Shea S, Basch C E, Gutin B, Stein A D, Contento I R, Irigoyen M, Zybert P
Department of Medicine, Columbia University College of Physicians & Surgeons, New York, NY.
Pediatrics. 1994 Oct;94(4 Pt 1):465-70.
To determine whether changes in aerobic fitness and body mass index are related to the age-related rise in blood pressure in healthy preschool children.
Longitudinal analyses of 196 free-living children aged 5 years at baseline who were followed over a mean of 19.7 months. Aerobic fitness was assessed using a treadmill. All measures were obtained on multiple occasions at scheduled visits as part of a longitudinal cohort study.
An inner-city medical center.
Blood pressure was measured using an automated Dinamap device.
Mean systolic blood pressure was 95.3 mmHg (SD 8.38) at baseline and increased by 4.46 mmHg per year. Mean diastolic blood pressure was 53.9 mmHg (SD 5.81) at baseline and did not change significantly. Children in the highest quintile of increase in fitness had a significantly smaller increase in systolic blood pressure compared to children in the lowest quintile (2.92 vs 5.10 mmHg/year; P = .03). Children in the lowest quintile of increase in body mass index did not differ significantly in rate of increase in systolic blood pressure compared to children in the highest quintile (3.92 vs 4.96 mmHg/year). In a multiple regression model including baseline systolic blood pressure, fitness, height, body mass index, and other covariates, greater increase in fitness (P = .03) and lesser increase in body mass index (P < .01) were associated with lower rates of increase in systolic blood pressure. In a similar multivariate analysis, an increase in fitness was also associated with a lower rate of increase in diastolic blood pressure (P = .02).
Young children who increase their aerobic fitness or decrease their body mass index reduce the rate of the age-related increase in blood pressure. These observations may have implications for development of interventions directed at the primary prevention of hypertension.
确定有氧适能和体重指数的变化是否与健康学龄前儿童血压随年龄增长而升高有关。
对196名基线时5岁的自由生活儿童进行纵向分析，平均随访19.7个月。使用跑步机评估有氧适能。作为纵向队列研究的一部分，在预定访视时多次获取所有测量值。
市中心医疗中心。
使用自动迪纳Map设备测量血压。
基线时平均收缩压为95.3 mmHg（标准差8.38），每年升高4.46 mmHg。基线时平均舒张压为53.9 mmHg（标准差5.81），无显著变化。与适能增加最低五分位数的儿童相比，适能增加最高五分位数的儿童收缩压升高幅度明显较小（2.92 vs 5.10 mmHg/年；P = 0.03）。与体重指数增加最高五分位数的儿童相比，体重指数增加最低五分位数的儿童收缩压升高率无显著差异（3.92 vs 4.96 mmHg/年）。在包含基线收缩压、适能、身高、体重指数和其他协变量的多元回归模型中，适能增加幅度越大（P = 0.03）和体重指数增加幅度越小（P < 0.01）与收缩压升高率越低相关。在类似的多变量分析中，适能增加也与舒张压升高率降低相关（P = 0.02）。
有氧适能增加或体重指数降低的幼儿可降低血压随年龄增长的升高率。这些观察结果可能对高血压一级预防干预措施的制定具有启示意义。
