Auscultatory Method Research Articles

Equipamentos das academias da terceira idade: influência sobre o comportamento da pressão arterial e da frequência cardíaca de idosos

OBJECTIVE: To analyze the behavior of blood pressure and heart rate in elderly people practicing physical exercises in Maringá, Paraná, Brazil. METHODS: 70 elderly volunteers were evaluated, 41 women and 29 men, with a mean age of 67.2 ± 6.6 and 65.9 ± 12.3 years, respectively. They performed three minutes of exercise on the selected equipment, evaluated by means of a frequency meter and by the auscultatory method, with the aid of a sphygmomanometer. RESULTS: High heart rate values were recorded in the multi-exerciser. In both the heart rate and the blood pressure, there were significant differences in the means of the values found in the initial evaluation, compared to the means of the final evaluation (p < 0.05). CONCLUSIONS: Blood pressure rises within the physiological limits established for the elderly, and these activities may be considered safe for this population.

Rapidity and efficacy of ultrasonographic sliding lung sign and auscultation in confirming endotracheal intubation in overweight and obese patients.

Background and Aims:Obese individuals are predisposed to difficult airway and intubation. They usually yield confusing or misleading auscultatory findings. We aimed to assess the rapidity and efficacy of ultrasonographic (USG) sliding lung sign for confirming endotracheal intubation in normal as well as overweight and obese surgical patients.Methods:This prospective, observational study was performed in forty surgical patients. Twenty patients with body mass index (BMI) <25 were recruited to Group A, whereas twenty patients with BMI ≥25 constituted Group B. Following induction and intubation, appearance of end-tidal carbon dioxide waveform was used to confirm endotracheal intubation. Presence of breath sounds bilaterally was sought by auscultation, and time taken for auscultatory confirmation was noted. The USG confirmation of air entry to the lung field as indicated by lung sliding was sought, and the time taken was noted. Chi-square test, independent t-test and paired t-test were used as applicable.Results:Auscultatory confirmation was more rapid in Group A as compared to Group B (9.34 ± 2.43 s vs. 14.35 ± 5.53 s, P = 0.001). However, there was no significant difference in USG confirmation time in both the groups (8.57 ± 2.05 s vs. 8.61 ± 1.66 s). Four patients in Group B had doubtful breath sounds against none in Group A. There was no doubtful lung slide with USG in both groups. One case of endobronchial intubation in Group B was diagnosed with USG which was doubtful by auscultation.Conclusion:Ultrasound directed confirmation of endotracheal tube placement in overweight and obese patients is superior in speed and accuracy in comparison to the standard auscultatory method.

Investigation of the efficacy of colorimetric capnometry method used to verify the correct placement of the nasogastric tube

This present study was designed to determine the efficacy of the colorimetric capnometry method used to verify the correct placement of the nasogastric tube. The present study comprised forty patients who had a nasogastric tube inserted and were being monitored in the adult intensive care unit. After the insertion of the nasogastric tube, 40 colorimetric capnometry and 40 auscultation measurements were performed. Auscultation and colorimetric capnometry results were compared with tube placement results confirmed radiologically. In the confirmation of the placement of the nasogastric tube, the consistency was 97.5% (p<0.05) between the colorimetric capnometry method and the radiological method, and 82.5% (p>0.05) between the auscultatory method and the radiological method. The oesophageal placement of the nasogastric tube was detected with the colorimetric capnometry method, but the gastric and duodenal insertions were not determined. While the sensitivity and specificity of the colorimetric capnometry method in determining the correct placement of the nasogastric tube were 1.00 and 0.667 respectively, those of the auscultatory method were 0.89 and 0.0 respectively. As a result, for the confirmation of the NGT placement, the colorimetric capnometry method is considered more reliable than the auscultatory method and is compatible with the radiological method. However, the colorimetric capnometry method is inadequate to distinguish between the gastric or duodenal insertion.

PS 05-05 Automated compared to manual office blood pressure and to home blood pressure in hypertensive patients

Objective: Automated office blood pressure (BP) was measured in the recently published SPRINT trial; low target values were shown beneficial. We studied the relationships of automated blood pressure, measured in the health care centre, to manual office BP and to home BP. Design and Method: Stable outpatients treated for hypertension were measured automatically, being seated alone in a quiet room, six times after a five-minute rest with the BpTRU device, and immediately afterwards using auscultatory method. Home BP was measured in a subgroup during seven days preceding the visit. Results: The automated, office and home BP values were 131.2 ± 21.8/77.8 ± 12.1, 146.9 ± 20.8/85.8 ± 12.4, and 137.7 ± 17.7/79.4 ± 8.2 mmHg, respectively. Limits of agreement between office and automated BP (2 SDs in the Bland Altman plot) were +42.6 to -12.6/+22.6 to -6.6 mmHg for systolic/diastolic BP; for home and automated BP, they were +45.8 to -25.8/+20.8 to -12.6 mmHg. For patients with two visits, intraclass correlation coefficients of BP values measured during the first and second visit were 0.66/0.72 for systolic/diastolic automated BP and 0.68/0.74 for systolic/diastolic office BP. Conclusions: Automated BP was much lower than manual office BP and still lower than home BP. It showed similar inter-visit variability as office BP. Whether automated BP and “white coat effect”, calculated as office BP – automated BP difference, should be used in clinical practice, deserves further studies.

OP.1A.01] REPRODUCIBILITY AND ACCURACY OF BLOOD PRESSURE MEASUREMENTS WITH THREE OSCILLOMETRIC DEVICES IN PATIENTS WITH ATRIAL FIBRILLATION

Objective:The measurement of blood pressure (BP) in atrial fibrillation (AF) is challenging and current guidelines recommend the use of the auscultatory method. The use of automated BP devices in AF is still debated. The objective was to analyze the reliability and the reproducibility of three diffe

Rapid location of nasointestinal tube by bedside ultrasound for critical patients in emergency intensive care unit

To evaluate the feasibility of method of bedside ultrasound to confirm correct nasointestinal tube placement of critical patients. From June 2015 to February 2016 , a total of 70 patients admitted to Emergency Intensive Care Unit, Zhejiang Provincial People's Hospital, 37 males and 33 females, using bedside ultrasound(vessels signe) to confirm the location of nasointestinal tube at different site of digestive tract, and then comparing with the traditional methods, the point-of-care systems. Auscultatory method and aspirates from tube method have lower sensitivity(78.6%, 72.7%) and specificity (25.0%, 75.0%) ; bedside ultrasound(vessels signe) method sensitivity (100%), accuracy (100%) , positive predictive value(100%), negative predictive value(100%) and precision ratio are all higher than auscultatory method and aspirates from tube method, the difference was statistically significant(P<0.05). The bedside ultrasound vessels signe method has more advantages in confirming the location of the tubes at sensitivity , accuracy , specificity and positive predictive value than the traditional methods.

Sleep duration and blood pressure: a longitudinal analysis from early to late adolescence

The aim of this study was to evaluate the association between sleep duration and blood pressure using a cross-sectional and longitudinal approach. As part of a population-based cohort, 1403 adolescents were evaluated at 13 and 17years old. Sleep duration was estimated by the difference between self-reported usual bedtime and wake-up time. Blood pressure was measured using the auscultatory method. Regression coefficients (β) and respective 95% confidence intervals were computed to evaluate the association between sleep duration and blood pressure, using linear regression models adjusted for practice of sports and body mass index at 17years old. The mean (standard deviation) sleep duration at 13years old was 9.0 (0.76)h per day, and on average it decreased by 46min up to 17years old. The median (25th-75th) systolic blood pressure at 17years old was 110.0 (103.5-119.0)mmHg in females and 114.0 (106.0-122.0)mmHg in males (P<0.001); for diastolic blood pressure the values were 66.0 (60.0-71.0) and 69.0 (62.0-75.0)mmHg, respectively (P<0.001). In cross-sectional analysis, at 17years old, after adjustment, a positive association was found between sleep duration and blood pressure, significant only for systolic blood pressure among females [β=0.730 (0.005; 1.455)]. In girls, no significant association was found between sleep duration at 13years old and blood pressure at 17years old, but in males an inverse association was found between sleep duration at 13years old and blood pressure at 17years old significant only for systolic blood pressure [β=-1.938 (-3.229; -0.647)]. This study found no association between sleep duration at 13years old and blood pressure at 17years old in girls, but among males an inverse association was found.

Automated compared to manual office blood pressure and to home blood pressure in hypertensive patients

We studied the relationships of automated blood pressure (BP), measured in the healthcare centre, with manual office BP and home BP. Stable outpatients treated for hypertension were measured automatically, seated alone in a quiet room, six times after a 5 min rest with the BpTRU device, and immediately afterwards using the auscultatory method. Home BP was measured in a subgroup during 7 days preceding the visit. The automated, office and home BP values were 131.2 ± 21.8/77.8 ± 12.1 mmHg, 146.9 ± 20.8/85.8 ± 12.4 mmHg and 137.7 ± 17.7/79.4 ± 8.2 mmHg, respectively. Limits of agreement between office and automated BP (2 SDs in Bland–Altman plots) were +42.6 to –12.6/+22.6 to –6.6 mmHg for systolic/diastolic BP; for home and automated BP they were +45.8 to –25.8/+20.8 to –12.6 mmHg. For patients with two visits, intraclass correlation coefficients of BP values measured during the first and second visits were 0.66/0.72 for systolic/diastolic automated BP and 0.68/0.74 for systolic/diastolic office BP. Automated BP was lower than home BP and no more closely related to home BP than to office BP. It did not show better repeatability than office BP. Whether automated BP and the “white-coat effect”, calculated cas the office BP–automated BP difference, have clinical and prognostic importance deserves further studies.

Contributions of the surgeon Nikolai Korotkov (1874-1920) to the management of extremity vascular injury.

The Russian military surgeon Nikolai Korotkov is known worldwide, mainly among internists and cardiovascular specialists, as the discoverer of the auscultatory method of measuring arterial blood pressure in 1905. This article reveals him as one of the first military vascular surgeons to carefully investigate, analyze, and register cases of vascular injury during his voluntarily trips to the Russian Far East in 1900 to 1901 and the Russo-Japanese War of 1904 to 1905. Examining 44 patients with extremity arterial and arterial-venous pseudoaneurysms following war-related injury, he routinely performed a measure termed the "arterial pressure index" using "Korotkov sounds." This pioneering approach to assessing extremity perfusion was the precursor to the modern-day ankle-brachial and injured extremity indices, and it initiated the quantitative assessment of the compensatory ability of the vascular system to restore circulation following axial artery ligation. Because of high thrombosis rates following direct vessel repair during his day, he proposed use of pharmacologic substances such as digitalis and amyl nitrite to improve extremity perfusion. As evidence of his innovative nature, Korotkov even proposed the use of "oxygenated nutrient solutions" in the future to improve extremity circulation. More than 100 years after his work, as continuous wave Doppler ultrasound, contrast angiography, and computed tomography are ubiquitous as diagnostic tools, the practice of surgery would be well served to recall Korotkov's foundational work and the rule of thumb for any physician: examine the patient.

A Sensor-Based Data Visualization System for Training Blood Pressure Measurement by Auscultatory Method

A Sensor-Based Data Visualization System for Training Blood Pressure Measurement by Auscultatory Method

Screening for Hypertension in People Aged 50 Years and Older in Byumba Sector: A Community-Based Approach

Background: Hypertension is taken as a global public health crisis and it is named as a “silent killer” since it is mostly asymptomatic with many life threatening complications such as stroke, coronary artery disease, heart attack… Hypertension as the cause of morbidity and mortality in older adults, it is one of the conditions that could be mostly prevented and treated. In developing countries, most people with raised blood pressure are unaware of their condition. Purpose: The purpose of this study was to detect high blood pressure in people aged 50 years and older who are not diagnosed for hypertension before, and approximate the prevalence of hypertension in older adults who are apparently healthy and determine if there is age and gender differences for people who have high blood pressure after screening. Methods: The study design was quantitative analytical cross-sectional study, and the sample of 149 people aged 50 years and older was obtained using convenient sampling method including 116 women and 33 men. A sphygmomanometer and a stethoscope for auscultatory method was used to measure blood pressure in the community. Results: The results showed that among 149 screened people, 38.3% (= 57) had hypertension. 40.5% of women were newly diagnosed with high blood pressure during screening, and 30.3% of men were newly diagnosed with high blood pressure. However, the difference between women and men in terms of the prevalence of newly diagnosed hypertension is not statistically significant [CI: 95% X2 (1, N = 149) = 1.13, p = 0.28]. The Pearson Chi square test shows no statistical significance in difference of high blood pressure among different age groups X2 (2, N = 149) = 1.12, p = 0.57. Conclusion: More than one third of the screened people aged fifty years and older were found hypertensive and they were not aware of the disease before screening. The early detection of hypertension through community screening is very important because it raises people’s awareness of their blood pressure and be able to seek care as soon as possible before the complications occur.

Feeding tube placement: auscultatory method and x-ray agreement

to evaluate the correlation between the auscultation test and X-ray when detecting the position of an enteral feeding tube. cross-sectional study in an intensive care unit in southern Brazil, in 2011. Clinical nurse and nurse researcher performed auscultation test recording the impressions regarding the placement of an enteral feeding tube in 80 patients. A doctor evaluated the X-ray. Kappa coefficient and PABAK reviewed the agreements. The X-ray showed that 70% of the enteral tubes were in the stomach, 27.4% in the duodenum, 1.3% in the esophagus, and 1.3% in the right lung. There was a weak correlation between clinical nurses and nurse researchers (PABAK=0.054; P=0.103), clinical nurses and X-rays (PABAK=0.188; P=0.111) and nurse researchers and X-rays (PABAK=0.128; P=0.107) . The auscultation test did not detect two risk conditions, enteral feeding tube in the esophagus and the bronchus. the auscultation test showed little agreement with the X-ray on the enteral feeding tube location.

Relationship between body mass index and hypertension

Background Obesity is associated with high cardiac risk in patients, who are undergoing non cardiac surgeries. Aim of the study is to evaluate any association between Body Mass Index (BMI) and blood pressure during preoperative assessment of patients. Methods BMI (Kg/m2) and BP measurement were performed in 195 subjects (age 11 - 84 years). Diagnosed patients with hypertension were excluded from the study. One weighing scale was used to measure the body weights and each individual height was measured using a standardized vertical scale. According to BMI, patients were classified in to underweight (<18.5kg/m2), normal range (18.5-24.99kg/m2), pre-obese (25.00-29.99kg/m2) and obese (≥30kg/m2) categories. BP of patients was measured in a seated position after resting for 10 min. Measurement was taken on the left arm (lower margin of the cuff applied 5cm above the medial epicondyle of humerus) by auscultatory method using a mercury sphygmomanometer. Systolic pressure ≥140mmHg and diastolic pressure ≥90mmHg was considered as hypertension. Results During observation, 48 (24.61%) patients were categorized in to underweight group, 84 (43.08%) patients with normal range BMI, 51 (26.15%) were pre-obese and 12 (6.15%) in the obese group. None of the patients in the underweight group had high BP. High BP was recorded in 12 (14.28%) in the normal weight group and 19 (37.25%) of the pre-obese group. Five patients (41.6%) in the obese group had high BP (1 patient with class III obesity). Conclusions There is a significant positive relationship between BMI and BP with high prevalence of undiagnosed hypertension among obese population.

Blood pressure measurement in children

In pediatric age diagnosis of hypertension is defined using a statistical criterion, the limit being the 95th percentile of the distribution of the blood pressure values, according to gender, age and height [1]. Pre-hypertension is defined as blood pressure (BP) values consistently above or equal to the 90th percentile, but lower than the 95th [Table ​[Table1].1]. The “gold standard” method to measure BP in children is auscultatory, using an aneroid non-mercury manometer (proscribed due to their toxicity). The aneroid devices need to be calibrated every six months. At least three measurements performed on different occasions are necessary for the diagnosis of hypertension [2]. Children above 3 years of age should have their blood pressure measured every year. In all children including the youngers ones blood pressure should be measured under special circumstances that increase the risk for hypertension: intensive neonatal care, renal disease, treatment with drugs known to increase blood pressure, evidence of elevated intracranial pressure. The cuff should be of the appropriate size for the children's upper arm. Small cuffs tend to overestimate while large cuffs underestimate. The width of the cuff should be 40% of the arm circumference at a point midway between the olecranon and the acromion. The children should be calm and relaxed, seated with their right arm resting at heart level. Systolic blood pressure is defined by the first Korotkoff sound (K1) whereas diastolic blood pressure coincides with the disappearance of the pulse (K5). The use of oscillometric devices is increased in the last years. Despite their large use, only few, reported on the internet site http://www.dableducational.org were been validated in children. A diagnosis of hypertension based on an oscillometric measurement should be confirmed by an auscultatory method. Currently other two methods are used in children to measure BP values: ambulatory blood pressure monitoring (ABPM) and home blood pressure measurement. In children the use of ABPM has significant limitations due to the lack of reference values. It allows to identify “white coat hypertension” (elevated office BP values and normal ABPM values), “masked hypertension” (normal office BP values and elevated ABPM values) and subjects with or without reduced physiological day-night blood pressure variations (dipping) [3]. A new methods is represented by the self-measurement of blood pressure at home [4]. Even in this case available data from children are scanty. Correct self-measurement requires two measurements within a few minutes, performed in the morning and in the evening for 3 consecutive days. Table 1 Definition and classification of hypertension in children and adolescents

PP.17.08

Objective: Arterial hypertension is the main risk factor attributable to cardiovascular morbidity and mortality. In population, studies have shown that there are a linear and continuous correlation between the increase blood pressure (BP) and risk of a coronary event, stroke, heart failure, renal failure. Most epidemiological studies in concentrated human groups have based hypertension with auscultatory BP measurement, even though guidelines recommend an oscillometric measurement, for diagnosis of hypertension, is also known that human group's agglomerates may have a greater possibility of observed inadequate variability with auscultatory method.Design and method: Cross-sectional study was conducted in a mall, where prior knowledge informed people are taking their blood pressure (BP), on 2 occasions, with a difference of five minutes between the two measurements, with auscultatory method, a Riester mercury sphygmomanometer and an oscillometric method with a OMRON HEM 907, in order to classifying the population as hypertensive or normotensive if BP was equal to or greater than 140/90 mm Hg or less respectively, and evaluate BP between the first and second take, both systolic and diastolic component, auscultatory and oscillometric method. It was used an statistical analysis package software SPS 19, and Student t test was performed for parametric variables correlated with a confidence interval of 95%. Results: 151 people were surveyed, 56.96% women and 43.04% men, mean age of 52.62 years, range between 18–81 years, 51.3% had no regular employment, 46% did not own housing and 62% had secondary and university education. The systolic mean value was 123, 10 mm Hg by oscillometric method and 117, 6 by auscultatory method, the difference between both systolic were 5,48 mm Hg, P < 0,05, and to diastolic no were significance Conclusions: The systolic values were underestimated by auscultatory method non diastolic blood pressure when compare auscultatory and oscillometric technique. Recommended an oscillometric measurement to avoid underestimated BP systolic values.

146 Could Placement of the Blood Pressure Cuff Over the Elbow Rather than the Upper Arm Increase the Accuracy of Automatic Blood Pressure Machines in the Detection of Systolic Blood Pressure?

Automatic blood pressure monitors (oscillometers) with the cuff placed over the upper arm give different systolic BP (SBP) readings to the Korotkoff/Riva-Rocci auscultatory method, influenced by quantity of soft tissue and arm circumference. Other studies have examined whether SBP measurement at the wrist or forearm is more accurate, with limited success. No literature was found on oscillometer use at the elbow. We therefore examined whether oscillometric SBP at the elbow was more accurate than the upper arm and the influence of demographic and anthropometric variables, using simultaneous Doppler return-to-flow at the wrist as the comparative method for SBP. Triplicate SBP readings at the upper arm and elbow were recorded in 62 participants. Bland-Altman plots showed similarly poor agreement between the oscillometers and Dopplers at each cuff position, despite upper arm oscillometry being a clinically validated method of blood pressure measurement. We found a significant difference (p Placing the cuff over the elbow may therefore be a feasible alternative to a cuff over the upper arm, especially in those with a large quantity of non-muscular soft tissue and older people. Additional development of this method and further comparison is needed as we must adapt to the increasingly obese and elderly population.

PP.17.07

Objective: Arterial hypertension is the main risk factor attributable to cardiovascular morbidity and mortality. In population, studies have shown that there are a linear and continuous correlation between the increase blood pressure (BP) and risk of a coronary event, stroke, heart failure, renal failure. Most epidemiological studies in concentrated human groups have based hypertension with the first BP measurement, even though guidelines require at least two, for diagnosis of hypertension, however this is obviated by the number of people that such studies should be done. Leaving a second take on another occasion to patients whose numbers was increased, losing at least 20% of the surveyed population. Is also known that human group's agglomerates may have a greater possibility of white coat hypertension phenomenon. Design and method: Under this, cross-sectional study was conducted in a mall, where prior knowledge informed people are taking their blood pressure (BP), on 2 occasions, with a difference of five minutes between the two measurements, in order to classifying the population as hypertensive or normotensive if BP was equal to or greater than 140/90 mm Hg or less respectively, and evaluate BP between the first and second take, both systolic and diastolic component, auscultatory and oscillometric. It was used an statistical analysis package software SPS 19, and Student t test was performed for parametric variables correlated with a confidence interval of 95%. Results: 151 people were surveyed, 56.96% women and 43.04% men, mean age of 52.62 years, range between 18–81 years, 51.3% had no regular employment, 46% did not own housing and 62% had secondary and university education. The prevalence of hypertension using the first measurement blood pressure was 40.3% and after the second was 38.9%, In the graph the relationship between the average systole / diastolic 1st and 2nd BP measurement are shown, auscultatory and oscillometric.Conclusions: The first measurement of systolic and diastolic blood pressure using the auscultatory or oscillometric method over estimated in the general population blood pressure, so it is necessary to perform a second take to minimize this pressor effect of alert.

Correlation of Hypertension with the severity of Osteoarthritis of Knee.

Objective : To analyze the correlation between hypertension with the clinico-radiological profile and severity of OA knee. Method: In this cohort study, total 120 cases of osteoarthritis knee patients of either sex or age > 40 years were enrolled. The entire study was conducted in department of Orthopedic Surgery, King Georges Medical University. Cases were selected as per the diagnostic criteria of the American College of Rheumatology. A detailed history was taken and thorough examination of the affected joints and related regions was done. For the clinical severity, VAS and Lequesne Index was used. To assess the radiological severity of the disease, K.L grading was used and X-ray bilateral knee was done to see the radiological changes of the disease. Blood pressure was measured in both the arms via auscultatory method following American Heart Association guidelines.The Blood Pressure was measured thrice in both the arms and the average was calculated. If the average was more than 140/90 mm Hg in any side; then the subject was labeled as hypertensive. Result : The correlation of hypertension with the clinical and radiological severity of OA knee was found to be statistically significant. Conclusion : The significant correlation of hypertension with osteoarthritis will not only bridge the information gap, but will also modify our approach towards the management of hypertension, heart diseases and osteoarthritis. We may be able to find out the new possible risk factors of these diseases hence it should be further investigated.

Validation of the BPLab(®) 24-hour blood pressure monitoring system in a pediatric population according to the 1993 British Hypertension Society protocol.

BackgroundAutomatic 24-hour ambulatory blood pressure (BP) monitoring (ABPM) is a basic procedure performed in adults with arterial hypertension, but ABPM monitors have become widely used in pediatric practice only recently. The main problem is the lack of common normative data sets for ABPM in children and the small number of appropriate monitors that can be used for analysis of the 24-hour BP profile in this age group. The aim of this study was to validate the BPLab® ABPM monitor according to the 1993 British Hypertension Society (BHS-93) protocol, as well as to work out solutions regarding the feasibility of this device in pediatric practice.MethodsOur study included 30 children of both sexes and aged 5–15 years, ie, “older” children according to the BHS-93 protocol. Before starting the study, we obtained ethical approval from the regional scientific ethics committee. All participants and their parents signed their written consent for participation in the study. The data were simultaneously obtained by three experts, who had completed a noninvasive BP measurement training course. BP values were measured using the Korotkoff auscultatory method (Phase I for systolic BP and Phase V for diastolic BP). Discrepancies in the systolic and diastolic BP measurements (n=180; 90 for each expert) were analyzed according to the criteria specified in the BHS-93 protocol.ResultsThe device was graded “A” for both systolic BP and diastolic BP according to the criteria of the BHS-93 protocol.ConclusionThe BPLab ABPM device may be recommended for extensive pediatric use.

Adolescent blood pressure pattern in Rivers State, Nigeria: A rural - urban comparison

Background : Childhood and adolescent blood pressure pattern have been known to predict adult blood pressure levels and development of hypertension. Hypertension, once rare in traditional African societies, is now the commonest non-communicable disease in Nigeria. There are few studies on adolescent blood pressure pattern, especially in adolescents living in rural areas. It is therefore important to identify blood pressure differences, if any, between adolescents living in rural areas compared to their urban counterparts. Objective : To determine and compare the blood pressure pattern of apparently healthy adolescents in rural and urban areas, and to determine the association between blood pressure and body mass index in these children. Subjects and Methods : A cross sectional population based blood pressure survey was carried out on 2,136 Nigerian school adolescents (1080 were resident in rural areas and 1056 in urban areas) aged 10-18 years, selected from 26 secondary schools using a multi-stage stratified sampling technique. Blood pressure measurements were taken by auscultatory method. An average of three readings was taken as the actual blood pressure. Results : Systolic and diastolic blood pressure increased with age in both rural and urban subjects. The mean systolic blood pressure of the rural subjects (111.10 ± 14.72 mm Hg) was significantly (p= < 0.001) higher than that of the urban subjects (108.09 ±15.40 mm Hg), whilst the mean diastolic blood pressure of the urban subjects (66.88 ± 11.27 mmHg) was slightly higher than those of the rural subjects (66.32±11.71 mmHg. Urban subjects had a higher mean body mass index (19.82± 3.57kg/m2) than their ruralcounterparts (19.59±2.78 kg/ m2).Systolic and diastolic blood pressure showed a positive significant (p= <0.001) correlation with BMI in subjects in rural and urban schools. Conclusion : Significant differences in blood pressure were observed between rural and urban adolescents in Rivers State, with a positive significant correlation between BMI and blood pressure. We recommend blood pressure surveillance as part of the School Health Programme. Keywords : adolescent, blood pressure, rural-urban, Nigeria