American Journal of Epidemiology Advance Access originally published online on January 29, 2008
American Journal of Epidemiology 2008 167(6):653-666; doi:10.1093/aje/kwm348
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PRACTICE OF EPIDEMIOLOGY |
Determination of Blood Pressure Percentiles in Normal-Weight Children: Some Methodological Issues
1 Channing Laboratory, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
2 University of Texas at Houston Health Science Center, University of Texas, Houston, TX
3 University of Colorado at Denver and Health Sciences Center, University of Colorado, Denver, CO
4 Department of Medicine, Jefferson Medical College, Thomas Jefferson University, Philadelphia, PA
Correspondence to Dr. Bernard Rosner, Channing Laboratory, Brigham and Women's Hospital and Harvard Medical School, 181 Longwood Avenue, Boston, MA 02115 (e-mail: bernard.rosner{at}channing.harvard.edu).
Received for publication February 7, 2007. Accepted for publication November 5, 2007.
Blood pressure in children has consistently been related to adult blood pressure, with implications for long-term prevention of cardiovascular disease. The epidemic of obesity in children has resulted in corresponding increases in childhood blood pressure. In this paper, the authors develop norms for childhood blood pressure among normal-weight children (body mass index <85th percentile based on Centers for Disease Control and Prevention guidelines) as a function of age, sex, and height, using data from 49,967 children included in the database of the National High Blood Pressure Education Program Working Group on High Blood Pressure in Children and Adolescents (the Pediatric Task Force). The authors considered three types of models for pediatric blood pressure data, including polynomial regression, restricted cubic splines, and quantile regression, with the latter providing the best fit. The sex-specific norms presented here are a nonlinear function of both age and height and are generally slightly lower than previously developed norms based on Pediatric Task Force data including both normal-weight and overweight children.
blood pressure; child; models, statistical; pediatrics; regression analysis
Abbreviations: CDC, Centers for Disease Control and Prevention; CI, confidence interval; DBP, diastolic blood pressure; NHANES, National Health and Nutrition Examination Survey; OR, odds ratio; SBP, systolic blood pressure
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