Blood pressure-to-height ratio as a screening indicator of elevated blood pressure among children and adolescents in Chongqing, China

Abstract

We aimed to evaluate the performance of blood pressure-to-height ratio (BPHR) and establish their optimal thresholds for elevated blood pressure (BP) among children aged 6 to 17 years in Chongqing, China. Data were collected from 11 029 children and adolescents aged 6-17 years in 12 schools in Chongqing according to multistage stratified cluster sampling method. The gold standard for elevated BP was defined as systolic blood pressure (SBP) and/or diastolic blood pressure (DBP) ⩾95th percentile for gender, age and height. The diagnostic performance of systolic BPHR (SBPHR) and diastolic BPHR (DBPHR) to screen for elevated BP was evaluated through receiver-operating characteristic curves (including the area under the curve (AUC) and its 95% confidence interval, sensitivity and specificity). The prevalence of elevated BP in children and adolescents in Chongqing was 10.36% by SBP and/or DBP ⩾95th percentile for gender, age and height. The optimal thresholds of SBPHR/DBPHR for identifying elevated BP were 0.86/0.58 for boys and 0.85/0.57 for girls among children aged 6 to 8 years, 0.81/0.53 for boys and 0.80/0.52 for girls among children aged 9 to 11 years and 0.71/0.45 for boys and 0.72/0.47 for girls among adolescents aged 12-17 years, respectively. Across gender and the specified age groups, AUC ranged from 0.82 to 0.88, sensitivity were above 0.94 and the specificities were over 0.7. The positive predictive values ranged from 0.30 to 0.38 and the negative predictive values were ⩾0.99. BPHR, with uniform values across broad age groups (6-8, 9-11 and 12-17 years) for boys and for girls is a simple indicator to screen elevated BP in children and adolescents in Chongqing.

Body Mass Index and Blood Pressure-to-Height Ratio in Predicting Incidence of Hypertension in Serbian Children

“…This study showed that BPHR ratios are a simple and accurate method of diagnosing high values of blood pressure. The findings are in agreement with the previous studies on this matter [8,[11][12][13][14][15]28], which demonstrated the feasibility and accuracy of the SBPHR and DBPHR for screening elevated BP/HTN. The optimal cutoffs of SBPHR for defining elevated BP were 0.79 for boys and 0.80 for girls, and for defining HTN were 0.83 for boys and 0.82 for girls.…”

“…Recently, Lu et al [11] developed a novel criterion, using ratios of systolic BP to height and diastolic BP to height to identify HBP. Since then, this new criterion has been used in several studies in the world [12][13][14][15] demonstrating high specificity and sensitivity from cutoff points determined by receiver operating characteristic (ROC) curves.…”