[Changing trends in the levels of blood pressure and prevalence of hypertension among Chinese children and adolescents from 1991 to 2015].

Objective: To examine the trends in blood pressure levels and prevalence of hypertension among Chinese children and adolescents aged 7-17 years from 1991 to 2015, using the four blood pressure references for children and adolescents, in order to provide basic data for the prevention and control of hypertension. Methods: A total of 14 622 children and adolescents aged 7-17 years were selected from the China Health and Nutrition Survey 1991-2015. Hypertension was defined under the four latest published references including the 2018 Health Industry pediatric blood pressure reference (Industry Reference), the 2018 Chinese Hypertension Prevention and Treatment Guideline reference (Guideline Reference), the 2016 International Child Blood Pressure Reference (International Reference), and the 2017 Blood Pressure Reference by the American Academy of Pediatrics (US Reference). Multivariable liner regression model was used to examine the trends in blood pressure levels from 1991 to 2015, and multivariable logistic regression model was used to examine the trend in prevalence of hypertension from 1991 to 2015. Results: After adjusted for factors as age, sex, region, and BMI, the SBP appeared an increase, from 96.1 mmHg in 1991 to 102.7 mmHg and DBP from 62.6 mmHg to 67.4 mmHg (all P for trend <0.001) in 2015. The prevalence rates of hypertension defined by Industry Reference, Guideline Reference, International Reference and US Reference increased from 5.7%, 8.9%, 4.4% and 8.1% in 1991, to 12.8%, 20.5%, 13.1% and 17.8% (all P for trend <0.001) in 2015, respectively. Conclusion: Both levels of blood pressure and the prevalence of hypertension increased significantly in Chinese children and adolescents from 1991 to 2015.目的： 采用4类儿童血压标准分析1991－2015年中国7～17岁儿童青少年血压水平和高血压检出率的变化趋势，为儿童青少年高血压的防控提供参考数据。 方法： 基于"中国健康与营养调查"1991－2015年数据，选取资料完整的14 622名7～17岁儿童青少年。儿童高血压的诊断分别采用2018年国家卫生行业儿童血压标准（行业标准）、《2018年中国高血压防治指南儿童血压标准》（指南标准）、2016年国际儿童血压参考值（国际标准）和2017年美国儿科协会血压参考值（美国标准）。采用多元线性回归模型分析1991－2015年儿童青少年血压水平的变化趋势，采用logistic回归模型分析血压偏高和高血压检出率的变化趋势。 结果： 调整年龄、性别、地区和BMI后，SBP从1991年的96.1 mmHg增加至2015年的102.7 mmHg；DBP从1991年的62.6 mmHg增加至2015年的67.4 mmHg（趋势检验均P<0.001）。采用行业标准、指南标准、国际标准和美国标准诊断的高血压检出率分别由1991年5.7%、8.9%、4.4%和8.1%增长至2015年的12.8%、20.5 %、13.1%和17.8%（趋势检验均P<0.001）。 结论： 1991－2015年中国儿童青少年血压水平及高血压检出率均呈增加趋势。.