Unattended automated office blood pressure measurement in children
Tomáš Seeman1, Kryštof Staněk2, Jakub Slížek2
1Department of Pediatrics, Charles University Prague, 2nd Faculty of Medicine, Prague, Czech Republic.
Insights
Unattended automated office blood pressure (uAOBP) measurement is feasible in children and yields lower readings than traditional methods. This technique may aid in detecting white-coat systolic hypertension, warranting further clinical validation.
Area of Science:
- Pediatric Cardiology
- Hypertension Research
- Diagnostic Technology
Background:
- Accurate blood pressure measurement in children is crucial for diagnosing and managing hypertension.
- Traditional office blood pressure (OBP) may be influenced by anxiety (white-coat effect).
- Unattended automated office blood pressure (uAOBP) offers a potential alternative for objective BP assessment.
Purpose of the Study:
- To evaluate the performance of unattended automated office blood pressure (uAOBP) in children.
- To compare uAOBP measurements with standard oscillometric office BP (OBP) and ambulatory blood pressure monitoring (ABPM).
Main Methods:
- 111 pediatric outpatients underwent uAOBP measurements using the BpTRU device after a 5-minute rest.
- OBP was measured immediately after uAOBP using an oscillometric device.
- ABPM was performed on the same day in a subgroup of 42 children.
Main Results:
- uAOBP was successful in 95% of children; 5 preschool children did not tolerate being alone.
- Mean uAOBP (109.1/70.8 mmHg) was significantly lower than OBP (121.6/77.6 mmHg) and daytime ABPM (123.5/73.7 mmHg).
- uAOBP correctly identified white-coat systolic hypertension in all cases and assisted in identifying white-coat diastolic hypertension.
Conclusions:
- uAOBP is a feasible method for school-aged children, providing lower BP values than OBP and daytime ABPM.
- uAOBP shows promise in detecting white-coat systolic hypertension.
- Further studies are needed to confirm the clinical applicability of uAOBP in pediatric populations.
Purpose:
We studied the performance of unattended automated office blood pressure (uAOBP) measurement in children, in relation to oscillometric office BP (OBP) and ambulatory blood pressure monitoring (ABPM).
Materials And Methods:
One hundred and eleven stable treated and untreated outpatients investigated for hypertension underwent uAOBP measurements (seated unattended in a quiet room separate from the renal clinic room, six times after a 5 min rest with the BpTRU device), and immediately before using the oscillometric device. Ambulatory 24 h blood pressure monitoring (ABPM) was performed on the same day in a subgroup of 42 children.
Results:
UAOBP measurements were successful in 106 children (95%), 5 pre-school children did not tolerate to be alone in the room. The mean ± SD systolic/diastolic uAOBP, OBP and daytime ABP were 109.1 ± 14.0/70.8 ± 10.7 mmHg, 121.6 ± 16.5/77.6 ± 10.5 mmHg and 123.5 ± 11.3/73.7 ± 6.8 mmHg, respectively. Systolic/diastolic uAOBP was significantly lower than OBP by 13.6/7.6 mmHg (p < 0.0001) and lower than daytime ABP by 14.4 ± 0.5/2.9 ± 0.3 mmHg (p < 0.0001). The heart rate was not significantly different during uAOBP than during OBP measurements. On Bland Altman analysis the uAOBP underestimated OBP by a mean of 15.6 mmHg for systolic BP and by 8.6 mmHg for diastolic BP. In all 9 children with white-coat systolic hypertension uAOBP was within the normal range (<95th pc for OBP), in six of nine children with white-coat diastolic hypertension uAOBP was within the normal range however, in three of them it was elevated despite normal ABP.
Conclusion:
uAOBP measurement is feasible in school-aged children, its values are considerably lower than OBP as well as daytime ABP and it could help with detection of white-coat systolic hypertension. The clinical applicability of uAOBP in children should be confirmed in further studies.
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