Adolescent blood pressure classification curves and cardiometabolic risk factors: a comparison of the Brazilian and American references.

BACKGROUND: The American Academy of Pediatrics (AAP) adolescent blood pressure (BP) percentiles were updated in 2017, and have been used as reference in Brazil since then. However, specific BP percentiles for Brazilian adolescents were recently proposed based on data from the Study of Cardiovascular Risk in Adolescents (ERICA). OBJECTIVES: To compare the prevalence of arterial hypertension according to each reference, as well as to assess the cardiometabolic risk associated with the reclassification by Brazilian BP percentiles. METHODS: Data from 73 399 adolescents aged 12-17 years who participated in the ERICA study were analyzed. To assess cardiometabolic risk, 6185 adolescents who were reclassified upwards by the Brazilian reference were 1 : 1 matched with adolescents that were normotensive by both references and were of the same age, sex and height percentile. The parameters evaluated were: overweight/obesity, waist circumference, total cholesterol, triglycerides, LDL-c, HDL-c, fasting glucose, HbA1c and HOMA-ir. RESULTS: The classification according to Brazilian BP percentiles resulted in a higher prevalence of arterial hypertension (14%, 95% CI 13.2-14.8), when compared with the AAP percentiles (10.6%, 95% CI 10.0-11.2). The use of the Brazilian reference also resulted in higher prevalence of arterial hypertension in girls, teenagers ranging from 12 to 14 years, and those classified with adequate weight, overweight or obesity. In the case-control analysis, cardiometabolic risk factors were present more often in adolescents reclassified with arterial hypertension by the ERICA reference. DISCUSSION: The use of the BP percentiles proposed by ERICA is a sensitive method for tracking Brazilian adolescents with hypertension and higher cardiometabolic risk.

Fatores de risco associados à hipertensão arterial em adolescentes / Risk factors associated with arterial hypertension in adolescents

OBJETIVO: Investigar os fatores de risco associados à hipertensão arterial primária em adolescentes. MÉTODOS: Estudo caso-controle de base ambulatorial com adolescentes, de 12 a 20 anos incompletos, todos provenientes do Núcleo de Estudos da Saúde do Adolescente da Universidade Estadual do Rio de Janeiro. O estado nutricional foi avaliado através do índice de massa corporal. Obteve-se ainda a medida da circunferência abdominal, estatura, história familiar de hipertensão arterial, peso ao nascer e desenvolvimento puberal. A análise foi elaborada através de regressão logística não condicional. RESULTADOS: Participaram 91 casos e 182 controles. O índice de massa corporal mostrou-se associado à hipertensão. A estatura mostrou associação positiva com hipertensão apenas em meninas. Não se evidenciou associação entre desenvolvimento puberal e peso ao nascer com hipertensão arterial na adolescência. Por outro lado, a história familiar, principalmente quando ambos os pais são hipertensos, apresentou forte associação, tanto em meninos (OR = 13,32; IC95 por cento 2,25-78,94), como em meninas (OR = 11,35; IC95 por cento 1,42-90,21). CONCLUSÕES: Em nosso estudo, sobrepeso, obesidade e história familiar de hipertensão (pai e mãe hipertensos) foram os principais fatores de risco para o desenvolvimento de hipertensão arterial em adolescentes.

OBJECTIVE: To investigate the risk factors associated with essential arterial hypertension in adolescents. METHODS: A case-control, outpatients-based study of adolescents, aged 11 to 19 years, all treated at the Center for Studies into Adolescent Health (Núcleo de Estudos da Saúde do Adolescente) at Universidade Estadual do Rio de Janeiro. Nutritional status was assessed by means of body mass index. Data were also obtained on waist circumference, height, family history of arterial hypertension, birth weight and pubertal development. The analysis was performed using unconditional logistic regression. RESULTS: The study investigated 91 cases and 182 controls. Body mass index was associated with hypertension. Height had a positive association with hypertension only among the girls. There was no evidence of an association between pubertal development or birth weight with arterial hypertension in adolescence. In contrast, family history, particularly when both parents had hypertension, exhibited a robust association, both among the boys (OR = 13.32; 95 percentCI 2.25-78.94), and the girls (OR = 11.35; 95 percentCI 1.42-90.21). CONCLUSIONS: In our study, overweight, obesity and family history of hypertension (father and mother with hypertension) were the principal risk factors for arterial hypertension in adolescents.

Risk factors associated with arterial hypertension in adolescents.

OBJECTIVE: To investigate the risk factors associated with essential arterial hypertension in adolescents. METHOD: A case-control, outpatient-based study of adolescents aged 11 to 19 years treated at the Center for Studies into Adolescent Health (Núcleo de Estudos da Saúde do Adolescente) at the Universidade Estadual do Rio de Janeiro. Nutritional status was assessed by means of body mass index. Data were also obtained on waist circumference, height, family history of arterial hypertension, birth weight and pubertal development. The analysis was performed using unconditional logistic regression. RESULTS: The study investigated 91 cases and 182 controls. Body mass index was associated with hypertension. Height had a positive association with hypertension only among the girls. There was no evidence of an association between pubertal development or birth weight with arterial hypertension in adolescence. In contrast, family history, particularly when both parents had hypertension, exhibited a robust association, both among the boys (OR = 13.32; 95%CI 2.25-78.94), and the girls (OR = 11.35; 95%CI 1.42-90.21). CONCLUSIONS: In our study, overweight, obesity and family history of hypertension (father and mother with hypertension) were the principal risk factors for arterial hypertension in adolescents.