Key result
Simplified blood pressure tables correctly identified all abnormal office blood pressure readings according to fourth report thresholds (kappa 0.72 for systolic, 0.92 for diastolic).
Why the study?
Do simplified office blood pressure thresholds accurately identify abnormal blood pressure for ambulatory blood pressure monitoring referral in children compared to fourth report thresholds?
Observational (n=155)
Do simplified office blood pressure thresholds accurately identify abnormal blood pressure for ambulatory blood pressure monitoring referral in children compared to fourth report thresholds?
Effect estimate: kappa 0.72 (95% CI 0.61 to 0.83)
Simplified blood pressure tables perform similarly to the fourth report thresholds for identifying abnormal blood pressure in children, serving as a useful screening tool for ambulatory blood pressure monitoring referral.
BACKGROUND: Recent studies have revealed that hypertension remains underdiagnosed in a significant number of children despite their recorded office blood pressure (OBP) exceeding the recommended fourth report OBP thresholds. Simplified OBP thresholds have been proposed to reduce this underdiagnosis of hypertension in children. In clinical practice, OBP screened as elevated according to the fourth report OBP thresholds are referred for ambulatory blood pressure (ABP) monitoring to rule out 'white coat' hypertension. OBJECTIVES: The present study tested the usefulness of simplified OBP thresholds to screen abnormal OBP for ABP monitoring referral. METHODS: A total of 155 subjects were retrospectively analyzed with paired OBP and ABP recordings obtained from an outpatient referral clinic. OBP recordings were classified as abnormal according to the simplified and fourth report OBP thresholds. ABP measurements were classified as abnormal according to the ABP reference tables. RESULTS: Simplified blood pressure (BP) tables correctly identified all OBP classified as abnormal according to fourth report BP thresholds (kappa [κ] 0.72 [95% CI 0.61 to 0.83]) for systolic OBP; κ 0.92 [95% CI 0.86 to 0.99] for diastolic OBP). OBP classified as abnormal by the simplified BP thresholds and by the fourth report BP thresholds performed similarly for correctly identifying abnormal ABP measurements as per ABP references (overlapping 95% CIs of the sensitivity, specificity and predictive values and likelihood ratios). CONCLUSIONS: Simplified BP tables, proposed to reduce the underdiagnosis of hypertension in children, can serve as a useful screening tool to decide a referral for ABP monitoring. Future prospective studies are needed to establish these findings.
No takes yet. Share an insight, caveat, or question.
Sharma et al. (2015) conducted an observational in childhood hypertension (n=155). Simplified blood pressure tables vs. Fourth report blood pressure thresholds was evaluated on Identification of abnormal systolic office blood pressure compared to fourth report thresholds (kappa 0.72, 95% CI 0.61 to 0.83). Simplified blood pressure tables correctly identified all abnormal office blood pressure readings according to fourth report thresholds (kappa 0.72 for systolic, 0.92 for diastolic).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: