中国7～17岁儿童青少年1993—2011年血压偏高变化趋势分析

Trends in elevated blood pressure among Chinese children and adolescents,1993-2011

目的了解中国7～17岁儿童青少年1993—2011年血压水平和血压偏高检出率变化趋势,为我国儿童青少年血压偏高防治提供基础数据。方法基于1993,2000和2011年3次中国健康和营养调查（CHNS）横断面数据,选取具有性别、年龄、身高、体重、腰围和血压完整资料的4 715名7～17岁的儿童青少年作为研究对象,采用Logistic回归模型分析儿童青少年血压偏高的影响因素。结果 1993—2011年儿童青少年SBP和DBP水平分别增长3.4和1.5 mm Hg,其中男生、7～12岁和城市儿童增长幅度较大。血压偏高、单纯收缩压偏高和单纯舒张压偏高检出率分别从1993年的10.0%,2.1%和9.3%增加到2011年的12.9%,3.0%和11.7%,分别增长2.9,0.9和2.4百分点。儿童青少年超重、肥胖和腹型肥胖检出率分别从1993年的4.8%,1.4%和4.9%增加到2011年的10.8%,8.8%和19.7%,分别增长6.0,7.4和14.8百分点（χ^2值分别为61.4,132.7,229.7,P值均〈0.05）。相对于男生,女生血压偏高的OR值为0.79（95%CI=0.66～0.95）;与正常体重儿童相比,超重儿童青少年血压偏高的OR值为2.11（95%CI=1.57～2.84）,肥胖OR值为3.14（95%CI=2.15～4.59）;与正常腰围相比,腹型肥胖OR值为1.65（95%CI=1.22～2.22）。结论 1993—2011年中国儿童青少年血压水平、血压偏高、超重、肥胖和腹型肥胖检出率均呈增加趋势。儿童青少年血压偏高防治形势依然严峻,肥胖是儿童青少年血压偏高的重要危险因素。

Objective To estimate the trends in blood pressure（BP） and prevalence of elevated blood pressure（BP） among Chinese Children and adolescents aged 7-17 years from 1993 to 2011. Methods Data were obtained from three waves of the China and Nutrition Survey（CHNS） launched in 1993, 2000 and 2011. A total of 4 715 children and adolescent were analyzed, including completed information on sex, age, height, weight, waist circumstance, systolic/diastolic BP（SBP/DBP）. After adjusted for sex, age, body mass index（BMI）, a multiple linear regression analysis was performed to evaluate the trend in SBP and DBP levels. Binary logistic regression analysis was performed to evaluate trends in the prevalence and risk of elevated BP, isolated systolic elevated BP and isolated diastolic elevated BP. Results During the period of 1993-2011, the levels of SBP and DBP absolutely increased by 3.4 and 1.5 mm Hg, respectively, and the increased trend was more obvious in boys, 7-12 years old and urban residents. The prevalence and risk of elevated BP, isolated systolic elevated BP and isolated diastolic elevated BP increased from10.0%, 2.1%, respectively, to 9.3% to 12.9%, 3.0% and 11.7%, respectively, absolutely increased by 2.9%, 0.9% and 2.4%,respectively. The prevalence of overweight, obesity and abdominal obesity increased from 4.8%, 1.4% and 4.9%, respectively, to10.8%, 8.8% and 19.7%, respectively, absolutely increased by 6. 0%, 7. 4% and 14. 8%, respectively. Elevated BP was influenced by sex and weight status（both P〈0.05）. The odds ratio（OR） and 95% confidence interval（CI） of elevated BP was 0.79（0.66-0.95） for girls compared to boys. The OR and 95% CI for overweight, obesity and abdominal obesity were 2.11（1.57-2.84）,3.14（2.15-4.59） and 1.65（1.22-2.22）, respectively. Conclusion The prevalence of elevated BP, general and abdominal obesity in Chinese children and adolescent increase greatly from 1993 to 2011. It is urgent to take effective measures, such as prevention and control of obesity, to curb the epidemic of elevated BP.