Gillman M W, Rosner B, Evans D A, Keough M E, Smith L A, Taylor J O, Hennekens C H
Channing Laboratory, Department of Medicine, Boston, Massachusetts.
Pediatrics. 1991 May;87(5):708-11.
Previous studies of childhood blood pressure have shown tracking correlations, which estimate the magnitude of association between initial and subsequent measurements, to be lower than corresponding adult values. Inasmuch as this disparity could arise from failing to account for a larger week-to-week variability in children, blood pressure was measured for 4 successive years, on four weekly visits in each year, and with three measurements at each visit, using a random-zero sphygmomanometer, in a cohort of 333 schoolchildren aged 8 through 15 at entry. Ninety percent of subjects had measurements in 1 or more years of follow-up. For all follow-up periods (1, 2, and 3 years from baseline), the Pearson correlation coefficient (r) for both systolic and diastolic blood pressure rose substantially with the number of weekly visits used to calculate each subject's yearly blood pressure (P less than .0001). For systolic pressure, the 3-year r values for 1, 2, 3, and 4 visits were .45, .55, .64, and .69, respectively. For diastolic pressure (Korotkoff phase 4), the corresponding values were .28, .41, .47, and .54. These higher multiple-visit estimates of tracking approximate published adult values and raise the possibility that prediction of adult blood pressure from childhood measurements may be improved by averaging readings from multiple weekly visits.
先前关于儿童血压的研究表明，追踪相关性（用于估计初始测量值与后续测量值之间的关联程度）低于相应的成人值。由于这种差异可能是由于未考虑到儿童每周血压变化较大所致，因此在一组333名入学时年龄在8至15岁的学童中，使用随机零点血压计，连续4年每年进行4次每周一次的访视，每次访视测量3次血压。90%的受试者在1年或更长时间的随访中有测量值。在所有随访期（从基线起1年、2年和3年），收缩压和舒张压的Pearson相关系数（r）均随着用于计算每个受试者年度血压的每周访视次数的增加而大幅上升（P<0.0001）。对于收缩压，1次、2次、3次和4次访视的3年r值分别为0.45、0.55、0.64和0.69。对于舒张压（柯氏音第4期），相应的值分别为0.28、0.41、0.47和0.54。这些更高的多次访视追踪估计值接近已发表的成人值，并增加了通过对多次每周访视的读数进行平均来改善从儿童测量值预测成人血压的可能性。
