Influence of Blood Pressure Level and Age on Within-visit Blood Pressure Variability in Children and Adolescents

Overview

Journal Eur J Pediatr

Specialty Pediatrics

Date 2017 Dec 6

PMID 29204850

Citations 6

Authors

Panagiota Veloudi

Christopher L Blizzard

Velandai K Srikanth

Martin G Schultz

James E Sharman

Affiliations

Soon will be listed here.

Abstract

Conclusions: BP is highly variable in children and adolescents, with the magnitude of variability being associated with both age and BP level. SBP increases on repeat measurement in a substantial proportion of the population. The optimal protocol of BP assessment to address this increased BPV needs to be determined. What is Known: • Diagnosis of elevated blood pressure (BP) is based on strict probabilistic criteria, the difference between the 90th (pre-hypertension) and 95th (hypertension) percentiles only being 3-4 mmHg. • BP variability could affect BP classification among children and adolescents. What is New: • The magnitude of BP change among children and adolescents is highly affected by BP level and age. • BP does not always drop on consecutive measurements, and evidence-based BP assessment protocols should be established to avoid misdiagnosis of hypertension.

Citing Articles

High Prevalence and Lack of Parental Awareness of Pediatric Hypertension Among a Low-income Sample in Worcester, MA.

Goulding M, Rosal M, Gupta N, Borg A, Lemon S Matern Child Health J. 2022; 26(11):2192-2197.

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Relation between Blood Pressure Variability within a Single Visit and Stroke.

Ma W, Yang Y, Qi L, Zhang B, Meng L, Zhang Y Int J Hypertens. 2021; 2021:2920140.

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Utility of blood pressure measurements at an initial screening visit to identify Chinese children and adolescents with hypertension.

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Predictive Model for Ambulatory Hypertension Based on Office Blood Pressure in Obese Children.

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Performance of blood pressure measurements at an initial screening visit for the diagnosis of hypertension in children.

Outdili Z, Marti-Soler H, Bovet P, Chiolero A J Clin Hypertens (Greenwich). 2019; 21(9):1352-1357.

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References

Muntner P, He J, Cutler J, Wildman R, Whelton P . Trends in blood pressure among children and adolescents. JAMA. 2004; 291(17):2107-13. DOI: 10.1001/jama.291.17.2107. View

Aatola H, Hutri-Kahonen N, Juonala M, Viikari J, Hulkkonen J, Laitinen T . Lifetime risk factors and arterial pulse wave velocity in adulthood: the cardiovascular risk in young Finns study. Hypertension. 2010; 55(3):806-11. DOI: 10.1161/HYPERTENSIONAHA.109.145102. View

Sorof J, Alexandrov A, Cardwell G, Portman R . Carotid artery intimal-medial thickness and left ventricular hypertrophy in children with elevated blood pressure. Pediatrics. 2003; 111(1):61-6. DOI: 10.1542/peds.111.1.61. 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

Ferreira De Moraes A, Carvalho H, Siani A, Barba G, Veidebaum T, Tornaritis M . Incidence of high blood pressure in children - effects of physical activity and sedentary behaviors: the IDEFICS study: High blood pressure, lifestyle and children. Int J Cardiol. 2014; 180:165-70. DOI: 10.1016/j.ijcard.2014.11.175. View

Rosner B, Cook N, Evans D, Keough M, Taylor J, Polk B . Reproducibility and predictive values of routine blood pressure measurements in children. Comparison with adult values and implications for screening children for elevated blood pressure. Am J Epidemiol. 1987; 126(6):1115-25. DOI: 10.1093/oxfordjournals.aje.a114750. View

Falkner B, Daniels S . Summary of the Fourth Report on the Diagnosis, Evaluation, and Treatment of High Blood Pressure in Children and Adolescents. Hypertension. 2004; 44(4):387-8. DOI: 10.1161/01.HYP.0000143545.54637.af. View

Hanevold C, Waller J, Daniels S, Portman R, Sorof J . The effects of obesity, gender, and ethnic group on left ventricular hypertrophy and geometry in hypertensive children: a collaborative study of the International Pediatric Hypertension Association. Pediatrics. 2004; 113(2):328-33. DOI: 10.1542/peds.113.2.328. View

Woroniecki R, Flynn J . How are hypertensive children evaluated and managed? A survey of North American pediatric nephrologists. Pediatr Nephrol. 2005; 20(6):791-7. DOI: 10.1007/s00467-004-1804-6. View

10.

Pandit J, Batlle D . Snapshot Hemodynamics and Clinical Outcomes in Hypertension: Precision in the Measurements Is Key. Hypertension. 2015; 67(2):270-1. DOI: 10.1161/HYPERTENSIONAHA.115.06818. View

11.

Papandreou D, Stamou M, Malindretos P, Rousso I, Mavromichalis I . Prevalence of hypertension and association of dietary mineral intake with blood pressure in healthy schoolchildren from northern Greece aged 7-15 years. Ann Nutr Metab. 2007; 51(5):471-6. DOI: 10.1159/000111169. View

12.

Kawabe H, Saito I, Saruta T . Influence of repeated measurement on one occasion, on successive days, and on workdays on home blood pressure values. Clin Exp Hypertens. 2005; 27(2-3):215-22. View

13.

Lurbe E, Agabiti-Rosei E, Cruickshank J, Dominiczak A, Erdine S, Hirth A . 2016 European Society of Hypertension guidelines for the management of high blood pressure in children and adolescents. J Hypertens. 2016; 34(10):1887-920. DOI: 10.1097/HJH.0000000000001039. View

14.

Negroni-Balasquide X, Bell C, Samuel J, Samuels J . Is one measurement enough to evaluate blood pressure among adolescents? A blood pressure screening experience in more than 9000 children with a subset comparison of auscultatory to mercury measurements. J Am Soc Hypertens. 2016; 10(2):95-100. DOI: 10.1016/j.jash.2015.12.001. View

15.

Moyer V . Screening for primary hypertension in children and adolescents: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2013; 159(9):613-9. DOI: 10.7326/0003-4819-159-9-201311050-00725. View

16.

Monyeki K, Kemper H, Makgae P . Relationship between fat patterns, physical fitness and blood pressure of rural South African children: Ellisras Longitudinal Growth and Health Study. J Hum Hypertens. 2008; 22(5):311-9. DOI: 10.1038/jhh.2008.3. View

17.

Sorof J, Lai D, Turner J, Poffenbarger T, Portman R . Overweight, ethnicity, and the prevalence of hypertension in school-aged children. Pediatrics. 2004; 113(3 Pt 1):475-82. DOI: 10.1542/peds.113.3.475. View

18.

Wirix A, Nauta J, Groothoff J, Rabelink T, Hirasing R, ChinAPaw M . Is the prevalence of hypertension in overweight children overestimated?. Arch Dis Child. 2016; 101(11):998-1003. DOI: 10.1136/archdischild-2015-309969. View

19.

Mancia G, Fagard R, Narkiewicz K, Redon J, Zanchetti A, Bohm M . 2013 ESH/ESC Guidelines for the management of arterial hypertension: the Task Force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). J Hypertens. 2013; 31(7):1281-357. DOI: 10.1097/01.hjh.0000431740.32696.cc. View

20.

Berenson G, Wattigney W, Tracy R, Newman 3rd W, Srinivasan S, Webber L . Atherosclerosis of the aorta and coronary arteries and cardiovascular risk factors in persons aged 6 to 30 years and studied at necropsy (The Bogalusa Heart Study). Am J Cardiol. 1992; 70(9):851-8. DOI: 10.1016/0002-9149(92)90726-f. View