Departments of Medicine (B.F.), Sydney Kimmel College of Medicine, Thomas Jefferson University, Philadelphia, PA.
Pediatrics (B.F.), Sydney Kimmel College of Medicine, Thomas Jefferson University, Philadelphia, PA.
Hypertension. 2024 Oct;81(10):2016-2026. doi: 10.1161/HYPERTENSIONAHA.124.21359. Epub 2024 Jul 29.
Hypertension has largely been viewed as a disorder of adulthood. Historically, blood pressure (BP) was not routinely measured in children because hypertension was considered uncommon in childhood. It was not until the 1970s that it was apparent that in childhood BP levels were normally lower compared with those in adults, were related to age and growth, and that abnormal BP in children needed different definitions. Based on the distribution of BP levels in available child cohorts, the 95th percentile of BP levels became the definition of hypertension in children and adolescents-an epidemiological definition. Subsequent clinical and epidemiological research identified associated risk factors in childhood that linked abnormal BP in youth with hypertension in adulthood. In the 1980s, the Barker hypothesis, based on observations that low birth weight could be linked to cardiovascular disease in adulthood, promoted further research spanning epidemiological, clinical, and basic science on the childhood origins of hypertension. This review focuses on recent findings from both longitudinal maternal-child cohorts and experimental models that examine both maternal and offspring conditions associated with risks of subsequent cardiovascular disease.
高血压在很大程度上被视为成人疾病。从历史上看，由于儿童期高血压较为少见，因此通常不会常规测量儿童的血压。直到 20 世纪 70 年代，人们才明显意识到，与成年人相比，儿童的血压水平通常较低，与年龄和生长有关，而且儿童的异常血压需要不同的定义。基于现有儿童队列中血压水平的分布，血压水平的第 95 百分位成为儿童和青少年高血压的定义——一种流行病学定义。随后的临床和流行病学研究确定了儿童时期与异常血压相关的风险因素，这些因素将青年时期的异常血压与成年期的高血压联系起来。20 世纪 80 年代，基于低出生体重可能与成年期心血管疾病有关的观察，Barker 假说促进了跨越流行病学、临床和基础科学的进一步研究，探讨了与高血压儿童起源相关的母婴状况。本综述重点介绍了来自纵向母婴队列和实验模型的最新发现，这些研究考察了与随后心血管疾病风险相关的母婴状况。
