Jafar Tazeen H, Islam Muhammad, Poulter Neil, Hatcher Juanita, Schmid Christopher H, Levey Andrew S, Chaturvedi Nish
Clinical Epidemiology Unit, Department of Community Health Sciences, Aga Khan University, PO Box 3500, Stadium Road, Karachi, Pakistan.
Circulation. 2005 Mar 15;111(10):1291-7. doi: 10.1161/01.CIR.0000157699.87728.F1.
Blood pressure during childhood is an established predictor of adult blood pressure, which in turn increases mortality as a result of cardiovascular disease. Adult South Asian populations are particularly predisposed to cardiovascular disease compared with whites, but the prevalence of high blood pressure and determinants of blood pressure in South Asian children have not been explored or compared with those of white children.
Analyses were performed on 5641 South Asian children 5 to 14 years old included in the nationally representative National Health Survey of Pakistan (NHSP) (1990-1994) and on 4756 white children 5 to 14 years old included in Third National Health and Nutrition Examination Survey (NHANES III) (1988-1994). Anthropometric measurements were obtained. Blood pressure was measured twice in the seated position with a mercury sphygmomanometer and an appropriate-size cuff. High blood pressure was defined as a systolic or diastolic blood pressure level that was > or =95th percentile of age-, sex-, and height-percentile-specific reference level for the US population. Mean body mass index (BMI)-adjusted blood pressure values were compared among children in 2 data sets by use of linear regression analysis. The overall prevalence (95% CI) of high blood pressure in South Asian children 5 to 14 years old was 12.2% (11.3% to 13.1%): 15.8% (14.5% to 17.1%) in boys and 8.7% (7.6% to 9.8%) in girls. This is in sharp contrast with the predicted 5% prevalence of high blood pressure in children in the United States (P<0.001). The mean BMI-adjusted systolic blood pressure levels (SD) were 100 (11) versus 99 (11) mm Hg (P<0.001), and diastolic blood pressure levels (SD) were 63 (10) versus 52 (12) mm Hg (P<0.001) in NHSP versus NHANES III, respectively.
South Asian children have higher body-mass-adjusted blood pressure levels than white children in the United States. Further studies are needed to determine factors responsible for these differences. Immediate attention is needed to address high blood pressure and its risk factors in native South Asian children.
儿童期血压是成人血压的既定预测指标，而成人血压又会因心血管疾病导致死亡率增加。与白人相比，成年南亚人群尤其易患心血管疾病，但南亚儿童高血压的患病率及其血压的决定因素尚未得到研究，也未与白人儿童进行比较。
对纳入具有全国代表性的巴基斯坦国家健康调查（NHSP）（1990 - 1994年）的5641名5至14岁南亚儿童以及纳入第三次全国健康和营养检查调查（NHANES III）（1988 - 1994年）的4756名5至14岁白人儿童进行了分析。获取了人体测量数据。使用汞柱式血压计和合适尺寸的袖带，让受试者坐位测量血压两次。高血压定义为收缩压或舒张压水平高于或等于美国人群按年龄、性别和身高百分位数划分的特定参考水平的第95百分位数。通过线性回归分析比较了两个数据集中儿童的平均体重指数（BMI）调整后的血压值。5至14岁南亚儿童高血压的总体患病率（95%可信区间）为12.2%（11.3%至13.1%）：男孩为15.8%（14.5%至17.1%），女孩为8.7%（7.6%至9.8%）。这与美国儿童高血压患病率预计为5%形成鲜明对比（P<0.001）。NHSP与NHANES III中，平均BMI调整后的收缩压水平（标准差）分别为100（11）与99（11）mmHg（P<0.001），舒张压水平（标准差）分别为63（10）与52（12）mmHg（P<0.001）。
南亚儿童的体重调整血压水平高于美国白人儿童。需要进一步研究以确定造成这些差异的因素。需要立即关注南亚本土儿童的高血压及其危险因素。
