Graduate Program in Endocrinology, Faculty of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre.
Institute of Studies in Collective Health, Universidade Federal do Rio de Janeiro.
J Hypertens. 2023 Mar 1;41(3):420-428. doi: 10.1097/HJH.0000000000003349. Epub 2022 Dec 27.
The American Academy of Pediatrics (AAP) adolescent blood pressure (BP) percentiles were updated in 2017, and have been used as reference in Brazil since then. However, specific BP percentiles for Brazilian adolescents were recently proposed based on data from the Study of Cardiovascular Risk in Adolescents (ERICA).
To compare the prevalence of arterial hypertension according to each reference, as well as to assess the cardiometabolic risk associated with the reclassification by Brazilian BP percentiles.
Data from 73 399 adolescents aged 12-17 years who participated in the ERICA study were analyzed. To assess cardiometabolic risk, 6185 adolescents who were reclassified upwards by the Brazilian reference were 1 : 1 matched with adolescents that were normotensive by both references and were of the same age, sex and height percentile. The parameters evaluated were: overweight/obesity, waist circumference, total cholesterol, triglycerides, LDL-c, HDL-c, fasting glucose, HbA1c and HOMA-ir.
The classification according to Brazilian BP percentiles resulted in a higher prevalence of arterial hypertension (14%, 95% CI 13.2-14.8), when compared with the AAP percentiles (10.6%, 95% CI 10.0-11.2). The use of the Brazilian reference also resulted in higher prevalence of arterial hypertension in girls, teenagers ranging from 12 to 14 years, and those classified with adequate weight, overweight or obesity. In the case-control analysis, cardiometabolic risk factors were present more often in adolescents reclassified with arterial hypertension by the ERICA reference.
The use of the BP percentiles proposed by ERICA is a sensitive method for tracking Brazilian adolescents with hypertension and higher cardiometabolic risk.
美国儿科学会（AAP）于 2017 年更新了青少年血压（BP）百分位数，并自此在巴西被用作参考。然而，最近基于心血管风险青少年研究（ERICA）的数据提出了具体的巴西青少年 BP 百分位数。
比较两种参考标准下动脉高血压的患病率，并评估巴西 BP 百分位数重新分类与心血管代谢风险的相关性。
分析了参加 ERICA 研究的 73399 名 12-17 岁青少年的数据。为了评估心血管代谢风险，将巴西参考标准下向上重新分类的 6185 名青少年与两种参考标准均为正常血压且年龄、性别和身高百分位数相同的正常血压青少年进行 1：1 匹配。评估的参数包括超重/肥胖、腰围、总胆固醇、甘油三酯、LDL-c、HDL-c、空腹血糖、HbA1c 和 HOMA-ir。
与 AAP 百分位数（10.6%，95%CI 10.0-11.2）相比，根据巴西 BP 百分位数进行分类导致动脉高血压的患病率更高（14%，95%CI 13.2-14.8）。使用巴西参考标准也导致女孩、12-14 岁青少年和体重、超重或肥胖分类的青少年中动脉高血压的患病率更高。在病例对照分析中，在 ERICA 参考标准下重新分类为高血压的青少年中，心血管代谢危险因素更为常见。
使用 ERICA 提出的 BP 百分位数是一种敏感的方法，可以跟踪巴西患有高血压和更高心血管代谢风险的青少年。
