Blood Pressure Percentiles in 22,051 German Children and Adolescents: The PEP Family Heart Study
Blood Pressure Percentiles in 22,051 German Children and Adolescents: The PEP Family Heart Study
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DOI：
10.1093/ajh/hpu208
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发表时间：
2015-05-01
影响因子：
3.2
通讯作者：
Haas, Gerda M.
中科院分区：
文献类型：
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作者：
Schwandt, Peter;Scholze, Juergen E.;Haas, Gerda M.
背景血压 (BP) 与超重之间的密切相关性提出了超重儿童（体重指数 (BMI) >= 85%）是否应纳入规范数据库的问题。方法使用 LMS (Lamda-Mu-Sigma) 方法，我们开发了年龄、性别和身高调整后的收缩压 (SBP) 和舒张压 (DBP) 百分位数曲线。 根据纽伦堡 PEP 家庭心脏研究的年度横断面调查，我们对 22,051 名 3-18 岁德国青少年（18,917 名正常体重、1,938 名超重和 1,196 名肥胖）的第 50、85、90、95 和 97 个百分位进行了研究。结果在儿童中，我们发现血压和体重指数没有性别差异。男性青少年更高、更重。儿童中高血压和肥胖症的平均患病率分别为7.3%和5.2%，青少年中高血压和肥胖症的平均患病率分别为7.2%和5.8%。不同体重组的血压升高患病率大幅增加，肥胖女性为 24.4%，肥胖男性为 21.9%，比值比分别为 5.9（95% 置信区间 (CI)：5.1-7.5）和 4.3（95% CI：3.5-5.2）。 10 LMS 平滑的 SBP 和 DBP 百分位数曲线的形状在性别和体重组之间存在显着差异。正常体重百分位数与整体生长图表几乎相同，但超重和肥胖青少年的单独百分位数提供了相当高的值，例如 17 岁男性的 148/91 与 136/86 毫米汞柱，女性的 136/91 与 123/81 毫米汞柱，在第 90 个百分位数处。超重和肥胖数据库 强烈建议儿童和青少年使用。
BACKGROUNDStrong associations between blood pressure (BP) and overweight raise the question whether overweight children (body mass index (BMI) >= 85th percentile) should be included in the normative database.METHODSUsing the LMS (Lamda-Mu-Sigma) method, we developed age-, gender-, and height-adjusted percentile curves for systolic blood pressure (SBP) and diastolic blood pressure (DBP) at the 50th, 85th, 90th, 95th, and 97th percentiles in 22,051 German youths (18,917 normal-weight, 1,938 overweight, and 1,196 obese) aged 3-18 years from yearly cross-sectional surveys of the PEP Family Heart Study Nuremberg.RESULTSAmong children, we found no gender differences for BP and BMI. Male adolescents are taller and heavier. The mean prevalence of hypertension and obesity is 7.3% and 5.2% among children and 7.2% and 5.8% among adolescents, respectively. The prevalence of elevated BP increased substantially by weight groups achieving 24.4% in obese females and 21.9% in obese males with odds ratios of 5.9 (95% confidence interval (CI): 5.1-7.5) and 4.3 (95% CI: 3.5-5.2), respectively. The shapes of the 10 LMS-smoothed SBP and DBP percentile curves differ substantially between gender and weight group. The normal-weight percentiles are nearly identical with the overall growth charts, but separate percentiles for overweight and obese youths provide considerably higher values, such as 148/91 vs. 136/86 mm Hg for a 17-year-old male and 136/91 vs. 123/81 mm Hg for female, respectively, at the 90th percentile.CONCLUSIONSBecause of substantially higher BP percentiles, separate databases for overweight and obese children and adolescents are strongly recommended.