430 Measuring blood pressure in children and adolescents: 20 years of change

<h3>Aims</h3> Our aim was to update our knowledge on the practice and interpretation of blood pressure (BP) measurement and treatment of hypertension (HTN) in children and adolescents. A previous study performed just over twenty years ago, suggested a general lack of standardisation of BP measurement techniques and little consensus on the criteria for diagnosing HTN amongst paediatricians.¹ Updated clinical practice guidelines have since been published.² Through sending a questionnaire consistent with that sent twenty years previously,¹ we hoped to compare clinical practice between the two time periods, in order to evaluate whether progress has been made, and identify further ways to standardise and improve patient care. <h3>Methods</h3> A national quality improvement survey was sent to the General and Adolescent Paediatric Research in the United Kingdom &amp; Ireland (GAPRUKI) committee for feedback and circulation to consultant-grade general paediatricians. <h3>Results</h3> The survey ran from 18/11/2021 – 12/01/2022. 125 analysable replies from 34 different sites were received and compared with the 1997 data. 106 (84.8%) reported clinic nurse involvement in BP measurement, more than double the previous data (40.6%). Most paediatricians (53.6%) now rely on BP recording systems, whereas previously the mercury sphygmomanometer was favoured (82.7%). If assessing BP manually (n=89), most (79.8%) now use Korotkoff phase V as the auscultatory endpoint for diastolic BP (phase IV was previously used (52.1%)). 102 (81.6%) paediatricians had access to Ambulatory BP Monitoring, making it six times more available than in 1997. For a diagnosis of HTN, the criteria (≥95^th centile for gender, age and height) were constant, and 100% of paediatricians diagnosed it using systolic BP, but only 43 (34.4%) would do so using diastolic BP, a decrease from 79.4% previously. Similar to previous findings, only 12 (9.6%) paediatricians would manage these patients themselves, however 82 (72.6%) would keep general paediatric input. <h3>Conclusion</h3> There is greater availability of BP equipment/technology, however nowadays paediatricians are more likely to rely on oscillometric technology. Less paediatricians are responding to high diastolic pressures than twenty years ago. <h3>References</h3> J Hum Hypertens, Lip GY, et al. J Hypertens, Lurbe E, et al.