Trends in blood pressure in relation to obesity

描述(申请人提供)：高血压仍然是一个主要的公共卫生问题。一些研究支持这样的理论，即原发性高血压的根源可能追溯到童年。由于肥胖达到了流行的比例，而青年肥胖是青年高血压的最强预测因素之一，关于青年高血压患病率的长期变化的经验信息很少。目前关于这一年龄段血压长期趋势的数据很少，而且不一致。拟议对美国全国调查数据进行的为期两年的二级分析旨在解决这一问题，目的如下： 1.(A)描述6-17岁所有男孩和女孩的年龄调整后平均收缩压、舒张压和脉压的趋势以及年龄调整后的高血压患病率；(B)分别为非洲裔美国人和白人参与者描述这些趋势。 2.评估肥胖是否改变了这些趋势或部分解释了肥胖，如体重指数、三头肌与肩峰下皮褶厚度的比率和体脂百分比。 3.评估饮食和血液中的抗氧化剂水平是否改变或解释了血压与肥胖的相关性。 研究人群将由6至17岁参加NHES II至NHANES IV-阶段I调查(1963-2000)的参与者组成。这些调查是由国家卫生统计中心对全国范围内的概率样本进行的，基于复杂的多阶段样本设计，以提供对美国2个月及以上非制度化平民人口的健康和营养状况的全国性估计。将使用加权分析来获得有效的估计。 这项研究有可能对面对日益严重的青年肥胖症的全国青年高血压负担提供新的知识。研究可能表明与高血压有关的炎症性病因成分，从肥胖儿童的青年时期开始。研究结果将导致更精细的机械性研究，最终实现更好的量身定制干预措施。

DESCRIPTION (provided by applicant): Hypertension remains a major public health problem. Several studies support the theory that the roots of essential hypertension may extend back to childhood. With obesity reaching epidemic proportions and youth obesity being one of the strongest predictor of young adulthood hypertension, little empirical information is available on secular changes in the prevalence of hypertension in youth. Current data on secular trends of blood pressure in this age group are sparse and inconsistent. The proposed 2-year secondary analysis of the US national survey data addresses this issue with the following aims: 1. (a) To describe the trends in age-adjusted mean systolic blood pressure, diastolic blood pressure, and pulse pressure and the age-adjusted prevalence of hypertension for all boys and girls, 6-17 years of age; (b) To describe these trends separately for African-American and White participants. 2. To evaluate whether these trends are modified or partially explained by obesity, as assessed by body-mass-index, the ratio of triceps over subscapular skinfold thickness, and percent body fat. 3. To evaluate whether the correlation of blood pressure with obesity is modified or explained by dietary and blood antioxidant levels. The study population will consist of 6 to 17 year old participants in NHES II through NHANES IV-Phase I Surveys (1963-2000). These surveys were conducted by the National Center for Health Statistics on a nationwide probability sample, based on a complex multistage sample design to provide national estimates of health and nutritional status of the civilian noninstitutionalized population of the United States aged 2 months and older. Weighted analyses will be used to obtain valid estimates. This study has the potential to contribute new knowledge with respect to the national burden of hypertension in youth in the face of increasing youth obesity. Studies may suggest an inflammatory etiologic component associated with hypertension, which starts in youth in obese children. Research findings would lead to more refined mechanistic studies for ultimately better tailored interventions.