Pirojsakul Kwanchai, Paksi Witchuri, Sirijunpen Suthatip, Nuntnarumit Pracha
Department of Pediatrics, Ramathibodi Hospital, Mahidol University , Bangkok , Thailand.
Paediatr Int Child Health. 2019 Nov;39(4):279-284. doi: 10.1080/20469047.2019.1608063. Epub 2019 Apr 30.
: In 2017, the American Academy of Pediatrics (AAP) launched a new clinical practice guideline for diagnosis of hypertension in children and adolescents. The new cut-off values were 2-3 mmHg lower than those of the previous 2004 guidelines. : This study was conducted to evaluate the effects of the new cut-off values on the prevalence of hypertensive-level blood pressure (BP) in children in a primary school in Bangkok, Thailand. : BP, weight, height and waist circumference were recorded in 536 school children aged 8-13 years (270 boys, 50.3%) in grades 4-6. For analysis, BP was classified by the two different cut-off values (the 2004 AAP and the 2017 AAP guidelines). Demographic data for the children whose BP was hypertensive according to the 2017 guidelines but not the 2004 guidelines were compared with those of the children with normal BP according to both guidelines. Logistic regression analysis was performed to evaluate the factors associated with hypertensive-level BP. : Fifty-eight children (10.8%) had hypertensive-level BP according to the 2017 guidelines but only 37 (6.9%) with the 2004 guidelines. Twenty-one children who would not have had hypertensive-level BP with the 2004 AAP guidelines had greater Z-scores for body mass index and a greater proportion had obesity than the normotensive children. Body mass index was the only independent factor associated with hypertensive-level BP. : The prevalence of hypertensive-level BP in children was increased using the 2017 guidelines. Children with hypertensive-level BP using the 2017 AAP guidelines but not the 2004 AAP guidelines had greater BMI Z-scores and a greater proportion were obese than the in the normotensive children. Body mass index was the only independent factor associated with hypertensive-level BP. AAP: American Academy of Pediatrics; BMI: body mass index; BP: blood pressure; cm: centimeter; DBP: diastolic blood pressure; HT: hypertension; kg: kilograms; m: meter; NHANES: National Health and Nutrition Examination Survey; ROC: receiver operating characteristic curve; SBP: systolic blood pressure; SBPHR: systolic blood pressure-to-height ratio; SD: standard deviation; WC: waist circumference; WHR: waist-to-height ratio.
2017年，美国儿科学会（AAP）发布了一项关于儿童及青少年高血压诊断的新临床实践指南。新的临界值比2004年的旧指南低2 - 3毫米汞柱。
本研究旨在评估新临界值对泰国曼谷一所小学儿童高血压水平血压（BP）患病率的影响。
研究记录了536名4至6年级8至13岁学童（270名男孩，占50.3%）的血压、体重、身高和腰围。分析时，血压按照两种不同的临界值分类（2004年AAP指南和2017年AAP指南）。将按照2017年指南血压为高血压但按照2004年指南不是高血压的儿童的人口统计学数据，与按照两个指南血压均正常的儿童的数据进行比较。进行逻辑回归分析以评估与高血压水平血压相关的因素。
按照2017年指南，58名儿童（10.8%）血压处于高血压水平，但按照2004年指南只有37名（6.9%）。21名按照2004年AAP指南血压不会处于高血压水平的儿童，其体重指数Z评分更高，肥胖比例也高于血压正常的儿童。体重指数是与高血压水平血压相关的唯一独立因素。
使用2017年指南时，儿童高血压水平血压的患病率有所增加。按照2017年AAP指南血压处于高血压水平但按照2004年AAP指南不是的儿童，其体重指数Z评分更高，肥胖比例也高于血压正常的儿童。体重指数是与高血压水平血压相关的唯一独立因素。
美国儿科学会；BMI：体重指数；BP：血压；cm：厘米；DBP：舒张压；HT：高血压；kg：千克；m：米；NHANES：美国国家健康与营养检查调查；ROC：受试者工作特征曲线；SBP：收缩压；SBPHR：收缩压与身高比；SD：标准差；WC：腰围；WHR：腰高比
