Schall J I, Hediger M L, Katz S H, Zemel B S, Valleroy L A
J Chronic Dis. 1985;38(3):241-51. doi: 10.1016/0021-9681(85)90067-0.
Patterns of pulse rate, blood pressure (BP), and body size and composition are investigated in a black urban sample of over 600 adolescents (aged 12-17) in Philadelphia as part of the Philadelphia Blood Pressure Project. Supine and seated pulse rates decline after the age of 13 in both males and females, and females have significantly higher pulse rates than males, ranging from 1.6 to 4.7 beats/30 sec higher depending upon chronological age and position. Seated pulse rates are consistently higher than supine in both sexes ranging from 1.3 to 2.9 beats/30 sec depending upon chronological age. Pulse rate and both systolic blood pressure (SBP) and diastolic phase IV blood pressure (DBP) show a positive association throughout adolescence for females (r = 0.16 SBP, r = 0.24 DBP) but not for males (r = -0.06 SBP, r = 0.06 DBP). Females in the highest diastolic IV blood pressure stratum (greater than 85%) maintain higher pulse rates throughout adolescence, while males with the highest DBP have higher pulse rates in early adolescence (ages 12-14) but lower pulse rates in later adolescence (ages 16 and 17). Females with the highest DBP also show consistently higher measures of relative fatness (triceps skinfolds) throughout adolescence. Males with the highest DBP have greater triceps skinfolds in early adolescence and lower triceps in later adolescence, a pattern similar to that shown for pulse rate. For DBP, triceps is significantly and positively associated with pulse rate in the upper DBP percentile group (p less than 0.05). Thus, females with the highest blood pressure during adolescence are characterized by higher pulse rate and greater fatness. Males show this same pattern in early adolescence; whereas, in contrast, the older adolescent males in our sample with the highest DBP are characterized by lower pulse rates, relatively decreased fatness, and increased muscularity. Our findings suggest that, at least in some older black male adolescents, a higher DBP may reflect a decrease in cardiac output as indicated by a lower pulse rate, or an increase in peripheral vascular resistance, possibly associated with relatively decreased fatness and increased muscle mass for size.
作为费城血压项目的一部分，在费城一个超过600名青少年（12 - 17岁）的城市黑人样本中，对脉搏率、血压（BP）以及身体大小和组成模式进行了研究。13岁以后，男性和女性的仰卧位和坐位脉搏率均下降，且女性的脉搏率显著高于男性，根据实际年龄和体位，女性比男性高1.6至4.7次/30秒。无论实际年龄如何，两性的坐位脉搏率始终高于仰卧位，相差1.3至2.9次/30秒。在整个青春期，女性的脉搏率与收缩压（SBP）和舒张期IV血压（DBP）均呈正相关（SBP的r = 0.16，DBP的r = 0.24），而男性则不然（SBP的r = -0.06，DBP的r = 0.06）。处于舒张期IV血压最高层（大于85%）的女性在整个青春期保持较高的脉搏率，而DBP最高的男性在青春期早期（12 - 14岁）脉搏率较高，但在青春期后期（16岁和17岁）脉搏率较低。DBP最高的女性在整个青春期的相对肥胖指标（肱三头肌皮褶厚度）也始终较高。DBP最高的男性在青春期早期肱三头肌皮褶厚度较大，而在青春期后期较小，这一模式与脉搏率相似。对于DBP，在DBP百分位数较高的组中，肱三头肌皮褶厚度与脉搏率显著正相关（p小于0.05）。因此，青春期血压最高的女性其特征是脉搏率较高且肥胖程度较高。男性在青春期早期呈现相同模式；然而，相比之下，我们样本中DBP最高的年龄较大的黑人男性其特征是脉搏率较低、相对肥胖程度降低且肌肉量增加。我们的研究结果表明，至少在一些年龄较大的黑人男性青少年中，较高的DBP可能反映心输出量降低，表现为脉搏率较低，或者外周血管阻力增加，这可能与相对肥胖程度降低和肌肉量随体型增加有关。
