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J Hum Hypertens. 2016 Nov;30(11):697-702. doi: 10.1038/jhh.2016.12. Epub 2016 Mar 3.

Performance of blood pressure-to-height ratio as a screening tool for elevated blood pressure in pediatric population: a systematic meta-analysis.

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Department of Maternal and Child Health, School of Public Health, Shandong University, Jinan, China.
Department of Ultrasound, Children's Hospital of the Capital Institute of Pediatrics, Beijing, China.
Institute of Social and Preventive Medicine, Lausanne University Hospital, Lausanne, Switzerland.
Departments of Epidemiology and Health Statistics, School of Public Health, Shandong University, Jinan, China.


The aim of this study was to assess the performance of the blood pressure-to-height ratio (BPHR) for screening elevated blood pressure (BP) in children and adolescents using a meta-analysis of eligible published studies. We retrieved studies that investigated the performance of the BPHR for identifying elevated BP from Pubmed and other databases. We performed meta-analyses by subgroups of sex, age and ethnicity using a fixed or random effect model based on whether there was between-study heterogeneity. A total of 13 publications including 262 830 children and adolescents aged 6-18 years on BPHR and a total of three publications including 95 343 children on the modified BPHR were included in this meta-analysis. The summary results suggested that BPHR performed well to identify pre-high BP and high BP for children aged 6-11 years and adolescents aged 12-18 years. The performance of BPHR was perfect for identifying severe high BP in adolescents aged 12-18 years. However, the modified BPHR did not improve accuracy for screening high BP in children aged 6-12 years. In summary, BPHR performed well for identifying elevated BP in children and adolescents, independently of sex, age and ethnicity group. In addition, the modified BPHR performed similarly with BPHR for screening high BP in childhood.

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