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目的探讨儿童期高血压对成年期高血压患病危险的预测价值。方法对1987年(基线)“北京儿童血压研究”人群(2505例,6~18岁)于2005年进行追访,进行血压测量及心血管相关因素的临床检查。结果儿童期血压水平位于﹤P25、﹤P75、﹤P90、﹤P95、P95各组人群其成年期高血压检出率分别为2.5%、9.5%、13.5%、19.4%和42.9%(趋势检验:掊2=40.129,P﹤0.001)。非条件Logistic回归分析显示,儿童期高血压[收缩压(SBP)和(或)舒张压(DBP)≥P95]患者成年期罹患高血压的风险(OR)是非高血压儿童的4.63倍(95%CI:2.09~10.25)。对SBP和DBP分别进行多因素分析显示,儿童期高SBP,成年罹患高压的危险是儿童期SBP正常者的8.63倍(95%CI:3.32~22.38);儿童期高DBP,成年罹患高血压的风险是儿童期DBP正常者的3.37倍(95%CI:1.29~8.82);儿童期SBP和DBP都高,成年高血压的患病危险为儿童期血压正常者的12.55倍(95%CI:2.86~55.05)。结论儿童期高血压(P95)对于个体成年罹患高血压具有重要的预测价值,重视儿童期血压监测,对于预防、延缓成人心血管病的发生具有重要的现实意义。
Objective To investigate the predictive value of childhood hypertension in the risk of adult hypertension. Methods A total of 2505 patients (6-18 years old) from 1987 (Baseline) and Beijing Children’s Blood Pressure Study were enrolled in 2005 for blood pressure measurement and cardiovascular related factors. Results The prevalence of hypertension in adulthood was 2.5%, 9.5%, 13.5%, 19.4% and 42.9% in children with P25, 95%] was 4.63 times (95% CI: 2.09-10.25). In the multivariate analysis of SBP and DBP respectively, the risk of high SBP in adulthood was 8.63 times (95% CI: 3.32 to 22.38) in children with normal SBP during normal childhood. High DBP in childhood and hypertensive adult The risk was 3.37 times (95% CI: 1.29-8.82) in children with normal DBP during childhood. SBP and DBP were both high in childhood. The risk of adult hypertension was 12.55 times that of normotensive children (95% CI: 2.86 ~ 55.05). Conclusions P95 in childhood is of great value in predicting hypertension in adulthood. Emphasis on blood pressure monitoring in childhood is of great practical significance for preventing and delaying the occurrence of cardiovascular disease in adults.