Update: ambulatory blood pressure monitoring in children and adolescents: a scientific statement from the American Heart Association.
Update: ambulatory blood pressure monitoring in children and adolescents: a scientific statement from the American Heart Association.
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DOI：
10.1161/hyp.0000000000000007
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发表时间：
2014-05
期刊：
影响因子：
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通讯作者：
American Heart Association Atherosclerosis, Hypertension and Obesity in Youth Committee of the Council on Cardiovascular Disease in the Young
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文献类型：
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作者：
Flynn JT;Daniels SR;Hayman LL;Maahs DM;McCrindle BW;Mitsnefes M;Zachariah JP;Urbina EM;American Heart Association Atherosclerosis, Hypertension and Obesity in Youth Committee of the Council on Cardiovascular Disease in the Young
然而，并非所有研究都记录了与肥胖相关的血压升高。在博加卢萨心脏研究中，使用6次静息血压测量的平均值而不是2次或3次测量，从1974年到1993年，肥胖的患病率显著增加，但血压水平只有很小的变化。13因此，尽管方法上的差异使得跨人群高血压的估计难以解释，14大多数研究人员认为肥胖相关的高血压正在上升。年轻人高血压患病率的上升尤其令人担忧，因为尸检研究，如博加卢萨心脏研究和青年动脉粥样硬化的病理生物学决定因素研究，已经证明青年人血压水平较高时动脉粥样硬化增加。因此，准确评估儿童和青少年的血压和治疗高血压对于预防未来的心脏病至关重要。17新的数据表明，在预测成人心血管发病率和死亡率方面，ABPM可能优于临床BP上级。18因此，ABPM越来越多地用于评估青年人的高血压和终末器官损伤风险。
However, an obesity-related increase in BP has not been documented in all studies. In the Bogalusa Heart Study, which used the mean of 6 resting BP measurements instead of 2 or 3 measurements, there was a significant increase in the prevalence of obesity from 1974 to 1993, yet there were only small changes in BP levels. 13 Therefore, despite methodological differences that make cross-population estimates of hypertension difficult to interpret, 14 most investigators believe obesity-related hypertension is on the rise. The rise in prevalence of hypertension in the young is especially worrisome, because autopsy studies such as the Bogalusa Heart Study and the Pathobiological Determinates of Atherosclerosis in Youth study have demonstrated increased atherosclerosis at higher BP levels in youths. 15, 16 Therefore, accurate assessment of BP and treatment of hypertension in children and adolescents are essential for the prevention of future heart disease. 17 Emerging data suggest that ABPM may be superior to clinic BP in predicting cardiovascular morbidity and mortality in adults. 18 For this reason, ABPM is being increasingly used in the evaluation for hypertension and risk of end-organ damage in youths.