AHA 2017:早期诊治儿童及青少年高血压之多学科项目一览

2017-11-22 佚名 国际循环

美国心脏协会(AHA)2017年科学年会的临床高血压专场发布了由美国费城儿童医院Michelle Kaplinski教授等开展的一项旨在早期识别和治疗儿童及青少年系统性高血压的多学科项目最新结果。

目前,儿童高血压已成为越来越严重的问题,却一直被低估和忽视而得不到有效及时的诊治。当地时间2017年11月12日,美国心脏协会(AHA)2017年科学年会的临床高血压专场发布了由美国费城儿童医院Michelle Kaplinski教授等开展的一项旨在早期识别和治疗儿童及青少年系统性高血压的多学科项目最新结果。

该研究项目是心内科和肾内科联合创建的综合性门诊高血压项目,旨在筛查存在高血压风险的儿童,评估高血压儿童的心血管健康状况并优化其医疗管理。研究收集2011年12月~2015年12月费城儿童医院242例高血压及血管评估项目的初次就诊患者数据,采用描述性统计评估其人口统计学、营养、体力活动水平、临床诊断方面的数据。

结果发现,受试患者的平均年龄为(14.5±4.2)岁,存在病态肥胖和/或原发性高血压、实体器官移植、糖尿病、肾动脉狭窄及主动脉缩窄者所占比例分别为26%、25%、12%、10%和8%,白种人及男性的比例分别为52%和57%,基线时接受降压药物治疗者的比例为67%。在81例未接受降压药物治疗的患者中,24小时动态血压监测(ABPM)存在高血压证据者占49%。此外,研究发现,门诊血压正常的患者约半数行ABPM后可见高血压的存在。同时,分析显示受试患者超半数(51%)伴有超重,其中大多受试者的体重指数(BMI)超过第95百分位数;83%每天摄入的水果及蔬菜量不足5份,40%自我报告未定期运动。更加不容乐观的是,虽然,推荐所有9~11岁儿童均应进行血脂筛查,但研究对象中11岁以上受试患儿中仅53%进行过血脂筛查。受试患者中,73%被推荐改变降压药物或进一步进行检查,95%被建议进行健康生活方式的咨询。

上述初步数据表明,关注儿童高血压的多学科项目有助于实现对高危人群的早期诊断并优化其医疗管理。其中,ABPM有助于在门诊血压正常者中识别和发现高血压。未来有必要进一步开展针对儿童高血压患者特征及亚临床终末器官改变的研究,以探寻靶向治疗方法,进而改善其成年期的心血管健康。

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    2017-11-24 zhaohui6731
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    2017-11-23 执着追梦

    学习.谢谢分享

    0

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    2017-11-23 swfzhanggui

    非常好.谢谢分享.学习了

    0

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