Study Of Blood Pressure In Children Research Articles

Blood Pressure Tables

To the Editor .— The Working Group of the National High Blood Pressure Education Program recently published updated guidelines on the diagnosis, evaluation, and treatment of high blood pressure (BP) in children and adolescents.1 This is a timely update, and the working group has done a commendable job in most areas of their recommendations. As a long-time student of children's BP measurement, however, I have some concerns about the current BP standards recommended by the working group,1 in particular, the validity of recommending age and height percentiles to express children's BP standards. In a recently published study from the San Antonio Children's Blood Pressure Study,2 we obtained triplicate BP readings by both the auscultatory2 and oscillometric (Dinamap Model 8100)3 methods in >8000 schoolchildren enrolled in kindergarten through 12th grade. We used the currently recommended BP-measuring technique (BP cuff width: 40–50% of the arm circumference; sitting position: K5 [level at which the Korotkoff sounds disappear] as the diastolic pressure; averaging multiple BP readings). In that study, auscultatory systolic pressures were correlated more closely with weight ( r = 0.677) than with height ( r = 0.626), as has been shown by many other studies. More importantly, we found that when age and weight were used in a partial correlation analysis, the effect of height on auscultatory systolic pressure level virtually disappeared …

Prevalence of increased arterial pulse pressure among children and adolescents

Purpose Arterial pulse pressure (APP) is used as a noninvasive measurement of arterial stiffness (AS). Most AS studies were conducted in adult populations as it is often considered a phenomenon of aging. The objective of this study is to assess the longitudinal change in prevalence of AS among children and adolescents. Methods The Minneapolis Children's Blood Pressure Study (MCBPS) is a prospective cohort study and the initial (1978) and multiple timed measurements of systolic blood pressure (SBP) and fourth phase diastolic blood pressure (DBP4) were made semiannually or annually. Visit 16 was completed in 1987. Black and white subjects who participated in all 16 visits were included in the analysis (n = 487). APP, a surrogate measure of AS, is derived mathematically as the difference between SBP and DBP4. The level of 60 mmHg or higher of APP was defined as presence of AS. Results There were 218 females, 269 males, 114 blacks and 373 whites. The mean ages of children in visits 1 and 16 were 7.7 (SD = 0.7) and 16.6 (SD = 0.7) years, respectively. Similarly, the mean APP levels at these two visits were 36.3 (SD = 12.0), and 43.6 (SD = 11.5) mmHg, respectively. Prevalence of increased APP varied at each timed point. At the beginning of the study (1978), prevalence was 3.9%. In 1987, prevalence increased to 10.1%. Proportions of those with increased APP ranged from 3.3% to 21.4% during 8 years of follow-up. Conclusion Our results indicate that AS, as defined by APP, exists even during childhood and adolescence. These results should be confirmed by using a more accurate measure of AS that can be used in population studies.

Body mass index growth in a sample of U.S. children: repeated measures data analysis of the Minneapolis Children's Blood Pressure Study.

Longitudinal assessments of the body mass index (BMI) in children and adolescents are limited. The purpose of the study was to describe the growth patterns of the BMI in children and young adults. Black and White children of Minneapolis Children's Blood Pressure Study (MCBPS) were 6 to 9 years old at entry and were followed for 12 years at 19 separate visits. Those with at least five visits (n = 1,302) were included for analysis, using non-linear mixed effects models in conjunction with the Gompertz curve. The growth patterns of four sex-ethnic groups were different at three levels: starting level (SL) (kg/m(2)), asymptote level (AL) (kg/m(2)), and peak growth age (PGA) (in years). In this context, SL is the average BMI level at age 6, AL is the average BMI level when growth diminishes, and PGA is the average age at which the rate of growth in the BMI peaks. The SL (16.3 +/- 0.1) for White males was significantly greater than SL in the other three sex-ethnic groups, among which there were no significant differences. There was a significant ethnic difference in AL between Black females (25.5 +/- 0.3) and White females (24.4 +/- 0.2) and a marginally significant difference in AL between Black females and Black males (24.4 +/- 0.3). For PGA, only sex differences were significant: Black females reached the peak at the earliest age at (11.5 +/- 0.1) years, followed by White females (11.7 +/- 0.1), Black males (12.6 +/- 0.1), and White males (12.8 +/- 0.1).

Type A behavior pattern and change in blood pressure from childhood to adolescence. The Minneapolis Children's Blood Pressure Study.

The association of the Type A behavior pattern with change in blood pressure was examined in a multiethnic sample of schoolchildren. Blood pressure was assessed in 1978 (mean age = 8 years) and approximately biannually thereafter through 1987-1990, when a post-high school screening was completed. The Matthews Youth Test for Health (MYTH) was completed by the teachers of a sample of participants in 1982 (n = 502). The Jenkins Activity Survey (JAS) was completed by all adolescents who participated in the post-high school screening (n = 816). Males were more likely to be classified as Type A than were females by the JAS and the MYTH. Type A status was not associated cross-sectionally with elevated blood pressure. JAS-assessed Type B males had significantly higher mean post-high school fourth- and fifth-phase diastolic blood pressures than did Type A males (70.2 mmHg vs. 68.2 mmHg, p < 0.05; 68.1 mmHg vs. 65.2 mmHg, p < 0.01). JAS-assessed Type A/B status was not associated with 10-year change in blood pressure. MYTH-determined Type B females tended to have higher diastolic blood pressures than MYTH-determined Type A females throughout the 10-year study period. Results from this study did not confirm the hypothesis that Type A participants would have significantly higher blood pressures than Type B participants at the time of Type A assessment; nor did they confirm the hypothesis that Type A participants would exhibit greater increases in blood pressure than Type B participants over a 10-year period.

I7 - Normative oscillometric blood pressure levels in children, kindergarten through 8th grade — the san antonio biethnic children's blood pressure study

I7 - Normative oscillometric blood pressure levels in children, kindergarten through 8th grade — the san antonio biethnic children's blood pressure study

I6 - Normative auscultatory blood pressure levels in children, kindergarten through 8th grade — the san antonio biethnic children's blood pressure study

I6 - Normative auscultatory blood pressure levels in children, kindergarten through 8th grade — the san antonio biethnic children's blood pressure study

Postural changes in blood pressure and pulse rate among black adolescents and white adolescents: the Minneapolis Children's Blood Pressure Study.

Because studies have suggested a possible relation between vascular responsiveness to postural changes and risk of subsequent myocardial infarction, the reactivity of blood pressure and pulse rate to change from supine to standing positions was examined in 158 black males, 144 black females, 342 white males, and 272 white females aged 14-16 years. The study was part of the Minneapolis Children's Blood Pressure Study and was conducted during October to December 1985. Two blood pressure readings and one pulse reading were taken after five minutes of supine rest, immediately upon standing, and five minutes after standing. After adjustment for body mass index, mean systolic blood pressure decreased, and fourth- and fifth-phase diastolic blood pressures and pulse rate increased from supine to standing positions in all race and sex groups. Black males had significantly larger changes in systolic pressure than did white males (-5.9 vs. -4.1 mmHg), and males had significantly larger changes in fourth- and fifth-phase diastolic pressures compared with females of the same race (fourth-phase diastolic pressure, 8.0 vs. 4.1 mmHg for blacks and 10.0 vs. 4.8 mmHg for whites). Fifth-phase diastolic pressure increased more than did fourth-phase diastolic pressure in all groups. No race or sex differences were seen for pulse changes. For all race-sex groups, decreases in systolic pressure were positively correlated with initial levels of supine systolic pressure, whereas increases in fourth- and fifth-phase diastolic pressures were negatively correlated with corresponding initial levels. Measurement of postural changes may provide a clinically simple and reproducible way of testing for abnormalities in blood pressure and may better discriminate those at high risk of hypertension and its cardiovascular complications than would the commonly used single-seated blood pressure measurement.

The Florence Children's Blood Pressure Study. A chronobiological approach by multiple self-measurements.

The Florence Children's Blood Pressure Study. A chronobiological approach by multiple self-measurements.

Personality, behavior, family environment, family social status and hypertension risk factors in children: The Minneapolis Children's Blood Pressure Study

To assess the relationship of psychosocial variables to risk factors for hypertension in children, we administered instruments designed to measure aspects of children's personality, behavior, family environment and family social status to 1505 school children aged 7–10 years. Children's blood pressure was significantly related only to mother's occupation, the children of unskilled employees having higher blood pressure than children of higher status workers. Children's body mass index was directly related to scores on the conformity scale of the personality inventory and inversely related to scores on the intellectual-cultural orientation scale of the family environment instrument and to social class. Social status but not measured dimensions of children's personality, behavior and family environment may influence the risk of hypertension in children.

Recent life events in school children: Race, socioeconomic status, and cardiovascular risk factors: The Minneapolis Children's Blood Pressure Study

During a study of children's blood pressure, recent life events were measured to determine their occurrence in elementary school children and to determine their relationship to blood pressure and other possible precursors of adult hypertension. Data about life events for a one-year period were obtained from a stratified sample of 1505, 6- to 9-year-old children enrolled in Minneapolis public schools. Children's age and sex were not related to life events. Parental education, employment, and income were related to the child's life event frequency. Indian and black children tended to experience significantly more undesirable life events than white children. Life events frequency was not related to baseline or to follow-up blood pressure or to obesity or other risk factors for adult hypertension.

Elevated blood pressure in school children—prevalence, persistence, and hemodynamics: The Minneapolis Children's Blood Pressure study

Elevated blood pressure in school children—prevalence, persistence, and hemodynamics: The Minneapolis Children's Blood Pressure study

The Minneapolis children's blood pressure study. Part 1: standards of measurement for children's blood pressure.

The Minneapolis children's blood pressure study. Part 1: standards of measurement for children's blood pressure.