Home monitors underestimate kids' blood pressure

Home blood pressure measurements do not seem to reflect readings obtained with ambulatory monitors in children and adolescents, according to a new report.

In contrast to what is known in adults - whose home and ambulatory blood pressure readings generally match - "in children and adolescents home blood pressure appears to be significantly lower than daytime ambulatory blood pressure," Dr. George S. Stergiou from Sotiria Hospital in Athens told AMN Health.

Home monitoring of blood pressure "should not be used in decision making in this age group," he recommended, until more is known.

Stergiou and his colleagues compared home blood pressure measurements, taken twice daily for two weeks, in 55 children and adolescents with measurements taken in the clinic and by 24-hour ambulatory monitors.

Home blood pressure measurements were an average of 3.6 points lower than clinic blood pressure measurements on the same day, the team found.

The upper reading of blood pressure as measured by home blood pressure was more than 12 points lower than that measured by ambulatory monitoring, the researchers note. The lower reading differed by less than 5 points.

"Measurement of blood pressure by a physician in the clinic or office remains the standard method for hypertension diagnosis in children and adolescents," Stergiou concluded.

However, for the long-term follow-up, measuring blood pressure at home "is clearly more appropriate than ambulatory blood pressure because of its lower cost and greater convenience."

SOURCE: American Journal of Hypertension, October 2004.