Absolute height-specific thresholds to identify elevated blood pressure in children

J Hypertens. 2013 Jun;31(6):1170-4. doi: 10.1097/HJH.0b013e32836041ff.

Abstract

Objective: Identification of children with elevated blood pressure (BP) is difficult because of the multiple sex, age, and height-specific thresholds to define elevated BP. We propose a simple set of absolute height-specific BP thresholds and evaluate their performance to identify children with elevated BP in two different populations.

Methods: Using the 95th sex, age, and relative-height BP US thresholds to define elevated BP in children (standard criteria), we derived a set of (non sex- and non age-specific) absolute height-specific BP thresholds for 11 height categories by 10 cm increments. Using data from large school-based surveys conducted in Switzerland (N = 5207; 2621 boys, 2586 girls; age range: 10.1-14.9 years) and in the Seychelles (N = 25 759; 13 048 boys, 12 711 girls; age range: 4.4-18.8 years), we evaluated the performance of these height-specific thresholds to identify children with elevated BP. We also derived sex-specific absolute height-specific BP thresholds and compared their performance.

Results: In the Swiss and the Seychelles surveys, the prevalence of elevated BP (standard criteria) was 11.4 and 9.1%, respectively. The height-specific thresholds to identify elevated BP had a sensitivity of 80 and 84%, a specificity of 99 and 99%, a positive predictive value of 92 and 91%, and a negative predictive value of 97 and 98%, respectively. Performance of sex-specific absolute height-specific BP thresholds was similar.

Conclusion: A simple table of height-specific BP thresholds allowed identifying children with elevated BP with high sensitivity and excellent specificity.

MeSH terms

  • Adolescent
  • Blood Pressure
  • Body Height
  • Child
  • Child, Preschool
  • Female
  • Humans
  • Hypertension / diagnosis*
  • Hypertension / epidemiology
  • Male
  • Reference Standards
  • Seychelles / epidemiology
  • Switzerland / epidemiology
  • Young Adult