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儿童和青少年高血压的定义和诊断

Author
Tej K Mattoo, MD, DCH, FRCP
Section Editors
F Bruder Stapleton, MD
David R Fulton, MD
Deputy Editor
Melanie S Kim, MD
Translators
闫辉, 副主任医师

引言

越来越多的证据表明成人高血压(hypertension, HTN)在儿童期已有先兆，因为儿童期血压(blood pressure, BP)可预测成人期血压[1,2]。儿童期和青春期高血压可能促成过早发生动脉粥样硬化以及早发心血管疾病(cardiovascular disease, CVD)。因此，识别高血压儿童并成功治疗其高血压对CVD的长期结局可能具有重要影响。 (参见“儿童动脉粥样硬化的危险因素及发病”，关于‘儿童期动脉粥样硬化性改变’一节和“儿童动脉粥样硬化的危险因素及发病”，关于‘高血压’一节和“儿童和青少年高血压的治疗”，关于‘进行干预的理论基础’一节)

儿童高血压的定义和诊断将总结在此。儿童高血压的危险因素、流行病学、病因、评估和治疗将单独讨论。 (参见“儿童与青少年高血压的流行病学、危险因素和病因学”和“儿童及青少年高血压的评估”和“儿童和青少年高血压的治疗”)

定义

美国 — 1987年，美国国家高血压教育项目(National High Blood Pressure Education Program, NHBPEP)工作组制定了儿童正常血压和血压升高的定义指南，并在2004年进行了更新[3,4]。

儿童期高血压的定义是基于健康儿童血压的常模分布。这与成人高血压不同，成人高血压主要是根据大型抗高血压治疗试验的临床结局数据(即，心血管疾病和死亡风险)来定义的[3-5]。该临床定义不适用于儿童，因为除左心室肥厚外的心血管(cardiovascular, CV)事件通常要到成人期才发生。 (参见“成人高血压的概述”)

体型大小是儿童和青少年血压的最重要决定因素。因此，当针对身高以及年龄和性别调整血压值时可避免将正常生长两个极端的儿童(即较高或较矮的儿童)进行错误分类，从而可使血压分类更加准确[4,6]。

                  

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Literature review current through: 2017-06 . | This topic last updated: 2017-06-30.
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