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Multiple office blood pressure measurement: a novel approach to overcome the weak cornerstone of blood pressure measurement in children. Data from the SPA project.

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A Correction to this article was published on 23 November 2020

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Abstract

Background

This contribution aims to report and analyze a novel approach for office blood pressure measurement in children.

Methods

Healthy children 5 to 8 years of age were eligible. After 5 minutes rest, 10 unattended blood pressure readings were taken at 3-minute intervals using a validated automated oscillometric device. After discarding outlier values (< 5th or > 95th percentile of the recorded values), the coefficient of variation and the mean of the 10 readings were calculated. The single readings #1 to #10 were compared with this elaborated average of the 10 measurements.

Results

Two hundred eighty-one healthy, non-obese children (137 females, 49%), median age 5.7 (IQR 5.3–6.1) years, were analyzed. The median coefficients of variation were 7% (IQR 5–9) for systolic and 4% (IQR 3–6) for diastolic blood pressure. The first 3 measurements were significantly different from the average, while the readings #4 to #10 were not. Based on the average, only nine subjects had a systolic or diastolic blood pressure > 90th centile (n = 3 > 95th percentile).

Conclusions

Although most guidelines advise three blood pressure readings, these findings suggest that in children, office blood pressure measurement might be improved by including ten measurements. In situations of time constraints, the fourth blood pressure reading might be used as a reliable approximation.

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Change history

  • 23 November 2020

    The authors regret that the name of the author Bertrand Tchana was incorrectly rendered as ���Bertrand Tchane���. The original article has been corrected.

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Acknowledgments

We are very thankful for the precious support provided by “Progetto Alice ONLUS. Associazione per la Lotta alla Sindrome Emolitica Uremica.”

SPA Project investigators (in addition to the already listed authors): Angelina Ardissino, Francesco Argirò, Patrizia Bardelli, Alessandra Bianchi, Annalisa Bosco, Patrizia Bonatesta, Milena Bonvissuto, Gabriella Bosetti, Marta Brambilla, Rosaria Cambria, Giovanni Capobianco, Valentina Capone, Giorgio Casani, Graziella Catanese, Dario Consonni, Ivan Cortinovis, Cristina Cauda, Paola Cinquepalmi, Silvana Coletta, Antonella Daverio, Gabriella De Amicis, Maria Elisabetta Di Pietro, Irene Felicetta, Angela Fornaro, Stefano Francario, Vera Gandini, Stefania Genoni, Antenore Giussani, Gabriella Grimaldi, Tommaso Lettera, Laura Loguercio, Alessandra Magnelli, Maria Cristina Mancuso, Paolo Marchetto, Alessio Magnani, Rita Maiavacca, Roberto Marinello, Laura Martelli, Lorena Martignoni, Martino Marsciani, Silvano Milani, Annalisa Monolo, Maura Morelli, Manuela Musetti, Filomena Napolitano, Rita Nardi, Sandro Paparone, Giuseppina Parlagreco, Giovannina Pastorelli, Giovanni Pieri, Marina Picca, Cristina Poletti, Roberto Romano, Stefania Rotondo, Pier Francesco Savina, Mirella Scarazzati, Loredana Simionato, Adelisa Spalla, Francesca Tel, Valeria Valdambrini, Laura Vento, Maria Lidia Vinciguerra, Loris Xaiz.

Author information

Authors and Affiliations

  1. Pediatric Nephrology, Dialysis and Transplantation Unit - Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy

    Gianluigi Ardissino & Sebastiano A. G. Lava

  2. Pediatric Cardiology, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy

    Silvia Ghiglia & Patrizia Salice

  3. Neonatology and Neonatal Intensive Care Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy

    Michela Perrone

  4. Unità operativa Cardiologia ad Indirizzo Pediatrico, Polo Materno-Infantile, Varese, Italy

    Sandra Piantanida

  5. Unità operativa semplice di Cardiologia Pediatrica, Policlinico Universitario, Messina, Italy

    Francesco L. De Luca

  6. Unità operativa complessa Pediatria Medica, Ospedale di Pescara, Pescara, Italy

    Silvia Di Michele

  7. Unità operativa Cardiologia Riabilitativa e Prevenzione Patologie Cardiovascolari, USL Umbria1, Perugia, Italy

    Lucia Filippucci

  8. Pediatric Practicioner, Milan, Italy

    Elena R. A. Dardi, Tiziana Bollani & Antonella Mezzopane

  9. Pediatric Cardiology Unit, General and University Hospital, Parma, Italy

    Bertrand Tchane

  10. Pediatric Cardiology Unit, Department of Pediatrics, Lausanne University Hospital and University of Lausanne, 1011, Lausanne, Switzerland

    Sebastiano A. G. Lava

  11. Division of Clinical Pharmacology and Toxicology, Institute of Pharmacological Sciences of Southern Switzerland, Ente Ospedaliero Cantonale, Lugano, Switzerland

    Sebastiano A. G. Lava

Authors
  1. Gianluigi Ardissino
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  2. Silvia Ghiglia
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  3. Patrizia Salice
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  4. Michela Perrone
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  5. Sandra Piantanida
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  6. Francesco L. De Luca
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  7. Silvia Di Michele
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  8. Lucia Filippucci
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  9. Elena R. A. Dardi
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  10. Tiziana Bollani
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  11. Antonella Mezzopane
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  12. Bertrand Tchane
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  13. Sebastiano A. G. Lava
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Consortia

SPA Project investigators

  • Angelina Ardissino
  • , Francesco Argirò
  • , Patrizia Bardelli
  • , Alessandra Bianchi
  • , Annalisa Bosco
  • , Patrizia Bonatesta
  • , Milena Bonvissuto
  • , Gabriella Bosetti
  • , Marta Brambilla
  • , Rosaria Cambria
  • , Giovanni Capobianco
  • , Valentina Capone
  • , Giorgio Casani
  • , Graziella Catanese
  • , Dario Consonni
  • , Ivan Cortinovis
  • , Cristina Cauda
  • , Paola Cinquepalmi
  • , Silvana Coletta
  • , Antonella Daverio
  • , Gabriella De Amicis
  • , Maria Elisabetta Di Pietro
  • , Irene Felicetta
  • , Angela Fornaro
  • , Stefano Francario
  • , Vera Gandini
  • , Stefania Genoni
  • , Antenore Giussani
  • , Gabriella Grimaldi
  • , Tommaso Lettera
  • , Laura Loguercio
  • , Alessandra Magnelli
  • , Maria Cristina Mancuso
  • , Paolo Marchetto
  • , Alessio Magnani
  • , Rita Maiavacca
  • , Roberto Marinello
  • , Laura Martelli
  • , Lorena Martignoni
  • , Martino Marsciani
  • , Silvano Milani
  • , Annalisa Monolo
  • , Maura Morelli
  • , Manuela Musetti
  • , Filomena Napolitano
  • , Rita Nardi
  • , Sandro Paparone
  • , Giuseppina Parlagreco
  • , Giovannina Pastorelli
  • , Giovanni Pieri
  • , Marina Picca
  • , Cristina Poletti
  • , Roberto Romano
  • , Stefania Rotondo
  • , Pier Francesco Savina
  • , Mirella Scarazzati
  • , Loredana Simionato
  • , Adelisa Spalla
  • , Bertrand Tchane
  • , Francesca Tel
  • , Valeria Valdambrini
  • , Laura Vento
  • , Maria Lidia Vinciguerra
  •  & Loris Xaiz

Corresponding author

Correspondence to Sebastiano A. G. Lava.

Ethics declarations

Ethical approval was granted by the institutional review board (Comitato Etico Milano Area B, approval number 746-2015). The study was performed in accordance with the ethical standards laid down in the Declaration of Helsinki and its amendments.

Conflict of interest

The authors declare that they have no conflict of interest.

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Ardissino, G., Ghiglia, S., Salice, P. et al. Multiple office blood pressure measurement: a novel approach to overcome the weak cornerstone of blood pressure measurement in children. Data from the SPA project.. Pediatr Nephrol 35, 687–693 (2020). https://doi.org/10.1007/s00467-019-04368-7

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  • DOI: https://doi.org/10.1007/s00467-019-04368-7

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