High blood pressure in the young.
High blood pressure in the young.
复制标题
年轻人高血压。
DOI：
10.1146/annurev.me.35.020184.002535
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发表时间：
1984
影响因子：
10.5
通讯作者：
Webber,LS
中科院分区：
文献类型：
--
作者：
Berenson,GS;Cresanta,JL;Webber,LS
原发性高血压始于儿童早期。目前的证据表明，这些儿童持续高水平随着时间的推移可能被认为是有原发性高血压。只要用于测量血压和生成网格的方法相似，最好根据代表人口测量值的血压百分位网格来判断高水平的评价。静息时的基础血压测量结果更具有可重复性，并且更适合于跟踪儿童血压水平的时间过程。测量应在一个不慌不忙，放松的气氛中进行，由训练有素的观察员使用充分照明的仪器放置在眼睛的水平和袖带大小适合儿童的手臂长度和周长。对生长期儿童进行反复观察和连续血压测量是判断异常水平所必需的。收缩压和舒张压分别以每年1.5 mm Hg和1 mm Hg的幅度递增，但生长期儿童的血压水平与身高的关系更为密切。在大多数情况下，儿童血压升高不能归因于继发性原因。在高血压的早期阶段已经确定了各种血液动力学和生化机制，并且在黑人儿童和白色儿童中，导致高血压发展的机制可能具有不同的程度。多年来对年轻人的研究表明，基线血压水平对随后的高血压具有预测价值。在高海拔地区追踪的儿童可以被识别出来，并可以进行早期干预。早期预防原发性高血压的关键是影响儿童和青少年采取促进健康和预防心血管危险因素发展的生活方式。
Essential hypertension begins in early childhood. Current evidence suggests that those children persisting at high levels over time may be considered to have essential hypertension. The evaluation of high levels is best judged from blood pressure percentile grids representing population measurements, as long as the methods used to measure blood pressure and to generate the grids are similar. Resting, basal blood pressure measurements are more reproducible and are better for following the time course of blood pressure levels in children. Measurements should be made in an unhurried, relaxed atmosphere by trained observers using adequately lighted instruments placed at eye level and a cuff size appropriate for the child's arm length and circumference. Repeated observations and serial blood pressure measurements of growing children are necessary for judgments of abnormal levels. There is a progressive rise of approximately 1.5 mm Hg systolic and 1 mm Hg diastolic pressure per year of age, but blood pressure levels in the growing child are more closely related to height. In most instances elevated blood pressure levels in children cannot be attributed to secondary causes. Various hemodynamic and biochemical mechanisms have been identified in the early stages of hypertension, and mechanisms contributing to the development of hypertension may be of different magnitudes in black children and white children. Studies following young adults over many years have shown the predictive value of baseline blood pressure levels for subsequent hypertension. Children tracking at the high percentiles can be identified and are candidates for early intervention. The key to early prevention of essential hypertension is to influence children and adolescents to adopt lifestyles that promote good health and prevent development of cardiovascular risk factors.