腰围动态变化与高血压发病关系的前瞻陛研究

目的 探讨腰围(WC)在随访过程中的动态变化对队列人群高血压发病率的影响.方法 采用前瞻性研究方法,以江苏省多代谢异常和代谢综合征综合防治研究队列满足2次随访的人群为研究对象.第一次随访时WC与基线WC之间的差值来衡量WC的动态变化量,并按照基线和第一次随访是否为腹型肥胖分为控制组和非控制组;以第二次随访是否为高血压作为结局变量(高血压=1,正常血压=0).运用Cox比例风险模型分析WC的变化量以及WC控制与否与随访新发高血压关系.结果 2778名研究对象中,660例为新发高血压患者.不论基线WC正常与否,WC水平在后两组的人群随访中发生高血压的RR值均高于第一组人群.基线WC正常组和腹型肥胖组中,非控制组的高血压累积发病率均高于控制组(基线WC正常组:35.0％vs.18.4％;基线腹型肥胖组:34.7％vs..21.4％).在基线腹型肥胖组中,其随访时仍为腹型肥胖的人群相比WC转为正常的人群发生高血压的RR值(95％CI)为1.95(1.19 ～ 3.19);基线WC正常组中,随访时转为腹型肥胖人群相比WC仍保持正常的人群发生高血压的RR值(95％CI)为2.38(1.89～2.99).调整基线性别、年龄和高血压一般危险因素后,基线腹型肥胖和WC正常组中,非控制组人群相比于控制组人群发生高血压的RR值(95％CI)分别为4.36( 1.69～9.74)和1.44( 1.03～2.35).结论 WC动态变化与高血压发病密切相关,控制WC的增长或降低WC是高血压早期预防的有效措施之一.     

体重控制与2型糖尿病发病前瞻性研究

目的 探讨体重控制情况与新发糖尿病(DM)的关系.方法 采用前瞻性研究方法,以江苏省多代谢异常和代谢综合征防治研究队列满足条件的人群为研究对象,比较随访体重控制在不同水平时DM的发病率,运用Cox比例风险模型分析体重控制情况与随访新发DM的关系.结果 3 168名研究对象中,有102例新发糖尿病患者;基线体重偏瘦组、正常组、超重组、肥胖组的DM累积发病率分别为3.4%、4.1%、5.5%、5.7%;基线体重正常、超重但随访转为肥胖的人群DM发病率分别为15.4%、7.2%,而随访体重保持或控制为正常的人群DM发病率仅为4.9%;多因素凋整后,以体重保持正常的人群为对照组,基线体重正常但随访转肥胖的人群发生DM的RR为4.09,95%CI为1.75～9.54,基线体重肥胖随访仍为肥胖的人群发生DM的RR为2.89,95%CI为1.54～5.42.结论 若随访人群的体重能有效控制,发生糖尿病的风险将会明显降低.     

浙江省海岛农村社区成年人代谢综合征发病率及其危险因素

目的估计浙江省海岛农村社区成年人代谢综合征发病情况, 探索该地区代谢综合征发病的相关影响因素。方法 2018年6-12月在浙江省玉环市对2012年开展的代谢综合征基线调查人群中无代谢综合征调查对象进行随访调查, 获取相关调查表信息以及实验室数据, 描述代谢综合征发病情况, 使用logistic回归探索发病危险因素及调整风险比(aRR)和95%CI。结果 3 162名随访对象中新发代谢综合征522例, 6年累积发病率为16.5%, 男女性累积发病率分别为12.3%、20.6%, 女性高于男性(P<0.001)。无业、吸烟、饮酒调查对象中代谢综合征发病率较高。女性(aRR=1.96, 95%CI:1.50～2.58)和高血压家族史(aRR=1.31, 95%CI:1.04～1.63)为代谢综合征发病独立危险因素。结论海岛农村社区成年人代谢综合征发病率相对较高, 其中女性以及有高血压家族史者发病风险更高。     

腰围和体质指数动态变化对高血压发病的影响

目的 探讨腰围(WC)和BMI在2年随访时间内的动态变化对队列人群高血压发病的影响.方法 采用前瞻性研究方法,于2002年1月,对江苏省多代谢异常和代谢综合征(MS)综合防治研究队列人群中随访时间满2年的5888名对象进行第1次随访,完成随访4582名,并于2006年3月对随访时间满5年及参与了第1次随访的对象进行了第2次随访,完成2次随访的对象共3847名,其中满足条件的共2778名基线血压正常对象被纳入分析.基线时WC或BMI正常者在第1次随访时变为非正常者以及基线WC或BMI不正常者在第1次随访时依旧不正常者定义为非控制组;基线WC或BMI非正常者在第1次随访时变为正常以及基线WC或BMI正常者在第1次随访时依旧保持正常者定义为控制组.以第2次随访时是否为高血压作为结局变量(高血压=1,正常血压=0).运用COX比例风险回归模型分析相互调整的WC和BMI差值与高血压发病的关系,以及按照WC和BMI控制与否分层的高血压发病风险,并计算相应的OR和RR值及95％ CI值.结果 2778名研究对象中,新发高血压660例.WC差值和BMI差值以连续型变量进入模型作相巨调整时,男女性中高血压发病与WC差值的关联仍具有统计学意义(男性:OR=1.04,95％ CI:1.01～1.05;女性:OR=1.04,95％CI:1.02 ～1.06),而与BMI差值的关联不再具有统计学意义(男性:OR=1.04,95％CI:0.97～1.11;女性:OR =0.98,95％ CI:0.93～1.03).不论基线WC正常与否,非控制组人群的高血压风险高于控制组人群(基线WC正常组:RR=1.41,95％ CI:1.01～2.39;基线WC非正常组:RR =4.41,95％ CI:1.66 ～9.80).而在基线BMI非正常组中,控制组与非控制组的高血压发病风险差异无统计学意义(RR=1.33,95％ CI:0.88 ～2.02).当WC得到控制,BM1控制与否对高血压发病风险无明显影响(男性:RR=1.03,95％ CI:0.36～2.96;女性:RR =1.02,95％ CI:0.70～5.85),WC未得到控制时,即使BMI得到控制,高血压发病风险仍会明显增加(男性:RR =4.03,95％ CI:1.61～10.09;女性:RR=1.55,95％ CI:1.13 ～3.60).结论 WC和BMI的控制均可降低高血压发病风险,而相比于控制BMI,控制WC对降低高血压风险的效果更好.     

中老年新发2型糖尿病患者合并高血压的现状和治疗

目的 了解我国中老年新发2型糖尿病合并高血压患者的现状及强化血压控制过程中的治疗策略.方法 回顾性分析中国2型糖尿病及其并发症预警干预的研究(chinese diabetes complication prevention study,CDCPS)Ⅰ期研究中年龄50-75岁新发2型糖尿病患者合并高血压的患病率和知晓率,根据血压控制方式分为4组(A组未用药;B组1种药;C组2种药:D组3种药),分析在第20次随访(第20个月)的血压情况与不同治疗方案的关系.结果 (1) 771例患者高血压患病率为48.4%.知晓率为81.0%.患病率随年龄增长而增加.(2)入组前高血压的治疗率为78.8%,入组后患者高血压的病程和血压水平与治疗方案的复杂性相关.除D组外,调整后的其余治疗方案均能使患者收缩压达到满意控制并基本维持稳定;舒张压也有下降趋势,但无明显统计学差异.随访第20次与基线相比,除D组舒张压外,所有组的收缩压及其余3组的舒张压均有显著下降(P<0.05).结论 中老年新发2型糖尿病患者中高血压的患病率较高.根据血压基线水平和高血压病程制定包括以生活方式指导为基础,以血管紧张素转换酶抑制剂(ACEI)或血管紧张素Ⅱ受体拮抗剂(ARB)为首选的1种或≥2种的降压药物治疗方案,均能使血压有进一步的下降并达到较满意的控制.     

血脂与高血压关系的前瞻性研究

目的 探讨基线血压正常者在随访期间发展为高血压的危险与基线时不同血脂变量水平的关系.方法 2000年4月建立年龄为34～74岁共8685人的研究队列,取得基线数据.2006年6月开始对其中基线调查满5年的对象进行随访;对进入随访、符合纳入标准且资料完整的2603名基线血压正常者在中位数随访6.38年期间发展为高血压的危险与基线不同血脂变量水平的关系进行分析.结果 基线血脂水平与随访期间高血压发生率之间有一定的联系,调整性别、年龄模型中,各血脂指标变量均与高血压有联系(趋势检验P<0.01);多变量调整模型中,HDL-C[αRR=0.71(95%CI:0.61～0.99)]、非HDL-C[αRR=1.28(95%CI:1.14～1.83)]、TC/HDL-C的比值[αRR=1.41(95%CI:1.25～2.03)]和TG[αRR=1.49(95%CI:1.30～2.13)]仍与高血压有联系(趋势检验P<0.05);进一步调整BMI后,减弱了各血脂指标变量与高血压联系的aRR,但aRR仍有统计学意义;用Cox模型调整基线SBP、DBP后各血脂指标变量与高血压关系的αRR有所降低,但HDL-C、TC/HDL-C比值、TG与高血压发病率仍有显著的联系.当剔除肥胖患者(BMl≥28)和已经诊断为糖尿病的这2个与高血压明显相关的危险因子后HDL-C(趋势检验P=0.01)、TG(趋势检验P<0.05)、非HDL-C(趋势检验P<0.05)和TC/HDL-C的比值(趋势检验P<0.05)仍然与高血压有联系.结论 血脂异常可能发生在高血压之前,即使排除了肥胖和糖尿病患者,或者调整了吸烟、饮酒甚至是基线SBP、DBP水平后,HDL-C、TC/HDL-C和TG仍与高血压有联系.     

基线总胆固醇水平对糖尿病人群新发脑梗死事件的影响

目的探讨基线总胆固醇水平对糖尿病人群新发脑梗死事件的影响。方法采用前瞻性队列研究方法,以空腹血糖≥7.0 mmo/lL或<7.0 mmo/lL但已确诊为糖尿病,正在使用降糖药物的8 306例糖尿病人群作为观察队列,随访(48.01±3.14)个月,随访期间每半年收集一次新发脑梗死事件情况。分析基线总胆固醇水平对糖尿病人群新发脑梗死事件的影响。结果 (1)随着基线总胆固醇水平的增高,研究对象的空腹血糖、甘油三酯、收缩压和舒张压的水平逐渐增高(P<0.05)。(2)总胆固醇<4.46 mmo/lL组累积发生脑梗死事件率最低(2.2%,P<0.05)。校正年龄、性别、空腹血糖、收缩压、舒张压、甘油三酯、体重指数、吸烟和糖尿病病程因素,Cox比例风险回归分析表明,相对于总胆固醇<4.46 mmo/lL组,总胆固醇≥5.93 mmo/lL组发生脑梗死事件的相对危险(RR)增加1.90倍(95%CI 1.24～2.89,P<0.01)。结论糖尿病人群总胆固醇控制在4.46 mmo/lL以下发生脑梗死事件率最低。     

2014—2017年浙江省中老年居民血清瘦素水平对血压值及高血压发病影响的队列研究

目的通过对浙江省非高血压居民的横断面调查和3年的随访研究,探讨不同性别人群血清瘦素水平与血压值及高血压发病之间的关系。方法于2014年12月,选取浙江省3个区县343名30～65岁的非高血压居民,进行体重、腰围、血压等体格检查和血脂、血清瘦素等血液指标的检测,追踪高血压的发病情况。2017年12月对入组人群再次进行体格检查和血液指标检测,比较新发高血压人群与非高血压人群血清瘦素水平的差异。通过Logistic回归,分析血清瘦素水平与高血压发病的关系。结果基线和随访结束时,女性血清瘦素水平均显著高于男性(P0.0001),男性血压平均值均高于女性(P0.05);随访结束时,新发了26例高血压,女性高血压发生组的血清瘦素水平高于非高血压发生组(P=0.0289),男性高血压发生组与非高血压发生组的血清瘦素水平差异无统计学意义;男性女性血清瘦素与体质指数(BMI)和腰围身高比(WHtR)呈显著正相关(P0.0001),与血压值也有一定的相关性,但校正了BMI或WHtR后,血清瘦素与血压值的相关性消失(P0.01);Logistic回归显示,校正了BMI和WHtR后,高血压发病风险显著下降。结论血清瘦素与血压值和高血压的发生无直接的联系,二者的正相关很大程度上可以用BMI和WHtR来解释。     

血压水平与代谢综合征关系

目的研究血压水平与代谢综合征（MS）的关系及其解相关影响因素。方法采用横断面研究方法,以2006年4月～9月黑龙江省电力医院体检职业人群共1 598人为研究对象,年龄在20～70岁。收集样本人群的相关信息、测量腰围、血压、血糖、血脂,并将各指标按照国际糖尿病联盟（IDF）标准分组。结果对血压水平与代谢综合征关系有意义的影响因素有性别、饮酒量、文化程度、体力活动及糖尿病家族史。代谢综合征患病风险随血压增高而增高,正常血压、高血压前期、高血压三组比值比以4倍递增,高血压组是正常血压组的17倍,1、2级高血压组间差异无统计学意义;单纯按收缩压及舒张压进行血压分类比较,结果可见,收缩压升高导致的代谢综合征患病风险增加的幅度较大;高血压前期组与正常血压组比较,随着血压的升高男性代谢综合征患病风险上升较明显,但高血压组与非高血压组比较,女性上升幅度较大。结论随着血压升高代谢综合征患病风险呈上升趋势,但在高血压人群其上升趋势不显著。不同性别其上升幅度不同。     

某高校大学新生血压偏高与高尿酸血症的关系

探讨大学新生正常高值血压、高血压现状及其与高尿酸血症的关系,为高校高血压早期预防和控制提供科学依据.方法 采用整群抽样法,于2015年9月对江汉大学4 333名入学新生进行血压及血尿酸测定,比较不同性别大学新生正常高值血压及高血压患病率,分析高尿酸血症与血压的关系.结果 大学新生正常高值血压、高血压患病率分别为32.40%和3.21%,男生患病率(49.73%,5.62%)均明显高于女生(17.14%,1.09%),差异均有统计学意义(x2值分别为522.995,71.412,P值均<0.01);高尿酸血症组正常高值血压及高血压患病率明显高于血尿酸正常组(P值均<0.01);正常血压组、正常高值血压组及高血压组高尿酸血症患病率分别为3.12%,14.67%和46.76%,差异有统计学意义(P<0.01).结论 高尿酸血症与血压偏高的发生密切相关,监测和控制血尿酸水平有助于预防高血压及心血管疾病的发生.     

Pilot study of potential barriers to blood pressure control in patients with inadequately controlled hypertension

BACKGROUND: Most people with high blood pressure (BP) are managed in primary care, but BP control is often inadequate. OBJECTIVES: To examine potential barriers to adequate BP control in patients with poorly controlled hypertension. DESIGN: Cross-sectional survey. SETTING: Computerized inner city general practice. PARTICIPANTS: A total of 155 hypertensive patients aged 50-80 years with last recorded BP > or =150/90 mm Hg (or > or =140/85 mm Hg if diabetic). METHODS: Patients were invited to attend a nurse-led clinic where BP was measured according to a standardized protocol and patients were asked to complete a semi-structured questionnaire including lifestyle, compliance with treatment and knowledge about hypertension. Details of BP reviews were obtained from medical records. RESULTS: A total of 110 patients (71%) with a mean age of 65 years attended the nurse-led clinic of whom 27% were of African origin. Of those who attended, 52 (47%) had adequately controlled BP when measured according to protocol. The remaining 58 (53%) had inadequately controlled BP. Of patients on treatment, 94% (83/88) reported taking it at least 6 days a week. Only 9% of patients knew their target BP and only 39% that treatment aims to prevent stroke or heart attack. Patients with diabetes were more likely than those without to have BP > or = audit standard (79% 26/33 versus 42% 32/77, P < 0.001). CONCLUSION: About half of apparently uncontrolled hypertensive patients had BP below target when measured according to standard methods. Reported compliance was good, but patient knowledge of target BP was poor. Patients with diabetes were more likely than those without to have inadequately controlled BP.     

Progression from prehypertension to hypertension and risk of cardiovascular disease

Background

Subjects with prehypertension (pre-HT; 120/80 to 139/89 mm Hg) have an increased risk of cardiovascular disease (CVD); however, whether the risk of pre-HT can be seen at the pre-HT status or only after progression to a hypertensive (HT; ≥140/90 mm Hg) state during the follow-up period is unknown.

高血压患者治疗后血压昼夜节律及影响因素的调查

目的了解高血压病患者经治疗血压达标后血压昼夜节律及影响因素.方法采用横断面调查的方法,采用进入法进行非条件logistic回归分析.结果共纳人208例患者,呈勺型曲线者79例(占38%),非勺型曲线者129例(占62%).logistic回归分析显示,年龄在70岁以上及60～69之间者24 h动态血压曲线呈非勺型的比例分别是60岁以下者的3.3倍(P=0.009)和2.3倍(P=0.031);有早发心血管疾病家族史的患者,其动态血压曲线形态呈非勺型的比例为无相应家族史患者的3.7倍(P=0.029);超重(BMI＜28)与肥胖(BMI≥28)者24 h动态血压曲线呈非勺型的比例分别是正常体重(BMI＜24)者的3.0倍(P=0.003)和4.8倍(P=0.009);与单独应用长效钙离子拮抗剂(CCBs)治疗相比,单用血管紧张素转换酶抑制剂(ACEIs)或血管紧张素Ⅱ受体阻滞剂(ARBs)治疗者动态血压曲线呈非勺型的机会较少(OR=0.139,P=0.010),采用包含ACEIs或ARBs(但不包括利尿剂)的联合用药方案的患者有较少非勺型曲线的趋势,但二组之间差异无显著性(OR=0.453,P=0.118);采用包括利尿剂(但无ACEIs或ARBs)的联合用药方案以及同时包含利尿剂与ACEIs或ARBs的联合用药方案的患者均有较少非勺型曲线的机会(OR值分别为0.378和0.273,P值分别为0.030和0.011).结论高血压患者经治疗血压达标后,有近三分之二的患者呈异常的血压昼夜节律.年龄、早发心血管疾病的家族史、超重或肥胖、降压药物治疗方案等4个因素与24 h血压曲线形态有关.与单用长效CCBs比较,利尿剂、ACEIs或ARBs可能有利于保持正常的血压昼夜节律.     

Periodic cohort health examinations in the TAMRISK study show untoward increases in body mass index and blood pressure during 15 years of follow-up

ABSTRACT: BACKGROUND: Obesity is a significant risk factor for hypertension and diabetes. A cohort of 50-year-old voluntary periodic health examination (PHE) participants was analyzed 15 years retrospectively. Our aim was to evaluate changes in body mass index (BMI) and blood pressure in subjects diagnosed with hypertension and/or diabetes in comparison with healthy controls. METHODS: Voluntary periodic health examinations (PHE) of the citizens have been carried out by the city of Tampere, Finland. Health data, including body mass index (BMI) and blood pressure, were recorded every five years, starting at the age of 35 (baseline). A total of 339 subjects from the 50-year-old cohort having hypertension and/or diabetes were chosen to the study group. The control group included 604 subjects from the 50-year-old cohort who had the same follow-up information but were not diagnosed with hypertension and/or diabetes. RESULTS: In the study group the mean BMI had increased from 26.1 at baseline to 28.5 at the final 15-year follow-up examination. The corresponding increase in the control group was from 23.8 at baseline to 25.5 at the final follow-up. The difference in change with time between the groups was statistically significant (p = 0.04). On the average, the controls gained 4.9 kilograms, whereas subjects in the study group gained 7.0 kilograms over the 15 years of follow-up. Systolic and diastolic blood pressures were also higher in the study group already at baseline and systolic blood pressure increased with time more in the study group than in the control group (p = 0.004). CONCLUSIONS: BMI and blood pressure were higher in the study group in comparison with the controls already at baseline at 35 years, and the differences were not favorably changed during the follow-up. Apparently, the effect of PHE had not been as efficient as planned on subjects in the study group, who were already slightly overweight at baseline.     

A survey of blood pressure in the state of Maryland

To provide baseline data for a state program to coordinate hypertension resources, a blood pressure (BP) survey was undertaken in Maryland in 1978. A statewide probability sample of households was chosen; each adult member was eligible for interview and measurement of BP. A total of 6,425 adults were interviewed for an overall response rate of 79.5%. Using a definition of diastolic blood pressure (DBP) of 95 mm Hg or higher or use of antihypertensive medication, 15.1% of state residents were estimated to be hypertensive. Of these, 85.8% were estimated to be aware of their condition, 77.6% of them were treated, and 67.6% had their BP controlled to a normal level by medication. Data are also presented using DBP 90 mm Hg or higher. A comparison of data from the Hypertension Detection and Follow-up Program (HDFP) home screen in 1973–1974 and comparable information from this survey showed lower rates of awareness, treatment, and BP control in hypertensives at HDFP home screen. Results of this survey will be compared with those of a second statewide survey conducted four years later to assess changes in rates of hypertension awareness, treatment, and control.     

Prevalence, awareness, treatment, and control of hypertension in Japanese rural communities]

BACKGROUND: In Japan, a national survey indicated that only 7% of hypertensive patients had a blood pressure less than 140/90 mmHg. There have been no reports of studies investigating all of the prevalence of hypertension, the percentage of subjects who are aware of hypertension, the percentage being treated, and the percentage that are well-controlled (awareness, treatment and control, respectively) among hypertensives in the Japanese general population. OBJECTIVE: To investigate the prevalence of hypertension, and awareness, treatment and control of hypertension among hypertensives in a Japanese rural population. DESIGN: A cross-sectional analysis of base-line data of the Jichi Medical School Cohort Study. SETTING: Twelve rural communities is 8 prefectures in Japan. PARTICIPANTS: Community-dwelling people who participated in the health examination program in 1992-1995. MAIN OUTCOME MEASURES: Blood pressure (BP) measured once in the sitting position after a 5-minute rest using oscillometric automatic BP monitors (BP203RV-II; Nippon Colin, Japan), and history of hypertension assessed using a self-administered questionnaire. RESULTS: We analyzed data from 11,302 subjects (4,415 men and 6,887 women). The mean (standard deviation) age was 55(12) years for men and 55(11) years for women. Mean systolic BP and diastolic BP levels were, respectively, 131(21) mmHg and 79(12) mmHg for men and 128(21) mmHg and 76(12) mmHg for women. Prevalence of hypertension (systolic BP > or = 140 mmHg or diastolic BP > or = 90 mmHg or on antihypertensive medication) was 37% for men and 33% for women. Percentages for awareness (on medication or present past history), treatment and control (both systolic BP < 140 mmHg and diastolic BP < 90 mmHg) were, respectively, 39%, 27% and 10% for men and 46%, 38% and 13% for women. CONCLUSIONS: About one third of the study popUlation were hypertensive, and awareness, treatment and control of hypertension among the hypertensives were 43%, 34% and 12%, respectively. Less than half of the hypertensives were well-controlled even when measurement bias was considered. In the rural Japanese population, improvements are required with regard to awareness, treatment and control of hypertension.     

高血压与男性性功能障碍发生风险的前瞻性队列研究

目的探讨高血压与男性性功能障碍发病风险的关系。方法采用前瞻性队列研究方法,随机抽取2015年中国人民解放军联勤保障部队第九二三医院进行健康体检的30~40岁已婚男性1000例进行基线调查,实际调查892人,有效应答率89.2%,剔除不符合调查条件者78例,最终可纳入研究对象为814例。按基线调查有或无高血压情况分为高血压组和正常血压组。随后开展3年随访,并剔除在随访中新发影响性功能的器质性疾病者、随访期服用降压药者、失访者,共135例。最后可纳入数据统计分析共679例。采用Cox模型分析高血压与男性性功能障碍发病风险比及95%可信区间(95%CI)。结果高血压组177例(26.07%),正常血压组502例(73.93%)。开展3年随访发现高血压组患者的性功能障碍发生率为48.58%,明显高于正常血压组的15.54%,差异有统计学意义(P<0.05)。Cox回归单因素结果显示,高血压组性功能障碍发病风险是正常血压组的2.056倍;调整高血压患者的年龄、BMI、饮酒、吸烟、职业类型、夫妻关系、高血脂症史和糖尿病史因素后,Cox回归多因素分析结果显示,高血压组性功能障碍发病风险是正常血压组的3.133倍。结论高血压是增加男性性功能障碍发生风险的危险因素,临床中应密切关注男性高血压患者的情况,并及早采取措施预防或避免性功能障碍发生。     

儿童期体重状态及其变化与血压偏高发生风险的关系

目的 探索儿童期体重状态及其变化与血压偏高发病风险的关系,为儿童高血压的防控提供依据。方法 数据来源于在2012—2018年间,基于自贡市开展的“自贡基于学校的心血管代谢风险队列研究”。本研究纳入至少接受2次调查;在基线（第一次调查）和随访（最后一次调查）时血压,身高,体重等信息完整;且在基线时血压正常的儿童。使用中介效应模型探索随访体质量指数(body mass index, BMI)在基线BMI与随访血压水平关系中的中介效应。运用logistic模型探索基线和随访时体重状态的变化与随访时血压偏高的关系。结果 基线时,5087名儿童平均年龄为8.9岁,男性占58.9%。在2年的中位随访时间后,血压偏高的发病率（95%置信区间）为8.5%(7.8%~9.3%)。在控制其它混杂因素后,基线BMI与随访收缩压和舒张压的总效应均有统计学意义（Ps<0.001）,但随访BMI的中介作用分别占73.6%和97.2%。相对于基线和随访时体重均正常的儿童,基线及随访持续超重肥胖（OR=2.592,P<0.001）及基线正常但随访超重肥胖的儿童（OR=1.649,P=0.013）更容易发生血压偏高;而基线超重肥胖但随访体重正常儿童发生血压偏高的风险没有增加（P=0.195）。结论 高BMI与儿童血压水平升高有关。基线超重肥胖但随访体重正常儿童相对于基线和随访体重均正常的儿童,血压偏高的发生风险没有增加。