Published online May 4, 2009
PEDIATRICS Vol. 123 No. 6 June 2009, pp. e972-e974 (doi:10.1542/peds.2008-2680)
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ARTICLE

Simple Table to Identify Children and Adolescents Needing Further Evaluation of Blood Pressure

David C. Kaelber, MD, PhD, MPHa,b,c,d and Frieda Pickett, RDH, MSe

a Departments of Pediatrics
b Internal Medicine
c Information Services, MetroHealth System
d Departments of Internal Medicine and Pediatrics, School of Medicine, Case Western Reserve University, Cleveland, Ohio
e Texas A&M Health Science Center-Baylor College of Dentistry, Dallas, Texas

OBJECTIVE. The goal was to create a tool to screen more easily for children and adolescents who might have hypertension or prehypertension.

METHODS: We took the existing tables from The Fourth Report on the Diagnosis, Evaluation and Treatment of High Blood Pressure in Children and Adolescents, which contain hundreds of normal and abnormal blood pressure values based on gender, age, and height percentile, and analyzed this data to develop a much simplified table based only on gender and age.

RESULTS. In our simplified table we reduced the number of values from 476 to 64 and have only one threshold value of abnormal systolic and diastolic blood pressure, by gender, for each year of life (ages 3 to ≥18). This table makes it easy to identify abnormal blood pressure values in almost any potential care or screening setting. This approach is ideal when blood pressure is measured outside a physician's office or even at intake in a pediatrician's office, when the height percentile (which is required for the use of current tables) may not be easily obtainable.

CONCLUSIONS. This screening tool can quickly and easily identify children and adolescents whose blood pressure readings merit further evaluation by a physician and rule out abnormal blood pressure in children and adolescents.

Key Words: hypertension • prehypertension • primary care • screening

Accepted Feb 4, 2009.


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