title: First report on simplified diagnostic criteria for pre-hypertension and hypertension in a national sample of adolescents from the Middle East and North Africa: the CASPIAN-III study.
abstract: OBJECTIVE
  This study aimed to simplify the diagnostic criteria of pre-hypertension (pre-HTN) and hypertension (HTN) in the pediatric age group, and to determine the accuracy of these simple indexes in a nationally-representative sample of Iranian children and adolescents.
  
  
  METHODS
  The diagnostic accuracy of the indexes of systolic blood pressure-to-height ratio (SBPHR) and diastolic BPHR (DBPHR) to define pre-HTN and HTN was determined by the area under the curve of the receiver operator characteristic curves.
  
  
  RESULTS
  The study population consisted of 5,738 Iranian students (2,875 females) with mean (SD) age of 14.7 (2.4) years. The prevalences of pre-HTN and HTN were 6.9% and 5.6%. The optimal thresholds for defining pre-HTN were 0.73 in males and 0.71 in females for SBPHR, and 0.47 in males and 0.45 in females for DBPHR, respectively. The corresponding figures for HTN were 0.73, 0.71, 0.48, and 0.46, respectively. In both genders, the accuracies of SBPHR and DBPHR in diagnosing pre-HTN and HTN were approximately 80%.
  
  
  CONCLUSIONS
  BPHR is a valid, simple, inexpensive, and accurate tool to diagnose pre-HTN and HTN in adolescents. The optimal thresholds of SBPHR and DBPHR were consistent with the corresponding figures in other populations of children and adolescents with different racial and ethnic backgrounds. Thus, it is suggested that the use of these indexes can be generalized in programs aiming to screen elevated blood pressure in the pediatric age group.
authors.affiliation: Pediatrics Department, Child Growth and Development Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Roya
authors.initials: R
authors.lastname: Kelishadi
authors.affiliation: Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Ramin
authors.initials: R
authors.lastname: Heshmat
authors.affiliation: Bureau of Population, Family, and School Health, Ministry of Health and Medical Education, Tehran, Iran.
authors.forename: Gelayol
authors.initials: G
authors.lastname: Ardalan
authors.affiliation: Department of Public Health, Alborz University of Medical Sciences, Karaj, Iran; Department of Epidemiology, Iran University of Medical Sciences, Tehran, Iran.
authors.forename: Mostafa
authors.initials: M
authors.lastname: Qorbani
authors.affiliation: School Health Department, Bureau of Health and Fitness, Ministry of Education, Tehran, Iran.
authors.forename: Mahnaz
authors.initials: M
authors.lastname: Taslimi
authors.affiliation: Environment Department, Environment Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Parinaz
authors.initials: P
authors.lastname: Poursafa
authors.affiliation: Pediatrics Department, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
authors.forename: Kasra
authors.initials: K
authors.lastname: Keramatian
authors.affiliation: Bureau of Population, Family, and School Health, Ministry of Health and Medical Education, Tehran, Iran.
authors.forename: Majzoubeh
authors.initials: M
authors.lastname: Taheri
authors.affiliation: Pediatrics Department, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. Electronic address: mohammad-motlagh1389@yahoo.com.
authors.forename: Mohammad-Esmaeil
authors.initials: ME
authors.lastname: Motlagh
mesh_terms: D000293:Adolescent; D000352:Africa, Northern / Q000453:epidemiology; D001794:Blood Pressure / Q000502:physiology*; D001827:Body Height / Q000502:physiology; D015992:Body Mass Index; D002648:Child; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis* / Q000453:epidemiology; D008297:Male; D008877:Middle East / Q000453:epidemiology; D058246:Prehypertension / Q000175:diagnosis* / Q000453:epidemiology; D015995:Prevalence; D012372:ROC Curve; D012494:Sampling Studies; D013334:Students
keywords: Adolescence; Adolescência; Blood pressure; Hipertensão; Hypertension; Pre-hypertension; Pressão sanguínea; Pré-hipertensão; Screening; Triagem