Abstract：
We aimed to evaluate the agreements between the guidelines used for both office blood pressure (OBP) and ambulatory blood pressure monitoring (ABPM). Our secondary aim was to define the best threshold to assess children at risk of left ventricular hypertrophy (LVH). Thresholds proposed by the Fourth Report (FR), European Society of Hypertension (ESH), and American Academy of Pediatrics (AAP) for OBP and the Wühl, ESH, and American Heart Association (AHA) for ABPM were used, and nine different BP phenotype combinations were created. The agreements between the thresholds, the sensitivity of the thresholds, and the BP phenotypes used to predict LVH were determined in 949 patients with different ages and body mass indices (BMIs). The agreements between the guidelines for OBP and ABPM were \"good\" and \"very good\" (κ = 0.639; 95% CI, 0.638-0.640, κ = 0.986; 95% CI, 0.985-0.988), respectively. To classify OBP and ABPM into BP phenotypes, we obtained nine different combinations, which had \"very good\" agreement (κ = 0.880; 95% CI, 0.879-0.880). The sensitivity of AAP for detecting LVH was the highest in <12-year-old obese children (S = 75.8, 95% CI, 56.4-89.7). The sensitivity of ABPM in detecting LVH was similar among different age and BMI groups. The sensitivity of different BP phenotypes tended to be higher in the groups where OBP was evaluated according to AAP. The highest sensitivity was detected in the 13- to 15-year-old normal weight group.(S: 88.8, 95% CI, 51.7-99.7). The AAP guideline is more sensitive and decisive for BP phenotypes to detect LVH, especially in normal-weight children ≤ 15 years, while ABPM thresholds for children have limited effect.
摘要：
我们旨在评估办公室血压（OBP）和动态血压监测（ABPM）指南之间的协议。我们的次要目的是确定评估处于左心室肥厚（LVH）风险的儿童的最佳阈值。第四次报告(FR)提出的门槛，欧洲高血压学会（ESH），和美国儿科学会（AAP）的OBP和Wühl，ESH,和美国心脏协会（AHA）用于ABPM，并创建了9种不同的BP表型组合。门槛之间的协议，阈值的灵敏度，并在949例不同年龄和体重指数（BMIs）的患者中确定了用于预测LVH的BP表型。OBP和ABPM指南之间的协议为“良好”和“非常好”（κ=0.639；95％CI，0.638-0.640，κ=0.986；95％CI，0.985-0.988），分别。将OBP和ABPM分为BP表型，我们得到了九种不同的组合，两者具有“非常好”的一致性(κ=0.880；95%CI，0.879-0.880)。在<12岁的肥胖儿童中，AAP检测LVH的敏感性最高（S=75.8，95％CI，56.4-89.7）。不同年龄和BMI组ABPM检测LVH的敏感性相似。在根据AAP评估OBP的组中，不同BP表型的敏感性往往更高。在13至15岁的正常体重组中检测到最高的灵敏度。（S：88.8，95%CI，51.7-99.7）。AAP指南对BP表型检测LVH更敏感和决定性，特别是在体重正常≤15岁的儿童中，而儿童ABPM阈值效果有限。
