Department of Epidemiology, Capital Institute of Pediatrics, Beijing, China.
Graduate School of Peking Union Medical College, Beijing, China.
J Clin Hypertens (Greenwich). 2018 Mar;20(3):508-514. doi: 10.1111/jch.13201. Epub 2018 Jan 25.
We aimed to compare the ability of the pediatric blood pressure (BP) standards issued by the US Fourth Report, the recently proposed US, Chinese, and international standards to predict adult hypertension and subclinical cardiovascular disease (CVD). 2296 children were randomly selected from Beijing at baseline. The follow-up survey was conducted among 1177 adults. Subclinical adult CVD was assessed using the carotid-femoral pulse wave velocity (cfPWV), carotid intima-media thickness (CIMT), and left ventricular mass index (LVMI). The prevalence of pediatric elevated BP was significantly higher according to the Chinese standards vs the Fourth Report, the updated US standards, and the international standards (18.7% vs 14.2%, 17.5%, and 18.0%, respectively; all Ps < .001). Children identified as elevated BP using any of the 4 standards were more likely to have adult hypertension, high cfPWV, and high LVMI than children without elevated BP. However, only the Chinese and updated US standards can predict the increased risk of adult high CIMT. Our results indicated that the Chinese standards performed equally or better compared with 3 other standards in predicting adult hypertension and subclinical CVD.
我们旨在比较美国第四版儿童血压（BP）标准、最近提出的美国、中国和国际标准在预测成人高血压和亚临床心血管疾病（CVD）方面的能力。在基线时，从北京随机选择了 2296 名儿童。对 1177 名成年人进行了随访调查。使用颈动脉-股动脉脉搏波速度（cfPWV）、颈动脉内膜中层厚度（CIMT）和左心室质量指数（LVMI）评估成人亚临床 CVD。根据中国标准，与第四版报告、更新的美国标准和国际标准相比，儿童高血压的患病率显著更高（18.7%比 14.2%、17.5%和 18.0%；均<0.001）。使用这 4 个标准中的任何一个标准诊断为高血压的儿童，其成年高血压、高 cfPWV 和高 LVMI 的可能性均高于血压正常的儿童。然而，只有中国和更新的美国标准可以预测成人高 CIMT 的风险增加。我们的研究结果表明，与其他 3 个标准相比，中国标准在预测成人高血压和亚临床 CVD 方面的表现相同或更好。
