Pontifícia Universidade Católica do Rio Grande do Sul Porto Alegre Brazil.
Postgraduate Program in Epidemiology Universidade Federal do Rio Grande do Sul Porto Alegre Brazil.
J Am Heart Assoc. 2023 Dec 5;12(23):e029627. doi: 10.1161/JAHA.123.029627. Epub 2023 Nov 28.
Arterial hypertension is the greatest cause of morbidity and mortality worldwide. Our aim was to investigate the prevalence of and factors associated with high blood pressure (HBP) among adolescents.
The Pelotas 2004 Birth Cohort included 4231 newborns from hospital births in Pelotas, Brazil. A digital automatic OMRON sphygmomanometer (model HEM 742) was used to measure blood pressure on 3 occasions (at 6, 11, and 15 years of age). Those with blood pressure ≥95th percentile for age, height, and sex on each of the 3 occasions were considered as presenting HBP. Independent variables included family (income and history of arterial hypertension), maternal (schooling, age, pregestational body mass index, and smoking during pregnancy), and adolescent characteristics at birth (sex, skin color, gestational age, intrauterine growth, and systolic and diastolic genetic factors), and at 15 years (sleep, physical activity, sodium intake, screen time, work, body mass index, fat mass index, fat-free mass index, growth pattern, and puberty status). The prevalence of HBP (95% CI) was calculated. Crude and adjusted odds ratios (ORs) stratified by sex were obtained by logistic regression. A total of 1417 adolescents with complete information on blood pressure on the 3 occasions were analyzed. The prevalence of HBP was 3.2% (95% CI, 1.9%-4.5%) in female adolescents and 4.3% (95% CI, 2.8%-5.8%) in male adolescents. Female adolescents with a family history of arterial hypertension had a 3 times higher chance of HBP than their counterparts (OR, 3.1 [95% CI, 1.26-7.54]). In male adolescents, excessive maternal pregestational weight was associated with a 2.3-fold increase in the chance of HBP. In both sexes, excessive adolescent weight was associated with HBP (ORs, 3.5 and 5.0, for female and male adolescents, respectively). A higher fat mass index and fat-free mass index in female (ORs, 1.4 and 1.2, respectively) and male adolescents (ORs, 2.5 and 3.0, respectively) increased the chance of HBP. Among male adolescents, the chance of HBP was higher among those with rapid weight gain between 48 months and 6 years and between 6 and 11 years and rapid height gain between 6 and 11 years.
Higher fat mass in both sexes and rapid weight gain in male adolescents are risk factors for HBP in adolescents aged 15 years, potentially amenable to prevention.
动脉高血压是全球发病率和死亡率最高的疾病。我们旨在调查青少年高血压（HBP）的患病率和相关因素。
佩洛塔斯 2004 年出生队列包括来自巴西佩洛塔斯医院出生的 4231 名新生儿。使用数字自动欧姆龙血压计（型号 HEM 742）在 3 次（6、11 和 15 岁时）测量血压。在每 3 次中血压≥年龄、身高和性别的第 95 百分位的人被认为患有 HBP。自变量包括家庭（收入和动脉高血压病史）、母亲（教育程度、年龄、孕前体重指数和孕期吸烟）以及青少年在出生时（性别、肤色、胎龄、宫内生长和收缩压和舒张压遗传因素）和 15 岁时的特征（睡眠、体力活动、钠摄入量、屏幕时间、工作、体重指数、脂肪质量指数、无脂肪质量指数、生长模式和青春期状态）。计算 HBP（95%CI）的患病率。通过逻辑回归获得按性别分层的粗和调整后比值比（OR）。共分析了 1417 名青少年，他们在 3 次中有完整的血压信息。女性青少年的 HBP 患病率为 3.2%（95%CI，1.9%-4.5%），男性青少年的 HBP 患病率为 4.3%（95%CI，2.8%-5.8%）。有家族动脉高血压病史的女性青少年患 HBP 的几率是其同龄人的 3 倍（OR，3.1 [95%CI，1.26-7.54]）。在男性青少年中，母亲孕前体重过大与 HBP 几率增加 2.3 倍相关。在两性中，青少年体重过大均与 HBP 相关（女性青少年 OR，3.5；男性青少年 OR，5.0）。女性青少年的脂肪质量指数和无脂肪质量指数较高（女性青少年 OR，1.4 和 1.2；男性青少年 OR，2.5 和 3.0）增加了 HBP 的几率。在男性青少年中，体重和身高快速增长（48 个月至 6 岁之间，6 至 11 岁之间以及 6 至 11 岁之间）的青少年患 HBP 的几率更高。
两性中脂肪质量较高和男性青少年体重快速增长是 15 岁青少年 HBP 的危险因素，可能有预防的潜力。
