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01.04.2020 | Original Article | Ausgabe 4/2020

Pediatric Nephrology 4/2020

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

Pediatric Nephrology > Ausgabe 4/2020
Gianluigi Ardissino, Silvia Ghiglia, Patrizia Salice, Michela Perrone, Sandra Piantanida, Francesco L. De Luca, Silvia Di Michele, Lucia Filippucci, Elena R. A. Dardi, Tiziana Bollani, Antonella Mezzopane, Bertrand Tchane, Sebastiano A. G. Lava, SPA Project investigators
Wichtige Hinweise
Preliminary results of this study were presented at the Kidney Week 2018 in San Diego (CA, USA), organized by the American Society of Nephrology, on October 25, 2018 (Abstract TH-PO435).

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


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.


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).


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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