Department of Clinical Epidemiology and Biostatistics, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, 400014, Chongqing, China.
Department of Endocrinology and Genetic Metabolism disease, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, 400014, Chongqing, China.
Hypertens Res. 2023 Sep;46(9):2085-2099. doi: 10.1038/s41440-023-01304-z. Epub 2023 May 15.
Uncontrolled pediatric hypertension may increase the risk of hypertension in adulthood. Several studies have reported an association between hematological parameters and blood pressure (BP) levels. However, epidemiologic evidence of this association in children and adolescents remains scarce. This study aims to explore the associations between hematological parameters and the incidence of prehypertension and hypertension in children and adolescents. This longitudinal study was conducted with 1368 participants aged 6-8 years from baseline visit to follow-up visit. Compared with participants from the normal blood pressure (BP) group, participants from the elevated BP group had significantly higher baseline red blood cell (RBC) counts, hemoglobin (Hb) counts and hematocrit (Hct) levels (all P < 0.001). A multilevel linear mixed model was conducted to analyze the relationship between hematological parameters and BP levels. The results suggested that SBP, DBP and MAP increased significantly with a quartile increase of levels of hematological parameters (all P < 0.05). Furthermore, a multilevel mixed logistic regression model was used to analyze the risk of per interquartile range increase in hematological parameters on the incidence of prehypertension and hypertension. The risk of prehypertension and hypertension incidence increased by (1.34 (95%CIs: 1.20, 1.50)), (1.38 (95%CIs: 1.24,1.54)), (1.33 (95%CIs: 1.19,1.50)), (1.14 (95%CIs: 1.03,1.26)) fold with a one-quartile increase in levels of RBC, Hb, Hct and Fe, respectively (all P < 0.05). This longitudinal study showed that hematological parameters were positively associated with BP levels in healthy children and adolescents, which excluded the effect of antihypertensive drugs on BP levels that often appeared in adults.
儿童期未控制的高血压可能会增加成年后患高血压的风险。有几项研究报告了血液学参数与血压（BP）水平之间的关系。然而，在儿童和青少年中，这种关联的流行病学证据仍然很少。本研究旨在探讨血液学参数与儿童和青少年前期高血压和高血压发病的关系。这项纵向研究共纳入了 1368 名基线访视至随访访视时年龄为 6-8 岁的参与者。与正常血压（BP）组的参与者相比，升高的 BP 组的参与者的基线红细胞（RBC）计数、血红蛋白（Hb）计数和血细胞比容（Hct）水平明显更高（均 P < 0.001）。采用多级线性混合模型分析血液学参数与 BP 水平之间的关系。结果表明，SBP、DBP 和 MAP 随着血液学参数水平的四分位距增加而显著升高（均 P < 0.05）。此外，采用多级混合逻辑回归模型分析血液学参数每增加一个四分位距对前期高血压和高血压发病的风险。前期高血压和高血压发病的风险分别增加了（1.34（95%CI：1.20，1.50））、（1.38（95%CI：1.24，1.54））、（1.33（95%CI：1.19，1.50））、（1.14（95%CI：1.03，1.26））倍，与 RBC、Hb、Hct 和 Fe 水平的一个四分位距增加相关（均 P < 0.05）。这项纵向研究表明，血液学参数与健康儿童和青少年的 BP 水平呈正相关，排除了降压药物对成人 BP 水平的影响，而降压药物对成人 BP 水平的影响经常出现。
