Mwanza Intervention Trials Unit/National Institute for Medical Research, Mwanza, Tanzania.
London School of Hygiene and Tropical Medicine, London, UK.
Sci Rep. 2021 Apr 16;11(1):8397. doi: 10.1038/s41598-021-87996-0.
Estimates for prevalence of high blood pressure (BP) among adolescents in Africa vary widely and few studies, if any, have documented the results of the recommended stepwise BP screening. In this cross-sectional study in Tanzania, we aimed to estimate prevalence of sustained high BP in 3 public secondary schools using the American Academy of Pediatrics BP screening strategy. On Day 1, one screening automated office BP (AOBP) measurement (Step 1) was followed by two more AOBP measurements (Step 2). Repeat AOBP measurements were obtained after about one month on adolescents with high AOBP measurements on Day 1 (Step 3). Participants with sustained high BP underwent 24-h ambulatory BP monitoring (step 4). Of all 500 enrolled participants, the prevalence of high blood pressure at each step in the process was 36.6% (183), 25.6% (128), 10.2% (51), and 2.6%(13) respectively for Steps 1-4. All except 6 students completed all 4 steps of the BP screening algorithm as indicated. We conclude that diagnosis of hypertension in African adolescents should use multiple AOBP measurements over multiple days followed by 24-h ABPM. Screening for high BP in school settings appears to be feasible and could provide a platform for cardiovascular disease education and health promotion.
非洲青少年高血压（BP）的患病率估计差异很大，很少有研究（如果有的话）记录了推荐的逐步 BP 筛查的结果。在坦桑尼亚的这项横断面研究中，我们旨在使用美国儿科学会 BP 筛查策略估算 3 所公立中学中持续高血压的患病率。第 1 天进行一次筛查自动化诊室 BP（AOBP）测量（步骤 1），然后进行另外两次 AOBP 测量（步骤 2）。对于第 1 天 AOBP 测量值较高的青少年，约一个月后重复进行 AOBP 测量（步骤 3）。持续高血压的参与者进行 24 小时动态血压监测（第 4 步）。在所有 500 名入组参与者中，在该过程的每一步骤中，高血压的患病率分别为 36.6%（183）、25.6%（128）、10.2%（51）和 2.6%（13），分别为步骤 1-4。除了 6 名学生外，所有学生都按指示完成了 BP 筛查算法的所有 4 个步骤。我们得出结论，非洲青少年高血压的诊断应使用多天多次 AOBP 测量，然后进行 24 小时 ABPM。在学校环境中筛查高血压似乎是可行的，并且可以为心血管疾病教育和健康促进提供平台。
