The implementation of a simple graphical representation of a child’s BP percentile similar to growth charts currently used for height, weight, BMI, and head circumference would improve and streamline pediatric primary care. The American Academy of Pediatrics has endorsed NHLBI guidelines that recommend all children over 3 years of age have BP measured at least annually for early recognition of BP abnormalities such as hypertension or syncope, although studies have shown this screening is rarely done in children. Often these tables are used incorrectly or not at all. Instead complex BP tables consisting of 476 threshold blood pressure values are used to lookup the BP percentile for a child. While BP tracks with growth in children, similar to anthropometric measurements such as height and weight, it is not currently charted in the same way using growth charts. While adult blood pressure thresholds are static, 140/90 mmHg for hypertension and 90/60 mmHg for hypotension, each child has his/her own BP thresholds based on gender, age, and height percentile. 2004 114(2 Suppl 4th Report):555–76.Recognizing blood pressure (BP) abnormalities in children is more cumbersome than in adults and contributes to underdiagnoses in pediatrics. The fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents. Office-based interventions for recognizing abnormal pediatric blood pressures. Incidence and recognition of elevated triage blood pressure in the pediatric emergency department. Ricke TL, Hendry PL, Kalynych C, Buzaianu EM, Kumar V, Redfield C. Underdiagnosis of hypertension in children and adolescents. Why pediatricians fail to diagnose hypertension: a multicenter survey. (c) easy to use with absolute height alone avoiding the additional step of determining height percentile, (d) incorporation of adult threshold for pre-hypertension to assist in accurate transition from adolescence into adulthood, (e) high sensitivity and specificity to ensure all children at risk are identified with very few false positives.īijlsma MW, Blufpand HN, Kaspers GJ, Bokenkamp A.
#BLOOD PRESSURE CHART FOR CHILDREN FULL#
These simplified BP charts improve upon currently available BP screening reference with the following features: (a) tracking BP longitudinally in an individual child, (b) full physiological range of BP percentiles represented in percentile curve format for rapid identification both high and low BP,īlood pressure Chart Graph Hypertension Hypotension Pediatrics Stature. Sensitivity was confirmed to be 100 % with specificity above 94 %. Shaded areas of the chart differentiate abnormal BP status categories: hypotension, normal BP, prehypertension, Stage 1 hypertension, and Stage 2 hypertension. The 1st, 5th, 25th, 50th, 75th, 90th, 95th, and 99th BP percentile curves are depicted in the chart for each corresponding gender and height from 85 to 190 cm, mimicking the ubiquitous CDC "growth charts". Sensitivity and specificity of the chart cut-offs were confirmed in a sample of 1254 healthy children from a school-based blood pressure screening program. By slightly underestimating a child's BP percentile for high BP and slightly overestimating a child's BP percentile for low BP, these charts guarantee 100 % sensitivity in detecting abnormal BP. We used the 2004 Fourth Report data source and equations to calculate the BP threshold value for each gender and 5 cm height group.
Since height accounts for substantially more BP variability than age and is a more direct measure of body size and maturation in children, height-specific BP percentile curves were drawn separately for males and females. The goal was to develop familiar blood pressure (BP) charts representing BP percentile curves similar to CDC growth charts to improve screening of both high and low BP in children.
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