Korean Circ J.  2019 Dec;49(12):1167-1180. 10.4070/kcj.2019.0075.

Blood Pressure Reference Values for Normal Weight Korean Children and Adolescents: Data from The Korea National Health and Nutrition Examination Survey 1998–2016: The Korean Working Group of Pediatric Hypertension

Affiliations
  • 1Department of Pediatrics, Hallym University Sacred Heart Hospital, Anyang, Korea.
  • 2The Korean Working Group of Pediatric Hypertension, Seoul, Korea. yhsong@snubh.org
  • 3Medical Research Collaborating Center, Seongnam, Korea.
  • 4Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam, Korea.
  • 5Department of Pediatrics, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Korea.
  • 6Department of Pediatrics, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, Korea.
  • 7Department of Pediatrics, The Catholic University of Korea, St.Vincent's Hospital, Suwon, Korea.
  • 8Department of Pediatrics, Ewha Womans University College of Medicine, Seoul, Korea.
  • 9Department of Pediatrics, Pusan National University Children's Hospital, Pusan, Korea.
  • 10Department of Pediatrics, National Medical Center, Seoul, Korea.
  • 11Department of Pediatrics, VHS Medical Center, Seoul, Korea.
  • 12Department of Pediatrics, Chosun University School of Medicine, Gwangju, Korea.
  • 13Department of Pediatrics, Yonsei University Wonju College of Medicine, Wonju, Korea.
  • 14Department of Pediatrics, Hanyang University Hospital, Seoul, Korea.
  • 15Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea.
  • 16Division of Statistics, Medical Research Collaborating Center, Seoul National University Bundang Hospital, Seongnam, Korea.
  • 17Department of Statistics, Inha University, Incheon, Korea.

Abstract

BACKGROUND AND OBJECTIVES
Hypertension is becoming one of the most common health conditions in children and adolescents due to increasing childhood obesity. We aimed to provide the auscultatory blood pressure (BP) normative reference values for Korean non-overweight children and adolescents.
METHODS
BP measurements in children and adolescents aged 10 to 18 years were performed in the Korean National Health and Nutrition Examination Survey (KNHANES) from 1998 to 2016. BP was measured using a mercury sphygmomanometer. Sex-, age- and height-specific systolic BP (SBP) and diastolic BP (DBP) percentiles were calculated in the non-overweight children (n=10,442). We used the General Additive Model for Location Scale and Shape method to calculate BP percentiles.
RESULTS
The 50th, 90th, 95th, and 99th percentiles of SBP and DBP tables and graphs of non-overweight children and adolescents aged 10 to 18 years were presented by age and height percentiles. We found that the SBP and DBP at the 95th percentile were well correlated with height. The BP tables presented by height contained BP values from 124 cm to 190 cm for boys and from 120 cm to 178 cm for girls. Boys had higher SBP and DBP.
CONCLUSIONS
We provided the sex-, age- and height-specific auscultatory BP values using the KNHANES big data. These may be useful in diagnosis and treatment of hypertension in Korean children and adolescents.

Keyword

Blood pressure; Hypertension; Adolescent; Auscultation

MeSH Terms

Adolescent*
Auscultation
Blood Pressure*
Child*
Diagnosis
Female
Humans
Hypertension*
Korea*
Methods
Nutrition Surveys*
Pediatric Obesity
Reference Values*
Sphygmomanometers

Figure

  • Figure 1 BP percentiles by (A-D) age and by (E-H) height. (A) SBP for boys by age. (B) DBP for boys by age. (C) SBP for girls by age. (D) DBP for girls by age. (E) SBP for boys by height. (F) DBP for boys by height. (G) SBP for girls by height. (H) DBP for girls by height. BP = blood pressure; DBP = diastolic blood pressure; SBP = systolic blood pressure.


Reference

1. Raj M. Obesity and cardiovascular risk in children and adolescents. Indian J Endocrinol Metab. 2012; 16:13–19.
Article
2. Flynn J. The changing face of pediatric hypertension in the era of the childhood obesity epidemic. Pediatr Nephrol. 2013; 28:1059–1066.
3. Jackson SL, Zhang Z, Wiltz JL, et al. Hypertension among youths - United States, 2001–2016. MMWR Morb Mortal Wkly Rep. 2018; 67:758–762.
Article
4. Juhola J, Magnussen CG, Berenson GS, et al. Combined effects of child and adult elevated blood pressure on subclinical atherosclerosis: the International Childhood Cardiovascular Cohort Consortium. Circulation. 2013; 128:217–224.
5. National High Blood Pressure Education Program Working Group on High Blood Pressure in Children and Adolescents. The fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents. Pediatrics. 2004; 114:555–576.
6. Lurbe E, Agabiti-Rosei E, Cruickshank JK, et al. 2016 European Society of Hypertension guidelines for the management of high blood pressure in children and adolescents. J Hypertens. 2016; 34:1887–1920.
Article
7. Flynn JT, Kaelber DC, Baker-Smith CM, et al. Clinical practice guideline for screening and management of high blood pressure in children and adolescents. Pediatrics. 2017; 140:e20171904.
8. Harris KC, Benoit G, Dionne J, et al. Hypertension Canada's 2016 Canadian Hypertension Education Program guidelines for blood pressure measurement, diagnosis, and assessment of risk of pediatric hypertension. Can J Cardiol. 2016; 32:589–597.
Article
9. Koebnick C, Black MH, Wu J, et al. High blood pressure in overweight and obese youth: implications for screening. J Clin Hypertens (Greenwich). 2013; 15:793–805.
10. Barba G, Buck C, Bammann K, et al. Blood pressure reference values for European non-overweight school children: the IDEFICS study. Int J Obes. 2014; 38:Suppl 2. S48–56.
Article
11. El-Shafie AM, El-Gendy FM, Allhony DM, et al. Establishment of blood pressure nomograms representative for Egyptian children and adolescents: a cross-sectional study. BMJ Open. 2018; 8:e020609.
12. Yan W, Liu F, Li X, et al. Blood pressure percentiles by age and height for non-overweight Chinese children and adolescents: analysis of the China Health and Nutrition Surveys 1991–2009. BMC Pediatr. 2013; 13:195.
Article
13. Lee CG, Moon JS, Choi JM, et al. Normative blood pressure references for Korean children and adolescents. Korean J Pediatr. 2008; 51:33–41.
14. Kim HS, Park MJ, Oh MK, Hong YM. Auscultatory measured normative blood pressure of Korean adolescents: using the Korean National Health and Nutrition Examination Survey 2001–2007. Korean Circ J. 2012; 42:809–815.
Article
15. Ministry of Health and Welfare (KR). The Korean National Health and Nutritional Examination Survey [Internet]. Sejong: Ministry of Health and Welfare;2018. 02. 01. cited 2018 May 1. Available from https://knhanes.cdc.go.kr.
16. Kweon S, Kim Y, Jang MJ, et al. Data resource profile: the Korea National Health and Nutrition Examination Survey (KNHANES). Int J Epidemiol. 2014; 43:69–77.
17. Korean Centers for Disease Control and Prevention. Source title [Internet]. Cheongju: Korean Centers for Disease Control and Prevention;2017. 12. 29. cited 2018 May 1. Available from http://www.cdc.go.kr/.
18. Harding S, Maynard M, Cruickshank JK, Gray L. Anthropometry and blood pressure differences in black Caribbean, African, South Asian and white adolescents: the MRC DASH study. J Hypertens. 2006; 24:1507–1514.
Article
19. Park MK, Menard SW, Yuan C. Comparison of auscultatory and oscillometric blood pressures. Arch Pediatr Adolesc Med. 2001; 155:50–53.
20. Lee CG, Park HM, Shin HJ, et al. Validation study of the Dinamap ProCare 200 upper arm blood pressure monitor in children and adolescents. Korean J Pediatr. 2011; 54:463–469.
Article
Full Text Links
  • KCJ
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr