Relationship between Clinic and Ambulatory Blood Pressure Measurements in Children

by Dejian Lai, Tim S. Poffenbarger, Kathy D. Franco, Ronald Portman and Jonathan M. Sorof

Journal of Data Science, v.2, no.4, 383-397

Abstract

Decision making on diagnosis of hypertension is important to clinicians, patients and general public. We analyzed the agreement between clinic blood pressure (BP) measurements (individual or in combination) and ambulatory wake BP in the diagnosis of hypertension in children. In this study, three sequential clinic BP measurements were performed at the initiation of the 24-hour ambulatory BP monitoring (ABPM) using the identical monitor for both clinic and ambulatory measurements. Ninety patients were reviewed. Pearson Correlation coefficient between clinic BP (individual or in combination) and wake ambulatory BP ranged from 0.81 to 0.85 for SBP and 0.52 to 0.60 for DBP. Multiple regression models showed no improvement using the mean of multiple versus single clinic BP measurements. We also tried principal component method that formed an optimal combination of the clinic measurements. The first principal component accounted about 95\% of the total variation, but there was little improvement of the regression model between the wake ambulatory and the first principal component of the three repeated clinic measurements. Our results suggest that assessment for hypertension in children by clinic BP alone is often unreliable and is not improved by multiple BP measurements on a single occasion.

Homepage | Table of Contents | Full Text of This Article