Performance of eleven simplified methods for the identification of elevated blood pressure in children and adolescents

Chuanwei Ma, Roya Kelishadi, Young Mi Hong, Pascal Bovet, Anuradha Khadilkar, Tadeusz Nawarycz, Małgorzata Krzywińska-Wiewiorowska, Hajer Aounallah-Skhiri, Xin'nan Zong, Mohammad Esmaeil Motlagh, Hae Soon Kim, Vaman Khadilkar, Alicja Krzyzaniak, Habiba Ben Romdhane, Ramin Heshmat, Shashi Chiplonkar, Barbara Stawińska-Witoszyńska, Jalila El Ati, Mostafa Qorbani, Neha KajalePierre Traissac, Lidia Ostrowska-Nawarycz, Gelayol Ardalan, Lavanya Parthasarathy, Min Zhao, Bo Xi

Research output: Contribution to journalArticlepeer-review

29 Scopus citations

Abstract

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 7 countries. Data on BP were available for a total of 58 899 children and adolescents aged 6 to 17 years from 7 national surveys in China, India, Iran, Korea, Poland, Tunisia, and the United States. Performance of the simplified methods for screening elevated or high BP was assessed with receiver operating characteristic curve (area under the curve), sensitivity, specificity, positive predictive value, and negative predictive value. When pooling individual data from the 7 countries, all 11 simplified methods performed well in screening high BP, with high area under the curve values (0.84-0.98), high sensitivity (0.69-1.00), high specificity (0.87-1.00), and high negative predictive values (≥0.98). However, positive predictive value was low for most simplified methods, but reached ≈0.90 for each of the 3 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 3 methods performed best and may be most useful for screening purposes.

Original languageEnglish
Pages (from-to)614-620
Number of pages7
JournalHypertension
Volume68
Issue number3
DOIs
StatePublished - 1 Sep 2016

Bibliographical note

Publisher Copyright:
© 2016 American Heart Association, Inc.

Keywords

  • adolescents
  • children
  • epidemiology
  • high blood pressure
  • hypertension
  • methodology

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