低出生体重作为动态血压监测变化的一个指标。

Low birth weight as a marker of changes in ambulatory blood pressure monitoring.

作者信息

Salgado Cláudia Maria, Jardim Paulo César Brandão Veiga, Teles Flávio Bittencourt Gonçalves, Nunes Mariana Cabral

机构信息

Liga de Hipertensão Arterial, Universidade Federal de Goiás, Goiânia, GO, Brasil.

出版信息

Arq Bras Cardiol. 2009 Feb;92(2):107-21. doi: 10.1590/s0066-782x2009000200007.

DOI:10.1590/s0066-782x2009000200007

PMID:19360243

Abstract

BACKGROUND

Low birth weight (LBW) is associated with increased incidence of high blood pressure (BP) and cardiovascular diseases in adulthood.

OBJECTIVE

To evaluate possible changes in Ambulatory Blood Pressure Monitoring (ABPM) in LBW children.

METHODS

The birth weight (BW) of 1049 school children (ages 8 to 11) living in Goiânia was assessed. Children with low birth weight (BW <or= 2.5 Kg) were compared with those of normal birth weight (BW >or= 3.0 Kg). Information on birth weight was obtained from each child's health card. Casual BP and ABPM were measured. Height and weight measurements were obtained to calculate the body mass index (BMI), and sexual maturity was assessed according to Tanner's criteria (those at Tanner stage >or= 2 were excluded).

RESULTS

Thirty-four children had low birth weight (LBW) and 34 had normal birth weight (NBW). Both groups were similar regarding age, gender, race, body weight, height, BMI, and family history of hypertension. Low-birth-weight children had higher casual systolic blood pressure (SBP) (p = 0.007). ABPM recordings showed that these children had higher 24-hour diastolic blood pressure (DBP) (p = 0.009), daytime DBP (p = 0.002), night-time DBP and SBP (p = 0.005 and p = 0.001), and reduced nocturnal dip in SBP and DBP (p = 0.001) than those born with normal weight. Birth weight was positively correlated with nocturnal dip in SBP (p = 0.022) and negatively correlated with sleep SBP (p = 0.032).

CONCLUSION

Low-birth-weight children have higher BP and changes in circadian rhythm of blood pressure, with reduced nocturnal dipping. These findings may reflect increased risk of adult hypertension and cardiovascular diseases.

摘要

背景

低出生体重与成年后高血压和心血管疾病发病率增加有关。

目的

评估低出生体重儿童动态血压监测（ABPM）的可能变化。

方法

对居住在戈亚尼亚的1049名学童（8至11岁）的出生体重（BW）进行评估。将低出生体重儿童（BW≤2.5千克）与正常出生体重儿童（BW≥3.0千克）进行比较。从每个孩子的健康卡中获取出生体重信息。测量了偶测血压和动态血压。获取身高和体重测量值以计算体重指数（BMI），并根据坦纳标准评估性成熟情况（排除坦纳分期≥2期的儿童）。

结果

34名儿童出生体重低（LBW），34名儿童出生体重正常（NBW）。两组在年龄、性别、种族、体重、身高、BMI和高血压家族史方面相似。低出生体重儿童的偶测收缩压（SBP）较高（p = 0.007）。动态血压记录显示，这些儿童的24小时舒张压（DBP）较高（p = 0.009），日间DBP较高（p = 0.002），夜间DBP和SBP较高（p = 0.005和p = 0.001），并且与正常体重出生的儿童相比，SBP和DBP的夜间下降幅度减小（p = 0.001）。出生体重与SBP的夜间下降呈正相关（p = 0.022），与睡眠SBP呈负相关（p = 0.032）。