Article Text

Download PDFPDF
Single blood pressure chart for children up to 13 years to improve the recognition of hypertension based on existing normative data
  1. Macolm G Coulthard
  1. Department of Paediatric Nephrology, Great North Children's Hospital, Newcastle, UK
  1. Correspondence to Dr Macolm G Coulthard, Paediatric Nephrology, Great North Children's Hospital, Newcastle NE461BS, UK; jeanandmalc{at}


Objective To produce a single ‘growth-chart-style’ blood pressure (BP) chart with clear diagnostic thresholds to assist paediatricians to make prompt and accurate diagnoses of hypertension.

Design The well-established but complex published data on normal BP ranges in prepubertal children were identified and analysed to determine if it was possible to produce a single, user-friendly, colour-coded chart, showing diagnostic hypertension thresholds for systolic and diastolic BP without losing clinically important information.

Results There were sufficient published normative childhood BP data available to define systolic and diastolic BP centiles from term onwards but only sufficient to determine systolic BP centiles from 28 weeks of gestation to term. Up to 13 years of age, it was possible to combine boys’ and girls’ data without loss of precision and to define the threshold between stage 1 and stage 2 (severe) hypertension as the 95th centile +12 mm Hg. This allowed the production of single colour-coded charts for systolic and diastolic BP and to advise on making simple adjustments for the impact of stature on individual children’s results.

Conclusions A simplified, integrated BP chart with colour-coded diagnostic thresholds was produced to assist the prompt diagnosis of hypertension in prepubertal children. This information could be included into a Paediatric Early Warning System score.

  • blood pressure
  • normal range
  • hypertension
  • childhood
  • preterm

Statistics from


  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement All data relevant to the study are included in the article or uploaded as supplementary information. The original data for the study are all in the public domain. Detailed calculations used to construct the plot are available on reasonable request from the author.

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.