儿童期血压升高与成年高血压和动脉硬化的关系:青少年队列30年随访研究

Association of elevated blood pressure in childhood with hypertension and arteriosclerosis in adulthood: a 30-year follow-up study of adolescent cohorts

摘要

目的 探讨儿童期血压升高对成年期高血压和动脉硬化的影响。方法 纳入1738名来自汉中青少年高血压队列参与者的30年随访纵向数据.儿童期血压升高定义为收缩压(SBP)/舒张压(DBP)≥«中国3~17岁儿童性别、年龄别和身高别血压参照标准»的第90百分位数,或SBP/DBP≥120/80mmHg;在3~18岁之间(1987年至1995年)至少2次达到上述标准.成年期的高血压定义为SBP≥140mmHg、DBP≥90mmHg,或自我报告正在服用降压药.在儿童期-成年期血压变化的分析中分为4个组:儿童期血压正常-成年期血压正常组,儿童期血压升高-成年期血压正常组,儿童期血压正常-成年期高血压组,儿童期血压升高-成年期高血压组.应用Logistic回归分析儿童期血压升高与成年期高血压和动脉硬化的关系。结果 Logistic回归分析显示:与儿童期血压正常组相比,儿童期血压升高组的成年期高血压和动脉硬化的发生风险更高(成年期高血压:OR=2.067,95%CI:1.603~2.664,P<0.05;成年期动脉硬化:OR=1.706,95%CI:1.351~2.154,P<0.05).与儿童期血压正常组相比,儿童临界高血压组和儿童高血压组的成年期高血压(OR=1.747,95%CI:1.290~2.366,P<0.05;OR=2.593,95%CI:1.875~3.587,P<0.05)、成年期动脉硬化(OR=1.787,95%CI:1.363~2.344,P<0.05;OR=1.588,95%CI:1.153~2.186,P<0.05)的发生风险更高.与儿童期血压正常-成年期血压正常组相比,儿童期血压升高-成年期血压正常组、儿童期血压正常-成年期高血压组、儿童期血压升高-成年期高血压组成年期动脉硬化的发生风险均显著升高(OR=1.580,95%CI:1.145~2.181,P<0.05;OR=18.521,95%CI:12.264~27.970,P<0.05;OR=15.922,95%CI:10.748~23.587,P<0.05)。结论 儿童期血压升高显著增加了成年期高血压和动脉硬化的风险,因此监测及控制儿童期血压对预防成年期高血压和动脉硬化至关重要.

Abstract

Objective To investigate the effect of elevated blood pressure in childhood on hypertension and arteriosclerosis in adulthood. Methods The 30-year follow-up longitudinal data of 1738 participants from the Hanzhong adolescent hypertension cohort were included. Elevated blood pressure in childhood is defined as systolic blood pressure (SBP)/diastolic blood pressure (DBP) ≥ the 90th percentile of the Chinese Reference Standard for Blood Pressure for Children Aged 3-17 Years by Sex, Age and Height, or SBP/DBP ≥ 120/80mmHg; Between the ages of 3-18 (1987 to 1995), meet the above criteria at least twice. Hypertension in adulthood is defined as SBP ≥ 140mmHg, DBP ≥ 90mmHg, or self-reported taking antihypertensive medications. In the analysis of changes in blood pressure from childhood to adulthood, they were divided into 4 groups: normal blood pressure in childhood-normal blood pressure in adulthood, elevated blood pressure in childhood-normal blood pressure in adulthood, normal blood pressure in childhood-hypertension in adulthood, and increased blood pressure in childhood-hypertension in adulthood. Logistic regression analysis was used to analyze the relationship between elevated blood pressure in childhood and hypertension and arteriosclerosis in adulthood. Results Logistic regression analysis showed that the risk of adult hypertension and arteriosclerosis was higher in the childhood hypertension group compared with the childhood hypertension group (adult hypertension: OR=2.067, 95% CI: 1.603-2.664, P<0.05; adult arteriosclerosis: OR=1.706, 95% CI: 1.351-2.154, P<0.05). Compared with the normal childhood hypertension group, the adult hypertension (OR=1.747, 95% CI: 1.290-2.366, P<0.05; OR=2.593, 95% CI: 1.875-3.587, P<0.05) and adult arteriosclerosis (OR=1.787, 95% CI: 1.363-2.344, P<0.05; OR=1.588, 95% CI: 1.153-2.186, P<0.05) were higher in the pediatric borderline hypertension group and the pediatric hypertension group. Compared with the normal blood pressure in childhood-normal blood pressure group, the risk of arteriosclerosis in the childhood hypertension-adult hypertension group, the childhood hypertension group, and the childhood hypertension-adult hypertension group were significantly higher (OR=1.580, 95% CI: 1.145-2.181, P<0.05; OR=18.521, 95% CI: 12.264-27.970, P<0.05; OR=15.922, 95% CI: 10.748-23.587, P<0.05). Conclusion Elevated blood pressure in childhood significantly increases the risk of hypertension and arteriosclerosis in adulthood, so monitoring and controlling blood pressure in childhood is essential to prevent hypertension and arteriosclerosis in adulthood.

关键词

高血压 / 动脉硬化 / 儿童期 / 成年期 / 队列研究

Key words

hypertension / arteriosclerosis / childhood / adulthood / cohort study

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基金资助

国家自然科学基金青年科学基金项目(82300502)

国家自然科学基金面上项目(82070437)