Lazarou C, Panagiotakos D B, Matalas A-L
Department of Nutrition Science and Dietetics, Harokopio University, Athens, Greece.
J Hum Hypertens. 2009 Jul;23(7):456-63. doi: 10.1038/jhh.2008.151. Epub 2008 Dec 18.
Elevated blood pressure (BP) levels represent an important risk factor for cardiovascular disease. Lifestyle factors associated with increased BP levels have been extensively investigated in adults, but not in children. Therefore, we aimed to explore associations among modifiable lifestyle and levels of BP in 10- to13-year-old children. A subsample of the CYKIDS (CYprus KIDS) national cross-sectional study consisting of 622 children (11.7+/-0.83 years) was used to evaluate the research hypothesis. Measurements included BP, height, weight and waist circumference. Body mass index (BMI) was calculated according to the International Obesity Task Force (IOTF) criteria. Adherence to the Mediterranean diet was assessed by the KIDMED (Mediterranean Diet Quality Index for children and adolescents) diet score, whereas physical activity was assessed through a physical activity index. Results have shown that the cutoff value of 120/80 mm Hg was significantly associated with various lifestyle indices. BMI was positively associated with systolic BP (SBP)>120 mm Hg (odds ratio (OR)=1.21, 95% confidence interval (CI) 1.11-1.32); diastolic BP (DBP)>80 mm Hg (OR=1.13, 95% CI 1.01-1.27) and SBP/DBP>120/80 mm Hg (OR=1.20, 95% CI 1.10-1.31). Moreover, children who reported that they frequently eat while watching television were about two times more likely to have elevated SBP or overall BP, whereas children with low socioeconomic status levels were more than 2.5 times more likely to have elevated BP levels. Finally, compared with those with low KIDMED score, children with at least an average [corrected] score were 75% less likely to have elevated DBP levels, whereas they exhibited a nonsignificant trend for lower SBP (by 29%) and lower overall BP levels (by 30%). Similar results emerged when the above analyses were repeated using the American reference values. Conclusively, our study suggests that lifestyle factors play an important role in determining BP levels in children; a finding that underlines the importance of lifestyle modifications in children.
血压升高是心血管疾病的一个重要风险因素。与血压升高相关的生活方式因素在成年人中已得到广泛研究，但在儿童中尚未有研究。因此，我们旨在探讨10至13岁儿童中可改变的生活方式与血压水平之间的关联。CYKIDS（塞浦路斯儿童）全国横断面研究的一个子样本，包含622名儿童（11.7±0.83岁），用于评估该研究假设。测量指标包括血压、身高、体重和腰围。根据国际肥胖特别工作组（IOTF）标准计算体重指数（BMI）。通过KIDMED（儿童和青少年地中海饮食质量指数）饮食评分评估对地中海饮食的依从性，而体育活动则通过体育活动指数进行评估。结果表明，120/80 mmHg的临界值与各种生活方式指标显著相关。BMI与收缩压（SBP）>120 mmHg呈正相关（优势比（OR）=1.21，95%置信区间（CI）1.11 - 1.32）；舒张压（DBP）>80 mmHg（OR = 1.13，95% CI 1.01 - 1.27）以及SBP/DBP>120/80 mmHg（OR = 1.20，95% CI 1.10 - 1.31）。此外，报告经常边看电视边吃饭的儿童患SBP升高或总体血压升高的可能性约为两倍，而社会经济地位较低的儿童患血压升高的可能性则超过2.5倍。最后，与KIDMED评分较低的儿童相比，至少具有平均[校正后]评分的儿童患DBP升高的可能性降低75%，而他们的SBP（降低29%）和总体血压水平（降低30%）呈现出不显著的下降趋势。当使用美国参考值重复上述分析时，出现了类似的结果。总之，我们的研究表明生活方式因素在决定儿童血压水平方面起着重要作用；这一发现强调了儿童生活方式改变的重要性。
