LAUSR

Objectives: The 2017 American Academy of Pediatrics guideline (AAP guideline) for assessing “elevated blood pressure (BP) (90th BP percentile)” and “high BP (95th BP percentile)” includes a large number of BP thresholds according to sex, age and height, which makes it cumbersome to use in clinical practice. We proposed the simplified height-specific BP thresholds to evaluate the performance of a simplified table with a smaller number of height-specific BP thresholds compared to the 2017 AAP guideline. Methods: We developed a simplified table of absolute height-specific BP thresholds based on the 2017 AAP guideline. We validated our simplified table using data from 15,037 youths aged 8–17 years from U.S. National Health and Nutrition Examination Survey (NHANES) 1999–2016 and data from 4,769 youths aged 5–17 years from NHANES III (1988–1994). Results: The simplified table performed nearly as well as the 2017 AAP guideline for screening high BP/elevated BP in U.S. youths aged 8–17 years from NHANES 1999–2016, with high values of AUC 0.94/0.98, sensitivity (88.3%/96.8%), specificity (99.6%/98.8%), PPV (92.8%/93.6%), NPV (99.3%/99.4%), and Kappa coefficient (0.90/0.94). The simplified table performed similarly well when applied to youths from NHANES 1988–1994. Conclusion: The simplified table with height-specific BP thresholds performed as well as the 2017 AAP guideline for identifying high BP and elevated BP in U.S. children and adolescents. This simplified table could be useful for identifying abnormal BP in youths in clinical practice.