最新临床血压指南对儿童和青少年高血压患病率的影响

IF 2.7 2区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Health Reports Pub Date : 2023-04-19 DOI:10.25318/82-003-x202300400001-eng

Tracey Bushnik, Thomas Ferrao, Alexander A Leung

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引用次数: 0

摘要

背景:迄今为止，加拿大儿童和青少年高血压患病率的人口估计是基于2004年国家高血压教育计划关于儿童和青少年高血压的诊断、评估和治疗的第四份报告(NHBPEP 2004)的临床指南。2017年，美国儿科学会(American Academy of Pediatrics)发布了《儿童和青少年高血压筛查和管理临床实践指南》(AAP 2017)的更新指南，随后，加拿大高血压协会(Hypertension Canada)于2020年发布了《成人和儿童高血压预防、诊断、风险评估和治疗综合指南》(HC 2020)。本研究比较了基于NHBPEP 2004、AAP 2017和HC 2020的全国儿童和青少年高血压患病率估计。数据和方法:使用加拿大健康措施调查(Canadian Health Measures Survey) 2007年至2019年的六个周期数据，比较了在所有6至17岁儿童和青少年指南下按性别和年龄组划分的血压(BP)类别和高血压患病率。研究了应用AAP 2017的不同时间和选择特征的影响，在AAP 2017下重新分类到更高的血压类别，以及应用HC 2020与AAP 2017导致的高血压患病率差异。结果:根据AAP 2017和HC 2020, 6至17岁儿童和青少年的1期高血压患病率高于NHBPEP 2004。总体高血压患病率也较高，肥胖是在2017年AAP下被重新分类为高血压类别的主要因素。解释:AAP 2017和HC 2020的实施与高血压流行病学的显著变化相关。了解应用最新临床指南的影响可能有助于为人口监测工作提供信息，以跟踪加拿大儿童和青少年的高血压患病率。

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The impact of updated clinical blood pressure guidelines on hypertension prevalence among children and adolescents.

Background: To date, population estimates of hypertension prevalence among children and adolescents in Canada have been based on clinical guidelines in the National High Blood Pressure Education Program's 2004 Fourth Report on the Diagnosis, Evaluation, and Treatment of High Blood Pressure in Children and Adolescents (NHBPEP 2004). In 2017, the American Academy of Pediatrics published updated guidelines in Clinical Practice Guideline for Screening and Management of High Blood Pressure in Children and Adolescents (AAP 2017), followed by Hypertension Canada in 2020 with its publication of Comprehensive Guidelines for the Prevention, Diagnosis, Risk Assessment, and Treatment of Hypertension in Adults and Children (HC 2020). This study compares national child and adolescent hypertension prevalence estimates based on NHBPEP 2004, AAP 2017 and HC 2020.

Data and methods: Six cycles of data spanning 2007 to 2019 from the Canadian Health Measures Survey were used to compare blood pressure (BP) categories and the prevalence of hypertension by sex and age group under all sets of guidelines for children and adolescents aged 6 to 17. The impact of applying AAP 2017 across time and selected characteristics, the resulting reclassification into a higher BP category under AAP 2017, and differences in hypertension prevalence resulting from applying HC 2020 versus AAP 2017 were examined.

Results: Prevalence of Stage 1 hypertension was higher among children and adolescents aged 6 to 17 under AAP 2017 and HC 2020 than under NHBPEP 2004. Overall hypertension prevalence was also higher, and obesity was a major factor associated with being reclassified into a higher BP category under AAP 2017.

Interpretation: Implementation of AAP 2017 and HC 2020 is associated with significant changes in the epidemiology of hypertension. Understanding the impact of applying updated clinical guidelines may help inform population surveillance efforts to track hypertension prevalence among Canada's children and adolescents.

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来源期刊

Health Reports PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-

CiteScore

7.30

自引率

4.00%

发文量

期刊介绍： Health Reports publishes original research on diverse topics related to understanding and improving the health of populations and the delivery of health care. We publish studies based on analyses of Canadian national/provincial representative surveys or Canadian national/provincial administrative databases, as well as results of international comparative health research. Health Reports encourages the sharing of methodological information among those engaged in the analysis of health surveys or administrative databases. Use of the most current data available is advised for all submissions.