Practice of Epidemiology Determination of Blood Pressure Percentiles in Normal-Weight Children: Some Methodological Issues

Blood pressure in children has consistently been related to adult blood pressure, with implications for long-term prevention of cardiovascular disease. The epidemic of obesity in children has resulted in corresponding increases in childhoodbloodpressure. In this paper, theauthors develop norms for childhoodbloodpressure amongnormal-weight children (body mass index <85th percentile based on Centers for Disease Control and Prevention guidelines) as a function of age, sex, and height, using data from 49,967 children included in the database of the National High Blood Pressure Education ProgramWorkingGroup onHighBloodPressure inChildren andAdolescents (thePediatric Task Force). The authors considered three types of models for pediatric blood pressure data, including polynomial re-gression, restricted cubic splines, and quantile regression, with the latter providing the best fit. The sex-specific norms presented here are a nonlinear function of both age and height and are generally slightly lower than previously developed norms based on Pediatric Task Force data including both normal-weight and overweight children. blood pressure; child; models, statistical; pediatrics; regression analysi