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Hypertension:儿童期高血压可预测成年心血管疾病发生

2015-10-11 phylis 译 MedSci原创

以前的有关血压随时间变化研究,已经形成了血压平均轨迹模型。在最近老年人的研究中,也表明可能存在不同血压轨迹的亚组。在生命早期识别成人高血压的高危亚组,能够采取有效的减少危险因素的措施。研究人员旨在识别儿童期不同收缩压轨迹,与其相关的危险因素,以及中年早期心血管预后。在一项纵向,有代表性的出生对列研究中(975人)获得受试者7,11,18,26,32岁以及38岁血压值,通过组的轨迹模,确定四个轨迹组

以前的有关血压随时间变化的研究,已经形成了血压平均轨迹模型。在最近老年人的研究中,也表明可能存在不同血压轨迹的亚组。在生命早期识别成人高血压的高危亚组,能够采取有效的减少危险因素的措施。研究人员旨在识别儿童期不同收缩压轨迹,与其相关的危险因素,以及中年早期心血管预后。

在一项纵向、有代表性的出生对列研究中(975人)获得受试者7,11,18,26,32岁以及38岁血压值,通过组的轨迹模,确定四个轨迹组,正常(21.8%),正常高值(43.3%),高血压前期(31.6%),高血压(4.2%))。血压分类涉及7岁时及38岁时的血压。

与正常血压组相比,高血压家族史(OR, 43.23;95% CI: 5.27–354.65),男性(OR, 109.48; 95% CI, 26.82–446.96),第一胎(OR, 2.5; 95% CI, 1.00–8.69),低体重儿(OR, 2.79; 95% CI, 2.49–3.09)与高血压组成员相关。高BMI和抽烟导致血压升高,尤其在较高血压组。高血压前期和高血压组在中年早期有着不良的心血管预后。

在儿童期就确定的不良的血压轨迹,与先前存在和随时间变化的危险因素相关,并且可以预测成人心血管疾病发生的风险。早期识别和针对性的预防和干预可能减少高血压患者的生命历程负担。

原文出处:

Reremoana F. et al.  Childhood to Early-Midlife Systolic Blood Pressure Trajectories: Early-Life Predictors, Effect Modifiers, and Adult Cardiovascular Outcomes .Hypertention. October 5 2015.

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