Blood pressure measurement in pediatric population: comparison between automated oscillometric devices and mercury sphygmomanometers-a systematic review and meta-analysis

Author(s)

Araujo-Moura, Keisyanne ^{[1, 2, 3]} ; Souza, Leticia Gabrielle ^{[1, 2, 3]} ; Mello, Gabriele Luz ^{[1, 2, 3]} ; Ferreira De Moraes, Augusto Cesar ^{[1, 2, 3, 4]}

Affiliation

^[1] Univ Sao Paulo, Fac Med, YCARE Youth Child cArdiovasc Risk & Environm Res, Sao Paulo, SP - Brazil

^[2] Univ Sao Paulo, Sch Publ Hlth, Dept Epidemiol, Grad Program Publ Hlth, BR-01246904 Sao Paulo, SP - Brazil

^[3] Univ Sao Paulo, Sch Publ Hlth, Grad Program Epidemiol, BR-01246904 Sao Paulo, SP - Brazil

^[4] Univ Texas Hlth Sci Ctr Houston, Dept Epidemiol, Sch Publ Hlth Human Genet & Environm Sci, Michael & Susan Ctr Hlth Living, Austin, TX - USA

• Document type: Review article
• Source: EUROPEAN JOURNAL OF PEDIATRICS; v. 181, n. 1 JUL 2021.
• Web of Science Citations: 0

Abstract

With the progressive elimination of mercury column devices for blood pressure (BP) measurement in children and adolescents, valid alternatives are needed. Oscillometric devices provide a replacement without mercury, are fully automated, and have excellent reliability among evaluators. Here, the goal was to test the accuracy of automatic blood pressure monitor devices compared to the mercury sphygmomanometer for BP measurement in children and adolescents. Electronic databases are EMBASE, MEDLINE (PubMed), SCOPUS, and Web of Science. We selected 8974 potentially eligible articles and two authors independently. We separately reviewed 370 full papers. Potentially eligible articles were selected according to the following criteria: (a) articles published in Portuguese, English, and Spanish; (b) screening of titles; (c) screening of abstracts; and (d) retrieval and screening of the full article to determine whether it met the inclusion criteria. We included 45 articles for analysis, 28 of which were selected for meta-analysis. The systolic BP measured by automatic blood pressure monitors presents 1.17 mmHg on average (95% CI 0.85; 1.48); for diastolic BP, it produced -0.08 mmHg (95% CI -0.69; 0.54) compared with a mercury sphygmomanometer. There is high heterogeneity between studies (> 90%) in the meta-analysis, partly explained by the device model, study environment, and observer training. Only articles that reported BP measurement by both methods were included. Conclusion: Automatic blood pressure monitors have strong measurement validity when compared with the mercury column. Thus, these can be safely used in blood pressure measurements of children and adolescents in clinical and epidemiological studies. (AU)

• FAPESP's process: 19/10852-0 - Sugar-sweetened beverage intake in South American children: validation of a food frequency questionnaire and consumption pattern
• Grantee: Gabriele da Luz Mello
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• FAPESP's process: 19/13527-3 - Body image and weight: association between parents' perception and the body adiposity of South American children: SAYCARE Cohort Study
• Grantee: Leticia Gabrielle de Assis Souza
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• FAPESP's process: 19/24224-1 - Prevalence and incidence of high blood pressure and its association with environmental and lifestyle factors in South American children: SAYCARE cohort study
• Grantee: Keisyanne de Araujo Moura
• Support Opportunities: Scholarships in Brazil - Doctorate
• FAPESP's process: 17/20317-0 - New frontiers in pediatric nutritional and cardiovascular health: methods development to assess the double burden of malnutrition and ideal cardiovascular health in low-in-middle income countries - SAYCARE cohort study
• Grantee: Augusto César Ferreira de Moraes
• Support Opportunities: Research Grants - Young Investigators Grants
• FAPESP's process: 19/02617-1 - New frontiers in pediatric nutritional and cardiovascular health: Methods development to assess the double burden of malnutrition and ideal cardiovascular health in low-in-middle income countries - SAYCARE Cohort Study
• Grantee: Augusto César Ferreira de Moraes
• Support Opportunities: Scholarships in Brazil - Young Researchers