小児生活習慣病の診断基準の年齢推移と変化―高血圧を中心に

Age-related changes in diagnostic criteria for lifestyle-related diseases (esp. hypertension) in childhood

本態性高血圧は児童生徒の1％前後に存在する．程度は軽いが，成人の本態性高血圧に高率に進展するほか，臓器障害を起こす可能性も高い．血圧は高校生くらいまで年齢とともに上昇するので，高血圧基準値も年齢により異なる．従来，わが国の高血圧基準値は米国よりかなり高かったが，最近のデータの蓄積により，米国に類似した基準値が提唱されている．高血圧以外の小児生活習慣病診断基準に関しては，肥満やメタボリックシンドロームで，年齢によりごく一部が異なるだけであり，脂質異常症や糖尿病に関しては年齢による診断基準の差はない．

Essential hypertension is found in aproximately 1% of school children.　The elevation of BP (blood pressure) is generally mild, but essential hypertension during childhood may endure into adulthood, and may involve organ damages even in childhood.　Since children's BP shows age-related increase, the diagnostic criteria for hypertension also change according to age.　The BPs shown in the criteria were higher by approximately 10 mmHg in Japan than in the United States probably because of the fewness of data available on children's BP in Japan.　Recent studies have, however demonstrated similar BPs between Japanese and American children.　Concerning other lifestyle-related diseases, diagnostic criteria for obesity and metabolic syndrome show minimal difference between young and older children.