内蒙古地区儿童青少年学生血压水平及相关因素分析

目的:研究内蒙古地区健康儿童青少年学生血压(BP)情况及其影响因素.方法:采用整群随机抽样方法,经体检确定为健康的5 363名10～18岁在校的儿童、青少年学生进行血压、身高、体重的测定,分析其相关关系.结果:儿童青少年学生的血压随着年龄、体重而升高,其中男生的血压高于女生,血压偏高者的收缩压(SBP)、舒张压(DBP)、体重、身高和BMI值均显著高于血压正常者(P＜0.01),pearson相关分析显示,男女学生收缩压与身高、年龄、体重、BMI值、舒张压水平呈正相关(P＜0.01).结论:内蒙古地区儿童青少年学生的血压水平随着性别、年龄、体重、身高而改变;儿童、青少年学生血压偏高的问题应引起重视,体重偏高或肥胖者应注意控制体重,以降低患原发性高血压的危险性.     

Study of blood pressure profile of school children 6–15 years in a rural setting of Maharashtra

Background

High blood pressure in childhood is a major risk factor for heart disease and stroke in adulthood. There is enough evidence to suggest that the roots of essential hypertension in adults extend into childhood. There is a paucity of literature on the blood pressure measurements amongst children. This study was done to study blood pressure profile of school children in rural area of Maharashtra.

Aim & objectives

This cross sectional study was carried out to determine the prevalence of hypertension in children 6–15 years and to study the association between selected variables and blood pressure.

Material & methods

This study was done using a predesigned questionnaire and making measurements of height, BMI and Blood pressure using standardized physical instruments following standard guidelines. The data was collected and analyzed using appropriate statistical tests.

Results

The prevalence of hypertension in the study was found to be 4.4% with 3.5% in females and 5.1% in males.

Conclusion

In the study, hypertension in students was found to be significantly associated with higher BMI and with family history of hypertension. Age, height and BMI were found to correlate positively with Blood pressure levels in this study.     

Study of blood pressure profile of school children 6–15 years in a rural setting of Maharashtra

Background

High blood pressure in childhood is a major risk factor for heart disease and stroke in adulthood. There is enough evidence to suggest that the roots of essential hypertension in adults extend into childhood. There is a paucity of literature on the blood pressure measurements amongst children. This study was done to study blood pressure profile of school children in rural area of Maharashtra.

Aim & objectives

This cross sectional study was carried out to determine the prevalence of hypertension in children 6–15 years and to study the association between selected variables and blood pressure.

Material & methods

This study was done using a predesigned questionnaire and making measurements of height, BMI and Blood pressure using standardized physical instruments following standard guidelines. The data was collected and analyzed using appropriate statistical tests.

Results

The prevalence of hypertension in the study was found to be 4.4% with 3.5% in females and 5.1% in males.

Conclusion

In the study, hypertension in students was found to be significantly associated with higher BMI and with family history of hypertension. Age, height and BMI were found to correlate positively with Blood pressure levels in this study.     

动脉导管未闭封堵术后即刻血压变化研究

目的：探查动脉导管未闭介入封堵手术后血压的急性变化规律。方法连续收录2009年10月-2012年12月间于大连医科大学附属第一医院住院拟行动脉导管未闭介入封堵手术的住院患者54例,根据年龄将患者分为儿童组（≤16岁,29例）和成人组（＞16岁,25例）,在介入手术过程中通过股动脉鞘管监测实时血压,通过右心导管测量肺动脉压力。分析比较不同年龄组血压的变化规律及其可能的相关因素。结果（1）均成功行经皮穿刺动脉导管未闭封堵术。24例合并不同程度的肺动脉高压,肺动脉平均压14～58 mmHg。主动脉造影显示动脉导管：41例呈漏斗型,11例呈管型,2例呈不规则型,最窄处内径1.9～9.7 mm。（2）成人组基线和术后即刻股动脉压力水平及升高的幅度显著高于儿童组（P＜0.01）,平均血压增高18.5％（儿童组13.6％,成人组23.0％,P＝0.001）。（3）术后即刻血压水平与年龄、基线血压水平密切相关（r＝0.881和0.867,P＜0.01）。结论动脉导管未闭介入封堵术后即刻所有患者血压均增高,增高幅度与年龄及基线血压水平密切相关。     

血压变化特征与急性脑卒中患者的相关性分析

目的分析动态血压变化特征及急性脑卒中志者血压影响因素。方法41例发病在7d内的急性脑卒患者。记录患者住院病室血压及24h动态血压。血压≥140／90mmHg为病室血压升高124h动态血压平均值〉130／80mmHg,日间平均值〉135／85mmHg,夜间平均值≥125／75mmHg为动态血压升高。结果既往有高血压病史对急性脑卒中患者病室血压有影响（P〈0．05）。有高血压病史者平均病室血压（146．02±18．89）／（86．36±11．52）mmHg,无高血压病史者平均病室血压（136．22±14．63）／（82．61±11．86）mmHg,二者收缩压水平差异有里著性意义（P〈0．05）。急性脑卒中患者动态土压表现为夜间血压升高,24h平均血压在发病后4～5d明显升高,6～7d降低。结论急性脑卒中病室血压升高与高土压病支有关,怠性脑卒中随发病时间延长,血压呈下降趋势。     

巴马地区壮族长寿家系血压水平及高血压患病率调查

目的：了解广西巴马地区壮族长寿家系血压水平和高血压患病率状况。方法：对巴马地区壮族长寿家系1362位家庭成员进行血压水平、体重、身高、体重指数等测定,并统计高血压患病率,然后与当地非长寿家系597人、其它地区长寿家系282人及非长寿家系725人的结果分别按家系、年龄段和性别进行比较。结果：巴马地区长寿家系的收缩压（SBP）、舒张压（DBP）和高血压患病率与本地区非长寿家系无明显差异（P〉0．05）,但均高于对照地区的长寿家系和非长寿家系人群（均P〈0．01）,而且其男性和女性的SBP、DBP水平和高血压患病率均明显高于对照地区（均P〈0.01）;男性的DBP水平和患病率均明显高于同家系女性（均P〈0.01）,但SBP无明显区别（P〉0．05）。年龄段比较显示,两地区长寿家系和非长寿家系的SBP水平、DBP水平和高血压患病率均随年龄增高而呈现升高的趋势;除80～岁等少数年龄段外,巴马地区长寿家系其它年龄段的SBP水平和高血压患病率均明显高于对照地区。结论：巴马地区壮族长寿家系的血压水平和高血压患病率较高,可能与饮食习惯和饮食结构的改变有关,其深层的机制有待进一步研究。     

Blood pressure control among type 2 diabetics

OBJECTIVE: To assess blood pressure (BP) control in patients with diabetes mellitus type 2 (DM type 2) treated in primary health care. METHODS: A cross-sectional study was conducted in primary health care at King Fahad Military Complex Hospital in Dhahran, Kingdom of Saudi Arabia, between August 2003 and February 2004, to assess blood pressure control in type 2 diabetics. A sample of 403 medical records of type 2 diabetic patients was selected using systematic random sampling after ordering the medical record numbers. The data were collected through a pre-coded checklist. RESULTS: Hypertension was found in 57.8% of diabetic patients with no statistically significant difference between males and females. The mean age of diabetic patients was significantly higher in hypertensives than non-hypertensives (p=0.001). The mean duration of hypertension was significantly higher in females (p=0.02). There were only 14.2% of hypertensive diabetic patients in whom blood pressure was controlled. Poor control was significantly associated with obesity, and a higher rate of complications. Blood pressure control correlated positively and significantly with the age of patients, and negatively with duration of diabetes and hypertension. The most commonly prescribed antihypertensive were angiotensin converting enzyme inhibitors in 29.3%, followed by angiotensin receptors blockers in 24.1%, and the least prescribed drug was thiazide diuretic. CONCLUSION: Blood pressure in diabetic patients needs to be given particular attention from all health care professionals, especially primary care family physicians, who should follow the new guidelines for better control of blood pressure, and fewer complications. Patient's awareness should be increased, through continuous health education with different modalities.     

学龄前儿童社区血压管理模式研究

背景　儿童期高血压流行率逐年增加,儿童期高血压会给人体带来长期的健康风险。儿童期高血压通常没有症状,早期诊断和治疗是关键。目前针对学龄前儿童的高血压监测管理模式尚不明确。目的　探索一种简单可行的学龄前儿童社区血压管理模式。方法　采用2010年《中国儿童青少年血压参照标准的研究制定》中血压测量方法及诊断标准,依托社区卫生服务中心于2018年1-7月对辖区内幼儿园共382名学龄前儿童进行血压筛查。根据筛查结果对不同血压水平儿童进行分类管理。结果　基于筛查结果共判定高血压儿童42名（11.0%）、正常高值血压儿童38名（9.9%）、正常血压儿童302名（79.1%）。分类管理：对42名高血压儿童进行两次复测,4名失访。将3名三次测量后均为高血压者输送至上游医院心内科门诊进行临床诊断及治疗;将筛查及复测后回落至正常高值血压的儿童（47名,12.3%）依照生活行为问卷进行生活行为干预;将328名（85.9%）血压正常儿童纳入社区卫生服务中心常规管理。该社区学龄前儿童的高血压知晓率和管理率为90.5%（38/42）。该社区男童平均收缩压和舒张压分别为（98±9） mm Hg和（55±8）mm Hg,女童分别为（95±9）mm Hg和（55±7）mm Hg,男童收缩压高于女童（P=0.001）,舒张压差异无统计学意义（P>0.05）。结论　社区血压管理模式可针对不同血压水平的学龄前儿童进行分类管理,尤其能提前发现高血压儿童并输送至临床,对高血压儿童的早发现早治疗具有重要意义。     

Obesity in Indian children: time trends and relationship with hypertension

BACKGROUND: Limited data are available from India regarding the distribution and profile of childhood obesity and hypertension. We examined the time trends in childhood obesity in a representative sample of schoolchildren from Ernakulam District, Kerala and determined the relationship of obesity with blood pressure. METHODS: We used a stratified random cluster sampling method to select the children. Anthropometric data were collected from 24 842 students, 5-16 years of age, during 2003-04. Blood pressure and anthropometric data were collected from 20 263 students during 2005-06. Overweight and obesity were defined by body mass index for gender and age. Gender, age and height were considered for determining hypertension. RESULTS: The proportion of overweight children increased from 4.94% of the total students in 2003 to 6.57% in 2005 (OR: 1.36; 95% CI: 1.25-1.47; p < 0.0001). The increase was significant in both boys and girls. The proportion of overweight children was significantly higher in urban regions and in private schools, and the rising trend was limited to private schools. Systolic or diastolic incident hypertension was found in 17.34% of overweight children versus 10.1% of the remaining students (OR: 1.87; 95% CI: 1.60-2.17; p < 0.0001). CONCLUSION: Childhood obesity showed an increasing trend in a short period of 2 years. Hypertension was common in overweight children. The results suggest the need for greater public awareness and prevention programmes on childhood obesity and hypertension.     

长沙市青春期儿童肥胖与血压的关系

目的:了解长沙市青春期儿童肥胖与血压的关系,为预防青春期儿童高血压提供依据。方法:采用随机整群抽样方法,随机抽取长沙市18所中学生,对其初一至高二的全部学生进行血压和体格测量,并进行血压和营养状况的评价。结果:(1)18922名12～17岁儿童青少年中,检出患高血压者1276人,占6.7%,男、女生检出率分别为7.6%和5.8%;(2)肥胖组各个年龄段收缩压和舒张压平均水平均显著高于同性别同龄儿童的收缩压和舒张压平均水平,且差异有显著性。(3)男、女生和所有儿童合计分析,均显示肥胖组儿童的高血压检出率明显高于对于对照组,且差异有显著性。结论:长沙市12～17岁青春期儿童高血压发生率处于中等水平;青春期儿童血压水平与肥胖密切相关,肥胖是青春期儿童高血压的重要危险因素。     

老年高血压患者动态血压分析

目的;探讨老年高血压患者的动态血压特征及意义。方法;采用无创性动态血压监护仪,对１００例老年和７５例老年前期（年龄４０￣６０岁）进行２４ｈ动态血压观察,其中老年高血压者５５例,老年血压正常者４５例,老年前期高血压者４０例,老年前期血压正常者３５例。结果：各期高血压组的收缩压和舒张压的昼夜血压,日间血压,夜间血压及血压负荷的明显高于健康对照组（Ｐ〈０．０５）,高血压组血压波动范围与健康对照组无明显差     

食蟹猴自发性高血压及患病危险性的相关性研究

目的建立各年龄段食蟹猴血压参考值。方法采用美国Beckman-CX4全自动生化分析仪和北京松下电工有限公司的腕式电子血压计,检测521只食蟹猴血压及血脂指标,对测定结果进行统计检验。结果经统计分析,不同年龄段的食蟹猴血压值差异显著,老年组食蟹猴血压值高于其它年龄组;老年组食蟹猴高血压的发病率高于其他年龄组,高血压组食蟹猴身体质量指数(body mass index,BMI)高于同年龄组血压正常的食蟹猴;老年组高脂血症食蟹猴高血压发病率高于其他年龄组。Logistic回归分析显示,年龄、BMI及高脂血症在预测高血压组的患病危险性的预测能力分别为血压正常组的1.435、1.218、2.337倍。结论初步建立不同年龄段食蟹猴的血压参考值。年龄、BMI、高脂血症为食蟹猴自发性高血压的危险因素,基础血压值测量为食蟹猴自发性高血压模型筛选及其相关研究提供了依据。     

The ethnic prevalence of hypertension in a diabetic clinic

Using the WHO criteria of hypertension, we have demonstrated that 40% of randomly selected diabetic clinic attenders under the age of 65 were hypertensive. Black diabetics had a significantly greater prevalence (P less than 0.001) of hypertension than either white or Asian diabetics. Hypertension was commoner in black and white females compared with males (P less than 0.001); in Asians this difference was not statistically significant. Systolic hypertension was the most common form in all ethnic groups. Only 38.7% of diabetics receiving antihypertensive therapy had normal blood pressure readings. Blood pressure measurement should therefore be routinely performed in all diabetic patients under the age of 65, particularly in females of all ethnic groups and in black males.     

血管紧张素原M235T基因多态性与原发性高血压的相关研究

目的:探讨浙江汉族人群中血管紧张素原(AGT)基因M235T变异与原发性高血压的关系.方法:对116例高血压病患者与114名正常血压者进行对照研究.采用聚合酶链式反应(PCR)与限制性片段长度多态性(RFLP)技术检测AGT基因M235T变异.同时测量血压、身高、体重、空腹血糖与血脂.结果:①高血压组收缩压与舒张压水平显著高于对照组(P＜0.01);而两组间年龄、性别、体重指数、血糖与血脂差异无显著性(P＞0.05).②经PCR扩增及Tth 111 I酶切,AGT基因型有三种形式:MM、TT与MT基因型.两组AGT基因型的分布均符合Hardy-Weinberg 平衡.③AGT基因M235T基因型在高血压组与对照组的分布差异有显著性(χ2=6.966,P＜0.05).高血压组TT基因型与T235等位基因的频率高于对照组(TT基因型:0.47 vs 0.33,χ2=5.36,P＜0.05;T235等位基因:0.71 vs 0.60,χ2=6.179,P＜0.05).结论:在浙江汉族人群中,AGT基因M235T变异与原发性高血压的发病显著相关,TT基因型或T235等位基因可能是高血压的一个遗传方面的危险因素.     

Clinical aspects of hypertension in children

The importance of measuring blood pressure routinely in children over 3 years, and in specific circumstances in younger children, is increasingly recognized. The incidence of pediatric hypertension is relatively high, its prevalence increasing, and high blood pressure tends to track into adulthood. Interpretation of a blood pressure measurement requires knowledge of sex-, age-, and height-specific normative values. Blood pressure is classified as normal if < 90th percentile, and high if > 95th percentile, and as prehypertension if 90-95th percentile. The methods available to measure blood pressure together with their advantages and disadvantages, as well as pitfalls in measurement, are discussed. Also discussed is Ambulatory Blood Pressure Monitoring which may define if there is "dipping", i.e. a decrease in blood pressure by > 10% during sleep, a novel parameter that may help identify children at risk of sustained hypertension or its complications. Signs, symptoms and physical findings of the child with hypertension are reviewed.     

老年原发性高血压患者血压变异性及其对血管内皮功能的影响

目的 探讨老年高血压病患者血压波动的程度及其对血管内皮细胞功能的影响.方法 随机选择2009年1月～2012年12月上海市浦东新区浦南医院年龄≥60岁的老年高血压患者65例（高血压组）和老年健康体检者52例（对照组）,以动态血压监测仪监测24 h血压变化,检测血浆血浆血管性血友病因子（vWF）、一氧化氮（NO）和内皮素-1（ET-1）水平.结果 高血压组昼间、夜间及24h收缩压变异性显著高于对照组（P=0.000）;高血压组血浆vWF水平显著高于对照组[（820.1±108.2）U/L比（648.4±128.3）U/L,P=0.000],ET-1水平明显高于对照组[（99.6±12.3）ng/L比（80.1±10.9）ng/L,P=0.000],而NO水平明显低于对照组[（42.0±6.6） μmol/L比（52.8±8.4） μmol/L,P=0.000],老年高血压组血浆vWF水平与24h收缩压变异性呈现显著正相关（r=0.518,P=0.006）.结论 老年高血压病患者血压变异性显著增高,并伴有血浆vWF、ET-1水平升高,提示内皮功能损害.     

24小时动态血压监测对中青年高血压病诊断探讨

目的：探讨２４ｈ动态血压监测（２４ｈＡＢＭＰ）对中青年正常血压及高血压分级的诊断参数以及２４ｈ血压波动规律的应用价值。方法：采用无创性携带式动态血压监测仪检测２０例正常中青年人及１７２例中青年高血压患的动态血压（ＡＢＰ）。根据ＷＨＯ／ＩＳＨ标准进行分级，１７２例中，高血压Ⅰ级５２例，Ⅱ级６０例，Ⅲ级６０例，将２４ｈＡＢＰＭ提供的血压参数进行统计学处理，并对血压波动规律进行分析。结果：正常血压组与     

缬沙坦与吲达帕胺联合用药对原发性高血压患者动态血压及胰岛素敏感性的影响

目的：探讨缬沙坦与吲达帕胺联合应用对原发性高血压（EH）患者动态血压及胰岛素敏感性的影响。方法：对65例EH患者于治疗前和治疗24周后分别进行动态血压监测（ABPM）和胰岛素敏感性测定。结果：治疗后24h平均pSB、pDB，血压负荷较治疗前均显著降低（P＜0．01）。治疗后血压昼夜节律消失者8例，较治疗前42例显著减少（P＜0．01）。治疗后各时点胰岛素与血糖比值（I／G）均明显下降（P＜0．01），治疗后胰岛素敏感指数（ISD）显著增高（P＜0．01）；治疗后葡萄糖 耐量试验120min和180min两个时点C／I比值比治疗前显著增高（P＜0．01－0．05）。结论：缬沙坦与吲达帕胺联合应用可显著降低EH患者动态血压水平和血压负荷，改善血压昼夜节律，显著改善胰岛素敏感性。     

查体职工血压水平与心电图改变的相关性分析

目的观测不同年龄组查体职工的血压水平及其与心电图异常改变的关系。方法将6498名查体职工按年龄分为两组：23～44岁为青年组（3652名）;45岁以上为中老年组（2846名）。对比两组及组内的血压水平,以及血压水平与心电图异常改变之间的关系。结果中老年组的高血压患病率明显高于青年组（P〈0.01）,青年组男、女性高血压患病率具有显著性差异（P〈0.05）。中老年组异常心电图检出率明显高于青年组（P〈0.01）;组内男、女性的异常心电图总检出率比较差异不显著（P〉0.05）;高血压者临床心电图异常检出率显著高于非高血压者（P〈0.01）。结论血压水平随年龄增长而增高。随着血压升高,临床心电图异常检出率明显增高,定期心电图检查对心脑血管疾病的防治具有重要意义。     

原发性肾病综合征儿童交感活性 与24 h动态血压的关系

目的：探讨原发性肾病综合征（PNS）患儿动态血压（ABP）的异常变化和交感神经系统（SNS）活性及两者之间的关系。方法：对114例PNS儿童测ABP和随机血压（CBP）,24 h尿去甲肾上腺素(NA)、肾上腺素(A)和多巴胺（DA）水平,并与ABP进行相关分析。结果：114例PNS儿童动态血压升高101例（88.6%）,轻重度隐匿性高血压45例（39.5%）,非杓型血压80例(70.2%)。收缩压（SBP）指数与负荷大于舒张压（DBP）。24 h尿NA,A和DA水平高于正常健康对照儿童。SNS水平与血压指数、血压负荷呈明显正相关,与夜间下降率呈明显负相关。结论：24 h动态血压监测发现PNS儿童高血压发病率高,非杓型血压、隐匿性高血压比例高;可以建立重度隐匿性高血压分类法;PNS儿童交感活性明显升高,可能是促使血压水平、血压负荷升高和夜间下降率减低的重要发病机制之一。