Objective-To define the range and variability of ambulatory blood pressure in normal schoolchildren. Design-Prospective study. Methods-Resting blood pressure of 1121 schoolchildren from Newcastle upon Tyne was recorded. An ambulatory blood pressure device, which uses both auscultatory (KorotkoV) and oscillometric methods of blood pressure measurement, was then put in place for 24 hours. Results-The day was divided into three time periods: school, home, and night time. Normal centiles for blood pressure for each of these time periods were obtained and many daytime readings were outside reported normal resting levels. The normal variation of blood pressure was quantified by comparing each of these time periods with the resting readings. Resting systolic blood pressure did not predict 24 hour mean systolic blood pressure. Conclusions-The availability of normal ambulatory blood pressure data on the level and variation of blood pressure in children may facilitate the early identification of hypertension in this age group. (Arch Dis Child 1999;80:529-532)
The purpose of this study was to assess the accuracy of an ambulatory monitor (Takeda 2421; A&D company) which measures blood pressure using oscillometric and Korotkoff methods, in children. Blood pressure was measured simultaneously by the device and two observers in 529 children aged 7-15 years. The Korotkoff method received BHS grade A for sitting and standing readings in all age groups except for age 13-15 years (grade C). The diastolic readings (phase V) received grade B for sitting and C when standing. The oscillometric method received grade C or worse for systolic and diastolic blood pressure in both sitting and standing positions except for systolic readings in those aged 13-15 years (grade B). During the ambulatory phase 30% of the Korotkoff readings and 4% of the oscillometric readings gave an error code. The Takeda 2421 ambulatory monitor achieved generally satisfactory grades using the Korotkoff system but the oscillometric readings were generally unacceptable. Ambulatory devices should be specifically validated in children before being accepted into clinical paediatric practice.
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