Blood pressure distribution in an Iranian adolescent population: "Tehran Lipid and Glucose study"

Significant hypertension in adolescence is defined according to Blood Pressure (BP) distribution among general population. The present study was conducted to determine the BP distribution in Iranian adolescents. In a population-based study held in Tehran, BP data for 2560 participants aged 10-17 years (1247 boys and 1313 girls) were collected. The 90th and 95th percentiles of systolic (SBP) and diastolic BP (DBP) were obtained for different age and height subgroups of boys and girls. While the 90th and 95th percentiles of SBP obtained in our study were generally lower than international guidelines, the corresponding percentiles of DBP were higher. Significant associations were found between BP and age, height, weight and BMI. According to our findings, it is necessary to prepare BP reference tables according to regional surveys.     

Role of insulin resistance in non-obese adolescents

Insulin resistance in the obese is closely related with cardiovascular diseases and their risk factors not only in adults but also in children and adolescents. We aimed to elucidate whether insulin resistance in non-obese adolescents is related with these conditions. A total of 74 non-obese high-school students (38 boys and 36 girls) were recruited. Anthropometry, blood pressure, fasting serum chemistry and insulin activity were measured. Subjects with a homeostasis model assessment-insulin resistance (HOMA-IR) level greater than the 75th percentile (> 2.25 for boys and > 2.89 for girls) were defined as insulin resistant. Non-obese boys with impaired insulin sensitivity had higher systolic blood pressure, lower HDL-cholesterol concentration, and fewer hours of vigorous exercise during weekdays, while non-obese girls with impaired insulin sensitivity had higher systolic blood pressure than their peers with normal insulin sensitivity. By multiple stepwise regression analysis, systolic blood pressure (p < 0.001) and the hours of vigorous exercise during weekdays (p < 0.03) were independently associated with HOMA-IR in boys, while systolic blood pressure (p < 0.0001) and serum concentrations of HDL-cholesterol (p < 0.01) were found in girls. In nonobese adolescents, insulin sensitivity is related with cardiovascular risk factors.     

Elevated blood pressure in overweight and obese Irish children

Background  The Irish childhood obesity epidemic, one of the highest ranking internationally, represents a major threat to public health. We sought to perform a retrospective observational study of a clinic based cohort of obese Irish children. Methods  Clinical data relating to gender, age, height, weight, body mass index and blood pressure were analysed, from 206 children referred to a paediatric endocrine referral centre over a 15-year period for assessment of obesity. Results  Younger patients tended to have a higher standardised body mass index at initial presentation; 92% of boys and 96% of girls referred were obese (age-related BMI ≥ 95th percentile). Boys (51%) and girls (49%) had initial blood pressure measurements in the hypertensive range. There was a correlation between the degree of obesity and systolic blood pressure, particularly in boys. Conclusions  Obese Irish children present with significant long-term health risks, including hypertension at baseline.     

青少年心血管危险因素聚集腰围切点的初步探讨

目的 探讨青少年心血管危险因素聚集的最佳腰围切点.方法 秦皇岛地区一项3986名14～18岁青少年的横断面调查.采用受试者工作特征(ROC)曲线分析确定心血管危险因素聚集的最佳腰围切点.结果 无论男性还是女性,心血管危险因素聚集的百分比均随着腰围的增加而增加.腰围≥80th百分位点(男性77.0～79.0 cm,女性70.0～72.5 cm)后心血管危险因素聚集明显升高,年龄标化检出率分别为24.9%(男性)和9.9%(女性).ROC分析显示以上相应腰围切点具有最佳的敏感性和特异性.结论 腰围与心血管危险因素聚集密切相关.预测心血管危险因素聚集的最佳腰围切点被定为80th百分位点.     

The effect of caffeine on postprandial blood pressure in the frail elderly

In a double-blind, random-order, cross-over study the effects of placebo and 100 mg of caffeine on postprandial sitting and erect blood pressure and heart rate were studied in 20 frail elderly subjects (mean age 84, range 75-93 years) after a standardized 400 K-calorie glucose drink. Maximal postprandial reduction in sitting systolic blood pressure occurred, at 60 minutes post-placebo, of - 11 mmHg (95% confidence interval -5 to -17 mmHg, P less than 0.01), and was attenuated by caffeine (P less than 0.05) with changes in systolic blood pressure, at 60 minutes post-drink, of 1 mmHg (95% CI -6 to 7 mmHg, not significant). Four subjects developed symptomatic postprandial hypotension after placebo which was prevented by caffeine. There were no significant changes in erect systolic blood pressure, postural systolic blood pressure change, sitting and erect, diastolic blood pressure and heart rate between treatment phases. Caffeine attenuates the postprandial fall in sitting blood pressure in frail elderly subjects and in particular prevented symptomatic blood pressure reductions in subjects with postprandial hypotension.     

Nationwide reference data for height, weight and body mass index of Indian schoolchildren

BACKGROUND. The assessment of growth is crucial for child care and reference data are central to growth monitoring. We aimed to assess the height, weight and body mass index (BMI) of Indian schoolchildren in order to develop genderappropriate growth charts for children 5-18 years of age. METHODS. Cross-sectional evaluation of anthropometric parameters (height, weight and BMI) was done in Indian schoolchildren (3-18 years) randomly selected from both fee-paying (upper socioeconomic strata) and non-fee paying (lower socioeconomic strata) schools from 4 regions (north, south, east and west) of India. A total of 106 843 children were evaluated, of which 42 214 children (19 303 boys, 22 911 girls) were from the lower socioeconomic strata and 64 629 children (34 411 boys, 30 218 girls) were from the upper socioeconomic strata. Normative charts, using the lambda-mu-sigma (LMS) method to smoothen the curves, were drawn from children belonging to the upper socioeconomic strata, in view of the gross discrepancy between the two socioeconomic strata. RESULTS. Height, weight and BMI percentile (3rd, 5th, 10th, 25th, 50th, 75th, 90th, 95th and 97th) data were calculated and charts generated. The height of boys and girls was consistently higher at all ages when compared with earlier India data, but the final height was 2-4 cm lower than that reported in the WHO multicentre study of 2007. Weight centiles showed a rising trend both in boys and girls compared not only to earlier Indian data published in 1992, but also to that reported by the WHO multicentre study. The median weight at all ages in both boys and girls was approximately 4 kg more than that reported in affluent Indian children two decades earlier. CONCLUSION. This large nationwide study indicates secular trends in height, weight and BMI in Indian children from the upper socioeconomic strata. We suggest that the height and weight percentiles reported by us may be used as reference standards for India.     

青春期血压调查研究

目的:了解青春期血压状况,探讨青春期血压的评价参考标准。方法:选择漯河市某中专学校14～18岁健康男女学生共4196人进行血压调查研究,以本次调查所测血压值计算出第25、50、75、90及95百分位值。结果:共检出高血压(血压在第95百分位以上)383例。高血压检出率为9.12％;血压与体重、身高、体重指数、皮脂厚度及年龄呈正相关。结论:血压各百分位值可作为河南省青少年青春期(14～18岁)血压评价的参考标准;预防高血压应从(儿童)青少年时期开始。     

围产期新生儿血压正常值

本文应用DINAMAPTM847XT型新生儿生命体征监护仪测定了351例足月新生儿出生7日内血压正常值。此期新生儿血压95%正常值范围为:收缩压57.0～91.2mmHg,舒张压为29.3～55.1mmHg,平均动脉压为43.7～71.5mmHg。根据本文资料,我们提出:出生7日内新生儿收缩压>90mmHg或舒张压>55mmHg,或平均动脉压>70mmHg,可诊断为高血压,而收缩压<50mmHg,或舒张压<30mmHg,或平均动脉压<40mmHg,可诊断为低血压。     

一级高血压早期非药物治疗与药物治疗比较

目的观察一级原发性高血压(临界高血压亚组)非药物治疗效果.分析单独采用非药物治疗早期临界高血压与药物治疗的疗效差异.方法随机选择80例初诊且无并发症和靶器官损害的临界高血压患者,随机分成二组.一组给予非药物治疗,包括限盐、戒烟酒、加强运动、减重、改善饮食结构等,另一组给予降压药氯沙坦(Losartan)治疗,观察比较两组临界高血压患者的血压变化.结果给予一级原发性高血压组非约物治疗3个月,使收缩压(SBP)和舒张压(DBP)分别下降8.4%和3.5%,血压控制在正常范围者占60%.药物治疗1个月使SBP和DBP分别下降7.9%和3.6%,3个月SBP和DBP下降值9.0%和4.1%,与非药物治疗组比较无显著性差异.其血压控制在正常范围者占65%.在非药物治疗中,限盐、运动和减重与血压下降有关.结论对于一级原发性高血压患者,早期单独采用改善生活和行为方式的非药物治疗可使血压下降,半数患者血压可降至正常范围,与单用降压药氯沙坦治疗效果相似.     

老年动脉粥样硬化性肾动脉狭窄支架置入术后血压变化随访

目的探讨经皮腔内肾动脉支架置入术(percutaneous transluminal renal angioplasty with stent,PTRAS)治疗动脉粥样硬化性肾动脉狭窄(atherosclerotic renal artery stenosis,ARAS)对血压的影响。方法经肾动脉造影确诊的ARAS并施行PTRAS的患者50例,术后随访3-48(16.3±14.8)个月,分析PTRAS术后患者血压水平。结果 50例PTRAS全部成功,术后所有患者血压改善,术后3、6、12个月的收缩压分别为(128.80±18.13)mmHg(1mmHg=0.133kPa),(125.41±16.70)mmHg,(129.48±9.67)mmHg;舒张压分别为(71.26±9.62)mmHg,(71.58±5.80)mmHg,(73.84±9.58)mmHg,各时间点分别与术前比较差异有统计学意义(P<0.05)。结论 PTRAS术后老年人肾动脉粥样硬化性狭窄患者血压水平下降,这种下降趋势至少维持12个月。     

Obesity and metabolic risks in children

BACKGROUND: We undertook this study to establish the prevalence of overweight, obesity, abdominal obesity, high blood pressure, and high glucose and triglyceride levels in school-age children from Mexico City, as well as to determine how overweight and obesity are related to the other risk factors. METHODS: The study was a cross-sectional survey comprised of 1819 children (6-13 years of age) attending six elementary schools. Gender, age, weight, height, waist circumference, blood pressure, and levels of triglycerides and glucose were registered. Percentiles were calculated according to American standards for BMI, height, waist circumference, and blood pressure. RESULTS: Compared to American references, mean percentiles for waist circumference and BMI were >50, and mean height percentiles were <50. Prevalence of overweight was 22.3 and 23.6% for boys and girls, respectively; obesity, 28 and 21.2%; abdominal obesity, 22.1 and 11.7%; high triglyceride levels, 11.3 and 15.4%; high blood pressure, 4.8 and 5.8%, respectively. Overweight, obesity, and abdominal obesity are associated with higher blood pressure and triglyceride levels (odds ratio>1.0, p<0.05). Percentiles for BMI, waist circumference, systolic blood pressure, and diastolic blood pressure also had significant correlations (r>0.2, p<0.001). CONCLUSIONS: This population of Mexican school-age children was shorter and heavier than their American standards. The prevalence of metabolic risks was similar to those reported in American adolescents in NHANES surveys.     

Assessment of Effect of Angiotensin Ⅱ Receptor Antagonist Losartan on Aortic Distensibility in Patients With Essential Hypertension by Echocardiography

It is well- known that aorta plays an importantrole in the function of the cardiovascular system.Oneof the mostimportantphysiological roles of aorta is abuffering Windkessel function,which is its capabilityto store part of the stroke volume during systole byaortic distention and to transfer this storage volumeinto peripheral circulation during diastole[1] . De-creased aortic distensibility has long been recognizedas a marker for early atherosclerosis[2 ] and may con-tribute to hypertension[3 ]…     

Age at maximum growth spurt in body height for Saudi school children aged 9-18 years

OBJECTIVE: To provide growth reference values in body height, to determine the specific age at peak height velocity for Saudi male and female adolescences aged 9-18 years and to evaluate the appropriateness of using the Centers for Disease Control/National Center for Health Statistics (CDC/NCHS) growth standards in body height for the assessment of Saudi adolescents. METHODS: A cross-sectional anthropometric survey was conducted in 1053 Saudi male and female school children living in Riyadh city. The study sample was collected in the year 2000 and data were completed and refined in the year 2002. Standing height measurements were recorded for each subject using standard measuring techniques. The 10th, 25th, 50th, 75th, 90th percentiles for body height were calculated separately for boys and girls in one year intervals. The median reference values were compared with the corresponding values in the CDC/NHCS and with other similar studies on Saudi population. RESULTS: The results revealed that the age at peak height velocity for Saudi boys is 13-14 years and for Saudi girls is 10-11 years. The median value for body height at 18 years old for male and female was comparable with other studies reported in similar ethnic group. CONCLUSION: The use of the CDC/NCHS growth standard for height does not appear appropriate for the assessment of growth of Saudi children aged 9-18 years.     

动态血压监测15种单药治疗原发性高血压的降压疗效

目的通过系统比较15种降压药单药治疗原发性高血压的降压疗效,为医师选择有效降压药物时提供依据。方法对370例原发性高血压患者应用动态血压监测对15种单药治疗8周的降压疗效进行系统比较。结果氯沙坦、缬沙坦、厄贝沙坦、奥美沙坦、苯那普利、依那普利、美托洛尔、贝凡洛尔、吲达帕胺、贝尼地平和氨氯地平均有效降低24h平均舒张压和收缩压,坎地沙坦能有效降低收缩压。但各单药间降压幅度无差异。而低剂量特拉唑嗪、多沙唑嗪仅能降低日间舒张压,托拉塞米降低24h平均血压的效果不明显。结论血管紧张素转换酶抑制剂、血管紧张素Ⅱ受体拮抗剂、β-阻滞剂和长效钙拮抗剂单药治疗能有效降压,而单用低剂量特拉唑嗪、多沙唑嗪和托拉塞米因短期作用有限,不建议作为单独药物治疗高血压,作为联合治疗可能更为适宜。     

重庆市城区3～18岁儿童青少年肥胖症及相关疾病的流行病学调查

目的为掌握重庆市儿童青少年超重肥胖的发病情况,并对心血管疾病相关的高危指标进行观察。方法对重庆市城区23293名3~18岁儿童青少年进行了流行病学调查。测量指标包括身高、体重、腰围、臀围、血压。结果(1)总体检出超重12.44%,肥胖为3.72%,其中男孩分别为14.38%、4.99%,女孩为10.37%、2.35%。(2)肥胖组及超重组男女儿童的收缩压及舒张压高于90百分位及95百分位者均多于正常体重组,χ2值分别为404.535、618.486,115.912、131.641,P值均<0.005。(3)腰-臀围比值肥胖男孩中有10.89%腰-臀围比值>1.0,肥胖女孩中有75.00%腰-臀围比值>0.85。结论重庆市城区儿童青少年超重检出率为12.44%,肥胖检出率为3.72%。肥胖儿童中的血压升高者明显的多于同年龄同性别正常体重儿童。女孩中心性肥胖高于男孩。     

Blood pressure in black, white and Asian factory workers in Birmingham

A screening survey was conducted among factory workers, aged 15-64 years, in Birmingham, England to investigate ethnic differences in blood pressure. One-thousand and forty-nine subjects (784 men, 265 women) were screened, representing 79% of the eligible population. Mean systolic and diastolic blood pressures generally did not differ between men of black West Indian (n = 173), local white (n = 439) or Asian (n = 172) origin, when matched by 10-year age groups. Analysis of covariance using age as the covariate revealed that, overall, Asian men had significantly lower systolic but higher diastolic pressures than the other ethnic groups. The proportion of men arbitrarily defined as hypertensive (greater than or equal to 160 mmHg systolic or greater than or equal to 95 diastolic or blood pressures below this figure whilst receiving antihypertensive therapy) was 26% of West Indians, 22% of whites and 17% of Asians, but these were not significantly different when age was accounted for. Black West Indian women (n = 101) did have higher diastolic pressure than white women (n = 164), but this difference was dependent on body mass index. Overall, systolic pressures in women were not significantly different. These findings differ from those consistently reported from the United States.     

Bp-MRI灰度直方图在鉴别移行带前列腺癌与良性前列腺增生中的应用价值

目的:探讨双参数磁共振成像（Bp-MRI）灰度直方图在鉴别移行带前列腺癌（PCa）与良性前列腺增生（BPH）中的价值。方法:回顾性分析经病理证实的移行带PCa患者43例与BPH患者52例。T2WI和ADC图像上,利用MaZda软件手动勾画感兴趣区（ROI）,进行灰度直方图分析,提取均值、方差、偏度、峰度、百分位数9个直方图纹理特征,对纹理特征进行统计学分析,获得有意义的纹理特征参数,并绘制受试者工作特征（ROC）曲线,以评价其鉴别移行带PCa与BPH的价值。结果:BPH组ADC均值、偏度、各百分位数均高于PCa组,差异均有统计学意义（t=-12.155～5.022,均P<0.05）,方差、峰度差异无统计学意义（均P>0.05）。BPH组T2WI均值、方差、第10百分位数、第50百分位数、第90百分位数、第99百分位数均高于PCa组,差异均有统计学意义（t=-6.618～-2.181,均P<0.05）,偏度、峰度、第1百分位数差异均无统计学意义（均P>0.05）。ADC均值、偏度、第1百分位数、第10百分位数、第50百分位数、第90百分位数、第99百分位数曲线下面积（AUC）差异均有统计学意义（均P<0.05）;T2WI均值、方差、第10百分位数、第50百分位数、第90百分位数、第99百分位数AUC差异均有统计学意义（均P<0.05）。其中,ADC均值的AUC最大,为0.963,以149.29为阈值时,敏感度为90.7%,特异度为92.3%。结论:Bp-MRI灰度直方图分析可以作为鉴别PCa与BPH的重要辅助手段。     

Elevation of ambulatory systolic blood pressure in hypertensive smokers. A case-control study

Although smoking raises blood pressure, the office blood pressure measurements of smokers are the same as, or lower than, those of nonsmokers. To resolve this paradox, we compared the office and 24-hour ambulatory blood pressures of 59 untreated hypertensive smokers with 118 nonsmoking hypertensives matched for age, sex, and race. The office blood pressures of the smoking and nonsmoking groups were 141/93 and 142/93 mm Hg, respectively. The awake ambulatory systolic blood pressure was significantly higher in the smokers (145 vs 140 mm Hg). This difference was greater among patients over the age of 50 years (153 vs 142 mmHg), and absent among patients under 50 years (140 vs 139 mm Hg). Blood pressures during sleep did not differ between the two groups (121/76 vs 123/77 mm Hg). We conclude that, among white hypertensives above the age of 50 years, smokers maintain a higher daytime ambulatory systolic blood pressure than nonsmokers even though blood pressure measured in the office is similar.     

Size-at-birth standards for an urban Canadian population

By random sampling of all births occurring in Hamilton, Ont. over an 18-month period the percentile distributions of the newborn infants' weight, length, and head and chest circumferences were determined. The resulting standards may be used in the clinical evaluation of size for gestational age. The smoothed 50th percentile values for newborns of 40 weeks gestational age were as follows for boys and girls respectively: birth weight 3530 and 3355 g, crown-heel length 52.0 and 51.3 cm, head circumference 35.2 and 34.4 cm, and chest circumference 33.4 and 32.8 cm. The mother's height averaged 160.8 +/- 6.1 cm and her weight before the pregnancy 59.2 +/- 10.5 kg. The prevalence of cigarette smoking during pregnancy was 34.8%.     

Prevalence of obesity among affluent school children in Dhaka

A cross sectional study was conducted in September 2006 in one of the private schools in Dhaka, Bangladesh to see the prevalence of obesity among affluent school children and adolescents. Informed consent was taken from school authority to take anthropometric measurement of all school children. Standing height was measured with a stadiometer and weight with a bathroom scale. Waist and hip circumference were measured with a measuring tape. The body mass index (BMI) was calculated using weight in kilogram/(height in meter)2 formula. Obesity was defined as BMI≥95th percentile for age and sex, over weight as BMI≥85th percentile for age and sex, normal weight as BMI between 5th and 84th percentile and underweight as BMI <5th percentile. Official centers for disease control (CDC) growth chart for boys and girls age 2-20 years was used. Children and adolescents were divided into group 1(3-5 years), Group 2(6-9years), group 3(10-13 years) and group 4(14-18 years). There were a total of 468 children and adolescents (male 266, female 202). In group 1 there were 110 children, in group 2 there were177 children, in group 3 and 4 there were 149 and 32 adolescents respectively. The prevalence of obesity was 17.9%, higher among males (19.9%), compared to females (15.3%). Obesity was highest (27.7%) in group 2, 14.5% in group 1, 10.7% in group 3 and 9.4% in group 4.