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Mid-upper arm circumference as a screening measure for identifying children with hypertension

Ma, Chun-ming; Li, Yang; Gao, Guo-qin; Yin, Fu-zai; Wang, Rui; Liu, Xiao-li; Lu, Qiang

doi: 10.1097/MBP.0000000000000122
Clinical Methods and Pathophysiology

Background Overweight and obesity, defined by BMI and waist circumference cut-off points, have long been recognized as risk factors for hypertension. Another proposed indicator of obesity in children is mid-upper arm circumference (MUAC).

Objective The aims of this study were to determine whether MUAC could be used to identify hypertension in Han children aged 7–12 years.

Participants and methods In 2011, anthropometric measurements were assessed in a cross-sectional population-based study of 1352 Han children aged 7–12 years. Hypertension was defined according to the 2004 National High Blood Pressure Education Program Working Group definition. Receiver operating characteristic curve analyses were carried out to assess the accuracy of MUAC as diagnostic tests for hypertension.

Results The accuracy levels of MUAC for identifying hypertension [as assessed by area under the curve (AUC)] were over 0.85 in boys (AUC: 0.894), but not in girls (AUC: 0.831), and the cut-off values were the 75th percentile for boys and girls. The sensitivities were 87.5% in boys and 70.0% in girls. The AUC of MUAC was not significantly different from the AUC of BMI and waist circumference for both boys and girls (P>0.05).

Conclusion The present study shows that MUAC is a simple, inexpensive, and accurate measurement for identifying hypertension in Han children. MUAC is equivalent to BMI and waist circumference as a screening test for hypertension.

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The First Hospital of Qinhuangdao, Hebei Medical University, Qinhuangdao, China

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Correspondence to Qiang Lu, BD, Department of Endocrinology, The First Hospital of Qinhuangdao, Hebei Medical University, No.258 Wenhua Road, Qinhuangdao 066000, Hebei Province, China Tel: +86 335 5908369; fax: +86 335 3032042; e-mail:

Received January 3, 2015

Received in revised form March 11, 2015

Accepted March 13, 2015

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