated diastolic (iDH), or Mixed.
resultsOverall, 86.0% (95% CI = 85.0-87.0) of the population had normal BP, 8.7% (8.0-9.3) elevated BP, 4.9% (4.4-5.5) Stage 1, and 0.4% (0.4-0.6) Stage 2. Moreover, 11.1% (10.3-12.0) had iSH, 1.9% (1.5-2.2) iDH, and 1.0% (0.8-1.2) Mixed. Children with iDH were more likely to be female, younger, white, and leaner than those with iSH, with lower rates of overweight/obesity. iDH was generally between normals and iSH. Resting heart rate was significantly higher in iDH even after adjustment for known covariates.
conclusionsChildren with iDH may have a distinct clinical picture. A leaner habitus and higher resting heart rate may reflect differences in underlying pathophysiology. Longitudinal follow-up studies are needed to better define the pathogenesis, progression, and long-term prognosis in iDH. IMPACT: Using gold-standard auscultation and 2017 guidelines, isolated diastolic high BP (iDH) is found in 1.9% (95% CI 1.5-2.2) of American children; these children are younger, leaner, more female, and have fewer cardiometabolic risks. Resting heart rate is significantly higher in iDH compared to both normals and iSH even after adjustments for known covariates. Autonomic hyperactivity in iDH may speak to both etiology and therapeutic approaches. iDH appears to be a distinct clinical phenotype characterized by differences in anthropometric measures, sex, age, and resting heart rate. Follow-up studies are clearly needed to clarify its pathogenesis, progression, and prognosis.
Indexed as
Identifiers
33504971What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.