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한국 소아 청소년 정상 혈압 참고치

Normative blood pressure references for Korean children and adolescents

  • 이종국 (소아청소년 신체발육 표준치 제정위원회) ;
  • 문진수 (소아청소년 신체발육 표준치 제정위원회) ;
  • 최중명 (소아청소년 신체발육 표준치 제정위원회) ;
  • 남정모 (소아청소년 신체발육 표준치 제정위원회) ;
  • 이순영 (소아청소년 신체발육 표준치 제정위원회) ;
  • 오경원 (소아청소년 신체발육 표준치 제정위원회) ;
  • 김영택 (소아청소년 신체발육 표준치 제정위원회)
  • Lee, Chong Guk (The Committee for the Development of Growth Standard for Korean Children and Adolescents) ;
  • Moon, Jin Soo (The Committee for the Development of Growth Standard for Korean Children and Adolescents) ;
  • Choi, Joong-Myung (The Committee for the Development of Growth Standard for Korean Children and Adolescents) ;
  • Nam, Chung Mo (The Committee for the Development of Growth Standard for Korean Children and Adolescents) ;
  • Lee, Soon Young (The Committee for the Development of Growth Standard for Korean Children and Adolescents) ;
  • Oh, Kyungwon (The Committee for the Development of Growth Standard for Korean Children and Adolescents) ;
  • Kim, Young Taek (The Committee for the Development of Growth Standard for Korean Children and Adolescents)
  • 투고 : 2007.11.05
  • 심사 : 2007.12.28
  • 발행 : 2008.01.15

초록

목 적 : 소아 청소년 건강관리에서 혈압 측정의 중요성이 점차 강조되고 있는 시점에서 한국의 소아 청소년들을 위한 정상 혈압 참고 치를 만들고자 하였다. 방 법 : 2005년에 새로운 신체성장 표준치를 만들기 위해 시행한 전국 소아 청소년들의 신체계측사업에 혈압 계측사업을 포함시켜 7-20세에 해당하는 소아 청소년 57,433명(남: 29,443명, 여: 27,990명)에서 신장, 체중 및 혈압 계측치를 얻었다. 혈압은 자동 진동혈압계인 Dinamap Procare 200(GE Inc., Milwaukee, Wi, USA)를 이용하여 측정하였고 앉은 자세에서 안정한 후 우측 팔에서 5분 간격으로 2번 측정하였다. 두 측정치의 평균치를 수축기 혈압과 이완기 혈압으로 기록하여 원 자료로 하였다. 체중이 +3SD 이상인 과체중아들 2,373명의 혈압은 제외하고 분석 하였다. 혈압 백분위수 표는 성별, 연령별, 신장 백분위수별로 만들어 졌으며 통계기법은 2004 Task Force in NHLBI (USA)이 사용한 통계기법을 원용한 고정 변형 LMS 방법을 사용하였다. 결 과 : 성별, 연령별(7-18세), 신장 백분위수별(5th, 10th, 25th, 50th, 75th, 90th, 95th) 혈압 참고치가 완성되었으며 신장 백분위수에 대한 자료는 질병관리본부 홈페이지인 http://www.cdc.go.kr/webcdc/에서 확인 할 수 있다. 고혈압의 기준치는 성별, 연령별, 신장대비에서 95 백분위수 이상으로 하고, 전고혈압 기준치는 90-95 백분위수 또는 수축기 및 이완기 혈압 130/80 mmHg 이상으로 정하였다. 결 론 : 이번에 마련된 우리나라 소아 청소년 정상 혈압 참고치는 처음이기 때문에 사용기준 및 고혈압의 기준은 앞으로 지속적인 논의와 연구가 필요할 것으로 생각된다. 또한 본 혈압 표는 자동 진동혈압계로 마련된 것이기 때문에 수동 수은 혈압계를 이용한 혈압 치를 평가하는 기준표로 사용하는 것은 주의해야 할 것이다.

Purpose : It is now understood that blood pressure (BP) measurement in the routine pediatric examination is very important because of the relevance of childhood BP to pediatric health care and the development of adult essential hypertension. There hasn't been a reference table of BP for Korean children and adolescents up to now. This study was to make normative BP references and to provide criteria of hypertension for Korean children and adolescents. Methods : BP measurements were done on 57,433 Koean children and adolescents (male: 29,443, female: 27,990), aged 7 to 20 years, in 2005. Heights and weights were measured simultaneously. Oscillometric devices, Dinamap Procare 200 (GE Inc., Milwaukee, Wi, USA), were used for the measurements. BPs were measured 2 times and mean levels were gathered for the analysis. Outliers of 2,373 subjects with overweight per height, over +3SD, were excluded for the analysis. For the BP centiles adjusted by sex, age and height, fixed modified LMS method which was adopted from the mixed effect model of 2004 Task Force in NHLBI (USA) was used. Results : Normative BP tables for Korean children and adolescents adjusted for height percentiles (5th, 10th, 25th, 50th, 75th, 90th, 95th), gender (male, female) and age(7 to 18 years) were completed. Height centiles of Korean children and adolescents are available from Korean Center for Disease Control and Prevention homepage, http://www.cdc.go.kr/webcdc/. Criteria of hypertension (95th, 99th percentile) and normal range of BP (50th, 90th) adjusted for height percentiles, age and gender were made. Conclusion : This is the first study to make normative BP tables and define hypertension for the Korean children and adolescents. Reliability and accuracy of Dinamap Procare 200 oscillometer for BP measurements remains debatable.

키워드

과제정보

연구 과제 주관 기관 : 보건복지부

참고문헌

  1. Sinaiko AR. Hypertension in children. N Engl J Med 1996; 335:1968-73 https://doi.org/10.1056/NEJM199612263352607
  2. Celermajer DS, Ayer JG. Childhood risk factors for adult cardiovascular disease and primary prevention in childhood. Heart 2006;92:1701-6 https://doi.org/10.1136/hrt.2005.081760
  3. Whincup PH, Cook DG, Geleijnse JM. A life course approach to blood pressure. In : Kuh D, Ben-Shlomo Y, editors. A life course approach to chronic disease epidemiology. Oxford; Oxford University Press, 2004:218-39
  4. Barker DJ, Bagby SP, Hanson MA. Mechanisms of disease: in utero programming in the pathogenesis of hypertension. Nat Clin Pract Nephrol 2006;2:700-7 https://doi.org/10.1038/ncpneph0344
  5. Sorof J, Daniels S. Obesity hypertension in children: a problem of epidemic proportions. Hypertension 2002;40:441-7 https://doi.org/10.1161/01.HYP.0000032940.33466.12
  6. National High Blood Pressure Education Program Working Group on High Blood Pressure in Children and Adolescents. The fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents. Pediatrics 2004;114(2 Suppl 4th Report):555-76
  7. National High Blood Pressure Education Program Working Group on Hypertension Control in Children and Adolescents. Update on the 1987 Task Force Report on High Blood Pressure in Children and Adolescents: a working group report from the National High Blood Pressure Education Program. Pediatrics 1996;98:649-58
  8. Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL Jr, et al. The seventh report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure: the JNC 7 report. JAMA 2003;289:2560-72 https://doi.org/10.1001/jama.289.19.2560
  9. Lee CG, Choi JM, Moon JS, Choe BK, Son CS, Yang SW, et al. 2005 Korean national survey of children and adolescents to establish the reference standard of growth and blood pressure. Final report. Gwacheon(Korea): Ministry of Health and Welfare(Korea); 2006 Mar
  10. Lee SY, Nam CM, Kim JH, Oh KW, Kim YN, Kang YJ, et al. Development of growth curves and the criteria of obesity in Korean children and adolescents. Final report. Gwacheon (Korea): Ministry of Health and Welfare(Korea); 2007 July
  11. Korea Center for Disease Control and Prevention, The Korean Pediatric Society, The Committee for the Development of Growth Standard for Korean Children and Adolescents. 2007 Korean Children and Adolescents Growth Standard (commentary for the development of 2007 growth charts). Government report online . Seoul: Division of Chronic Disease Surveillance; 2007 Nov. Available from: URL://www.cdc.go.kr/webcdc/
  12. Lee CG, Kim YT. 2007 Korean Children and Adolescents Growth Standard. Seoul: Korean Center for Disease Control and Prevention, The Korean Pediatric Society, The Committee for the Development of Growth Standard for Korean Children and Adolescents; 2007 Oct
  13. Park MK, Menard SM. Accuracy of blood pressure measurement by the Dinamap monitor in infants and children. Pediatrics 1987;79:907-14
  14. Ramsey M III. Noninvasive blood pressure monitoring methods and validation. In: Gravenstein JS, Newbower R, Ream AK, editors. Essential Noninvasive Monitoring in Anesthesia. New York: Grune & Straton Inc; 1980:37-51
  15. Park MK, Menard SW, Yuan C. Comparison of auscultatory and oscillometric blood pressures. Arch Pediatr Adolesc Med 2001;155:50-3 https://doi.org/10.1001/archpedi.155.1.50
  16. Park MK, Menard SW, Schoolfield J. Oscillometric blood pressure standards for children. Pediatr Cardiol 2005;26:601-7 https://doi.org/10.1007/s00246-004-0828-9
  17. Jackson LV, Thalange NK, Cole TJ. Blood pressure centiles for Great Britain. Arch Dis Child 2007;92:298-303 https://doi.org/10.1136/adc.2005.081216
  18. Muntner P, He J, Cutler JA, Wildman RP, Whelton PK. Trends in blood pressure among children and adolescents. JAMA 2004;291:2107-13 https://doi.org/10.1001/jama.291.17.2107
  19. Stranges S, Cappuccio FP. Children under pressure: an underestimated burden? Arch Dis Child 2007;92:288-90 https://doi.org/10.1136/adc.2006.110643
  20. McNiece KL, Poffenbarger TS, Turner JL, Franco KD, Sorof JM, Portman RJ. Prevalence of hypertension and pre-hypertension among adolescents. J Pediatr 2007;150:640-4 https://doi.org/10.1016/j.jpeds.2007.01.052
  21. Adrogue HE, Sinaiko AR. Prevalence of hypertension in junior high school-aged children: effect of new recommendations in the 1996 Updated Task Force Report. Am J Hypertens 2001;14:412-4 https://doi.org/10.1016/S0895-7061(00)01277-2

피인용 문헌

  1. 한국 소아청소년의 비만 유병률 추이: 1997년과 2005년 비교 vol.51, pp.9, 2008, https://doi.org/10.3345/kjp.2008.51.9.950
  2. 진동식 자동 혈압계로 측정한 6세 이하 아동의 정상 혈압치와 백분위수 곡선 vol.51, pp.9, 2008, https://doi.org/10.3345/kjp.2008.51.9.998
  3. 한국국민건강영양조사 병합자료(1998년, 2001년, 2005년)를 이용한 소아청소년에서의 대사증후군 진단 요인의 기초 분석 vol.51, pp.12, 2008, https://doi.org/10.3345/kjp.2008.51.12.1300
  4. 고혈압 청소년의 심혈관계 위험요소로서 Angiotensinogen M235T 유전자 다형 vol.52, pp.1, 2009, https://doi.org/10.3345/kjp.2009.52.1.36
  5. Association between Blood Pressure and Carotid Intima-Media Thickness vol.154, pp.5, 2008, https://doi.org/10.1016/j.jpeds.2008.10.047
  6. 소아 청소년기에서 고혈압 vol.52, pp.7, 2009, https://doi.org/10.3345/kjp.2009.52.7.745
  7. 소아 IgA 신병증의 장기 추적(평균 10.8년)에 따른 임상 경과 및 병리학적 변화 vol.14, pp.2, 2008, https://doi.org/10.3339/jkspn.2010.14.2.154
  8. Clinical Nutrition Therapy of Metabolic Syndrome in Adolescents vol.14, pp.4, 2011, https://doi.org/10.5223/kjpgn.2011.14.4.350
  9. Waist-to-height Ratio, a Simple and Practical Index for Screening of Adolescent Metabolic Syndrome Aged 17~19 Years vol.14, pp.4, 2008, https://doi.org/10.5223/kjpgn.2011.14.4.385
  10. Age effects on the differences between Omron HEM 907 blood pressure monitor and manual mercury sphygmomanometer blood pressure readings vol.17, pp.3, 2008, https://doi.org/10.5646/jksh.2011.17.3.114
  11. 소아 및 청소년에서 24시간 활동 혈압 측정의 임상적 유용성 vol.15, pp.2, 2008, https://doi.org/10.3339/jkspn.2011.15.2.154
  12. The Emerging Epidemic of Hypertension in Asian Children and Adolescents vol.16, pp.12, 2014, https://doi.org/10.1007/s11906-014-0495-z
  13. Blood pressure tables for Chinese adolescents: justification for incorporation of important influencing factors of height, age and sex in the tables vol.14, pp.None, 2008, https://doi.org/10.1186/1471-2431-14-10
  14. 아동.청소년의 대사증후군 및 대사이상 지표의 분포와 영양소 섭취 -2008 국민건강영양조사 자료 이용- vol.19, pp.2, 2008, https://doi.org/10.5720/kjcn.2014.19.2.133
  15. 아동.청소년의 대사증후군 및 대사이상 지표의 분포와 영양소 섭취 -2008 국민건강영양조사 자료 이용- vol.19, pp.2, 2008, https://doi.org/10.5720/kjcn.2014.19.2.133
  16. Left ventricular hypertrophy and diastolic function in children and adolescents with essential hypertension vol.21, pp.None, 2008, https://doi.org/10.1186/s40885-015-0031-8
  17. 아동 및 청소년의 대사증후군 유병여부에 따른 식생활 평가 및 관련 요인: 2007~2013 국민건강영양조사 자료를 중심으로 vol.27, pp.4, 2008, https://doi.org/10.7856/kjcls.2016.27.4.875
  18. Red meat and chicken consumption and its association with high blood pressure and obesity in South Korean children and adolescents: a cross-sectional analysis of KSHES, 2011–2015 vol.16, pp.1, 2017, https://doi.org/10.1186/s12937-017-0252-7
  19. Hypertension Risk of Obesity and Abdominal Obesity in High School Students vol.41, pp.1, 2018, https://doi.org/10.12771/emj.2018.41.1.13
  20. Clinical Relevance of C4d Deposition in Pediatric Immunoglobulin A Nephropathy vol.37, pp.5, 2018, https://doi.org/10.1080/15513815.2018.1504841
  21. Effects of Prenatal Growth Status on Subsequent Childhood Renal Function Related to High Blood Pressure vol.34, pp.25, 2008, https://doi.org/10.3346/jkms.2019.34.e174
  22. Secular change in waist circumference and waist-height ratio and optimal cutoff of waist-height ratio for abdominal obesity among Korean children and adolescents over 10 years vol.62, pp.7, 2008, https://doi.org/10.3345/kjp.2018.07038
  23. Mental health and psychosocial adjustment in pediatric chronic kidney disease derived from the KNOW-Ped CKD study vol.34, pp.10, 2008, https://doi.org/10.1007/s00467-019-04292-w
  24. Secular trends in hypertension and elevated blood pressure among Korean children and adolescents in the Korea National Health and Nutrition Examination Survey 2007‐2015 vol.22, pp.4, 2008, https://doi.org/10.1111/jch.13842
  25. Rasburicase improves the outcome of acute kidney injury from typical hemolytic uremic syndrome vol.35, pp.11, 2008, https://doi.org/10.1007/s00467-020-04644-x
  26. Impact of size at birth and postnatal growth on metabolic and neurocognitive outcomes in prematurely born school-age children vol.11, pp.1, 2008, https://doi.org/10.1038/s41598-021-86292-1