Horn N J, Watson A R, Coleman J E
Nottingham Community Health Trust, City Hospital Trust Nottingham, UK.
J Hum Hypertens. 1994 May;8(5):319-21.
BP has been measured in secondary school children in Nottingham as part of a routine health appraisal since 1988. School nurses who have received appropriate training refer children with a BP greater than the 95th centile for age and sex (Task Force USA 1987) initially to a community paediatrician or general practitioner. Of 14,570 children checked, only 23 patients (14 female) with a mean age of 13.9 years (range 10-15.8 years) were referred to a paediatric nephrology clinic to be seen in consultation with a dietitian. In 12 of 23 children there was a family history of hypertension and in seven a family history of other cardiovascular disease. No patient with secondary hypertension was identified; 14 patients (61%) were overweight or obese (nine) on the basis of percentage weight for height at the time of referral. BP values have tended to normalise on follow-up. Although six of 22 patients lost weight with dietetic support, eight patients gained weight. The school surveillance programme for BP is felt by the school nurses to be a valuable health educational tool and has resulted in few hospital referrals. Although initial dietetic advice may be of value, obesity remains a significant problem for the majority of adolescents in this group.
自1988年以来，作为常规健康评估的一部分，诺丁汉的中学生接受了血压测量。接受过适当培训的学校护士会将血压高于同年龄、同性别第95百分位数的儿童（美国工作组，1987年）首先转介给社区儿科医生或全科医生。在接受检查的14570名儿童中，只有23名患者（14名女性）被转介到儿科肾病诊所，与营养师会诊，这些患者的平均年龄为13.9岁（范围10 - 15.8岁）。在这23名儿童中，有12名有高血压家族史，7名有其他心血管疾病家族史。未发现继发性高血压患者；14名患者（61%）在转诊时根据身高体重百分比被判定超重或肥胖（9名）。随访时血压值趋于正常化。虽然22名患者中有6名在饮食支持下体重减轻，但有8名患者体重增加。学校护士认为学校血压监测项目是一种有价值的健康教育工具，导致很少有患者被转诊至医院。虽然最初的饮食建议可能有价值，但肥胖对该组大多数青少年来说仍然是一个重大问题。
