Blood pressure centiles for Great Britain
- 1Willow Wood Medical Practice and University of East Anglia School of Medicine, Health Policy and Practice, Norwich, UK
- 2Norfolk and Norwich University Hospital, Norwich, UK
- 3Centre for Paediatric Epidemiology and Biostatistics, Institute of Child Health, University College London, London, UK
- Correspondence to:
Dr L V Jackson
Willow Wood Surgery, Aslake Close, Sprowston, Norwich NR7 8TT, UK;
- Accepted 10 July 2006
- Published Online First 11 August 2006
Objective: To produce representative cross-sectional blood pressure reference centiles for children and young people living in Great Britain.
Design: Analysis of blood pressure data from seven nationally representative surveys: Health Surveys for England 1995–8, Scottish Health Surveys 1995 and 1998, and National Diet & Nutrition Survey 1997.
Methods: Blood pressure was measured using the Dinamap 8100 with the same protocol throughout. Weight and height were also measured. Data for 11 364 males and 11 537 females aged 4–23 years were included in the analysis, after excluding 0.3% missing or outlying data. Centiles were derived for systolic, diastolic, mean arterial and pulse pressure using the latent moderated structural (LMS) equations method.
Results: Blood pressure in the two sexes was similar in childhood, rising progressively with age and more rapidly during puberty. Systolic pressure rose faster and was appreciably higher in adult men than in adult women. After adjustment for age, blood pressure was related more to weight than height, the effect being stronger for systolic blood pressure. Pulse pressure peaked at 18 years in males and 16 years in females.
Conclusions: These centiles increase our knowledge of blood pressure norms in contemporary British children and young people. High blood pressure for age should be defined as blood pressure above the 98th centile, and high-normal blood pressure for age as blood pressure between the 91st and 98th centiles. The centiles identify children and young people with increased blood pressure, and will be of benefit to both clinical practice and research.
Published Online First 11 August 2006
Funding: TJC is funded by the Medical Research Council.
Research at the UCL Institute of Child Health and Great Ormond Street Hospital for Children NHS Trust benefits from R&D funding received from the NHS Executive.
Competing interests: Subsequent to the presentation of data at the Spring Meeting in April 2003, blood pressure centile charts using these data were published commercially.
Previous publication: Some of this work was presented as an oral presentation at the Royal College of Paediatrics & Child Health Spring Meeting, April 2003: G203. Blood pressure centiles for children and young people aged 4–24 years in Great Britain. Arch Dis Child 2003; 88:A66.
Contributors: all authors contributed to the design, analysis and writing up of the paper. LVJ is guarantor.