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Utility of blood pressure measurements at an initial screening visit to identify Chinese children and adolescents with hypertension

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Duan, Y, Sun, J, Zhao, M, Magnussen, CG ORCID: 0000-0002-6238-5730 and Xi, B 2021 , 'Utility of blood pressure measurements at an initial screening visit to identify Chinese children and adolescents with hypertension' , Journal of Clinical Hypertension, vol. 23, no. 4 , pp. 766-772 , doi: 10.1111/jch.14127.

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Abstract

The performance of different BP readings and their combinations at a visit to identify children and adolescents with pediatric hypertension remains controversial. We aimed to assess the utility of different blood pressure (BP) readings and their combinations obtained at the initial screening visit for identifying Chinese children and adolescents with hypertension. Participants were 7831 children and adolescents aged 6-17 years measured as part of a cross-sectional survey conducted in Jinan, China between September 2012 and November 2014. BP was measured three times at up to three visits. Elevated BP at the initial visit was defined as systolic BP and/or diastolic BP ≥ age- and sex-specific 95th percentiles using the Chinese BP references for children and adolescents based on different BP readings and their combinations. Participants with elevated BP using (BP2+BP3)/2 across three visits were defined as having hypertension. Of the different readings or combinations examined, the mean of the last two readings at the initial visit had the best predictive utility for children and adolescents with hypertension (sensitivity: 100.0%; specificity: 86.9%; positive predictive value: 27.6%; negative predictive value: 100.0%). This was also reflected in the area under the curve being highest for the mean of the last two readings (0.93, 95% confidence interval: 0.93-0.94) compared with any of the other readings or combinations (BP1, BP2, BP3, [BP1+BP2]/2, [BP1+BP3]/2, and [BP1+BP2+BP3]/3; all p < .001). Taking three measurements of BP and using the average of the last two readings at a screening visit may be optimal for the identification of hypertension in youth.

Item Type: Article
Authors/Creators:Duan, Y and Sun, J and Zhao, M and Magnussen, CG and Xi, B
Keywords: blood pressure measurements, hypertension, pediatrics, screening
Journal or Publication Title: Journal of Clinical Hypertension
Publisher: Wiley Periodicals Inc.
ISSN: 1524-6175
DOI / ID Number: 10.1111/jch.14127
Copyright Information:

© 2021 The Authors. The Journal of Clinical Hypertension published by Wiley Periodicals LLC. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0) License, (https://creativecommons.org/licenses/by-nc/4.0/) which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

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