Prehypertension and Hypertension in Community-Based Pediatric Practice
Prehypertension and Hypertension in Community-Based Pediatric Practice
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DOI：
10.1542/peds.2012-1292
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发表时间：
2013-02-01
期刊：
影响因子：
8
通讯作者：
O'Connor, Patrick J.
中科院分区：
文献类型：
--
作者：
Lo, Joan C.;Sinaiko, Alan;O'Connor, Patrick J.
目的：为了研究高血压前期和高血压的患病率在儿童接受良好的儿童保健在社区为基础的practices.METHODS：儿童年龄3至17岁的身高，体重和血压（BP）的测量，在2007年7月和2009年12月之间的首次（索引）良好的儿童访问获得了这项回顾性队列研究在3个大型，综合医疗保健提供系统。指数血压分类基于儿童和青少年高血压诊断、评估和治疗第四次报告：正常血压，≥第95百分位数（首次和随后2次连续访视）。该队列包括199513名儿童（24.3%年龄为3-5岁，34.5%年龄为6-11岁，41.2%年龄为12-17岁），具有显著的种族/民族多样性（35.9%为白色，7.8%为黑人，17.6%为西班牙裔，11.7%为亚洲/太平洋岛民，27.0%为其他/未知人种）。在首次访视时，81.9%的参与者血压正常，12.7%有高血压前期，5.4%的血压在高血压范围内（>= 95百分位数）。在10848名具有指数高血压血压水平的儿童中，3.8%的随访血压测量结果证实了高血压（估计患病率为0.3%）。年龄和BMI的增加与高血压前期和确诊的高血压显著相关（趋势P <0.001）。在种族/民族群体中，黑人和亚洲人的高血压患病率最高。结论：高血压的患病率在这个以社区为基础的研究是低于以前报道的以学校为基础的研究。由于该队列的规模和多样性，这些结果表明儿童高血压的患病率实际上可能低于以前的报道。儿科2013;131：e415-e424
OBJECTIVE: To examine the prevalence of prehypertension and hypertension among children receiving well-child care in community-based practices.METHODS: Children aged 3 to 17 years with measurements of height, weight, and blood pressure (BP) obtained at an initial (index) well-child visit between July 2007 and December 2009 were included in this retrospective cohort study across 3 large, integrated health care delivery systems. Index BP classification was based on the Fourth Report on the Diagnosis, Evaluation, and Treatment of High Blood Pressure in Children and Adolescents: normal BP, = 95th percentile (index and 2 subsequent consecutive visits).RESULTS: The cohort included 199 513 children (24.3% aged 3-5 years, 34.5% aged 6-11 years, and 41.2% aged 12-17 years) with substantial racial/ethnic diversity (35.9% white, 7.8% black, 17.6% Hispanic, 11.7% Asian/Pacific Islander, and 27.0% other/unknown race). At the index visit, 81.9% of participants were normotensive, 12.7% had prehypertension, and 5.4% had a BP in the hypertension range (>= 95th percentile). Of the 10 848 children with an index hypertensive BP level, 3.8% of those with a follow-up BP measurement had confirmed hypertension (estimated 0.3% prevalence). Increasing age and BMI were significantly associated with prehypertension and confirmed hypertension (P < .001 for trend). Among racial/ethnic groups, blacks and Asians had the highest prevalence of hypertension.CONCLUSIONS: The prevalence of hypertension in this community-based study is lower than previously reported from school-based studies. With the size and diversity of this cohort, these results suggest the prevalence of hypertension in children may actually be lower than previously reported. Pediatrics 2013;131:e415-e424