Normal values of peripheral (brachial) blood pressure measured in 14 062 Hungarian healthy children and adolescents with normal body mass index

Introduction: Previously, guidelines for blood pressure reference values for children and adolescents included data from overweight and obese patients. The strong association between blood pressure and overweight/obesity, alongside the global rise in their prevalence over the recent decades, necessitates a revision of normative blood pressure percentiles for this population. Objectives: Our aim was to produce cross-sectional blood pressure normal values for normal-weight children and adolescents in Hungary as well as to compare blood pressure measurements in normal-weight, overweight and obese subjects. Methods: 17 828 (9350 boys) subjects aged 3 to 19 years were recruited. Standardized oscillometric blood pressure and anthropometric measures were performed. The subjects were categorized into normal-weight (n = 14 062, 7195 boys), overweight (n = 2527, 1427 boys), and obese (n = 1239, 728 boys) groups using relevant body mass index cut-off values. Blood pressure percentiles were obtained using the LMS method. Results: Systolic and diastolic blood pressure increased with age in both sexes. The 50th th percentile values of systolic and diastolic blood pressure raised from 94/59 mmHg to 124/68 mmHg in normal-weight boys and from 94/59 mmHg to 116/68 mmHg in normal-weight girls. Systolic blood pressure did not differ significantly between the sexes before puberty but increased more significantly in boys later on. No clinically significant difference in diastolic blood pressure was found between the sexes. The percentiles values for overweight and obese patients were significantly higher (p<0.001). Conclusions: These percentiles broaden our understanding of blood pressure norms in a contemporary cohort of Hungarian children and adolescents. Due to the higher blood pressure percentiles observed, it is strongly recommended to establish separate databases for overweight and obese children and adolescents.