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Oscillometric casual blood pressure normative standards for Swedish children using ABPM to exclude casual
Rafael T Krmar1, Ulla Holtbäck1, Anita Bergh1
1Karolinska Institutet, Department for Clinical Science, Intervention and Technology, Division of Pediatrics, Karolinska University Hospital, Huddinge, Sweden;
Insights
New standards for oscillometric casual blood pressure (CBP) in Swedish children aged 6-16 are established. These findings aid in screening and managing pediatric hypertension, considering factors like age, BMI, and parental history.
Area of Science:
- Pediatric Cardiology
- Biomedical Engineering
- Public Health
Background:
- Casual blood pressure (CBP) is a key indicator of cardiovascular health.
- Oscillometric devices are increasingly used for pediatric CBP measurement, complementing the auscultatory method.
- Establishing normative standards for pediatric CBP is crucial for accurate health assessment.
Purpose of the Study:
- To establish oscillometric casual blood pressure (CBP) normative standards for Swedish children aged 6-16 years.
- To provide reliable reference data for pediatric blood pressure screening and control programs.
- To investigate the influence of age, sex, BMI, and parental history on pediatric CBP.
Main Methods:
- Cross-sectional study involving 1,470 healthy Swedish schoolchildren (772 males) aged 6-16 years.
- Oscillometric CBP readings obtained using the Welch Allyn Spot Vital Signs 420 monitor.
- Verification of elevated readings by auscultatory method and exclusion of hypertension via ambulatory blood pressure monitoring (ABPM).
Main Results:
- Systolic and diastolic CBP increased significantly with age, height, BMI, and their respective SDS.
- Gender differences in CBP emerged at different ages, with boys showing higher systolic values from age 15 and girls higher diastolic values from age 12.
- Increased BMI and a positive parental history of hypertension were identified as risk factors for elevated CBP.
Conclusions:
- The developed normative standards for oscillometric CBP are suitable for screening and control programs in Swedish children.
- Ambulatory blood pressure monitoring (ABPM) is recommended for confirming diagnoses of casual hypertension.
- These standards contribute to better cardiovascular health monitoring in pediatric populations.
Background:
Casual blood pressure (CBP) is considered a reliable proxy for cardiovascular health. Although the auscultatory technique is the reference standard method for measuring CBP, oscillometric devices are increasingly being used in children. We sought to establish oscillometric CBP normative standards for Swedish children.
Methods:
Cross-sectional oscillometric CBP readings were obtained by the Welch Allyn Spot Vital Signs 420 monitor and measured according to the International Guidelines' recommendations. Participants with elevated oscillometric CBP levels underwent verification by the auscultatory method. Ambulatory blood pressure monitoring (ABPM) was used to exclude casual hypertension. Data on 1,470 (772 males) apparently healthy Swedish schoolchildren aged 6-16 years were analyzed and sex-specific reference charts normalized to age or height were constructed.
Results:
Systolic and diastolic CBP values were significantly higher with age, height, height standard deviation score (SDS), body mass index (BMI), and BMI SDS. Gender differences for systolic CBP were present starting from age of 15 years and revealed significantly higher values in boys than in girls, whereas for diastolic CBP, the differences were apparent at the age of 12 years, with higher values in girls. Increased BMI and BMI SDS were positively associated with CBP levels. Positive parental history of hypertension turned out to be a risk factor for higher systolic and diastolic CBP across all ages.
Conclusions:
Our normative standard for CBP can be used for blood pressure screening and control programs in Swedish children. The use of ABPM should be considered to confirm the diagnosis of casual hypertension.
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