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Reevaluate secular trends of body size measurements and prevalence of hypertension among Chinese children and adolescents in past two decades. J Hypertens 2017; 34:2337-2343. [PMID: 27607456 DOI: 10.1097/hjh.0000000000001114] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
OBJECTIVE This study reevaluated the secular trends of blood pressure and hypertension prevalence in Chinese children and adolescents by adjusting for growing body sizes. METHODS The study population was from the China Health and Nutrition Survey (1991-2011) and included 7358 boys and 6881 girls aged 8-17 years. Body size measurements and blood pressure were standardized into z-scores using national references to allow comparisons among different age groups and survey years. Prehypertension and hypertension rates were defined by using national and international age-specific and height-specific references. RESULTS SBP and DBP increased 0.07 and 0.09 SD per survey year, respectively. BMI, waist circumference, and height increased 0.14, 0.11, and 0.29 SD, respectively. The general obesity prevalence increased from 1.5 to 8.1% (Ptrends ≤ 0.0001), with an average annual increase (AAI) of 0.36 and 0.42% for urban and rural boys, respectively, and of 0.33 and 0.22% for urban and rural girls, respectively. The hypertension prevalence increased from 6.9 to 10.7% (Ptrends ≤ 0.0001). The overall AAI in hypertension was 0.19% and was three-fold higher among boys (0.29%) than among girls (0.09%), explaining the sex difference in the rural population. The area and sex differences in AAI remained after applying the international criteria. CONCLUSION By adjusting for height, the hypertension prevalence in Chinese children increased 0.19% per year on average over the last two decades, which is much less than that reported in previous studies. This trend appears regardless of sex and area and is consistent with the obesity trend.
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Feng Y, Tang X, Liu M, Zhou J, Zhao X, Li Q. Clinical study of children with Takayasu arteritis: a retrospective study from a single center in China. Pediatr Rheumatol Online J 2017; 15:29. [PMID: 28416004 PMCID: PMC5393038 DOI: 10.1186/s12969-017-0164-2] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Accepted: 04/11/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Delayed diagnosis of childhood Takayasu arteritis (TA) is common due to its atypical symptoms. The objective of the present study was to summarize the clinical features of childhood TA to raise awareness and improve management. METHODS Eleven children diagnosed with TA at our hospital were enrolled. Clinical information, diagnosis, treatment, and outcome were then examined retrospectively. The Pediatric Vasculitis Activity Score (PVAS) and the Indian Takayasu Clinical Activity Score (ITAS2010) were used to assess disease activity. RESULTS Male-to-female ratio was 4:7. The mean age was 9.4 (1.4-14) years and the average time to diagnosis was 40.6 days (12-90 days). All patients suffered from hypertension and few had immunologic abnormalities. Two patients had low levels of autoantibodies and one had elevated immunoglobulin E levels. Aberrant (elevated) laboratory parameters included erythrocyte sedimentation rate (ESR) (9/10 patients, 90.0%), protein excretion (8/9 patients, 88.9%), renin-angiotensin-aldosterone system (RAAS) activity (5/5 patients, 100.0%), and serum lipid levels (3/5 patients, 60%). The common onset patterns were headache with convulsions (27.2%) and kidney damage (27.2%). The abdominal aorta (81.8%) and renal artery (72.7%) were the most commonly involved vessels. At presentation, the mean PVAS and ITAS2010 scores were 12.1 (6-26)/63 and 9.7 (5-14)/57, respectively. All patients were treated with glucocorticoids and antihypertensive agents; two underwent renal artery stent placement. CONCLUSION The diagnosis of TA should be considered in patients with pediatric hypertension and high expression of inflammatory markers or abnormal urine results. Doppler ultrasonography of major vessels may be helpful. PVAS and ITAS2010 both help to evaluate disease activity, and the PVAS is recommended for patients with kidney damage. Glucocorticoid and antihypertensive agents are effective. Interventional therapy can be an option for patients with persistent hypertension.
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Affiliation(s)
- Ye Feng
- 0000 0000 8653 0555grid.203458.8Department of Rheumatology and Immunology, Children’s Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, No. 136, Zhongshan 2nd Road, Yuzhong District, Chongqing, 400014 People’s Republic of China ,Chongqing Key Laboratory of Pediatrics, No. 136, Zhongshan 2nd Road, Yuzhong District, Chongqing, 400014 People’s Republic of China
| | - Xuemei Tang
- Department of Rheumatology and Immunology, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, No. 136, Zhongshan 2nd Road, Yuzhong District, Chongqing, 400014, People's Republic of China. .,China International Science and Technology Cooperation base of Child development and Critical Disorders, No. 136, Zhongshan 2nd Road, Yuzhong District, Chongqing, 400014, People's Republic of China. .,Chongqing Key Laboratory of Pediatrics, No. 136, Zhongshan 2nd Road, Yuzhong District, Chongqing, 400014, People's Republic of China.
| | - Mingyue Liu
- 0000 0000 8653 0555grid.203458.8Department of Rheumatology and Immunology, Children’s Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, No. 136, Zhongshan 2nd Road, Yuzhong District, Chongqing, 400014 People’s Republic of China ,Chongqing Key Laboratory of Pediatrics, No. 136, Zhongshan 2nd Road, Yuzhong District, Chongqing, 400014 People’s Republic of China
| | - Juan Zhou
- 0000 0000 8653 0555grid.203458.8Department of Rheumatology and Immunology, Children’s Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, No. 136, Zhongshan 2nd Road, Yuzhong District, Chongqing, 400014 People’s Republic of China ,China International Science and Technology Cooperation base of Child development and Critical Disorders, No. 136, Zhongshan 2nd Road, Yuzhong District, Chongqing, 400014 People’s Republic of China ,Chongqing Key Laboratory of Pediatrics, No. 136, Zhongshan 2nd Road, Yuzhong District, Chongqing, 400014 People’s Republic of China
| | - Xiaodong Zhao
- 0000 0000 8653 0555grid.203458.8Department of Rheumatology and Immunology, Children’s Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, No. 136, Zhongshan 2nd Road, Yuzhong District, Chongqing, 400014 People’s Republic of China ,China International Science and Technology Cooperation base of Child development and Critical Disorders, No. 136, Zhongshan 2nd Road, Yuzhong District, Chongqing, 400014 People’s Republic of China ,Chongqing Key Laboratory of Pediatrics, No. 136, Zhongshan 2nd Road, Yuzhong District, Chongqing, 400014 People’s Republic of China
| | - Qiu Li
- China International Science and Technology Cooperation base of Child development and Critical Disorders, No. 136, Zhongshan 2nd Road, Yuzhong District, Chongqing, 400014 People’s Republic of China ,Chongqing Key Laboratory of Pediatrics, No. 136, Zhongshan 2nd Road, Yuzhong District, Chongqing, 400014 People’s Republic of China
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