正常高值血压对于儿童青少年的意义

doi:10.12114/j.issn.1007-9572.2022.0834

摘要/Abstract

摘要： 目前大部分国家和组织发布的儿科高血压指南对高血压的定义基于健康儿童青少年血压序列的第95百分位（P95）的血压值。然而，大量数据显示正常高值血压发展为高血压的风险更高且会造成和高血压类似的靶器官损害。本综述对不同国家和组织关于儿童青少年血压的分类方法、儿童青少年正常高值血压和高血压的患病率、正常高值血压向高血压的进展比例及正常高值血压造成的靶器官损害进行阐述，强调儿科医生未来应加强对儿童青少年正常高值血压和高血压定义的关注。

关键词: 高血压, 正常高值血压, 高血压前期, 儿童青少年, 靶器官, 综述

Abstract:

At present, almost all the definitions of hypertension in pediatric hypertension guidelines issued by countries and organizations are based on blood pressure percentile of 95% (P₉₅). However, a large number of research data have shown that high normal blood pressure has a higher risk of progression to hypertension and cause similar target organ damage as hypertension. The review summarized the classification methods of blood pressure of children and adolescents in different countries and organizations, the prevalence of hypertension and high normal blood pressure, the rate of progression from high normal blood pressure to hypertension, and target organ damage caused by high normal blood pressure in children and adolescents, emphasizing that pediatricians should pay greater attention to the definition of high normal blood pressure and hypertension for children and adolescents.

Key words: Hypertension, Normal high blood pressure, Prehypertension, Children and adolescents, Target organ, Review

刘海,黄冠华. 正常高值血压对于儿童青少年的意义[J]. 中国全科医学, 2023, 26(18): 2183-2189. DOI: 10.12114/j.issn.1007-9572.2022.0834.
LIU Hai,HUANG Guanhua. The Significance of High Normal Blood Pressure for Children and Adolescents[J]. Chinese General Practice, 2023, 26(18): 2183-2189. DOI: 10.12114/j.issn.1007-9572.2022.0834.

图/表 4

表1 《中国高血压防治指南（2018年修订版）》对儿童青少年血压的分类方法

Table 1 Classification method of blood pressure of children and adolescents in 2018 Chinese Guidelines for the Management of Hypertension

血压分类	对应血压值
正常血压	<P₉₀
正常高值血压	P₉₀~P₉₅或≥120/80 mm Hg
1级高血压	（P₉₅~P₉₉）+5 mm Hg
2级高血压	≥P₉₉+5 mm Hg

表2 2017年美国儿科学会发布的儿童青少年高血压临床筛查和建议指南对儿童青少年血压的分类方法

Table 2 Classification method of blood pressure of children and adolescents in Clinical Practice Guideline for Screening and Management of High Blood Pressure in Children and Adolescents published by American Academy of Pediatrics

血压分类	1~<13岁	≥13岁
正常血压	<P₉₀	<120/<80 mm Hg
血压升高	P₉₀~<P₉₅或120/80 mm Hg~P₉₅（以较低者为准）	120~129 mm Hg/<80 mm Hg
1级高血压	≥P₉₅~P₉₅+12 mm Hg或130/80 mm Hg~139/89 mm Hg（以较低者为准）	130/80 mm Hg~139/89 mm Hg
2级高血压	≥P₉₅+12 mm Hg或≥140/90 mm Hg（以较低者为准）	≥140/90 mm Hg

表3 2016欧洲高血压学会儿童和青少年高血压管理指南对儿童青少年血压的分类方法

Table 3 Classification method of blood pressure of children and adolescents in 2016 European Society of Hypertension Guidelines for the Management of High Blood Pressure in Children and Adolescents

血压分类	1~15岁	≥16岁
正常血压	<P₉₀	<130/85 mm Hg
血压升高	P₉₀~<P₉₅	130~139 mm Hg/85~89 mm Hg
高血压	≥P₉₅	≥140/90 mm Hg
1级高血压	≥P₉₅~P₉₉+5 mm Hg	140~159 mm Hg/90~99 mm Hg
2级高血压	≥P₉₉+5 mm Hg	160~179 mm Hg/100~109 mm Hg
单纯收缩期高血压	收缩压≥P₉₅且舒张压<P₉₀	收缩压≥140 mm Hg且舒张压<90 mm Hg

表4 加拿大2020年成人和儿童高血压预防、诊断、风险评估和治疗综合指南对儿童青少年血压的分类方法

Table 4 Classification method of blood pressure of children and adolescents in Hypertension Canada's 2020 Comprehensive Guidelines for the Prevention，Diagnosis，Risk Assessment，and Treatment of Hypertension in Adults and Children

血压分类	6~11岁	12~17岁
高血压	>120/80 mm Hg或≥P₉₅	>130/85 mm Hg或≥P₉₅
1级高血压	P₉₅~P₉₅+12 mm Hg	P₉₅~P₉₅+12 mm Hg
2级高血压	>P₉₅+12 mm Hg	>P₉₅+12 mm Hg

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