Reproducibility of home and ambulatory blood pressure in children and adolescents.
OBJECTIVE
To evaluate the reproducibility of blood pressure measured at home (HBP) in comparison with ambulatory (ABP) and clinic blood pressure (CBP) in children and adolescents.


METHODS
Individuals aged 8-17 years who had been referred for elevated CBP were included. CBP was measured at two visits, HBP on 5 days and ABP for 24 h. A second session including all the above measurements was performed after 8 weeks. The reproducibility of CBP (second visit of each session), HBP (average of days 2-5 of each session) and ABP (average 24-h, awake and asleep) was quantified using test-retest correlations coefficients (r) and the standard deviation of differences (SDD) between repeated measurements.


RESULTS
Sixteen individuals were included [mean age 13.3+/-2.9 (SD)] years, range 8-17, nine boys]. According to Task Force CBP criteria, eight were classified as hypertensives, three as high normal and five as normotensives. The reproducibility of HBP (systolic/diastolic r, 0.74/0.82, SDD 7.0/4.3) was superior to that of CBP (r, 0.63/0.80, SDD 10.4/6.3). However, ABP appeared to provide the most reproducible values (r, 0.87/0.84, SDD 5.5/4.3 for 24-h ABP; r, 0.85/0.76, SDD 5.9/5.0 for awake; r, 0.76/0.79, SDD 7.0/5.0 for asleep ABP). Aspects of the diurnal ABP variation were poorly reproducible (r, 0.62/0.14, SDD 6.8/5.5 for awake-asleep ABP difference; r, 0.55/0.26, SDD 0.07/0.11 for awake : asleep ratio).


CONCLUSIONS
These data suggest that in children and adolescents home blood pressure measurements are more reproducible than clinic measurements. However, 24-h ambulatory monitoring appears to provide the most reproducible blood pressure values.
Stergiou
George S
GS
Hypertension Center, Third University Department of Medicine, Sotiria Hospital, Athens, Greece. gstergi@med.uoa.gr
Alamara
Christina V
CV
Salgami
Eleanna V
EV
Vaindirlis
Iraklis N
IN
Dacou-Voutetakis
Catherine
C
Mountokalakis
Theodore D
TD
D000293:Adolescent; D001794:Blood Pressure / Q000502:physiology*; D001795:Blood Pressure Determination; D018660:Blood Pressure Monitoring, Ambulatory; D002648:Child; D005260:Female; D006699:Home Care Services; D006801:Humans; D006973:Hypertension / Q000503:physiopathology*; D008297:Male; D009819:Office Visits; D015203:Reproducibility of Results