Correlation analysis of child and adolescent Korotkoff phase Ⅳ and Ⅴ sound with subclinical cardiovascular diseases in adulthood / 中华实用儿科临床杂志

ABSTRACT

Objective To examine the value of child and adolescent Korotkoff phase Ⅳ(K4)and Korotkoff phaseⅤ(K5)diastolic blood pressures for predicting subclinical cardiovascular disease(CVD)in adulthood.Methods The data was obtained from the Beijing Children Blood Pressure Study.A total of 3 198(1 700 males,53.2%)healthy children aged 6-18 years from 6 districts in Beijing in 1987 were selected.The physical examination process included measuring height,weight,and blood pressure.From a follow-up survey in 2010-2012,1 252 subjects were analyzed by the same measurements (height,weight and blood pressure)and also by using subclinical markers for vascular damage,including carotid intima-media thickness (cIMT)and carotid-femoral pulse wave velocity (cfPWV).Childhood hypertension at baseline and adulthood hypertension were diagnosed according to the China Guideline for Hypertension Prevention and Control issued in 2010.High cfPWV and high cIMT were defined in adults as having higher than age and gender-specific 75th percentile of cfPWV and cIMT.Pearson correlation coefficients were calculated to describe the association of K4 and K5 in childhood with systolic blood pressure(SBP),diastolic blood pressure(DBP),cfPWV, and cIMT in adulthood.Logistic regression was used to analyze the values of K4 and K5 to predict subclinical CVD in adulthood.Results The baseline mean value of K4 DBP was (66.4 ± 9.1)mmHg (1 mmHg＝0.133 kPa)and K5 DBP was (54.1 ± 11.1)mmHg.The prevalence rates of high-normal blood pressure were 9.4% with DBP measured by using K4,and 6.9% with DBP measured by using K5,respectively. The prevalence rates of hypertension were 11. 3% with DBP measured by using K4,and 8.4%with DBP measured by using K5.After adjustment for age and follow-up age,Pearson correlation analyses showed K4 DBP and K5 DBP in childhood were all significantly associated with adult SBP,DBP,cIMT,cfPWV in males and in females (all P＜0.05).K4 in childhood was better correlated with SBP,DBP,cIMT and cfPWV in adulthood than K5.With multi-factor logistic regression analysis,K4 was better than K5 in predicting CVD in adulthood after controlling gender and age.Further K4 was more effective in predicting cfPWV than cIMT.Conclusions There was a significant difference between K4 and K5 in Chinese children and adolescents. K4 in childhood was better correlated with CVD in adults than K5,and K4 is superior to K5 when using auscultator technique to measure DBP.