Gianluigi Ardissino1, Silvia Ghiglia2, Patrizia Salice2, Michela Perrone3, Sandra Piantanida4, Francesco L De Luca5, Silvia Di Michele6, Lucia Filippucci7, Elena R A Dardi8, Tiziana Bollani8, Antonella Mezzopane8, Bertrand Tchane9, Sebastiano A G Lava10,11,12. 1. Pediatric Nephrology, Dialysis and Transplantation Unit - Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy. 2. Pediatric Cardiology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy. 3. Neonatology and Neonatal Intensive Care Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy. 4. Unità operativa Cardiologia ad Indirizzo Pediatrico, Polo Materno-Infantile, Varese, Italy. 5. Unità operativa semplice di Cardiologia Pediatrica, Policlinico Universitario, Messina, Italy. 6. Unità operativa complessa Pediatria Medica, Ospedale di Pescara, Pescara, Italy. 7. Unità operativa Cardiologia Riabilitativa e Prevenzione Patologie Cardiovascolari, USL Umbria1, Perugia, Italy. 8. Pediatric Practicioner, Milan, Italy. 9. Pediatric Cardiology Unit, General and University Hospital, Parma, Italy. 10. Pediatric Nephrology, Dialysis and Transplantation Unit - Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy. webmaster@sebastianolava.ch. 11. Pediatric Cardiology Unit, Department of Pediatrics, Lausanne University Hospital and University of Lausanne, 1011, Lausanne, Switzerland. webmaster@sebastianolava.ch. 12. Division of Clinical Pharmacology and Toxicology, Institute of Pharmacological Sciences of Southern Switzerland, Ente Ospedaliero Cantonale, Lugano, Switzerland. webmaster@sebastianolava.ch.
Abstract
BACKGROUND: This contribution aims to report and analyze a novel approach for office blood pressure measurement in children. METHODS: 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 (< 5th or > 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. RESULTS: 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). CONCLUSIONS: 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.
BACKGROUND: This contribution aims to report and analyze a novel approach for office blood pressure measurement in children. METHODS: 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 (< 5th or > 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. RESULTS: Two hundred eighty-one healthy, non-obesechildren (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). CONCLUSIONS: 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.
Authors: Maristella Santi; Sebastiano A G Lava; Giacomo D Simonetti; Andreas Stettbacher; Mario G Bianchetti; Franco Muggli Journal: Swiss Med Wkly Date: 2016-08-21 Impact factor: 2.193
Authors: José R Banegas; Luis M Ruilope; Alejandro de la Sierra; Ernest Vinyoles; Manuel Gorostidi; Juan J de la Cruz; Gema Ruiz-Hurtado; Julián Segura; Fernando Rodríguez-Artalejo; Bryan Williams Journal: N Engl J Med Date: 2018-04-19 Impact factor: 91.245
Authors: Karen C Johnson; Paul K Whelton; William C Cushman; Jeffrey A Cutler; Gregory W Evans; Joni K Snyder; Walter T Ambrosius; Srinivasan Beddhu; Alfred K Cheung; Lawrence J Fine; Cora E Lewis; Mahboob Rahman; David M Reboussin; Michael V Rocco; Suzanne Oparil; Jackson T Wright Journal: Hypertension Date: 2018-03-12 Impact factor: 10.190