Key result
Blood pressure-to-height ratios accurately diagnosed (pre)hypertension in Nigerian adolescents with area under the curve values >0.92 and sensitivity and specificity >96%.
Why the study?
Does blood pressure-to-height ratio accurately diagnose (pre)hypertension in Nigerian adolescents?
Cross-Sectional (n=1,173)
Yes
Does blood pressure-to-height ratio accurately diagnose (pre)hypertension in Nigerian adolescents?
Effect estimate: AUC 0.925 to 1.000
p-value: p=<0.001
Blood pressure-to-height ratio is a simple, highly sensitive, and specific tool for diagnosing (pre)hypertension in Nigerian adolescents, though race-specific thresholds are required.
May support screening use in Nigerian adolescents; leaves open prospective validation and race-specific thresholds.
BACKGROUND: The age-, gender-, and height-percentile requirements of the 'gold-standard' for the diagnosis of (pre)hypertension in adolescents make it time-consuming for clinicians and difficult-to-use by non-professionals. Simplified diagnostic tools are therefore needed. The use of blood pressure-to-height ratio (BPHR)--systolic BPHR (SBPHR) and diastolic BPHR (DBPHR)--has been reported in Han adolescents, but it requires validation in other racial groups. The diagnostic accuracy of SBPHR and DBPHR in a population of 1,173 Nigerian adolescents aged 11-17 years, was therefore studied. METHODS: Blood pressures were measured using standard procedures and (pre)hypertension were defined according to international recommendations. ROC curve analyses were used to assess the diagnostic accuracy of BPHR in defining (pre)hypertension in this population. Sex-specific threshold values for SBPHR and DBPHR were determined, and thereafter used to define (pre)hypertension. The sensitivity/specificity of this method was determined. RESULTS: The accuracies of SBPHR and DBPHR in diagnosing (pre)hypertension, in both sexes, was > 92%. The optimal thresholds for diagnosing prehypertension were 0.72/0.46 in boys and 0.73/0.48 in girls; while for hypertension, they were 0.75/0.51 in boys and 0.77/0.50 in girls. The sensitivity and specificity of this method were > 96%. CONCLUSIONS: The use of BPHR is valid, simple and accurate in this population. Race-specific thresholds are however needed.
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Chukwunonso E.C.C. Ejike (2011) conducted a cross-sectional in Adolescent (pre)hypertension (n=1,173). Blood pressure-to-height ratio (BPHR) vs. Standard age-, gender-, and height-specific percentiles was evaluated on Diagnostic accuracy (AUC) of SBPHR and DBPHR for (pre)hypertension (AUC 0.925 to 1.000, p=<0.001). Blood pressure-to-height ratios accurately diagnosed (pre)hypertension in Nigerian adolescents with area under the curve values >0.92 and sensitivity and specificity >96%.
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