儿童和青少年高血压（英文）.ppt

Childhood and Adolescent Hypertension Cardiovascular Disease Prevention Childhood and Adolescent Hypertension Trends during past 50 years- 1958-mostly “secondary” Primary considered rare. 2008-mostly “primary”, Secondary to obesity and lack of physical activity Childhood and Adolescent Hypertension Types of Cardiovascular prevention Primordial-Prevention of development of cardiovascular risk factors. Primary-Control cardiovascular risk factors once they are present. Secondary-Reduction of risk factors once a cardiovascular event has occurred. Childhood and Adolescent Hypertension PDAY and Bogalusa Studies Fatty streaks in coronary arteries and aorta occur early in life. More advanced fibrous plaques in adolescents and young adults. 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 abdom