Is automatic blood pressure measurement accurate and valid in the pediatric population of South America? SAYCARE Study

Author(s)

Keisyanne de Araujo Moura

• Document type: Master's Dissertation
• Press: São Paulo.
• Institution: Universidade de São Paulo (USP). Faculdade de Medicina (FM/SBD)
• Defense date: 2020-01-22

Examining board members

Heraclito Barbosa de Carvalho; Francisco Leonardo Tôrres Leal; Moacyr Roberto Cuce Nobre; Luiz Alberto Amador Pereira

• Advisor: Heraclito Barbosa de Carvalho

Abstract

Introduction: High Blood Pressure (SAP) is currently one of the major health problems in the world. Its prevalence has increased markedly among both men and women. The pursuit of accurate blood pressure measurements is still a major challenge and is an essential procedure to aid in data interpretation and diagnosis. Verification and recognition of the quality of the devices used are essential to give legitimacy and reliability to the measured data. Thus, it is important that the equipment in use is always evaluated according to the validation standards required by international entities, so that, among other reasons, it makes valid the development of studies that evaluate individual and population pressure levels. Objective: To estimate the validity of blood pressure measurement using an automatic oscillometric device (Omron HEM-7200) in front of the mercury column in children and adolescents aged 3 to 17 years. Methods: The SAYCARE study is a cross-sectional observational epidemiological study conducted in seven South American cities: Buenos Aires (Argentina), Lima (Peru), Medelín (Colombia), Montevideo (Uruguay), Santiago (Chile), São Paulo (Brazil), Teresina (Brazil), Blood pressure was measured by the Onrom HEM 7200 automatic device, connected at Y with the mercury column, performed three consecutive and simultaneous measurements between the devices. Independent measurements were analyzed and mean differences between systolic and diastolic measurements for both methods calculated and compared with the British Hypertension Society (BHS) criteria. To verify validity, Bland-Altman plots and 95% agreement limits (95% LOA), device specificity and sensitivity, and British Society of Hypertension criteria were used. Results: Monitor measurements showed lower measurement bias (mean difference [95% LOA]): 1.4 (29.9 to 12.8) mmHg in children and 4.3 (27.8 to 16.5) mmHg in adolescents for SBP. For DBP, they were 2.2 (27.4 to 11.7) mmHg in children and 1.4 (28.4 to 11.1) mmHg in adolescents. Sensitivity in children was 21.4 (95% CI 516.3-26.6) and in adolescents was 20.0 (95% CI 513.2-26.8); the specificity was 95.9 (95% CI, 43-98.4) in children and 100.0 (IC5100.0-100.0) in adolescents. The ratings tested by the monitor are Grade B for SBP in children and SBP and DBP in adolescents and Grade C for DBP in children. Conclusions: The automatic monitor presented high specificity values and lower sensitivity values for the diagnosis of hypertension; however, it can be considered accurate (lower measurement bias) and valid for epidemiological and clinical practice by BHS criteria (AU)

• FAPESP's process: 17/07615-1 - Is accurate and valid measurement of blood pressure by automatic monitor in the pediatric population of South America? SAYCARE study
• Grantee: Keisyanne de Araujo Moura
• Support Opportunities: Scholarships in Brazil - Master