1
|
Chen A, Waite L, Mocumbi AO, Chan YK, Beilby J, Ojji DB, Stewart S. Elevated blood pressure among adolescents in sub-Saharan Africa: a systematic review and meta-analysis. Lancet Glob Health 2023; 11:e1238-e1248. [PMID: 37474231 DOI: 10.1016/s2214-109x(23)00218-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 04/28/2023] [Accepted: 04/28/2023] [Indexed: 07/22/2023]
Abstract
BACKGROUND More people from sub-Saharan Africa aged between 20 years and 60 years are affected by end-organ damage due to underlying hypertension than people in high-income countries. However, there is a paucity of data on the pattern of elevated blood pressure among adolescents aged 10-19 years in sub-Saharan Africa. We aimed to provide pooled estimates of high blood pressure prevalence and mean levels in adolescents aged 10-19 years across sub-Saharan Africa. METHODS In this systematic review and meta-analysis, we searched PubMed, Google Scholar, African Index Medicus, and Embase to identify studies published from Jan 1, 2010, to Dec 31, 2021. To be included, primary studies had to be observational studies of adolescents aged 10-19 years residing in sub-Saharan African countries reporting the pooled prevalence of elevated blood pressure or with enough data to compute these estimates. We excluded studies on non-systemic hypertension, in African people not living in sub-Saharan Africa, with participant selection based on the presence of hypertension, and with adult cohorts in which we could not disaggregate data for adolescents. We independently extracted relevant data from individual studies using a standard data extraction form. We used a random-effects model to estimate the pooled prevalence of elevated blood pressure and mean systolic blood pressure (SBP) and diastolic blood pressure (DBP) levels overall and on a sex-specific basis. This study is registered with PROSPERO (CRD42022297948). FINDINGS We identified 2559 studies, and assessed 81 full-text studies for eligibility, of which 36 studies comprising 37 926 participants aged 10-19 years from ten (20%) of 49 sub-Saharan African countries were eligible. A pooled sample of 29 696 adolescents informed meta-analyses of elevated blood pressure and 27 155 adolescents informed meta-analyses of mean blood pressure. Sex data were available from 26 818 adolescents (14 369 [53·6%] were female and 12 449 [46·4%] were male) for the prevalence of elevated blood pressure and 23 777 adolescents (12 864 [54·1%] were female and 10 913 [45·9%] were male) for mean blood pressure. Study quality was high, with no low-quality studies. The reported prevalence of elevated blood pressure ranged from 4 (0·2%) of 1727 to 1755 (25·1%) of 6980 (pooled prevalence 9·9%, 95% CI 7·3-12·5; I?=99·2%, pheterogeneity<0·0001). Mean SBP was 111 mm Hg (95% CI 108-114) and mean DBP was 68 mm Hg (66-70). 13·4% (95% CI 12·9-13·9; pheterogeneity<0·0001) of male participants had elevated blood pressure compared with 11·9% (11·3-12·4; pheterogeneity<0·0001) of female participants (odds ratio 1·04, 95% CI 0·81-1·34; pheterogeneity<0·0001). INTERPRETATION To our knowledge, this systematic review and meta-analysis is the first systematic synthesis of blood pressure data specifically derived from adolescents in sub-Saharan Africa. Although many low-income countries were not represented in our study, our findings suggest that approximately one in ten adolescents have elevated blood pressure across sub-Saharan Africa. Accordingly, there is an urgent need to improve preventive heart-health programmes in the region. FUNDING None.
Collapse
Affiliation(s)
| | - Laura Waite
- Victorian Department of Health, Melbourne, VIC, Australia
| | - Ana O Mocumbi
- Faculty of Medicine, Universidade Eduardo Mondlane, Maputo, Mozambique; Instituto Nacional de Saúde, Marracuene, Mozambique
| | - Yih-Kai Chan
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, VIC, Australia
| | - Justin Beilby
- Torrens University Australia, Adelaide, SA, Australia
| | - Dike B Ojji
- Department of Internal Medicine, Faculty of Clinical Sciences, University of Abuja, Abuja, Nigeria; Cape Heart Institute, Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - Simon Stewart
- Faculty of Medicine, Universidade Eduardo Mondlane, Maputo, Mozambique; Cape Heart Institute, Department of Medicine, University of Cape Town, Cape Town, South Africa; Institute for Health Research, University of Notre Dame, Fremantle, WA, Australia.
| |
Collapse
|
2
|
Jiang Q, Gong D, Li H, Zhang D, Hu S, Xia Q, Yuan H, Zhou P, Zhang Y, Liu X, Sun M, Lv J, Li C. Development and Validation of a Risk Score Screening Tool to Identify People at Risk for Hypertension in Shanghai, China. Risk Manag Healthc Policy 2022; 15:553-562. [PMID: 35386277 PMCID: PMC8977866 DOI: 10.2147/rmhp.s354057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 03/14/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose This study aimed to develop a screening tool based on a risk scoring approach that could identify individuals at high risk for hypertension in Shanghai, China. Methods A total of 3147 respondents from the 2013 Shanghai Chronic Disease and Risk Factor Surveillance were randomly divided into the derivation group and validation group. The coefficients obtained from multivariable logistic regression were used to assign a score to each variable category. The receiver operating characteristic (ROC) curve was used to find the optimal cut-off point and to evaluate the screening performance. Results Age, family history of hypertension, having diabetes, having dyslipidemia, body mass index, and having abdominal obesity contributed to the risk score. The area under the ROC curve was 0.817 (95% CI: 0.797–0.836). The optimal cut-off value of 20 had a sensitivity of 83.4%, and a specificity of 64.3%, demonstrating good performance. Conclusion We developed a simple and valid screening tool to identify individuals at risk for hypertension. Early detection could be beneficial for high-risk groups to better manage their conditions and delay the progression of hypertension and related complications.
Collapse
Affiliation(s)
- Qiyun Jiang
- Department of Health Policy and Management, School of Public Health, Fudan University, Shanghai, People’s Republic of China
- Research Institute of Health Development Strategies, Fudan University, Shanghai, People’s Republic of China
| | - Dan Gong
- Department of Health Policy and Management, School of Public Health, Fudan University, Shanghai, People’s Republic of China
- Research Institute of Health Development Strategies, Fudan University, Shanghai, People’s Republic of China
| | - Huiqi Li
- School of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Donglan Zhang
- Department of Health Policy and Management, College of Public Health, University of Georgia, Athens, GA, USA
| | - Suzhen Hu
- Department of Medical Affairs, Liaocheng People’s Hospital, Liaocheng, People’s Republic of China
| | - Qinghua Xia
- Department of Chronic Disease Prevention and Control, Changning District Center for Disease Control and Prevention, Shanghai, People’s Republic of China
| | - Hong Yuan
- Department of Chronic Disease Prevention and Control, Jiading District Center for Disease Control and Prevention, Shanghai, People’s Republic of China
| | - Peng Zhou
- Department of Chronic Disease Prevention and Control, Changning District Center for Disease Control and Prevention, Shanghai, People’s Republic of China
| | - Yiying Zhang
- Department of Chronic Disease Prevention and Control, Jiading District Center for Disease Control and Prevention, Shanghai, People’s Republic of China
| | - Xing Liu
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai, People’s Republic of China
| | - Mei Sun
- Department of Health Policy and Management, School of Public Health, Fudan University, Shanghai, People’s Republic of China
- Research Institute of Health Development Strategies, Fudan University, Shanghai, People’s Republic of China
| | - Jun Lv
- Department of Health Policy and Management, School of Public Health, Fudan University, Shanghai, People’s Republic of China
- Research Institute of Health Development Strategies, Fudan University, Shanghai, People’s Republic of China
| | - Chengyue Li
- Department of Health Policy and Management, School of Public Health, Fudan University, Shanghai, People’s Republic of China
- Research Institute of Health Development Strategies, Fudan University, Shanghai, People’s Republic of China
- Correspondence: Chengyue Li; Jun Lv, Department of Health Policy and Management, School of Public Health, Fudan University, P.O. Box 177, 130 Dong’an Road, Shanghai, 200032, People’s Republic of China, Tel +86-21-33561022; +86-21-33563953, Fax +86-21-33563380, Email ;
| |
Collapse
|
3
|
Body Mass Index and Blood Pressure-to-Height Ratio in Predicting Incidence of Hypertension in Serbian Children. CHILDREN-BASEL 2020; 7:children7120254. [PMID: 33255542 PMCID: PMC7760787 DOI: 10.3390/children7120254] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 11/14/2020] [Accepted: 11/20/2020] [Indexed: 11/16/2022]
Abstract
BACKGROUND A new method using blood pressure-to-height ratio for diagnosing elevated blood pressure/hypertension in children has been introduced recently. We aimed to compare blood pressure-to-height ratio (BPHR) and Body Mass Index (BMI) in predicting incidence of hypertension (HTN). METHODS The sample consisted of 1133 boys and 1154 girls aged 7-15. We used the following equations for BPHR: systolic BPHR (SBPHR) = SBP (mm Hg)/height (cm) and diastolic BPHR (DBPHR) = DBP (mm Hg)/height (cm). In order to determine the accuracy of SBPHR, DBPHR and BMI as diagnostic tests for elevated blood pressure (elevated BP), we used the receiveroperating characteristic curve analyses. RESULTS The area under the curve (AUC) values for BMI ranged from 0.625 to 0.723 with quite low sensitivity rates from 62% to 72.5% and specificities from 58.2% to 67.3% showing a modest ability to identify children with elevated BP and HTN. On the contrary, BPHR showed a great predictive ability to identify elevated BP and HTN with AUC values of 0.836 to 0.949 for SBP and from 0.777 to 0.904 for DBP. Furthermore, the sensitivity ranged from 78.5% to 95.7%, and the specificity from 73.9% to 87.6%. CONCLUSION the current study showed that BPHR is an accurate index for detecting elevated BP and HTN in children aged 7 to 15 years and can be used for early screening.
Collapse
|
4
|
Raphadu TT, Staden MV, Dibakwane WM, Monyeki KD. A Non-Invasive Investigation into the Prevalence of Higher than Normal Blood Pressure, Hypertension and the Association between Blood Pressure and Body Weight in Male and Female Adolescents in the Polokwane Local Municipality, Limpopo-South Africa: A Cross-Sectional Study. CHILDREN (BASEL, SWITZERLAND) 2020; 7:E18. [PMID: 32143272 PMCID: PMC7140854 DOI: 10.3390/children7030018] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 02/18/2020] [Accepted: 02/19/2020] [Indexed: 11/16/2022]
Abstract
BACKGROUND Hypertension (HT) is one of the greatest non-communicable diseases affecting both sexes in all human populations; and it is a major cause of death and morbidity across the world. The purpose of this study was to investigate the prevalence of pre-hypertension, hypertension and investigate the association between blood pressure (BP) and body weight (looking into body mass index (BMI) and body surface area (BSA)). METHOD A cross-sectional study of adolescents aged 13-19 years was conducted at three secondary schools consisting of 121 females and 97 males. Data on height; weight; and blood pressure was collected from all participants. BMI and BP percentiles were calculated for each participant. RESULTS The prevalence of pre-hypertension and hypertension in males was 28.9% and 10.3% compared to 25.6% and 7.4% in females. The prevalence of pre-hypertension and hypertension in adolescents who are overweight/obese was 7.3% and 2.7%. A weak positive association between BMI; systolic blood pressure (SBP) and diastolic blood pressure (DBP) was found (r = 0.254 and 0.216; p-value = 0.001) for the whole population. A significant, moderate correlation was found between BSA on SBP was found (r = 0.407, p-value = 0.001); and a significant, weak correlation between BSA and DBP was found (r = 0.183, p-value = 0.007. In conclusion, the prevalence of pre-hypertension and hypertension was higher in males as compared to females. Results highlight the need for screening for blood pressure and body weight in adolescents; especially in adolescents who were found to have pre-hypertension as they are at high risk of developing hypertension.
Collapse
|
5
|
Using blood pressure height index to define hypertension among secondary school adolescents in southwestern Uganda. J Hum Hypertens 2019; 34:76-81. [PMID: 31792440 DOI: 10.1038/s41371-019-0292-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Revised: 10/10/2019] [Accepted: 11/20/2019] [Indexed: 01/26/2023]
Abstract
Hypertension is the number one risk factor for cardiovascular diseases worldwide and yet its diagnosis among adolescents, based on blood pressure percentiles which are age, height, and sex-specific, is complex. Our study intended to determine the suitability of blood pressure height index in defining adolescent hypertension among secondary school adolescents aged 12-17 years in Mbarara municipality, southwestern Uganda. Our study used data of 485 secondary school adolescents of which 173 were boys. Receiver operating characteristic curve analysis was performed to assess the performance of systolic blood pressure height index (SBPHI) and diastolic blood pressure height index (DBPHI) for screening for adolescent prehypertension and hypertension. The optimal systolic/diastolic thresholds for defining prehypertension were 0.70/0.43 mmHg/cm in boys and 0.76/0.43 in girls. The corresponding values for hypertension were 0.78/0.43 and 0.77/0.48 mmHg/cm, respectively. The negative predictive values were much higher (all ≥ 95%) for prehypertension and hypertension, while the positive predictive value was 100% for hypertension in both sexes. In conclusion, Blood pressure height index is simple and accurate for screening for prehypertension and hypertension in adolescents aged 12-17 years hence can be used for early screening of adolescents at high risk of hypertension but not its diagnosis.
Collapse
|
6
|
Çöl N, Kilinc A, Demircioğlu-Kılıç B, Aydin N, Keskin M, Balat A. Predictive value of the “Blood Pressure To Height Ratio” in diagnosis of prehypertension and hypertension during childhood in Southeastern Turkey. Clin Exp Hypertens 2019. [DOI: 10.1080/10641963.2018.1433198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Nilgün Çöl
- Department of Social Pediatrics, School of Medicine, Gaziantep University, Gaziantep, Turkey
| | - Arda Kilinc
- Intensive Care Unit, School of Medicine, Ege University, İzmir, Turkey
| | | | - Neriman Aydin
- Department of Public Health, School of Medicine, Gaziantep University, Gaziantep, Turkey
| | - Mehmet Keskin
- Department of Pediatric Endocrinology, School of Medicine, Gaziantep University, Gaziantep, Turkey
| | - Ayse Balat
- Department of Pediatric Nephrology, School of Medicine, İstanbul Aydın University, İstanbul, Turkey
| |
Collapse
|
7
|
Sekgala MD, Monyeki KD, Mogale MA, Ramoshaba NE. Performance of blood pressure to height ratio as a screening tool for elevated blood pressure in rural children: Ellisras Longitudinal Study. J Hum Hypertens 2017; 31:591-595. [PMID: 28382960 DOI: 10.1038/jhh.2017.25] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2016] [Revised: 12/19/2016] [Accepted: 02/16/2017] [Indexed: 11/09/2022]
Abstract
There are complications in diagnosing hypertension in children and adolescents due to variation of blood pressure (BP) values to age, gender and height. This study was aimed at assessing whether the performance of BP-to-height ratio (BPHR) can be an effective tool for screening prehypertension and hypertension in Ellisras Longitudinal Study (ELS) children aged between 6 and 17 years. A number of the 9002 children aged 6-17 years who were part of the ELS underwent height and BP measurements using standard procedures. Receiver-operating characteristic curve was used to assess the accuracy of BPHR to screen children with prehypertension and hypertension. The optimal systolic BPHR (SBPHR) and diastolic BPHR (DBPHR) cut-off points for hypertension were determined. Sensitivity/specificity, positive predictive values and negative predictive values were calculated. The optimal thresholds for defining prehypertension was 0.77 in children aged 6-10 years and 0.73 in adolescents aged between 11 and 17 years for systolic BPHR and 0.55 in children and 0.53 in adolescents for diastolic BPHR, respectively. The corresponding values for hypertension stage 1 were 0.76 and 0.73 for SBPHR and 0.50 and 0.58 for DBPHR, respectively. BPHR can be used as an effective tool for screening both prehypertension and hypertension in ELS children aged 6-17 years.
Collapse
Affiliation(s)
- M D Sekgala
- Department of Physiology and Environmental Health, University of Limpopo, Sovenga, South Africa
| | - K D Monyeki
- Department of Physiology and Environmental Health, University of Limpopo, Sovenga, South Africa
| | - M A Mogale
- Department of Biochemistry, Sefako Makgatho Health Science University, Medunsa, South Africa
| | - N E Ramoshaba
- Department of Physiology and Environmental Health, University of Limpopo, Sovenga, South Africa
| |
Collapse
|
8
|
How to Simplify the Diagnostic Criteria of Metabolic Syndrome in Adolescents. Pediatr Neonatol 2017; 58:178-184. [PMID: 27543380 DOI: 10.1016/j.pedneo.2016.03.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2015] [Revised: 02/01/2016] [Accepted: 03/17/2016] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND This study evaluated the feasibility and accuracy of the height-corrected definition for identifying metabolic syndrome (MS). METHODS In 2006, anthropometric and biochemical measurements were assessed in a cross-sectional population-based study of 3136 Han adolescents, aged 13-17 years. MS was defined according to the definitions of Cook et al, International Diabetes Federation, and the Society of Pediatrics, Chinese Medical Association. Waist-to-height and blood pressure-to-height ratios were alternatives to waist circumference and blood pressure in the height-corrected definition. RESULTS According to the MS definition and the height-corrected MS definition, this agreement would be classified as "very good" (National Cholesterol Education Program kappa coefficients: 0.850 in boys and 0.816 in girls; International Diabetes Federation kappa coefficients: 0.953 in boys and 0.807 in girls; Society of Pediatrics, Chinese Medical Association kappa coefficients: 0.932 in boys; p < 0.001) and "good" (Society of Pediatrics, Chinese Medical Association kappa coefficients: 0.737 in girls; p < 0.001). CONCLUSION The present study demonstrates that the height-corrected definition of MS is a simple, inexpensive, and accurate tool for identifying MS in Han adolescents.
Collapse
|
9
|
Paunović K, Jakovljević B. Suitability of blood-pressure-to-height ratio as the criterion for high blood pressure in children in an environmental study. Curr Med Res Opin 2017; 33:149-154. [PMID: 27983893 DOI: 10.1080/03007995.2016.1240667] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Blood-pressure-to-height ratio is considered a simple, accurate, inexpensive and non-age-dependent index for screening high blood pressure in a clinical setting, but its suitability in epidemiological surveys was not taken into consideration. The aim of this study was to test the suitability of blood-pressure-to-height ratio against blood pressure for age percentiles for the identification of high blood pressure in an environmental study. METHODS The sample consisted of 2195 children, aged 3 to 15 years, whose blood pressure was measured as part of an environmental study in Belgrade, Serbia. High blood pressure was estimated using percentiles (gold standard) and blood-pressure-to-height ratios for systolic and diastolic pressures separately (proposed criterion). The optimal cut-offs of the blood-pressure-to-height ratio (BPHR) were selected based on Youden's index (sensitivity + specificity - 1) calculated from the receiver operator characteristic curve analysis. RESULTS The proposed criterion identified five times more cases of high blood pressure in the investigated children of all age groups in comparison to the gold standard. The optimal cut-off values were selected based on the sensitivity and specificity values by age groups and gender. CONCLUSION Blood-pressure-to-height ratio can be a reliable criterion for the estimation of high blood pressure in epidemiological studies. This is the first study on the applicability of blood-pressure-to-height ratio in Serbian children, but it may not be easily generalized to other populations due to small sample size across the examined age groups and potential diversities in risk factors for high blood pressure. Applied in epidemiological studies, BPHR would help researchers estimate the role of certain environmental factors on blood pressure in children.
Collapse
Affiliation(s)
- Katarina Paunović
- a Institute for Hygiene with Medical Ecology, Faculty of Medicine , University of Belgrade , Serbia
| | - Branko Jakovljević
- a Institute for Hygiene with Medical Ecology, Faculty of Medicine , University of Belgrade , Serbia
| |
Collapse
|
10
|
Banker A, Bell C, Gupta-Malhotra M, Samuels J. Blood pressure percentile charts to identify high or low blood pressure in children. BMC Pediatr 2016; 16:98. [PMID: 27430884 PMCID: PMC4950817 DOI: 10.1186/s12887-016-0633-7] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2015] [Accepted: 07/09/2016] [Indexed: 12/23/2022] Open
Abstract
Background The goal was to develop familiar blood pressure (BP) charts representing BP percentile curves similar to CDC growth charts to improve screening of both high and low BP in children. Methods Since height accounts for substantially more BP variability than age and is a more direct measure of body size and maturation in children, height-specific BP percentile curves were drawn separately for males and females. We used the 2004 Fourth Report data source and equations to calculate the BP threshold value for each gender and 5 cm height group. By slightly underestimating a child’s BP percentile for high BP and slightly overestimating a child’s BP percentile for low BP, these charts guarantee 100 % sensitivity in detecting abnormal BP. Sensitivity and specificity of the chart cut-offs were confirmed in a sample of 1254 healthy children from a school-based blood pressure screening program. Results The 1st, 5th, 25th, 50th, 75th, 90th, 95th, and 99th BP percentile curves are depicted in the chart for each corresponding gender and height from 85 to 190 cm, mimicking the ubiquitous CDC “growth charts”. Shaded areas of the chart differentiate abnormal BP status categories: hypotension, normal BP, prehypertension, Stage 1 hypertension, and Stage 2 hypertension. Sensitivity was confirmed to be 100 % with specificity above 94 %. Conclusions These simplified BP charts improve upon currently available BP screening reference with the following features: (a) tracking BP longitudinally in an individual child, (b) full physiological range of BP percentiles represented in percentile curve format for rapid identification both high and low BP, (c) easy to use with absolute height alone avoiding the additional step of determining height percentile, (d) incorporation of adult threshold for pre-hypertension to assist in accurate transition from adolescence into adulthood, (e) high sensitivity and specificity to ensure all children at risk are identified with very few false positives.
Collapse
Affiliation(s)
- Ashish Banker
- Division of Pediatric Cardiology, University of Texas McGovern Medical School at Houston / Children's Memorial Hermann Hospital, TexasMedical Center, 6431 Fannin Street, MSB 3-121, Houston, 77030, TX, USA
| | - Cynthia Bell
- Divisions of Pediatric Nephrology & Hypertension, University of Texas McGovern Medical School at Houston / Children's Memorial Hermann Hospital, Texas Medical Center, 6431 Fannin Street, MSB 3-121, Houston, 77030, TX, USA
| | - Monesha Gupta-Malhotra
- Division of Pediatric Cardiology, University of Texas McGovern Medical School at Houston / Children's Memorial Hermann Hospital, TexasMedical Center, 6431 Fannin Street, MSB 3-121, Houston, 77030, TX, USA
| | - Joshua Samuels
- Divisions of Pediatric Nephrology & Hypertension, University of Texas McGovern Medical School at Houston / Children's Memorial Hermann Hospital, Texas Medical Center, 6431 Fannin Street, MSB 3-121, Houston, 77030, TX, USA.
| |
Collapse
|
11
|
Ma C, Lu Q, Wang R, Liu X, Lou D, Yin F. A new modified blood pressure-to-height ratio simplifies the screening of hypertension in Han Chinese children. Hypertens Res 2016; 39:893-898. [DOI: 10.1038/hr.2016.89] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2016] [Revised: 05/06/2016] [Accepted: 06/08/2016] [Indexed: 11/09/2022]
|
12
|
Ma C, Liu Y, Liu X, Yin F, Lu Q. Comparison of Different Screening Methods for Hypertension in Han Adolescents. Clin Pediatr (Phila) 2016; 55:363-7. [PMID: 26134554 DOI: 10.1177/0009922815591886] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The aim of this study was to compare different methods of screening for hypertension in Han adolescents. We analyzed data on 3136 Han adolescents (1601 boys and 1535 girls) aged 13 to 17 years from the adolescents hypertension survey of Qinhuangdao in 2006. The blood pressure was classified as without hypertension and with hypertension, consistent with the 2004 Working Group on High Blood Pressure in Children and Adolescents guidelines and the selected screening methods. Sensitivity and specificity were then calculated according to gender range. Somu's formulas and the table proposed by Chiolero had low sensitivities (58.4% to 83.1%), despite good specificities (99.0% to 100.0%). The tables proposed by Mitchell and Kaelber had high sensitivities (100%), but their specificities were low (62.0% to 73.8%). Blood pressure-to-height ratio (BPHR) was a good compromise between sensitivities (boys 99.1% and girls 98.9%) and specificities (boys 91.0% and girls 94.9%). As screening tools, the table proposed by Mitchell and Kaelber and BPHR have high sensitivities. However, BPHR demonstrated specific advantages, and it does not require tables.
Collapse
Affiliation(s)
- Chunming Ma
- The First Hospital of Qinhuangdao, Qinhuangdao, China
| | - Yue Liu
- The First Hospital of Qinhuangdao, Qinhuangdao, China
| | - Xiaoli Liu
- The First Hospital of Qinhuangdao, Qinhuangdao, China
| | - Fuzai Yin
- The First Hospital of Qinhuangdao, Qinhuangdao, China
| | - Qiang Lu
- The First Hospital of Qinhuangdao, Qinhuangdao, China
| |
Collapse
|
13
|
Yin X, Liu Q, Bovet P, Ma C, Xi B. Performance of blood pressure-to-height ratio as a screening tool for elevated blood pressure in pediatric population: a systematic meta-analysis. J Hum Hypertens 2016; 30:697-702. [PMID: 26935285 DOI: 10.1038/jhh.2016.12] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2015] [Revised: 12/11/2015] [Accepted: 01/29/2016] [Indexed: 11/09/2022]
Abstract
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.
Collapse
Affiliation(s)
- X Yin
- Department of Maternal and Child Health, School of Public Health, Shandong University, Jinan, China
| | - Q Liu
- Department of Ultrasound, Children's Hospital of the Capital Institute of Pediatrics, Beijing, China
| | - P Bovet
- Institute of Social and Preventive Medicine, Lausanne University Hospital, Lausanne, Switzerland
| | - C Ma
- Department of Maternal and Child Health, School of Public Health, Shandong University, Jinan, China
| | - B Xi
- Departments of Epidemiology and Health Statistics, School of Public Health, Shandong University, Jinan, China
| |
Collapse
|
14
|
Kelishadi R, Bahreynian M, Heshmat R, Motlagh ME, Djalalinia S, Naji F, Ardalan G, Asayesh H, Qorbani M. Accuracy of Blood Pressure-to-Height Ratio to Define Elevated Blood Pressure in Children and Adolescents: The CASPIAN-IV Study. Pediatr Cardiol 2016; 37:378-85. [PMID: 26559185 DOI: 10.1007/s00246-015-1287-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2015] [Accepted: 10/09/2015] [Indexed: 01/19/2023]
Abstract
The aim of this study was to propose a simple practical diagnostic criterion for pre-hypertension (pre-HTN) and hypertension (HTN) in the pediatric age group. This study was conducted on a nationally representative sample of 14,880 students, aged 6-18 years. HTN and pre-HTN were defined as systolic blood pressure (SBP) and/or diastolic blood pressure (DBP) ≥ 95 and 90-95th percentile for age, gender, and height, respectively. By using the area under the curve (AUC) of the receiver operator characteristic curves, we estimated the diagnostic accuracy of two indexes of SBP-to-height ratio (SBPHR) and DBP-to-height (DBPHR) to define pre-HTN and HTN. Overall, SBPHR performed relatively well in classifying subjects to HTN (AUC 0.80-0.85) and pre-HTN (AUC 0.84-0.90). Likewise, DBPHR performed relatively well in classifying subjects to HTN (AUC 0.90-0.97) and pre-HTN (AUC 0.70-0.83). Two indexes of SBPHR and DBPHR are considered as valid, simple, inexpensive, and accurate tools to diagnose pre-HTN and HTN in pediatric age group.
Collapse
Affiliation(s)
- Roya Kelishadi
- Department of Pediatrics, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Maryam Bahreynian
- Department of Nutrition, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ramin Heshmat
- Department of Epidemiology, Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
| | | | - Shirin Djalalinia
- Non-communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.,Development of Research and Technology Center, Deputy of Research and Technology, Ministry of Health and Medical Education, Tehran, Iran
| | - Fatemeh Naji
- Department of Epidemiology, School of Public Health, Iran University of Medical Sciences Tehran, Tehran, Iran
| | - Gelayol Ardalan
- Department of Pediatrics, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hamid Asayesh
- Department of Medical Emergencies, Qom University of Medical Sciences, Qom, Iran
| | - Mostafa Qorbani
- Department of Community Medicine, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran. .,Department of Community Medicine, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran.
| |
Collapse
|
15
|
Ma C, Lu Q, Yin F. The performance of modified blood pressure-to-height ratio as a screening measure for identifying children with hypertension. Clin Exp Hypertens 2015; 38:155-9. [DOI: 10.3109/10641963.2015.1081210] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|
16
|
Xi B, Zhang M, Zhang T, Li S, Steffen LM. Simplification of childhood hypertension definition using blood pressure to height ratio among US youths aged 8–17years, NHANES 1999–2012. Int J Cardiol 2015; 180:210-3. [DOI: 10.1016/j.ijcard.2014.10.166] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2014] [Revised: 10/22/2014] [Accepted: 10/27/2014] [Indexed: 11/30/2022]
|
17
|
Xi B, Zhang M, Zhang T, Liang Y, Li S, Steffen LM. Hypertension screening using blood pressure to height ratio. Pediatrics 2014; 134:e106-11. [PMID: 24913794 PMCID: PMC4067644 DOI: 10.1542/peds.2014-0643] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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.
Collapse
Affiliation(s)
- Bo Xi
- Department of Epidemiology and Health Statistics School of Public Health, Shandong University, Jinan, China;
| | - Meixian Zhang
- Department of Epidemiology, Capital Institute of Pediatrics, Beijing, China;,Graduate School, Peking Union Medical College, Beijing, China
| | - Tao Zhang
- Department of Epidemiology and Health Statistics School of Public Health, Shandong University, Jinan, China
| | - Yajun Liang
- 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
| | - Shuangshuang Li
- Department of Epidemiology and Health Statistics School of Public Health, Shandong University, Jinan, China
| | - Lyn M. Steffen
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis
| |
Collapse
|
18
|
Performance of blood pressure-to-height ratio at a single screening visit for the identification of hypertension in children. J Hypertens 2014; 32:1068-74; discussion 1074. [DOI: 10.1097/hjh.0000000000000152] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
19
|
Chiolero A, Paradis G. User-friendly tools to identify elevated blood pressure in children. Paediatr Child Health 2014; 18:63-4. [PMID: 24421657 DOI: 10.1093/pch/18.2.63] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/22/2012] [Indexed: 11/14/2022] Open
Affiliation(s)
- Arnaud Chiolero
- Institute of Social and Preventive Medicine, Lausanne University Hospital, Lausanne, Switzerland
| | - Gilles Paradis
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec
| |
Collapse
|
20
|
Kelishadi R, Heshmat R, Ardalan G, Qorbani M, Taslimi M, Poursafa P, Keramatian K, Taheri M, Motlagh ME. First report on simplified diagnostic criteria for pre-hypertension and hypertension in a national sample of adolescents from the Middle East and North Africa: the CASPIAN-III study. J Pediatr (Rio J) 2014; 90:85-91. [PMID: 24131741 DOI: 10.1016/j.jped.2013.06.005] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2013] [Accepted: 06/19/2013] [Indexed: 10/26/2022] Open
Abstract
OBJECTIVE This study aimed to simplify the diagnostic criteria of pre-hypertension (pre-HTN) and hypertension (HTN) in the pediatric age group, and to determine the accuracy of these simple indexes in a nationally-representative sample of Iranian children and adolescents. METHOD The diagnostic accuracy of the indexes of systolic blood pressure-to-height ratio (SBPHR) and diastolic BPHR (DBPHR) to define pre-HTN and HTN was determined by the area under the curve of the receiver operator characteristic curves. RESULTS The study population consisted of 5,738 Iranian students (2,875 females) with mean (SD) age of 14.7 (2.4) years. The prevalences of pre-HTN and HTN were 6.9% and 5.6%. The optimal thresholds for defining pre-HTN were 0.73 in males and 0.71 in females for SBPHR, and 0.47 in males and 0.45 in females for DBPHR, respectively. The corresponding figures for HTN were 0.73, 0.71, 0.48, and 0.46, respectively. In both genders, the accuracies of SBPHR and DBPHR in diagnosing pre-HTN and HTN were approximately 80%. CONCLUSIONS BPHR is a valid, simple, inexpensive, and accurate tool to diagnose pre-HTN and HTN in adolescents. The optimal thresholds of SBPHR and DBPHR were consistent with the corresponding figures in other populations of children and adolescents with different racial and ethnic backgrounds. Thus, it is suggested that the use of these indexes can be generalized in programs aiming to screen elevated blood pressure in the pediatric age group.
Collapse
Affiliation(s)
- Roya Kelishadi
- Pediatrics Department, Child Growth and Development Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ramin Heshmat
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Gelayol Ardalan
- Bureau of Population, Family, and School Health, Ministry of Health and Medical Education, Tehran, Iran
| | - Mostafa Qorbani
- Department of Public Health, Alborz University of Medical Sciences, Karaj, Iran; Department of Epidemiology, Iran University of Medical Sciences, Tehran, Iran
| | - Mahnaz Taslimi
- School Health Department, Bureau of Health and Fitness, Ministry of Education, Tehran, Iran
| | - Parinaz Poursafa
- Environment Department, Environment Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Kasra Keramatian
- Pediatrics Department, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Majzoubeh Taheri
- Bureau of Population, Family, and School Health, Ministry of Health and Medical Education, Tehran, Iran
| | | |
Collapse
|
21
|
Kelishadi R, Heshmat R, Ardalan G, Qorbani M, Taslimi M, Poursafa P, Keramatian K, Taheri M, Motlagh ME. First report on simplified diagnostic criteria for pre-hypertension and hypertension in a national sample of adolescents from the Middle East and North Africa: the CASPIAN-III study. JORNAL DE PEDIATRIA (VERSÃO EM PORTUGUÊS) 2014. [DOI: 10.1016/j.jpedp.2013.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
|
22
|
Ejike CECC, Yin FZ. Blood pressure-to-height ratio simplifies the diagnosis of hypertension in Nigerian children. J Trop Pediatr 2013; 59:160-1. [PMID: 23230005 DOI: 10.1093/tropej/fms064] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The diagnostic accuracy of blood-pressure-to-height-ratios (BPHRs) in 716 Nigerian children was studied, using standard protocols. Systolic BPHR (SBPHR) and diastolic BPHR (DBPHR) had diagnostic accuracies ranging from 0.934 to 1.000, irrespective of sex and age. Optimal thresholds of SBPHR/DBPHR are provided, and their sensitivities and specificities all exceeded 80%. BPHR is a simple, sensitive and specific tool for the diagnosis of hypertension in this population.
Collapse
|
23
|
Ejike CE. Obesity and Hypertension in Children and Adolescents: Developing New Tools for the Diagnosis of Two Global Pediatric Challenges. JOURNAL OF MEDICAL SCIENCES 2013. [DOI: 10.3923/jms.2013.151.159] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
|
24
|
Lu Q, Ma C, Yin F, Wang R, Lou D, Liu X. Blood pressure-to-height ratio as a screening measure for identifying children with hypertension. Eur J Pediatr 2013; 172:99-105. [PMID: 23052612 DOI: 10.1007/s00431-012-1836-z] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2012] [Revised: 08/30/2012] [Accepted: 09/04/2012] [Indexed: 11/24/2022]
Abstract
The present study evaluated the feasibility and accuracy of the blood pressure-to-height ratio (BPHR) and proposed the optimal thresholds of BPHR for identifying hypertension in Han children aged 7-12 years. In 2011, anthropometric measurements were assessed in a cross-sectional population-based study of 1,352 Han children aged 7-12 years. Hypertension was defined according to the 2004 National High Blood Pressure Education Program Working Group definition (as gold standard). The following equations for BPHR were used: systolic blood pressure-to-height ratio (SBPHR) = SBP (mmHg)/height (cm) and diastolic blood pressure-to-height ratio (DBPHR) = DBP (mmHg)/height (cm). Receiver operating characteristic curve analyses were performed to assess the accuracy of SBPHR and DBPHR as diagnostic tests for elevated SBP and DBP, respectively. After the cutoff points were determined, hypertension was defined by SBPHR/DBPHR (new standard), and the sensitivity and specificity were calculated. The accuracy of SBPHR and DBPHR (assessed by area under the curve) for identifying elevated SBP and DBP was over 0.85 (0.946-1.000). SBPHR cutoff values for elevated SBP were calculated to be 0.76-0.88 mmHg/cm in boys and 0.78-0.90 mmHg/cm in girls. DBPHR cutoff values for elevated DBP were calculated to be 0.51-0.60 mmHg/cm in boys and 0.51-0.58 mmHg/cm in girls. When hypertension was defined by BPHR, the sensitivities were 100 % in boys and 95.0 % in girls. The specificity was 94.3 % in boys and 96.8 % in girls. BPHR is a simple, inexpensive, and accurate index for screening hypertension in Han children.
Collapse
Affiliation(s)
- Qiang Lu
- Department of Endocrinology, The First Hospital of Qinhuangdao, No. 258 Wenhua Road, Qinhuangdao 066000, Hebei, China
| | | | | | | | | | | |
Collapse
|
25
|
Blood Pressure over Height Ratios: Simple and Accurate Method of Detecting Elevated Blood Pressure in Children. Int J Pediatr 2012; 2012:253497. [PMID: 22577400 PMCID: PMC3332207 DOI: 10.1155/2012/253497] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2011] [Revised: 01/19/2012] [Accepted: 02/09/2012] [Indexed: 12/31/2022] Open
Abstract
Background. Blood pressure (BP) percentiles in childhood are assessed according to age, gender, and height. Objective. To create a simple BP/height ratio for both systolic BP (SBP) and diastolic BP (DBP). To study the relationship between BP/height ratios and corresponding BP percentiles in children. Methods. We analyzed data on height and BP from 2006-2007 NHANES data. BP percentiles were calculated for 3775 children. Receiver-operating characteristic (ROC) curve analyses were performed to calculate sensitivity and specificity of BP/height ratios as diagnostic tests for elevated BP (>90%). Correlation analysis was performed between BP percentiles and BP/height ratios. Results. The average age was 12.54 ± 2.67 years. SBP/height and DBP/height ratios strongly correlated with SBP & DBP percentiles in both boys (P < 0.001, R2 = 0.85, R2 = 0.86) and girls (P < 0.001, R2 = 0.85, R2 = 0.90). The cutoffs of SBP/height and DBP/height ratios in boys were ≥0.75 and ≥0.46, respectively; in girls the ratios were ≥0.75 and ≥0.48, respectively with sensitivity and specificity in range of 83–100%. Conclusion. BP/height ratios are simple with high sensitivity and specificity to detect elevated BP in children. These ratios can be easily used in routine medical care of children.
Collapse
|
26
|
Bassareo PP, Marras AR, Mercuro G. About the need to use specific population references in estimating paediatric hypertension: Sardinian blood pressure standards (age 11-14 years). Ital J Pediatr 2012; 38:1. [PMID: 22233935 PMCID: PMC3275472 DOI: 10.1186/1824-7288-38-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2011] [Accepted: 01/10/2012] [Indexed: 12/20/2022] Open
Abstract
Background Previous Italian paediatric blood pressure (BP) tables overestimated the prevalence of hypertension in adolescents of specific geographic areas, such as Sardinia, an island in the Mediterranean Sea. This is probably due to a not very homogeneous distribution of the subjects studied, most from Middle and Northern Italy, and the long period from the survey. Methods BPs were repeatedly measured over a period of 3 years in 839 children (52.6% males. Age range: from 11 to 14 years during this period), using a standard mercury sphygmomanometer. For each gender, the specific percentile curves of systolic and diastolic BP were constructed. Results (corrected by the 50th percentile of height) Conclusions Sardinian BP tables emphasizes the need to integrate the previous standards with more up-to-date and representative reports on Italian children, as periodically performed in the USA, in order to increase the number of subjects to be checked, and to obtain a national coverage better and more completely representative of every geographic area of our country.
Collapse
Affiliation(s)
- Pier Paolo Bassareo
- Department of Cardiovascular and Neurological Sciences, University of Cagliari, Italy.
| | | | | |
Collapse
|