Detection of hypertension and prehypertension in paediatric patients with type 1 diabetes using a simple blood pressure table

BACKGROUND: The diagnosis of hypertension is often unrecognized in the general paediatric and type 1 diabetes populations. Reference to a simple blood pressure table has been proposed as a screening tool for the identification of abnormal paediatric blood pressure. This simple table lists one cut-off blood pressure value for each sex and year of age, compared with the standard blood pressure tables, which list 476 abnormal and normal blood pressure values. OBJECTIVE: To determine the sensitivity and specificity of the simple blood pressure table in identifying hypertensive and abnormal (hypertensive or prehypertensive) blood pressure values in children with type 1 diabetes. METHODS: A retrospective cohort study was conducted. Data regarding baseline characteristics and blood pressure measurements were collected. Blood pressure values were categorized as nonhypertensive, prehypertensive or hypertensive using the standard and simple blood pressure tables. Sensitivity and specificity of the simple blood pressure table was determined for the identification of hypertensive and abnormal (hypertensive or prehypertensive) blood pressure values using a generalized estimating equation approach. RESULTS: The simple blood pressure table had sensitivities of 100% (95% CI 95.7% to 100%) and 100% (95% CI 97.6% to 100%), and specificities of 61.1% (95% CI 54.0% to 67.8%) and 81.3% (95% CI 74.4% to 86.6%), for the identification of hypertensive and abnormal blood pressure values, respectively. CONCLUSION: The simple blood pressure table is an effective screening tool that may enable earlier detection and timely treatment of abnormal blood pressure.