Pediatric blood pressure: ethnic comparisons in a primary care center

This study reviews the blood pressure (BP) determinations previously recorded in a primary care center serving a low socioeconomic population and compares the systolic blood pressure (SBP) and diastolic blood pressure (DBP) distributions within the clinic population among the three major ethnic groups represented, and also between this clinic population and a recently reported standard population (Task Force for Blood Pressure Control in Children, NHLBI). The study group consisted of 2810 children 3-17 years of age, of whom 49.2% were of Spanish surname, 23.4% black, and 27.4% white. As a standard clinic procedure, BP readings were obtained from the right arm with the subject seated. Comparisons of the average SBP by 3-year age groups, by sex, within the clinic population showed that blacks had higher SBPs than children with Spanish surnames or whites in all of the five male subgroups and in four of the five female subgroups. Black males had higher DBPs than Spanish or whites in four of the five subgroups; black females had higher DBPs in three of the five subgroups. In comparison with the standard population, the overall 95th percentile values for both SBP and DBP were lower. The prevalence of readings above the 95th percentile values reported for the standard population over all age groups was as follows: SBP, 1.53%; DBP, 1.60%; and both SBP and DBP, 0.57%. Proportionately, elevated readings were most common among blacks and least common among whites. However, these differences between ethnic groups could be accounted for statistically, to a great extent, by adjusting for height and weight, since blacks were the tallest and heaviest of the three groups. These results suggest that, even in childhood, blacks presenting at a primary care center have higher BPs than Spanish or whites, but that this differences is largely related to body size.