Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan.
Health Center, Keio University, Kanagawa, Japan.
Hypertens Res. 2019 Jul;42(7):935-948. doi: 10.1038/s41440-019-0229-3. Epub 2019 Mar 20.
The Japanese hypertension guidelines report that essential hypertension is detected in 1-3% of upper elementary and high school students during blood pressure (BP) screenings. Hypertension in these age groups is an emerging public health concern mainly attributed to the rising rate of pediatric obesity. Considering the existence of BP tracking phenomenon, early preventive education and instruction are necessary, especially for male students with moderately elevated BP showing a tendency toward obesity, despite the low prevalence of hypertension in high school students. Students with a positive family history of hypertension and those born with low birth weight need the same measures. Lifestyle habits, such as increased alcohol intake, dramatically change once students begin university; thus, early education and instruction regarding the factors influencing BP are necessary. In particular, for male students with higher BP during high school, caution regarding increased body weight is required irrespective of their level of obesity. Young adults aged <40 years should be educated about the association between body weight and hypertension. Particular caution surrounding lifestyle habits, including drinking and smoking, is warranted in male hypertensive subjects because hypertension at a young age is strongly associated with obesity. BP monitoring and the management of obesity should be considered efficient approaches to the detection and treatment of hypertension. For the lifetime prevention of hypertension, it is essential to be aware of one's health status and learn about healthy lifestyles beginning in childhood. BP measurement may be an appropriate means to achieve this goal.
日本高血压指南报告称,在血压筛查中,1%-3%的小学生和高中生被诊断为原发性高血压。这一年龄组的高血压是一个新出现的公共卫生问题,主要归因于儿童肥胖率的上升。考虑到存在血压跟踪现象,早期进行预防教育和指导是必要的,特别是对于那些血压中度升高且有肥胖趋势的男学生,尽管高中生的高血压患病率较低。有高血压家族史和出生体重低的学生也需要同样的措施。一旦学生开始上大学,他们的生活习惯,如饮酒量的增加,就会发生巨大变化;因此,有必要对影响血压的因素进行早期教育和指导。特别是对于那些在高中时期血压较高的男学生,无论肥胖程度如何,都需要注意体重增加的问题。年龄<40 岁的年轻人应该了解体重与高血压之间的关系。对于年轻的高血压男性患者,尤其需要注意生活习惯,包括饮酒和吸烟,因为年轻时的高血压与肥胖密切相关。血压监测和肥胖管理应被视为检测和治疗高血压的有效方法。为了终生预防高血压,从儿童时期开始了解自己的健康状况和健康的生活方式至关重要。血压测量可能是实现这一目标的一种适当手段。