Blood Pressure over Height Ratios: Simple and Accurate Method of Detecting Elevated Blood Pressure in Children

Galescu, Ovidiu; George, Minu; Basetty, Sudhakar; Predescu, I; Mongia, Anil; Ten, Svetlana; Bhangoo, Amrit

doi:10.1155/2012/253497

Cited by 41 publications

(46 citation statements)

References 14 publications

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“…In the current study, the higher sensitivities and specificities of the BPHR in identifying HTN in comparison with pre-HTN were in agreement with previous studies and confirmed the better ability of the test for identifying hypertensives versus pre-hypertensives. Also, the higher sensitivity than specificity across all categories of HTN and pre-HTN in both sexes supported previous findings 12, 27,30,33,34 . This matches the purpose of this screening index, as it is desirable to have a low rate of false negative subjects who may miss diagnosis than to have a low rate of false positives who can be further excluded.…”

Section: Discussionsupporting

confidence: 89%

“…These results were consistent with those of previous studies conducted in various countries 12,27,32 . However a relatively higher discriminating power has been documented in a previous study (ranging from 0.95 to 0.99) where authors have analysed all children with BP >90 th percentile for age and sex as one group, and didn't differentiate between pre-HTN and HTN 33 . The higher accuracy of the ROC curves in discriminating HTN compared to pre-HTN was similar to findings in similar studies, where AUC values increased with the degree of HTN in children and adolescents 24,30,34 .…”

Section: Discussionmentioning

confidence: 81%

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Accuracy of blood pressure-to-height ratio for screening elevated blood pressure in Egyptian adolescents aged 11-15 years

2018

The Egypt. J. of Community Medicine

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Objective: This study aims to validate measures of blood pressure-to-height ratios (BPHR) in screening for elevated blood pressure (EBP) in a sample of the Egyptian adolescence aged 11-15 years.Methods: A cross sectional study was conducted on a sample of 1707 students aged 11-15 years. Elevated blood pressure was defined according to the international gold standard definition. Systolic and diastolic BPHR (SBPHR and DBPHR) were calculated for boys and girls, and their ability to identify EBP has been determined by the area under the curve of the receiver operator characteristic curves. Sex-specific optimal cut-off points were determined along the curve, and their sensitivity, specificity, positive and negative predictive values (PPVs, and NPVs), and positive and negative likelihood ratios (LR+, and LR-) were estimated. Results: The accuracy of SBPHR and DBPHR in diagnosing EBP in both sexes ranged from 0.906 to 0.981. For diagnosing systolic and diastolic pre-hypertension (pre-HTN), the optimal cut-off points were: 0.69, 0.44 in boys, and 0.71, 0.46 in girls respectively. For diagnosing systolic and diastolic hypertension (HTN), the corresponding values were 0.75, 0.49, and 0.75, 0.50 respectively. These determined cut-off points revealed high sensitivity (0.88-1.00), moderate to high specificity (0.77-0.95), high NPVs (0.99-1.00), low PPVs (0.15-0.38), and variable likelihood ratio values (LR+: 3.8-20.0, and LR-: 0.0-.36.0).Conclusion: Blood pressure-to-height ratios are considered of high accuracy in identifying pre-HTN and HTN in the Egyptian adolescents aged 11-15 years. Further research is needed for examining the performance of the BPHR in other age groups, in high risk adolescents, and for examining the performance of modified ratios.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 81%

Accuracy of blood pressure-to-height ratio for screening elevated blood pressure in Egyptian adolescents aged 11-15 years

2018

The Egypt. J. of Community Medicine

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“…These results are consistent with previous studies which stated that BPHR was not associated with age and height. 1,2,23,24 Thus, BPHR is simpler to use than the gold standard NHBPEP tables.…”

Section: Discussionmentioning

confidence: 99%

Blood pressure-to-height ratio for diagnosing hypertension in adolescents

Ambarita

Ramayani

Lubis

et al. 2017

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“…8 Thus, the need for a simple, inexpensive, and acceptable tool for detecting hypertension in children was urgent. The BPHR index was suggested as a simple and accurate index for identifying childhood hypertension in a local area of China 9 and has been replicated in Italian, 13 Nigerian, 14 US, 15 and Iranian children. 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.…”

Section: Discussionmentioning

confidence: 99%

Hypertension Screening Using Blood Pressure to Height Ratio

Zhang

et al. 2014

Pediatrics

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WHAT'S KNOWN ON THIS SUBJECT:The definition of hypertension in children is complex because of the age-, gender-, and heightspecific blood pressure algorithm. Blood pressure to height ratio was reported to easily identify hypertension in Chinese children living in a local area (Hebei Province). WHAT THIS STUDY ADDS:Blood pressure to height ratio index is simple and accurate for screening for prehypertension and hypertension in Chinese children aged 6 to 17 years and can be used for early screening or treating Chinese children with hypertension.abstract OBJECTIVES: The definition of hypertension in children is too complex to be used by medical professionals and children and their parents because of the age-, gender-, and height-specific blood pressure (BP) algorithm. The aim of this study was to simplify the pediatric BP percentile references using BP to height ratio (BPHR, equal to BP/height) for screening for prehypertension and hypertension in Chinese children.METHODS: Data were obtained from the China Health and Nutrition Survey, which was conducted from 1991 to 2009 and included 11 661 children aged 6 to 17 years with complete data on age, gender, height, and BP values. Receiver operating characteristic curve analysis was performed to assess the performance of systolic BPHR (SBPHR) and diastolic BPHR (DBPHR) for screening for pediatric prehypertension and hypertension. RESULTS:The optimal thresholds for defining prehypertension were 0.81 in children aged 6 to 11 years and 0.70 in adolescents aged 12 to 17 years for SBPHR and 0.52 in children and 0.46 in adolescents for DBPHR, respectively. The corresponding values for hypertension were 0.84, 0.78, 0.55, and 0.50, respectively. The negative predictive values were much higher (all $99%) for prehypertension and hypertension, although the positive predictive values were relatively lower, ranging from 13% to 75%.CONCLUSIONS: BPHR index is simple and accurate for screening for prehypertension and hypertension in Chinese children aged 6 to 17 years and can be used for early screening or treating Chinese children with hypertension. Pediatrics 2014;134:e106-e111 5 This report defined pediatric hypertension as systolic/diastolic blood pressure (SBP/DBP) above the 95th percentile specific to age, gender, and height. 5 These diagnostic criteria are widely used in epidemiologic surveys and clinical practice. In China, 2 diagnostic criteria for childhood hypertension have been established recently, which also used the similar BP algorithm. 6,7 This algorithm is too complex to be applied in clinical practice, and it is even more difficult for use by nonmedical professionals or children and their parents or guardians. In addition, hypertension in children is usually underdiagnosed in the outpatient clinics, mainly because of the complexity of the BP algorithm. 8 Therefore, a simple and accurate screening method to identify childhood hypertension is urgently needed. In 2011, Lu et al 9 first reported that BP to height ratio (BPHR) can easily and accurately identify hypertens...

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Blood Pressure over Height Ratios: Simple and Accurate Method of Detecting Elevated Blood Pressure in Children

Cited by 41 publications

References 14 publications

Accuracy of blood pressure-to-height ratio for screening elevated blood pressure in Egyptian adolescents aged 11-15 years

Accuracy of blood pressure-to-height ratio for screening elevated blood pressure in Egyptian adolescents aged 11-15 years

Blood pressure-to-height ratio for diagnosing hypertension in adolescents

Hypertension Screening Using Blood Pressure to Height Ratio

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