Performance of blood pressure-to-height ratio at a single screening visit for the identification of hypertension in children.

TitrePerformance of blood pressure-to-height ratio at a single screening visit for the identification of hypertension in children.
Publication TypeJournal Article
Year of Publication2014
AuthorsOutdili, Z, Marti-Soler, H, Simonetti, GD, Bovet, P, Paccaud, F, Burnier, M, Paradis, G, Chiolero, A
JournalJournal of Hypertension
Pagination1068-74; discussion 1074
Date Published05/2014
ISBN Number1473-5598 (Electronic)
Mots-clésblood pressure-to-height ratio, children, Hypertension, screening

BACKGROUND: The diagnosis of hypertension in children is difficult because of the multiple sex-, age-, and height-specific thresholds to define elevated blood pressure (BP). Blood pressure-to-height ratio (BPHR) has been proposed to facilitate the identification of elevated BP in children.

OBJECTIVE: We assessed the performance of BPHR at a single screening visit to identify children with hypertension that is sustained elevated BP.

METHOD: In a school-based study conducted in Switzerland, BP was measured at up to three visits in 5207 children. Children had hypertension if BP was elevated at the three visits. Sensitivity, specificity, negative predictive value (NPV), and positive predictive value (PPV) for the identification of hypertension were assessed for different thresholds of BPHR. The ability of BPHR at a single screening visit to discriminate children with and without hypertension was evaluated with receiver operating characteristic (ROC) curve analyses.

RESULTS: The prevalence of systolic/diastolic hypertension was 2.2%. Systolic BPHR had a better performance to identify hypertension compared with diastolic BPHR (area under the ROC curve: 0.95 vs. 0.84). The highest performance was obtained with a systolic BPHR threshold set at 0.80 mmHg/cm (sensitivity: 98%; specificity: 85%; PPV: 12%; and NPV: 100%) and a diastolic BPHR threshold set at 0.45 mmHg/cm (sensitivity: 79%; specificity: 70%; PPV: 5%; and NPV: 99%). The PPV was higher among tall or overweight children.

CONCLUSION: BPHR at a single screening visit had a high performance to identify hypertension in children, although the low prevalence of hypertension led to a low PPV.


Publication types: Journal Article ; Research Support, Non-U.S. Gov't Publication Status: ppublish PDF : Original article



Alternate JournalJ. Hypertens.
Citation Key / SERVAL ID1779
Peer reviewRefereed
PubMed ID24625656


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