About the need to use specific population references in estimating paediatric hypertension: Sardinian blood pressure standards (age 11-14 years)

BACKGROUND: Previous Italian paediatric blood pressure (BP) tables overestimated the prevalence of hypertension in adolescents of specific geographic areas, such as Sardinia, an island in the Mediterranean Sea. This is probably due to a not very homogeneous distribution of the subjects studied, most from Middle and Northern Italy, and the long period from the survey. METHODS: BPs were repeatedly measured over a period of 3 years in 839 children (52.6% males. Age range: from 11 to 14 years during this period), using a standard mercury sphygmomanometer. For each gender, the specific percentile curves of systolic and diastolic BP were constructed. RESULTS (CORRECTED BY THE 50TH PERCENTILE OF HEIGHT): MALES (11-14 YEARS): mean systolic BP (50(th )centile): from 111 to 115 mmHg. Hypertensive systolic BP (> 95(th )percentile): from 127 to 135 mmHg. Mean diastolic BP (50(th )centile): from 65 to 69 mmHg. Hypertensive diastolic BP (> 95(th )percentile): from 78 to 82 mmHg. FEMALES(11-14 YEARS): mean systolic BP (50(th )centile): from 110 to 112 mmHg. Hypertensive systolic BP (> 95(th )percentile): from 127 to 130 mmHg. Mean diastolic BP (50(th )centile): from 65 to 67. Hypertensive diastolic BP (> 95(th )percentile): from 78 to 80 mmHg. CONCLUSIONS: Sardinian BP tables emphasizes the need to integrate the previous standards with more up-to-date and representative reports on Italian children, as periodically performed in the USA, in order to increase the number of subjects to be checked, and to obtain a national coverage better and more completely representative of every geographic area of our country.