Alpay Harika, Ozdemir Nihal, Wühl Elke, Topuzoğlu Ahmet
Division of Pediatric Nephrology, Marmara University Medical School, Istanbul, Turkey.
Pediatr Nephrol. 2009 Jan;24(1):155-61. doi: 10.1007/s00467-008-0975-y. Epub 2008 Sep 17.
The aim of this study was to compare ambulatory blood pressure monitoring (ABPM) parameters in offspring with at least one hypertensive parent (HP) to offspring with normotensive parents (NP) and to determine whether gender of parent or child might influence the association between parental hypertension and blood pressure (BP). Eighty-nine healthy children (mean age 11.1 +/- 3.9 years) with HP and 90 controls (mean age 10.5 +/- 3.1 years) with NP were recruited. Age, gender, and height did not differ between the two groups, whereas children of HP had higher weight, body mass index (BMI), and waist circumference compared with healthy controls. No difference was found in casual BP between the two groups. In contrast, during ABPM daytime and nighttime mean systolic and diastolic BP and mean arterial pressure (MAP) standard deviation scores (SDS) were significantly elevated in children with HP. The mean percentage of nocturnal BP decline (dipping) was not significantly different between the two groups. Children with hypertensive mothers had higher daytime systolic and MAP SDS than controls; no such difference was detected for children with hypertensive fathers. Daytime systolic and MAP SDS were significantly elevated in boys with HP compared with boys with NP but failed to be significant in girls. Multiple linear regression analysis showed that parental history of hypertension (B = 0.29) and BMI (B = 0.03) were independently correlated with increase of daytime MAP SDS. Early changes in ambulatory BP parameters were present in healthy children of HP. BP in HP offspring was influenced by the gender of the affected parent and the offspring.
本研究的目的是比较至少有一位高血压父母(HP)的后代与血压正常父母(NP)的后代的动态血压监测(ABPM)参数,并确定父母或孩子的性别是否可能影响父母高血压与血压(BP)之间的关联。招募了89名有高血压父母的健康儿童(平均年龄11.1±3.9岁)和90名血压正常父母的对照儿童(平均年龄10.5±3.1岁)。两组之间的年龄、性别和身高没有差异,然而,与健康对照组相比,有高血压父母的儿童体重、体重指数(BMI)和腰围更高。两组之间的偶测血压没有差异。相比之下,在ABPM期间,有高血压父母的儿童白天和夜间的平均收缩压、舒张压和平均动脉压(MAP)标准差评分(SDS)显著升高。两组之间夜间血压下降(勺型)的平均百分比没有显著差异。有高血压母亲的儿童白天收缩压和MAP SDS高于对照组;有高血压父亲的儿童未检测到此类差异。与血压正常父母的男孩相比,有高血压父母的男孩白天收缩压和MAP SDS显著升高,但女孩中未显著升高。多元线性回归分析表明,父母高血压病史(B = 0.29)和BMI(B = 0.03)与白天MAP SDS升高独立相关。有高血压父母的健康儿童存在动态血压参数的早期变化。有高血压父母的后代血压受患病父母和后代性别的影响。