青少年初始血压高者在高血压发生中的预测意义

Thepredictivevalueofhigherlevelbloodpressureinchildrenindevelopinghypertension

为探讨初始血压偏高者在高血压发生中的预测意义，对汉中农村４６２３名年龄６～１５岁青少年血压，经过８年随访（末次随访率为８２．０７％）证明，基线调查收缩压百分位与８年后的收缩压相关系数，男为０．３３，女为０．２８，舒张压均为０．２０；基线调查收缩压在第７５百分位（Ｐ７５）以上者，８年后血压≥１８．７／１２．０ｋＰａ（１４０／９０ｍｍＨｇ）的机率是＜Ｐ５０以下的３．９１倍，初始血压百分位愈高相对危险性愈大；如同时初始收缩压≥Ｐ７５、体重指数≥Ｐ９０，并有高血压病家族史者，发生高血压的机率为２７．６％，是收缩压＜Ｐ７５、体重指数＜Ｐ９０和无高血压家族史者的６．５７倍。我们认为，青少年初始血压高者是成年高血压的易感人群，特别当伴有肥胖或超重及高血压家族史者，预测意义更大。

Tostudythepossibilityofdevelopingintohypertensioninthenearfutureinchildrenwithhighersystolicbloodpressure(SBP),abase-linesurveyof4623schoolchildrenforbloodpres-sureinHanzhongruralareainSouthernShaanxiprovince,aged6～15yearsold,wasundertakenin1987andfolowedupin1989,1992and1995.Thefolow-upratewas77.7%,84.8%and82.1%,respectively.TheSBPpercentiles(P)inbase-linewerepositivelycorelatedtothelastexamination(r=0.33forboys,0.28forgirls,P<0.01).InchildrenwithSBP>P75,thepossibilityofhavingbloodpresure≥140/90mmHg8-yearslaterwas3.91timesgreaterthanthatinchildrenwithSBP<P50(13.81%vs3.53%).Children,intheirinitialbodymassindex≥P90,SBP≥P75andhavingfamilyhistoryofhypertension,theposibilityofhavinghypertension8yearslaterwasmuchgreaterthantheopposite,27.6%vs4.2%.Webelievethatchildrenwithhighlevelbloodpressurearepre-disposedtodevelophypertension,especialywhenassociatedwithobeseandfamilyhistoryofhyper-tension.