[早发性冠心病患者子女动脉高血压前期和高血压的自身及父母预测因素]

[Own and parental predictors of arterial prehypertension and hypertension in children of persons with premature coronary heart disease].

作者信息

Konnov M V, Dobordzhginidze L M, Deev A D, Gratsianskiĭ N A

机构信息

Laboratory of Clinical Cardiology and Center for Atherosclerosis, Institute of Physico-Chemical Medicine, ul. Malaya Pirogovskaya la, 119828 Moscow, Russia.

出版信息

Kardiologiia. 2010;50(3):22-5.

PMID:20459401

Abstract

AIM

to elucidate own and parental predictors of arterial prehypertension (PreHT) and hypertension (HT) in children of patients with premature manifested before 55 years in men or before 60 years in women) coronary heart disease (CHD).

METHODS

We surveyed 276 families: 258 probands parents with premature CHD, their 214 spouses and 362 native probands children aged 5-37 years. In persons aged 17 years we used criteria of 4 th Report National Education Program Working Group on High BP in Children and Adolescents, in persons 18 years - 7 th Report Joint National Committee (USA). Predictors were selected by logistical regression with adjustment for sex and age.

RESULTS

PreHT/HT was revealed in 26/143 (18.2%) children aged 5-17 years. Their own (body mass index [BMI], waist circumference, glucose) and parental (diastolic BP of proband) predictors related to the presence of PreHT/HT with <0.1 in univariate analysis were included in stepwise regression procedure. PreHT/HT was independently associated only with higher own BMI: odds ratio (OR) of top vs bottom tertile 10.2 (95% confidence interval [CI] 1.99-52.8; p=0.005). PreHT and HT were found in 75/219 (34.2%) and 40/219 (18.3%) children aged 18-37 years, respectively. Their own (BMI, waist circumference, glucose, triglycerides and total cholesterol) and parental (waist circumference, BMI, diabetes mellitus, PreHT/HT and triglycerides of proband; education level, alcohol consumption and oral hormonal contraceptive drugs use of spouse) predictors selected in univariate analysis with <0.1, were included in stepwise regression procedure. HT was independently associated with higher BMI (OR top vs bottom tertile 19.9 [95% CI 4.34-90.8]; <0.0001) and glucose (OR top vs bottom tertile 7.85 [95% CI 2.73-22.6]; <0.0001) of children, and PreHT/HT of probands (OR 2.80 [95% CI 1.13-6.94]; =0.026).

CONCLUSION

PreHT and HT (age group 5-17 years) and HT (age group 18-37 years) in children of persons with premature CHD were independently related to own "metabolic" risk factors (BMI in both age groups and basal glucose in adult children). Association of preHT/HT of proband with HT in their children became manifested later in childrens life (18-37 years).

摘要

目的

阐明男性55岁前或女性60岁前患冠心病（CHD）的患者子女中动脉高血压前期（PreHT）和高血压（HT）的自身及父母预测因素。

方法

我们调查了276个家庭：258名患有早发性冠心病的先证者父母、他们的214名配偶以及362名年龄在5至37岁的亲生先证者子女。对于17岁及以下的人群，我们采用美国国家儿童青少年高血压教育计划工作组第四次报告的标准；对于18岁及以上的人群，采用美国国家联合委员会第七次报告的标准。通过逻辑回归并对性别和年龄进行调整来选择预测因素。

结果

在5至17岁的儿童中，有26/143（18.2%）被发现患有PreHT/HT。在单变量分析中与PreHT/HT存在相关且P<0.1的自身因素（体重指数[BMI]、腰围、血糖）和父母因素（先证者的舒张压）被纳入逐步回归程序。PreHT/HT仅与较高的自身BMI独立相关：最高三分位数与最低三分位数的比值比（OR）为10.2（95%置信区间[CI] 1.99 - 52.8；P = 0.0０5）。在18至37岁的儿童中，分别有75/219（34.2%）和40/219（18.3%）被发现患有PreHT和HT。在单变量分析中选择的且P<0.1的自身因素（BMI、腰围、血糖、甘油三酯和总胆固醇）和父母因素（腰围、BMI、糖尿病、先证者的PreHT/HT和甘油三酯；配偶的教育水平、饮酒情况和口服激素类避孕药的使用情况）被纳入逐步回归程序。HT与儿童较高的BMI（最高三分位数与最低三分位数的OR为19.9 [95% CI 4.34 - 90.8]；P<0.0001）和血糖（最高三分位数与最低三分位数的OR为7.85 [95% CI 2.73 - 22.6]；P<0.0001）以及先证者的PreHT/HT（OR为2.80 [95% CI 1.13 - 6.94]；P = 0.026）独立相关。