1. Multiple office blood pressure measurement: a novel approach to overcome the weak cornerstone of blood pressure measurement in children. Data from the SPA project
- Author
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Bertrand Tchana, Sandra Piantanida, Silvia Ghiglia, Tiziana Bollani, Michela Perrone, Sebastiano A. G. Lava, Antonella Mezzopane, Gianluigi Ardissino, Elena Dardi, Lucia Filippucci, Silvia Di Michele, Patrizia Salice, and Francesco L. De Luca
- Subjects
Male ,medicine.medical_specialty ,Percentile ,business.industry ,Office Visits ,Coefficient of variation ,030232 urology & nephrology ,Blood Pressure ,Blood Pressure Determination ,030204 cardiovascular system & hematology ,03 medical and health sciences ,0302 clinical medicine ,Blood pressure ,Nephrology ,Internal medicine ,Child, Preschool ,Pediatrics, Perinatology and Child Health ,medicine ,Cardiology ,Humans ,Female ,business ,Child ,White Coat Hypertension - Abstract
This contribution aims to report and analyze a novel approach for office blood pressure measurement in children. Healthy children 5 to 8 years of age were eligible. After 5 minutes rest, 10 unattended blood pressure readings were taken at 3-minute intervals using a validated automated oscillometric device. After discarding outlier values ( 95th percentile of the recorded values), the coefficient of variation and the mean of the 10 readings were calculated. The single readings #1 to #10 were compared with this elaborated average of the 10 measurements. Two hundred eighty-one healthy, non-obese children (137 females, 49%), median age 5.7 (IQR 5.3–6.1) years, were analyzed. The median coefficients of variation were 7% (IQR 5–9) for systolic and 4% (IQR 3–6) for diastolic blood pressure. The first 3 measurements were significantly different from the average, while the readings #4 to #10 were not. Based on the average, only nine subjects had a systolic or diastolic blood pressure > 90th centile (n = 3 > 95th percentile). Although most guidelines advise three blood pressure readings, these findings suggest that in children, office blood pressure measurement might be improved by including ten measurements. In situations of time constraints, the fourth blood pressure reading might be used as a reliable approximation.
- Published
- 2019