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Abstract
BackgroundThe age-, gender-, and height-percentile requirements of the 'gold-standard' for the diagnosis of (pre)hypertension in adolescents make it time-consuming for clinicians and difficult-to-use by non-professionals. Simplified diagnostic tools are therefore needed. The use of blood pressure-to-height ratio (BPHR) - systolic BPHR (SBPHR) and diastolic BPHR (DBPHR) - has been reported in Han adolescents, but it requires validation in other racial groups. The diagnostic accuracy of SBPHR and DBPHR in a population of 1,173 Nigerian adolescents aged 11-17 years, was therefore studied.MethodsBlood pressures were measured using standard procedures and (pre)hypertension were defined according to international recommendations. ROC curve analyses were used to assess the diagnostic accuracy of BPHR in defining (pre)hypertension in this population. Sex-specific threshold values for SBPHR and DBPHR were determined, and thereafter used to define (pre)hypertension. The sensitivity/specificity of this method was determined.ResultsThe accuracies of SBPHR and DBPHR in diagnosing (pre)hypertension, in both sexes, was >92%. The optimal thresholds for diagnosing prehypertension were 0.72/0.46 in boys and 0.73/0.48 in girls; while for hypertension, they were 0.75/0.51 in boys and 0.77/0.50 in girls. The sensitivity and specificity of this method were >96%.ConclusionsThe use of BPHR is valid, simple and accurate in this population. Race-specific thresholds are however needed.
Highlights
The age, gender, and height-percentile requirements of the ‘gold-standard’ for the diagnosis ofhypertension in adolescents make it time-consuming for clinicians and difficult-to-use by non-professionals
systolic blood pressure (SBP) for both sexes increased with increasing age, and there was no significant difference (p > 0.05) between the mean SBP values of the boys compared to the boys at any given age
systolic BPHR (SBPHR) and diastolic BPHR (DBPHR) both followed the patterns observed for SBP and diastolic blood pressure (DBP) respectively
Summary
The age-, gender-, and height-percentile requirements of the ‘gold-standard’ for the diagnosis of (pre)hypertension in adolescents make it time-consuming for clinicians and difficult-to-use by non-professionals. The presence of hypertension in adolescents may lead to early manifestation of its sequelae, for instance, coronary artery disease [7]. The “gold standard” for the diagnosis of (pre)hypertension in adolescents is difficult to appreciate and use by parents and non medical professionals [because of the age-, gender-and height-specific standards for both systolic blood pressure (SBP) and diastolic blood pressure (DBP)] [7]
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