Sorof Jonathan M
Department of Pediatrics, University of Texas-Houston School of Medicine, 77030, USA.
Am J Hypertens. 2002 Feb;15(2 Pt 2):57S-60S. doi: 10.1016/s0895-7061(01)02303-2.
Systolic blood pressure (SBP) has become the major criterion for the diagnosis, staging, and treatment of hypertension in adults, based on the epidemiology and pathophysiology of adult hypertension, linkage between SBP levels and disease, and benefits of treatment of isolated SBP hypertension. Although children do not typically suffer overt hypertensive disease, an accumulation of data suggests that SBP elevation is as important a factor in the morbidity of hypertension in children as in adults. Systolic BP hypertension is more common in children, whether examining an unselected sampling of patients by routine screening or a selected sampling of referred hypertensive patients. Mild-to-moderate BP elevation in children is associated with increased left ventricular mass (LVM), with SBP more closely linked to LV morphology than diastolic BP (DBP). Furthermore, SBP is associated with increased LVM even in patients with SBP within the normal range. Among hypertensive children, the reported prevalence of left ventricular hypertrophy (LVH) ranges from 30% to 70%, and LVH is more closely related to SBP than to DBP. These data suggest that treatment of hypertension should be directed at normalization of SBP, even when DBP is within the normal range. In addition, trials of antihypertensive medications in children should incorporate SBP hypertension into study inclusion criteria.
基于成人高血压的流行病学和病理生理学、收缩压（SBP）水平与疾病的关联以及单纯收缩期高血压治疗的益处，收缩压已成为成人高血压诊断、分期和治疗的主要标准。虽然儿童通常不会患明显的高血压疾病，但大量数据表明，收缩压升高在儿童高血压发病中与在成人中一样，是一个重要因素。无论是通过常规筛查对未选患者样本进行检查，还是对转诊的高血压患者进行选样检查，收缩期血压高血压在儿童中都更为常见。儿童轻度至中度血压升高与左心室质量（LVM）增加有关，收缩压比舒张压（DBP）与左心室形态的联系更为紧密。此外，即使收缩压在正常范围内的患者，收缩压也与左心室质量增加有关。在高血压儿童中，报告的左心室肥厚（LVH）患病率在30%至70%之间，且左心室肥厚与收缩压的关系比与舒张压更为密切。这些数据表明，即使舒张压在正常范围内，高血压治疗也应旨在使收缩压正常化。此外，儿童抗高血压药物试验应将收缩期血压高血压纳入研究纳入标准。
