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Normative oscillometric blood pressure values in the first 5 years in an office setting
1Department of Pediatrics, University of Texas Health Science Center, San Antonio 78284.
Insights
This study establishes normative blood pressure (BP) and heart rate values for healthy infants and children up to 5 years old. Findings show BP increases with age, while heart rate decreases, suggesting routine BP monitoring in pediatrics.
Area of Science:
- Pediatrics
- Cardiovascular Physiology
- Biostatistics
Background:
- Establishing normative blood pressure (BP) and heart rate values is crucial for monitoring pediatric cardiovascular health.
- Previous studies may have limitations in age range or measurement techniques for young children.
Purpose of the Study:
- To establish normative blood pressure (BP) and heart rate values in healthy infants and children aged 2 weeks to 5 years.
- To assess the feasibility and utility of oscillometric BP measurement in this pediatric population.
Main Methods:
- A cross-sectional study involving 1554 healthy infants and children aged 2 weeks to 5 years.
- Blood pressure (BP) and heart rate were measured using an oscillometric device with appropriate cuff size (40-50% of upper arm circumference).
- Triplicate measurements were taken in a waiting room setting prior to clinical examination.
Main Results:
- Average BP increased from 78/47 mm Hg at 2-3 weeks to 95/60 mm Hg at 1-5 months, with a slower increase from 2 to 5 years (104/58 mm Hg).
- Diastolic BP showed no significant increase between 1 month and 5 years.
- Heart rate decreased significantly with age, from 153 beats per minute at 2-3 weeks to 97 beats per minute at 5 years.
- No significant differences in BP or heart rate were observed between sexes or ethnic groups.
Conclusions:
- The study provides valuable normative data for pediatric BP and heart rate using a reliable oscillometric method.
- The high success rate suggests routine BP monitoring is feasible and recommended in pediatric care, especially with available oscillometric devices.
- These findings contribute to early detection of potential cardiovascular abnormalities in children.
Abstract:
We measured blood pressure (BP) and heart rate in 1554 healthy infants and children aged 2 weeks to 5 years using an oscillometric device, to establish normative values in this age group. The BP cuff width was selected to be 40% to 50% of the circumference of the upper arm. Triplicate measurements of BP and heart rate were obtained in the waiting room of pediatricians' offices and well-baby clinics before the patients were examined by the physician or nurse. Three readings were possible in 87% of the infants less than 3 years of age and in all children 3 years of age and older. The average BP value (systolic/diastolic [mean]) increased rapidly from the 2- to 3-week value of 78/47 (59) mm Hg to the 1- to 5-month value of 95/60 (74) mm Hg. No subsequent increase in BP occurred until 2 years of age (96/56 [71] mm Hg) when systolic and mean pressures started to increase at an average annual rate of 2 mm Hg for systolic pressure and 1 mm Hg for mean pressure until reaching the 5-year value of 104/58 (75) mm Hg. Diastolic pressure did not increase from 1 month to 5 years of age. Heart rate decreased with increasing age from the 2- to 3-week value of 153 to the 5-year value of 97 beats per minute. There was no difference in BP and heart rate values between boys and girls or among ethnic groups over the age ranges studied. Considering the high success rate in obtaining BPs in infants and small children, it appears that BP should be determined routinely, regardless of the age of the patients, when an oscillometric device is available.