title: The performance of modified blood pressure-to-height ratio as a screening measure for identifying children with hypertension.
abstract: OBJECTIVE
  This study evaluated the accuracy of modified blood pressure-to-height ratio (MBPHR) for identifying hypertension in Han children aged 7-12 years.
  
  
  METHODS
  In 2011, anthropometric measurements were assessed in a cross-sectional population-based study of 1352 Han children aged 7-12 years. Elevated blood pressure was defined according to the 2004 National High Blood Pressure Education Program Working Group definition (as gold standard). The following equations for MBPHR were used: modified systolic blood pressure to height ratio(MSBPHR) = SBP(mmHg)/(height(cm) + 7 × (13 - age(years))), modified diastolic blood pressure to height ratio (MDBPHR) = DBP(mmHg)/(height(cm) + 7 × (13 - age(years))). Receiver operating characteristic curve analyses were performed to assess the accuracy of MSBPHR and MDBPHR as diagnostic tests for elevated SBP and DBP, respectively.
  
  
  RESULTS
  The accuracy of MSBPHR and MDBPHR (assessed by area under the curve) for identifying elevated SBP and DBP were over 0.85 (0.953-1.000). When elevated blood pressure was defined by MBPHR (age-dependent cut-off point), the sensitivities were 99.1% in boys and 97.0% in girls and the specificities were 89.0% in boys and 92.3% in girls. When elevated blood pressure was defined by MBPHR (non-age-dependent cut-off point), the sensitivities were 96.4% in boys and 99.2% in girls and the specificities were 81.2% in boys and 75.5% in girls.
  
  
  CONCLUSIONS
  MBPHR is an accurate index for screening hypertension in children, but is not superior to BPHR. Compared with age-dependent BPHR cutoff points, non-age-dependent MBPHR cut-off point is simple but increase the proportion of reexamination.
authors.affiliation: a Department of Endocrinology , The First Hospital of Qinhuangdao , Hebei Province , China.
authors.forename: Chunming
authors.initials: C
authors.lastname: Ma
authors.affiliation: a Department of Endocrinology , The First Hospital of Qinhuangdao , Hebei Province , China.
authors.forename: Qiang
authors.initials: Q
authors.lastname: Lu
authors.affiliation: a Department of Endocrinology , The First Hospital of Qinhuangdao , Hebei Province , China.
authors.forename: Fuzai
authors.initials: F
authors.lastname: Yin
mesh_terms: D000886:Anthropometry; D044466:Asian People; D001794:Blood Pressure; D001795:Blood Pressure Determination; D001827:Body Height; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis* / Q000503:physiopathology; D008297:Male; D008403:Mass Screening; D012372:ROC Curve; D012680:Sensitivity and Specificity; D013599:Systole
keywords: Hypertension; children; elevated blood pressure; modified blood pressure-to-height ratio; screening method