Overweight and obesity associated with high blood pressure: a cross-sectional study in Brazilian students. / Sobrepeso e obesidade associados à pressão arterial elevada: um estudo seccional em escolares brasileiros.

OBJECTIVE: To verify the association among overweight, obesity and high blood pressure in Brazilian students aged between 6 and 10 years old. METHOD: Cross-sectional study carried out in the city of Macaé, RJ, in which body mass, height and blood pressure were collected. The body mass index was calculated using the Anthro Plus software and classified according to SISVAN. High systolic/diastolic blood pressure when ≥ 90th percentile by age, gender and height/age percentile (7th Brazilian Guideline on Hypertension). Logistic regression with a 95% confidence interval, using SPSS software were done. RESULTS: A total of 911 children were evaluated and, after stratification by nutritional status, the underweight were excluded. Among the remaining 888 children, the prevalence of overweight was 17.7% and obesity 16.2%. The prevalence of high blood pressure was 34%, with no statistical difference between gender (p=0.57). Overweight was significantly associated with high blood pressure in the 8-9 year old group (OR 1.99; p=004), while obesity was associated in both groups (6-7 year old OR 2.50; p=0.004 and 8-9 year old OR 4.21 p=0.001). CONCLUSION: The results showed that overweight and obesity significantly increased the chance of high blood pressure among children aged 6 to 10 years old.

Status de peso de escolares: prevalência e combinação de excesso de peso e obesidade abdominal / Childhood weight status: prevalence and combination of overweight and abdominal obesity

Identificar a prevalência de excesso de peso e obesidade abdominal de forma isolada e combinada em escolares de 6 a 10 anos de idade. Participaram do estudo 1267 escolares do município de Macaé, RJ, Brasil. Os dados antropométricos analisados foram a massa corporal, a estatura, e a perimetria da cintura (PC). Os critérios da Organização Mundial da Saúde (OMS) foram usados para definir o sobrepeso e a obesidade. A obesidade abdominal (OA) foi estimada pela relação cintura/estatura (RCEst) ≥0,50. A prevalência de excesso de peso e obesidade nos escolares foi de 33,8% e 16,4%, respectivamente.A prevalência de OA foi de 22,7%, sendo 11,9% meninas e 10,8% meninos (p>0,05). Verificamos que 37,7 %das crianças com sobrepeso apresentam OA, sendo mais presente entre as meninas em comparação com os meninos (50% vs. 26,3%, respetivamente; p<0,05). Entre as crianças obesas, 93,7% apresentaram OA. O status de peso dos escolares esteve acompanhado pela elevada prevalência de excesso de peso e pela presença combinação de obesidade e OA, encontradas em ambos os sexos e em todas as idades.

To identify the prevalence of overweight and abdominal obesity in an isolated and combined way in schoolchildren aged 6 to 10 years old. 1267 schoolchildren from Macaé, RJ, and Brazil participated in the study. The anthropometric data analyzed were body mass, height, and waist circumference (WC). The World Health Organization (WHO) criteria were used to define overweight and obesity. Abdominal obesity (AO) was estimated by the waist / height ratio (WHtR) ≥ 0.50. The prevalence of overweight and obesity in schoolchildren was 33.8% and 16.4%, respectively. The prevalence of AO was 22.7%, 11.9% girls and 10.8% boys (p> 0.05). We found that 37.7% of overweight children have AO, being more present among girls when compared to boys (50% vs. 26.3%, respectively; p <0.05). Among obese children, 93.7% had AO. The students' weight status was accompanied by the high prevalence of overweight and the presence of a combination of obesity and AO, found in both sexes and at all ages.

Overweight or obesity and abdominal obesity and their association with cardiometabolic risk factors in Brazilian schoolchildren: A cross-sectional study.

OBJECTIVES: The aim of this study was to access the association between overweight or obesity and abdominal obesity (AO) and cardiometabolic risk factors (CRF) of schoolchildren. METHODS: We evaluated body weight (BW), height, body mass index (BMI), waist circumference (WC), fasting glycaemia (FG), blood pressure (BP), triacylglycerides (TGs), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) in 501 students (6-10 y of age) from municipal schools in Macaé, Brazil. Statistical analyses were performed by χ2, Fisher exact tests, and odds ratio (OR; 95% confidence interval [CI]). RESULTS: Children with overweight or obesity had higher TG, TC, and BP values than normal weight children (P < 0.05). The same trend was observed in children with AO versus those without AO. Among the schoolchildren, 58.5% had at least one CRF. Overweight or obese children had increased risk for high BP (OR, 3.98; 95% CI, 2.4-6.57), high TGs (OR, 2.81; 95% CI, 1.64-4.8), high TC (OR, 2.47; 95% CI, 1.53-4), high LDL-C (OR, 3.07; 95% CI, 1.09-8.6) and two or more CRFs (OR, 4.6; 95% CI, 2.89-7.3). Children with AO had increased risk for high BP (OR, 3.97; 95% CI, 2.18-7.22), high TGs (OR, 3.4; 95% CI, 1.79-6.49), high TC (OR, 2.57; 95% CI, 1.39-4.75), high LDL-C (OR, 3.7; 95% CI, 1.24-11.07), and two or more CRFs (OR, 3.25; 95% CI, 1.82-5.78). Schoolchildren with CRFs presented higher means of BW, BMI, WC, FG, TGs, TC, LDL-C, SBP, DBP, and lower HDL-C than children without CRFs. CONCLUSION: The relationship between increased body weight or AO and CRF, described in the present data, reinforces the importance of early prevention of excess weight in children.

Sobrepeso e obesidade associados à pressão arterial elevada: um estudo seccional em escolares brasileiros / Sobrepeso y obesidad asociados a la presión arterial alta: un estudio seccional en escolares brasileños / Overweight and obesity associated with high blood pressure: a cross-sectional study in Brazilian students

RESUMO Objetivo: Verificar associação entre sobrepeso, obesidade e pressão arterial elevada em escolares brasileiros com idade entre 6 e 10 anos incompletos. Método: Estudo seccional realizado no município de Macaé, RJ, em que foi coletado massa corporal, estatura e pressão arterial. O índice de massa corporal foi calculado pelo software Anthro Plus e classificado conforme SISVAN. Pressão arterial sistólica/diastólica elevada quando ≥ percentil 90 por idade, sexo e percentil da estatura/idade (7ª Diretriz Brasileira de Hipertensão). A análise foi por regressão logística com intervalo de confiança 95%, software SPSS. Resultados: Foram avaliadas 911 crianças e, após estratificação por estado nutricional, as com magreza foram excluídas. Entre as 888 crianças restantes, a prevalência de sobrepeso foi 17,7% e obesidade 16,2%. A prevalência de pressão arterial elevada foi 34%, não diferindo entre sexo (p=0,57). Sobrepeso foi significativamente associado à pressão elevada no grupo de 8-9 anos (OR 1,99; p=0,004), enquanto a obesidade associou-se em ambos os grupos (6-7 anos OR 2,50; p=0,004 e 8-9 anos OR 4,21 p=0,001). Conclusão: Os resultados demonstraram que sobrepeso e obesidade aumentaram expressivamente a chance de pressão arterial elevada entre crianças de 6 a 10 anos incompletos.

RESUMEN Objetivo: Comprobar la asociación entre sobrepeso, obesidad y presión arterial alta en escolares brasileños con edad comprendida entre 6 y 10 años incompletos. Método: Se trata de un estudio seccional realizado en el municipio de Macaé, Río de Janeiro, en el que se recogió masa corporal, estatura y presión arterial. El índice de masa corporal se calculó con el software Anthro Plus y se clasificó conforme SISVAN. Se estima como presión arterial sistólica/diastólica alta ≥ 90 percentil por edad, sexo y percentil de estatura/ edad (7ª Directiva Brasileña de Hipertensión). El análisis se realizó por regresión logística con intervalo de confianza del 95% mediante el software SPSS. Resultados: Se evaluó un total de 911 niños y, tras la estratificación por estado nutricional, se excluyeron los delgados. Entre los 888 niños restantes, la prevalencia del sobrepeso era del 17,7% y la obesidad, del 16,2%. La prevalencia de la hipertensión arterial fue del 34%, sin diferencia entre géneros (p=0,57). El sobrepeso estaba asociado significativamente a la hipertensión arterial en el grupo de 8-9 años (OR 1,99; p=0,004), y la obesidad, a ambos grupos (6-7 años OR 2,50; p=0,004 y 8-9 años OR 4,21 p=0,001). Conclusión: Los resultados demuestran que el sobrepeso y la obesidad de niños entre 6 y 10 años incompletos aumentan expresivamente la posibilidad de padecer hipertensión.

ABSTRACT Objective: To verify the association among overweight, obesity and high blood pressure in Brazilian students aged between 6 and 10 years old. Method: Cross-sectional study carried out in the city of Macaé, RJ, in which body mass, height and blood pressure were collected. The body mass index was calculated using the Anthro Plus software and classified according to SISVAN. High systolic/diastolic blood pressure when ≥ 90th percentile by age, gender and height/age percentile (7th Brazilian Guideline on Hypertension). Logistic regression with a 95% confidence interval, using SPSS software were done. Results: A total of 911 children were evaluated and, after stratification by nutritional status, the underweight were excluded. Among the remaining 888 children, the prevalence of overweight was 17.7% and obesity 16.2%. The prevalence of high blood pressure was 34%, with no statistical difference between gender (p=0.57). Overweight was significantly associated with high blood pressure in the 8-9 year old group (OR 1.99; p=004), while obesity was associated in both groups (6-7 year old OR 2.50; p=0.004 and 8-9 year old OR 4.21 p=0.001). Conclusion: The results showed that overweight and obesity significantly increased the chance of high blood pressure among children aged 6 to 10 years old.

Metabolic syndrome's risk factors and its association with nutritional status in schoolchildren.

The metabolic risk factors (RF) to the diagnosis of metabolic syndrome (MetS) have been evidenced at early ages, including children. The aim of the present study was to identify the prevalence of RF to the diagnosis of MetS and its association with nutritional status of schoolchildren from 6 to 10 years old. A cross-sectional study was carried out in 505 students of municipal schools in Macae, Brazil, conducted from 2013 to 2014. The RF evaluated were: blood pressure (mm Hg), triglycerides (mmol/L), HDL-cholesterol (mmol/L) fasting glucose (mmol/L) and waist circumference (cm). At least one RF was present in 61% (n = 308) of the sample. By nutritional status, there was higher prevalence of RF in overweight/obese schoolchildren compared to those with normal weight, except in the concentration of HDL-c. The prevalence of one, two and three RF (MetS) were 34.7% (n = 175), 21.0% (n = 106) and 5.3% (n = 27), respectively. Two RF were more present in overweight (28.2% 95%CI 19.0; 39.0) and obese (41.5% 95%CI 31.4; 52.1) compared to normal weight children (13.5% 95%CI 9.9; 17.8). Three or more RF were more frequent among obese (25.5% 95%CI 17.0; 35.5) in relation to overweight (2.4% 95%CI 0.2; 8.2) and normal weight children (0.3% 95%CI 0; 1.7). The data indicate high prevalence of RF and its relationship with the magnitude of body weight excess. Therefore, the identification and early treatment of these RF might minimize the risk of MetS and related diseases.

Prevalência de hipertensão arterial em escolares brasileiros: uma revisão sistemática / Prevalence of arterial hypertension in children in schools of Brazil

Introdução: As doenças cardiovasculares representam a maior causa de morte no Brasil e no mundo, sendo a hipertensão arterial sistêmica, um importante fator de risco para seu desenvolvimento. É sugerido que a hipertensão arterial primária inicia-se na infância, podendo agravar com o avançar da idade. Objetivo: Revisar a literatura acerca da prevalência de hipertensão arterial, entre crianças brasileiras em idade escolar. Métodos: Revisão sistemática de trabalhos científicos publicados entre janeiro de 2004 e julho de 2014. A busca foi realizada nas bases de dados Scielo e PubMed, além de pesquisa manual nos artigos presentes nas referências. Os descritores foram: 'hipertensão arterial', ‘pressão arterial alta’, 'crianças', 'escolares' e 'Brasil.' Resultados: Foram selecionados 8 artigos pertinentes. A faixa etária dos voluntários dos estudos selecionados variou de 6 a 10 anos de idade. Todos foram realizados em escolas públicas ou privadas e em municípios distintos. A prevalência de hipertensão arterial variou de 2,3% a 13,8%, dependendo do estado nutricional da amostra e da metodologia empregada. Entre os artigos em que a pré-hipertensão foi também avaliada a variação foi de 3,8% a 40,6%. Maiores prevalências foram observadas em crianças com excesso de peso. Conclusão: Os dados apresentados indicaram que a presença de níveis altos de pressão arterial na infância não é rara com prevalências distintas, influenciadas, principalmente, pelo estado nutricional. Novos estudos para avaliar a pressão arterial na infância são necessários a fim de fomentar subsídios para programas de prevenção (AU)

Introduction: Cardiovascular diseases are the leading cause of death in Brazil and in the world, and high blood pressure is an important risk factor for its development. It is suggested that primary hypertension starts in childhood, and it may worse with advancing age. Objective: Review the literature about the prevalence of hypertension among Brazilian school-age children. Methods: Systematic review of cientific studies published from January 2004 to July 2014. The search was conducted in Scielo and PubMed databases, and manual research of articles presented in the references. The used key words were: 'arterial hypertension', 'high blood pressure', 'children', 'school' and 'Brazil.' Results: 8 articles were selected. The volunteer’s age range was from 6 to 10 years old. All studies were carried out in public or private schools and in different cities. The prevalence of hypertension ranged from 2.3% to 13.8% varying according to nutritional status of the sample and methodology used. In articles that pre-hypertension was also evaluated the range was from 3.8% to 40.6%. Highest prevalence rates were found in children with overweight. Conclusion: The presented data indicate that the presence of high levels of blood pressure in childhood is not rare, with distinct prevalence, influenced mainly by the lifestyle and nutritional status. New studies to evaluate blood pressure in childhood are necessary in order to promote grants for prevention programs (AU)