045 - Validation of Multiple Office Blood Pressure Measurement (mOBPM). A novel tool for evaluating blood pressure in children.

Publication Number: 45.7058

Daniele Rossetti, Pediatric Nephrology, Dialysis and Transplantation Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy, Milano, Lombardia, Italy; Letizia Dato, Università del Piemonte Orientale, Biella, Piemonte, Italy; Thomas Ria, Pediatric Nephrology, Dialysis and Transplantation, Fondazione IRCSS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Milan, Lombardia, Italy; Maria Cristina Mancuso, IRCS Fondazione Ca' Granda Ospedale Maggiore Policlinico di Milano, Milano, Lombardia, Italy; Giacomo Tamburini, IRCCS Ospedale Policlinico di Milano, MILAN, Lombardia, Italy; Gianluigi Ardissino, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milano, Lombardia, Italy

Background: Blood pressure measurement (BPM) is a common procedure in clinical practice, but it can be challenging to obtain reliable values in children. Casual office BPM (gold standard) is all but accurate and Ambulatory BPM (ABPM) may be difficult to perform or even misleading. Multiple Office Blood Pressure Measurement (mOBPM) was developed at our Center in 2010 for evaluating BP with serial and automated measurements (10 determinations in at least 30 minutes) using standard oscillometric devices in the absence of healthcare providers. After discarding outlier values, the coefficient of variation (CV) and the mean of the remaining systolic (S) and diastolic (D) values are calculated by a custom-built software.

Objective: The present paper is aimed at comparing BP values obtained with ABPM and mOBPM in a cohort of patients referred to our center because of suspected hypertension

Design/Methods: The present study compares results obtained with mOBPM vs ABPM in children addressed to our center for suspected arterial hypertension (AH). Given that children develop myocardial hypertrophy soon after the development of AH, Left Ventricular Mass Index (LVMI) was used as gold standard to categorize patients as hypertensive or normotensive.

Results: Forty-six children were enrolled. AH was confirmed by increased LVMI in 16 (35%) of them. ABPM identified 26 (56%) hypertensive children vs 27 (59%) identified by mOBPM. Sensitivity and specificity were 75% and 53% using ABPM vs 81% and 53% using mOBPM. Positive Predictive Value (PPV) and Negative Predictive Value (PNV) were 46% and 80% vs 48% and 84%, respectively.

Conclusion(s): The present analysis shows that mOBPM provides similar results for the diagnosis of arterial hypertension compared with ABPM. In addition, mOBPM is less time consuming, available everywhere, cheaper, easier to repeat and less stressful. Thus, we recommend the routine use of mOBPM for measuring BP in children.