DR. SHREENIVAS R,DR. SHALINI PRIYA N,DR. KARTHIK VVN,DR. ELILARASI S,DR. MATHANGI
DOI: https://doi.org/Introduction:
Hypertension in childhood is an under-recognized condition that can lead to long-term cardiovascular complications. Conventional diagnosis relies on age-, sex-, and height-specific BP percentile charts, which can be cumbersome in clinical practice. Blood pressure-to-height (BP/Ht) ratios have been proposed as a simpler alternative, but evidence from the Indian pediatric population is limited.
Aim:
To evaluate the diagnostic accuracy of systolic BP-to-height (SBP/Ht) and diastolic BP-to-height (DBP/Ht) ratios as screening tools for hypertension in South Indian children aged 5–15 years.
Materials and Methods:
A retrospective observational study was conducted at Saveetha Medical College and Hospital, Chennai, using anonymized pediatric outpatient records from April to December 2023. Children aged 5–15 years with complete anthropometric and BP data were included. BP classification was based on the 2017 AAP guidelines. SBP/Ht and DBP/Ht ratios were calculated for each child. Receiver operating characteristic (ROC) curve analyses determined optimal cut-off values, sensitivity, specificity, and area under the curve (AUC) for detecting elevated BP (≥90th percentile) and hypertension (≥95th percentile). Pearson’s correlation assessed associations between BP/Ht ratios and BP percentiles. Statistical analysis was performed using SPSS v29.0.2.0.
Results:
The study included 150 children (65 males, 85 females; mean age 9.75 ± 2.74 years). According to AAP criteria, 46.7% were normotensive, 22.0% prehypertensive, and 31.3% hypertensive. Males had higher mean SBP/Ht and DBP/Ht ratios than females, though differences were not statistically significant. Hypertensive children were significantly younger than normotensive and prehypertensive peers (p = 0.010). Both SBP/Ht and DBP/Ht ratios were significantly higher in hypertensive children (p< 0.001). SBP/Ht ratio showed a strong positive correlation with SBP percentile (r = 0.691, p< 0.001). ROC analysis identified optimal cut-offs of 0.878 for SBP/Ht (AUC 0.876, 95% CI: 0.813–0.928; sensitivity 78.7%, specificity 83.5%) and 0.520 for DBP/Ht (AUC 0.669, 95% CI: 0.573–0.766; sensitivity 72.3%, specificity 64.1%).
Conclusion:
SBP/Ht and DBP/Ht ratios are simple, cost-effective, and reliable screening tools for pediatric hypertension. The SBP/Ht ratio demonstrated superior diagnostic accuracy and could be integrated into school health programs and primary care screening to enable earlier detection and intervention in resource-limited settings.
