BLOOD PRESSURE TRACKING--CHILDHOOD TO YOUNG ADULTHOOD

儿童期和青年期的血压（BP）测量结果如下： 对未来水平的预测性低于中年人。 在 部分，这可能是由于这样一个事实，即在人的变化出现 在儿童期的总变异中所占的比例 成年 我们以前在NHLBI支持赠款方面的工作表明， 重复的血压测量和访问导致更高的童年 追踪三年内的相关性。 我们建议使用数据 在同一组339名儿童（入组时年龄为8-15岁）中， 跟踪了9-12年，将我们对BP跟踪的分析扩展到 跨越童年和青年的时期。 后续数据还 包括多次访问，这将减少大量的人内 BP测量的可变性和改善跟踪相关性。 在 此外，我们将通过以下方式提供“真实”或“校正”的跟踪相关性： 消除了随机测量误差的影响。 我们会研究 时变协变量对观测跟踪和真实跟踪的影响 相关性 除了计算跟踪相关性外，我们还打算计算预测相关性。 根据儿童时期的血压水平，年轻成人的血压值。 这是 年轻成人的真实血压高于特定临界点的概率 根据儿童时期的血压 这些值将使用数据进行验证 来自Fels纵向研究，其中包括连续BP测量 在我们研究的年龄范围内。 预测模型还将 推导出包括协变量（如年龄、性别、身高和 重量. 从这些模型中可以构建列线图， 对于医生用于预后目的是有用的。 因此，由于这些数据中使用了独特的多次访视方法， 可以消除随机测量误差的影响， 关于个人真实基础血压的陈述。 这些 方法学的改进可能会加强BP筛查的有用性 在儿童时期检测高血压的高危人群。

Blood pressure (BP) measurements in childhood and young adulthood are less predictive of future levels than those taken in middle age. In part, this may be due to the fact that within-person variability appears to make up a larger proportion of total variability in childhood than adulthood. Our previous work on an NHLBI supported grant has indicated that repeated BP measurements and visits lead to higher childhood tracking correlations over a period of 3 years. We propose to use data on the same cohort of 339 children (ages 8-15 at entry), who have been followed for 9-12 years, to extend our analyses of BP tracking to a period that spans childhood and young adulthood. The follow-up data also include multiple visits which will reduce the large within-person variability of BP measurements and improve the tracking correlations. In addition, we will provide "true" or "corrected" tracking correlations by eliminating the effects of random measurement error. We will examine the effect of time-varying covariates on both the observed and true tracking correlations. Besides computing tracking correlations, we intend to compute predictive values for young adult BP given childhood levels. This is the probability that a young adult's true BP is above a specific cutpoint conditional on childhood BP. These values will be validated using data from the Fels Longitudinal Study, which includes serial BP measurements over the age range in our study. The prediction models will also be derived including terms for covariates such as age, sex, height and weight. From these models nomograms can be constructed which would be useful to physicians for prognostic purposes. Thus, because of the unique multiple-visit approach used in these data, we can eliminate the effect of random measurement error, and make statements about an individual's true underlying blood pressure. These methodologic improvements may strengthen the usefulness of BP screening in childhood to detect those at high risk of developing hypertension.