Normative oscillometric blood pressure values in the first 5 years in an office setting

Article Abstract:

It is difficult to obtain accurate blood pressure (BP) measurements in infants and children using standard techniques. Blood pressure is usually determined by listening (auscultating) to specific sounds made by the flow of blood while using an inflatable blood pressure cuff. These sounds are difficult to hear and may be missed in small children and infants. An automated oscillometric device detects the motion of blood flow through an artery that is surrounded by a cuff. With the use of an oscillometric device, the physician or nurse does not need to be present during blood pressure measurements. Consequently, environmental effects that can influence BP values may be diminished. Normal BP values for infants and children have been obtained using conventional methods of auscultation and Doppler ultrasonography (the use if high frequency sound to study the motion of blood through vessels). Normal BP values using the oscillometric device were established by testing 1,554 healthy children between the ages of two weeks and five years. Three measurements were made in the waiting room of pediatric clinics before the children were seen by practitioners. There were no differences in BP and heart rate readings among boys, girls and various ethnic groups over the age ranges studied. In general, the first BP reading was higher than the average of all three BP measurements. This difference was not statistically significant in children less than one year of age, but it was significantly different in children one year and older. Blood pressures are defined for particular age groups. Although the cost of the oscillometric device is high ($3,100), blood pressure measurements are easily obtained, reliable and valid in infants and children. Blood pressure measurements should be obtained routinely when an oscillometric device is available. (Consumer Summary produced by Reliance Medical Information, Inc.)

Methods, Usage, Measurement, Hemodynamic monitoring, Blood pressure measurement, Oscillation, Oscillations

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Sexual maturation and blood pressure levels of a biracial sample of girls

Article Abstract:

Standards for normal blood pressure for children and adolescents now take into account their height, weight, and age, but it is possible that degree of sexual maturation is another important factor affecting this variable. Since blacks tend to enter puberty earlier than whites, differences in blood pressure between same-aged white and black girls might be associated with their levels of sexual maturation. To evaluate this, blood pressure was compared for black and white girls of similar ages. Students from eight schools (elementary, middle, and high schools) were categorized according to age and family income level and evaluated for sexual development by a method that used self-assessment to compare breast and pubic hair growth with that shown in standardized pictures. Subjects' blood pressure, height, weight, and body-mass index (in kilograms per square meter) were recorded. Results for the 142 black and 361 white girls showed that the black girls were taller and heavier than the white girls at 7, 9, and 12 years of age, and taller but not heavier at 10 and 14. No racial differences were seen in the body-mass index. A greater proportion of blacks than whites were at higher stages of sexual maturation, and more black girls had begun menstruation (36 percent versus 24 percent). Blood pressure for black girls was higher than for whites at each age measured, although only the results for subjects aged 10 to 12 were statistically significant. The findings suggest that sexual maturation, which is accompanied by sweeping physiologic and hormonal changes, could be associated with higher blood pressure; adolescents who mature earlier may be at increased risk for high blood pressure later in life. (Consumer Summary produced by Reliance Medical Information, Inc.)

Demographic aspects, Puberty

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Familial isolated growth-hormone deficiency with advanced sexual maturation

Article Abstract:

Case studies of two brothers with growth-hormone (GH) deficiency and sexual precocity suggest the two conditions have an underlying mechanism in common. Both boys had dwarfism, abnormally small heads, the skeletal maturation of a 17-year-old and advanced sexual maturity. Their testosterone levels were normal but other androgen levels were elevated. Their parents were first cousins, and two other siblings were also shorter than average and had abnormally small heads but were otherwise normal. Excessive androgen levels would explain their sexual precocity, but GH is thought to be necessary for androgen expression. Other cases of GH deficiency accompanied by advanced puberty, although rare, have been reported. That two brothers whose parents are so closely related had both of these rare conditions points to a genetic cause.

Somatotropin, Precocious puberty

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