血压测量次数对藏族青少年血压偏高检出率的影响分析

Effect of blood pressure measurement on detection of elevated blood pressure in Tibetan adolescents

目的分析血压测量次数对藏族青少年血压偏高检出率的影响,为规范血压测量次数,准确诊断青少年血压偏高提供科学依据。方法数据来源于2018年8-9月在西藏自治区日喀则地区开展的“藏族青少年血压偏高影响因素调查”项目。采用方便分层整群抽样的方法,共纳入2822名12~17岁藏族青少年,其中男生1275人(占45.2%)。对所有研究对象进行连续3次血压测量,依据我国卫生行业标准——WS/T 610-2018《7岁~18岁儿童青少年血压偏高筛查界值》进行青少年血压偏高的诊断。采用方差分析和χ2检验分别探讨不同的测量次数及其组合对血压均值和血压偏高检出率的影响。结果第1、2、3次的平均SBP和DBP值分别逐渐下降[SBP依次为(112.7±9.7)、(110.7±9.7)、(110.2±9.5)mmHg(1 mmHg=0.133 kPa);DBP依次为(62.7±8.2)、(61.1±8.5)、(60.6±8.5)mmHg;趋势检验P<0.001]。基于第1、2、3次血压值诊断的血压偏高检出率依次为12.8%、8.7%和7.9%(趋势检验P<0.001)。基于第2次血压值、基于第2、3次血压均值诊断的血压偏高检出率,差异无统计学意义(分别为8.7%和7.2%,P=0.039)。结论随着血压测量次数的增加,青少年平均血压水平和血压偏高检出率逐渐下降。基于第2次血压测量值,足以用于筛查青少年血压偏高。

Objective To analyze the influence of different number of blood pressure measurement on the detection of elevated blood pressure in Tibetan adolescents and provide scientific reference for standardizing the number of blood pressure measurement and accurately diagnosing elevated blood pressure in adolescents.Methods Data were from the project“survey of the risk factors for elevated blood pressure among Tibetan adolescents”conducted from August to September 2018 in Shigatse in Tibet.A total of 2822 Tibetan adolescents aged 12-17 years,including 1275 boys(45.2%),were recruited by a convenient,stratified cluster sampling method.Each participant underwent three consecutive blood pressure measurements.Elevated blood pressure was defined according to the Health Industry Criterion of China:WS/T 610-2018“Reference of screening for elevated blood pressure among children and adolescents aged 7-18 years”.Analysis of variance andχ2 test were used to analyze the effect of different blood pressure measurement on blood pressure levels and detection of elevated blood pressure,respectively.Results SBP and DBP decreased substantially across three consecutive blood pressure measurements[SBP:(112.7±9.7),(110.7±9.7)and(110.2±9.5)mmHg(1 mmHg=0.133 kPa);DBP:(62.7±8.2),(61.1±8.5)and(60.6±8.5)mmHg;P value for trend<0.001].The detection rates of elevated blood pressure based on three blood pressure measurements were 12.8%,8.7%and 7.9%,respectively(P value for trend<0.001).Of note,the difference in the detection of elevated blood pressure based on the second blood pressure measurement or based on the average value of the second and third blood pressure measurements showed no significance(8.7%and 7.2%,P=0.039).Conclusions Blood pressure levels and the detection of elevated blood pressure in adolescents decreased substantially across three consecutive blood pressure measurements.The second blood pressure measurement might be sufficient for screening elevated blood pressure in adolescents.