Impacts of measurement protocols on blood pressure tracking from childhood into adulthood: a metaregression analysis

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Published on: February 2, 2017

Xiaoli Chen1, Youfa Wang, Lawrence J Appel

  • 1Center for Human Nutrition, Department of International Health, Bloomberg School of Public Health, Hopkins University, Baltimore, Johns Hopkins University, 615 N Wolfe St, Baltimore, MD 21205, USA.

Hypertension (Dallas, Tex. : 1979)
|January 24, 2008
PubMed

Insights

Diastolic blood pressure (DBP) tracking in children is better with automated devices than mercury manometers. Korotkoff phase 4 may be more reliable than phase 5 for DBP measurement in children.

Area of Science:

  • Pediatrics
  • Cardiology
  • Public Health

Background:

  • Blood pressure (BP) measurement protocols in children, including Korotkoff phase 4 versus phase 5 for diastolic BP (DBP) and automated devices, lack consensus.
  • Understanding BP tracking from childhood to adulthood is crucial for identifying long-term cardiovascular risk.

Purpose of the Study:

  • To analyze the impact of different BP measurement protocols on BP tracking from childhood into adulthood.
  • To compare BP tracking using Korotkoff phase 4 versus phase 5 and automated versus manual devices.

Main Methods:

  • A meta-analysis of 50 studies (1970-2006) identified via PubMed search.
  • Included 617 data points for systolic BP and 547 for DBP tracking correlation coefficients.
  • Analyzed explanatory variables: Korotkoff phase, BP device type, and number of measurements, adjusting for confounders.

Main Results:

  • DBP tracking was significantly higher with automated devices compared to Korotkoff phase 5 (0.152, P=0.024) and mercury manometers (0.223, P=0.005).
  • Korotkoff phase 4 showed a non-significant trend towards higher DBP tracking (0.035) than phase 5.
  • Multiple BP measurements per visit slightly improved tracking, with no further benefit beyond two measurements.

Conclusions:

  • Current recommendations for using Korotkoff phase 5 for pediatric DBP measurement are not supported by this meta-regression analysis.
  • Automated BP devices show promise for improved BP assessment and tracking in childhood.
  • Korotkoff phase 4 and 5 appear to yield different tracking results, warranting further investigation.

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