title: Blood pressure to height ratio as a screening tool for prehypertension and hypertension in adolescents.
abstract: BACKGROUND
  Current methods of detection of childhood hypertension are cumbersome and contribute to under-diagnosis hence, the need to generate simpler diagnostic tools. The blood pressure to height ratio has recently been proposed as a novel screening tool for prehypertension and hypertension in some populations. We evaluated its applicability in our environment.
  
  
  METHODS
  The weights, heights, and blood pressure measurements of 2364 apparently healthy adolescents were determined. Sex-specific systolic and diastolic blood pressure to height ratios (SBPHR) and (DBPHR) were calculated, and their ability to detect prehypertension and hypertension was determined using receiver operating curves. Discriminatory ability was measured by the area under the curve (AUC) and optimal cutoff points along the curve were determined. P < 0.05 was considered statistically significant.
  
  
  RESULTS
  The SBPHR and DBPHR were similar across all age groups and sexes. The AUC of SBPHR and DBPHR for diagnosing prehypertension and hypertension by sex was >0.95 for both diastolic and systolic hypertension in both sexes. It ranged between 0.803 and 0.922 for prehypertension and 0.954-0.978 for hypertension indicating higher accuracy for hypertension. Sensitivity was higher for systolic and diastolic hypertension (90-98%) compared with prehypertension (87-98%). Specificity was lower than sensitivity across all categories of hypertension and prehypertension (0.64-0.88%) though higher for hypertension (0.75-0.88) compared with prehypertension (0.64-0.75).
  
  
  CONCLUSIONS
  BPHR is a useful screening tool for prehypertension and hypertension in black adolescents. Accuracy increased with higher degrees of hypertension.
authors.affiliation: Department of Paediatrics, College of Medicine, University of Lagos and Lagos University Teaching Hospital, PMB 12003, Idi-Araba, Lagos, Nigeria.
authors.forename: T A
authors.initials: TA
authors.lastname: Ladapo
authors.forename: I B
authors.initials: IB
authors.lastname: Fajolu
authors.forename: O F
authors.initials: OF
authors.lastname: Adeniyi
authors.forename: E N
authors.initials: EN
authors.lastname: Ekure
authors.forename: R O
authors.initials: RO
authors.lastname: Maduako
authors.forename: T C
authors.initials: TC
authors.lastname: Jaja
authors.forename: A O
authors.initials: AO
authors.lastname: Oduwole
mesh_terms: D000293:Adolescent; D001794:Blood Pressure / Q000502:physiology*; D001795:Blood Pressure Determination / Q000379:methods*; D001827:Body Height / Q000502:physiology*; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D008297:Male; D008403:Mass Screening / Q000379:methods*; D009549:Nigeria / Q000453:epidemiology; D058246:Prehypertension / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology