Loo Wesley Teck Wee, Ho Wilbert Hsien Hao, Lim Daniel Yan Zheng, Thiagarajan Nishanth, Ang Wee Kiat, Han Jonathan Yong Jun, Goy Shen, Sng Gerald Gui Ren, Lim Lian Kiat, Lim Huai Yang
Medical Classification Centre, Central Manpower Base, Singapore Armed Forces, Singapore, Singapore.
J Clin Hypertens (Greenwich). 2025 Aug;27(8):e70075. doi: 10.1111/jch.70075.
Literature on blood pressure (BP) norms in the adolescent and young adult (AYA) population remains sparse compared to adults. This study aims to describe the BP norms, prevalence of undiagnosed hypertension, and associations with demographic and anthropometric data among asymptomatic Asian AYA males. We studied retrospective cross-sectional data from individuals attending a national centralized BP screening program for enlistment over 30 months. Each individual's initial office BP reading was used to determine the cohort's BP norms. Individuals with a high reading, defined as systolic ≥140 mmHg and/or diastolic ≥90 mmHg, repeated office BP at a separate office visit. Those demonstrating two high readings underwent 24-h ambulatory BP (ABP) measurement. 49 033 males of median age 18.1 years were studied. The median, 75th centile, and 95th centile initial visit office BP readings were 121/74, 130/81, and 139/89 mmHg. 302 (0.62%; 95% CI, 0.55-0.69) were diagnosed with hypertension by office BP criteria. 270 underwent ABP measurement-180 (0.37%; 95% CI, 0.31-0.42) and 239 (0.49%; 95% CI, 0.43-0.55) had hypertension by ESC/ESH and ACC/AHA criteria, respectively. Higher weight, body mass index (BMI), and body fat percentage were associated with hypertension. The prevalence of undiagnosed hypertension among Asian AYA males is <1%. Norm-based cut-offs for high BP yielded absolute-value cut-offs similar to those recommended by adult guidelines; the 95th centile corresponded closely to 140/90 mmHg. Given similar diagnostic cut-offs with both norm-based and absolute-value approaches, both methods may be adopted. Focused screening of subgroups at higher risk of hypertension, such as obese individuals, may be considered in resource-limited settings.
与成年人相比，关于青少年和青年（AYA）人群血压（BP）规范的文献仍然很少。本研究旨在描述无症状亚洲AYA男性的血压规范、未诊断高血压的患病率以及与人口统计学和人体测量数据的关联。我们研究了在30个月内参加全国集中血压筛查计划以应征入伍的个人的回顾性横断面数据。每个人的首次诊室血压读数用于确定队列的血压规范。读数高的个体，定义为收缩压≥140 mmHg和/或舒张压≥90 mmHg，在另一次诊室就诊时重复测量血压。那些显示两次高读数的个体进行24小时动态血压（ABP）测量。研究了49033名中位年龄为18.1岁的男性。首次就诊诊室血压读数的中位数、第75百分位数和第95百分位数分别为121/74、130/81和139/89 mmHg。根据诊室血压标准，302人（0.62%；95%CI，0.55-0.69）被诊断为高血压。270人接受了ABP测量，分别有180人（0.37%；95%CI，0.31-0.42）和239人（0.49%；95%CI，0.43-0.55）根据欧洲心脏病学会/欧洲高血压学会（ESC/ESH）和美国心脏病学会/美国心脏协会（ACC/AHA）标准被诊断为高血压。较高的体重、体重指数（BMI）和体脂百分比与高血压有关。亚洲AYA男性中未诊断高血压的患病率<1%。基于规范的高血压临界值产生的绝对值临界值与成人指南推荐的临界值相似；第95百分位数与140/90 mmHg密切对应。鉴于基于规范和绝对值方法的诊断临界值相似，两种方法均可采用。在资源有限的环境中，可考虑对高血压风险较高的亚组进行重点筛查，如肥胖个体。
