title: Comparison of auscultatory and oscillometric BP measurements in children with obesity and their effect on the diagnosis of arterial hypertension.
abstract: OBJECTIVE
  The level of agreement between two blood pressure (BP) reading methods, auscultatory vs oscillometric, was examined using a mercury sphygmomanometer and an electronic device in children and adolescents with different levels of obesity. The readings were compared to determine their impact on the diagnosis of pre-hypertension/hypertension.
  
  
  METHODS
  Blood pressure readings were taken in children with obesity (body mass index ≥ 95th percentile) and severe obesity (≥120% 95th percentile). Bland-Altman analysis and Intraclass Correlation Coefficient were used to determine the agreement between measurements.
  
  
  RESULTS
  The mercury sphygmomanometer readings were lower than those obtained with the electronic device for both systolic and diastolic BP (P=.01 and P=.001, respectively). The mean systolic and diastolic BP differences between the oscillometric vs first mercury reading were 4.2/10.2mmHg, respectively. A large difference was observed between the BP measurement methods. The ICC showed regular to moderate reliability for the systolic BP (.595), but poor for the diastolic BP (.330). Screening using the first of three mercury measurements showed that 10.4% of the children and adolescents had BPs within the pre-hypertension/hypertension range. This was reduced to 5.2% when the mean of three mercury readings was used.
  
  
  CONCLUSIONS
  Large discrepancies were observed in both the systolic and diastolic BP. These differences are not clinically acceptable as to consider the two instruments interchangeable. The electronic device readings were higher, and they overestimated the diagnosis of hypertension.
authors.affiliation: Instituto de Investigación Cardiovascular, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Nuevo Hospital Civil de Guadalajara, Mexico. Electronic address: salvadorf@mail.hcg.udg.mx.
authors.forename: Salvador
authors.initials: S
authors.lastname: Fonseca-Reyes
authors.affiliation: Instituto de Nutrición Humana, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Nuevo Hospital Civil de Guadalajara, Mexico.
authors.forename: Enrique
authors.initials: E
authors.lastname: Romero-Velarde
authors.affiliation: Instituto de Investigación Cardiovascular, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Nuevo Hospital Civil de Guadalajara, Mexico.
authors.forename: Edith
authors.initials: E
authors.lastname: Torres-Gudiño
authors.affiliation: Instituto de Nutrición Humana, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Nuevo Hospital Civil de Guadalajara, Mexico.
authors.forename: Daniel
authors.initials: D
authors.lastname: Illescas-Zarate
authors.affiliation: Instituto de Investigación Cardiovascular, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Nuevo Hospital Civil de Guadalajara, Mexico.
authors.forename: Avril M
authors.initials: AM
authors.lastname: Forsyth-MacQuarrie
mesh_terms: D000293:Adolescent; D001314:Auscultation; D001795:Blood Pressure Determination / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000175:diagnosis*; D008297:Male; D009991:Oscillometry; D063766:Pediatric Obesity / Q000150:complications*; D058246:Prehypertension / Q000150:complications* / Q000175:diagnosis*; D019722:Sphygmomanometers
keywords: Blood pressure measurement; Childhood hypertension diagnosis; Diagnóstico de hipertensión en niños; Dispositivos oscilométricos; Medición de presión arterial; Mexico; México; Oscillometric devices