上海市流行病11至17岁青少年高血压的学调查

Epidemiological survey on pre-hypertension and hypertension prevalence among adolescents aged 11 to 17 years in Shanghai

目的分析上海市11至17岁青少年人群高血压的检出率以及其与超重、肥胖的关系。方法2010年5月，采用整群抽样方法抽取上海市2所初级中学和2所高级中学的11至17岁在校学生进行流行病学调查。采用问卷调查的形式收集父母高血压史、体育锻炼状况，同时测量血压、身高和体质量。调查时发现血压超过正常水平的调查对象，在1个月内复测血压。正常高值血压和高血压的定义采用2004年美国高血压教育项目工作组的标准。超重和肥胖的定义采用中国肥胖工作组的标准。结果参加调查的学生共4175名，52．3％（2183例）为女性，47．7％（1992例）为男性，年龄（15．0±1．9）岁。血压正常者3025名（占72．5％），其中女性1666名（占76．3％），男性1361名（占68．3％）；正常高值血压者750名（占18．0％），其中女性310名（占14．2％），男性440名（占22．1％）；高血压1级者346例（占8．3％），其中女性179例（占8．2％），男性165例（占8．3％）；高血压2级者54例（占1．3％），其中女性28例（占1．3％），男性26例（占1．3％）。超重和肥胖的检出率女性分别为6．7％（147例）和3．O％（66例），男性分别为13．7％（273例）和6．3％（125例）。在调整性别、年龄、父母高血压史和体育活动水平后，多因素logistic回归分析显示，超重和肥胖是高血压的危险因素，优势比和95％可信区间分别为1．42（1．16～1．75）和2．35（1．78～3．11）。结论上海市11至17岁青少年高血压常见，超重和肥胖可能与血压水平增高有关。

Objective To assess the prevalence of pre-hypertension and hypertension as well as the association with overweight/obesity in Shanghai adolescents. Methods School children aged 11 - 17 years in four schools in Shanghai were included in this survey. All students were visited in May 2010 at school by trained nurses or physicians who administered a questionnaire and carried out anthropometric measurements. Anthropometric measurements included height, weight, heart rate and blood pressure. Repeat measurements were performed in school children with elevated blood pressure within one month. The pre-hypertension and hypertension was defined on the basis of the 2004 National High Blood Pressure Education Program Working Group definitions. The overweight and obesity was defined using cutoff points recommended by Working Group of Obesity, China （WGOC）. Results There were 4175 school children aged 11 - 17 years [ mean （15.0_＋l.9）years, 52. 3% （n=2183） girls and 47.7% （n=1992） boysl,There were 72.5 % （n= 3025） participants with normal blood pressure [ girls （n = 1666）76. 3% and boys （n = 1361 ） 68.3% , 18. 0% （n =750）participants with pre-hypertension [ 14. 2% （n =310） for girls and 22. 1% （n =440） for boys] , 8.3% （n =346） participants with stage 1 hypertension [ 8.2% （n = 179） for gifts and 8.3% （n = 165） for boys] and 1.3% （n =54） participants with stage 2 hypertension [ 1.3% （n =28） for girls and 1.3% （ n = 26） for boys]. The prevalence of overweight and obesity was 6.7% （ n = 147 ） and 3.0% （n =66） for girls and 13.7% （n =273） and 6. 3% （ n = 125） for boys. After adjusting for gender, age, parental history of hypertension and physical activities, muhivariable logistic regression analysis showed that the overweight [ adjusted odds ratio and 95% confidence interval： 1.42 （ 1.16 - 1.75 ） ] and obesity [adjusted odds ratio and 95% confidence interval： 2.35 （ 1.78 - 3. 11 ） ] were independent predictors of elevated blood pressure in this cohort. Conclusions The prevalence of elevated blood pressure is common in adolescents in Shanghai. Overweight and obesity are closely associated with the elevated blood pressure in this cohort.