title: Is one measurement enough to evaluate blood pressure among adolescents? A blood pressure screening experience in more than 9000 children with a subset comparison of auscultatory to mercury measurements.
abstract: Evaluation of blood pressure is recommended in all children older than 3 years. Auscultatory devices are the recommended method to assess blood pressure in pediatrics, but automated oscillometric devices are increasingly common. A retrospective analysis of our school-based blood pressure screening was performed to determine if multiple oscillometric blood pressure measurements are needed to approach true blood pressure. All children had 4 oscillometric measurements of blood pressures and a random subset of 287 had an additional auscultatory measurement. Among 9870 participants, we observed a nonlinear decrease in blood pressure over time. The largest decrease in systolic blood pressure was between first and second (-3.8 mm Hg) and in diastolic from second to third (-3.3 mm Hg) measurement. For systolic blood pressure, the second oscillometric measurement, the average of second to third and the average of first to third were statistically similar to a single auscultatory measurement. We conclude that assessment of blood pressure using oscillometric devices should include at least 3 measurements in the same sitting to avoid inaccurate assessment.
authors.affiliation: Department of Pediatrics, Division of Pediatric Nephrology and Hypertension, University of Texas Health Science Center, Houston, TX, USA. Electronic address: xnegronibalasquide@mhs.net.
authors.forename: Xamayta
authors.initials: X
authors.lastname: Negroni-Balasquide
authors.affiliation: Department of Pediatrics, Division of Pediatric Nephrology and Hypertension, University of Texas Health Science Center, Houston, TX, USA.
authors.forename: Cynthia S
authors.initials: CS
authors.lastname: Bell
authors.affiliation: Department of Pediatrics, Division of Pediatric Nephrology and Hypertension, University of Texas Health Science Center, Houston, TX, USA.
authors.forename: Joyce
authors.initials: J
authors.lastname: Samuel
authors.affiliation: Department of Pediatrics, Division of Pediatric Nephrology and Hypertension, University of Texas Health Science Center, Houston, TX, USA.
authors.forename: Joshua A
authors.initials: JA
authors.lastname: Samuels
mesh_terms: D000293:Adolescent; D001314:Auscultation; D001794:Blood Pressure; D001795:Blood Pressure Determination / Q000379:methods*; D002648:Child; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis*; D008297:Male; D009991:Oscillometry / Q000295:instrumentation; D017410:Practice Guidelines as Topic; D012189:Retrospective Studies; D013781:Texas / Q000453:epidemiology; D055815:Young Adult
keywords: Blood pressure measurement; adolescent; auscultatory; oscillometric