Key result
Blood-pressure-to-height ratios showed good sensitivity for identifying pediatric hypertension compared to standard tables, but yielded low positive predictive values and high false-positive rates.
Why the study?
Simplified blood pressure screening methods could facilitate primary care routine and increase adherence to pediatric hypertension guidelines.
Do blood-pressure-to-height ratios accurately identify high blood pressure in children and adolescents compared to standard tables?
Do blood-pressure-to-height ratios accurately identify high blood pressure in children and adolescents compared to standard tables?
Blood-pressure-to-height ratios require further improvement and validation before routine clinical use for pediatric hypertension screening due to high false-positive rates.
High false-positive rates advise against routine use of blood-pressure-to-height ratios; leaves open need for refined thresholds after prospective pediatric validation.
Simplified methods of blood pressure screening could facilitate the clinical routine of the primary care physicians and may increase adherence to pediatric hypertension guidelines. Blood-pressure-to-height ratios are appealing for the simplicity of data needed to evaluate a child's blood pressure status, including only office blood pressure values and height. In several epidemiological studies around the world blood-pressure-to-height ratios showed good predictive power in identifying children with high blood pressure in terms of area under the curve and sensitivity compared to the gold standard National High Blood Pressure Education Program blood pressure tables, but low positive predictive values meaning a high rate of false-positive cases and possibly increased subsequent work load for primary physicians. Finally, blood-pressure-to height ratios seem to be dependent to age, sex, and weight status. In conclusion, blood-pressure-to-height ratios need to be further improved and validated in different pediatric populations before routine clinical use.
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Stabouli et al. (2020) conducted a review in pediatric hypertension. Blood-pressure-to-height ratios vs. National High Blood Pressure Education Program blood pressure tables was evaluated on predictive power in identifying children with high blood pressure. Blood-pressure-to-height ratios showed good sensitivity for identifying pediatric hypertension compared to standard tables, but yielded low positive predictive values and high false-positive rates.
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