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

BMJ Open. 2015 Jun 1;5(6):e007356. doi: 10.1136/bmjopen-2014-007356.

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 (P(95)) 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. P(95) of δ systolic blood pressure (SBP) increase was 18 mm Hg and P(95) of upright SBP was 132 mm Hg in group I and 138 mm Hg in group II. P(95) of δ diastolic blood pressure (DBP) increase was 24 mm Hg in group I and 21 mm Hg in group II, and P(95) 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 pm (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).

Keywords: CARDIOLOGY.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Age Distribution
  • Blood Pressure / physiology*
  • Child
  • China
  • Cross-Sectional Studies
  • Female
  • Heart Rate / physiology*
  • Humans
  • Hypertension / diagnosis*
  • Hypertension / physiopathology
  • Male
  • Postural Orthostatic Tachycardia Syndrome / diagnosis*
  • Postural Orthostatic Tachycardia Syndrome / physiopathology
  • Posture
  • Urban Population / statistics & numerical data