Home Blood Pressure Monitoring in Children: How Many Measurements are Needed?
Abstract
OBJECTIVE: To investigate the minimum schedule of blood pressure (BP) measurements necessary to provide a reliable assessment of home BP (HBP) in children and adolescents. METHODS: Subjects aged 6-18 years referred for elevated BP were assessed with HBP monitoring (6 workdays, duplicate morning and evening measurements) and 24-h ambulatory BP monitoring (ABP). Criteria for HBP reliability were its reproducibility (test-retest correlations and SD of differences (SDDs) between repeated measurements), its stability (average home BP of an increasing number of readings and its SD), and its relationship with ABP. RESULTS: Data from 100 subjects were analyzed (mean age 13 +/- 2.8 (SD) years, 61 boys). The reproducibility of 3-day HBP (r 0.88/0.79, SDDs 5.1/4.9, systolic/diastolic) was superior to that of a single (r 0.79/0.65, SDDs 7.6/7.1) or 2-day HBP (r 0.85/0.72, SDDs 6.1/5.4). By averaging up to 12 readings (3 days), there was a progressive decline in average HBP, with no further decline thereafter. The SD of average HBP was also progressively reduced, with little change after day 3. The association of HBP with ABP was improved by averaging more readings up to 12, with no further improvement when more readings were averaged. The exclusion of first-day measurements slightly increased the SD of average HBP and weakened the correlation with ABP, probably due to reduced number of readings. CONCLUSIONS: In children and adolescents, 3-day monitoring with duplicate morning and evening measurements appears to be the minimum schedule for the reliable assessment of HBP.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Very few oscillometric home BP monitors have been tested in children.
“Unfortunately, very few oscillometric home BP monitors have been tested in children [91,182]”
An automated oscillometric device successfully validated in adults may not be accurate in children.
“An automated oscillometric device, which has been successfully validated in adults may not be accurate in children [90,91,182]”
Cites
Stergiou, G. S., Baibas, N. M., Gantzarou, A. P., Skeva, I. I., Kalkana, C. B., Roussias, L. G., & Mountokalakis, T. D. (2002) · American Journal of Hypertension · doi:10.1016/s0895-7061(01)02324-x · Cited by 268 · see citing works
Self-citationHome blood pressure normalcy in children and adolescents: the Arsakeion School study
Stergiou, G. S., Yiannes, N. G., Rarra, V. C., & Panagiotakos, D. B. (2007) · Journal of Hypertension · doi:10.1097/hjh.0b013e328122d3fc · Cited by 119 · see citing works
Self-citationHome Self Blood Pressure Measurement in General Practice The SMART Study
Chatellier, G. (1996) · American Journal of Hypertension · doi:10.1016/0895-7061(96)00018-0 · Cited by 116 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Lurbe, E., Agabiti-Rosei, E., Cruickshank, J. K., Dominiczak, A., Erdine, S., Hirth, A., Invitti, C., Litwin, M., Mancia, G., Pall, D., et al. (2016) · Journal of Hypertension · doi:10.1097/hjh.0000000000001039 · Cited by 1,379 · see citing works
“A 3-day monitoring was found to be the minimum reliable schedule against 6-day readings [75].”
Parati, G., Stergiou, G. S., Asmar, R., Bilo, G., de Leeuw, P., Imai, Y., Kario, K., Lurbe, E., Manolis, A., Mengden, T., et al. (2008) · Journal of Hypertension · doi:10.1097/hjh.0b013e328308da66 · Cited by 837 · see citing works
Self-citationLurbe, E., Cífková, R., Cruickshank, J., Dillon, M., Ferreira, I., Invitti, C., Kuznetsova, T., Laurent, S., Mancia, G., Morales-Olivas, F., et al. (2009) · Journal of Hypertension · doi:10.1097/hjh.0b013e32832f4f6b · Cited by 486 · see citing works
Self-citationLurbe, E., Cífková, R., Cruickshank, J., Dillon, M., Ferreira, I., Invitti, C., Kuznetsova, T., Laurent, S., Mancia, G., Morales-Olivas, F., et al. (2010) · Anales de Pediatría · doi:10.1016/j.anpedi.2010.04.001 · Cited by 376 · see citing works
Self-citationParati, G., Stergiou, G. S., Bilo, G., Kollias, A., Pengo, M., Ochoa, J. E., Agarwal, R., Asayama, K., Asmar, R., Burnier, M., et al. (2021) · Journal of Hypertension · doi:10.1097/hjh.0000000000002922 · Cited by 178 · see citing works
“Preliminary evidenceon the optimal HBPM schedule in children showed that 6-day monitoring (no less than 3days) with duplicate morning and evening measurements taken after few minutes rest in the sitting position is adequate,which is in linewith the evidence in the adults [186].”
Self-citationStergiou, G. S., Nasothimiou, E., Giovas, P., Kapoyiannis, A., & Vazeou, A. (2008) · Journal of Hypertension · doi:10.1097/hjh.0b013e328301c411 · Cited by 114 · see citing works
Self-citationHarris, K., Benoît, G., Dionne, J., Feber, J., Cloutier, L., Zarnke, K., Padwal, R., Rabi, D., & Fournier, A. (2016) · Canadian Journal of Cardiology · doi:10.1016/j.cjca.2016.02.075 · Cited by 74 · see citing works
“Limited studies suggest that HBPM can be performed in children starting at 6 years of age.(22-24) Patients or parents of younger children who measure their BP at home should have adequate training, including direct observation.”
BackgroundThe optimal home blood pressure monitoring schedule based on the Didima outcome study
Stergiou, G. S., Nasothimiou, E. G., Kalogeropoulos, P. G., Pantazis, N., & Baibas, N. M. (2010) · Journal of Human Hypertension · doi:10.1038/jhh.2009.54 · Cited by 56 · see citing works
Self-citationHome blood pressure monitoring in children and adolescents: a systematic review
Stergiou, G., Karpettas, N., Kapoyiannis, A., Stefanidis, C., & Vazeou, A. (2009) · Journal of Hypertension · doi:10.1097/hjh.0b013e32832ea93e · Cited by 55 · see citing works
Self-citationStergiou, G. S., Bountzona, I., Alamara, C., Vazeou, A., Kollias, A., & Ntineri, A. (2021) · Hypertension · doi:10.1161/hypertensionaha.120.16531 · Cited by 31 · see citing works
Self-citationStergiou, G., Rarra, V. C., & Yiannes, N. G. (2009) · American Journal of Hypertension · doi:10.1038/ajh.2009.34 · Cited by 31 · see citing works
Self-citationStergiou, G., Nasothimiou, E., Giovas, P., & Rarra, V. C. (2009) · Hypertension Research · doi:10.1038/hr.2009.9 · Cited by 31 · see citing works
Self-citationStergiou, G., Stambolliu, E., Bountzona, I., Ntineri, A., Kollias, A., Vazeou, A., & Soldatou, A. (2019) · Current Hypertension Reports · doi:10.1007/s11906-019-0967-2 · Cited by 28 · see citing works
Self-citationSalgado, C., Jardim, P. V., Viana, J. K. B., Jardim, T. D. S. V., & Velasquez, P. P. C. (2011) · Acta paediatrica · doi:10.1111/j.1651-2227.2011.02300.x · Cited by 27 · see citing works
Litwin, M., Niemirska, A., Obrycki, Ł., Myśliwiec, M., Szadkowska, A., Szalecki, M., Buraczewska, M., Brzezinska-Rajszys, G., Prokurat, S., & Tykarski, A. (2018) · Arterial Hypertension · doi:10.5603/ah.2018.0007 · Cited by 21 · see citing works
“Adequate home BP measurements are considered a reliable indicator of the effectiveness of antihypertensive therapy [20].”
BackgroundOffice, ambulatory and home blood pressure measurement in children and adolescents
Karpettas, N., Kollias, A., Vazeou, A., & Stergiou, G. (2010) · Expert Review of Cardiovascular Therapy · doi:10.1586/erc.10.148 · Cited by 20 · see citing works
Self-citationKarpettas, N., Nasothimiou, E., Kollias, A., Vazeou, A., & Stergiou, G. (2013) · Hypertension Research · doi:10.1038/hr.2012.220 · Cited by 15 · see citing works
Self-citationHome blood pressure monitoring in paediatric chronic hypertension
Furusawa, É., Filho, U., & Koch, V. (2009) · Journal of Human Hypertension · doi:10.1038/jhh.2008.167 · Cited by 12 · see citing works
Home blood pressure monitoring in pediatric hypertension: the US perspective and a plan for action
Stergiou, G., Ntineri, A., Kollias, A., Stambolliu, E., Kapogiannis, A., Vazeou, A., Stefanidis, C., & Soldatou, A. (2018) · Hypertension Research · doi:10.1038/s41440-018-0078-5 · Cited by 11 · see citing works
Self-citationBlood pressure measurement in children: which method? which is the gold standard.
Vidal, E., Murer, L., & Matteucci, M. (2013) · JN. Journal of Nephrology (Milano. 1992) · doi:10.5301/jn.5000244 · Cited by 11 · see citing works
Jardim, T., Gaziano, T., Nascente, F., Carneiro, C. D. S., Morais, P., Roriz, V., Mendonça, K., Póvoa, T., Barroso, W., Sousa, A., et al. (2017) · Blood Pressure · doi:10.1080/08037051.2017.1312279 · Cited by 10 · see citing works
“One study suggests that home monitoring for 3 days, with duplicate morning and evening measurements, is the minimum schedule required, though 6–7 days of monitoring is recommended [26].”
BackgroundA systems-based approach to managing blood pressure in children following kidney transplantation
Hooper, D., & Mitsnefes, M. (2016) · Pediatric nephrology (Berlin, West) · doi:10.1007/s00467-015-3192-5 · Cited by 10 · see citing works
Clothier, J., Rigby, E., & Sinha, M. (2012) · Archives of Disease in Childhood · doi:10.1136/archdischild-2011-301160 · Cited by 8 · see citing works
Methodology and Applicability of Home Blood Pressure Monitoring in Children and Adolescents
Stergiou, G. S., & Ntineri, A. (2018) · Pediatric Hypertension · doi:10.1007/978-3-319-31107-4_45 · Cited by 7 · see citing works
Self-citationHome blood pressure monitoring in children, pregnancy, and chronic kidney disease
Kollias, A., Shennan, A., Agarwal, R., Ntineri, A., & Stergiou, G. S. (2020) · Updates in Hypertension and Cardiovascular Protection · doi:10.1007/978-3-030-23065-4_13 · Cited by 5 · see citing works
Self-citationAccuracy of Home Blood Pressure Monitoring in Youth: A Systematic Review and Meta-Analysis
Cueto, V., Medvecky, H., Funaro, M., & Nugent, J. T. (2025) · Jornal de Pediatria · doi:10.1016/j.jpeds.2025.114633 · Cited by 4 · see citing works
Newton, J., Haseler, E., Higgins, C., Futcher, C., Singh, C., & Sinha, M. D. (2023) · Journal of Hypertension · doi:10.1097/hjh.0000000000003602 · Cited by 4 · see citing works
“Empiric sample size estimates based on pilot data and in keeping with previously published data [9] estimated difference between Office-SBP Doppler and Home-SBP Doppler at 5 mmHg. statistics software (IBM Corp. Released 2020, IBM SPSS Statistics for Macin-tosh, Version 28.0.”
BackgroundMethodInfluentialArterielle Hypertonie bei Kindern und Jugendlichen
Bald, M., & Wühl, E. (2019) · Monatsschrift Kinderheilkunde · doi:10.1007/s00112-019-0669-5 · Cited by 3 · see citing works
Home Blood Pressure Assessment in Children with Autism Spectrum Disorder: A Feasibility Study
Heffernan, K., Columna, L., Prieto, L. A., Pagan, P., DeBlois, J., Prawl, A., Revolledo, G. J. E., Russo, N., & Barreira, T. (2019) · Artery Research · doi:10.2991/artres.k.191123.001 · Cited by 2 · see citing works
“has found that 3-day home monitoring with duplicate morning and evening measurements is sufficiently reliable for home BP appraisal in typically developing children [29].”
Epidemiology of hypertension in children
Awazu, M. (2015) · Springer eBooks · doi:10.1007/978-3-662-43596-0_54 · Cited by 2 · see citing works
Office and Out of Office Blood Pressure Measurements
Stabouli, S. (2019) · Updates in Hypertension and Cardiovascular Protection · doi:10.1007/978-3-030-18167-3_4 · Cited by 1 · see citing works
Stergiou, G., & Ntineri, A. (2017) · Springer eBooks · doi:10.1007/978-3-319-31420-4_45-1 · Cited by 1 · see citing works
Self-citationStambolliu, E., Kollias, A., Bountzona, I., Ntineri, A., Servos, G., Vazeou, A., & Stergiou, G. (2025) · Hypertension Research · doi:10.1038/s41440-025-02238-4
“Thus, nighttime HBP appears to be rather stable, as it is the case in the adults [13], and in contrast to the evidence regarding daytime HBP schedule where the fi rst monitoring day has been shown to provide higher and more unstable (higher SD) values to subsequent ones [21].”
Self-citationAlabeidi, F., Alosaimi, F., Alsaeed, S., Alshammari, I., Shamry, M. H. A., Alamri, A. M. M., Aljehani, M., Alsulaiman, A. I., Almutairi, F., Almzairie, K. A., et al. (2020) · International Journal of Health Sciences · doi:10.53730/ijhs.v4ns1.15263
“This method has been proven to work well with pediatric populations and is in line with adult standards [17].”
Method
- Authors
- Stergiou, G. S., Christodoulakis, G., Giovas, P., Lourida, P., Alamara, C., & Roussias, L. G.
- Affiliations
- Sotiria General Hospital (GR)
- Venue
- American Journal of Hypertension
- Publisher
- Oxford University Press (OUP)
- Published
- 2008-06-01
- Volume
- 21
- Issue
- 6
- Pages
- 633-638
- ISSN
- 0895-7061 (ISSN-L)
- 1941-7225
- OpenAlex
- W2160521270
- Cited by
- 40
- References
- 0
- Citations by year
- 2025: 2 · 2024: 1 · 2023: 2 · 2022: 1 · 2021: 2 · 2020: 1 · 2019: 5 · 2018: 3 · 2017: 2 · 2016: 3 · 2015: 3 · 2014: 1 · 2013: 2 · 2012: 1
- FWCI
- 2.66
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- American Journal of Hypertension (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Disease Prevention
- Physical Sciences › Engineering › Biomedical Engineering › Non-Invasive Vital Sign Monitoring
- Keywords
- home blood pressure monitoring, children, adolescents, hypertension, ambulatory blood pressure monitoring, measurement reliability, reproducibility, test-retest correlation, coefficient of variation
- MeSH terms
- Adolescent, Blood Pressure Determination, Child, Home Care Services, Humans, Reproducibility of Results
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
