The San Antonio Biethnic Children's Blood Pressure Study: auscultatory findings

The purpose of this study were to: (a) examine for possible ethnicity-related and gender-related differences in blood pressure (BP) in Mexican American and non-Hispanic White schoolchildren; (b) compare auscultatory and oscillometric BP levels; and (c) establish auscultatory BP standards using the width of the BP cuff based on the circumference of the arm in schoolchildren in K-12.

Participants were 6259 schoolchildren in kindergarten through 12th grade in the San Antonio, Texas, area. Auscultatory and oscillometric BP readings were obtained in random sequence, using BP cuff width 40% to 50% of the circumference of the upper arm. Averages of 3 readings were used for statistical analyses.

Auscultatory systolic pressures (SPs) in preadolescent Mexican American boys and girls were higher (1 to 3 mm Hg) auscultatory (SP) than in their White counterparts, but the difference was clinically not important. Diastolic pressures (DP) showed no important differences. Auscultatory SPs in 13- to 18-year-old boys of both ethnic groups were significantly (P < .05) higher (3 to 12 mm Hg) than they were for girls, with no ethnic differences. Oscillometric SP was higher than auscultatory SP in children of all ages studied. Oscillometric (DP) was slightly lower (0 to 5 mm Hg) than was auscultatory K4 and higher (4 to 5 mm Hg) than was auscultatory K5 DP.

No important ethnicity-related difference was found for auscultatory BP, but significant gender-related differences (boys greater than girls) were found in SP in subjects ages 13 to 18 years. Differences in BP readings by oscillometric and auscultatory methods do not allow interchange of readings. This study provides, for the first time, auscultatory BP standards using BP cuff width 40% to 50% of the arm circumference.