Brotons C (Epidemiology Research Centre, School of Public Health, The University of Texas Health Science Center at Houston, Houston, Texas, USA), Singh P, Nishio T and Labarthe D R. Blood pressure by age in childhood and adolescence: a review of 129 surveys worldwide. International Journal of Epidemiology 1989, 18: 824-829.The pre-adult patterns of change in blood pressure with age have been investigated by review and pooled analysis of the relevant worldwide literature. The results indicate, foremost, the almost universal overall upward progression of blood pressure levels between ages 6 and 18 years, separately for systolic, fourth-phase and fifth-phase diastolic pressures (SBP, DBP4, DBP5). This report summarizes results of an extensive literature search based on 129 qualifying publications, in many languages, of which 79 yielded data adequate for a pooled age-sex-specific analysis for boys and girls aged 6-18 years. More than 200 000 observations were available for SBP and nearly 100 000 each for DBP4 and DBP5, respectively.In this overall pool, SBP increased uniformly for boys from age 6-12 and for girls from 6-9, at 1.4 mm Hg/yr; for boys the slope increased abruptly to 3.2 mm Hg/yr from 12-15 and fell to 0 at age 18; for girls the maximum increase was only 2.1 mm Hg/yr, from 9-13, and it reversed at age 16, reaching -3.4 mm Hg/yr from 17-18. Thus for SBP the absolute values for boys and girls were identical up to age nine and nearly so to age 14 and then separated, with values for girls increasing only slightly to age 16 and actually decreasing to age 18. A similar separation of age-specific values by sex occurred with DBP4, but not until age 16, after which DBP4 decreased for girls. For DBP5, values were more nearly equal for boys and girls at all ages but did separate at age 12, with girls having the higher values. DBP4 and DBP5 had much lesser slopes of change than did SBP across the whole age range, and DBP5 was consistently about 5 mm Hg lower than DBP4.
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