title: Absolute height-specific thresholds to identify elevated blood pressure in children.
abstract: OBJECTIVE
  Identification of children with elevated blood pressure (BP) is difficult because of the multiple sex, age, and height-specific thresholds to define elevated BP. We propose a simple set of absolute height-specific BP thresholds and evaluate their performance to identify children with elevated BP in two different populations.
  
  
  METHODS
  Using the 95th sex, age, and relative-height BP US thresholds to define elevated BP in children (standard criteria), we derived a set of (non sex- and non age-specific) absolute height-specific BP thresholds for 11 height categories by 10 cm increments. Using data from large school-based surveys conducted in Switzerland (N = 5207; 2621 boys, 2586 girls; age range: 10.1-14.9 years) and in the Seychelles (N = 25 759; 13 048 boys, 12 711 girls; age range: 4.4-18.8 years), we evaluated the performance of these height-specific thresholds to identify children with elevated BP. We also derived sex-specific absolute height-specific BP thresholds and compared their performance.
  
  
  RESULTS
  In the Swiss and the Seychelles surveys, the prevalence of elevated BP (standard criteria) was 11.4 and 9.1%, respectively. The height-specific thresholds to identify elevated BP had a sensitivity of 80 and 84%, a specificity of 99 and 99%, a positive predictive value of 92 and 91%, and a negative predictive value of 97 and 98%, respectively. Performance of sex-specific absolute height-specific BP thresholds was similar.
  
  
  CONCLUSIONS
  A simple table of height-specific BP thresholds allowed identifying children with elevated BP with high sensitivity and excellent specificity.
authors.affiliation: Institute of Social and Preventive Medicine IUMSP, University Hospital Center, 1010 Lausanne, Switzerland. arnaud.chiolero@chuv.ch
authors.forename: Arnaud
authors.initials: A
authors.lastname: Chiolero
authors.forename: Gilles
authors.initials: G
authors.lastname: Paradis
authors.forename: Giacomo D
authors.initials: GD
authors.lastname: Simonetti
authors.forename: Pascal
authors.initials: P
authors.lastname: Bovet
mesh_terms: D000293:Adolescent; D001794:Blood Pressure; D001827:Body Height; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis* / Q000453:epidemiology; D008297:Male; D012015:Reference Standards; D012750:Seychelles / Q000453:epidemiology; D013557:Switzerland / Q000453:epidemiology; D055815:Young Adult