Objective: This study aimed to test the validity of an automatic oscillometric device to measure the blood pressure (BP) in children (n = 191) and adolescents (n = 127) aged 3 to 18 years. Methods: Systolic BP (SBP) and diastolic BP (DBP) levels were measured simultaneous by automatic device and mercury column with Y-connection. To verify the validity, Bland-Altman plots and limits of agreement of 95% (95% LOA), specificity and sensitivity of the device, and the grade of British Hypertension Society (BHS) criteria were used. Results: The monitor measurements demonstrated lower measurement bias (mean difference [95% LOA]): 1.4 (−9.9 to 12.8) mmHg in children and 4.3 (−7.8 to 16.5) mmHg in adolescents for SBP. For DBP, it was 2.2 (−7.4 to 11.7) mmHg in children and 1.4 (−8.4 to 11.1) mmHg in adolescents. The sensitivity in children was 21.4 (95% CI = 16.3-26.6), and in adolescents, it was 20.0 (95% CI = 13.2-26.8); the specificity was 95.9 (95% CI = 93.4-98.4) in children and 100.0 (95% CI = 100.0-100.0) in adolescents. The monitor-tested ratings 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 values of specificity and lower values of sensitivity to the diagnosis of HBP; however, it can be considered accurate (lower measurement bias) and valid for epidemiological and clinical practice in accordance with BHS criteria.
Bibliographical noteFunding Information:
Funding agencies: ACFDeM received a postdoctoral scholarship from the National Counsel of Technological and Scientific Development (CNPq; proc. 313772/2014-2) and São Paulo Research Foundation, FAPESP (proc. 2014/13367-2 and 2015/14319-4). LAM was given a visiting professor scholarship from the São Paulo Research Foundation, FAPESP (proc. 2015/11406-3). CLMF received an advanced scientist scholarship from the National Counsel of Technological and Scientific Development (CNPq; proc. 304003/2014-0). HBC received a research grant from the São Paulo Research Foundation (2014/11468-6), Research Grant for Scientific Publication Paper from the São Paulo Research Foundation (FAPESP; proc 2017/15588-4), and an advanced scientist scholarship from the National Counsel of Technological and Scientific Development (CNPq; proc. 300951/2015-9). The SAYCARE study was supported mainly by the Brazilian Government from the National Counsel of Technological and Scientific Development (CNPq; proc. 471266/2013-2) and the São Paulo State Government from the São Paulo Research Foundation (FAPESP; proc. 2014/11468-6). The SAYCARE study was also cofunded by other agencies in other countries as follows: (1) Collaborative Projects Fund (R.D. N8501-2015-INSN-DG-OEA) granted by the Instituto Nacional de Salud del Niño, Lima, Peru; (2) Sustainability Strategy at the University of Antioquia 2014-2015, Research Group of Social and Economic Determinants of Health and Nutrition, Demography and Health Research Group, and Interuniversity Services Corporation (CIS) at the University of Antioquia, Medellin, Colombia; (3) Secretary of University Extension and Student Welfare, University of Buenos Aires, Buenos Aires, Argentina; and (4) European Regional Development Fund (MICINN-FEDER) to the GENUD Research Group. Disclosure: The authors declared no conflict of interest. Author contributions: KAM, ECOF, GGC, PM, DGC, CAD, GB, and ACFDeM were involved in the data collection. KAM and ACFDeM were involved in conducting the study, the analysis, and the writing of the manuscript. KAM, GGC, CLMF, and ACFDeM were involved in data interpretation and critically reviewed the manuscript. FLTL, LAM, ACFDeM, and HBC were involved in the design and funding of the study and critically reviewed the manuscript. All authors were involved in writing the paper and had final approval of the submitted and published versions. *Keisyanne Araújo-Moura and Augusto César Ferreira De Moraes contributed equally to this work. Additional Supporting Information may be found in the online version of this article Received: 16 June 2017; Accepted: 21 December 2017; Published online 21 February 2018. doi:10.1002/oby.22119