A importância da pressão arterial na adolescência para o perfil de risco cardiovascular em adultos jovens acompanhados por 18 anos: estudo do Rio de Janeiro

• Autor(a) principal: Campana, Erika Maria Gonçalves
• Data de Publicação: 2014
• Tipo de documento: Tese
• Idioma: por
• Título da fonte: Biblioteca Digital de Teses e Dissertações da UERJ
• Texto Completo: http://www.bdtd.uerj.br/handle/1/8624
• topic: Blood pressure; Follow-up studies; Metabolic syndrome X; Anthropometry; Adolescents; Genetics; Pressão sanguínea; Seguimentos; Síndrome X metabólica; Antropometria; Adolescente; Genética; Pressão arterial; Síndrome metabólica Adolescentes; Sistema cardiovascular Doenças; Adolescência; Antropometria; CNPQ::CIENCIAS DA SAUDE::MEDICINA::CLINICA MEDICA::CARDIOLOGIA

The longitudinal study of cardiovascular risk variables and their genetic interactions with young populations are fundamental for defining primary preventive strategies for cardiovascular disease. The objectives of the present study are the following: to evaluate the behavior and the relation among clinical variables (blood pressure [BP], anthropometric indices), laboratorial, metabolic and inflammatory variables, pulse wave velocity (PWV) and the genetic polymorphisms of the nitric oxide synthase enzyme (NOS-e), of angiotensinogen (AGT) and of the angiotensin converting enzyme (ACE) in young adults followed-up for 18 years by the Rio de Janeiro Study, and stratified by BP measured in adolescence. 116 individuals were evaluated (63 males / 53 females) in three different moments: A1 (10-16 years old), A2 (18-26 years old) and A3 (27-35 years old). They were divided into two groups: GN (n=71) presented normal BP in A1, GH (n=45) presented abnormal BP in A1. In all three occasions the following was measured: BP, weight, height and body mass index (BMI). In A2 and A3, fasting glucose levels, HOMA-IR insulin, triglycerides, total cholesterol, LDL-C and HDL-c were determined. In A3, the following was assessed: abdominal circumference (AC), apolipoprotein A1, apolipoprotein B100, lipoprotein (a), adiponectin, leptin, E-selectin, V-CAM 1 and ICAM-1, us-CRP, fibrinogen, PWV and genetic polymorphisms of NOS-e, AGT and ACE. The main results were: 1) GH presented greater means of SBP, DBP and BMI (p<0.0001) and greater prevalence of hypertension and overweight/obesity (O/O) (p<0.01) in all three evaluations. 2) In A2, GH presented greater means of insulin, HOMA-IR, Apo B100 and reduced means of HDL-c (p<0.04). In A3, GH presented greater means of AC (p<0.0001), insulin, HOMA-IR and leptin (p<0.03) and of increased AC, increased insulin and metabolic syndrome (MS) (p<0.03). 3) There was no significant statistical difference between the groups in inflammatory variables, adhesion molecules, coagulation system elements and PWV. 4) BP and BMI in adolescence were correlated with BP (p<0.0001), with anthropometric (p<0.0001) and metabolic (p<0.04) variables in young adulthood. The positive variations of SBP, DBP and BMI were correlated with BP (p<0.0001), anthropometric variables (p<0.0001), lipid variables (p<0.03), us-CRP (p<0.007), E-selectin (p<0.001) and PWV (p<0.001) in young adulthood. 5) In the logistic regression analysis, BMI in A1 (odds ratio 1.549; IC95%: 1.244-1.927; p<0.001) and a positive BMI variation from A1 to A3 (odds ratio 1.304; IC95% 1.108-1.535; p<0.001) determined a higher risk of MS in A3. 6) There was no significant statistical difference between the groups in terms of the frequency of different genotypes and haplotypes. In conclusion, BP in adolescence was able to identify a group of individuals with a worse cardiovascular risk profile in young adulthood, which suggests that prevention measures should be implemented since early stages of life.