From the Department of Physical Medicine and Rehabilitation (BCS, BED) and Adult Outpatient Spina Bifida Clinic (BED), University of Pittsburgh Medical Center, Pennsylvania; Human Engineering Research Laboratories, VA Pittsburgh Healthcare System, Pennsylvania (BED); Department of Rehabilitation Science and Technology, University of Pittsburgh, Pennsylvania (BED); and Huntersville Pediatrics and Internal Medicine, Huntersville, North Carolina (TSW).
Am J Phys Med Rehabil. 2014 Mar;93(3):200-6. doi: 10.1097/PHM.0b013e3182a92b03.
The aims of this study were to determine the occurrence of prehypertension and high blood pressure in adults with spina bifida (SB) and to examine relationships among blood pressure, cardiovascular disease risk factors, and SB-specific factors.
This is a cross-sectional, retrospective analysis of adults with SB. SB-specific factors and cardiovascular disease risk factors were compared among subjects with high blood pressure, subjects with blood pressure in the prehypertensive range, and normotensive subjects using the χ, Kruskal-Wallis, or Fisher's exact tests.
Of 225 subjects, the occurrence of prehypertension and high blood pressure was 27% (n = 22) and 27% (n = 22) for ages 18-29 yrs, 35% (n = 26) and 41% (n = 30) for ages 30-39 yrs, 18% (n = 8) and 66% (n = 29) for ages 40-49 yrs, and 21% (n = 5) and 67% (n = 16) for 50 yrs or older, respectively. Of the subjects with high blood pressure, 56% were men, 14% had obstructive sleep apnea, 14% had diabetes, 19% had renal dysfunction, 38% used tobacco, 16% had hydronephrosis, and 71% had a shunt. The groups differed significantly with respect to diabetes (P = 0.004), bladder procedures (P = 0.001), and renal dysfunction (P < 0.001), with higher proportions of subjects with high blood pressure having these comorbidities.
Fewer than half of the subjects were considered normotensive. A greater proportion of young adults with SB appear to have high blood pressure compared with the general United States population. Because elevated blood pressure is an independent, modifiable risk factor of cardiovascular disease, these findings support early screening and intervention for elevated blood pressure in individuals with SB.
本研究旨在确定成人脊柱裂（SB）患者中高血压前期和高血压的发生情况，并探讨血压、心血管疾病危险因素与 SB 特有因素之间的关系。
这是一项成人 SB 患者的横断面、回顾性分析。采用 χ²、Kruskal-Wallis 或 Fisher 精确检验比较高血压患者、血压处于高血压前期患者和血压正常患者之间的 SB 特有因素和心血管疾病危险因素。
在 225 名患者中，18-29 岁年龄组高血压前期和高血压的发生率分别为 27%（n=22）和 27%（n=22），30-39 岁年龄组分别为 35%（n=26）和 41%（n=30），40-49 岁年龄组分别为 18%（n=8）和 66%（n=29），50 岁及以上年龄组分别为 21%（n=5）和 67%（n=16）。高血压患者中，56%为男性，14%患有阻塞性睡眠呼吸暂停，14%患有糖尿病，19%患有肾功能不全，38%吸烟，16%患有肾积水，71%有分流。各组在糖尿病（P=0.004）、膀胱手术（P=0.001）和肾功能不全（P<0.001）方面差异有统计学意义，高血压患者中有更高比例的人患有这些合并症。
不到一半的患者被认为血压正常。与美国一般人群相比，年轻成人脊柱裂患者高血压的比例似乎更高。由于高血压是心血管疾病的一个独立、可改变的危险因素，这些发现支持对脊柱裂患者进行早期血压升高筛查和干预。
