Department of Public Health, Erasmus University Medical Center, Rotterdam.
Department of Health Sciences, University Medical Center Groningen, Groningen.
J Hypertens. 2019 May;37(5):865-877. doi: 10.1097/HJH.0000000000001970.
Hypertension, even during childhood, increases the risk of developing atherosclerosis and cardiovascular disease. Therefore, starting prevention of hypertension early in the life course could be beneficial. Prediction models might be useful for identifying children at increased risk of developing hypertension, which may enable targeted primordial prevention of cardiovascular disease.
To provide an overview of childhood prediction models for future hypertension.
Embase and Medline were systematically searched. Studies were included that were performed in the general population, and that reported on development or validation of a multivariable model for children to predict future high blood pressure, prehypertension or hypertension. Data were extracted using the CHARMS checklist for prediction modelling studies.
Out of 12 780 reviewed records, six studies were included in which 18 models were presented. Five studies predicted adulthood hypertension, and one predicted adolescent prehypertension/hypertension. BMI and current blood pressure were most commonly included as predictors in the final models. Considerable heterogeneity existed in timing of prediction (from early childhood to late adolescence) and outcome measurement. Important methodological information was often missing, and in four studies information to apply the model in new individuals was insufficient. Reported area under the ROC curves ranged from 0.51 to 0.74. As none of the models were validated, generalizability could not be confirmed.
Several childhood prediction models for future hypertension were identified, but their value for practice remains unclear because of suboptimal methods, limited information on performance, or the lack of external validation. Further validation studies are indicated.
高血压，即使在儿童时期，也会增加患动脉粥样硬化和心血管疾病的风险。因此，尽早在生命过程中开始预防高血压可能是有益的。预测模型可能有助于识别患有高血压风险增加的儿童，从而可以针对心血管疾病进行一级预防。
提供儿童期未来高血压预测模型的概述。
系统检索了 Embase 和 Medline。纳入了在普通人群中进行的研究，并报告了用于预测儿童未来高血压、高血压前期或高血压的多变量模型的开发或验证。使用预测模型研究的 CHARMS 清单提取数据。
在审查的 12780 条记录中，有 6 项研究被纳入，其中提出了 18 个模型。五项研究预测成年期高血压，一项预测青少年高血压前期/高血压。体重指数和当前血压是最终模型中最常用的预测因子。预测时间（从儿童早期到青春期晚期）和结果测量存在相当大的异质性。重要的方法学信息经常缺失，在四项研究中，应用模型的新个体的信息不足。报告的 ROC 曲线下面积范围为 0.51 至 0.74。由于没有对这些模型进行验证，因此无法确认其普遍性。
确定了几个用于预测未来高血压的儿童期预测模型，但由于方法欠佳、性能信息有限或缺乏外部验证，其在实践中的价值仍不清楚。需要进一步的验证研究。
