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Height-specific blood pressure cutoffs for screening elevated and high blood pressure in children and adolescents: an International Study

  • 주제(키워드) adolescents , children , epidemiology , high blood pressure , elevated blood pressure , methodology
  • 주제(기타) Peripheral Vascular Disease
  • 설명문(일반) [Hou, Yaping; Yang, Liu; Xi, Bo] Shandong Univ, Sch Publ Hlth, Dept Epidemiol, Jinan, Shandong, Peoples R China; [Bovet, Pascal; Chiolero, Arnaud] Lausanne Univ Hosp, Inst Social & Prevent Med IUMSP, Lausanne, Switzerland; [Kelishadi, Roya; Ardalan, Gelayol] Isfahan Univ Med Sci, Res Inst Primordial Prevent Non Communicable Dis, Child Growth & Dev Res Ctr, Dept Pediat, Esfahan, Iran; [Litwin, Mieczyslaw] Childrens Mem Hlth Inst, Dept Nephrol & Arterial Hypertens, Warsaw, Poland; [Khadilkar, Anuradha; Khadilkar, Vaman; Chiplonkar, Shashi; Kajale, Neha; Parthasarathy, Lavanya] Jehangir Hosp, Hirabai Cowasji Jehangir Med Res Inst, Growth & Endocrine Unit, Pune, Maharashtra, India; [Hong, Young Mi; Kim, Hae Soon] Ewha Womans Univ, Dept Pediat, Sch Med, Seoul, South Korea; [Nawarycz, Tadeusz; Ostrowska-Nawarycz, Lidia] Med Univ Lodz, Dept Biophys, Chair Expt & Clin Physiol, Lodz, Poland; [Stawinska-Witoszynska, Barbara; Krzyzaniak, Alicja; Krzywinska-Wiewiorowska, Malgorzata] Poznan Univ Med Sci, Dept Epidemiol, Poznan, Poland; [Aounallah-Skhiri, Hajer] Natl Inst Publ Hlth INSP, Nutr Surveillance & Epidemiol Tunisia SURVEN Res, Tunis 1002, Tunisia; [Motlagh, Mohammad Esmaeil] Ahvaz Jundishapur Univ Med Sci, Dept Pediat, Ahwaz, Iran; [Ben Romdhane, Habiba] Univ Tunis El Manar, Res Lab, Cardiovasc Epidemiol & Prevent, Fac Med, Tunis, Tunisia; [Heshmat, Ramin] Univ Tehran Med Sci, Endocrinol & Metab Populat Sci Inst, Chron Dis Res Ctr, Dept Epidemiol, Tehran, Iran; [El Ati, Jalila] Natl Inst Nutr & Food Technol, Nutr Surveillance & Epidemiol Unit SURVEN, Tunis, Tunisia; [Qorbani, Mostafa] Alborz Univ Med Sci, Dept Epidemiol, Noncommunicable Dis Res Ctr, Karaj, Iran; [Traissac, Pierre] IRD, UMR NUTRIPASS IRD UM SupAgro, Montpellier, France; [Zhao, Min] Shandong Univ, Sch Publ Hlth, Dept Nutr & Food Hyg, Jinan, Shandong, Peoples R China; [Chiolero, Arnaud] Univ Bern, Inst Primary Hlth Care BIHAM, Bern, Switzerland; [Chiolero, Arnaud] McGill Univ, Dept Epidemiol, Montreal, PQ, Canada
  • 등재 SCIE, SCOPUS
  • 발행기관 NATURE PUBLISHING GROUP
  • 발행년도 2019
  • URI http://www.dcollection.net/handler/ewha/000000159804
  • 본문언어 영어
  • Published As http://dx.doi.org/10.1038/s41440-018-0178-2
  • PubMed https://pubmed.ncbi.nlm.nih.gov/30587855

초록/요약

Pediatric blood pressure (BP) reference tables are generally based on sex, age, and height and tend to be cumbersome to use in routine clinical practice. In this study, we aimed to develop a new, height-specific simple BP table according to the international child BP reference table based on sex, age and height and to evaluate its performance using international data. We validated the simple table in a derivation cohort that included 58,899 children and adolescents aged 6-17 years from surveys in 7 countries (China, India, Iran, Korea, Poland, Tunisia, and the United States) and in a validation cohort that included 70,072 participants from three other surveys (China, Poland and Seychelles). The BP cutoff values for the simple table were calculated for eight height categories for both the 90th ("elevated BP") and 95th ("high BP") percentiles of BP. The simple table had a high performance to predict high BP compared to the reference table, with high values (boys/girls) of area under the curve (0.94/0.91), sensitivity (88.5%/82.9%), specificity (99.3%/99.7%), positive predictive values (93.9%/97.3%), and negative predictive values (98.5%/97.8%) in the pooled data from 10 studies. The simple table performed similarly well for predicting elevated BP. A simple table based on height only predicts elevated BP and high BP in children and adolescents nearly as well as the international table based on sex, age, and height. This has important implications for simplifying the detection of pediatric high BP in clinical practice.

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