Kidney Week

Abstract: TH-PO435

Office Blood Pressure Measurement (OBPM) in Children: The SPA Project

Session Information

• Hypertension and CVD: Epidemiology, Risk Factors, Prevention
  October 25, 2018 | Location: Exhibit Hall, San Diego Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Hypertension and CVD

• 1401 Hypertension and CVD: Epidemiology, Risk Factors, and Prevention

Authors

• Ardissino, Gianluigi, Center for HUS Prevention, Control and Management, Milano, Italy

Gianluigi Ardissino,

• Ghiglia, Silvia, Cardiology Unit. Ospedale Policlinico, MILANO, Italy

Silvia Ghiglia,

• Lava, Sebastiano A.g., University Children''s Hospital, Inselspital, Bern, Switzerland

Sebastiano A.g. Lava,

• Longhi, Selena, Center for HUS Prevention, Control and Management, Milano, Italy

Selena Longhi,

• Martelli, Laura, Center for HUS Prevention, Control and Management, Milano, Italy

Laura Martelli,

• Perrone, Michela, Center for HUS Prevention, Control and Management, Milano, Italy

Michela Perrone,

• Salice, Patrizia, Fondazione Policlinico IRCCS Ca' Granda Milano, MILANO, Italy

Patrizia Salice,

• Piantanida, Sandra, Polo Materno Infantile- Ospedale F. del Ponte - Varese, COMERIO, Italy

Sandra Piantanida,

Group or Team Name

• The SPA Project

Background

If blood pressure (BP) measurement still remains challenging in adults, it is even more in children. Current guidelines suggest to measure office BP with three readings and average them when the first BP is elevated otherwise to perform only one BP reading (AAP 2017) or to measure BP 3 times every 3 min using the average of the last two (ESH 2016).

Methods

Since 2010, we regularly perform unattended multiple OBPM (mOBPM) with a validated (OMRON M3) device: after 5 min rest, at least 10 automated readings are taken every 3 min on the non-dominant arm. Readings <5th or >95th centile and mOBPM with coefficient of variation (CV)>15% are discarded.

Results

286 healthy, non-obese children (141 females; median BMI 15.4 Kg/m2 IQR 14.5-16.4), median age 5.7 (IQR 5.3-6.1) years, were analyzed. The median CVs of included mOBPMs were 7% (IQR 5-9) for systolic and 4% (IQR 3-6) for diastolic BP. The readings #1-10 were compared with the mean of all 10 measurements (Wilcoxon matched-paired-signed-rank-test, significance assigned at p<0.01). The first 3 measurements were significantly different from the mean, while the readings #4-10 were not. Based on the mean, only 11 subjects had a systolic or diastolic BP >90th centile (n=5 >95th c.le) while single measurement significantly over-estimated high BP (Fig.1).

Conclusion

Although most guidelines advice ≥2 BP readings, these findings suggest that mOBPM should include ideally 10, but at least 4 repeated measurements.

Acknowledgements:F.Argirò,P.Bardelli,A.Bianchi,T.Bollani,M.Bonvissuto,G.Bosetti,R.Cambria,G.Capobianco,G.Casani,G.Catanese,C.Cauda,P.Cinquepalmi,S.Coletta,E.Dardi,A.Daverio,M.DiPietro,L.Filippucci,A.Fornaro,S.Francario,V.Gandini,S.Genoni,L.Loguercio,A.Manolo,P.Marchetto,R.Marinello,L.Martignoni,A.Mezzopane,A.Monolo,M.Morelli,M.Musetti,S.Paparone,G.Pastorelli,M.Picca,C.Poletti,M.Scarazatti,L.Simionato,A.Spalla,F.Tel,V.Valdambrini,M.Vinciguerra.