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心脏自主调节是青少年高血压的关键因素。

Cardiac Autonomic Modulation is a Key Factor for High Blood Pressure in Adolescentes.

机构信息

Universidade Federal do Maranhão, São Luís, MA - Brasil.

Faculdade Uninassau, São Luís, MA - Brasil.

出版信息

Arq Bras Cardiol. 2021 Oct;117(4):648-654. doi: 10.36660/abc.20200093.

Abstract

BACKGROUND

The interest regarding hypertension among children and adolescents has increased since the blood pressure rating system was updated to be compared with the adult rating system, changing the terminology from "normal high" to "prehypertension".

OBJECTIVE

This study aimed to analyze the association between cardiac autonomic modulation and pressure levels of adolescents.

METHODS

203 adolescents were grouped according to systolic blood pressure (SBP) and diastolic blood pressure (DBP). One group was characterized as prehypertension, and the other as normotensive. Anthropometric, cardiovascular and sleep quality characteristics were collected. Initially, the data were submitted to the Kolmogorov-Smirnov normality test. Continuous quantitative variables were analyzed using the unpaired Student t-test. For the analysis of categorical variables, a chi-square test was used. A logistic regression model was performed. The level of significance was set at p<0.05. The data were expressed as mean ± standard deviation and confidence interval. The R software was used for data analysis. The effect size was calculated using the Cohen's formula.

RESULTS

The prehypertension group showed an increase in Shannon entropy and a decrease in total variance. Also, in the logistic regression model, adolescents in this group were 1.03 times more likely to have Shannon entropy's affected when SBP was adjusted for gender, sexual maturation, school time, age, waist circumference, and sleep quality.

CONCLUSION

Our data show that autonomic modulation may play an important role in the development of elevated blood pressure in adolescents, when controlling for other factors, such as school time and sleep quality.

摘要

背景

自从血压评级系统更新为与成人评级系统相比较,将术语从“正常高值”改为“前期高血压”以来,儿童和青少年的高血压关注度有所增加。

目的

本研究旨在分析青少年心脏自主神经调节与血压水平之间的关系。

方法

根据收缩压(SBP)和舒张压(DBP)将 203 名青少年分组。一组表现为前期高血压,另一组表现为正常血压。收集了青少年的人体测量、心血管和睡眠质量特征。最初,数据经过柯尔莫哥洛夫-斯米尔诺夫正态性检验。使用独立样本 t 检验分析连续定量变量。对于分类变量的分析,使用卡方检验。进行逻辑回归模型分析。显著性水平设为 p<0.05。数据以均值 ±标准差和置信区间表示。使用 R 软件进行数据分析。使用科恩公式计算效应大小。

结果

前期高血压组的香农熵增加,总方差减少。此外,在逻辑回归模型中,当调整性别、性成熟度、在校时间、年龄、腰围和睡眠质量等因素后,该组青少年的 SBP 与 Shannon 熵相关的可能性增加了 1.03 倍。

结论

我们的数据表明,自主神经调节在控制其他因素(如在校时间和睡眠质量)的情况下,可能在青少年血压升高的发展中发挥重要作用。

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