Blood Pressure Nomograms by Age and Weight for Iranian Children and Adolescents

Normal standard references of blood pressure (BP) for children and adolescents have been suggested to be constructed based on anthropometric indices. Accordingly, we aimed to develop first BP reference percentiles by weight and age for Iranian children aged 3-18 years old.
A total of 16,246 children and adolescents aged 3-18 years were included from 3 cross-sectional studies conducted in Tehran- Iran. Data on demographic characteristics, anthropometric indices and BP values of these subjects were gathered. Quantile regression model was used to assess the need for weight adjustment in different percentiles of systolic and diastolic BPs with age, gender, and the corresponding weight percentiles. Then, Age- and sex-specific BP nomograms were developed according to weight.
All the regression coefficients for weight percentiles were statistically significant in quantile regression of BPs, which confirms the positive effect of adjustment for weight (P This study presents the first Iranian BP references by age and weight for 3 to 18 year old children and adolescents. BMI-adjusted BP curves were found to be a better tool for assessing the prevalence of hypertension in children and adolescents, on the basis of which a more reliable classification standard for hypertension could be obtained.