Comparison of different screening methods for blood pressure disorders in children and adolescents

Mourato, Felipe Alves; Filho, J. L. Lima; Mattos, Sandra da Silva

doi:10.1016/j.jped.2014.08.008

Cited by 9 publications

(5 citation statements)

References 16 publications

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“…Second, interpretation of some results should be re-assessed. For example, in two validation studies, 22, 23 the authors mentioned that the simplified table by Kaelber et al 16 (which provides 64 BP cut-offs by age and sex) performed best, followed by the BPHR (which provides 4 cutoffs for systolic/diastolic BP in boys/girls) 19 . However, the positive predictive values (PPV) of both methods were lower (Kaelber et al: 16.1%; BPHR: 44.2%) than the simplified methods by Chiolero et al 18 (88.3%) and by Somu et al 14 (86.4%).…”

Section: Introductionmentioning

confidence: 99%

Performance of Eleven Simplified Methods for the Identification of Elevated Blood Pressure in Children and Adolescents

Kelishadi

Hong

et al. 2016

Hypertension

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The identification of elevated blood pressure (BP) in children and adolescents relies on complex percentile tables. The present study compares the performance of 11 simplified methods for assessing elevated or high BP in children and adolescents using individual-level data from seven countries. Data on BP were available for a total of 58,899 children and adolescents aged 6–17 years from seven national surveys in China, India, Iran, Korea, Poland, Tunisia and the USA. Performance of the simplified methods for screening elevated or high BP were assessed with receiver operating characteristic curve (area under the curve, AUC), sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV). When pooling individual data from the seven countries, all 11 simplified methods performed well in screening high BP, with high AUC values (0.84 to 0.98), high sensitivity (0.69 to 1.00), high specificity (0.87 to 1) and high NPV values (≥0.98). However, PPV was low for most simplified methods, but reached ~0.90 for each of the three methods including sex- and age- specific BP references (at the 95th percentile of height), the formula for BP references (at the 95th percentile of height), and the simplified method relying on a child’s absolute height. These findings were found independently of sex, age and geographical location. Similar results were found for simplified methods for screening elevated BP. In conclusion, all 11 simplified methods performed well for identifying high or elevated BP in children and adolescents, but three methods performed best, and may be most useful for screening purposes.

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Section: Introductionmentioning

confidence: 99%

Performance of Eleven Simplified Methods for the Identification of Elevated Blood Pressure in Children and Adolescents

Kelishadi

Hong

et al. 2016

Hypertension

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“…However, in Brazil, BP monitoring in pediatric age groups is still inadequate and does not cover a large proportion of young people, especially those belonging to the less favored social classes 6 . The reasons for the under-evaluation of BP are little studied, but could be related to the short duration of pediatric appointments, lack of equipment, especially appropriate cuffs for the arm circumference of young people, and the difficulty in interpreting BP values due to their complex classification criterion -based on percentile distribution according to age, gender, and height 7,8 .…”

Section: Introductionmentioning

confidence: 99%

Triagem da pressão arterial elevada em crianças e adolescentes de Amargosa, Bahia: utilidade de indicadores antropométricos de obesidade

Quadros

Gordia

Andaki

et al. 2019

Rev. bras. epidemiol.

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RESUMO: Objetivo: Determinar o poder preditivo do índice de massa corporal (IMC), perímetro da cintura (PC) e razão da cintura pela estatura (RCEst) e de seus respectivos pontos de corte para triagem de pressão arterial (PA) elevada em crianças e adolescentes brasileiros. Método: Estudo transversal realizado com1.139 escolares de 6 a 17 anos de idade. A massa corporal, a estatura, o PC e a PA foram mensurados. A PA elevada foi classificada como sistólica ou diastólica≥ percentil 95. Curvas Receiver Operating Characteristic (ROC) foram construídas e a área sob a curva, a sensibilidade e a especificidade foram calculadas. Resultados: A prevalência de PA elevada foi de 27,0%. Os indicadores antropométricos apresentaram associação significativa com PA elevada (acurácia variando de 0,62 - 0,81), exceto RCEst entre adolescentes do sexo masculino.Observou-se baixa sensibilidade, independentemente do indicador antropométrico, do sexo e da faixa etária. Conclusão: OIMC, o PC e a RCEst estiveram associados a PA elevada, porém os pontos de corte testados apresentaram baixa sensibilidade. A determinação de pontos de corte específicos para cada população pode viabilizar a triagem de PA elevada por meio de indicadores antropométricos.

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“…15, 16 However, these simplified methods are either still difficult to use or have low positive predictive values compared with the complex definition specific for sex, age and height percentiles. 17–19 …”

Section: Introductionmentioning

confidence: 99%

Can Pediatric Hypertension Criteria Be Simplified?

Zhang

et al. 2017

Hypertension

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Pre-hypertension and hypertension in childhood are defined by sex-, age- and height-specific 90th (or ≥120/80 mmHg) and 95th percentiles of blood pressure (BP), respectively, by the 2004 Fourth Report. However, these cut-offs are complex and cumbersome for use. This study assessed the performance of a simplified BP definition to predict adult hypertension and subclinical cardiovascular disease. The cohort consisted of 1,225 adults (530 males, aged 26.3–47.7 years) from the Bogalusa Heart Study with 27.1 years follow-up since childhood. We used 110/70 and 120/80 mmHg for children (age 6–11 years), and 120/80 and 130/85 mmHg for adolescents (age 12–17 years) as the simplified definition of childhood pre-hypertension and hypertension, respectively, to compare with the 2004 Fourth Report (the complex definition). Adult carotid intima-media thickness (CIMT), pulse wave velocity (PWV), and left ventricular mass were measured using digital ultrasound instruments. Compared to normal BP, childhood hypertensives diagnosed by the simplified definition and the complex definition were both at higher risk of adult hypertension with hazard ratio=3.1 (95% confidence interval=1.8–5.3) by the simplified definition and 3.2 (2.0–5.0) by the complex definition, high PWV with 3.5 (1.7–7.1) and 2.2 (1.2–4.1), high CIMT with 3.1 (1.7–5.6) and 2.0 (1.2–3.6), and left ventricular hypertrophy with 3.4 (1.7–6.8) and 3.0 (1.6–5.6). The results were confirmed by reclassification or receiver operating curve analyses. The simplified childhood BP definition predicts the risk of adult hypertension and subclinical cardiovascular disease equally as the complex definition does, which could be useful for screening hypertensive children to reduce risk of adult cardiovascular disease.

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Comparison of different screening methods for blood pressure disorders in children and adolescents

Cited by 9 publications

References 16 publications

Performance of Eleven Simplified Methods for the Identification of Elevated Blood Pressure in Children and Adolescents

Performance of Eleven Simplified Methods for the Identification of Elevated Blood Pressure in Children and Adolescents

Triagem da pressão arterial elevada em crianças e adolescentes de Amargosa, Bahia: utilidade de indicadores antropométricos de obesidade

Can Pediatric Hypertension Criteria Be Simplified?

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