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Development of normative ambulatory blood pressure data in children. Arbeitsgruppe Pädiatrische Hypertonie
1University Children's Hospital, Deutschhausstrasse 12, D-35033 Marburg, Germany. soergel@mailer.uni-marburg.de
Insights
This study establishes normal ranges for pediatric ambulatory blood pressure (ABP) monitoring in healthy children. Findings provide crucial reference values for evaluating blood pressure in youth.
Area of Science:
- Pediatric Cardiology
- Clinical Physiology
- Biomedical Engineering
Background:
- Ambulatory blood pressure (ABP) monitoring is increasingly utilized for pediatric hypertension assessment.
- Establishing normative data is essential for accurate interpretation of pediatric ABP.
- Current reference values require validation in large, healthy pediatric populations.
Purpose of the Study:
- To define the normal range of values for pediatric ambulatory blood pressure.
- To provide reference data for children and adolescents based on height and sex.
Main Methods:
- A multicenter trial involving 1141 healthy children and adolescents (height 115-185 cm).
- Standardized ABP monitoring procedures were employed across seven centers.
- Only oscillometric devices (SpaceLab 90207, Meditech) were used.
Main Results:
- The 50th percentile for 24-hour systolic ABP increased with height in both girls and boys.
- The 50th percentile for 24-hour diastolic ABP was approximately 66 mmHg, independent of height or sex.
- Nocturnal ABP values were significantly lower than daytime values for both systolic and diastolic pressures.
Conclusions:
- This study presents the largest descriptive estimation of normal pediatric ABP values to date.
- Further research is needed to explore influences of genetics, environment, and devices on pediatric ABP.
- The optimal range for pediatric ABP, linked to cardiovascular outcomes, requires further definition.
Background:
Ambulatory blood pressure (ABP) monitoring is used increasingly to evaluate the blood pressure of children and adolescents. Reference values based on a sufficiently high number of healthy children are necessary to estimate the limits of the 'normal' range.
Objective:
To begin to define the normal range of values for pediatric ABP.
Design:
In this multicenter trial, we pooled ABP records of 1141 healthy children and adolescents with body heights between 115 and 185 cm. The study was carried out at seven centers, according to a common procedure. Only oscillometric devices (SpaceLab 90207 and Meditech) were included in the evaluation.
Results:
The 50th percentile for 24h systolic ABP increased moderately with height, from 103 mmHg to 113 mmHg in girls and from 105 mmHg to 120 mmHg in boys. The 50th percentile for diastolic 24h means was 66+/-1 mmHg, irrespective of height or sex. Diastolic daytime means were 73+/-1 mmHg, which is remarkably high compared with reference values for casual blood pressure. The mean nocturnal systolic and diastolic ABP values (0000-0600 h) were 13+/-6% and 23+/-9% less than the daytime means (0800-2000h), respectively.
Discussion:
This multicenter study is, to date, the largest descriptive estimation of the normal range of values for pediatric ABP monitoring. Further investigation is needed, to evaluate the influences of genetic and environmental background, and that of the monitoring device, on pediatric ABP measurements. The optimal range for ABP in children as defined by cardiovascular prognosis or end-organ damage remains to be established.