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  • A cross-sectional study on upright heart rate and BP changing characteristics: basic data for establishing diagnosis of postural orthostatic tachycardia syndrome and orthostatic hypertension

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Paediatrics
Research
A cross-sectional study on upright heart rate and BP changing characteristics: basic data for establishing diagnosis of postural orthostatic tachycardia syndrome and orthostatic hypertension
  1. Juan Zhao1,
  2. Zhenhui Han2,
  3. Xi Zhang2,
  4. Shuxu Du3,
  5. Angie Dong Liu4,
  6. Lukas Holmberg4,
  7. Xueying Li5,
  8. Jing Lin1,
  9. Zhenyu Xiong2,
  10. Yong Gai2,
  11. Jinyan Yang1,
  12. Ping Liu1,
  13. Chaoshu Tang6,
  14. Junbao Du1,7,
  15. Hongfang Jin1
  1. 1Department of Pediatrics, Peking University First Hospital, Beijing, People's Republic of China
  2. 2Department of Pediatrics, Kaifeng Children's Hospital, Henan, People's Republic of China
  3. 3Department of Pediatrics, The Capital Medical University, Shijitan Hospital, Beijing, People's Republic of China
  4. 4Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
  5. 5Department of Medical Statistics, Peking University First Hospital, Beijing, People's Republic of China
  6. 6Department of Physiology and Pathophysiology, Peking University Health Sciences Centre, Beijing, People's Republic of China
  7. 7Key Laboratory of Cardiovascular Medicine, Ministry of Education, Beijing, People's Republic of China
  1. Correspondence to Dr Junbao Du; junbaodu1{at}126.com

Abstract

Objective We aimed to determine upright heart rate and blood pressure (BP) changes to suggest diagnostic criteria for postural orthostatic tachycardia syndrome (POTS) and orthostatic hypertension (OHT) in Chinese children.

Methods In this cross-sectional study, 1449 children and adolescents aged 6–18 years were randomly recruited from two cities in China, Kaifeng in Henan province and Anguo in Hebei province. They were divided into two groups: 844 children aged 6–12 years (group I) and 605 adolescents aged 13–18 years (group II). Heart rate and BP were recorded during an active standing test.

Results 95th percentile (P95) of δ heart rate from supine to upright was 38 bpm, with a maximum upright heart rate of 130 and 124 bpm in group I and group II, respectively. P95 of δ systolic blood pressure (SBP) increase was 18 mm Hg and P95 of upright SBP was 132 mm Hg in group I and 138 mm Hg in group II. P95 of δ diastolic blood pressure (DBP) increase was 24 mm Hg in group I and 21 mm Hg in group II, and P95 of upright DBP was 89 mm Hg in group I and 91 mm Hg in group II.

Conclusions POTS is suggested when δ heart rate is ≥38 bpm (for easy memory, ≥40 bpm) from supine to upright, or maximum heart rate ≥130 bpm (children aged 6–12 years) and ≥125 bpm (adolescents aged 13–18 years), associated with orthostatic symptoms. OHT is suggested when δ SBP (increase) is ≥20 mm Hg, and/or δ DBP (increase) ≥25 mm Hg (in children aged 6–12 years) or ≥20 mm Hg (in adolescents aged 13–18 years) from supine to upright; or upright BP≥130/90 mm Hg (in children aged 6–12 years) or ≥140/90 mm Hg (in adolescents aged 13–18 years).

  • CARDIOLOGY

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/bmjopen-2014-007356

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