Abstrakt
Cardiovascular events are the most common causes of adult mortality with hypertension, being one of the most important treatable risk factors in both developed and developing countries. Globally, 7.6 million (13%) of premature deaths, 54% of all strokes, and 47% of all ischemic heart disease cases can be attributed to high blood pressure (BP) in adults.
The global prevalence of hypertension in adults has been increasing; it is estimated to reach 29% in 2025. The prevalence of hypertension in pediatric populations is much lower, but high BP is associated with signs of hypertensive target organ damage even childhood.
In 1987, only approximately 1% of children and adolescents were hypertensive with repeated measurements. However, in the past decades, there has been an evident increase in the prevalence of hypertension (up to 4%), especially in the United States, but also in Canada, Europe, Asia, and Latin America.
Therefore, detection of high BP is of a great clinical importance for the pediatric population and public health. The main diagnostic procedure in determining hypertension is BP measurement.
The true goal of BP measurement in children and adolescents is to provide strategies for promoting cardiovascular health. Although the auscultatory method has always been the mainstay of clinical BP measurement, the clinical use of other BP measurement techniques is steadily increasing, especially oscillometric methods.
The measurement of BP in children and adolescent is indisputable; however, some issues should be solved, e.g., the method of measurement and availability of reference values for BP in children, as in this age group hypertension is defined statistically using the percentiles. In the last decade, many countries have developed their specific reference values, as the distribution of BP differs from one population to the other, both for auscultatory as well for oscillometric measurement.
Moreover, as overweight/obesity has a great impact on the level of BP, some BP guidelines have included only the healthy population without overweight and obesity8, 9 or were revisited for only the lean population.