Purpose

A significant proportion of noncommunicable diseases in adults has its roots in adolescence, and this is particularly true for cardiovascular disease and stroke. Detection of vascular and metabolic risk factors at young ages may aid disease prevention.

Methods

In 2,088 adolescents sampled from the general population of Tyrol, Austria, and South Tyrol, Italy, we systematically assessed the frequency of yet unknown vascular and metabolic risk conditions that require further diagnostic workup or intervention (lifestyle counselling or pharmacotherapy). The health screening included medical history taking, fasting blood analysis, and blood pressure and body measurements and was performed at schools. To recruit a representative sample of adolescents, equal proportions (about 67%) of schools were invited per school type and region.

Results

Adolescents were on average 16.4 (standard deviation 1.1) years old, and 56.4% were female. A proportion of 22.8% (95% confidence interval [CI], 19.6–26.3) had previous or current physician-confirmed diseases. The health screening newly detected relevant medical conditions in 45.4% [95% CI, 41.5–49.4] (55.8% [95% CI, 52.7–58.7] in boys and 37.4% [95% CI, 35.0–39.8] in girls, p < .001). The most prevalent were elevated blood pressure and hypertension, metabolic syndrome, hypercholesterolemia, hypertriglyceridemia, hyperuricemia, and subclinical hypothyroidism. Detection of risk conditions did not depend on socioeconomic status but increased with age and body mass index.

Conclusions

Vascular health screening in adolescents at schools has a high diagnostic yield and may aid guideline-recommended prevention in the youth. Implementation should carefully consider national differences in healthcare systems, resources, and existing programs.

中文翻译：

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系统性血管健康筛查方法在学校青少年中的诊断率

目的

成人中很大一部分非传染性疾病起源于青春期，心血管疾病和中风尤其如此。在年轻时检测血管和代谢危险因素可能有助于疾病预防。

方法

在从奥地利蒂罗尔和意大利南蒂罗尔的普通人群中抽取的 2,088 名青少年中，我们系统地评估了需要进一步诊断检查或干预（生活方式咨询或药物治疗）的未知血管和代谢风险状况的频率。健康检查包括病史采集、空腹血液分析、血压和身体测量，并在学校进行。为了招募具有代表性的青少年样本，每个学校类型和地区都邀请了相同比例（约 67%）的学校。

结果

青少年平均年龄为 16.4（标准差 1.1）岁，其中 56.4% 为女性。22.8%（95% 置信区间 [CI]，19.6-26.3）的比例有既往或当前经医生确认的疾病。健康筛查新发现了 45.4% [95% CI, 41.5–49.4] (55.8% [95% CI, 52.7–58.7] 的男孩和 37.4% [95% CI, 35.0–39.8] 的女孩, p < .001)。最常见的是血压升高和高血压、代谢综合征、高胆固醇血症、高甘油三酯血症、高尿酸血症和亚临床甲状腺功能减退症。风险状况的检测不依赖于社会经济地位，而是随着年龄和体重指数的增加而增加。

结论

在学校对青少年进行血管健康筛查具有很高的诊断率，并且可能有助于青少年指南推荐的预防措施。实施应仔细考虑医疗保健系统、资源和现有计划的国家差异。