Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
J Pediatr. 2012 Jan;160(1):98-103. doi: 10.1016/j.jpeds.2011.07.010. Epub 2011 Aug 24.
To evaluate the risk for developing incident hypertension (HTN) in adolescents with pre-hypertension.
A secondary analysis of students participating in multiple school-based blood pressure (BP) screens from 2000 to 2007 was completed. At each screen, height, weight, and 2 to 4 BPs were measured on as many as 3 occasions when BP remained ≥ 95th percentile. Students with confirmed HTN at their initial screen were excluded, and incident HTN was defined as having a BP ≥ 95th percentile at all 3 visits of a later screen. Incidence rates (IR) and hazard ratios (HR) were calculated by using Cox Proportional models.
Of 1006 students, HTN developed in 11 (IR 0.5%/year) in a mean of 2.1 years of observation. IRs were higher in "at-risk" students (pre-hypertensive or hypertensive with follow-up BP <95th percentile), 1.4%/year (HR, 4.89; 1.48-16.19) and students with a BP ≥ 90th percentile at 3 baseline visits, 6.6%/year HR 24.33 (5.68-104.29)]. Although not significant, students with pre-hypertension by the 2004 Task Force definition also had an increased IR of 1.1%/year (HR, 2.98; 0.77-11.56)].
Elevated BP increases the risk for the development of HTN during adolescence. Effective strategies for preventing HTN in at-risk adolescents are needed.
评估青少年高血压前期患者发生高血压的风险。
对 2000 年至 2007 年期间参加多次学校血压（BP）筛查的学生进行了二次分析。在每次筛查中，当 BP 持续≥95 百分位时，在多达 3 次就诊时测量身高、体重和 2 至 4 次 BP。在最初的筛查中确诊为高血压的学生被排除在外，新发高血压定义为在随后的一次筛查的 3 次就诊中均有 BP≥95 百分位。使用 Cox 比例模型计算发病率（IR）和风险比（HR）。
在 1006 名学生中，有 11 名（IR 0.5%/年）在平均 2.1 年的观察期内发生高血压（IR 0.5%/年）。在“高危”学生（有高血压前期或高血压但随访 BP<95 百分位）中，IR 更高，为 1.4%/年（HR，4.89；1.48-16.19）和在基线就诊时 3 次就诊 BP≥90 百分位的学生，IR 为 6.6%/年（HR 24.33；5.68-104.29）]。尽管不显著，但根据 2004 年工作组定义患有高血压前期的学生也有较高的发病率风险，为 1.1%/年（HR，2.98；0.77-11.56））]。
升高的 BP 增加了青少年发生高血压的风险。需要有效的策略来预防高危青少年高血压的发生。
