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Pediatrics. 2014 Jul;134(1):e106-11. doi: 10.1542/peds.2014-0643. Epub 2014 Jun 9.

Hypertension screening using blood pressure to height ratio.

Author information

1
Department of Epidemiology and Health Statistics School of Public Health, Shandong University, Jinan, China; xibo2010@sdu.edu.cn steffen@umn.edu.
2
Department of Epidemiology, Capital Institute of Pediatrics, Beijing, China;Graduate School, Peking Union Medical College, Beijing, China;
3
Department of Epidemiology and Health Statistics School of Public Health, Shandong University, Jinan, China;
4
School of Public Health, Jining Medical University, Jining, China;Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet-Stockholm University, Stockholm, Sweden;
5
Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis xibo2010@sdu.edu.cn steffen@umn.edu.

Abstract

OBJECTIVES:

The definition of hypertension in children is too complex to be used by medical professionals and children and their parents because of the age-, gender-, and height-specific blood pressure (BP) algorithm. The aim of this study was to simplify the pediatric BP percentile references using BP to height ratio (BPHR, equal to BP/height) for screening for prehypertension and hypertension in Chinese children.

METHODS:

Data were obtained from the China Health and Nutrition Survey, which was conducted from 1991 to 2009 and included 11 661 children aged 6 to 17 years with complete data on age, gender, height, and BP values. Receiver operating characteristic curve analysis was performed to assess the performance of systolic BPHR (SBPHR) and diastolic BPHR (DBPHR) for screening for pediatric prehypertension and hypertension.

RESULTS:

The optimal thresholds for defining prehypertension were 0.81 in children aged 6 to 11 years and 0.70 in adolescents aged 12 to 17 years for SBPHR and 0.52 in children and 0.46 in adolescents for DBPHR, respectively. The corresponding values for hypertension were 0.84, 0.78, 0.55, and 0.50, respectively. The negative predictive values were much higher (all ≥99%) for prehypertension and hypertension, although the positive predictive values were relatively lower, ranging from 13% to 75%.

CONCLUSIONS:

BPHR index is simple and accurate for screening for prehypertension and hypertension in Chinese children aged 6 to 17 years and can be used for early screening or treating Chinese children with hypertension.

KEYWORDS:

blood pressure to height ratio; children; diagnostic criteria; high blood pressure

PMID:
24913794
PMCID:
PMC4067644
DOI:
10.1542/peds.2014-0643
[Indexed for MEDLINE]
Free PMC Article

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