Ultra-processed food intake is associated with children and adolescents with congenital heart disease clustered by high cardiovascular risk factors.

The excessive intake of ultra-processed foods (UPF) is associated with an increase in cardiovascular risk. However, the effect of UPF intake on cardiovascular health in children and adolescents with congenital heart disease (CHD) is unknown. The aim of the present study was to describe UPF intake and evaluate associations with isolated cardiovascular risk factors and children and adolescents with CHD clustered by cardiovascular risk factors. A cross-sectional study was conducted involving 232 children and adolescents with CHD. Dietary intake was assessed using three 24-hour recalls. UPFs were categorized using the NOVA classification. The cardiovascular risk factors evaluated were central adiposity, elevated high-sensitivity C-reactive protein (hs-CRP) and subclinical atherosclerosis. The clustering of cardiovascular risk factors (waist circumference, hs-CRP and carotid intima-media thickness) was performed, allocating the participants to two groups (high versus low cardiovascular risk). UPFs contributed 40.69% (SD 6.21) to total energy intake. The main UPF groups were ready-to-eat and take-away/fast foods (22.2% energy from UPFs). The multivariable logistic regression revealed that an absolute increase of 10% in UPF intake (OR=1.90; 95% CI: 1.01;3.58) was associated with central adiposity. An absolute increase of 10% in UPF intake (OR=3.77; 95% CI: 1.80;7.87) was also associated with children and adolescents with CHD clustered by high cardiovascular risk after adjusting for confounding factors. Our findings demonstrate that UPF intake should be considered a modifiable risk factor for obesity and its cardiovascular consequences in children and adolescents with CHD.

Asociación de factores de riesgo cardiovascular modificables y la capacidad cardio-vascular en población universitaria de 18 a 29 años / Association of modifiable cardiovascular risk factors and functional capacity in university populations aged 18 to 29

Contexto. Las enfermedades cardiovasculares son la principal causa de muerte a nivel mundial; el tabaquismo, sedentarismo y hábitos alimenticios son los principales factores de riesgo cardiovascular modificables. Objetivo. Identificar el nivel de riesgo cardiovascular que presentan los estudiantes universitarios y, establecer la asociación de los factores de riesgo cardiovascular modificables con la capacidad cardio-vascular determinada mediante la "caminata de seis minutos".Material y Métodos. Estudio observacional, transversal, de campo, no experimental y correlacional. La población fue de 421 sujetos y la muestra de 229 estudiantes universitarios (adultos jóvenes) de ambos géneros (30,6% masculino, 69,4% femenino), de 18 a 29 años. Los sujetos analizados se encuentran a 2.850m de altitud. El muestreo fue probabilístico estratificado proporcional. Las técnicas aplicadas fue-ron: la encuesta, diseñada a partir del cuestionario base: "Instrumento STEPS de la OMS", Cuestionario de Identificación de los Trastornos Debidos al Consumo de Alcohol y Cuestionario Internacional de Actividad Física; y la "caminata de seis minutos". Los instrumentos usados tienen validación internacional. Resultados. El 93% de los sujetos presentan uno o más factores de riesgo cardiovascular modificables; los predominantes fueron: consumo de alcohol (84,7%) y sedentarismo (81,7%). El 62% presentan riesgo cardiovascular moderado. El nivel de riesgo cardiovascular tiene una correlación débil con el consumo de oxígeno (VO2) (r=0.20); existe una relación estadísticamente significativa entre el nivel de actividad física y VO2 (p=0,02). Discusión. Los principales factores de riesgo cardiovascular modificables identificados fueron el consumo de alcohol y el sedentarismo; no existió asociación estadísticamente significativa entre los factores de riesgo cardiovascular modificables con la capacidad cardiovascular; pero la capacidad cardiovascular tiene relación estadísticamente significativa con el nivel de actividad física.

Context. Cardiovascular diseases are the major cause of death worldwide; smoking, sedentary lifestyle and eating habits are the main modicable cardiovascular risk factors.Objective. To identify the modifiable cardiovascular risk factors presented by university students and, establish the association between cardiovascular modificable risk factors and the cardiovascular capa-city determined by the "six minute walk". Material and Methods. Observational, cross-sectional, field, non-experimental and correlational study. The population was 421 subjects and the sample was 229 university students (young adults) of both genders (30.6% male, 69.4% female), from 18 to 29 years old. The subjects analyzed are located at an altitude of 2,850m. Sampling was proportional stratified probabilistic. The techniques applied were: the survey, designed based on the basic questionnaire: "WHO STEPS Instrument", Questionnaire for the Identification of Disorders Due to Alcohol Consumption and International Questionnaire on Physical Activity; and the "six minute walk". The instruments used have international validation.Results. 93% of the subjects present one or more modifiable cardiovascular risk factors; the predomi-nant ones were: alcohol consumption (84.7%) and sedentary lifestyle (81.7%). 62% present moderate cardiovascular risk. The level of cardiovascular risk has a weak correlation with oxygen consumption (VO2) (r=0.20); there is a statistically significant relationship between the level of physical activity and VO2 (p=0.02).Discussion. The main modifiable cardiovascular risk factors identified were alcohol consumption and a sedentary lifestyle; there was no statistically significant association between modifiable cardiovascular risk factors with cardiovascular capacity; but cardiovascular capacity has a statistically significant rela-tionship with the level of physical activity

A cross-sectional analysis of risk factors for cardiovascular diseases in older females: association between body fat distribution and physical fitness.

This study aimed to determine whether body fat distribution and physical fitness would be associated with risk factors for cardiovascular diseases (CVDs) in post-menopausal females. Android fat distribution were more likely to have altered total cholesterol (TC), high-density lipoprotein (HDL-C), triglycerides (TG), glycemic levels (GL) body fat percentage (%BF), and body mass index (BMI), and those with inadequate physical fitness showed clear alterations in TC, HDL-C, and TG. Gynoid fat distribution group fared better regarding CVD risk. In conclusion, adequate physical fitness demonstrates a protective factor against CVDs, with the greatest benefit to those with gynoid fat distribution.

Cardiometabolic risk factors in children and adolescents from southern Brazil: comparison to international reference values.

OBJECTIVES: To compare cardiometabolic risk factors of Brazilian children and adolescents with international reference values. Cardiometabolic risk factors constitute the Metabolic Syndrome, whose evaluation is important to assess pediatric populations' health and potential to experience metabolic disorders. METHODS: Cross-sectional study that included 2,250 randomly selected children and adolescents (55.6% girls), aged 6 to 17. Cardiometabolic parameters (body mass index [BMI], waist circumference [WC], systolic and diastolic blood pressures [SBP and DBP], total cholesterol [TC], low-density lipoprotein cholesterol [LDL-C], high-density lipoprotein cholesterol [HDL-C], TC:HDL-C ratio, triglycerides [TG], glucose and peak oxygen uptake [VO2peak]), and clustered risk scores were compared to international age- and sex-specific reference values. A clustered risk score was calculated by summing the WC, glucose, SBP, TG, and the TC:HDL-C ratio Z-scores divided by five. A second clustered was calculated including VO2peak (inverted) Z-score, but divided by six. RESULTS: The clustered risk score, considering the all ages sample, was better in the Brazilian boys (-0.20 [-0.41;0.01] and -0.18 [-0.37;0.01], including or not VO2peak, respectively) but not significantly, and worse in girls (0.24 [0.05;0.43] and 0.28 [0.11;0.44], including or not VO2peak, respectively) than the international reference. Additionally, Brazilian youth had a statistically better profile in TC, LDL-C, HDL-C, TC:HDL-C ratio, and VO2peak (only girls) as well as a worse profile in BMI, WC, SBP, DBP, TG (only girls), and VO2peak (only boys). CONCLUSIONS: The clustered cardiometabolic risk score (including or not VO2peak), considering the all ages sample, was better in the Brazilian boys, but not significantly, and worse in girls compared to the international reference.

Dietary patterns are associated with central adiposity and carotid intima-media thickness in children and adolescents with congenital heart disease.

PURPOSE: Unhealthy dietary patterns (DP) in childhood are associated with cardiovascular disease in adulthood. DP in children and adolescents with congenital heart disease (CHD) are unknown. The aims of this study were to describe DPs of children and adolescents with CHD and to evaluate their associations with central adiposity, high-sensitivity C-reactive protein (hs-CRP) and carotid intima-media thickness (cIMT). METHODS: A cross-sectional study including 232 children and adolescents with CHD. Dietary data were based on three 24-h dietary recalls. Central adiposity was evaluated by waist circumference. hs-CRPs were determined by nephelometry. The cIMT was measured using ultrasound. DPs were identified using principal component analysis. Data were examined using logistic and linear regressions. RESULTS: Six DPs were identified. In multivariable-adjusted analysis, unhealthy DP (high intake of poultry, red meat, cold cuts and processed meats, soft drinks and sweetened beverages) and healthy DP (high intake of fish, eggs, bread, beans, tubers and roots, fruit and fruit juice) were associated with increased and decreased odds of central adiposity, respectively (Odds ratio (OR): 2.10; 95% confidence interval (95% CI) 1.09; 4.02; OR: 0.48 95% CI 0.24; 0.93). Besides, low-fat dairy DP (high intake of low-fat milk and dairy, mixed dishes, ultra-processed breads, candy and chocolate) was inversely associated with cIMT (ß: - 0.024; 95% CI - 0.04; - 0.01). CONCLUSION: Unhealthy DP seems to increase the risk of central adiposity, while the healthy DP seems to decrease the risk of central adiposity. Still, low-fat dairy DP was inversely associated with cIMT. These findings may be helpful to develop nutrition recommendations for early cardiovascular disease prevention in children and adolescents with CHD.

Work-Family Conflict and Ideal Cardiovascular Health Score in the ELSA-Brasil Baseline Assessment.

Background There are few data about the association between work-related stress and the American Heart Association ideal cardiovascular health (CVH) metrics. We studied the association between work-family conflict (WFC) and ideal CVH scores in the ELSA-Brasil (Brazilian Longitudinal Study of Adult Health) baseline study. Methods and Results We analyzed data of active workers (5424 men and 5967 women), aged 35 to 74 years, from 2008 to 2010. Ideal CVH scores were calculated based on the lifestyle and health metrics proposed by the American Heart Association, using data from questionnaires and clinical and laboratory examinations from the ELSA-Brasil study baseline. The WFC questionnaire was based on the Frone model, validated for Brazilian Portuguese. WFC domains (time and strain-based work interference with family, family interference with work, and lack of time for personal care and leisure) and frequency (never to rarely, sometimes, or frequently) were self-reported. Main models were adjusted for age, sex, race, educational level, income, and study site. Positive relative predicted score differences (rPSDs) indicate higher predicted scores. We found lower lifestyle ideal CVH scores among men (rPSD, -5.7%; P=0.002) and women (rPSD, -10.2%; P<0.001) with frequent lack of time for personal care and leisure. We found lower lifestyle ideal CVH scores among women with frequent strain-based work interference with family (rPSD, -5.1%; P=0.002), and family interference with work (rPSD, -8.6%; P=0.001). We found higher health ideal CVH scores among men with frequent WFC, which may be attributable to reverse causation. Conclusions We found significant associations between WFC and ideal CVH scores. These associations were heterogeneous according to sex.

Tea Consumption and Longitudinal Change in High-Density Lipoprotein Cholesterol Concentration in Chinese Adults.

BACKGROUND: The relation between tea consumption and age-related changes in high-density lipoprotein cholesterol (HDL-C) concentrations remains unclear, and longitudinal human data are limited. The aim of current study was to examine the relation between tea intake and longitudinal change in HDL-C concentrations. METHODS AND RESULTS: Baseline (2006) tea consumption was assessed via a questionnaire, and plasma HDL-C concentrations were measured in 2006, 2008, 2010, and 2012 among 80 182 individuals (49±12 years of age) who did not have cardiovascular diseases or cancer, or did not use cholesterol-lowering agents both at baseline (2006) and during the follow-up period (2006-2012). The associations between baseline tea consumption and rate of change in HDL-C concentrations were examined using generalized estimating equation models. Tea consumption was inversely associated with a decreased rate of HDL-C concentrations (P-trend <0.0001) in the fully adjusted model. The adjusted mean difference in the HDL-C decreased rate was 0.010 (95% confidence interval, 0.008, 0.012) mmol/L per year for tea consumers versus nonconsumers (never or less than once/month group). Interactions between tea consumption and age, sex, lifestyle scores, and metabolic syndrome (all P-interaction <0.0001) were identified. The associations between greater tea consumption and slower decrease in HDL-C concentrations were more pronounced in men, individuals aged 60 or older, individuals with a lower lifestyle score, and individuals with metabolic syndrome (all P-trend <0.0001). CONCLUSIONS: Tea consumption was associated with slower age-related decreases in HDL-C concentrations during 6 years of follow-up. CLINICAL TRIAL REGISTRATION: URL: www.chictr.org. Unique identifier: ChiCTR-TNRC-11001489.

Factors associated with elevated blood pressure or hypertension in Afro-Caribbean youth: a cross-sectional study.

BACKGROUND: Although several studies have identified risk factors for high blood pressure (BP), data from Afro-Caribbean populations are limited. Additionally, less is known about how putative risk factors operate in young adults and how social factors influence the risk of high BP. In this study, we estimated the relative risk for elevated BP or hypertension (EBP/HTN), defined as BP ≥ 120/80 mmHg, among young adults with putative cardiovascular disease (CVD) risk factors in Jamaica and evaluated whether relative risks differed by sex. METHODS: Data from 898 young adults, 18-20 years old, were analysed. BP was measured with a mercury sphygmomanometer after participants had been seated for 5 min. Anthropometric measurements were obtained, and glucose, lipids and insulin measured from a fasting venous blood sample. Data on socioeconomic status (SES) were obtained via questionnaire. CVD risk factor status was defined using standard cut-points or the upper quintile of the distribution where the numbers meeting standard cut-points were small. Relative risks were estimated using odds ratios (OR) from logistic regression models. RESULTS: Prevalence of EBP/HTN was 30% among males and 13% among females (p < 0.001 for sex difference). There was evidence for sex interaction in the relationship between EBP/HTN and some of risk factors (obesity and household possessions), therefore we report sex-specific analyses. In multivariable logistic regression models, factors independently associated with EBP/HTN among men were obesity (OR 8.48, 95% CI [2.64-27.2], p < 0.001), and high glucose (OR 2.01, CI [1.20-3.37], p = 0.008), while high HOMA-IR did not achieve statistical significance (OR 2.08, CI [0.94-4.58], p = 0.069). In similar models for women, high triglycerides (OR 1.98, CI [1.03-3.81], p = 0.040) and high HOMA-IR (OR 2.07, CI [1.03-4.12], p = 0.039) were positively associated with EBP/HTN. Lower SES was also associated with higher odds for EBP/HTN (OR 4.63, CI [1.31-16.4], p = 0.017, for moderate vs. high household possessions; OR 2.61, CI [0.70-9.77], p = 0.154 for low vs. high household possessions). Alcohol consumption was associated with lower odds of EBP/HTN among females only; OR 0.41 (CI [0.18-0.90], p = 0.026) for drinking <1 time per week vs. never drinkers, and OR 0.28 (CI [0.11-0.76], p = 0.012) for drinking ≥3 times per week vs. never drinkers. Physical activity was inversely associated with EBP/HTN in both males and females. CONCLUSION: Factors associated with EBP/HTN among Jamaican young adults include obesity, high glucose, high triglycerides and high HOMA-IR, with some significant differences by sex. Among women lower SES was positively associated with EBP/HTN, while moderate alcohol consumption was associated lower odds of EBP/HTN.

Reasons for Nonadherence to Psychiatric Medication and Cardiovascular Risk Factors Treatment Among Latino Bipolar Disorder Patients Living in Puerto Rico: A Qualitative Study.

Latinos with bipolar disorder (BD) have a high rate of nonadherence to psychiatric medication and treatment for other medical conditions such as cardiovascular disease (CVD) risk factors than non-Latinos with BD. The aim of this study is to identify patients' perspectives on the reasons for nonadherence to psychiatric medication and for CVD risk factors conditions in outpatients with BD. Three focus group sessions were held for a total of 22 adults ranging from 23 to 60 years old. Participants had BD, Type I/II and CVD risk factors. Audio-recordings of focus groups were transcribed and a content analysis was performed. Reasons identified as barriers to adherence were somewhat different for BD medications in comparison to CVD risk factors suggesting the need for integrated interventions targeting these barriers to adherence for both BD and CVD risk factors.

Structural social support and cardiovascular disease risk factors in Hispanic/Latino adults with diabetes: results from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL).

OBJECTIVE(S): Cross-sectional and longitudinal studies have yielded inconsistent findings on the associations of social support networks with cardiovascular health in Hispanic/Latino adults with diabetes. We examined the cross-sectional associations of structural social support and traditional cardiovascular disease (CVD) risk factors in a diverse sample of Hispanic/Latino adults with diabetes. RESEARCH DESIGN AND METHODS: This analysis included 2994 adult participants ages 18-74 with diabetes from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL - 2008-2011). Select items from the Social Network Inventory (SNI) were used to assess indices of structural social support, i.e. network size (number of children, parents, and in-laws) and frequency of familial contact. Standardized methods were used to measure abdominal obesity, BMI, hypertension, hypercholesterolemia, and smoking status. Multivariate regression was used to examine associations of structural support with individual CVD risk factors with demographics, acculturation, physical health, and psychological ill-being (depressive symptoms and anxiety) included as covariates. RESULTS: There were no significant cross-sectional associations of structural support indices with abdominal obesity, hypertension, hypercholesterolemia, or smoking status. There was a marginally significant (OR: 1.05; 95%CI 0.99-1.11) trend toward higher odds of obesity in participants reporting a larger family unit (including children, parents, and in-laws) and those with closer ties with extended family relatives (OR: 1.04; 95%CI 0.99-1.09). CONCLUSIONS: Structural social support was marginally associated with higher odds of obesity in Hispanic/Latino adults with diabetes. Alternate forms of social support (e.g. healthcare professionals, friends, peers) should be further explored as potential markers of cardiac risk in Hispanics/Latinos with diabetes.

Effects of Dark Chocolate and Almonds on Cardiovascular Risk Factors in Overweight and Obese Individuals: A Randomized Controlled-Feeding Trial.

BACKGROUND: Consumption of almonds or dark chocolate and cocoa has favorable effects on markers of coronary heart disease; however, the combined effects have not been evaluated in a well-controlled feeding study. The aim of this study was to examine the individual and combined effects of consumption of dark chocolate and cocoa and almonds on markers of coronary heart disease risk. METHODS AND RESULTS: A randomized controlled, 4-period, crossover, feeding trial was conducted in overweight and obese individuals aged 30 to 70 years. Forty-eight participants were randomized, and 31 participants completed the entire study. Each diet period was 4 weeks long, followed by a 2-week compliance break. Participants consumed each of 4 isocaloric, weight maintenance diets: (1) no treatment foods (average American diet), (2) 42.5 g/d of almonds (almond diet [ALD]), (3) 18 g/d of cocoa powder and 43 g/d of dark chocolate (chocolate diet [CHOC]), or (4) all 3 foods (CHOC+ALD). Compared with the average American diet, total cholesterol, non-high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol after the ALD were lower by 4%, 5%, and 7%, respectively (P<0.05). The CHOC+ALD decreased apolipoprotein B by 5% compared with the average American diet. For low-density lipoprotein subclasses, compared with the average American diet, the ALD showed a greater reduction in large buoyant low-density lipoprotein particles (-5.7±2.3 versus -0.3±2.3 mg/dL; P=0.04), whereas the CHOC+ALD had a greater decrease in small dense low-density lipoprotein particles (-12.0±2.8 versus -5.3±2.8 mg/dL; P=0.04). There were no significant differences between diets for measures of vascular health and oxidative stress. CONCLUSIONS: Our results demonstrate that consumption of almonds alone or combined with dark chocolate under controlled-feeding conditions improves lipid profiles. Incorporating almonds, dark chocolate, and cocoa into a typical American diet without exceeding energy needs may reduce the risk of coronary heart disease. CLINICAL TRIAL REGISTRATION: URL: https://www.clinicaltrials.gov. Unique identifier: NCT01882881.

Adolescent Childbirth Is Associated With Greater Framingham Risk Scores for Cardiovascular Disease Among Participants of the IMIAS (International Mobility in Aging Study).

BACKGROUND: Previous studies observe associations between lifetime parity and cardiovascular disease, but relatively fewer investigate age at first childbirth (AFB). Herein, we examine the association of AFB with a summary cardiovascular risk measure (Framingham Risk Score [FRS]). METHODS AND RESULTS: As part of the IMIAS (International Mobility in Aging Study), data were collected in 2012 among 1047 women, aged 65 to 74 years, from Canada, Albania, Colombia, and Brazil. FRSs were calculated to describe cardiovascular risk profiles, and linear regression analyses were performed, adjusting for early life and socioeconomic variables. Women with an AFB of <20 years were compared with women with an AFB of 20 to 24, 25 to 29, and ≥30 years, as well as nulliparous women. We also compared FRS between combinations of AFB and parity categories: nulliparous women, parity 1 to 3 combined with AFB <20 years, parity ≥4 with AFB <20 years, parity 1 to 3 with AFB ≥20 years, and parity ≥4 with AFB ≥20 years. Women with an AFB of <20 years had a higher mean FRS compared with all other AFB groups. Compared with the lowest AFB risk group (25-29 years), women with an AFB of <20 years had a 5.8-point higher mean FRS (95% confidence interval, 3.4-8.3 points). Nulliparous women presented the lowest mean FRS in all analyses. The analysis comparing combinations of AFB and parity categories showed no meaningful differences in FRS between women who had 1 to 3 childbirths and those who had ≥4 childbirths within the stratum of AFB <20 years, and in the stratum of AFB ≥20 years. CONCLUSIONS: Our analyses suggest that nulliparity and AFB, rather than increasing parity, drive the association with cardiovascular disease risk.

Could Low Birth Weight be Associated with Cardiovascular Disease in Adolescence? / Poderia o baixo peso ao nascimento ser associado com risco cardiovascular na adolescência?

Abstract Purpose Previous studies have shown that low birth weight (LBW) is associated with cardiovascular risk in late adulthood. Recent studies in adolescents suggest that modifiable factors may have greater influence on increased cardiovascular risk. This study aims to investigate the association between LBW and changes in anthropometric and biochemical risk factors during adolescence in a population with low average socioeconomic status. Methods In a retrospective double cohort, data of birth weight were extracted from hospital records of children born on the same day between 1992 and 2002. According to the World Health Organization, we classified the children as having LBW or normal birth weight. A total of 172 subjects among children, adolescents and adults were researched. We measured anthropometric and clinical data, lipid profile and glucose after an overnight fasting. The low and normal weight groups were compared using Mann-Whitney U, Fischer exact, Chi-square (2) and Student's t tests. Results Pregnant women with preeclampsia delivered more newborns with LBW (p< 0.001). Anthropometric and clinical parameters were similar between groups. No differences were found in the family history of cardiovascular diseases (p= 0.1), family incomes (p= 0.8) and maternal school education (p= 0.8) between groups. Conclusion In this study, LBW did not increase cardiovascular disease risk factors in adolescents. We observed absence of association between low birth weight and poor health outcomes among adolescents with low socioeconomic status from an urban city in the Brazilian northeast.

Resumo Objetivo Estudos mostram que o baixo peso ao nascer está associado ao risco cardiovascular na idade adulta. Estudos recentes em adolescentes sugerem que fatores modificáveis podem ter grande influência no aumento do risco cardiovascular. Este estudo busca investigar a associação entre baixo peso ao nascer com mudanças nos fatores de risco antropométricos e bioquímicos durante a adolescência em uma população com baixo nível socioeconômico. Métodos Em um estudo retrospectivo de coorte, dados de peso ao nascimento foram extraídos de registros de hospitais, de crianças que nasceram no mesmo dia, entre 1992 e 2002. De acordo com a Organização Mundial da Saúde, classificamos as crianças como baixo peso e peso normal. Um total de 172 pessoas, com idades entre 10 e 20 anos, foram pesquisadas. Avaliamos dados clínicos e antropométricos, perfil lipídico e glicemia de jejum. Os grupos de baixo peso e de peso normal foram comparados pelos testes de Mann-Whitney, Exato de Fisher, Qui-quadrado e t-Student. Resultados Gestantes com pré-eclâmpsia tiveram mais partos de recém-nascidos com baixo peso (p< 0,001). Parâmetros clínicos e antropométricos foram similares em ambos os grupos. Não houve diferença na história familiar de doença cardiovascular (p= 0,1), renda familiar (p= 0,8) e nível educacional materno (p= 0,8) entre os grupos. Conclusão Neste estudo, o baixo peso ao nascimento não aumentou o risco de doença cardiovascular na adolescência. Observou-se ausência de associação entre o baixo peso ao nascer e adversos resultados de saúde entre os adolescentes com baixo nível socioeconômico de um centro urbano no Nordeste brasileiro.

Adiposity and cardiovascular disease risk factors in renal transplant recipients: Are there differences between sexes?

OBJECTIVE: The aim of this study was to evaluate high body adiposity and cardiovascular disease (CVD) risk factors prevalence, in renal transplant recipients (RTR), comparing men with women. METHODS: In this retrospective cross-sectional study, 102 patients (55 men) who were 49 ± 1.2 y and 114.3 ± 9 mo post-transplant (post-tx) were evaluated. Pretransplant (pre-tx) period data and weight gain during the first year post-tx were obtained from patient charts and post-tx data were collected during a routine visit at nephrology clinic. Body mass index (BMI) ≥ 25 kg/m(2) defined overweight and BMI ≥ 30 kg/m(2) defined obesity. RESULTS: Pre-tx overweight prevalence was low and similar between men and women (26%), whereas only women showed obesity (11%). Post-tx body weight increased significantly in the entire group, leading to an increase in overweight (to 38% in men and 51% in women) and obesity (to 11% in men and 23% in women) prevalence. Post-tx comparisons between men and women showed that women had higher (women versus men; P < 0.05) BMI values (26.7 ± 0.8 versus 24.7 ± 0.5 kg/m(2)), weight gain during first year post-tx (9.2 ± 1.1 versus 5.5 ± 1 kg), abdominal obesity (57% versus 23%) and diabetes (34% versus 16%) prevalence. The associations between adiposity and CVD risk factors showed that pre-tx overweight increased the risk for diabetes in post-tx; pos-tx high BMI and abdominal obesity increased the risk for metabolic syndrome; abdominal obesity increased the risk for dyslipidemia in women. CONCLUSIONS: High body adiposity prevalence was high after transplantation and increased the risk for metabolic syndrome, an important CVD risk factor. Women showed higher total body adiposity values, abdominal obesity, and diabetes prevalence than men. Abdominal obesity increased the risk for dyslipidemia in women.

Prehypertension in Jamaica: a review of data from recent studies / Prehipertensión en Jamaica: revisión de datos de estudios recientes

Prehypertension is defined as a systolic blood pressure of 120-139 mmHg or diastolic blood pressure of 80-89 mmHg in patients not on medication for hypertension. Recent studies have shown that prehypertension has a high prevalence in both western and eastern countries and is associated with cardiovascular disease (CVD) risk factors, incident CVD and CVD mortality. We reviewed data from ongoing epidemiological studies in Jamaica in order to provide an update on the prevalence and predictors of prehypertension in Jamaica. Studies included were the Jamaica Health and Lifestyle Surveys (2000-2001 and 2007-2008), the Jamaica Youth Risk and Resiliency Behaviour Survey 2006, the 1986 Jamaica Birth Cohort Study and the Spanish Town Cohort Study. The prevalence of prehypertension in the most recent national survey was 35% (95% CI 33, 38%). Prevalence was higher in men compared to women (42% versus 29%). Jamaicans with prehypertension were more likely to have other CVD risk factors and were three times more likely to develop hypertension compared with persons with a normal blood pressure. Prevalence was also high among youth, particularly males. Longitudinal analysis from the 1986 birth cohort suggested that prehypertnsion may be more common in persons with low birthweight or short birth length. Physicians and public health practitioners should recognize the increased CVD risk associated with prehypertension and should begin to institute CVD prevention measures in persons with prehypertension. Sex differences and the early onset of prehypertension in men require further exploration.

La prehipertensión se define como una tensión arterial sistólica de 120-139 mmHg o tensión arterial diastólica de 80-89 mmHg en pacientes que no se hallan bajo medicación a causa de hipertensión. Estudios recientes han mostrado que la hipertensión tiene una alta prevalencia tanto en los países occidentales como en los orientales, hallándose asociada con factores de riesgo de la enfermedad cardiovascular (ECV), ECV incidente y la mortalidad por ECV. Se examinan los datos de los estudios epidemiológicos en curso en Jamaica para ofrecer una actualización acerca de la prevalencia y los predictores de la prehipertensión en Jamaica. Los estudios incluidos fueron las encuestas sobre salud y estilo de vida Jamaica Health and Lifestyle Surveys (2000-2001 y 2007-2008), la encuesta Jamaica Youth Risk and Resiliency Behaviour Survey 2006 sobre las conductas de resiliencia y riesgo de los jóvenes, el estudio de cohorte 1986 Jamaica Birth Cohort Study sobre los nacimientos, y finalmente el llamado Spanish Town Cohort Study. La prevalencia de la prehipertensión en la encuesta nacional más reciente fue de 35% (95% CI 33, 38%). La prevalencia fue más alta en los hombres en comparación con las mujeres (42% frente a 29%). Los jamaicanos con prehipertensión presentaban una mayor probabilidad de tener otros factores de riesgo de ECV, y tenían una probabilidad tres veces mayor de desarrollar hipertensión en comparación con las personas de presión arterial normal. La prevalencia fue también alta entre los jóvenes, particularmente entre los varones. El análisis longitudinal de la cohorte de nacimientos de 1986 sugirió que la hipertensión puede ser más común en las personas con bajo peso al nacer o corta longitud al nacer. Los médicos y los practicantes de salud pública deben reconocer el aumento de riesgo de ECV asociado con la prehipertensión, y deben empezar a instituir medidas de prevención de ECV en personas con prehipertensión. Las diferencias de sexo y el comienzo temprano de la prehipertensión en los hombres requieren ser explorada ulteriormente.