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Critical Care

Open Access

Update of the pediatric hypertension graphic adjusted for gender and height percentiles: systolic blood pressure for boys, 1 to 17 years old

  • HH Shieh1,
  • AE Gilio1,
  • VHK Koch1,
  • DC Raulik1,
  • C Vranjac1,
  • S Fukugava1,
  • ER Barreira1 and
  • EJ Troster1
Critical Care201317(Suppl 3):P18

Published: 19 June 2013


Hypertension is the most important preventable risk factor for premature death worldwide. It increases the risk of ischemic heart disease, strokes, peripheral vascular disease, and other cardiovascular diseases, including heart failure, aortic aneurysms, diffuse atherosclerosis, and pulmonary embolism. In childhood, hypertension can be determined according to a table adjusted for height, age and gender [1]. A graphic representation of pediatric hypertension was published in 1987 [2], and no graphic updates have been published since then. The objective of this study was to update the graphic representation of pediatric hypertension.


We used a computerized calculation method to develop high-resolution graphics containing curves with 5,841 points each, to depict the main percentiles associated with high blood pressure for boys from 1 to 17 years old in the 50th percentile of height. Each point represents the calculation of the polynomial equation that includes the statistical processing of the last Report on Blood Pressure [1]. We also analyzed the effect of height on blood pressure in the 5th to 95th percentile range. Statistical functions generated by computerized program were used.


Six monotonic curves of systolic BP for boys representing the 50th, 75th, 90th, 95th, 99th, and 99th +5 percentiles were built (Figure 1). In relation to the table published by the NIH, we confirm use of approximation of the values in the published table by truncation. Considering a tolerance of 1 mmHg, the monotonic curve of adjustment for height of the systolic BP for boys does not need any correction in the 36.5th to 64.5th percentile of height, but needs maximal correction for the 95th percentile of height (+3.8 mmHg correction).
Figure 1

Update of chart for systolic blood pressure (SBP) based on the last Report on Blood Pressure in 2004 [1], for boys 1 to 17 years old (50th percentile of height). Considering a tolerance of 1 mmHg, the curve of adjustment for height of the SBP for boys does not need any correction in the 36.5th to 64.5th percentile of height.


The adjustment of systolic BP for height is of little significance, and the updated graphic can be used to diagnose high systolic blood pressure for boys. Clinical studies are necessary to determine the systolic BP percentile that better represents clinically significant hypertension.

Authors’ Affiliations

University Hospital of Universidade de São Paulo,, Vila Iara São Paulo,, Brazil


  1. National High Blood Pressure Education Program Working Group on High Blood Pressure in Children and Adolescents: the fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents Pediatrics 2004,114(Suppl 4th Report):555-576.Google Scholar
  2. Report of the Second Task Force on Blood Pressure Control in Children-1987 Task Force on Blood Pressure Control in Children Pediatrics 1987, 79: 1-25.Google Scholar


© Shieh et al; licensee BioMed Central Ltd. 2013

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.