Home blood pressure normalcy in children and adolescents: the Arsakeion School study

Abstract

Objective: There is evidence that home blood pressure (BP) is being used in clinical practice for the assessment of out-of-office blood pressure in children. However, there is no information on the normal range of home BP in this population. This prospective school-based study was designed to investigate the normal range of home BP in children and adolescents.

Subjects and methods: A total of 778 healthy subjects (358 boys) with mean age 12.3 +/- 3.3 (SD) years (range 6-18 years), height 157 +/- 18 cm (113-198 cm) and weight 50 +/- 18 kg (16-135 kg) were included. Home BP was monitored for 3 days using validated electronic devices (Omron 705IT).

Results: Reliable home BP readings provided by 767 subjects (98%) were analysed. Strong correlations were found between systolic home BP and body height (r = 0.49) and age (r = 0.41), whereas for diastolic BP these correlations were poor (r = 0.11 and 0.08, respectively). The 50th (midpoint of distribution) and the 95th percentile (suggested upper normal limit) for systolic and diastolic home BP in children are provided by body height. There was a marked increase in the estimated 95th percentile for systolic home BP with increasing height in boys (from 119 to 134 mmHg) and less so in girls (from 119 to 128 cm). Regarding diastolic home BP, there was little change with increasing height (from 75 to 80 cm) and no difference between boys and girls.

Conclusions: These data suggest that home BP monitoring in children and adolescents is feasible. Reference values for home BP in the paediatric population are provided.