The prevalence of paediatric hypertension, emphasising the need to use specific population references: the Sardinian Hypertensive Adolescents Research Programme Study

The Sardinian Hypertensive Adolescents Research Programme Study, which for the sake of simplicity we will describe as SHARP, was aimed at detecting the prevalence of hypertension in a number of Southern Italian students, using a process of longitudinal screening lasting 3 years, hoping to answer the question whether it is better to use tables charting values established in the United States of America, or to use charts specific for the Italian population. In all, we studied 839 children, of whom 52.6% were male. We defined hypertension as the average blood pressure exceeding the 95th percentile according to previous tables prepared by the United States Task Force, and previous Italian references. Use of the American tables identified very high proportions of hypertensive subjects if compared with the distribution curves from our own study (p less than 0.00001), albeit that our findings correlated well with previous Italian charts as reference (no statistical significance). In short, notwithstanding a little difference in millimetres of mercury about the same percentiles, the tables prepared in the United States of America overestimate the prevalence of hypertension, specific Italian material being more suitable for our needs. Our study emphasises the need to integrate these standards with more upto- date and representative reports on Italian children, as is done periodically in the United States of America. Even using the Italian specific charts, nonetheless, hypertension was more common in Sardinian children than would be expected from international studies, with one-tenth of the sample being hypertensive.