title: A modified blood pressure to height ratio improves accuracy for hypertension in childhood.
abstract: BACKGROUND
  The blood pressure to height ratio (BP:HT) has been proposed as a simple method for identifying children with elevated BP. This procedure shows good accuracy for the screening of hypertension in adolescents but less so in younger children. Our aim in this study was to modify the BP:HT ratio and determine if this change would increase accuracy when measuring hypertension during childhood.
  
  
  METHODS
  BP levels of 4,327 children (aged 5-12 years) were retrospectively obtained from medical charts. The modified ratio (BT:eHT13) was calculated as: BP/(HT + 7 × (13 - age in years)). Receiver operating characteristic curves were used to estimate cutoff points and the accuracy of the conventional and modified ratio to detect prehypertension and hypertension.
  
  
  RESULTS
  The prevalences of prehypertension and hypertension were 3.91% and 5.44%, respectively. In general, BP:eHT13 showed higher sensitivity (ranging from 0.95 to 1.00) and specificity (ranging from 0.80 to 0.98) in detecting prehypertension, level I hypertension, and level II hypertension than BP:HT (sensitivity ranging from 0.91 to 1.00; specificity ranging from 0.59 to 0.89).
  
  
  CONCLUSIONS
  The modified BP:eHT13 ratio showed better sensitivity and specificity for the screening of BP abnormalities in children aged 5-12 years.
authors.affiliation: Círculo do Coração de Pernambuco, Pernambuco, Brazil; Laboratório de Imunopatologia Keizo Asami, Pernambuco, Brazil; and felipe.a.mourato@gmail.com.
authors.forename: Felipe A
authors.initials: FA
authors.lastname: Mourato
authors.affiliation: Laboratório de Imunopatologia Keizo Asami, Pernambuco, Brazil; and Universidade Estadual de Campinas, São Paulo, Brazil.
authors.forename: Wilson
authors.initials: W
authors.lastname: Nadruz
authors.affiliation: Círculo do Coração de Pernambuco, Pernambuco, Brazil;
authors.forename: Lucia R D N
authors.initials: LR
authors.lastname: Moser
authors.affiliation: Laboratório de Imunopatologia Keizo Asami, Pernambuco, Brazil; and.
authors.forename: José L
authors.initials: JL
authors.lastname: de Lima Filho
authors.affiliation: Círculo do Coração de Pernambuco, Pernambuco, Brazil; Laboratório de Imunopatologia Keizo Asami, Pernambuco, Brazil; and.
authors.forename: Sandra S
authors.initials: SS
authors.lastname: Mattos
mesh_terms: D001794:Blood Pressure; D001827:Body Height; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis*; D008297:Male; D012189:Retrospective Studies; D012680:Sensitivity and Specificity
keywords: blood pressure; diagnosis; hypertension; mass screening; pediatrics.