Hypertension screening using blood pressure to height ratio

Area of Science:

• Pediatric Cardiology
• Public Health
• Biostatistics

Background:

• Current pediatric hypertension definitions rely on complex age-, gender-, and height-specific blood pressure (BP) algorithms.
• These complex algorithms pose challenges for medical professionals, children, and parents in practical application.

Purpose of the Study:

• To simplify pediatric blood pressure percentile references using the blood pressure to height ratio (BPHR).
• To evaluate the efficacy of BPHR for screening prehypertension and hypertension in Chinese children aged 6 to 17 years.

Main Methods:

• Utilized data from 11,661 Chinese children (aged 6–17 years) from the China Health and Nutrition Survey (1991–2009).
• Employed Receiver Operating Characteristic (ROC) curve analysis to assess the performance of systolic BPHR (SBPHR) and diastolic BPHR (DBPHR).

Main Results:

• Identified optimal SBPHR thresholds for prehypertension (0.81 for children, 0.70 for adolescents) and hypertension (0.84 for children, 0.78 for adolescents).
• Determined optimal DBPHR thresholds for prehypertension (0.52 for children, 0.46 for adolescents) and hypertension (0.55 for children, 0.50 for adolescents).
• Achieved high negative predictive values (≥99%) for both conditions, with positive predictive values ranging from 13% to 75%.

Conclusions:

• The BPHR index provides a simple and accurate method for screening prehypertension and hypertension in Chinese children.
• This BPHR approach facilitates early screening and potential treatment of hypertension in pediatric populations.