Abstract
BACKGROUND: There is little evidence to show that the blood pressure-to-height ratio (BPHR) accurately detects elevated blood pressure (EBP) in children. The present study evaluated the accuracy of BPHR in detecting EBP in children aged 8-11 years. MATERIALS AND METHODS: This cross-sectional study involved 1087 children (531 boys and 556 girls), aged 8-11 years. Weight, height, and blood pressure (BP) were measured using the standard procedure. EBP was defined as systolic or diastolic pressure at the 90th percentile or above at a specific gender, age, and height. Mann-Whitney U test and Spearman's correlation were applied. The diagnostic accuracy was set at an area-under-the-curve of ≥0.90. Sex-specific cutoff points for systolic BPHR (SBPHR) and diastolic BPHR (DBPHR) were determined. The sensitivity and specificity of SBPHR and DBPHR were also determined. RESULTS: Most variables between sexes were comparable (P > 0.05), except weight, height, and body mass index (BMI) in the 8-9 years' age group. Almost all variables for children with EBP were significantly higher than normotensive (P < 0.05). SBPHR correlated with all variables except BMI in girls. DBPHR correlated with almost all variables except age (sexes) and height (girls). The accuracy of SBPHR and DBPHR in diagnosing EBP in both sexes was above 95%. The optimal threshold of SBPHR and DBPHR for diagnosing EBP was 0.804/0.519 in boys and 0.831/0.530 in girls. The sensitivity and specificity were 90.8%-96.5% and 86.0%-93.2%, respectively. CONCLUSION: SBPHR and DBPHR have high accuracy, sensitivity, and specificity in detecting EBP in Indonesian children aged 8-11 years.