Geographical and ethnic variations significantly influence adolescent blood pressure distributions, highlighting the need for population-specific thresholds to prevent misdiagnosis of hypertension.
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Geographic BP differences in Hungarian adolescents may warrant local norms; leaves open whether population-specific thresholds improve hypertension classification accuracy.
OBJECTIVES: To describe the blood pressure characteristics and distribution of all adolescent high school students (aged 15-18 years) in Debrecen (total population 230 000), Hungary. To define threshold values for normal blood pressure by age-, sex- and height-specific groups. To compare our data with results from a USA meta-analysis, which forms the basis of current guidelines. PARTICIPANTS AND METHODS: All young people attending high school in Debrecen (final sample = 10 359) participated in the study. After they had rested for 10 min, three blood pressure measurements were taken from the right upper arm, separated by 5 min intervals. All measurements were obtained by a validated, automated, digital Omron M4 device. RESULTS: The 50th, 90th and 95th percentile values of blood pressure were defined by dividing the adolescent population into age-, sex- and height-specific subgroups. In comparison with USA guidelines, in our sample the systolic blood pressure of boys in the different subgroups was 6-11 mmHg greater, whereas this difference was less marked for girls (1-5 mmHg). There were no marked differences in diastolic blood pressure, but our values were slightly lower. CONCLUSIONS: Our findings demonstrate the influence of geographical and ethnic variations on blood pressure. Acceptance and use of non-population-specific blood pressure distributions may lead to under- or overdiagnosis of adolescent hypertension. The use of geographically more relevant data should be encouraged.
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Páll et al. (2003) studied this question.
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