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Defining systolic blood pressure normative values in hospitalized pediatric patients: a single center experience

Pediatric Research (2024)Cite this article

Abstract

Background

Normative blood pressure (BP) values and definition of hypertension (HTN) in children in outpatient setting cannot be reliably used for inpatient therapy initiation. No normative exists to describe HTN in hospitalized pediatric populations. We aimed to study the prevalence of hypertension and produce normative BP values in hospitalized children.

Methods

Cross sectional observational study of all children hospitalized on acute care floors, ≥2 and <18 years age, at Stanford Children’s Hospital, from Jan-01-2014 to Dec-31-2018. Cohort included 7468 hospital encounters with a total of 118,423 automated, oscillometric, BPs measured in the upper extremity during a hospitalization of >24 hours.

Results

Overall prevalence of HTN, defined by outpatient guidelines, was 12–48% in boys and 6–39% in girls, stage 1 systolic HTN in 12–38% of boys and 6–31% of girls, stage 2 systolic HTN in 3–10% of boys and 1–8% of girls. Centile curves were derived demonstrating overall higher BP reading for hospitalized patients compared to the outpatient setting.

Conclusion

Higher blood pressures are anticipated during hospitalization. Thresholds provided by the centile curves generated in this study may provide the clinician with some guidance on how to manage hospitalized pediatric patients based on clinical circumstances.

Impact

  • Hospitalized children have higher blood pressures compared to patients in the ambulatory setting, hence outpatient normative blood pressure values cannot be reliably used for inpatient therapy initiation.

  • No normative exists to describe hypertension in hospitalized pediatric populations.

  • The thresholds provided by the centile curves generated in this study may provide the clinician with some guidance on how to manage hospitalized pediatric patients based on clinical circumstances.

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Fig. 1: Data Collection Algorithm.
Fig. 2: Systolic blood pressure percentiles for hospitalized patients based on age.

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Data availability

De-identified data from the analysis can be made available after authors’ review of request and might require compilation of specific categories to protect patient privacy.

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Funding

Funding

AMU was a Paul and Yuanbi Ramsay Endowed Postdoctoral Fellow of the Maternal and Child Health Research Institute at Stanford during a period of production of this manuscript. The other authors received no additional funding.

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Authors and Affiliations

  1. Department of Nephrology, Primary Children’s Hospital, University of Utah, Salt Lake City, UT, USA

    Amanda M. Uber

  2. Department of Nephrology, Stanford University School of Medicine, Stanford, CA, USA

    Jialin Han & Maria E. Montez-Rath

  3. Department of Pediatrics (Nephrology), Stanford University School of Medicine, Stanford, CA, USA

    Paul Grimm & Abanti Chaudhuri

Authors
  1. Amanda M. Uber
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  2. Jialin Han
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  5. Abanti Chaudhuri
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Contributions

Study design: Amanda M. Uber, Jialin Han, Maria E. Montez-Rath, Abanti Chaudhuri. Data collection and analysis: Jialin Han, Maria E. Montez-Rath. Data verification: Amanda M. Uber, Jialin Han, Maria E. Montez-Rath, Abanti Chaudhuri. Manuscript writing: Amanda M. Uber, Jialin Han, Paul Grimm, Maria E. Montez-Rath, Abanti Chaudhuri. Writing of the first draft of the manuscript: Amanda M. Uber, Jialin Han, Maria E. Montez-Rath, Abanti Chaudhuri. Final approval of the version to be published: Amanda M. Uber, Jialin Han, Maria E. Montez-Rath, Abanti Chaudhuri

Corresponding author

Correspondence to Abanti Chaudhuri.

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Uber, A.M., Han, J., Grimm, P. et al. Defining systolic blood pressure normative values in hospitalized pediatric patients: a single center experience. Pediatr Res (2024). https://doi.org/10.1038/s41390-024-03059-w

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