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J Clin Hypertens (Greenwich). 2016 Jun;18(6):557-64. doi: 10.1111/jch.12712. Epub 2015 Oct 12.

Improving Hypertension Screening in Childhood Using Modified Blood Pressure to Height Ratio.

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Institute of Child and Adolescent Health, School of Public Health, Peking University Health Science Center, Beijing, China.
Centre for Chronic Disease, School of Medicine, The University of Queensland, Brisbane, Qld, Australia.


Blood pressure to height ratio (BPHR) has been suggested as a simple method for screening children with hypertension, but its discriminatory ability in young children is not as good as that in older children. Using data of 89,664 Chinese children aged 7 to 11 years, the authors assessed whether modified BPHR (BP:eHT13) was better than BPHR in identifying young children with hypertension. BP:eHT13 was estimated as BP/(height+7×(13-age in years)). Using Youden's index, the thresholds of systolic/diastolic BP:eHT13 for identifying prehypertension and hypertension were 0.67/0.44 and 0.69/0.45, respectively. These proposed thresholds revealed high sensitivity, specificity, negative predictive value, and area under the curve (AUC), ranging from 0.874 to 0.999. In addition, BP:eHT13 showed better AUCs and fewer cutoff points than, if not similar to, two existing BPHR references. BP:eHT13 generally performed better than BPHR in discriminating BP abnormalities in young children and may improve early hypertension recognition and control.

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