Differences in blood pressure levels obtained by auscultatory and oscillometric methods

Levels of blood pressure measured by the conventional auscultatory method were compared with those measured by the Dinamap Monitor (Dinamap Monitor 1846 SX, Critikon Inc, Tampa, Fla), an oscillometric device. Triplicate measurements were obtained by the two methods 10 to 15 minutes apart in 381 seated fifth-grade children, ages 10 to 13 years. The width of the air bladder of the blood pressure cuff was selected to be 40% to 50% of the circumference of the upper arm. The mean systolic and diastolic pressures (at the fourth phase of Korotkoff sounds) by the auscultatory method were 6.4 mm Hg lower and 8.7 mm Hg higher than the oscillometric systolic and diastolic blood pressures, respectively. The findings of this study suggest that published normative levels of auscultatory blood pressure may be inappropriate as a standard when blood pressure measurement is obtained by the Dinamap Monitor. Until a new set of normative Dinamap blood pressure levels becomes available, one should use equations (A = 12.8 + 0.82D for systolic, and A = 34.3 + 0.54D for diastolic blood pressures at the fourth phase of Korotkoff sounds, where A is auscultatory blood pressure and D is Dinamap blood pressure) to predict auscultatory blood pressures before Dinamap blood pressures are compared with normative auscultatory blood pressure levels.     

Accuracy of blood pressure measurement by the Dinamap monitor in infants and children

Indirect BPs measured by the Dinamap monitor, an oscillometric device, and the conventional auscultatory method were compared with the direct radial artery pressure in infants and children. There were 29 patients in the Dinamap group with a median age of 18 months (ranges 1 month to 16 years) and 20 patients in the auscultatory group with a median age of 3.5 years (ranges 3 months to 16 years). The direct radial artery pressures were recorded on a strip chart and the ranges of pressures were obtained for systolic, diastolic, and mean pressures. The range of the direct readings was converted to a weighted single reading, and comparisons were made between the direct and indirect readings. The linear regression equation between the direct (x) and the Dinamap (y) readings (with correlation coefficient) was y = 1.05x - 5.36 (r = .97) for systolic, y = 1.10x - 4.65 (r = .903) for diastolic, and y = 1.06x - 4.21 (r = .917) for mean pressures. The linear regression equation (with correlation coefficient) for the auscultatory pressure was y = 1.60x - 68.23 (r = .872) and y = 1.38x - 16.47 (r = .874) for diastolic pressures. The error was defined as the indirect reading minus the direct reading. The mean error +/- SD was -0.24 +/- 3.26 for systolic, 1.28 +/- 4.74 for diastolic, and 0.10 +/- 4.56 mm Hg for mean pressures by the Dinamap method. It was -1.65 +/- 6.68 for systolic, and 8.70 +/- 5.97 for diastolic pressures by the auscultatory method.(ABSTRACT TRUNCATED AT 250 WORDS)     

The association of caffeinated beverages with blood pressure in adolescents

OBJECTIVE: To assess the association between the consumption of caffeinated beverages and blood pressure in African American and white adolescents. DESIGN: This study was part of ongoing research examining stress-induced hemodynamic responses in adolescents. African American and white adolescents (n = 159) selected foods and beverages for a 3-day sodium-controlled diet. Caffeine in these foods was used to stratify participants into 3 categories (0-50 mg/d, >50-100 mg/d, and >100 mg/d). Before menu selection, blood pressure readings were obtained. STATISTICAL ANALYSIS: A general linear model (multiple regression with both categorical and continuous variables) was developed to assess the effects of race, category of caffeine intake, and interaction of race and caffeine intake on systolic and diastolic blood pressure controlling for sex and body mass index (calculated as weight in kilograms divided by height in meters squared). RESULTS: The association between systolic blood pressure and caffeine category varied by race (P =.001). African Americans consuming more than 100 mg/d of caffeine had higher systolic blood pressure readings than the groups consuming 0 to 50 mg/d (mean difference, 6.0 mm Hg; 95% confidence interval [CI], 2.3 to 9.7) or more than 50 to 100 mg/d (mean difference, 7.1 mm Hg; 95% CI, 3.4 to 10.7). The effect on diastolic blood pressure was less pronounced (P =.08). The diastolic blood pressure of the group consuming more than 100 mg/d was 3.7 mm Hg (95% CI, 0.41 to 7.0) higher than the group consuming more than 50 to 100 mg/d and was not statistically different from the group consuming 0 to 50 mg/d (mean difference, 2.4 mm Hg; 95% CI, -0.9 to 5.8). There was no evidence that the association between diastolic blood pressure and caffeine intake varied by race (P =.80). CONCLUSIONS: For adolescents, especially African American adolescents, caffeine intake may increase blood pressure and thereby increase the risk of hypertension. Alternatively, caffeinated drink consumption may be a marker for dietary and lifestyle practices that together influence blood pressure. Additional research is needed owing to rising rates of adolescent hypertension and soft drink consumption.     

The San Antonio Biethnic Children's Blood Pressure Study: auscultatory findings.

INTRODUCTION: The purpose of this study were to: (a) examine for possible ethnicity-related and gender-related differences in blood pressure (BP) in Mexican American and non-Hispanic White schoolchildren; (b) compare auscultatory and oscillometric BP levels; and (c) establish auscultatory BP standards using the width of the BP cuff based on the circumference of the arm in schoolchildren in K-12. METHODS: Participants were 6259 schoolchildren in kindergarten through 12th grade in the San Antonio, Texas, area. Auscultatory and oscillometric BP readings were obtained in random sequence, using BP cuff width 40% to 50% of the circumference of the upper arm. Averages of 3 readings were used for statistical analyses. RESULTS: Auscultatory systolic pressures (SPs) in preadolescent Mexican American boys and girls were higher (1 to 3 mm Hg) auscultatory (SP) than in their White counterparts, but the difference was clinically not important. Diastolic pressures (DP) showed no important differences. Auscultatory SPs in 13- to 18-year-old boys of both ethnic groups were significantly (P < .05) higher (3 to 12 mm Hg) than they were for girls, with no ethnic differences. Oscillometric SP was higher than auscultatory SP in children of all ages studied. Oscillometric (DP) was slightly lower (0 to 5 mm Hg) than was auscultatory K4 and higher (4 to 5 mm Hg) than was auscultatory K5 DP. DISCUSSION: No important ethnicity-related difference was found for auscultatory BP, but significant gender-related differences (boys greater than girls) were found in SP in subjects ages 13 to 18 years. Differences in BP readings by oscillometric and auscultatory methods do not allow interchange of readings. This study provides, for the first time, auscultatory BP standards using BP cuff width 40% to 50% of the arm circumference.     

Reliability of the Dinamap non-invasive monitor in the measurement of blood pressure of ill Asian newborns

Four hundred thirty-one paired sets of readings of systolic and diastolic blood pressure and 438 paired sets of readings of mean arterial BP from 49 ill newborns, including 21 very low birth weight infants, were analyzed for the extent and pattern of agreement and the linear relationship between the Dinamap oscillometric monitor and the direct intraarterial blood pressure readings. Agreement between the two methods was measured by the intraclass correlation, whereas the linear relationship was assessed by the product-moment correlation. The intraclass correlations for systolic, diastolic and mean blood pressures were 0.696, 0.766, and 0.781, respectively. The product-moment correlations for systolic, diastolic and mean blood pressures were 0.706, 0.768, and 0.786, respectively. BP measurements by the Dinamap monitor showed reasonably close agreement to those obtained by the intraarterial mean arterial pressure ranges above 40 mmHg. For mean arterial pressure of 40 mmHg and lower, BP readings by the Dinamap monitor tended to be higher than those obtained by the intraarterial method. These findings appeared to be consistent regardless of the birth weight of the newborn.     

Comparison of traditional and plethysmographic methods for measuring pulsus paradoxus

BACKGROUND: In the evaluation of patients with acute asthma, pulsus paradoxus (PP) is an objective and noninvasive indicator of the severity of airway obstruction. However, in children PP may be difficult or impossible to measure. Indwelling arterial catheters facilitate the measurement of PP, but they are invasive and generally reserved for critically ill patients. OBJECTIVE: To determine the utility of the plethysmographic waveform (PPpleth) of the pulse oximeter in measuring PP. METHODS: Patients from the pediatric intensive care unit, emergency department, and inpatient wards of a tertiary care pediatric hospital were eligible for the study. A total of 36 patients (mean age [SD], 11.2 [4.7] years) were enrolled in the study. Pulsus paradoxus was measured using the traditional auscultatory (PPausc) method with a sphygmomanometer. Pulsus paradoxus was then measured using a blood pressure cuff observing for the disappearance and reappearance of the (PPpleth) on the pulse oximeter. Mean difference and 95% confidence intervals were calculated for each method. The 2 methods were also analyzed for correlation and agreement using the Pearson product moment correlation and a Bland and Altman plot. RESULTS: Patients with status asthmaticus had higher PPausc and PPpleth readings compared with nonasthmatic patients. Pulsus paradoxus measured by plethysmography in patients with and without asthma was similar to PPausc readings (mean difference, 0.6 mm Hg; 95% confidence interval, -0.6 to 2.1 mm Hg). Individual PPpleth readings showed significant correlation and agreement with PPausc readings in patients both with and without asthma. CONCLUSION: Measurement of PP using the pulse oximeter-pulse plethysmographic waveform offers a simple and noninvasive method for evaluating patients with airway obstruction.     

Ambulatory blood pressure monitoring

Ambulatory blood pressure monitoring (ABPM) in adults is proving to be useful. The aim of this study was to determine if ABPM is accurate in the lower blood pressure range encountered in children and, equally important, whether it is acceptable to children. Thirty one children, between the ages of 6 and 18 years, were assessed using an ambulatory blood pressure monitor that uses an auscultatory method. Blood pressure was measured in the contralateral arm with a mercury sphygmomanometer and an oscillometric device at the beginning and end of the study for comparison. Over a blood pressure range of 90-130 mm Hg systolic and 40-80 mm Hg diastolic, a close agreement was found with the sphygmomanometer; the limits of agreement (+/- 2 SD) were 11.6 mm Hg for systolic blood pressure and 13.6 mm Hg for diastolic blood pressure. The bias was less than 1.0 mm Hg. The ambulatory device was worn by all patients for at least 16 hours with an average of 52 recordings per patient. The majority found the device comfortable to wear and were not woken from sleep.     

Ambulatory blood pressure monitoring.

Ambulatory blood pressure monitoring (ABPM) in adults is proving to be useful. The aim of this study was to determine if ABPM is accurate in the lower blood pressure range encountered in children and, equally important, whether it is acceptable to children. Thirty one children, between the ages of 6 and 18 years, were assessed using an ambulatory blood pressure monitor that uses an auscultatory method. Blood pressure was measured in the contralateral arm with a mercury sphygmomanometer and an oscillometric device at the beginning and end of the study for comparison. Over a blood pressure range of 90-130 mm Hg systolic and 40-80 mm Hg diastolic, a close agreement was found with the sphygmomanometer; the limits of agreement (+/- 2 SD) were 11.6 mm Hg for systolic blood pressure and 13.6 mm Hg for diastolic blood pressure. The bias was less than 1.0 mm Hg. The ambulatory device was worn by all patients for at least 16 hours with an average of 52 recordings per patient. The majority found the device comfortable to wear and were not woken from sleep.     

Maternal age and other predictors of newborn blood pressure

OBJECTIVE: To investigate perinatal predictors of newborn blood pressure. STUDY DESIGN: Among 1059 mothers and their newborn infants participating in Project Viva, a US cohort study of pregnant women and their offspring, we obtained five systolic blood pressure readings on a single occasion in the first few days of life. Using multivariate linear regression models, we examined the extent to which maternal age and other pre- and perinatal factors predicted newborn blood pressure level. RESULTS: Mean (SD) maternal age was 32.0 (5.2) years, and mean (SD) newborn systolic blood pressure was 72.6 (9.0) mm Hg. A multivariate model showed that for each 5-year increase in maternal age, newborn systolic blood pressure was 0.8 mm Hg higher (95% CI, 0.2, 1.4). In addition to maternal age, independent predictors of newborn blood pressure included maternal third trimester blood pressure (0.9 mm Hg [95% CI, 0.2, 1.6] for each increment in maternal blood pressure); infant age at which we measured blood pressure (2.4 mm Hg [95% CI 1.7, 3.0] for each additional day of life); and birth weight (2.9 mm Hg [95% CI, 1.6, 4.2] per kg). CONCLUSIONS: Higher maternal age, maternal blood pressure, and birth weight were associated with higher newborn systolic blood pressure. Whereas blood pressure later in childhood predicts adult hypertension and its consequences, newborn blood pressure may represent different phenomena, such as pre- and perinatal influences on cardiac structure and function.     

Prediction of arterial blood pressure in the premature neonate using the oscillometric method

The noninvasive oscillometric measurement of blood pressure (BP) in preterm neonates has become a common practice in intensive care nurseries. The method has gained acceptance primarily through its correlation with direct arterial measurement. In this study, the oscillometric method (using Dinamap 1846) was compared with direct intra-arterial BP monitoring in 15 preterm infants. The 95% prediction intervals for individual oscillometric measurements were wide, ranging from 17 mm Hg for the mean BP to 20 mm Hg for the systolic and diastolic BP. The oscillometric method also underestimated intra-arterial systolic and mean BP and overestimated diastolic BP. Caution must be used when oscillometrically measuring BP in premature neonates.     

Longitudinal data of blood pressure and pulse frequency during childhood (author's transl)

From 1968-1980 the development of blood pressure and pulse frequency in 221 healthy boys and 230 healthy girls aged 2-16 years was studied longitudinally. An automatic blood pressure device recording on a paper tape pulse frequence as well was used. Systolic readings are taken at the first appearance, diastolic readings at the disappearance of the Korotkoff sounds. A steady increase of the systolic, and to a lesser extent, of the diastolic pressure can be observed. Boys have a more pronouned increase of systolic pressure than girls. From year 2-16 the 50th percentile increases from 90 mm Hg to 128 mm Hg in boys and from 92 mmHg to 116 mm Hg in girls. The 50th percentile of diastolic pressure increases from 61 to 66 mm Hg in boys and 65 to 71 mm Hg in girls. Pulse frequency of boys is comparable to that of girls. The 50th percentile decreases from 100 to 75 beats. Increasing age is paralleled by decreasing pulse frequency.     

Comparison of Dinamap 8100 with sphygmomanometer blood pressure measurement in a prepubertal diabetes cohort

OBJECTIVE: To compare the conventional sphygmomanometer with the semiautomated Dinamap 8100 (Critikon, Tampa, FL, USA) for the measurement of blood pressure in prepubertal children with insulin-dependent diabetes mellitus. METHODOLOGY: Blood pressure was measured using both methods in 61 prepubertal children (aged 8-13 years) on 189 occasions over 4 years. The measurements were compared using the Bland-Altman plot. Tracking correlations of blood pressure centiles over time were analyzed by the general estimating equation. RESULTS: Accuracy criteria of the Association for the Advancement of Medical Instrumentation were met and a British Hypertensive Society 'B' grading was reached. Differences in systolic and diastolic blood pressure were found between the two methods (P < 0.01). For systolic blood pressure, common correlations were 0.54 (Dinamap) and 0.51 (sphygmomanometer) and for diastolic blood pressure were 0.33 and 0.42, respectively. CONCLUSION: The Dinamap 8100 is an acceptable alternative in clinic practice and research for prepubertal children.     

Accuracy of the oscillometric method to measure blood pressure in children

OBJECTIVE: The aim of this study is to analyze the substitution of the standard auscultatory method by the oscillometric blood pressure monitor, independently of the validity of the intraarterial blood pressure measurement. The accuracy of the automatic oscillometric monitor was compared to the auscultatory mercury manometer blood pressure measurement in apparently healthy school age children. METHODS: A device able to perform 3 simultaneous readings are used: one reading by the monitor and the others by two "blind" observers. We studied 72 school age children with the following characteristics: mean age 9.5 (6.1-16.1) and 39 males (54.2%). RESULTS: The difference for the systolic and diastolic blood pressure obtained by the monitor was in average + 6.2 mmHg and + 10.0 mmHg, respectively, when compared to the observer's readings. There was neither a good correlation nor a good agreement between the two observers and the monitor in the blood pressure determination. CONCLUSIONS: We concluded that the substitution of the standard auscultatory method for the non-invasive oscillometric method to measure blood pressure in school age children can not be generally recommended.     

Placental weight, birth measurements, and blood pressure at age 8 years

OBJECTIVE: To examine relationships between blood pressure during childhood and both placental weight and body size at birth, in an Australian population. DESIGN: A follow up study of a birth cohort, undertaken when cohort members were aged 8 years. SETTING: Adelaide, South Australia. SUBJECTS: 830 children born in the Queen Victoria Hospital in Adelaide, South Australia, during 1975-6. MAIN OUTCOME MEASURES: Systolic and diastolic blood pressure measured when the children were aged 8 years. RESULTS: Blood pressure at 8 years was positively related to placental weight and inversely related to birth weight, after adjusting for the child's current weight. For diastolic pressure there was a decrease of 1.0 mm Hg for each 1 kg increase in birth weight (95% confidence interval (CI) = -0.4 to 2.4) and an increase of 0.7 mm Hg for each 100 g increase in placental weight (95% CI = 0.1 to 1.3). Diastolic pressure was also inversely related to chest circumference at birth, independently of placental weight, with a decrease of 0.3 mm Hg for each 1 cm increase in chest circumference (95% CI = 0.2 to 0.5). CONCLUSIONS: These findings are further evidence that birth characteristics, indicative of fetal growth patterns, are related to blood pressure in later life.     

Placental weight,birth measurements,and blood pressure at age 8 years.

OBJECTIVE: To examine relationships between blood pressure during childhood and both placental weight and body size at birth, in an Australian population. DESIGN: A follow up study of a birth cohort, undertaken when cohort members were aged 8 years. SETTING: Adelaide, South Australia. SUBJECTS: 830 children born in the Queen Victoria Hospital in Adelaide, South Australia, during 1975-6. MAIN OUTCOME MEASURES: Systolic and diastolic blood pressure measured when the children were aged 8 years. RESULTS: Blood pressure at 8 years was positively related to placental weight and inversely related to birth weight, after adjusting for the child''s current weight. For diastolic pressure there was a decrease of 1.0 mm Hg for each 1 kg increase in birth weight (95% confidence interval (CI) = -0.4 to 2.4) and an increase of 0.7 mm Hg for each 100 g increase in placental weight (95% CI = 0.1 to 1.3). Diastolic pressure was also inversely related to chest circumference at birth, independently of placental weight, with a decrease of 0.3 mm Hg for each 1 cm increase in chest circumference (95% CI = 0.2 to 0.5). CONCLUSIONS: These findings are further evidence that birth characteristics, indicative of fetal growth patterns, are related to blood pressure in later life.     

Oscillometric and intra-arterial blood pressure measurements in the neonate: a comparison of methods

ABSTRACT. A number of methods exist to measure neonatal blood pressure, one of which involves oscillometric principles. This method is the functional basis of the Dinamap 847 which has been studied for accuracy and reproductibility in 398 paired comparisons with direct arterial measurements in nine neonates. The correlation between the Dinamap and direct arterial pressure values were excellent, although for systolic blood pressure the Dinamap tends to underestimate by 2.4 ± 3.9 mm Hg. The present study has shown the Dinamap to be a clinically reliable instrument for measuring neonatal blood pressure.     

Cerebral pressure autoregulation and vasoreactivity in the newborn rat

Perinatal brain injury has been associated with impaired cerebral blood flow (CBF) pressure autoregulation. The brain of 3- to 5-d-old rat pups is immature and similar to that of a preterm infant, and therefore we tested cerebral vasoreactivity in that animal. CBF pressure autoregulation was tested in 20 Wistar pups during normocapnia and hypercapnia, respectively. Hypotension was induced by hemorrhage and cerebral perfusion was monitored with laser Doppler flowmetry and near-infrared spectroscopy. Systolic blood pressure was measured noninvasively from the tail. During normocapnia, the autoregulatory plateau was narrow. Resting systolic blood pressure (SBP) was 39.2 mm Hg and CBF remained constant until SBP decreased below 36.0 mm Hg (SE 0.8). Below the lower limit, CBF declined by a mean of 2.7% per mm Hg [95% confidence interval (CI), 2.4-3.0%], and hemoglobin difference (HbD) and total hemoglobin (HbT) changed proportionally to CBF. After inhalation of carbon dioxide, CBF increased significantly by a mean of 17.7% (95% CI, 13.7-22.8%). The CBF-CO2 reactivity was estimated to 13.4% per kPa (95% CI, 2-24.8%), p=0.026. Over the range of SBP (6-54 mm Hg), a linear relationship between CBF and SBP was found during hypercapnia, indicating abolished pressure autoregulation. A linear correlation between CBF and HbD was found (r=0.80). CBF pressure autoregulation and reactivity to CO2 operate in the newborn rat. This model may be useful for future investigations concerning perinatal pathophysiology in the immature brain.     

Ambulatory blood pressure patterns in children and adolescents: influence of renin-sodium profiles

A renin-sodium nomogram for normotensive children and adolescents was developed at our institution. The ambulatory blood pressure patterns of subjects classified by the nomogram were then compared. A biracial sample of 159 children and adolescents were classified as having a low, intermediate, or high renin-sodium profile based on the relationship between their plasma renin activity and 24-hour urinary sodium excretion. Casual (106/58 vs 107/61 vs 106/62 mm Hg) and awake (116/69 vs 117/69 vs 116/70 mm Hg) blood pressure values were comparable among subjects with low, intermediate, and high renin-sodium profiles. Subjects with high renin-sodium profiles, however, had a smaller decline in systolic blood pressure with sleep than did subjects with low renin-sodium profiles (7 vs 11 mm Hg; P less than .04), and higher diastolic blood pressure readings during sleep than subjects with intermediate renin-sodium profiles (65 vs 62 mm Hg; P less than .05). Subjects with high renin-sodium profiles also had greater variance of diastolic blood pressure readings during sleep than either subjects with low renin-sodium profiles (P less than .01) or those with intermediate renin-sodium profiles (P less than .02). The blunted nocturnal decline and increased nocturnal variance of blood pressure among subjects with high renin-sodium profiles may be a marker or mechanism for the future development of essential hypertension.     

Continuous non-invasive finger blood pressure monitoring in children

Tanaka H, Thulesius O, Yamaguchi H, Mino M, Konishi K. Continuous non-invasive finger blood pressure monitoring in children. Acta Padiatr 1994;83:646–52. Stockholm. ISSN 0803–5253
We evaluated the performance of continuous non-invasive finger arterial pressure measurement using the volume-clamp technique (Finapres). The study was designed to compare finger arterial pressure with brachial blood pressure estimated by the auscultatory method in 217 children (90 boys and 127 girls) aged 4–16 years and in 38 adults (aged 18–45 years). Finger and brachial artery pressure readings were obtained consecutively from the ipsilateral side in the supine position. Fingcr arterial pressure waveforms were recorded in all children except 4 with small and thin fingers. There was good agreement for systolic pressure with only a slight underestimation of 1.9 mmHg and 5.1 mmHg lower for diastolic pressure. This difference most probably reflects inaccuracy of the auscultatory cuff method rather than an error in the Finapres. There was large inter-individual variability in Finapres recordings which might be due to diffcrences in vasomotor tone, as demonstrated by systolic amplification in 5 patients with anorexia. However, Finapres showed a small within-subject variability (3.8 mmHg for systolic and 4.1 mmHg for diastolic pressure) dctermined in 5 patients during phenylephrine infusion, and as good reproducibility as the auscultatory method. These results suggest that finger arterial pressure measurement in children older than 6 years of age has similar accuracy as that in adults, and that this method is useful for clinical applications in children, especially for the non-invasive evaluation of autonomic control and cardiovascular reflexes involving transient and rapid blood pressure changes.     

Comparison of body mass index and triceps skinfold at 5 years and young adult body mass index, waist circumference and blood pressure

Aim: To examine which measure of obesity at 5 years, body mass index (BMI) or triceps skinfold thickness, is most strongly associated with 21‐year risk factors for cardiovascular disease (CVD), including BMI, waist circumference (WC), systolic blood pressure (SBP) and diastolic blood pressure (DBP). Methods: Longitudinal birth cohort study with BMI and triceps skinfold measurements at age 5, and BMI, WC and blood pressure at 21 years. Overweight and obesity at 5 years were determined according to Cole‐International Obesity Task Force standards, at 21, by World Health Organization definitions. Triceps skinfold thickness measurements were converted to a z‐score, and cut‐offs for overweight and obesity were chosen to reflect similar proportions to the BMI subgroups. BMI, WC, SBP and DBP were also measured at 21 years. Results: Five‐year BMI and triceps skinfold thickness were both significantly associated with the CVD risk measures at 21 years. For overweight/obesity at 5 years, the adjusted odds ratio (95% confidence interval) for 21‐year overweight/obesity was 5.6 (4.2, 7.4), for 21‐year WC was 1.5 (1.2, 2.0). Mean difference (95% CI) in BMI was 4.4 (3.9, 5.0), in WC 8.3 cm (6.8, 9.8), in SBP 2.4 mm Hg (0.5, 4.3), in DBP 1.1 mm Hg (0.1, 2.2). For skinfold, the similar findings were odds ratio 2.6 (2.0, 3.4) and 1.2 (0.9, 1.6) for 21‐year BMI and WC, and mean differences of 2.6 (2.0, 3.2), WC 4.8 cm (3.3, 6.3), SBP 2.3 mm Hg (0.5, 4.2) and DBP 0.7 mm Hg (?0.4, 1.8). Conclusions: In children with overweight/obesity, BMI rather than triceps skinfold is the preferred epidemiological measure for identifying young adult CVD risk markers of BMI, WC and blood pressure.