How to simplify the diagnostic criteria of hypertension in adolescents

Abstract

Diagnosis of hypertension in adolescents is complicated because blood pressure values vary with age, gender and height. How can we simplify the diagnostic criteria for hypertension in adolescents? In 2006, anthropometric measurements were assessed in a cross-sectional population-based study of 3136 Han adolescents aged 13-17 years. Hypertension was defined according to the 2004 National High Blood Pressure Education Program Working Group definition. The following equations for blood pressure-to-height ratio (BPHR) were used: systolic BPHR (SBPHR) ¼ SBP (mm Hg)/height (cm) and diastolic BPHR (DBPHR) ¼ DBP (mm Hg)/height (cm). Receiver-operating characteristic curve analyses were performed to assess the accuracy of SBPHR and DBPHR as diagnostic tests for elevated systolic blood pressure (SBP) and diastolic blood pressure (DBP), respectively. After the cutoff points were determined, hypertension was defined by SBPHR/ DBPHR, and the sensitivity and specificity were calculated. The accuracy of SBPHR and DBPHR (assessed by area under the curve) for identifying elevated SBP and DBP was 40.85 (0.989-1.000). The optimal thresholds of SBPHR/DBPHR for defining hypertension (stages 1 and 2) were 0.75/0.48 for boys and 0.78/0.51 for girls, and for defining hypertension (stage 2) were 0.81/0.57 for boys and 0.84/0.63 for girls. In identifying hypertension, the sensitivity and specificity were both 490% (91.0-99.1%). In identifying stage 2 hypertension, when the sensitivity was 100%, the specificity was 98.6% for boys and 99.1% for girls. BPHR is a simple, accurate and nonage-dependent index for screening hypertension in Han adolescents, especially for stage 2 hypertension.

Hypertension Screening Using Blood Pressure to Height Ratio

“…16 The BPHR index, standardized for height, is strongly and positively associated with SBP and DBP but is not related to age, so it is not dependent on height or age. 9 Our results confirmed the previous findings and established nationwide cutoffs for the BPHR index for detecting hypertension in Chinese children.…”

Evaluation of blood pressure/height ratio as an index to simplify diagnostic criteria of hypertension in Caucasian adolescents

“…The population we studied was comparable for age and anthropometric parameters with the Chinese sample by Lu and co-workers 1 . As in Chinese population, we found stage 1 hypertension to be more common, whereas, the prevalence of hypertension was higher in our population (15 vs 6%).…”

“…In a recent issue of this journal, Lu and co-workers 1 found that blood pressure/height ratio (BPHR) was a simple and accurate index for screening hypertension in Han adolescents. However, they suggested that this index had to be validated in other ethnic groups.…”

Study of body mass index, waist-to-hip ratio, systolic blood pressure-to-height ratio, and diastolic blood pressure-to-height ratio among prehypertensive and normotensive students

“…[14] Different cutoff for SBPHR as 0.73 in males and 0.71 in females, for DBPHR as 0.47, 0.48 in males and 0.45, 0.46 in females were taken. [14] Some other cutoff as per one Chinese study [15] for SBPHR as 0.75, 0.81 in males and 0.78, 0.84 in females, for DBPHR as 0.48, 0.57 in males and 0.51, 0.63 in females were also taken. For all these cutoffs, sensitivity and specificity were calculated.…”

“…[14] The optimal thresholds of SBPHR/DBPHR for defining HTN (stage I) were 0.75/0.48 for boys and 0.78/0.51 for girls, and for defining HTN (stage II) were 0.81/0.57 for boys and 0.84/0.63 for girls. [15] Aims and Objectives of Study 1. To study BMI in pre-hypertensive and normotensive medical students 2.…”