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- Original article Device-related differences in blood pressure measurement and their impact on hypertension prevalence in children and adolescents
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Sung Hye Kim2
, Yu-Mi Kim3
, Hack-Lyoung Kim4
, Sang Min Park5
, In-Jeong Cho6
, Dae-Hee Kim7
, Kwang-Il Kim8
, Jinho Shin9
, Kyungwon Oh10
, Eun Mi Lee1
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Epidemiol Health 2026;e2026037
DOI: https://doi.org/10.4178/epih.e2026037 [Accepted]
Published online: July 27, 2026
2Department of Pediatrics, CHA Bundang Medical Center, CHA University, Seongnam, Korea
3Department of Preventive Medicine, Hanyang University College of Medicine, Seoul, Korea
4Department of Internal Medicine, Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
5Division of Cardiology, Dept. Internal Medicine, Nowon Eulji Medical Center, Eulji University College of Medicine, Seoul, Korea
6Division of Cardiology, Department of Internal Medicine, Ewha Womans University Seoul Hospital, Ewha Womans University College of Medicine, Seoul, Korea
7Division of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
8Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
9Division of Cardiology, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
10Division of Health and Nutrition Survey and Analysis, Bureau of Chronic Disease Prevention and Control, Korea Disease Control and Prevention Agency, Cheongju, Korea
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Corresponding author:
Eun Mi Lee,
Email: mdemlee@naver.com
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Abstract
OBJECTIVES
Accurate blood pressure (BP) measurement is essential for reliably estimating hypertension prevalence in population-based surveys. However, evidence supporting the use of oscillometric BP devices in pediatric populations remains limited. This study compared BP measurements obtained using an oscillometric device (OD) and an auscultatory device (AD) and evaluated inter-device agreement and the impact of device choice on hypertension prevalence estimates.
METHODS
BP was measured sequentially with the AD and OD in 251 children and adolescents participating in the Korea National Health and Nutrition Examination Survey. Inter-device agreement was assessed using mean differences, limits of agreement, concordance correlation coefficients (CCCs), and regression analyses. Differences in prevalence estimates for elevated BP (EBP) and hypertension were also examined.
RESULTS
Mean inter-device differences were minimal for systolic BP (SBP) (0.2 ± 5.9 mmHg) but negative for diastolic BP (DBP) (−1.5 ± 6.1 mmHg), with larger discrepancies in older girls. Agreement was moderate to good for SBP (CCC = 0.79) and weaker for DBP (CCC = 0.60). Nevertheless, more than 85% of paired measurements were within ±10 mmHg. Prevalence estimates for EBP (11.6% vs. 10.0%) and hypertension (4.8% vs. 4.4%) were comparable between devices, with relatively high negative agreement and overall agreement.
CONCLUSIONS
Despite modest underestimation of DBP in specific subgroups, oscillometric BP measurement showed acceptable agreement with the auscultatory method and yielded similar hypertension prevalence estimates. These findings suggest that oscillometric devices may be useful for pediatric BP measurement in public health surveillance systems.
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