Belsha C W, Spencer H J, Berry P L, Plummer J K, Wells T G
Department of Pediatrics, University of Arkansas for Medical Sciences and the Arkansas Children's Hospital, Little Rock 72202, USA.
J Hum Hypertens. 1997 Dec;11(12):801-6. doi: 10.1038/sj.jhh.1000553.
As abnormalities in diurnal ambulatory blood pressure (BP) have been associated with hypertensive target organ damage in adults, we investigated the diurnal systolic BP (SBP) and diastolic BP (DBP) patterns of 54 normotensive children, age 13.4 +/- 3.0 years, and 45 untreated borderline and mildly hypertensive children, age 14.4 +/- 2.6 years. Subjects wore the SpaceLabs 90207 ambulatory BP monitor for 24 h. BP was measured q 15 min from 08.00-21.00 h then q 30 min from 21.00-08.00 h. Nocturnal BP fall, the night-day ratio and cusum derived measures were calculated from time-weighted daytime and night-time SBP and DBP. The groups were compared using analysis of covariance with adjustment for age, race, gender and body mass index. The influence of age, gender and race on the diurnal BP profile was also examined. Nocturnal SBP fall was greater in hypertensive compared to normotensive subjects (17.1 +/- 6.7 vs 14.6 +/- 7.1 mm Hg; unadjusted mean +/- s.d., P = 0.022). Normotensive and hypertensive groups did not differ in nocturnal DBP fall or SBP or DBP night-day ratio. Race appeared to influence the diurnal BP pattern as black subjects had less nocturnal SBP fall (12.9 +/- 6.9 vs 17.1 +/- 6.5 mm Hg; P < 0.005) and a higher night-day SBP ratio (90.1 +/- 5.3 vs 86.7 +/- 4.6%; P < 0.005) than white subjects. In conclusion, hypertensive children and adolescents have a similar diurnal BP pattern as their normotensive counterparts, except that the entire BP profile is shifted upward with a greater absolute fall in SBP at night. Race also appears to influence the diurnal BP profile of normotensive and hypertensive children and adolescents.
由于成人动态血压（BP）异常与高血压靶器官损害相关，我们调查了54名血压正常儿童（年龄13.4±3.0岁）和45名未经治疗的临界高血压和轻度高血压儿童（年龄14.4±2.6岁）的日间收缩压（SBP）和舒张压（DBP）模式。受试者佩戴太空实验室90207动态血压监测仪24小时。血压测量时间为：08:00至21:00每15分钟一次，21:00至08:00每30分钟一次。根据时间加权的日间和夜间SBP及DBP计算夜间血压下降、昼夜比和累积和衍生指标。使用协方差分析对年龄、种族、性别和体重指数进行校正后对各组进行比较。还研究了年龄、性别和种族对昼夜血压曲线的影响。与血压正常的受试者相比，高血压受试者夜间SBP下降幅度更大（17.1±6.7 vs 14.6±7.1 mmHg；未校正均值±标准差，P = 0.022）。血压正常组和高血压组在夜间DBP下降或SBP及DBP昼夜比方面无差异。种族似乎影响昼夜血压模式，因为黑人受试者夜间SBP下降幅度较小（12.9±6.9 vs 17.1±6.5 mmHg；P < 0.005），昼夜SBP比更高（90.1±5.3 vs 86.7±4.6%；P < 0.005）。总之，高血压儿童和青少年的昼夜血压模式与其血压正常的同龄人相似，只是整个血压曲线向上偏移，夜间SBP绝对下降幅度更大。种族似乎也影响血压正常和高血压儿童及青少年的昼夜血压曲线。
