Nurses seek ‘normal’ values
for children’s blood pressures
Are "normal" blood pressure values for African American children the same as those values for Hispanic or Anglo children?
Shirley W. Menard, PhD, RN, CPNP, FAAN, associate professor of family nursing care, and her research team are conducting a two-year study funded by the Office of Maternal Child Health (Department of Health and Human Services) to find answers to this question.
"Current guides are not very accurate," explained Dr. Menard, principal investigator. "’Normal’ blood pressure values may be different for children and adolescents of various ethnic groups." Heretofore, values have been established without considerations of ethnicity and/or culture and were based mostly on normal values for Anglo children.
While Dr. Menard’s study focuses primarily on African Americans and Hispanics, Anglos also are included. Students in the San Antonio Independent School District (SAISD), ages 5 to 18, are the study’s participants.
Composed of nurses and clerical assistants, Dr. Menard’s research team travels to various schools in the SAISD and compiles data from a minimum of 100 boys and 100 girls in each grade (kindergarten through 12). Blood pressure, weight, height and skin fold values are measured and recorded for each student participant. Their blood pressures are taken with both an oscillometric device and with the older, traditional blood pressure cuff (sphygmomanometer) and stethoscope.
"We’re really establishing norms with the oscillometric device," Dr. Menard said. "The machine is more accurate than the cuff and stethoscope, but there is no widespread knowledge nor are there normal values for blood pressures taken with the machine."
The researchers also gather data about the participants’ diets. This information will assist them in determining correlations between obesity and diet and blood pressure values.
This is the second child/adolescent blood pressure study in which Dr. Menard has participated. "In 1992 through 1995, we studied primarily the Hispanic and Anglo populations," she said.
"We have paid so much attention for so many years to adults with high blood pressure, but not enough attention to the children," Dr. Menard stated. "Some of the reason for that was not having a device to take their blood pressures. But, now that we do have one, we still don’t pay enough attention." During the 1992-1995 study, the research team identified an elementary school student with high blood pressure. "In his case, our study led to lifesaving heart surgery," Dr. Menard said. "When we find kids with hypertension, we refer them to the school nurse or to their family doctor. "We need to pick up kids tending toward hypertension," she stressed. "We need to detect it early, so we won’t be treating all the other diseases that can result."
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