Diagnosis of adolescent hypertension on initial screening by the use of height age

The tremendous variability in growth and maturation during adolescence makes body mass a better determinant of blood pressure (BP) than chronologic age (CA). To evaluate whether two accepted indicators of body mass, height age (HA), and weight age (WA) could accurately predict hypertension on initial screening, 1426 healthy adolescents had their BP, height, and weight measured and Tanner stage assessed. The mean of three BP measurements were compared to eight published nomograms which correlate BP with height, weight, or CA. Patients with an initial elevated BP (greater than 95 percentile for height, weight or CA) were reevaluated to verify persistent hypertension. Eighty-seven (6.1%) initially appeared to be hypertensive with 0.84% persistently hypertensive. The diagnosis of hypertension varied considerably when the BP measurements were reevaluated based on HA or WA. Height age was the most sensitive (100%) and specific (62.6%) criteria for the diagnosis of hypertension and can be used for initial BP screening in this age group.