Interpretation of children's blood pressure using a physiologic height correction

In a cross-sectional survey of 1834 black, Atlanta schoolchildren we corrected the customary blood pressure (BP) observations for the height of the arterial column extending from the BP cuff to the top (vertex) of the subject's head. Each cuff-to-vertex height was converted to its pressure equivalent in mmHg; then this pressure was subtracted from the observed BP to compute vertex-corrected BP values. The vertex-corrected mean arterial pressure (VMAP) ranged from 22.3 to 83.2 mmHg, but there was no estimated linear association between VMAP and age. For males, mean VMAP was 49.4 mmHg for ages 6-13 and 46.0 mmHg for ages 14-17. For females, mean VMAP was 50.2 mmHg for ages 6-17. Since VMAP appears to be independent of age in most of childhood, its use may simplify the development of pediatric BP reference values. VMAP can also serve as a non-invasive approximation of cerebral perfusion pressure. Investigators of primary hypertension may wish to use VMAP for comparing average BP levels between childhood groups which differ by potentially etiologic characteristics.