Isolated systolic hypertension, obesity, and hyperkinetic hemodynamic states in children
Isolated systolic hypertension, obesity, and hyperkinetic hemodynamic states in children
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DOI：
10.1067/mpd.2002.125228
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发表时间：
2002-06-01
影响因子：
5.1
通讯作者：
Portman, RJ
中科院分区：
文献类型：
--
作者：
Sorof, JM;Poffenbarger, T;Portman, RJ
目的：探讨儿童单纯收缩期高血压的发病因素。方法：对8所城市公立学校2460名12~16岁学生(西班牙裔占49%，黑人占31%，白人占13%)进行血压、心率、体重和身高的校本测量。对71名未接受治疗的儿童进行24小时动态血压监测(ABPM)，以确定临床高血压和血压昼夜节律。结果：170%的学生有高血压，6%有肥胖，23%有肥胖。在高血压学生中，88%(363/413)的学生有单纯的收缩期高血压。肥胖学生中高血压的患病率高于非肥胖学生(33%比11%，P<；.0001)。高血压肥胖者的静息心率高于血压正常的非肥胖者(85.9vs79.6次/分钟，P<；0.001)。在接受动态血压监测的患者中，临床血压检出单纯收缩期高血压510例(36171%)，动态血压监测确诊为高血压的患者中有62%(18/29)。肥胖组与非肥胖组比较，白天和睡眠时的血压变异性显著升高，分别为收缩压(P<；.01)和舒张压(P<；.05)。结论：单纯收缩期高血压肥胖儿童心率和血压变异性增加，提示交感神经系统过度活动可能参与其发病机制。
Objective: To determine the factors that contribute to the pathogenesis of isolated systolic hypertension in children.Methods: School-based measurement was performed of blood pressure (BP), heart rate, weight, and height in 2460 students (49% Hispanic, 31% black, 13% white) 12 to 16 years of age in 8 urban public schools. Air independent group of 71 untreated children underwent 24-hour ambulatory BP monitoring (ABPM) to confirm clinic hypertension and assess circadian BP patterns.Results: Hypertension and obesity were found in 170,6 and 23% of students, respectively. Among hypertensive students, 88% (363/413) had isolated systolic hypertension. Hypertension was more prevalent in obese than nonobese students (33% vs 11%, P < .0001). Obese hypertensive students had higher resting heart rate than nonobese normotensive patients (85.9 vs 79.6 beats/min, P < .001). Among patients who underwent ABPM, isolated systolic hypertension was found in 510/0 (36171) by clinic BP and in 62% (18/29) with confirmed hypertension by ABPM. Blood pressure variability during daytime and sleep periods was higher in obese than nonobese patients for systolic BP (P < .01) and diastolic BP (P < .05).Conclusions: The findings of increased heart rate and BP variability in obese children with isolated systolic hypertension suggest that Sympathetic nervous system hyperactivity may contribute to its pathogenesis.