Kids’ blood pressure measurements differ substantially between arms

Australia would benefit from having its own set of clinical guidelines addressing high blood pressure in children, according to researchers at the Murdoch Children’s Research Institute (MCRI), whose recent study showed substantial differences in measurements could be seen depending on which arm was used.
 
Published in the Journal of Hypertension, the study found even a small difference in blood pressure measurements between arms could lead to a missed diagnosis of hypertension. As such, researchers suggest measurements in children and adolescents should be taken from both arms.
 
‘Misdiagnosis could occur when the blood pressure difference is greater than about 5 mmHg, but one in seven healthy children [in the study] had a difference greater than 10 mmHg, which could lead to a failure to identify stage one or two hypertension,’ MCRI PhD candidate and lead study author Melanie Clarke said.
 
‘Given blood pressure measured in a child’s right and left arm are often different, it’s important to take measurements in both arms to make a correct diagnosis.
 
‘Accurate blood pressure assessment in kids is critical for identifying the potential risk for damage to the heart and blood vessels, which can lead to early-onset cardiovascular disease.’
 
The study, which involved 118 participants aged 7–18 recruited from a cardiology day clinic in Melbourne, found one in four healthy children had an inter-arm difference that could lead to misdiagnosis. This figure doubled in children with a history of aortic surgery.
 
‘Children with high blood pressure, many of whom appear to be healthy, have a greater risk of developing hypertension in adulthood, a major risk factor for cardiovascular disease,’ MCRI Associate Professor Jonathan Mynard said.
 
‘We know high blood pressure is common in adults, but many people don’t realise how common it is in kids, too. More work needs to be done to draw attention to the problem of childhood hypertension and its long-term consequences.
 
‘Australia would benefit from having its own set of clinical guidelines addressing high blood pressure in children, including how to obtain accurate measurements and avoid misclassification.’
 
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