Medical School, Swansea University, Swansea, UK.
Faculty of Health and Wellbeing, University of Central Lancashire, Preston, UK.
Open Heart. 2019 Oct 28;6(2):e001147. doi: 10.1136/openhrt-2019-001147. eCollection 2019.
To examine the predictors of cardiovascular health in teenagers (aged 13-14 years).
Measures of arterial stiffness (augmentation index (AIx)), blood pressure and cardiovascular fitness were taken from 234 teenage children (n=152 boys) and subsequently linked to routine data (birth and general practice records, education data and hospital admission data). Deprivation at school and at individual level was measured at birth, at 1 year old, at 13 years old and at secondary school using the Welsh Index of Multiple Deprivation. Multivariate regression analysis determined associations between routinely collected data and cardiovascular measures.
Teenagers had higher AIx (2.41 (95% CI 1.10 to 3.72)), ran fewer metres (-130.08 m (95% CI -234.35 to -25.78)) in the Cooper Run Test if they attended a more deprived school. However, higher individual level deprivation was associated with greater fitness (199.38 m (95% CI 83.90 to 314.84)). Higher systolic blood pressure was observed in first born children (10.23 mm Hg (95% CI 1.58 to 18.88)) and in those who were never breastfed (4.77 mm Hg (95% CI 1.10 to 8.42)).
Improving heart health in deprived areas requires multilevel action across childhood namely, active play and programmes that promote physical activity and fitness and, the promotion of breastfeeding. Recognition of the important early indicators and determinants of cardiovascular health supports further development of the evidence base to encourage policy-makers to implement preventative measures in young people.
研究青少年（13-14 岁）心血管健康的预测因素。
从 234 名青少年儿童（n=152 名男孩）中获取动脉僵硬度（增强指数（AIx））、血压和心血管健康状况的测量值，随后将这些测量值与常规数据（出生和全科医生记录、教育数据和住院数据）相关联。在出生时、1 岁时、13 岁时和中学时，使用威尔士多因素贫困指数（Welsh Index of Multiple Deprivation）测量学校和个体层面的贫困程度。多元回归分析确定了常规收集数据与心血管测量值之间的关联。
如果青少年就读于较贫困的学校，他们的 AIx 更高（2.41（95% CI 1.10 至 3.72）），在库珀跑步测试中跑的距离更短（-130.08 米（95% CI -234.35 至-25.78））。然而，较高的个体层面贫困与更好的健康相关（199.38 米（95% CI 83.90 至 314.84））。初产妇的收缩压更高（10.23 毫米汞柱（95% CI 1.58 至 18.88）），从未母乳喂养的儿童的收缩压更高（4.77 毫米汞柱（95% CI 1.10 至 8.42））。
改善贫困地区的心脏健康需要在整个儿童时期采取多层次的行动，即积极的游戏和促进体育活动和健身的计划，以及促进母乳喂养。认识到心血管健康的重要早期指标和决定因素，支持进一步发展证据基础，鼓励政策制定者在年轻人中实施预防措施。
