title: Making a diagnosis of hypertension and defining treatment threshold in very low birth weight infants' need revision?
abstract: BACKGROUND
  Recent evidence suggests that preterm birth is a possible risk factor for high blood pressure (BP) in later life. The most widely quoted blood pressure centiles for very low birth weight (VLBW, ≤1500 g birth weight) infants at corrected term gestation is based on a cohort with mostly late preterm or term infants (Zubrow curves).
  
  
  OBJECTIVE
  The objective of this study was to determine the clinical utility of the Zubrow curves in diagnosis of hypertension in VLBW infants at their term corrected gestational age (CGA).
  
  
  METHODS
  In a case-control study, we compared BP in 75 VLBW infants at 40 weeks CGA (cases) to 69 full term infants admitted to neonatal intensive care unit (NICU) (controls).
  
  
  RESULTS
  In spite of having lower weights, VLBW infants compared to term infants (2612.8 ± 546 vs. 3308.2 ± 373 g, P ≤ 0.001) had higher average systolic (88.8 ± 7.6 vs. 82.33 ± 8.5 mm Hg; P ≤ 0.001) and mean BP (61.2 ± 6.6 vs. 57.61 ± 6.9, P = 0.01). Although 41% (31/75) VLBW infants would have met the criteria for hypertension according to Zubrow curves only 4% (3/75) were diagnosed with hypertension.
  
  
  CONCLUSIONS
  Since Zubrow BP centiles were based on a heterogeneous population of infants including preterm and term infants, new BP centiles based on chronological data from VLBW infants would allow a better definition of hypertension in these infants and identify the threshold BP for initiating treatment.
authors.affiliation: Rainbow Babies and Children Hospital, Cleveland, Ohio, USA.
authors.forename: Sreekanth
authors.initials: S
authors.lastname: Viswanathan
authors.affiliation: MetroHealth Medical Center, Cleveland, Ohio, USA.
authors.forename: Deepak
authors.initials: D
authors.lastname: Kumar
authors.affiliation: MetroHealth Medical Center, Cleveland, Ohio, USA.
authors.forename: Craig
authors.initials: C
authors.lastname: Sykes
authors.affiliation: MetroHealth Medical Center, Cleveland, Ohio, USA.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Olbrych
authors.affiliation: MetroHealth Medical Center, Cleveland, Ohio, USA.
authors.forename: Nishant
authors.initials: N
authors.lastname: Patel
authors.affiliation: MetroHealth Medical Center, Cleveland, Ohio, USA.
authors.forename: Dennis M
authors.initials: DM
authors.lastname: Super
authors.affiliation: Rainbow Babies and Children Hospital, Cleveland, Ohio, USA.
authors.forename: Jessica
authors.initials: J
authors.lastname: Darusz
authors.affiliation: MetroHealth Medical Center, Cleveland, Ohio, USA ; Akron Children Hospital, Akron, Ohio, USA.
authors.forename: Rupesh
authors.initials: R
authors.lastname: Raina
keywords: Blood pressure; Hypertension; Prematurity; Very low birth weight infants