# bililite.com

## pediatrics and medical informatics from the heart of the midwest

Plots and categorizes blood pressure according to the The Fourth Report on the Diagnosis, Evaluation, and Treatment of High Blood Pressure in Children and Adolescents from National High Blood Pressure Education Program Working Group on High Blood Pressure in Children and Adolescents. "Prehypertension" is from the 90th to 95th percentile, while "hypertension" is anything above the 95th percentile. The report further divides hypertension into "Stage 1", less than the 99th percentile plus 5 mmHg, and "Stage 2" which is anything above that. Stage 2 requires more urgent evaluation and treatment. The data are from tables 3 (boys) and 4 (girls) from that paper.

For scale, the 50th percentile line is shown, with pressures above that labelled "High Normal" and "Low Normal", though there is no clinical importance to that distinction. For systolic blood pressures, the approximate 5th percentile line is also shown. This is the cutoff for decompensated shock in the American Heart Association's Pediatric Advanced Life Support algorithm.

The blood pressure norms are a function of height in the original report, but as Dr. David Kaelber points out, using the 5th percentile height values is simpler and likely as useful. Thus, if the patient's height is not given, the graph uses those norms.

The field `type=diastolic` shows the diastolic pressure graph, while any other value shows the systolic pressure graph. The sex is set with `sex=male` or `sex=female`. If the sex is not set, the values shown are averages. Setting `height=nnn` makes the program look up the height percentile and determine the blood pressure percentiles based on that; if `height` is not set then the program uses the 5th percentile height values, as discussed above.

The height is assumed to have been measured at the time of the last data point. If there is no data, the current date is used.

### Examples

/webservices/bp.txt?birth=12/17/2001&time[]=today&data[]=120
Returns the hypertension zone for the patient, based on systolic blood pressure
/webservices/bp.png?birth=12/17/2001&time[]=today&data[]=120
Shows the relevant graph for this patient
/webservices/bp.txt?birth=12/17/2001&time[]=today&data[]=70&type=diastolic
Returns the hypertension zone for the patient, based on diastolic blood pressure
/webservices/bp.png?birth=12/17/2001&date[]=1/1/2006&data[]=90&date[]=1/1/2008&data[]=102&height=124&sex=female
Plots the systolic blood pressure for a girl in the 95th percentile for height. Assumes the height given, 124 cm, was taken 1/1/2008
Patient Information
Data
Date/TimeBlood Pressure (mmHg)Age