title: Hypertension screening using blood pressure to height ratio.
abstract: OBJECTIVE
  The definition of hypertension in children is too complex to be used by medical professionals and children and their parents because of the age-, gender-, and height-specific blood pressure (BP) algorithm. The aim of this study was to simplify the pediatric BP percentile references using BP to height ratio (BPHR, equal to BP/height) for screening for prehypertension and hypertension in Chinese children.
  
  
  METHODS
  Data were obtained from the China Health and Nutrition Survey, which was conducted from 1991 to 2009 and included 11 661 children aged 6 to 17 years with complete data on age, gender, height, and BP values. Receiver operating characteristic curve analysis was performed to assess the performance of systolic BPHR (SBPHR) and diastolic BPHR (DBPHR) for screening for pediatric prehypertension and hypertension.
  
  
  RESULTS
  The optimal thresholds for defining prehypertension were 0.81 in children aged 6 to 11 years and 0.70 in adolescents aged 12 to 17 years for SBPHR and 0.52 in children and 0.46 in adolescents for DBPHR, respectively. The corresponding values for hypertension were 0.84, 0.78, 0.55, and 0.50, respectively. The negative predictive values were much higher (all ≥99%) for prehypertension and hypertension, although the positive predictive values were relatively lower, ranging from 13% to 75%.
  
  
  CONCLUSIONS
  BPHR index is simple and accurate for screening for prehypertension and hypertension in Chinese children aged 6 to 17 years and can be used for early screening or treating Chinese children with hypertension.
authors.affiliation: Department of Epidemiology and Health Statistics School of Public Health, Shandong University, Jinan, China; xibo2010@sdu.edu.cn steffen@umn.edu.
authors.forename: Bo
authors.initials: B
authors.lastname: Xi
authors.affiliation: Department of Epidemiology, Capital Institute of Pediatrics, Beijing, China;Graduate School, Peking Union Medical College, Beijing, China;
authors.forename: Meixian
authors.initials: M
authors.lastname: Zhang
authors.affiliation: Department of Epidemiology and Health Statistics School of Public Health, Shandong University, Jinan, China;
authors.forename: Tao
authors.initials: T
authors.lastname: Zhang
authors.affiliation: School of Public Health, Jining Medical University, Jining, China;Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet-Stockholm University, Stockholm, Sweden;
authors.forename: Yajun
authors.initials: Y
authors.lastname: Liang
authors.affiliation: Department of Epidemiology and Health Statistics School of Public Health, Shandong University, Jinan, China;
authors.forename: Shuangshuang
authors.initials: S
authors.lastname: Li
authors.affiliation: Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis xibo2010@sdu.edu.cn steffen@umn.edu.
authors.forename: Lyn M
authors.initials: LM
authors.lastname: Steffen
mesh_terms: D000293:Adolescent; D044466:Asian People; D001794:Blood Pressure; D001795:Blood Pressure Determination / Q000379:methods*; D001827:Body Height; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis*; D008297:Male; D058246:Prehypertension / Q000175:diagnosis*
keywords: blood pressure to height ratio; children; diagnostic criteria; high blood pressure