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Multiple office blood pressure measurement: a novel approach to overcome the weak cornerstone of blood pressure measurement in children. Data from the SPA project.

  • Ardissino, Gianluigi1
  • Ghiglia, Silvia2
  • Salice, Patrizia2
  • Perrone, Michela2
  • Piantanida, Sandra3
  • De Luca, Francesco L.4
  • Di Michele, Silvia5
  • Filippucci, Lucia6
  • Dardi, Elena R. A.7
  • Bollani, Tiziana7
  • Mezzopane, Antonella7
  • Tchane, Bertrand8
  • Lava, Sebastiano A. G.1, 9, 10
  • Ardissino, Angelina
  • Argirò, Francesco
  • Bardelli, Patrizia
  • Bianchi, Alessandra
  • Bosco, Annalisa
  • Bonatesta, Patrizia
  • Bonvissuto, Milena
  • And 57 more
  • 1 Pediatric Nephrology, Dialysis and Transplantation Unit - Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy , Milan (Italy)
  • 2 Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy , Milan (Italy)
  • 3 Polo Materno-Infantile, Varese, Italy , Varese (Italy)
  • 4 Policlinico Universitario, Messina, Italy , Messina (Italy)
  • 5 Ospedale di Pescara, Pescara, Italy , Pescara (Italy)
  • 6 USL Umbria1, Perugia, Italy , Perugia (Italy)
  • 7 Pediatric Practicioner, Milan, Italy , Milan (Italy)
  • 8 Pediatric Cardiology Unit, General and University Hospital, Parma, Italy , Parma (Italy)
  • 9 Lausanne University Hospital and University of Lausanne, Lausanne, 1011, Switzerland , Lausanne (Switzerland)
  • 10 Ente Ospedaliero Cantonale, Lugano, Switzerland , Lugano (Switzerland)
Published Article
Pediatric Nephrology
Publication Date
Jan 03, 2020
DOI: 10.1007/s00467-019-04368-7
Springer Nature


BackgroundThis contribution aims to report and analyze a novel approach for office blood pressure measurement in children.MethodsHealthy children 5 to 8 years of age were eligible. After 5 minutes rest, 10 unattended blood pressure readings were taken at 3-minute intervals using a validated automated oscillometric device. After discarding outlier values (< 5th or > 95th percentile of the recorded values), the coefficient of variation and the mean of the 10 readings were calculated. The single readings #1 to #10 were compared with this elaborated average of the 10 measurements.ResultsTwo hundred eighty-one healthy, non-obese children (137 females, 49%), median age 5.7 (IQR 5.3–6.1) years, were analyzed. The median coefficients of variation were 7% (IQR 5–9) for systolic and 4% (IQR 3–6) for diastolic blood pressure. The first 3 measurements were significantly different from the average, while the readings #4 to #10 were not. Based on the average, only nine subjects had a systolic or diastolic blood pressure > 90th centile (n = 3 > 95th percentile).ConclusionsAlthough most guidelines advise three blood pressure readings, these findings suggest that in children, office blood pressure measurement might be improved by including ten measurements. In situations of time constraints, the fourth blood pressure reading might be used as a reliable approximation.

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