Trends in Blood Pressure and Hypertension Among US Children and Adolescents, 1999-2018.
Trends in Blood Pressure and Hypertension Among US Children and Adolescents, 1999-2018.
复制标题
DOI：
10.1001/jamanetworkopen.2021.3917
复制
发表时间：
2021-04-01
影响因子：
13.8
通讯作者：
Muntner P
中科院分区：
文献类型：
--
作者：
Hardy ST;Sakhuja S;Jaeger BC;Urbina EM;Suglia SF;Feig DI;Muntner P
在过去的20年里，美国儿童的收缩压（SBP）和舒张压（DBP）水平是否发生了变化？在这项对国家健康和营养检查调查（NHANES）中纳入的19273名儿童和青少年的连续横断面研究中，与1999-2002年周期相比，2015-2018年周期中年龄调整后的平均SBP在13至17岁的青少年中较低，与1999-2002年周期相比，2015-2018年周期中8至12岁儿童和13至17岁青少年的平均DBP较低。这些代表性结果表明，从1999-2002年至2015-2018年，美国13至17岁青少年的平均SBP降低，8至12岁和13至17岁儿童和青少年的平均DBP分别降低。这项横断面研究评估了国家健康和营养检查调查的数据，以确定美国儿童和青少年的收缩压和舒张压水平在过去20年中是否发生了变化。儿童血压（BP）水平较高与成年期高血压和亚临床心血管疾病的风险增加有关。确定BP的趋势可以为降低BP的干预措施提供信息。确定美国儿童的收缩压（SBP）和舒张压（DBP）水平在过去20年中是否发生变化。这项对国家健康和营养检查调查数据的连续横断面分析包括9117名8至12岁的儿童和10156名13至17岁的青少年，从1999-2002年到2015-2018年加权到美国人口。数据收集时间为1999年3月至2018年12月，分析时间为2020年3月26日至2021年2月2日。历年主要结局为平均SBP和平均DBP。共有19273名参与者被纳入分析。2015-2018年8至12岁儿童中（平均年龄，10.5 [95% CI，10.5-10.6]岁），48.7%（95% CI，45.2%-52.2%）为女孩，51.3%为（95% CI，47.8%-54.8%）为男孩; 49.7%（95% CI，42.2%-57.1%）为非西班牙裔白色人; 13.7%（95% CI，10.3%-18.1%）为非西班牙裔黑人; 25.5%（95% CI，19.9%-32.0%）为西班牙裔; 4.7%（95% CI，3.2%-6.7%）为非西班牙裔亚裔; 6.5%（95% CI，4.9%-8.5%）为其他非西班牙裔人种/种族。2015-2018年13至17岁的人中（平均年龄，15.5 [95% CI，15.5-15.5]岁），49.1%（95% CI，46.1%-52.2%）为女孩，50.9%为（95% CI，47.8%-53.9%）为男孩; 53.3%（95% CI，46.4%-60.1%）为非西班牙裔白色人; 13.9%（95% CI，10.3%-18.7%）为非西班牙裔黑人; 21.9%（95% CI，16.6%-28.2%）为西班牙裔; 4.6%（95% CI，3.2%-6.5%）为非西班牙裔亚裔; 6.3%（95% CI，4.7%-8.5%）为其他非西班牙裔人种/种族。在8至12岁的儿童中，年龄校正的平均SBP从102.4（95% CI，101.7-103.1）mmHg，1999-2002年为101.5（95% CI，100.8-102.2）mmHg，然后在2015-2018年增加至102.5（95% CI，101.9-103.2）mmHg。DBP校正后的平均值从1999-2002年的57.2（95% CI，56.5-58.0）mmHg降至2011-2014年的51.9（95% CI，50.1-53.7）mmHg，并在2015-2018年增加至53.2（95% CI，52.2-54.1）mmHg。在13至17岁的青少年中，年龄校正的平均SBP从109.2（95%CI，108.7-109.7）1999-2002年至108.4（95% CI，107.8-109.1）mmHg，2015-2018年保持不变（108.4 [95% CI，107.8-109.1] mmHg）。平均DBP从1999-2002年的62.6（95% CI，61.7-63.5）mmHg降至2011-2014年的59.6（95% CI，58.2-60.9）mmHg，然后在2015-2018年升高至60.8（95% CI，59.8-61.7）mmHg。在8至12岁的儿童中，平均SBP为3.2（95% CI，1.7-4.6）超重者和肥胖者的mmHg值分别为6.8（95% CI，5.6-8.1）mmHg在肥胖者中比正常体重者高;与正常体重者相比，超重者的平均DBP高3.2（95% CI，0.7-5.6）mmHg，肥胖者的平均DBP高3.5（95% CI，1.9- 5.1）mmHg。在13至17岁的青少年中，平均SBP为3.5（95%置信区间1.9-5.1）超重者mmHg高，6.6（95% CI，5.2-8.0）与正常体重相比，肥胖者的mmHg高4.8（95% CI，3.8-5.8）mmHg，男孩比女孩高，非西班牙裔黑人比非西班牙裔白色参与者高3.0（95% CI，1.7-4.3）mmHg。尽管从1999-2002年到2015-2018年平均SBP和DBP总体下降，但儿童和青少年的BP水平可能从2011-2014年到2015-2018年有所增加。
Have systolic blood pressure (SBP) and diastolic blood pressure (DBP) levels among US children changed during the past 20 years? In this serial cross-sectional study of 19 273 children and adolescents included in the National Health and Nutrition Examination Survey (NHANES), age-adjusted mean SBP was lower in the 2015-2018 cycle compared with the 1999-2002 cycle among adolescents aged 13 to 17 years, and mean DBP was lower in the 2015-2018 cycle compared with the 1999-2002 cycle among children aged 8 to 12 and adolescents aged 13 to 17 years. These representative findings suggest that from 1999-2002 to 2015-2018, mean SBP decreased among adolescents aged 13 to 17 years and mean DBP decreased among children and adolescents aged 8 to 12 and 13 to 17 years, respectively, in the US. This cross-sectional study assesses data from the National Health and Nutrition Examination Survey to determine whether systolic and diastolic blood pressure levels among US children and adolescents have changed during the past 20 years. Higher blood pressure (BP) levels in children are associated with an increased risk for hypertension and subclinical cardiovascular disease in adulthood. Identifying trends in BP could inform the need for interventions to lower BP. To determine whether systolic BP (SBP) and diastolic BP (DBP) levels among US children have changed during the past 20 years. This serial cross-sectional analysis of National Health and Nutrition Examination Survey data included 9117 children aged 8 to 12 years and 10 156 adolescents aged 13 to 17 years, weighted to the US population from 1999-2002 to 2015-2018. Data were collected from March 1999 to December 2018 and analyzed from March 26, 2020, to February 2, 2021. Calendar year. The primary outcomes were mean SBP and mean DBP. A total of 19 273 participants were included in the analysis. Among children aged 8 to 12 years in 2015-2018 (mean age, 10.5 [95% CI, 10.5-10.6] years), 48.7% (95% CI, 45.2%-52.2%) were girls and 51.3% (95% CI, 47.8%-54.8%) were boys; 49.7% (95% CI, 42.2%-57.1%) were non-Hispanic White; 13.7% (95% CI, 10.3%-18.1%) were non-Hispanic Black; 25.5% (95% CI, 19.9%-32.0%) were Hispanic; 4.7% (95% CI, 3.2%-6.7%) were non-Hispanic Asian; and 6.5% (95% CI, 4.9%-8.5%) were other non-Hispanic race/ethnicity. Among those aged 13 to 17 years in 2015-2018 (mean age, 15.5 [95% CI, 15.5-15.5] years), 49.1% (95% CI, 46.1%-52.2%) were girls and 50.9% (95% CI, 47.8%-53.9%) were boys; 53.3% (95% CI, 46.4%-60.1%) were non-Hispanic White; 13.9% (95% CI, 10.3%-18.7%) were non-Hispanic Black; 21.9% (95% CI, 16.6%-28.2%) were Hispanic; 4.6% (95% CI, 3.2%-6.5%) were non-Hispanic Asian; and 6.3% (95% CI, 4.7%-8.5%) were other non-Hispanic race/ethnicity. Among children aged 8 to 12 years, age-adjusted mean SBP decreased from 102.4 (95% CI, 101.7-103.1) mm Hg in 1999-2002 to 101.5 (95% CI, 100.8-102.2) mm Hg in 2011-2014 and then increased to 102.5 (95% CI, 101.9-103.2) mm Hg in 2015-2018. Age-adjusted mean DBP decreased from 57.2 (95% CI, 56.5-58.0) mm Hg in 1999-2002 to 51.9 (95% CI, 50.1-53.7) mm Hg in 2011-2014 and increased to 53.2 (95% CI, 52.2-54.1) mm Hg in 2015-2018. Among adolescents aged 13 to 17 years, age-adjusted mean SBP decreased from 109.2 (95% CI, 108.7-109.7) mm Hg in 1999-2002 to 108.4 (95% CI, 107.8-109.1) mm Hg in 2011-2014 and remained unchanged in 2015-2018 (108.4 [95% CI, 107.8-109.1] mm Hg). Mean DBP decreased from 62.6 (95% CI, 61.7-63.5) mm Hg in 1999-2002 to 59.6 (95% CI, 58.2-60.9) mm Hg in 2011-2014 and then increased to 60.8 (95% CI, 59.8-61.7) mm Hg in 2015-2018. Among children aged 8 to 12 years, mean SBP was 3.2 (95% CI, 1.7-4.6) mm Hg higher among those with overweight and 6.8 (95% CI, 5.6-8.1) mm Hg higher among those with obesity compared with normal weight; mean DBP was 3.2 (95% CI, 0.7-5.6) mm Hg higher among those with overweight and 3.5 (95% CI, 1.9- 5.1) mm Hg higher among those with obesity compared with normal weight. Among adolescents aged 13 to 17 years, mean SBP was 3.5 (95% CI 1.9-5.1) mm Hg higher among those with overweight and 6.6 (95% CI, 5.2-8.0) mm Hg higher among those with obesity compared with normal weight, 4.8 (95% CI, 3.8-5.8) mm Hg higher among boys compared with girls, and 3.0 (95% CI, 1.7-4.3) mm Hg higher among non-Hispanic Black compared with non-Hispanic White participants. Despite an overall decline in mean SBP and DBP from 1999-2002 to 2015-2018, BP levels among children and adolescents may have increased from 2011-2014 to 2015-2018.
登录
查看更多内容
影响因子：
3.7
作者：
Chen L;Simonsen N;Liu L
通讯作者：
Liu L
影响因子：
3.2
作者：
Harshfield, GA;Wilson, ME;Treiber, FA
通讯作者：
Treiber, FA
影响因子：
24
作者：
Hartiala, Olli;Magnussen, Costan G.;Raitakari, Olli T.
通讯作者：
Raitakari, Olli T.
影响因子：
168.9
作者：
Lim, Stephen S.;Vos, Theo;Flaxman, Abraham D.;Danaei, Goodarz;Shibuya, Kenji;Adair-Rohani, Heather;Amann, Markus;Anderson, H. Ross;Andrews, Kathryn G.;Aryee, Martin;Atkinson, Charles;Bacchus, Loraine J.;Bahalim, Adil N.;Balakrishnan, Kalpana;Balmes, John;Barker-Collo, Suzanne;Baxter, Amanda;Bell, Michelle L.;Blore, Jed D.;Blyth, Fiona;Bonner, Carissa;Borges, Guilherme;Bourne, Rupert;Boussinesq, Michel;Brauer, Michael;Brooks, Peter;Bruce, Nigel G.;Brunekreef, Bert;Bryan-Hancock, Claire;Bucello, Chiara;Buchbinder, Rachelle;Bull, Fiona;Burnett, Richard T.;Byers, Tim E.;Calabria, Bianca;Carapetis, Jonathan;Carnahan, Emily;Chafe, Zoe;Charlson, Fiona;Chen, Honglei;Chen, Jian Shen;Cheng, Andrew Tai-Ann;Child, Jennifer Christine;Cohen, Aaron;Colson, K. Ellicott;Cowie, Benjamin C.;Darby, Sarah;Darling, Susan;Davis, Adrian;Degenhardt, Louisa;Dentener, Frank;Des Jarlais, Don C.;Devries, Karen;Dherani, Mukesh;Ding, Eric L.;Dorsey, E. Ray;Driscoll, Tim;Edmond, Karen;Ali, Suad Eltahir;Engell, Rebecca E.;Erwin, Patricia J.;Fahimi, Saman;Falder, Gail;Farzadfar, Farshad;Ferrari, Alize;Finucane, Mariel M.;Flaxman, Seth;Fowkes, Francis Gerry R.;Freedman, Greg;Freeman, Michael K.;Gakidou, Emmanuela;Ghosh, Santu;Giovannucci, Edward;Gmel, Gerhard;Graham, Kathryn;Grainger, Rebecca;Grant, Bridget;Gunnell, David;Gutierrez, Hialy R.;Hall, Wayne;Hoek, Hans W.;Hogan, Anthony;Hosgood, H. Dean, III;Hoy, Damian;Hu, Howard;Hubbell, Bryan J.;Hutchings, Sally J.;Ibeanusi, Sydney E.;Jacklyn, Gemma L.;Jasrasaria, Rashmi;Jonas, Jost B.;Kan, Haidong;Kanis, John A.;Kassebaum, Nicholas;Kawakami, Norito;Khang, Young-Ho;Khatibzadeh, Shahab;Khoo, Jon-Paul;Kok, Cindy;Laden, Francine;Lalloo, Ratilal;Lan, Qing;Lathlean, Tim;Leasher, Janet L.;Leigh, James;Li, Yang;Lin, John Kent;Lipshultz, Steven E.;London, Stephanie;Lozano, Rafael;Lu, Yuan;Mak, Joelle;Malekzadeh, Reza;Mallinger, Leslie;Marcenes, Wagner;March, Lyn;Marks, Robin;Martin, Randall;McGale, Paul;McGrath, John;Mehta, Sumi;Mensah, George A.;Merriman, Tony R.;Micha, Renata;Michaud, Catherine;Mishra, Vinod;Hanafiah, Khayriyyah Mohd;Mokdad, Ali A.;Morawska, Lidia;Mozaffarian, Dariush;Murphy, Tasha;Naghavi, Mohsen;Neal, Bruce;Nelson, Paul K.;Miquel Nolla, Joan;Norman, Rosana;Olives, Casey;Omer, Saad B.;Orchard, Jessica;Osborne, Richard;Ostro, Bart;Page, Andrew;Pandey, Kiran D.;Parry, Charles D. H.;Passmore, Erin;Patra, Jayadeep;Pearce, Neil;Pelizzari, Pamela M.;Petzold, Max;Phillips, Michael R.;Pope, Dan;Pope, C. Arden, III;Powles, John;Rao, Mayuree;Razavi, Homie;Rehfuess, Eva A.;Rehm, Juergen T.;Ritz, Beate;Rivara, Frederick P.;Roberts, Thomas;Robinson, Carolyn;Rodriguez-Portales, Jose A.;Romieu, Isabelle;Room, Robin;Rosenfeld, Lisa C.;Roy, Ananya;Rushton, Lesley;Salomon, Joshua A.;Sampson, Uchechukwu;Sanchez-Riera, Lidia;Sanman, Ella;Sapkota, Amir;Seedat, Soraya;Shi, Peilin;Shield, Kevin;Shivakoti, Rupak;Singh, Gitanjali M.;Sleet, David A.;Smith, Emma;Smith, Kirk R.;Stapelberg, Nicolas J. C.;Steenland, Kyle;Stoeckl, Heidi;Stovner, Lars Jacob;Straif, Kurt;Straney, Lahn;Thurston, George D.;Tran, Jimmy H.;Van Dingenen, Rita;van Donkelaar, Aaron;Veerman, J. Lennert;Vijayakumar, Lakshmi;Weintraub, Robert;Weissman, Myrna M.;White, Richard A.;Whiteford, Harvey;Wiersma, Steven T.;Wilkinson, James D.;Williams, Hywel C.;Williams, Warwick;Wilson, Nicholas;Woolf, Anthony D.;Yip, Paul;Zielinski, Jan M.;Lopez, Alan D.;Murray, Christopher J. L.;Ezzati, Majid
通讯作者：
Ezzati, Majid
影响因子：
120.7
作者：
Muntner, P;He, J;Whelton, PK
通讯作者：
Whelton, PK