儿童和青少年高血压(英文）文件材料.ppt

Childhood and Adolescent Hypertension James H. Moller, M.D. Professor and former Head of Pediatrics University of Minnesota Minneapolis Minnesota, 55455 molle002@umn.edu Childhood and Adolescent Hypertension Cardiovascular Disease Prevention Childhood and Adolescent Hypertension PDAY and Bogalusa Studies Risk factors of high body mass index, high blood pressure, dyslipidemia – strongly associated with extent of arterial lesions. Presence of multiple risk factors associated with higher risk of atherosclerotic lesions. Childhood and Adolescent Hypertension Long-term study of children first seen from 1922 to1935. Of adolescents with BMI greater than 75% relative risk of death from coronary heart disease is 2.3. Also higher morbidity from coronary artery disease. Childhood and Adolescent Hypertension Clustering of Cardiovascular Risk Factors Stroke associated with obesity and hypertension Obese children often have some degree of insulin resistance Insulin resistance syndrome occurs in children with truncal obesity, high triglycerides, low LDL-C, hyperinsulinemia Childhood and Adolescent Hypertension Evaluation of Children and Adolescents History about physical activity, food choices, smoking, sleep disorders. Family history of early (under 55 years) of cardiovascular events or disease. Childhood and Adolescent Hypertension Evaluation of Children and Adolescents Careful and repeated measurement of blood pressure Measure height and weight-compare to growth charts Measure abdominal circumference Calculate body mass index (BMI) BMI=weight (kg)/height(M)squared Childhood and Adolescent Hypertension Blood Pressure Measurement All children over 3 years old in medical setting should have blood pressure measured. Auscultation preferred measurement method. Use appropriate sized blood pressure cuff. Elevated blood pressure measurement must be confirmed by repeat readings Childhood and Adolescent Hypertension Management of Normal BP BP less than 90%. Measure BP on next regu