CURRENT PRACTICES OF BP MEASUREMENT IN CHILDREN AND ADOLESCENTS ACROSS EUROPEAN COUNTRIES: A SURVEY BY THE HYPERCHILDNET COST ACTION WG ON DEVICES

Abstract

Objective: Objective: The main objective was to carry out a survey on current practices of BP measurement used among health care providers involved in the care of children and adolescents. Design and method: Design and methods: A 22 questions survey was released online from September 2, 2021 to September 27, 2021. The survey's link was sent to primary care physicians and pediatricians from the 22 European COST country members and it was also posted on the HyperChildNET website. Results: Results: The survey was assessed by 476 individuals and fully completed by 293. It was answered by general practioneers and pediatricians as well as pediatric nephrologists, pediatric cardiologists and pediatric endocrinologists, half of them working in primary care and the other half in hospital settings. Office BP measurement was used for clinical decision-making by 49% of the survey respondents while 29.7% used ABPM (Ambulatory BP Monitoring) and 16% home BP measurements. Only 11% routinely screen for high BP in normotensive children (Figure). Auscultatory and oscillometric devices were used in 57% and 41% of the settings, respectively. The main reason for selecting a BP device was availability in the institution in 60%, ease to use in 25.5% and validation in the relevant age group in 11.5%. Cuff size was selected according to individual child or adolescent mid arm circumference by 55% of the responders. A usual pitfall was combining cuffs from different devices and manufactures reported by 47.7% of the responders. Moreover, 42% performed only one BP measurement at each office BP visit. There was heterogeneity on the reference values used to evaluate the BP status with 27.4% using country specific BP reference tables and the rest different guidelines’ staging schemes. Eighty-three % used published reference values and 15.4% internet-based application for BP staging in children and adolescents. Conclusions: Conclusions: Variation in practices among health care providers show the emerging need of defining criteria to benchmark the different BP measurement devices, as well as to promote awareness for the evaluation of hypertensive children across Europe.