Simplified blood pressure tables based on different height percentiles for screening elevated blood pressure in children.

TitreSimplified blood pressure tables based on different height percentiles for screening elevated blood pressure in children.
Publication TypeJournal Article
Year of Publication2019
AuthorsYang, L, Hou, Y, Zhao, M, Bovet, P, Xi, B
JournalJournal of hypertension
Volume37
Issue2
Pagination292-296
Date Published02/2019
DOI10.1097/HJH.0000000000001880
ISSN1473-5598
Abstract

OBJECTIVE: In 2017, the American Academy of Pediatrics (AAP) updated its clinical practice guideline for screening and management of high blood pressure (BP) in children. In addition, the AAP guideline also recommended a simplified BP table for screening purposes in children aged 1-12 years, which was based on the fifth height percentile. The aim of this study was to assess the performance of the simplified AAP table and six other simplified tables across different height percentiles in predicting elevated BP in US children.

METHODS: We included 6816 children aged 8-12 years in the National Health and Nutrition Examination Survey (NHANES) in 1999-2016 and 3145 children aged 5-12 years in the NHANES III in 1988-1994. Apart from the AAP simplified table at fifth height percentile, we generated sex and age-specific BP tables to predict elevated BP at the 10th, 25th, 50th, 75th, 90th and 95th percentiles of height, respectively, based on the reference AAP guideline.

RESULTS: In NHANES 1999-2016, with the height percentile increasing (5th-95th), positive predictive value (PPV) substantially increased (46.9 to 94.0%), while negative predictive value (NPV) slightly decreased (100 to 96.7%); specificity increased (84.4 to 99.3%) while sensitivity decreased (99.9 to 75.7%). The results were similar in NHANES III.

CONCLUSION: The simplified AAP table could be necessary in clinical practice to avoid omitting any true positive case, but a simplified and more efficient table at a higher height percentile could be more suitable in settings such as school screening programs by nonpaediatricians.

Alternate URL

http://www.ncbi.nlm.nih.gov/pubmed/30067249?dopt=Abstract

First publication date (online)

07/2018

Alternate JournalJ. Hypertens.
Citation Key / SERVAL ID9031
Peer reviewRefereed
PubMed ID30067249
                         

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