Epidemiology of arterial hypotension

The prevalence of arterial hypotension. According to various authors, ranges from 0.6 to 29% among adults and from 3 to 21% among children. Its prevalence increases with age. So, if among the children of primary school age it is 1-3%, then among the children of the senior school age - 10-14%. Girls suffer from arterial hypotension somewhat more often than boys.

Causes of variability in the prevalence of arterial hypotension

• Inhomogeneity of the examined patients.
• Use of various standards of blood pressure during research.
• Conducting a survey in different seasons of the year (the prevalence of arterial hypotension increases in the winter-spring period, when daily changes in meteorological conditions require additional tension of the regulation systems).
• Conducting a survey at different times of the day (diurnal changes in blood pressure in healthy children are 10-16 mm Hg, blood pressure is highest at 12-15 h, the lowest at 3-4 h).
• Various climatic and geographic conditions in which studies were conducted (in the northern regions, the cold contributes to spasm of peripheral vessels and elevation of arterial pressure, and residence in a hot climate - vasodilation and lowering blood pressure).

The procedure for determining and assessing the value of blood pressure

To diagnose arterial hypotension, it is necessary to correctly determine the level of blood pressure.

Rules for determining blood pressure

• Arterial pressure should be measured several times (at least 3 times) with a periodicity of 3 minutes.
• Measurement of blood pressure should be conducted in the first half of the day, not earlier than 1 hour after physical education classes or tests, in comfortable conditions after a five-minute rest.
• Measurement of blood pressure should be carried out in the sitting position, with the location of the ulnar fossa at the heart level.
• It is necessary to use the size of the cuff according to the age of the child, corresponding to the length of the shoulder circumference.
• For systolic blood pressure take the first phase of Korotkov's tones; for diastolic arterial pressure - the fifth phase of Korotkov's tones or the fourth during the "phenomenon" of infinite sound.

Criteria for diagnosing low blood pressure There are two basic approaches to developing criteria for low blood pressure. Use the average age indicators (single criteria) or centile distribution of blood pressure indicators taking into account age, gender and growth.

The systolic indices of systolic and diastolic blood pressure. They are obtained on the basis of a mass examination of children and adolescents of the same age and sex. After receiving the blood pressure measurement data, a blood pressure distribution curve is constructed and a centile distribution scale is created. For arterial hypotension, blood pressure values below the 10th centile of the distribution curve in the children's population are taken for a threefold measurement.

Unified criteria for arterial hypotension

Age	Systolic BP, mmHg	Diastolic blood pressure, mmHg
7-9 years	80	40
10-13 years old	85	45
14-15 years old	90	50
16-17 years old	90	55

[1], [2], [3], [4], [5], [6], [7]