Clinical and Experimental Pediatrics

The Korean Pediatric Society (대한소아청소년과학회)
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Normative blood pressure references for Korean children and adolescents

한국 소아 청소년 정상 혈압 참고치

  • 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)
  • 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)
  • Received : 2007.11.05
  • Accepted : 2007.12.28
  • Published : 2008.01.15
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Abstract

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.

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.

Keywords

Acknowledgement

Supported by : 보건복지부

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