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01-02-2018 | Original Article

Influence of blood pressure level and age on within-visit blood pressure variability in children and adolescents

Authors: Panagiota Veloudi, Christopher L. Blizzard, Velandai K. Srikanth, Martin G. Schultz, James E. Sharman

Published in: European Journal of Pediatrics | Issue 2/2018

Abstract

Blood pressure (BP) is variable in children and this could affect BP assessment, but the magnitude of within-visit BP variability (BPV) over consecutive measurements has never been investigated. This study aimed to determine the direction and magnitude of, and factors affecting, within-visit BPV in children and adolescents. BP was recorded among 3047 children (aged 12 years [95%CI 12, 13], males 52%) from the 2011–2013 Australian Health Survey. BPV was defined as the absolute difference (∆SBP_ABS) between the first (SBP1) and second systolic BP (SBP2) and the overall variability in three measures when available (SBPV). On average, ∆SBP_ABS was 6.7 mmHg (95%CI 6.3, 7.0) and SBPV was 8.2% (95%CI 7.8, 8.6). ∆SBP_ABS was greater with higher BP levels but lower with older age. From first to second measurements, SBP decreased in 58% (95%CI 56, 60), did not change in 10% (95%CI 9, 12), and increased in 32% (95%CI 29, 34) of the population.

Conclusions: BP is highly variable in children and adolescents, with the magnitude of variability being associated with both age and BP level. SBP increases on repeat measurement in a substantial proportion of the population. The optimal protocol of BP assessment to address this increased BPV needs to be determined.

What is Known:

• Diagnosis of elevated blood pressure (BP) is based on strict probabilistic criteria, the difference between the 90th (pre-hypertension) and 95th (hypertension) percentiles only being 3–4 mmHg.

• BP variability could affect BP classification among children and adolescents.

What is New:

• The magnitude of BP change among children and adolescents is highly affected by BP level and age.

• BP does not always drop on consecutive measurements, and evidence-based BP assessment protocols should be established to avoid misdiagnosis of hypertension.

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Title: Influence of blood pressure level and age on within-visit blood pressure variability in children and adolescents
Authors: Panagiota Veloudi
Christopher L. Blizzard
Velandai K. Srikanth
Martin G. Schultz
James E. Sharman
Publication date: 01-02-2018
Publisher: Springer Berlin Heidelberg
Published in: European Journal of Pediatrics / Issue 2/2018
Print ISSN: 0340-6199
Electronic ISSN: 1432-1076
DOI: https://doi.org/10.1007/s00431-017-3049-y

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Springer Medicine

Influence of blood pressure level and age on within-visit blood pressure variability in children and adolescents

Abstract

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Abstract

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