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Hypertension screening using blood pressure to height ratio
Bo Xi1, Meixian Zhang2, Tao Zhang3
1Department of Epidemiology and Health Statistics School of Public Health, Shandong University, Jinan, China; xibo2010@sdu.edu.cn steffen@umn.edu.
Insights
A simplified blood pressure to height ratio (BPHR) effectively screens for prehypertension and hypertension in Chinese children. This method offers a straightforward approach for early detection and management of pediatric hypertension.
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.
Objectives:
The definition of hypertension in children is too complex to be used by medical professionals and children and their parents because of the age-, gender-, and height-specific blood pressure (BP) algorithm. The aim of this study was to simplify the pediatric BP percentile references using BP to height ratio (BPHR, equal to BP/height) for screening for prehypertension and hypertension in Chinese children.
Methods:
Data were obtained from the China Health and Nutrition Survey, which was conducted from 1991 to 2009 and included 11 661 children aged 6 to 17 years with complete data on age, gender, height, and BP values. Receiver operating characteristic curve analysis was performed to assess the performance of systolic BPHR (SBPHR) and diastolic BPHR (DBPHR) for screening for pediatric prehypertension and hypertension.
Results:
The optimal thresholds for defining prehypertension were 0.81 in children aged 6 to 11 years and 0.70 in adolescents aged 12 to 17 years for SBPHR and 0.52 in children and 0.46 in adolescents for DBPHR, respectively. The corresponding values for hypertension were 0.84, 0.78, 0.55, and 0.50, respectively. The negative predictive values were much higher (all ≥99%) for prehypertension and hypertension, although the positive predictive values were relatively lower, ranging from 13% to 75%.
Conclusions:
BPHR index is simple and accurate for screening for prehypertension and hypertension in Chinese children aged 6 to 17 years and can be used for early screening or treating Chinese children with hypertension.
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