Accuracy of Automated Blood Pressure Measurement in Children: Evidence, Issues, and Perspectives
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There is close agreement between home and ambulatory BP monitoring in diagnosing hypertension phenotypes within the range of 80-85%.
“there is close agreement between home and ambulatory BP monitoring in diagnosing hypertension phenotypes within the range of 80–85% [176–179]”
ABPM is currently regarded as the reference method for hypertension diagnosis in children and adolescents as white-coat, masked and nocturnal hypertension are as common as in adults.
“ABPM is currently regarded as the reference method for hypertension diagnosis in children and adolescents as white-coat, masked and nocturnal hypertension are as common as in the adults [174–178]”
HBPM appears to have several potential advantages over both OBP and ABPM, including user convenience and acceptance, and the ability to obtain multiple measurements in the usual environment over several days, weeks or months.
“HBPM appears to have several potential advantages over both OBP and ABPM, including user convenience and acceptance, and the ability to obtain multiple measurements in the usual environment over several days, weeks or months [174–179]”
The association of HBPM with several indices of preclinical target-organ damage, mainly LVMI, appears to be superior to OBP measurements and similar to ABPM.
“the association of HBPM with several indices of preclinical target-organ damage, mainly LVMI, appears to be superior to OBP measurements and similar to ABPM [176–178,180,181]”
Preliminary evidence for HBPM in children shows that its reproducibility is superior to that of OBP measurements and close to that of ambulatory monitoring.
“Preliminary evidence for HBPM in children shows that, as in the adults: its reproducibility is superior to that of OBP measurements and close to that of ambulatory monitoring [21,176–178]”
Even antenatal schedules may not be sufficiently frequent to identify fulminant preeclampsia where onset and progress can be rapid and often asymptomatic.
“However, even antenatal schedules may not be sufficiently frequent to identify fulminant preeclampsia where onset and progress can be rapid and often asymptomatic [178]”
Both home and ambulatory BP monitoring have been shown to more accurately characterize BP in pregnancy as in nonpregnant individuals.
“Both home and ambulatory BP monitoring have been shown to more accurately characterize BP in pregnancy as in nonpregnant individuals [178]”
The sitting position appears to be appropriate for HBPM during pregnancy.
“The sitting position appears to be appropriate for HBPM during pregnancy [178]”
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“Preta 8,0 (7,4-8,8) 6,5 (5,8-7,2) 9,6 (8,6-10,7) Parda 48,8 (47,4-50,1) 51,2 (49,5-52,9) 46,4 (44,7-48,1) Amarela 2,2 (1,9-2,5) 2,3 (2,0-2,7) 2,1 (1,7-2,5) Nativa brasileira 0,7 (0,5-0,8) 0,4 (0,3-0,6) 0,9 (0,7-1,2) Não declarada 2,5 (2,2-2,8) 1,4 (1,2-1,7) 3,6 (3,2-4,1)”
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Khong, T. K., & Fok, H. (2021) · Drug and Therapeutics Bulletin · doi:10.1136/dtb.2021.000025 · Cited by 8 · see citing works
Parent and Primary Care Clinician Perceptions About Pediatric Hypertension
Zaidi, A. H., Sood, E., de Ferranti, S. D., Gidding, S. S., Zadokar, V., Miller, J. M., & Kazak, A. E. (2024) · JAMA Network Open · doi:10.1001/jamanetworkopen.2024.51103 · Cited by 7 · see citing works
Vazeou, A., Birkebæk, N., Iotova, V., Cherubini, V., Piccini, B., Biester, T., Stipančić, G., Jefferies, C., Maffeis, C., Stergiou, G. S., et al. (2020) · Pediatric Diabetes · doi:10.1111/pedi.13114 · Cited by 6 · see citing works
“Current guidelines recommend using only validated devices in children and adolescents.(5,7,20) There are data suggesting that an electronic BP monitor which has been successfully validated in adults, might be inaccurate in children.”
BackgroundMethodInfluentialSelf-citationLurbe, E. (2018) · Anales de Pediatría · doi:10.1016/j.anpedi.2018.08.004 · Cited by 6 · see citing works
Newton, J., Singh, C., & Sinha, M. D. (2020) · Journal of Hypertension · doi:10.1097/hjh.0000000000002736 · Cited by 6 · see citing works
“have previously recommended that using an oscillometric device, HBPM in children should be performed over 7 days (minimum of 3 days) with morning and evening readings measured with a minimum of 12 readings in total obtained [4,18].”
MethodNeuhauser, H. K., Adler, C., & Sarganas, G. (2019) · International Journal of Hypertension · doi:10.1155/2019/2314029 · Cited by 6 · see citing works
“Strengths of our analysis include the large and population-based sample with BP data based on highly standardized measurements with one of the few oscillometric devices validated in children [25, 26].”
MethodArtificial Intelligence in Cardiovascular Medicine: A Giant Step in Personalized Medicine?
Jankauskas, S. S., Varzideh, F., Kansakar, U., & Santulli, G. (2026) · Journal of Personalized Medicine · doi:10.3390/jpm16040192 · Cited by 6 · see citing works
Glenning, J. P., Sheeran, F. L., Cuthbert, J., Harris, W., Quinlan, C., & Mynard, J. P. (2024) · Hypertension Research · doi:10.1038/s41440-024-01992-1 · Cited by 5 · see citing works
“Validating automated BP devices for use in children and adolescents is a critical, yet relatively rare undertaking [10].”
Home 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-citationNoninvasive pediatric blood pressure assessment: exploring the clinicians’ perspective
Stewart, N. P., Quinlan, C., Best, S., & Mynard, J. P. (2024) · Blood Pressure Monitoring · doi:10.1097/mbp.0000000000000693 · Cited by 4 · see citing works
“Automated BP devices should be validated against manual BP readings, although a recognized problem is that many automated devices have not been validated for use in children [12].”
BackgroundMenti, A., Ntineri, A., Theodosiadi, A. G., Ntousopoulos, V., Κόλλιας, Α., & Stergiou, G. S. (2025) · Hypertension Research · doi:10.1038/s41440-024-02093-9 · Cited by 4 · see citing works
Self-citationFerrer, E. L. I. (2018) · Anales de Pediatría (English Edition) · doi:10.1016/j.anpede.2018.08.005 · Cited by 3 · see citing works
Cribado, diagnóstico y tratamiento de la hipertensión arterial en niños y adolescentes
Antón-Gamero, M., Idarreta, M. A., & Vargas, E. L. (2022) · FMC - Formación Médica Continuada en Atención Primaria · doi:10.1016/j.fmc.2022.02.009 · Cited by 3 · 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
Home Blood Pressure Assessment in Children with Autism Spectrum Disorder: A Feasibility Study
Heffernan, K. S., Columna, L. A., Prieto, L. A., Pagán-Lassalle, P., DeBlois, J. P., Prawl, A., Elías, G., Russo, N. N., & Barreira, T. V. (2019) · Artery Research · doi:10.2991/artres.k.191123.001 · Cited by 2 · see citing works
“Oscillometric cuff-based methods tend to overestimate the measure DBP in adults and children alike when compared to invasive intra-arterial recordings [28].”
Evaluation and Management of Hypertension in Children
Larkins, N., Lurbe, E., & Flynn, J. T. (2022) · Springer eBooks · doi:10.1007/978-3-030-52719-8_123 · Cited by 2 · see citing works
Jardim, T. V., ROSNER, B. A., Bloch, K. V., Kuschnir, M. C. C., Szklo, M., & Jardim, P. C. B. V. (2020) · Jornal de Pediatria (Versão em Português) · doi:10.1016/j.jpedp.2018.09.002 · Cited by 2 · see citing works
Methodology and Applicability of Home Blood Pressure Monitoring in Children and Adolescents
Stergiou, G. S., & Ntineri, A. (2023) · Springer eBooks · doi:10.1007/978-3-031-06231-5_45 · Cited by 2 · see citing works
Self-citationHypertension in Children: Diagnosis and Treatment
Hanevold, C. D., & Flynn, J. T. (2023) · Elsevier eBooks · doi:10.1016/b978-0-323-88369-6.00049-9 · Cited by 2 · see citing works
Kuok, M. C. I., Newton, J., Singh, C., & Sinha, M. D. (2025) · Journal of Human Hypertension · doi:10.1038/s41371-025-01038-0 · Cited by 1 · see citing works
“Home BP monitoring with oscillometric devices is recommended in older children and adolescents, but its use is limited in young infants due to concerns regarding accuracy [14].”
Mahapatra, A., Siddiqui, M. S., Haseeb, M., Sangle, A. L., Ingale, V., Joshi, P. M., Supe, P., Sachdev, S., Shaikh, R., & Mohapatra, A. (2026) · Cureus · doi:10.7759/cureus.110605 · Cited by 1 · see citing works
“Smaller limb dimensions, lower BP levels, higher heart rates, greater movement, and altered oscillometric waveform behavior reduce the transferability of adult validation data [11].”
Sahoo, T., Jayashree, M., Baranwal, A. K., Gupta, P., & Khan, A. A. (2023) · Indian Journal of Critical Care Medicine · doi:10.5005/jp-journals-10071-24424 · Cited by 1 · see citing works
“Arch Pediatr Adolesc Med 2001;155(1):50–53.”
Home Monitoring of Blood Pressure
Stergiou, G. S., & Κόλλιας, Α. (2023) · Elsevier eBooks · doi:10.1016/b978-0-323-88369-6.00010-4 · Cited by 1 · see citing works
Self-citationRai, B., Rajesh, R., & Saritha, G. (2024) · International Journal of Science and Healthcare Research · doi:10.52403/ijshr.20240130 · Cited by 1 · see citing works
Evaluation and Management of Hypertension in Children
Larkins, N., Lurbe, E., & Flynn, J. T. (2021) · Springer eBooks · doi:10.1007/978-3-642-27843-3_123-1 · Cited by 1 · see citing works
Hypertension Care During Emergencies and Pandemics
Samuel, J. P., & Hyman, B. K. (2023) · Springer eBooks · doi:10.1007/978-3-031-06231-5_63 · Cited by 1 · see citing works
Methods for Measuring Blood Pressure and Applications to Diabetes
Vazeou, A., & Stergiou, G. S. (2022) · Biomarkers in disease · doi:10.1007/978-3-030-81303-1_37-1
Self-citationHypertension Care During Emergencies and Pandemics
Samuel, J. P., & Hyman, B. K. (2022) · Springer eBooks · doi:10.1007/978-3-319-31420-4_63-1
Methodology and Applicability of Home Blood Pressure Monitoring in Children and Adolescents
Stergiou, G. S., & Ntineri, A. (2022) · Springer eBooks · doi:10.1007/978-3-319-31420-4_45-2
Self-citationMethods for Measuring Blood Pressure and Applications to Diabetes
Vazeou, A., & Stergiou, G. S. (2022) · Biomarkers in disease · doi:10.1007/978-3-031-08014-2_37
Self-citationLeft ventricle mass index in paediatric intensive care unit acquired hypertension
Mekki, M., Algebaly, H. F., Sabry, H. A., Samir, M., & Rady, H. I. (2023) · Cardiology in the Young · doi:10.1017/s1047951123000781
Rozé, J., Bacchetta, J., Lapillonne, A., Boubred, F., Picaud, J., Marchand‐Martin, L., Bruel, A., Harambat, J., Biran, V., Nuyt, A. M., et al. (2023) · Journal of the American Heart Association · doi:10.1161/jaha.123.032804
“18 Sensitivity analyses were performed among the matched cohort but restricted to children with at least 2 BP measurements performed with a validated automatic BP monitor 19 to have an analysis among more homogenous measurements.”
MethodAlabeidi, 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
“31 validation studies of oscillometric blood pressure monitors in pediatric populations were found in a recent systematic review [13], 42% of which were published more than ten years ago.”
BackgroundSingh, Y., Villaescusa, J. U., da Cruz, E. M., Tibby, S. M., Bottari, G., Saxena, R., Guillén, M., Herce, J. L., Di Nardo, M., Cecchetti, C., et al. (2020) · Figshare · doi:10.6084/m9.figshare.13142327
Validated Automated Cuff Blood Pressure Devices for Children: STRIDE BP Report and Call to Action
Stergiou, G. S., Menti, A., Palatini, P., Parati, G., Wang, J.-G., Mariglis, D., Schutte, A. E., & Κόλλιας, Α. (2026) · Hypertension · doi:10.1161/hypertensionaha.125.26206
Self-citationPisithkul, T., & Pirojsakul, K. (2026) · Journal of Clinical Hypertension · doi:10.1111/jch.70370
- Authors
- Stergiou, G. S., Boubouchairopoulou, N., & Kollias, A.
- Affiliations
- National and Kapodistrian University of Athens (GR)
- From the Hypertension Center STRIDE-7, National and Kapodistrian University of Athens, School of Medicine, Third Department of Medicine, Sotiria Hospital, Athens, Greece.
- Venue
- Hypertension
- Published
- 2017-06
- Volume
- 69
- Issue
- 6
- Pages
- 1000-1006
- ISSN
- 0194-911X (ISSN-L)
- 1524-4563
- OpenAlex
- W2609070632
- Cited by
- 72
- References
- 53
- Citations by year
- 2026: 5 · 2025: 3 · 2024: 5 · 2023: 12 · 2022: 9 · 2021: 9 · 2020: 10 · 2019: 7 · 2018: 10 · 2017: 2
- FWCI
- 1.11
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Hypertension (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Physical Sciences › Engineering › Biomedical Engineering › Non-Invasive Vital Sign Monitoring
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Disease Prevention
- Keywords
- automated blood pressure measurement, blood pressure measurement accuracy, children, pediatric hypertension, cuffless blood pressure measurement
- MeSH terms
- Blood Pressure, Blood Pressure Determination, Child, Child, Preschool, Humans, Sensitivity and Specificity, Blood Pressure Monitoring, Ambulatory
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