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青少年高血压 - 美国,2001-2016 年。

Hypertension Among Youths - United States, 2001-2016.

出版信息

MMWR Morb Mortal Wkly Rep. 2018 Jul 13;67(27):758-762. doi: 10.15585/mmwr.mm6727a2.

Abstract

Hypertension is an important modifiable risk factor for cardiovascular morbidity and mortality, and hypertension in adolescents and young adults is associated with long-term negative health effects (1,2).* In 2017, the American Academy of Pediatrics (AAP) released a new Clinical Practice Guideline (3), which updated 2004 pediatric hypertension guidance with new thresholds and percentile references calculated from a healthy-weight population. To examine trends in youth hypertension and the impact of the new guideline on classification of hypertension status, CDC analyzed data from 12,004 participants aged 12-19 years in the 2001-2016 National Health and Nutrition Examination Survey (NHANES). During this time, prevalence of hypertension declined, using both the new (from 7.7% to 4.2%, p<0.001) and former (from 3.2% to 1.5%, p<0.001) guidelines, and declines were observed across all weight status categories. However, because of the new percentile tables and lower threshold for hypertension (4), application of the new guideline compared with the former guideline resulted in a weighted net estimated increase of 795,000 U.S. youths being reclassified as having hypertension using 2013-2016 data. Youths who were older, male, and those with obesity accounted for a disproportionate share of persons reclassified as having hypertension. Clinicians and public health professionals might expect to see a higher prevalence of hypertension with application of the new guideline and can use these data to inform actions to address hypertension among youths. Strategies to improve cardiovascular health include adoption of healthy eating patterns and increased physical activity (3).

摘要

高血压是心血管发病率和死亡率的一个重要可改变的危险因素,青少年和年轻人的高血压与长期的负面健康影响有关 (1,2)。* 2017 年,美国儿科学会 (AAP) 发布了一项新的临床实践指南 (3),该指南用从健康体重人群中计算得出的新阈值和百分位参考值更新了 2004 年的儿科高血压指南。为了研究青少年高血压的趋势以及新指南对高血压分类的影响,CDC 分析了 2001-2016 年全国健康和营养调查 (NHANES) 中 12004 名年龄在 12-19 岁的参与者的数据。在此期间,使用新的 (从 7.7%降至 4.2%,p<0.001) 和以前的 (从 3.2%降至 1.5%,p<0.001) 指南,高血压的患病率均有所下降,而且在所有体重类别中都观察到了下降。然而,由于新的百分位表和更低的高血压阈值 (4),与以前的指南相比,新指南的应用导致使用 2013-2016 年数据,估计有 795 万名美国青少年重新分类为高血压,这是一个加权净增长。年龄较大、男性和肥胖的青少年中,被重新分类为高血压的人数比例不成比例。临床医生和公共卫生专业人员可能预计新指南的应用会导致高血压的患病率上升,并且可以使用这些数据来告知解决青少年高血压问题的措施。改善心血管健康的策略包括采用健康的饮食模式和增加身体活动 (3)。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/62e7/6047471/4a8a68423e35/mm6727a2-F.jpg

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