Blood pressure reference values for Brazilian adolescents: data from the Study of Cardiovascular Risk in Adolescents (ERICA Study)

Objective: Blood pressure (BP) references for Brazilian adolescents are lacking in the literature. This study aims to investigate the normal range of office BP in a healthy, non-overweight Brazilian population of adolescents. Method: The Brazilian Study of Cardiovascular Risks in Adolescents (Portuguese acronym “ERICA”) is a national school-based study that included adolescents (aged 12 through 17 years), enrolled in public and private schools, in cities with over 100,000 inhabitants, from all five Brazilian macro-regions. Adolescents’ height and body mass index (BMI) were classified in percentiles according to age and gender, and reference curves from the World Health Organization were adopted. Three consecutive office BP measurements were taken with a validated oscillometric device using the appropriate cuff size. The mean values of the last two readings were used for analysis. Polynomial regression models relating BP, age, and height were applied. Results: Among 73,999 adolescents, non-overweight individuals represented 74.5% (95% CI: 73.3–75.6) of the total, with similar distribution across ages. The majority of the non-overweight sample was from public schools 84.2% (95% CI: 79.9–87.7) and sedentary 54.8% (95% CI: 53.7–55.8). Adolescents reporting their skin color as brown (48.8% [95% CI: 47.4–50.1]) or white (37.8% [95% CI: 36.1–39.5]) were most frequently represented. BP increased by both age and height percentile. Systolic BP growth patterns were more marked in males when compared to females, along all height percentiles. The same pattern was not observed for diastolic BP. Conclusions: Blood pressure references by sex, age, and height percentiles for Brazilian adolescents are provided.