儿童高血压患病率及抗高血压药物使用情况：系统评价与Meta分析方案

The Prevalence of Hypertension Among Children and Antihypertensive Use: Protocol for a Systematic Review and Meta-Analysis.

作者信息

Maamor Nur Hasnah, Zainudin Nur Ain Zahidah, Md Nasir Nur Liana, Manoharan Kasturi, Syed Ahmad Yunus Sharifah Zawani, Muhamad Nor Asiah, Nai Ming Lai

机构信息

Sector for Evidence-based Healthcare, National Institutes of Health, Shah Alam, Malaysia.

Virology Unit, Infectious Disease Research Centre, Institute for Medical Research, National Institutes of Health, Shah Alam, Malaysia.

出版信息

JMIR Res Protoc. 2025 May 12;14:e65807. doi: 10.2196/65807.

DOI:10.2196/65807

PMID:40354645

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12107194/

Abstract

BACKGROUND

Early-onset hypertension (HT) presents compounded risks for cardiovascular, renal, and other systemic complications. Childhood HT is associated with HT during adulthood and detrimental lifelong cardiovascular disease events. However, most of the cases are not detectable as HT measurement in children is complicated and unstable. The global prevalence of HT among children is rapidly increasing. A previous study (2019) reported that the pooled global HT prevalence is 4.0% and the number is believed to be elevated. However, prevalence estimates of childhood HT have rarely been synthesized globally.

OBJECTIVE

This study aims to systematically pool all evidence from published articles and synthesize the evidence on the global prevalence of childhood HT and antihypertensive (anti-HT) use among children and its effects.

METHODS

This systematic review of observational and experimental studies will investigate the overall prevalence of HT and anti-HT use among children. We will search articles from 4 web-based databases: PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), Embase, and Scopus using the specific keywords across the databases. During the article search conducted until October 2024, we retrieved 14,575 articles. Articles published in the English language with full text and are peer-reviewed journals included children aged between 0 and 18 years, confirmed with HT or high blood pressure (BP) on at least 3 separate occasions, and stated the definition of HT will be included in this protocol. Study selection and reporting will follow the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) and the Meta-Analysis of Observational Studies in Epidemiology guidelines and Cochrane Risk of bias tool (ACROBAT) for experimental studies. Data will be extracted using a standardized data extraction form using Microsoft Excel software and the studies' quality will be assessed using the Joanna Briggs Institute's guideline according to the study design. We will use STATA software (version 17.0; StataCorp LLC) to calculate the global pooled prevalence and RevMan software (version 5.4; StataCorp LLC) to observe the effect of anti-HT use and BP among children. The risk of bias will be assessed using a funnel plot.

RESULTS

We retrieved 14,575 articles from 4 databases in October 2024. We will report the current global overall or pooled prevalence of HT as well as by region, risk factors, anti-HT use, and the anti-HT BP-lowering effect among the general children population. The findings will be presented in summary table findings and forest plot. This review is expected to be completed in the middle of 2025.

CONCLUSIONS

This review will provide a comprehensive synthesis of the overall prevalence of HT among children-a public health issue of growing concern with long-term impact. This review will also provide important information to inform practice in developing effective strategies for preventing and managing childhood HT.

TRIAL REGISTRATION

PROSPERO CRD42024500248; https://www.crd.york.ac.uk/PROSPERO/view/CRD42024500248.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/65807.

摘要

背景

早发性高血压（HT）会增加心血管、肾脏及其他全身并发症的风险。儿童期高血压与成年期高血压以及终身有害的心血管疾病事件相关。然而，大多数病例难以检测出来，因为儿童高血压测量复杂且不稳定。全球儿童高血压患病率正在迅速上升。此前一项研究（2019年）报告称，全球高血压合并患病率为4.0%，且这一数字据信还在上升。然而，全球范围内儿童高血压患病率的估计很少被综合起来。

目的

本研究旨在系统地汇总已发表文章中的所有证据，综合有关全球儿童高血压患病率、儿童使用抗高血压药物（抗HT）情况及其效果的证据。

方法

这项对观察性和实验性研究的系统评价将调查儿童高血压和抗高血压药物使用的总体患病率。我们将使用特定关键词在4个基于网络的数据库中搜索文章：PubMed、Cochrane对照试验中心注册库（CENTRAL）、Embase和Scopus。在截至2024年10月的文章搜索过程中，我们检索到14575篇文章。发表于英文、有全文且为同行评审期刊的文章，纳入年龄在0至18岁之间、至少3次独立测量确诊为高血压（HT）或高血压（BP）且说明了高血压定义的儿童。研究的选择和报告将遵循PRISMA（系统评价和荟萃分析的首选报告项目）以及流行病学观察性研究的荟萃分析指南和实验性研究的Cochrane偏倚风险工具（ACROBAT）。将使用标准化数据提取表通过Microsoft Excel软件提取数据，并根据研究设计使用乔安娜·布里格斯研究所的指南评估研究质量。我们将使用STATA软件（版本17.0；StataCorp有限责任公司）计算全球合并患病率，并使用RevMan软件（版本5.4；StataCorp有限责任公司）观察儿童使用抗高血压药物和血压的效果。将使用漏斗图评估偏倚风险。