Potential Misclassification of Blood Pressure Status in Children and Adolescents with Short or Tall Stature

Emily D. Parker; Alan R. Sinaiko; Patrick J. O'Connor; Heidi Ekstrom; Deepika Appana; Jerry Amundson; Elyse Olshen Kharbanda

doi:10.1093/aje/kwv208

Potential Misclassification of Blood Pressure Status in Children and Adolescents with Short or Tall Stature

Emily D. Parker, Alan R. Sinaiko, Patrick J. O'Connor, Heidi Ekstrom, Deepika Appana, Jerry Amundson, Elyse Olshen Kharbanda

Pediatric Nephrology

Research output: Contribution to journal › Article › peer-review

5 Scopus citations

Abstract

Blood pressure (BP) is measured in percentiles that are adjusted for sex, age, and height percentile in children and adolescents. Standard tables for the conversion of BP percentiles do not present exact BP percentile cutoffs for extremes in stature, either short (<5th percentile) or tall (>95th percentile). An algorithm can be used to calculate exact BP percentiles across a range of height z scores. We compared values from standard BP tables with exact calculations of BP percentiles to see which were better at identifying hypertension in more than 5,000 children with either short or tall stature. Study subjects were 3-17-year-old patients within HealthPartners Medical Group, an integrated health care delivery system in Minnesota, at any time between 2007 and 2012. Approximately half of the subjects who met the criteria for hypertension using exact calculation would be misclassified as normal using available thresholds in the published BP tables instead of the recommended algorithm, which was not included in the tables.

Original language	English (US)
Pages (from-to)	79-83
Number of pages	5
Journal	American journal of epidemiology
Volume	183
Issue number	1
DOIs	https://doi.org/10.1093/aje/kwv208
State	Published - Jan 1 2016

Bibliographical note

Funding Information:
This study was funded by the National Heart, Lung, and Blood Institute at the National Institutes of Health (grant R01 HL093345: Childhood Hypertension and Obesity: Diagnosis, Care, and Costs Study to HealthPartners Institute for Education and Research; Patrick J. O''Connor, principal investigator). Additional funding for this study was received from National Heart, Lung, and Blood Institute (grant R01 HL115082-01: Electronic Health Record-Based Decision Support to Improve BP Management in Adolescents; Elyse Olshen Kharbanda, principal investigator).

Publisher Copyright:
© 2015 The Author. All rights reserved.

Keywords

blood pressure
misclassification
pediatrics

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10.1093/aje/kwv208

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title = "Potential Misclassification of Blood Pressure Status in Children and Adolescents with Short or Tall Stature",

abstract = "Blood pressure (BP) is measured in percentiles that are adjusted for sex, age, and height percentile in children and adolescents. Standard tables for the conversion of BP percentiles do not present exact BP percentile cutoffs for extremes in stature, either short (<5th percentile) or tall (>95th percentile). An algorithm can be used to calculate exact BP percentiles across a range of height z scores. We compared values from standard BP tables with exact calculations of BP percentiles to see which were better at identifying hypertension in more than 5,000 children with either short or tall stature. Study subjects were 3-17-year-old patients within HealthPartners Medical Group, an integrated health care delivery system in Minnesota, at any time between 2007 and 2012. Approximately half of the subjects who met the criteria for hypertension using exact calculation would be misclassified as normal using available thresholds in the published BP tables instead of the recommended algorithm, which was not included in the tables.",

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Potential Misclassification of Blood Pressure Status in Children and Adolescents with Short or Tall Stature

Abstract

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