Performance of blood pressure-to-height ratio as a screening tool for elevated blood pressure in pediatric population: a systematic meta-analysis

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The aim of this study was to assess the performance of the blood pressure-to-height ratio (BPHR) for screening elevated blood pressure (BP) in children and adolescents using a meta-analysis of eligible published studies. We retrieved studies that investigated the performance of the BPHR for identifying elevated BP from Pubmed and other databases. We performed meta-analyses by subgroups of sex, age and ethnicity using a fixed or random effect model based on whether there was between-study heterogeneity. A total of 13 publications including 262 830 children and adolescents aged 6–18 years on BPHR and a total of three publications including 95 343 children on the modified BPHR were included in this meta-analysis. The summary results suggested that BPHR performed well to identify pre-high BP and high BP for children aged 6–11 years and adolescents aged 12–18 years. The performance of BPHR was perfect for identifying severe high BP in adolescents aged 12–18 years. However, the modified BPHR did not improve accuracy for screening high BP in children aged 6–12 years. In summary, BPHR performed well for identifying elevated BP in children and adolescents, independently of sex, age and ethnicity group. In addition, the modified BPHR performed similarly with BPHR for screening high BP in childhood.

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This work was supported by Young Scholars Program of Shandong University (2015WLJH51), the Research Fund for the Doctoral Program of Higher Education of China (20120131120004), National Natural Science Foundation of China (81302496) and Shandong Natural Science Foundation (ZR2012HQ033).

Author contributions

XY, QL, PB, CM and BX contributed to the manuscript including the conception and design of the study, analysis and interpretation of the data, drafting and critically revising the manuscript, and approval for publication.

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Correspondence to B Xi.

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The authors declare no conflict of interest.

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