Establishing International Blood Pressure References among Nonoverweight Children and Adolescents Aged 6 to 17 Years

Bo Xi, Xin'Nan Zong, Roya Kelishadi, Young Mi Hong, Anuradha Khadilkar, Lyn M. Steffen, Tadeusz Nawarycz, Małgorzata Krzywińska-Wiewiorowska, Hajer Aounallah-Skhiri, Pascal Bovet, Arnaud Chiolero, Haiyan Pan, Mieczysław Litwin, Bee Koon Poh, Rita Y T Sung, Hung Kwan So, Peter Schwandt, Gerda Maria Haas, Hannelore K. Neuhauser, Lachezar MarinovSonya V. Galcheva, Mohammad Esmaeil Motlagh, Hae Soon Kim, Vaman Khadilkar, Alicja Krzyzaniak, Habiba Ben Romdhane, Ramin Heshmat, Shashi Chiplonkar, Barbara Stawińska-Witoszyńska, Jalila El Ati, Mostafa Qorbani, Neha Kajale, Pierre Traissac, Lidia Ostrowska-Nawarycz, Gelayol Ardalan, Lavanya Parthasarathy, Min Zhao, Tao Zhang

Research output: Contribution to journalArticle

48 Citations (Scopus)

Abstract

Background-Several distributions of country-specific blood pressure (BP) percentiles by sex, age, and height for children and adolescents have been established worldwide. However, there are no globally unified BP references for defining elevated BP in children and adolescents, which limits international comparisons of the prevalence of pediatric elevated BP. We aimed to establish international BP references for children and adolescents by using 7 nationally representative data sets (China, India, Iran, Korea, Poland, Tunisia, and the United States). Methods and Results-Data on BP for 52 636 nonoverweight children and adolescents aged 6 to 19 years were obtained from 7 large nationally representative cross-sectional surveys in China, India, Iran, Korea, Poland, Tunisia, and the United States. BP values were obtained with certified mercury sphygmomanometers in all 7 countries by using standard procedures for BP measurement. Smoothed BP percentiles (50th, 90th, 95th, and 99th) by age and height were estimated by using the Generalized Additive Model for Location Scale and Shape model. BP values were similar between males and females until the age of 13 years and were higher in males than females thereafter. In comparison with the BP levels of the 90th and 95th percentiles of the US Fourth Report at median height, systolic BP of the corresponding percentiles of these international references was lower, whereas diastolic BP was similar. Conclusions-These international BP references will be a useful tool for international comparison of the prevalence of elevated BP in children and adolescents and may help to identify hypertensive youths in diverse populations.

Original languageEnglish
Pages (from-to)398-408
Number of pages11
JournalCirculation
Volume133
Issue number4
DOIs
Publication statusPublished - 26 Jan 2016
Externally publishedYes

Fingerprint

Blood Pressure
Tunisia
Poland
Korea
Iran
India
China
Sphygmomanometers
Mercury
Cross-Sectional Studies
Pediatrics

Keywords

  • Adolescent
  • Blood pressure
  • Child
  • Hypertension

ASJC Scopus subject areas

  • Medicine(all)
  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

Xi, B., Zong, XN., Kelishadi, R., Hong, Y. M., Khadilkar, A., Steffen, L. M., ... Zhang, T. (2016). Establishing International Blood Pressure References among Nonoverweight Children and Adolescents Aged 6 to 17 Years. Circulation, 133(4), 398-408. https://doi.org/10.1161/CIRCULATIONAHA.115.017936

Establishing International Blood Pressure References among Nonoverweight Children and Adolescents Aged 6 to 17 Years. / Xi, Bo; Zong, Xin'Nan; Kelishadi, Roya; Hong, Young Mi; Khadilkar, Anuradha; Steffen, Lyn M.; Nawarycz, Tadeusz; Krzywińska-Wiewiorowska, Małgorzata; Aounallah-Skhiri, Hajer; Bovet, Pascal; Chiolero, Arnaud; Pan, Haiyan; Litwin, Mieczysław; Poh, Bee Koon; Sung, Rita Y T; So, Hung Kwan; Schwandt, Peter; Haas, Gerda Maria; Neuhauser, Hannelore K.; Marinov, Lachezar; Galcheva, Sonya V.; Motlagh, Mohammad Esmaeil; Kim, Hae Soon; Khadilkar, Vaman; Krzyzaniak, Alicja; Romdhane, Habiba Ben; Heshmat, Ramin; Chiplonkar, Shashi; Stawińska-Witoszyńska, Barbara; El Ati, Jalila; Qorbani, Mostafa; Kajale, Neha; Traissac, Pierre; Ostrowska-Nawarycz, Lidia; Ardalan, Gelayol; Parthasarathy, Lavanya; Zhao, Min; Zhang, Tao.

In: Circulation, Vol. 133, No. 4, 26.01.2016, p. 398-408.

Research output: Contribution to journalArticle

Xi, B, Zong, XN, Kelishadi, R, Hong, YM, Khadilkar, A, Steffen, LM, Nawarycz, T, Krzywińska-Wiewiorowska, M, Aounallah-Skhiri, H, Bovet, P, Chiolero, A, Pan, H, Litwin, M, Poh, BK, Sung, RYT, So, HK, Schwandt, P, Haas, GM, Neuhauser, HK, Marinov, L, Galcheva, SV, Motlagh, ME, Kim, HS, Khadilkar, V, Krzyzaniak, A, Romdhane, HB, Heshmat, R, Chiplonkar, S, Stawińska-Witoszyńska, B, El Ati, J, Qorbani, M, Kajale, N, Traissac, P, Ostrowska-Nawarycz, L, Ardalan, G, Parthasarathy, L, Zhao, M & Zhang, T 2016, 'Establishing International Blood Pressure References among Nonoverweight Children and Adolescents Aged 6 to 17 Years', Circulation, vol. 133, no. 4, pp. 398-408. https://doi.org/10.1161/CIRCULATIONAHA.115.017936
Xi, Bo ; Zong, Xin'Nan ; Kelishadi, Roya ; Hong, Young Mi ; Khadilkar, Anuradha ; Steffen, Lyn M. ; Nawarycz, Tadeusz ; Krzywińska-Wiewiorowska, Małgorzata ; Aounallah-Skhiri, Hajer ; Bovet, Pascal ; Chiolero, Arnaud ; Pan, Haiyan ; Litwin, Mieczysław ; Poh, Bee Koon ; Sung, Rita Y T ; So, Hung Kwan ; Schwandt, Peter ; Haas, Gerda Maria ; Neuhauser, Hannelore K. ; Marinov, Lachezar ; Galcheva, Sonya V. ; Motlagh, Mohammad Esmaeil ; Kim, Hae Soon ; Khadilkar, Vaman ; Krzyzaniak, Alicja ; Romdhane, Habiba Ben ; Heshmat, Ramin ; Chiplonkar, Shashi ; Stawińska-Witoszyńska, Barbara ; El Ati, Jalila ; Qorbani, Mostafa ; Kajale, Neha ; Traissac, Pierre ; Ostrowska-Nawarycz, Lidia ; Ardalan, Gelayol ; Parthasarathy, Lavanya ; Zhao, Min ; Zhang, Tao. / Establishing International Blood Pressure References among Nonoverweight Children and Adolescents Aged 6 to 17 Years. In: Circulation. 2016 ; Vol. 133, No. 4. pp. 398-408.
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AU - Zong, Xin'Nan

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AU - Hong, Young Mi

AU - Khadilkar, Anuradha

AU - Steffen, Lyn M.

AU - Nawarycz, Tadeusz

AU - Krzywińska-Wiewiorowska, Małgorzata

AU - Aounallah-Skhiri, Hajer

AU - Bovet, Pascal

AU - Chiolero, Arnaud

AU - Pan, Haiyan

AU - Litwin, Mieczysław

AU - Poh, Bee Koon

AU - Sung, Rita Y T

AU - So, Hung Kwan

AU - Schwandt, Peter

AU - Haas, Gerda Maria

AU - Neuhauser, Hannelore K.

AU - Marinov, Lachezar

AU - Galcheva, Sonya V.

AU - Motlagh, Mohammad Esmaeil

AU - Kim, Hae Soon

AU - Khadilkar, Vaman

AU - Krzyzaniak, Alicja

AU - Romdhane, Habiba Ben

AU - Heshmat, Ramin

AU - Chiplonkar, Shashi

AU - Stawińska-Witoszyńska, Barbara

AU - El Ati, Jalila

AU - Qorbani, Mostafa

AU - Kajale, Neha

AU - Traissac, Pierre

AU - Ostrowska-Nawarycz, Lidia

AU - Ardalan, Gelayol

AU - Parthasarathy, Lavanya

AU - Zhao, Min

AU - Zhang, Tao

PY - 2016/1/26

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