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How would we evaluate hypertension if we had hypertension norms created from population data same as we evaluate hypertension in children?


 
 
 When we evaluate blood pressure in adolescent children, at 18 years we look at adult hypertension classification. Some of limits in paediatrics can be slightly higher. In some cases, the limits for hypertension can be more than 10 mmHg lower than in adult population. We wanted to compare adult classification with percentile-based limits calculated from population data (Graph 1).
 Tables for paediatric hypertension published by European society of hypertension, that are based on report published by US national health institute, were used for constructing paediatric part of the graph. To match general population limits for 50th height percentile were used. With data from Czech post-MONICA study, we have calculated percentiles to match algorithm in paediatric population.
 Difference in normal blood pressure between young men and woman can be observed, corresponding with paediatrics norms. For 17 years old boy with height over 95th percentile limit for hypertension is 140 mmHg in contrast for 17 years old girl under 5th percentile limit for hypertension is 125 mmHg. To match general population, we are comparing data for 50th percentile of height for 17-year-old and percentile for age group 25–34 (Table 1). For boys limits for hypertension are 136 and 141,5 mmHg. For girls limits for hypertension are 125 and 127,9 mmHg. Average blood pressure rises with age and there is difference between blood pressure in young population for men and women.
 The purpose is not to change limits in older population, but we believe that connection between blood pressure norms for paediatrics and adult population should be addressed in next guidelines. Big technological advances in personal devices for blood pressure monitoring will probably bring lot of data and technological companies will offer our patients comparison with others. Graphical comparison of blood pressure will be available for everyone on mobile phone, so we should focus on publishing population norms in format, which software developers can use for graphs. Graphical comparison especially for young population is easier to use than complex tables.
 
 
 
 Type of funding sources: Private company.
