Fatores de risco cardiovascular em escolares pré-púberes de Luanda - Angola

• Autor(a) principal: Silva, Amílcar Bernardo Tomé da
• Data de Publicação: 2015
• Tipo de documento: Tese
• Idioma: por
• Título da fonte: Repositório Institucional da Universidade Federal do Espírito Santo (riUfes)
• Texto Completo: http://repositorio.ufes.br/handle/10/8078
• topic: Cardiovascular risk; overweight/obesity; blood pressure; prepubertal children; Pulse wave velocity; Risco Cardiovascular; Sobrepeso/obesidade; Pressão arterial; Criança pré-púbere; Velocidade da Onda de Pulso; Angola; Fisiologia

Background: The incidence of cardiovascular disease has increased worldwide and studies have suggested that their predictors can be detected in childhood. Excessive fat accumulation seems to predispose to hypertension, diabetes and dyslipidemias, three conditions strongly associated with cardiovascular risk in adults. The increasing incidence of cardiovascular (CV) risk factors in children is a rapidly growing problem in many countries, especially in those experiencing accelerated economic growth where lifestyle and food intake habits tend to change rapidly. Arterial stiffness assessed by the carotid-femoral pulse wave velocity (PWV) is a strong predictor of CV risk, but it is rarely used in children because of values of reference have not been determined. Therefore, the aims of this study were to determine the association of birth weight with cardiovascular risk factors, to identify predictors and to determine reference values of the VOP in prepubertal schoolchildren of Luanda, Angola. Methods: Cross-sectional study of 198 prepubertal boys and girls (7-11 years) enrolled in a public school. Clinical, biochemical and anthropometric exams were obtained on a pre-scheduled day. Children attended to the Faculty of Medicine in fasting to take a venous blood sample and to get anthropometric measurements (height, weight, waist and hip circumferences), blood pressure (BP) and electrocardiogram (ECG). Data are reported as prevalence (95% confidence limits) or means and standard deviation. Intergroup comparisons were performed with Student’s t test or ANOVA followed by Tukey test. The degree of association between continuous variables was obtained by Pearson correlation analysis. Predictors of systolic and diastolic BP and PWV were obtained by multivariate analysis. Statistical significance was set at P <0.05. Results: The age mean was 9.3 ± 1.41 years. Low birth weight (<2.5 kg) was found in 7.6% of the children. The prevalence of overweight/obesity was 17.7% (95%CI, 12.4 to 23.0) with 7.1% of overweight and 10.6% of obese. High BP was found in 14.6% (95%CI; 9.69 to 19.5), with 10.1% of pre-hypertension and 4.5% of hypertension. Glucose was high in 16.7% (95%CI ; 14.5 to 18.9), however only 1 case could be classified as diabetes. Prevalence of dyslipidemia was 69.2% (95% CI, 62.8 to 75.6), and 50% showed hypercholesterolemia (cholesterol mean = 171.8 ± 34.1 mg / dL), 27.3% elevated triglycerides and 9.6¨low HDL-c low, the only risk factor different between genders (boys 18.2% vs. girls 4.1%; P = 0.002). Considering the most common CV risk factors in children (overweight/obesity, high BP, high blood glucose, high total cholesterol and low HDL-c), we observed that 35.9% had one risk factor, 25.3% two and 27.8% three or more risk factors. Predictors of systolic BP were hip circumference, PWV and BMI, while fat mass was predictor for diastolic BP, Height was the only independent predictor of PWV. However, no association was detected between BMI and elevated glucose or dyslipidemia. Conclusions: There is a high prevalence of cardiovascular risk factors in prepubertal school in Angola. The birth weight was directly associated with overweight/obesity, which was closely associated with high BP, but with no other cardiovascular risk factors classics.