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Age- and height-specific reference limits of blood pressure of Indian children
S L Chadha1, R S Vasan, P S Sarma
1Sitaram Bhartia Institute for Science and Research, New Delhi, India.
Insights
Childhood blood pressure is key for adult hypertension prediction. New age- and height-specific blood pressure norms for Indian children help identify high blood pressure early.
Area of Science:
- Pediatrics
- Cardiology
- Public Health
Background:
- Childhood blood pressure is a critical predictor of adult hypertension.
- Establishing accurate, age- and height-specific blood pressure norms in children is essential for early detection and management.
- Existing norms may not adequately represent diverse pediatric populations.
Purpose of the Study:
- To establish age- and height-specific reference values for blood pressure in Indian children.
- To identify key determinants of blood pressure in the pediatric population.
- To provide a basis for categorizing children's blood pressure levels.
Main Methods:
- A cross-sectional survey of 8293 school children aged 5-14 years in South Delhi.
- Standardized measurement of systolic and diastolic blood pressure using a mercury sphygmomanometer.
- Multiple linear regression analysis to determine age- and height-specific 90th and 95th percentile blood pressure values.
Main Results:
- Age and height were identified as the primary determinants of blood pressure in children, not gender.
- Age- and height-specific 90th and 95th percentile values for systolic and diastolic blood pressure were calculated.
- These values allow for the categorization of children into 'normal', 'high normal', and 'high' blood pressure groups.
Conclusions:
- Presents the first large-scale, age- and height-specific blood pressure reference values for Indian children.
- These newly established standards are crucial for accurately identifying children with elevated blood pressure.
- Facilitates early intervention strategies to mitigate the risk of adult hypertension.
Background:
Blood pressure in childhood is the most powerful predictor of hypertension in adults. Norms for blood pressure in children are based on the age- and height-specific distribution of blood pressure in a reference sample of healthy children.
Methods:
We performed a cross-sectional survey of school-children in the age group 5 to 14 years in south Delhi and studied the distribution of systolic and diastolic blood pressure in 8293 children (4623 boys and 3670 girls). Blood pressure was measured in all children with a mercury column sphygmomanometer using a standardized technique. The first and the fourth Korotkoff sounds were taken as indicative of the systolic and the diastolic blood pressure, respectively. Height percentiles were computed for the study sample for every one-year sex-pooled group. Multiple linear regression was then performed for every one-year group in order to estimate the 90th and 95th percentiles of systolic and diastolic blood pressure according to percentiles of height.
Results:
Age and height, but not gender, emerged as the principal determinants of systolic and diastolic blood pressure in multivariable linear regression analyses. Age- and height-specific 90th and 95th percentile values of systolic and diastolic blood pressure were estimated, which enabled us to categorize children into 'normal', 'high normal' and 'high' blood pressure groups.
Conclusions:
We present age- and height-specific reference values for blood pressure of Indian children based on a large study sample. The use of these standards should aid the identification of children with high blood pressure.