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Establishing International Blood Pressure References Among Nonoverweight Children and Adolescents Aged 6 to 17 Years Publisher Pubmed



Xi B1 ; Zong X2 ; Kelishadi R3 ; Hong YM4 ; Khadilkar A5, 21 ; Steffen LM5 ; Nawarycz T6, 22 ; Krzywinskawiewiorowska M7 ; Aounallahskhiri H8, 23 ; Bovet P9 ; Chiolero A10, 24 ; Pan H11, 25 ; Litwin M12, 26 ; Poh BK13, 27 Show All Authors
Authors
  1. Xi B1
  2. Zong X2
  3. Kelishadi R3
  4. Hong YM4
  5. Khadilkar A5, 21
  6. Steffen LM5
  7. Nawarycz T6, 22
  8. Krzywinskawiewiorowska M7
  9. Aounallahskhiri H8, 23
  10. Bovet P9
  11. Chiolero A10, 24
  12. Pan H11, 25
  13. Litwin M12, 26
  14. Poh BK13, 27
  15. Sung RYT14
  16. So HK4
  17. Schwandt P15
  18. Haas GM16, 28
  19. Neuhauser HK17
  20. Marinov L18
  21. Galcheva SV19
  22. Motlagh ME20
  23. Kim HS11
  24. Khadilkar V13
  25. Krzyzaniak A12
  26. Romdhane HB8
  27. Heshmat R7
  28. Chiplonkar S6
  29. Stawinskawitoszynska B9
  30. El Ati J10
  31. Qorbani M12
  32. Kajale N14
  33. Traissac P15
  34. Ostrowskanawarycz L16
  35. Ardalan G15
  36. Parthasarathy L3
  37. Zhao M2
  38. Zhang T1

Source: Circulation Published:2016


Abstract

Background-Several distributions of country-specific blood pressure (BP) percentiles by sex, age, and height for children and adolescents have been established worldwide. However, there are no globally unified BP references for defining elevated BP in children and adolescents, which limits international comparisons of the prevalence of pediatric elevated BP. We aimed to establish international BP references for children and adolescents by using 7 nationally representative data sets (China, India, Iran, Korea, Poland, Tunisia, and the United States). Methods and Results-Data on BP for 52 636 nonoverweight children and adolescents aged 6 to 19 years were obtained from 7 large nationally representative cross-sectional surveys in China, India, Iran, Korea, Poland, Tunisia, and the United States. BP values were obtained with certified mercury sphygmomanometers in all 7 countries by using standard procedures for BP measurement. Smoothed BP percentiles (50th, 90th, 95th, and 99th) by age and height were estimated by using the Generalized Additive Model for Location Scale and Shape model. BP values were similar between males and females until the age of 13 years and were higher in males than females thereafter. In comparison with the BP levels of the 90th and 95th percentiles of the US Fourth Report at median height, systolic BP of the corresponding percentiles of these international references was lower, whereas diastolic BP was similar. Conclusions-These international BP references will be a useful tool for international comparison of the prevalence of elevated BP in children and adolescents and may help to identify hypertensive youths in diverse populations. © 2015 American Heart Association, Inc.
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