Blood pressure tables for Chinese adolescents: justification for incorporation of important influencing factors of height, age and sex in the tables

BMC Pediatrics

Youjie Wang¹  Jing Gao¹  Zhongliang Li¹  Jing Wu¹  Lijun Shen¹  Zhongqiang Cao¹  Xuejin Jiang¹ 

[1] Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science & Technology, HangKong Road 13, Wuhan, China

关键词: Blood pressure table;    Hypertension;    Adolescent;   

Others  :  1143991
DOI  :  10.1186/1471-2431-14-10

 received in 2013-07-12, accepted in 2014-01-14,  发布年份 2014

【 摘 要 】

Background

Elevated blood pressure (BP) in childhood was a predictor of hypertension in adulthood and contributes to the current epidemic of cardiovascular disease. It is necessary to identify abnormal BP in children and adolescents with accurate BP tables based on several crucial factors. The purpose of this study was to identify the important influencing factors of BP of Chinese adolescents.

Methods

BP, height, and body weight were assessed in 32221 normal-weight Chinese adolescents aged 12–17 years. An equal number of 6815 subjects from boys and girls were individually matched by height and age to assess the independent effect of sex on BP; and an equal number of 1422 subjects from each of the age groups (12, 13, 14, 15, 16 and 17 years) were individually matched by sex and height to estimate the independent effect of age on BP. Height of each sex and age was divided into eight height groups - ~5^th, ~10^th, ~25^th, ~50^th, ~75^th, ~90^th, ~95^th, and 95^th ~ percentiles- and the Spearman’s correlation between height percentiles and BP was used to examine the independent effect of height on BP.

Results

Boys had higher systolic BP (SBP) and diastolic BP (DBP) than girls after controlling for age and height. BP increased with age after controlling for sex and height. In each age group, both SBP and DBP increased alongside increasing height in boys and girls.

Conclusions

Sex, age and height are all independent determinants for BP levels in Chinese adolescents. It is essential to incorporate these three factors for the establishment of the BP reference tables.

【 授权许可】

   
2014 Jiang et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

【 参考文献 】

• [1]Feber J, Ahmed M: Hypertension in children: new trends and challenges. Clin Sci 2010, 119:151-161.
• [2]McNiece KL, Poffenbarger TS, Turner JL, Franco KD, Sorof JM, Portman RJ: Prevalence of hypertension and pre-hypertension among adolescents. J Pediatr 2007, 150(6):640-644.
• [3]Cao ZQ, Zhu LP, Zhang T, Wu L, Wang YJ: Blood pressure and obesity among adolescents: a school-based population study in China. Am J Hypertens 2012, 25(5):576-582.
• [4]Bao W, Threefoot SA, Srinivasan SR, Berenson GS: Essential hypertension predicted by tracking of elevated blood pressure from childhood to adulthood: the Bogalusa Heart Study. Am J Hypertens 1995, 8(7):657-665.
• [5]Klumbiene J, Sileikiene L, Milasauskiene Z, Zaborskis A, Shatchkute A: The relationship of childhood to adult blood pressure: longitudinal study of juvenile hypertension in Lithuania. J Hypertens 2000, 18(5):531-538.
• [6]Lauer R, Clarke W: Childhood risk factors for high adult blood pressure: the Muscatine Study. Pediatrics 1989, 84(4):633-641.
• [7]Cook NR, Gillman MW, Rosner BA, Taylor JO, Hennekens CH: Prediction of young adult blood pressure from childhood blood pressure, height, and weight. J Clin Epidemiol 1997, 50(5):571-579.
• [8]Hansen ML, Gunn PW, Kaelber DC: Underdiagnosis of hypertension in children and adolescents. JAMA 2007, 298(8):874-879.
• [9]NHBPEP: The fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents. Pediatrics 2004, 114(suppl 2):555-576.
• [10]Rosner B, Cook N, Portman R, Daniels S, Falkner B: Blood pressure differences by ethnic group among United States children and adolescents. Hypertension 2009, 54(3):502-508.
• [11]Suglia SF, Clark CJ, Gary-Webb TL: Adolescent Obesity, Change in Weight Status, and HypertensionNovelty and Significance Racial/Ethnic Variations. Hypertension 2013, 61(2):290-295.
• [12]Mi J, Wang T, Meng L, Zhu G, Han S, Zhong Y, Liu G, Wan Y, Xiong F, Shi J: Development of blood pressure reference standards for Chinese children. Chin J Evid Based Pediatr 2010, 5(1):4-14.
• [13]Gillum RF, Prineas RJ, Horibe H: Maturation vs age: assessing blood pressure by height. J Natl Med Assoc 1982, 74(1):43.
• [14]Voors A, Foster T, Frerichs R, Webber L, Berenson G: Studies of blood pressures in children, ages 5–14 years, in a total biracial community: the Bogalusa Heart Study. Circulation 1976, 54(2):319-327.
• [15]Harlan WR, Cornoni-Huntley J, Leaverton PE: Blood pressure in childhood. The National Health Examination Survey. Hypertension 1979, 1(6):559-565.
• [16]Li H, Ji C, Zong X, Zhang Y: Body mass index growth curves for Chinese children and adolescents aged 0 to 18 years. Chin J Pediatr 2009, 47(7):493-498.
• [17]Ji CY, Liu BL: Child and adolescent health. 6th edition. Beijing: People’s Medical Publishing House; 2007.
• [18]Elkasabany AM, Urbina EM, Daniels SR, Berenson GS: Prediction of adult blood pressure by K4 and K5 diastolic blood pressure in children: the Bogalusa Heart Study. J Pediatr 1998, 132(4):687-692.
• [19]Liang L, Mi J, Zhang MM, Wang YF, Wang TY: Study on the impact of the choice of diastolic Korotkoff phase in childhood on prediction to adult hypertension. Chin J Epidemiol 2008, 29(2):110-115.
• [20]Rosner B, Cook N, Portman R, Daniels S, Falkner B: Determination of blood pressure percentiles in normal-weight children: some methodological issues. Am J Epidemiol 2008, 167(6):653-666.
• [21]Neuhauser HK, Thamm M, Ellert U, Hense HW, Rosario AS: Blood pressure percentiles by age and height from nonoverweight children and adolescents in Germany. Pediatrics 2011, 127(4):e978-e988.
• [22]Lee CG, Moon JS, Choi J-M, Nam CM, Lee SY, Oh K, Kim YT: Normative blood pressure references for Korean children and adolescents. Korean J Pediatr 2008, 51(1):33-41.
• [23]Lurbe E, Cifkova R, Cruickshank JK, Dillon MJ, Ferreira I, Invitti C, Kuznetsova T, Laurent S, Mancia G, Morales-Olivas F: Management of high blood pressure in children and adolescents: recommendations of the European Society of Hypertension. J Hypertens 2009, 27(9):1719-1742.
• [24]Wang Z, Ma J, Dong B, Song Y, Hu P, Zhang B: Comparison of blood pressure levels among four age groups of Chinese children matched by height. J Hum Hypertens 2011, 26(7):437-442.
• [25]Kaelber DC, Pickett F: Simple table to identify children and adolescents needing further evaluation of blood pressure. Pediatrics 2009, 123(6):e972-e974.
• [26]Badeli H, Sajedi SA, Shakiba M: Simple Formulas for Screening Abnormal Blood Pressure in Children and Adolescents. Iran J Kidney Dis 2010, 4(3):250-252.