Perímetro de cuello en el cribado de presión arterial elevada

Abstract

Introduction

High blood pressure (BP) in childhood is associated with excess adiposity. The aim of our study was to compare anthropometric and body composition indicators for screening of high BP (≥ 90th percentile) in school-aged children.

Materials and methods

Cross-sectional study in 497 school-aged children (aged 6-15 years) in rural Andalusia. We recorded weight, height, waist and neck circumference, and biceps, triceps, subscapular, and suprailiac skinfold values to calculate the body mass index, waist-to-height ratio, the sum of the four skinfolds and the body fat percentage. Blood pressure was measured by oscillometry (3 readings, the mean of the last two was used) and classified using Spanish age- and sex-specific references (≥90th percentile for systolic and/or diastolic BP). We fitted age- and sex-adjusted logistic models and performed sex-stratified analyses of discrimination and calibration, and derived optimal cutoffs with the Youden index.

Results

The prevalence of high BP was 5.8% and increased with excess weight, particularly in girls. After multivariable adjustment, neck circumference (NC) was the indicator most consistently associated with high BP. The discriminatory power was moderate in boys and high in girls, with optimal cutoffs of 29.15 and 30.65 cm, respectively.

Conclusions

The NC is a simple, low-cost measure that may complement traditional indicators for high BP screening in school and primary care settings; the proposed cutoffs require external validation.