Carolina de Souza Carneiro

Efeito de suplemento hidroeletrolítico na hidratação de jogadores juniores de futebol

The hydration status of nine male under 18 soccer players was evaluated after ingestion of the most accepted carbohydrate-electrolyte drink between three tests. The study was conducted during 80 minutes of training. The soccer players ingested 900 mL of a commercial carbohydrate-electrolyte drink (control) plus 300 mL of water or 900 mL of the most accepted drink (test) plus 300 mL of water. The time of training, exercise intensity, urinary status, weight, weight loss, the weight loss rate, the dehydration degree and the sweat rate were determined to verify the hydration status. The drink with 8% carbohydrate was the best accepted. The exercise intensity of the players was higher on the days that they ingested the tested drink. The time of training in relation to the tested drink was significantly lower than the control beverage (p = 0.008). The weight loss, the dehydration degree and sweat rate of the athletes with fluid intake test was higher when compared to control fluid intake. The athletes completed the game more dehydrated with the drinking fluid test; however, the limit of 2% weight loss was not exceeded. The exercise intensity (mild to moderate) and climatic conditions (lower temperature and higher relative humidity) on the day of the fluid control intake control may have helped the best results from the hydration capacity of the fluid control.

Office blood pressure measurements with oscillometric devices in adolescents: a comparison with home blood pressure

Abstract Purpose: Compare multiple in office BP measurements in adolescents using an oscillometric device with out-of-office blood pressure measurements (home blood pressure monitoring – HBPM). Materials and methods: Office measurements were performed with validated semi-automatic devices twice (3 minutes interval) in two different moments (1 week apart), with a total of four readings. These BP readings were named R1, R2, R3 and R4 (following the sequence they were performed), FDM (mean of two readings on first day) and SDM (mean of two readings on second day) and SRM (R2–R4 means). The HBPM protocol included two day-time and two evening-time measurements over 6 days. Results: A total of 1024 students between 12 and 17 years were included (mean age 14.68 years; 52.4% females). The mean systolic blood pressure (SBP) values of R2, SDM and SRM were similar to HBPM values. Regarding diastolic blood pressure (DBP) HBPM value was different than R4. High SBP and DBP correlation coefficients with HBPM values were found for R2, SDM and SRM values. Conclusion: The second office BP measurement performed with an oscilometric device in adolescents was comparable to HBPM values, suggesting that two office readings might be suitable to rule out hypertension in this age group.

Correlation of Insulin Resistance with Anthropometric Measures and Blood Pressure in Adolescents

Background Blood pressure is directly related to body mass index, and individuals with increased waist circumference have higher risk of developing hypertension, insulin resistance, and other metabolic changes, since adolescence. Objective to evaluate the correlation of blood pressure with insulin resistance, waist circumference and body mass index in adolescents. Methods Cross-section study on a representative sample of adolescent students. One group of adolescents with altered blood pressure detected by casual blood pressure and/or home blood pressure monitoring (blood pressure > 90th percentile) and one group of normotensive adolescents were studied. Body mass index, waist circumference were measured, and fasting glucose and plasma insulin levels were determined, using the HOMA-IR index to identify insulin resistance. Results A total of 162 adolescents (35 with normal blood pressure and 127 with altered blood pressure) were studied; 61% (n = 99) of them were boys and the mean age was 14.9 ± 1.62 years. Thirty-eight (23.5%) adolescents had altered HOMA-IR. The group with altered blood pressure had higher values of waist circumference, body mass index and HOMA-IR (p<0.05). Waist circumference was higher among boys in both groups (p<0.05) and girls with altered blood pressure had higher HOMA-IR than boys (p<0.05). There was a significant moderate correlation between body mass index and HOMA-IR in the group with altered blood pressure (ρ = 0.394; p < 0.001), and such correlation was stronger than in the normotensive group. There was also a significant moderate correlation between waist circumference and HOMA-IR in both groups (ρ = 0.345; p < 0.05). Logistic regression showed that HOMA-IR was as predictor of altered blood pressure (odds ratio - OR = 2.0; p = 0.001). Conclusion There was a significant association of insulin resistance with blood pressure and the impact of insulin resistance on blood pressure since childhood. The correlation and association between markers of cardiovascular diseases was more pronounced in adolescents with altered blood pressure, suggesting that primary prevention strategies for cardiovascular risk factors should be early implemented in childhood and adolescence.

Multiple cardiovascular risk factors in adolescents from a middle-income country: Prevalence and associated factors

Multiple cardiovascular risk factors are directly related to the severity of atherosclerosis, even in children and adolescents. In this context accurate assessment of risk factors at the individual level play a decisive role in cardiovascular disease (CVD) prevention. The objective of this study was to estimate the prevalence of cardiovascular risk factors, the frequency of their coexistence in individuals, and identify possible determinants associated with this coexistence in Brazilian adolescents. A cross-sectional study with 1170 students (12–17 years) from public and private schools of a large city was conducted. In addition to family history, modifiable cardiovascular risk factors were assessed including: tobacco use, alcohol consumption, sedentary lifestyle, overweight/obesity, increased waist circumference, and high blood pressure (office and home). We built a linear regression model to identify determinants associated with increasing number of modifiable risk factors. Mean study population age was 14.7±1.6 years, 67% were enrolled in public schools and 33% in private ones. The majority of the adolescents had at least two risk factors (68.9%), more than 10% had more than 4 risk factors, and in only 6.7% of the sample no risk factor was identified. Family history of CVD (β-coefficient = 1.20; 95%CI 1.07–1.34; p<0.001), increasing age (β-coefficient = 0.08; 95%CI 0.04–0.11; p<0.001), and being enrolled in private schools (β-coefficient = 0.16; 95%CI 0.02–0.30; p = 0.023) were directly associated with the modifiable CV risk factors. In conclusion, the prevalence of multiple cardiovascular risk factors was high in the population of adolescents studied. School based interventions should be addressed to change this scenario.

White-coat, masked and sustained hypertension detected by home blood pressure monitoring in adolescents: prevalence and associated factors

Abstract Purpose: Population-based studies estimating prevalence’s of white-coat, masked and sustained hypertension in non-European adolescents are needed, particularly in developing countries. Aiming to determine these estimates and, additionally identify factors associated to these conditions this study was conducted. Materials and methods: Cross-sectional study with a representative sample of secondary school students from a Brazilian state capital. Office measurements were performed with validated semi-automatic devices. Home BP (blood pressure) monitoring protocol included two day-time and two evening-time measurements over 6 days. Adolescents’ were classified as: normotensives (office and home BP <95th percentile); sustained hypertensives (office and home BP ≥95th percentile); white-coat hypertensives (office BP ≥95th percentile and home BP <95th percentile) and masked hypertensives (office BP <95th percentile and home BP ≥95th percentile). Logistic regression models were built to identify if sex, age, BMI and family history of HTN were independently associated with white-coat, masked and sustained hypertension. Results: In a sample of 1024 adolescents, prevalence of white-coat, masked and sustained hypertension was 7.5%, 2.2% and 1.7%, respectively. Male sex was positively associated with white-coat hypertension (OR 2.68; 95%CI 1.58–4.54; p < 0.001). BMI was positively associated with both white-coat (OR 1.23; 95%CI 1.16–1.30; p < 0.001) and sustained hypertension (OR 1.19; 95%CI 1.11–1.29; p < 0.001). None of the independent variables were associated with masked hypertension in this population. Conclusion: The estimated prevalence of white-coat hypertension, masked and sustained hypertension in a population of non-European adolescents assessed by home BP monitoring was 7.5%, 2.2% and 1.7% respectively. Male sex was positively associated with white-coat hypertension in these adolescents while BMI was positively associated with both white-coat and sustained hypertension.

Excesso de peso e fatores associados em adolescentes de uma capital brasileira

Objective: To evaluate the prevalence of overweight in adolescents and its associated factors. Methods: A cross-sectional study in public and private schools in Goiania, Brazil. Socioeconomic status, family history of obesity, lifestyle, blood pressure and Body Mass Index were studied in a sample of 1,169 Brazilian youth aged 12 - 18 years, who attended public and private schools. Data were obtained from a questionnaire and anthropometric measurements previously tested in a pilot study. Poisson regression was used to estimate the prevalence of overweight, prevalence ratios and associations with the other factors. Results: The prevalence of overweight was 21.2%, with a significant difference between boys and girls (26.3 and 16.8% respectively). Regression analysis showed that maternal obesity was associated with a higher prevalence of overweight in boys (PR = 1.86; p = 0.004), and boys aged 15 - 18 years had a lower prevalence of overweight than boys aged 12 - 14 years (PR = 0.70; p = 0.021). Among the girls, the presence of obese parents was associated with higher prevalence of overweight (PR = 2.42; p < 0.001), and the girls from a C class socioeconomic position were negatively associated with overweight (PR = 0.67; p = 0.035). Conclusions: Overweight in adolescence is associated with gender, obesity family history, and socioeconomic position. These data should be considered when planning intervention programs.

[LB.01.24] HOME BLOOD PRESSURE NORMALCY IN NON-EUROPEAN ADOLESCENTS

Objective: Evidence on normal range of home blood pressure (BP) in adolescents relies on only one European study. This study aims to investigate the normal range of home BP in a healthy non-European population of adolescents. Design and method: Cross-sectional study with a representative sample of secondary school students (12–17 years) from a Brazilian capital. Adolescents’ heights were classified in percentiles according to age and gender. Height percentiles were divided in <=50th or >50th percentile. The home BP protocol included two day-time and two evening-time measurements over 6 days. Exams were considered valid with at least 12 measurements. Results: A total of 1024 adolescents were included, mean age 14.68 ± 1.61 years, predominantly female (52.4%), from public schools (68.4%) and non-white (51.3%). The 50th (midpoint of distribution) and the 95th percentile (upper normal limit) for systolic and diastolic home BP in adolescents are provided by gender, age and height percentiles. There was a marked increase in the estimated 95th percentile for systolic home BP with increasing age in males for both height percentiles examined (16 mmHg for <=50th percentile and 14.5mmHg for >50th percentile) and less so for diastolic home BP (1 mmHg and 5 mmHg, respectively). In females the 95th percentile increase with age was less significant for systolic and similar for diastolic BP when compared to males in the two height percentiles evaluated (6/2 mmHg for <=50th percentile and 4/4 mmHg for >50th percentile). Conclusions: Reference values for home BP by height percentiles for age and sex in a non-European population of adolescents are provided.

Home Blood Pressure Monitoring as an Alternative to Confirm Diagnoses of Hypertension in Adolescents with Elevated Office Blood Pressure from a Brazilian State Capital

Background Regional differences of using home blood pressure monitoring (HBPM) as an alternative to ambulatory blood pressure monitoring (ABPM) in hypertensive adolescents are unknown. Objectives Define if HBPM is an option to confirm diagnoses of hypertension in adolescents from a Brazilian capital with elevated office blood pressure (BP). Methods Adolescents (12-18years) from public and private schools with BP > 90th percentile were studied to compare and evaluate the agreement among office BP measurements, HBPM and ambulatory BP monitoring. Office BP measurements, HBPM and ABPM were performed according to guidelines recommendations. Semi-automatic devices were used for BP measurements. Values of p < 0.05 were considered significant. Results We included 133 predominantly males (63.2%) adolescents with a mean age of 15±1.6 years. HBPM systolic blood pressure and diastolic blood pressure mean values were similar to the daytime ABPM values (120.3 ± 12.6 mmHg x 121.5 ± 9.8 mmHg - p = 0.111 and 69.4 ± 7.7 mmHg x 70.2 ± 6.6 mmHg - p = 0.139) and lower than the office measurement values (127.3 ± 13.8 mmHg over 74.4 ± 9.5 mmHg - p < 0,001). The Bland-Altman plots showed good agreement between HBPM and ABPM. Conclusions HBPM is an option to confirm diagnoses of hypertension in adolescents from a Brazilian state capital with elevated office BP and can be used as an alternative to ABPM.

[OP.6A.05] CARDIOVASCULAR DISEASE RISK FACTORS IN ADOLESCENT STUDENTS FROM A BRAZILIAN STATE CAPITAL.

Objective: To determine the prevalence of cardiovascular disease risk factors in adolescents from public and private schools of a Brazilian state capital. Design and method: Cross-sectional study with a representative sample of adolescents aged 14 to 18 years, enrolled in public and private schools in Goiânia, Goiás state, Brazil. The data collection included a standard questionnaire (gender, age, ethnicity, smoking, alcohol consumption in the last 30 days, socioeconomic status, and family history of cardiovascular disease); the International Physical Activity Questionnaire (IPAQ); and a physical assessment (weight, height, waist circumference, and blood pressure). The prevalence ratio was used as the measure of association, estimated by Poisson regression. Results: The sample was composed of 862 adolescents with a mean age of 15.4 ± 1.1 years and with a predominance of females (52.8%). Alcohol consumption in the last 30 days (72.2%) and physical inactivity (66.8%) were the most prevalent cardiovascular risk factors. The most prevalent variables in female adolescents were socioeconomic class C (53.6%; p = 0.022), alcohol consumption in the last 30 days (75.4%; p = 0.025) and physical inactivity (66.8%, p = 0.000). In male adolescents, the most prevalent variables were abnormal blood pressure (24.3%; p = 0.000), abnormal waist circumference (17.2%; p = 0.011), and overweight (24.6%; p = 0.001). The prevalence of a family history of cardiovascular disease was 39.5%. Most adolescents (60.3%) had three or more risk factors, and only 1.1% did not present any cardiovascular risk factor. Conclusions: The prevalence of cardiovascular disease risk factors, particularly the occurrence of multiple risk factors, was high in the population studied.