Blood Pressure Tables for Chinese Adolescents: Justification for Incorporation of Important Influencing Factors of Height, Age and Sex in the Tables

Overview

Journal BMC Pediatr

Publisher Biomed Central

Specialty Pediatrics

Date 2014 Jan 18

PMID 24433550

Citations 5

Authors

Xuejin Jiang

Zhongqiang Cao

Lijun Shen

Jing Wu

Zhongliang Li

Jing Gao

Youjie Wang

Affiliations

Soon will be listed here.

Abstract

Background: Elevated blood pressure (BP) in childhood was a predictor of hypertension in adulthood and contributes to the current epidemic of cardiovascular disease. It is necessary to identify abnormal BP in children and adolescents with accurate BP tables based on several crucial factors. The purpose of this study was to identify the important influencing factors of BP of Chinese adolescents.

Methods: BP, height, and body weight were assessed in 32221 normal-weight Chinese adolescents aged 12-17 years. An equal number of 6815 subjects from boys and girls were individually matched by height and age to assess the independent effect of sex on BP; and an equal number of 1422 subjects from each of the age groups (12, 13, 14, 15, 16 and 17 years) were individually matched by sex and height to estimate the independent effect of age on BP. Height of each sex and age was divided into eight height groups - ~5th, ~10th, ~25th, ~50th, ~75th, ~90th, ~95th, and 95th ~ percentiles- and the Spearman's correlation between height percentiles and BP was used to examine the independent effect of height on BP.

Results: Boys had higher systolic BP (SBP) and diastolic BP (DBP) than girls after controlling for age and height. BP increased with age after controlling for sex and height. In each age group, both SBP and DBP increased alongside increasing height in boys and girls.

Conclusions: Sex, age and height are all independent determinants for BP levels in Chinese adolescents. It is essential to incorporate these three factors for the establishment of the BP reference tables.

Citing Articles

Longitudinal associations between early-life fluoride exposures and cardiometabolic outcomes in school-aged children.

India Aldana S, Colicino E, Cantoral Preciado A, Tolentino M, Baccarelli A, Wright R Environ Int. 2023; 183:108375.

PMID: 38128386 PMC: 10842303. DOI: 10.1016/j.envint.2023.108375.

Temporal trends in pulse pressure and mean arterial pressure in Chinese children and adolescents over two decades (1991-2015).

Zhang X, Zhu Y, Li S, Ye X, Hou L, You Y Front Cardiovasc Med. 2022; 9:910810.

PMID: 36158841 PMC: 9500211. DOI: 10.3389/fcvm.2022.910810.

The prevalence of hypertension in Chinese adolescents aged 15-17 years: A comparison of different criteria.

Zhou H, Li S, Wang X, Chen Z, Zhang L, Shao L J Clin Hypertens (Greenwich). 2022; 24(4):378-384.

PMID: 35297171 PMC: 8989742. DOI: 10.1111/jch.14462.

Longitudinal associations of away-from-home eating, snacking, screen time, and physical activity behaviors with cardiometabolic risk factors among Chinese children and their parents.

Dong F, Howard A, Herring A, Thompson A, Adair L, Popkin B Am J Clin Nutr. 2017; 106(1):168-178.

PMID: 28539376 PMC: 5486196. DOI: 10.3945/ajcn.116.146217.

Concordance of haemoglobin A1c, blood pressure and C-reactive protein between children and their parents in Chinese households.

Dong F, Howard A, Herring A, Adair L, Thompson A, Popkin B Pediatr Obes. 2016; 12(5):422-430.

PMID: 27273455 PMC: 5201443. DOI: 10.1111/ijpo.12160.

References

Wang Z, Ma J, Dong B, Song Y, Hu P, Zhang B . Comparison of blood pressure levels among four age groups of Chinese children matched by height. J Hum Hypertens. 2011; 26(7):437-42. PMC: 3376308. DOI: 10.1038/jhh.2011.45. View

Elkasabany A, Urbina E, Daniels S, Berenson G . Prediction of adult hypertension by K4 and K5 diastolic blood pressure in children: the Bogalusa Heart Study. J Pediatr. 1998; 132(4):687-92. DOI: 10.1016/s0022-3476(98)70361-0. View

Hansen M, Gunn P, Kaelber D . Underdiagnosis of hypertension in children and adolescents. JAMA. 2007; 298(8):874-9. DOI: 10.1001/jama.298.8.874. View

Badeli H, Sajedi S, Shakiba M . Simple formulas for screening abnormal blood pressure in children and adolescents. Iran J Kidney Dis. 2010; 4(3):250-2. View

Li H, Ji C, Zong X, Zhang Y . [Body mass index growth curves for Chinese children and adolescents aged 0 to 18 years]. Zhonghua Er Ke Za Zhi. 2009; 47(7):493-8. View

Cao Z, Zhu L, Zhang T, Wu L, Wang Y . Blood pressure and obesity among adolescents: a school-based population study in China. Am J Hypertens. 2012; 25(5):576-82. DOI: 10.1038/ajh.2012.5. View

McNiece K, Poffenbarger T, Turner J, Franco K, Sorof J, Portman R . Prevalence of hypertension and pre-hypertension among adolescents. J Pediatr. 2007; 150(6):640-4, 644.e1. DOI: 10.1016/j.jpeds.2007.01.052. View

Gillum R, Prineas R, Horibe H . Maturation vs age: assessing blood pressure by height. J Natl Med Assoc. 1982; 74(1):43-6. PMC: 2552808. View

Suglia S, Clark C, Gary-Webb T . Adolescent obesity, change in weight status, and hypertension: racial/ethnic variations. Hypertension. 2012; 61(2):290-5. PMC: 3938160. DOI: 10.1161/HYPERTENSIONAHA.111.00214. View

10.

VOORS A, FOSTER T, Frerichs R, Webber L, Berenson G . Studies of blood pressures in children, ages 5-14 years, in a total biracial community: the Bogalusa Heart Study. Circulation. 1976; 54(2):319-27. DOI: 10.1161/01.cir.54.2.319. View

11.

Lauer R, Clarke W . Childhood risk factors for high adult blood pressure: the Muscatine Study. Pediatrics. 1989; 84(4):633-41. View

12.

Rosner B, Cook N, Portman R, Daniels S, Falkner B . Blood pressure differences by ethnic group among United States children and adolescents. Hypertension. 2009; 54(3):502-8. PMC: 3064557. DOI: 10.1161/HYPERTENSIONAHA.109.134049. View

13.

Rosner B, Cook N, Portman R, Daniels S, Falkner B . Determination of blood pressure percentiles in normal-weight children: some methodological issues. Am J Epidemiol. 2008; 167(6):653-66. DOI: 10.1093/aje/kwm348. View

14.

Lurbe E, Cifkova R, Cruickshank J, Dillon M, Ferreira I, Invitti C . Management of high blood pressure in children and adolescents: recommendations of the European Society of Hypertension. J Hypertens. 2009; 27(9):1719-42. DOI: 10.1097/HJH.0b013e32832f4f6b. View

15.

Klumbiene J, Sileikiene L, Milasauskiene Z, Zaborskis A, Shatchkute A . The relationship of childhood to adult blood pressure: longitudinal study of juvenile hypertension in Lithuania. J Hypertens. 2000; 18(5):531-8. DOI: 10.1097/00004872-200018050-00004. View

16.

Cook N, Gillman M, Rosner B, Taylor J, Hennekens C . Prediction of young adult blood pressure from childhood blood pressure, height, and weight. J Clin Epidemiol. 1997; 50(5):571-9. DOI: 10.1016/s0895-4356(97)00046-2. View

17.

. The fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents. Pediatrics. 2004; 114(2 Suppl 4th Report):555-76. View

18.

Kaelber D, Pickett F . Simple table to identify children and adolescents needing further evaluation of blood pressure. Pediatrics. 2009; 123(6):e972-4. DOI: 10.1542/peds.2008-2680. View

19.

Feber J, Ahmed M . Hypertension in children: new trends and challenges. Clin Sci (Lond). 2010; 119(4):151-61. DOI: 10.1042/CS20090544. View

20.

Neuhauser H, Thamm M, Ellert U, Hense H, Schaffrath Rosario A . Blood pressure percentiles by age and height from nonoverweight children and adolescents in Germany. Pediatrics. 2011; 127(4):e978-88. DOI: 10.1542/peds.2010-1290. View