Jardim Thiago Veiga, Carneiro Carolina de Souza, Morais Polyana, Roriz Vanessa, Mendonça Karla Lorena, Nascente Flávia Miquetichuc, Póvoa Thaís Inácio Rolim, Barroso Weimar Kunz Sebba, Sousa Ana Luiza Lima, Jardim Paulo César Veiga
a Hypertension League , Federal University of Goias , Goiânia , GO , Brazil.
b Division of Cardiovascular Medicine , Brigham & Women's Hospital , Boston , MA , USA.
Blood Press. 2018 Jun;27(3):151-157. doi: 10.1080/08037051.2017.1422388. Epub 2018 Jan 5.
Population-based studies estimating prevalence's of white-coat, masked and sustained hypertension in non-European adolescents are needed, particularly in developing countries. Aiming to determine these estimates and, additionally identify factors associated to these conditions this study was conducted.
Cross-sectional study with a representative sample of secondary school students from a Brazilian state capital. Office measurements were performed with validated semi-automatic devices. Home BP (blood pressure) monitoring protocol included two day-time and two evening-time measurements over 6 days. Adolescents' were classified as: normotensives (office and home BP <95th percentile); sustained hypertensives (office and home BP ≥95th percentile); white-coat hypertensives (office BP ≥95th percentile and home BP <95th percentile) and masked hypertensives (office BP <95th percentile and home BP ≥95th percentile). Logistic regression models were built to identify if sex, age, BMI and family history of HTN were independently associated with white-coat, masked and sustained hypertension.
In a sample of 1024 adolescents, prevalence of white-coat, masked and sustained hypertension was 7.5%, 2.2% and 1.7%, respectively. Male sex was positively associated with white-coat hypertension (OR 2.68; 95%CI 1.58-4.54; p < 0.001). BMI was positively associated with both white-coat (OR 1.23; 95%CI 1.16-1.30; p < 0.001) and sustained hypertension (OR 1.19; 95%CI 1.11-1.29; p < 0.001). None of the independent variables were associated with masked hypertension in this population.
The estimated prevalence of white-coat hypertension, masked and sustained hypertension in a population of non-European adolescents assessed by home BP monitoring was 7.5%, 2.2% and 1.7% respectively. Male sex was positively associated with white-coat hypertension in these adolescents while BMI was positively associated with both white-coat and sustained hypertension.
需要开展基于人群的研究来估计非欧洲青少年白大衣高血压、隐匿性高血压和持续性高血压的患病率，尤其是在发展中国家。本研究旨在确定这些估计值，并另外识别与这些情况相关的因素。
对来自巴西一个州首府的中学生代表性样本进行横断面研究。使用经过验证的半自动设备进行诊室测量。家庭血压监测方案包括在6天内进行两次白天和两次晚上的测量。青少年被分类为：血压正常者（诊室和家庭血压均<第95百分位数）；持续性高血压患者（诊室和家庭血压均≥第95百分位数）；白大衣高血压患者（诊室血压≥第95百分位数且家庭血压<第95百分位数）和隐匿性高血压患者（诊室血压<第95百分位数且家庭血压≥第95百分位数）。构建逻辑回归模型以确定性别、年龄、体重指数和高血压家族史是否与白大衣高血压、隐匿性高血压和持续性高血压独立相关。
在1024名青少年样本中，白大衣高血压、隐匿性高血压和持续性高血压的患病率分别为7.5%、2.2%和1.7%。男性与白大衣高血压呈正相关（比值比2.68；95%置信区间1.58 - 4.54；p<0.001）。体重指数与白大衣高血压（比值比1.23；95%置信区间1.16 - 1.30；p<0.001）和持续性高血压均呈正相关（比值比1.19；95%置信区间1.11 - 1.29；p<0.001）。在该人群中，没有一个自变量与隐匿性高血压相关。
通过家庭血压监测评估的非欧洲青少年人群中，白大衣高血压、隐匿性高血压和持续性高血压的估计患病率分别为7.5%、2.2%和1.7%。在这些青少年中，男性与白大衣高血压呈正相关，而体重指数与白大衣高血压和持续性高血压均呈正相关。
