Validity and reliability of 24h blood pressure monitoring in children and adolescents using a portable, oscillometric device.

Noninvasive 24h BP monitoring using portable devices is a new method for the diagnosis of arterial hypertension and for the control of antihypertensive therapy in adults. Recently, it is also used in juvenile hypertension. We now report on the validity and reliability of an oscillometric BP recorder (SpaceLabs 90207) widely used in children and adolescents. Single BP recordings with this monitor were compared with manual auscultation of Korotkoff sounds and with measurements by an other oscillometric device (Dinamap). SBP measured by the SpaceLabs monitor was 5 mmHg (2-10 mmHg, median and quartiles) higher than manual readings whereas there was no difference in DBP between these methods. With the Dinamap monitor, SBP was identical to manual readings but DBP was underestimated by 8.5 mmHg (1-13 mmHg). The 24h BP monitoring was performed in 101 children < 13 years of age and in 58 adolescents > 12 years of age. Seventy-eight per cent (64-89%) of all readings were complete in the younger probands and 91% (84-95%) in the older ones (P < 0.01). Measurements failed more often during daytime compared with nighttime in both groups. In conclusion, long-term BP monitoring using an oscillometric device is useful and reliable in adolescents and even in smaller children.