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Blood pressure measurement in children: which method? which is the gold standard
Enrico Vidal1, Luisa Murer, Maria Chiara Matteucci
1Pediatric Nephrology, Dialysis and Transplantation Unit, Department of Pediatrics, Padua University Hospital, Padua - Italy.
Insights
Pediatric hypertension is rising. This review clarifies defining and measuring high blood pressure in children using age- and height-specific standards for better long-term health outcomes.
Area of Science:
- Pediatric Nephrology
- Cardiovascular Health in Children
Background:
- Childhood hypertension is a growing concern with potential lifelong implications.
- Current practices for diagnosing pediatric hypertension lack standardized instruments and reference standards.
- Physiological changes during growth necessitate age- and height-specific definitions for hypertension in children.
Purpose of the Study:
- To guide nephrologists on the accurate definition of hypertension in pediatric patients.
- To review practical aspects of various blood pressure measurement modalities for children.
- To present current international guidelines and reference standards for pediatric blood pressure monitoring.
Main Methods:
- Review of current international guidelines for pediatric hypertension.
- Analysis of different blood pressure measurement techniques (office, ambulatory, home).
- Focus on age- and height-specific percentile-based definitions.
Main Results:
- Hypertension in children requires definitions based on age- and height-specific percentiles, not fixed values.
- Different measurement modalities (office, ambulatory, home) have unique characteristics for pediatric use.
- Latest guidelines and reference standards are available for accurate diagnosis and monitoring.
Conclusions:
- Accurate definition and measurement of pediatric hypertension are crucial for early intervention.
- Clinicians must be aware of the specific challenges and standards in pediatric blood pressure assessment.
- Implementing evidence-based guidelines can improve management of childhood hypertension.
Abstract:
The burden of hypertension has become increasingly prevalent in children. Hypertension that begins in childhood can carry on into adulthood, therefore early detection, accurate diagnosis and effective therapy of high blood pressure may improve long-term outcomes of children and adolescents. As far as pediatric hypertension is concerned, doubts still persist about the right instruments, modalities and standards of reference that should be used in routine practice. Due to the dynamic process of growth and development, many physiological parameters undergo intensive change with age. Therefore, in children, the definition of hypertension can not rely on a single blood pressure level but should be based on age- and height-specific percentiles. In this review, we introduce the nephrologist to the correct definition of high blood pressure in children. Moreover, we specifically address the main characteristics of different modalities for blood pressure measurement in children, focusing on practical aspects. The latest international guidelines and appropriate standards of reference for office, ambulatory and home blood pressure data collection are presented. As clinicians are being faced with a greater number of children with hypertension, they should be aware of these peculiarities.
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