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患有高血压的儿童和青少年的长期结局:一种倾向匹配的队列研究
Junayd Hussain1, Kalina Georgieva1, Cal H Robinson2
1Michael G DeGroote School of Medicine, McMaster University, Hamilton, ON, Canada.
The Lancet. Child & adolescent health
|June 27, 2025
概括
患有高血压的儿童和青少年面临重大脏不良事件 (MAKE) 的显著更高风险,包括功能衰竭. 儿童高血压的早期识别和治疗对于预防长期损伤至关重要.
科学领域:
- 儿科脏病学 儿科脏病学
- 年轻人心血管健康问题
- 公共卫生流行病学 流行病学
背景情况:
- 高血压影响6%的儿童和青少年,患病率不断增加,并与不良心血管结果有关.
- 儿童高血压与慢性病进展有关,但对长期病结果的直接证据有限.
研究的目的:
- 确定诊断为高血压的儿童和青少年长期出现重大脏不良事件 (MAKE) 的风险.
主要方法:
- 基于人口的回顾性队列研究在加拿大安大略省 (1996-2023) 使用卫生行政数据.
- 26,324名高血压儿童/青少年的倾向性得分与126,834名对照进行匹配.
- 通过加权考克斯回归评估的MAKE (死亡率,慢性病,功能衰竭).
主要成果:
- 高血压队列 (n=26,324) 随访时间平均为14.2年;对照组 (n=126,834) 随访时间平均为13.7年.
- 在高血压组中,MAKE发生率为每1000人年5.52,对照组为1.66 (HR 3.03).
- 总体而言,MAKE发生在7.7%的高血压青少年中,而对照组为2.4%.
结论:
- 患有高血压的儿童和青少年长期患有重大脏不良事件的风险要大得多.
- 改善儿科高血压的识别和管理可能会防止进展性功能障碍.
- 建议进行进一步的大规模前性研究来证实这些发现.
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