Centre for Paediatric Epidemiology & Biostatistics/MRC Centre of Epidemiology for Child Health, UCL Institute of Child Health, London, UK.
J Hypertens. 2012 Sep;30(9):1708-17. doi: 10.1097/HJH.0b013e3283562a6b.
High blood pressure (BP) is a major public health issue, both in the United Kingdom and worldwide. Although BP levels in UK adults are declining, there is little published information on BP trends in children, a particular concern in the context of the rising levels of childhood adiposity. Our aims are to determine whether BP in children has changed over time and whether the change reflected trends in adiposity.
We collated data from seven population-based BP studies conducted in the United Kingdom between 1980 and 2008. Children of white European origin were included (9-11 years, mean 10.3 years). Adjustments were made to account for differences in mean ages, BP devices and cuff sizes used in different studies.
Mean SBP increased over time both in boys and girls: annual increases were 0.45 mmHg (95% CI: 0.43, 0.48) for boys; 0.51 mmHg (0.49, 0.53) for girls. Mean BMI increased by 0.064 kg/m(2) (0.060, 0.068) per year for boys; 0.070 kg/m(2) (0.065, 0.074) for girls; the prevalence of overweight/obesity increased from 5.7 to 21.1% and from 9.7 to 24.1%, respectively. The SBP trends occurred both in children with low and high BMI, but were more marked in low BMI group; BMI explained only 15.3% (15.1%, 15.6%) of increases in SBP for boys and 14.9% (14.6%, 15.1%) for girls. The BMI/SBP association appeared to become weaker over time (P < 0.001 for negative interaction from 1984). There was only a modest annual increase in DBP (<0.1 mmHg).
SBP levels have increased with time, but the increase is not explained by increased BMI. Further research is needed to identify the factors responsible.
高血压（BP）是英国乃至全球的一个主要公共卫生问题。尽管英国成年人的血压水平正在下降，但有关儿童 BP 趋势的信息很少，这在儿童肥胖率上升的背景下尤其令人关注。我们的目的是确定儿童的 BP 是否随时间发生了变化，以及这种变化是否反映了肥胖趋势。
我们整理了 1980 年至 2008 年期间在英国进行的七项基于人群的 BP 研究的数据。研究对象为白种欧洲血统的儿童（9-11 岁，平均年龄 10.3 岁）。根据不同研究中使用的平均年龄、BP 设备和袖带尺寸的差异，对数据进行了调整。
男孩和女孩的 SBP 均值随时间呈上升趋势：男孩的年增长率为 0.45mmHg（95%CI：0.43，0.48）；女孩的年增长率为 0.51mmHg（0.49，0.53）。男孩的 BMI 每年增加 0.064kg/m2（0.060，0.068）；女孩的 BMI 每年增加 0.070kg/m2（0.065，0.074）。超重/肥胖的患病率分别从 5.7%上升到 21.1%和从 9.7%上升到 24.1%。SBP 趋势既出现在 BMI 较低的儿童中，也出现在 BMI 较高的儿童中，但在 BMI 较低的儿童中更为明显；BMI 仅解释了男孩 SBP 增加的 15.3%（15.1%，15.6%）和女孩 SBP 增加的 14.9%（14.6%，15.1%）。BMI/SBP 之间的关联似乎随着时间的推移而减弱（1984 年起负交互作用的 P<0.001）。DBP 每年仅略有增加（<0.1mmHg）。
SBP 水平随时间推移而升高，但这种升高不能用 BMI 的增加来解释。需要进一步研究以确定导致这种情况的因素。
