McNiece Karen L, Poffenbarger Timothy S, Turner Jennifer L, Franco Kathy D, Sorof Jonathan M, Portman Ronald J
Department of Pediatrics, Division of Pediatric Nephrology and Hypertension, University of Texas-Houston, School of Medicine, Houston, Texas 77057, USA.
J Pediatr. 2007 Jun;150(6):640-4, 644.e1. doi: 10.1016/j.jpeds.2007.01.052.
To determine the prevalence of hypertension and pre-hypertension on the basis of the 2004 National High Blood Pressure Education Program Working Group guidelines in an adolescent school-screening population.
Cross-sectional assessment of blood pressure (BP) in 6790 adolescents (11-17 years) in Houston schools was conducted from 2003 to 2005. Initial measurements included height, weight, and 4 oscillometric BP readings. Repeat measurements were obtained on 2 subsequent occasions in students with persistently elevated BP. Final prevalence was adjusted for loss to follow-up and logistic regression used to assess risk factors.
BP distribution at initial screen was 81.1% normal, 9.5% pre-hypertension, and 9.4% hypertension (8.4% Stage 1; 1% Stage 2). Prevalence after 3 screenings was 81.1% normal, 15.7% pre-hypertension, and 3.2% hypertension (2.6% Stage 1; 0.6% Stage 2). Hypertension and pre-hypertension increased with increasing body mass index. Sex, race, and classification as either at-risk for overweight or overweight were independently associated with pre-hypertension. Only classification as overweight was associated with hypertension.
Application of new classification guidelines for adolescents with elevated BP reveals approximately 20% are at risk for hypertension. Further research determining the significance of each BP category and refining definitions to account for BP variability is warranted.
根据2004年国家高血压教育计划工作组指南，确定青少年学校筛查人群中高血压和高血压前期的患病率。
2003年至2005年对休斯顿学校的6790名青少年（11 - 17岁）进行了血压横断面评估。初始测量包括身高、体重和4次示波血压读数。血压持续升高的学生在随后的2次测量中进行复测。最终患病率针对失访情况进行了调整，并使用逻辑回归评估危险因素。
初次筛查时血压分布为正常81.1%，高血压前期9.5%，高血压9.4%（1期8.4%；2期1%）。三次筛查后的患病率为正常81.1%，高血压前期15.7%，高血压3.2%（1期2.6%；2期0.6%）。高血压和高血压前期患病率随体重指数增加而升高。性别、种族以及超重风险或超重分类与高血压前期独立相关。只有超重分类与高血压相关。
对血压升高的青少年应用新的分类指南显示，约20%有患高血压风险。有必要进一步研究确定每个血压类别意义并完善定义以考虑血压变异性。
