Incidência de Hipertensão Arterial está Associada com Adiposidade em Crianças e Adolescentes / Incidence of Arterial Hypertension is Associated with Adiposity in Children and Adolescents

Resumo Fundamento O aumento de hipertensão em crianças e adolescentes tem atraído a atenção da comunidade científica, especialmente por sua associação com a epidemia da obesidade. Objetivos Descrever a incidência de hipertensão e sua relação com o perfil cardiometabólico e genético em crianças e adolescentes de uma cidade do sul do Brasil em um período de três anos. Métodos Este estudo longitudinal acompanhou 469 crianças e adolescentes com idade entre 7 e 17 anos (43,1% do sexo masculino), avaliados em dois momentos. Avaliamos pressão arterial sistólica (PAS), pressão arterial diastólica (PAD), circunferência da cintura (CC), índice de massa corporal (IMC), porcentagem de gordura corporal (%GC), perfil lipídico, glicemia, aptidão cardiorrespiratória (APCR), e polimorfismo rs9939609 (gene FTO ) ( fat mass and obesity - associated gene ). A incidência cumulativa da hipertensão foi calculada, e realizada regressão logística multinominal. A diferença estatística foi estabelecida em p<0,05. Resultados Após três anos, a incidência de hipertensão foi de 11,5%. Indivíduos com sobrepeso e indivíduos obesos apresentaram maior probabilidade de se tornarem indivíduos classificados como borderline para hipertensão (sobrepeso OR: 3,22; IC95%: 1,08-9,55; obesidade OR: 4,05; IC95%: 1,68-9,75), e indivíduos obesos apresentaram maior probabilidade de se tornarem hipertensos (obesidade OR: 4,84; IC95%: 1,57-14,95). Valores de CC e de %GC considerados de alto risco foram associados com o desenvolvimento de hipertensão (OR: 3,41; IC95%: 126-9,19; OR: 2,49, IC95%: 1,08-5,75, respectivamente). Conclusão Encontramos uma incidência de hipertensão em crianças e adolescentes mais alta em comparação a estudos anteriores. Indivíduos com valores mais altos de IMC, CC e %GC no baseline apresentaram maior probabilidade de desenvolverem hipertensão, sugerindo a importância da adiposidade no desenvolvimento de hipertensão, mesmo em uma população tão jovem.

Abstract Background The increase of hypertension in children and adolescents has attracted the attention of the scientific community largely due to its association with the obesity epidemic. Objectives To describe the incidence of hypertension and its relationship with the cardiometabolic and genetic profile in children and adolescents from a city in southern Brazil in a three-year period. Methods This longitudinal study followed 469 children and adolescents, aged 7-17 years old (43.1% boys), assessed at two-time points. We evaluated systolic and diastolic blood pressures (SBP and DBP), waist circumference (WC), body mass index (BMI), body fat percentage (%BF), lipid profile, glucose, cardiorespiratory fitness (CRF), and rs9939609 Polymorphism ( FTO ). Cumulative incidence of hypertension was calculated, and multinomial logistic regression was conducted. The statistical significance was established as p < 0.05. Results After three years, the incidence of hypertension was 11.5%. Overweight or obese individuals were more likely to become borderline hypertensive (overweight OR: 3.22, 95% CI: 1.08-9.55; obesity OR: 4.05, 95% CI: 1.68-9.75), and obese individuals were more likely to become hypertensive (obesity OR: 4.84, 95% CI: 1.57-14.95). High-risk WC and %BF values were associated with hypertension development (OR: 3.41, 95% CI: 1.26-9.19; OR: 2.49, 95% CI: 1.08-5.75, respectively). Conclusions We found a higher incidence of hypertension in children and adolescents as compared with previous studies. Individuals with higher values of BMI, WC and %BF at baseline were more likely to develop hypertension, suggesting the importance of adiposity in the development of hypertension even in such a young population.

Hypertension and Different Levels of Body Mass Index and Cardiorespiratory Fitness Amongst Adolescents

Abstract Background Hypertension is an increasingly common problem in adolescents; amongst the associated factors, physical inactivity and obesity are increasing the risk of developing cardiovascular diseases. Objective To verify whether there is an association between higher blood pressure levels amongst adolescents with the relationship between different levels of body mass index (BMI) and cardiorespiratory fitness (CRF). Method Cross-sectional study consisting of 860 adolescents. Higher blood pressure (BP) was considered as borderline and hypertension as the classification. BMI was categorized as low-normal weight and overweight-obesity. The CRF was assessed by a nine-minute run/walk test and classified into low or appropriate levels (less and more favorable to health, respectively). Later, BMI and CRF were grouped into one categorical variable: (I) low/normal weight and appropriate CRF levels; (II) low/normal weight and low CRF levels; (III) overweight/obesity and appropriate CRF levels; and (IV) overweight/obesity and low CRF levels. Data were analyzed using Poisson regression, through the prevalence ratio (PR) and 95% confidence intervals (CI). The p-values of p <0.05 were considered significant. Results Adolescents with overweight/obesity and low CRF levels had a 22% higher BP prevalence. Moreover, children with overweight/obesity, but with appropriate CRF levels, have a 15% higher BP prevalence. Conclusion Adolescents with overweight/obesity had a higher prevalence of BP, regardless of CRF levels. It is suggested that maintaining normal BMI is a protective factor for less favorable BP.

Association between the screen time and the cardiorespiratory fitness with the presence of metabolic risk in schoolchildren / Associação entre o tempo de tela e a aptidão cardiorrespiratória e a presença de risco metabólico em escolares

ABSTRACT Objective: To verify the association between screen time and cardiorespiratory fitness with the presence of metabolic risk in schoolchildren in an isolated and clustered manner. Methods: Cross-sectional study with 1.200 schoolchildren from Santa Cruz do Sul-RS. Screen time and cardiorespiratory fitness were evaluated. The continuous metabolic risk score was calculated by summing the Z score of the waist circumference, systolic blood pressure, glucose, triglycerides, total cholesterol, low-density lipoprotein (LDL-C) and high-density lipoprotein (HDL-C). Results: Children (34.3%) and adolescents (48.2%) had high screen time, while 44.3% of the children and 53.3% of the adolescents were unfit in relation to cardiorespiratory fitness. Regarding the relation of screen time/cardiorespiratory fitness, 14.7% of the children and 26.9% of the adolescents presented high screen time and low levels of cardiorespiratory fitness. The presence of metabolic risk was shown in children (17.1%) and adolescents (14.7%). The presence of metabolic risk was directly associated with low levels of cardiorespiratory fitness in children and adolescents. When analyzed in clusters, the metabolic risk in children was 11% more prevalent in subjects with low screen time/unfit and 12% in subjects with high screen time/unfit, whereas in adolescents, the prevalence of metabolic risk was also higher in those with low screen time/unfit (8%) and high screen time/unfit (7%). Conclusions: The presence of metabolic risk in children and adolescents was associated with low levels of cardiorespiratory fitness, independent of screen time, in an isolated or clustered manner.

RESUMO Objetivo: Verificar a associação entre tempo de tela e aptidão cardiorrespiratória, de forma isolada e agrupada, e a presença de risco metabólico em escolares. Métodos: Estudo transversal com 1.200 escolares de Santa Cruz do Sul (RS). Foram avaliados o tempo de tela e a aptidão cardiorrespiratória. Foi calculado o escore de risco metabólico por meio da soma do escore Z, da circunferência da cintura, da pressão arterial sistólica, da glicose, dos triglicerídeos, do colesterol total, do colesterol da lipoproteína de baixa densidade (LDL) e do colesterol da lipoproteína de alta densidade (HDL). Resultados: Crianças (34,3%) e adolescentes (48,2%) apresentaram elevado tempo de tela, enquanto 44,3% das crianças e 53,3% dos adolescentes foram inaptos no tocante à aptidão cardiorrespiratória. Na relação tempo de tela/aptidão cardiorrespiratória, 14,7% das crianças e 26,9% dos adolescentes exibiram elevado tempo de tela e baixos níveis de aptidão cardiorrespiratória. A presença de risco metabólico foi evidenciada em crianças (17,1%) e em adolescentes (14,7%). A presença de risco metabólico esteve associada diretamente com baixos níveis de aptidão cardiorrespiratória nas crianças e nos adolescentes no que se refere às variáveis de forma isolada. Quando analisado de modo agrupado, o risco metabólico em crianças foi 11% mais prevalente em sujeitos com baixo tempo de tela/inaptos e 12% em sujeitos com elevado tempo de tela/inaptos, enquanto em adolescentes a prevalência de risco metabólico também foi superior nos escolares com baixo tempo de tela/inaptos (8%) e elevado tempo de tela/inaptos (7%). Conclusões: A presença de risco metabólico em crianças e adolescentes esteve associada com baixos níveis de aptidão cardiorrespiratória, independentemente do tempo de tela, tanto de modo isolado quanto agrupado.

Youth overweight/obesity and its relationship with cardiovascular disease and parental risk factors

ABSTRACT Objective The prevalence of overweight and obesity is gradually increasing in both developed and developing countries. Obesity, for instance, can present multifactorial causes that interact with each other. Among the important factors, parental obesity plays a prominent role in the onset of obesity during childhood and teenage years through genetics and ambient aspects. This study aims to verify the possible existence of an association between overweight/obesity of schoolchildren and cardiovascular risk (CVR) factors for their parents. Subjetcs and methods For this purpose, a cross-sectional study was conducted with a sample of 1,243 children and adolescents, aged between 7 and 17. Out of the total number of participants, 563 (45.3%) were boys who were selected across 19 schools in the urban and rural areas of Santa Cruz do Sul, Rio Grande do Sul (Brazil). The overweight/obesity status of the schoolchildren was evaluated through their body mass index (BMI). Additionally, a self-reference questionnaire was employed to measure their parents' CVR. Results The results of this study revealed that students with overweight/obesity have a higher probability of having a father with hypertension (OR = 1.49; p = 0.038) and obesity (OR = 2.36; p = 0.002) and a mother with obesity (OR = 1.72; p = 0.016). Conclusion To conclude, this study confirms a relationship between overweight/obesity of schoolchildren with CVR for their parents.

Obesidade e aptidão física relacionada à saúde: um estudo com escolares de 10 a 13 anos de Santa Cruz do Sul - Brasil / Obesity and health related physical fitness: a study with schoolchildren aged 10 to 13 years from Santa Cruz do Sul ­ Brazil

Introdução: O sobrepeso e a obesidade são considerados problemas de saúde pública e têm sido ligados a baixos níveis de atividade física, tornando-se fatores de risco à saúde e contribuindo para o aparecimento de doenças crônicas.Bons níveis de aptidão física também são fatores que reduzemdoenças crônicas. Objetivo: Avaliar a associação entre obesidade e aptidão física relacionada àsaúde em escolares de 10 a 13 anos de idade. Casuística e métodos: Estudo transversal compostopor 785 escolares, de ambos os sexos, entre 10 e 13 anos de idade, pertencentes a escolas municipais e estaduais de Santa Cruz do Sul, RS ­ Brasil. Foram avaliados o Índice de Massa Corporal (IMC) de acordo com os parâmetros da Organização Mundial da Saúde, e as características de aptidão físicade flexibilidade, resistência muscular e aptidão cardiorrespiratória (APCR) segundo os protocolosdo Projeto Esporte Brasil. Resultados: Em ambos os sexos, os valores médios de Índice de MassaCorporal são superiores entre os adolescentes classificados na faixa de risco à saúde para resistênciaabdominal e aptidão cardiorrespiratória, em relação aos adolescentes na faixa saudável (p<0,05).Além disso, adolescentes com sobrepeso/obesidade apresentam maior prevalência de baixos níveisde resistência abdominal (10% para meninos e 20% para meninas) e de aptidão cardiorrespiratória(21% para meninos e 22% para meninas). Conclusão: A presença de sobrepeso e obesidade estáassociada com baixos níveis de resistência abdominal e de aptidão cardiorrespiratória, em escolarescom 10 a 13 anos de idade.

Introduction: Overweight and obesity are considered public health problems and have been linked to low levels of physical activity. Both diseases became risk factors for health and contribute to the development of chronic diseases. Good levels of physical fitness are risk-reducing factors for chronic diseases. Objective: Evaluate the association between obesity and health-related physical fitness in schoolchildren aged 10 to 13 years. Patients and Methods: We carried out a cross-sectional study with 785 schoolchildren of both sexes age ranging from 10 to 13 years-old, who attend public schools in Santa Cruz do Sul, RS ­ Brazil. We evaluated the Body Mass Index (BMI), according to parameters of World Health Organization, and health-related physical fitness characteristics of flexibility, muscular endurance and cardiorespiratory fitness (CRF) according to the protocols of the Projeto Esporte Brasil. Results: In both sexes, the mean values ofBody MassIndex were higher among adolescents classified in the health-risk zone for abdominal resistance and cardiorespiratory fitness, in relation to adolescents in the healthy zone (p<0.05). In addition, overweight/obese adolescents showeda higher prevalence of low levels of abdominal resistance (10% for boys and 20% for girls) and cardiorespiratory fitness (21% for boys and 22% for girls). Conclusion: The presence of overweight and obesity is associated with low levels of abdominal resistance and cardiorespiratory fitness in schoolchildren aged 10 to 13 years-old.