Diego Giulliano Destro Christofaro

Validação do monitor de medida de pressão arterial Omron HEM 742 em adolescentes

BACKGROUND Accurate blood pressure measurement is fundamental for scientific investigation or clinical decision-making. In this sense, it is important to verify the values provided by electronic devices. OBJECTIVE To validate the Omron HEM 742 blood pressure monitoring device in adolescents according to criteria suggested by the British Hypertension Society. METHODS A total of 150 adolescents aged between 10 and 16 years participated in the study. The automated Omron HEM 742 monitor was connected in Y to the mercury column auscultatory device, then three simultaneous measurements were taken, and the differences between the readings of the two devices were calculated. The intraclass correlation coefficient and Bland-Altman plot (agreement) were used to verify the relationship between both devices. Specificity and sensitivity of the device were determined by using the ROC curve. RESULTS The comparison between the measurements showed an equal to or lower than 5mmHg difference in 67.3% of the systolic values, and 69.3% of the diastolic values; an equal to or lower than 10mmHg difference occurred in 87.3% and 90.6% of the systolic and diastolic values, respectively; an equal to or lower than 15mmHg difference was found in 96.6% of the systolic values and 97.3% of the diastolic values. These findings are consistent with a grade A according to the British Hypertension Society protocol. A marked consonance was observed between the values obtained by the automated monitor and this device was proven to be capable of identifying the presence or absence of high blood pressure. CONCLUSION The Omron HEM 742 monitor was proved valid for blood pressure measurement in adolescents according to the criteria suggested by the British Hypertension Society.BACKGROUND: Accurate blood pressure measurement is fundamental for scientific investigation or clinical decision-making. In this sense, it is important to verify the values provided by electronic devices. OBJECTIVE: To validate the Omron HEM 742 blood pressure monitoring device in adolescents according to criteria suggested by the British Hypertension Society. METHODS: A total of 150 adolescents aged between 10 and 16 years participated in the study. The automated Omron HEM 742 monitor was connected in Y to the mercury column auscultatory device, then three simultaneous measurements were taken, and the differences between the readings of the two devices were calculated. The intraclass correlation coefficient and Bland-Altman plot (agreement) were used to verify the relationship between both devices. Specificity and sensitivity of the device were determined by using the ROC curve. RESULTS: The comparison between the measurements showed an equal to or lower than 5mmHg difference in 67.3% of the systolic values, and 69.3% of the diastolic values; an equal to or lower than 10mmHg difference occurred in 87.3% and 90.6% of the systolic and diastolic values, respectively; an equal to or lower than 15mmHg difference was found in 96.6% of the systolic values and 97.3% of the diastolic values. These findings are consistent with a grade A according to the British Hypertension Society protocol. A marked consonance was observed between the values obtained by the automated monitor and this device was proven to be capable of identifying the presence or absence of high blood pressure. CONCLUSION: The Omron HEM 742 monitor was proved valid for blood pressure measurement in adolescents according to the criteria suggested by the British Hypertension Society.

Prevalence of dyslipidemia in individuals physically active during childhood, adolescence and adult age

BACKGROUND The prevalence of dyslipidemia is increasing in many parts of Brazil, but it is yet unclear how much exercise is needed to attain beneficial effects on plasma lipoprotein levels. OBJECTIVE The study analyzed eight cities of the state of São Paulo, the association between the continued practice of physical exercise throughout life and the occurrence of dyslipidemia in adulthood. METHODS Cross-sectional study involving 2,720 adults, of both sexes, living in eight cities of the state of São Paulo. Through household interviews, the presence of dyslipidemia was self-reported and physical exercise practice was assessed in childhood (7-10 years), adolescence (11-17 years) and adulthood (leisure activities). In the statistical analysis, multivariate models were created using binary logistic regression. RESULTS The prevalence of dyslipidemia was 12.2% (95%CI: 11.1% -13.5%) and there was no difference between cities (p = 0.443). Women (p = 0.001) and obese individuals (p = 0.001) had a higher rate of dyslipidemia. Current practice of physical exercise was not associated with the presence of dyslipidemia ([≥ 180 minutes per week] p = 0.165); however, physical exercise, both in childhood (p = 0.001) and adolescence (p = 0.001) was associated with a lower incidence of the disease. Physically active adults in all three stages of life were 65% less likely to report dyslipidemia (OR = 0.35 [0.15 to 0.78]). CONCLUSION The continued practice of physical exercise throughout life was associated with a lower incidence of dyslipidemia in adults in the State of São Paulo.

Validation of the omron HEM 742 blood pressure monitoring device in adolescents

BACKGROUND Accurate blood pressure measurement is fundamental for scientific investigation or clinical decision-making. In this sense, it is important to verify the values provided by electronic devices. OBJECTIVE To validate the Omron HEM 742 blood pressure monitoring device in adolescents according to criteria suggested by the British Hypertension Society. METHODS A total of 150 adolescents aged between 10 and 16 years participated in the study. The automated Omron HEM 742 monitor was connected in Y to the mercury column auscultatory device, then three simultaneous measurements were taken, and the differences between the readings of the two devices were calculated. The intraclass correlation coefficient and Bland-Altman plot (agreement) were used to verify the relationship between both devices. Specificity and sensitivity of the device were determined by using the ROC curve. RESULTS The comparison between the measurements showed an equal to or lower than 5mmHg difference in 67.3% of the systolic values, and 69.3% of the diastolic values; an equal to or lower than 10mmHg difference occurred in 87.3% and 90.6% of the systolic and diastolic values, respectively; an equal to or lower than 15mmHg difference was found in 96.6% of the systolic values and 97.3% of the diastolic values. These findings are consistent with a grade A according to the British Hypertension Society protocol. A marked consonance was observed between the values obtained by the automated monitor and this device was proven to be capable of identifying the presence or absence of high blood pressure. CONCLUSION The Omron HEM 742 monitor was proved valid for blood pressure measurement in adolescents according to the criteria suggested by the British Hypertension Society.BACKGROUND: Accurate blood pressure measurement is fundamental for scientific investigation or clinical decision-making. In this sense, it is important to verify the values provided by electronic devices. OBJECTIVE: To validate the Omron HEM 742 blood pressure monitoring device in adolescents according to criteria suggested by the British Hypertension Society. METHODS: A total of 150 adolescents aged between 10 and 16 years participated in the study. The automated Omron HEM 742 monitor was connected in Y to the mercury column auscultatory device, then three simultaneous measurements were taken, and the differences between the readings of the two devices were calculated. The intraclass correlation coefficient and Bland-Altman plot (agreement) were used to verify the relationship between both devices. Specificity and sensitivity of the device were determined by using the ROC curve. RESULTS: The comparison between the measurements showed an equal to or lower than 5mmHg difference in 67.3% of the systolic values, and 69.3% of the diastolic values; an equal to or lower than 10mmHg difference occurred in 87.3% and 90.6% of the systolic and diastolic values, respectively; an equal to or lower than 15mmHg difference was found in 96.6% of the systolic values and 97.3% of the diastolic values. These findings are consistent with a grade A according to the British Hypertension Society protocol. A marked consonance was observed between the values obtained by the automated monitor and this device was proven to be capable of identifying the presence or absence of high blood pressure. CONCLUSION: The Omron HEM 742 monitor was proved valid for blood pressure measurement in adolescents according to the criteria suggested by the British Hypertension Society.

Resting Heart Rate is Associated with Blood Pressure in Male Children and Adolescents

OBJECTIVES To analyze the association between resting heart rate and blood pressure in male children and adolescents and to identify if this association is mediated by important confounders. STUDY DESIGN Cross-sectional study carried out with 356 male children and adolescents from 8 to 18 years old. Resting heart rate was measured by a portable heart rate monitor according to recommendations and stratified into quartiles. Blood pressure was measured with an electronic device previously validated for pediatric populations. Body fatness was estimated by a dual-energy x-ray absorptiometry. RESULTS Obese subjects had values of resting heart rate 7.8% higher than nonobese (P = .001). Hypertensive children and adolescents also had elevated values of resting heart rate (P = .001). When the sample was stratified in nonobese and obese, the higher quartile of resting heart rate was associated with hypertension in both groups of children and adolescents. CONCLUSIONS This study confirms the existence of a relationship between elevated resting heart rate and increased blood pressure in a pediatric population, independent of adiposity, ethnicity and age.

Evaluation of the Omron MX3 Plus monitor for blood pressure measurement in adolescents

This study analyzed the accuracy/agreement of the Omron MX3 monitor on 165 adolescents. Blood pressure was measured by the automatic monitor connected in Y with the mercury column (three consecutive and simultaneous measures). The independent measures were analyzed, and the mean differences between systolic and diastolic measures for both methods were calculated and compared with British Hypertension Society (BHS) and Association for the Advancement of Medical Instrumentation (AAMI) criteria. The automatic monitor received the highest degree of BHS recommendations for systolic and diastolic blood pressures according to the BHS. The median (25th and 75th) difference between the observer and the monitor measurements was −2 (−6 and 1) mmHg for systolic and 0 (−3 and1) mmHg for diastolic pressures. The monitor also satisfies the AAMI standard for the studied population. In conclusion, the Omron MX3 Plus monitor can be considered reliable and valid for clinical practice and is in accordance with BHS and AAMI criteria.

Prevalência de fatores de risco para doenças cardiovasculares entre escolares em Londrina - PR: diferenças entre classes econômicas

OBJETIVO: Avaliar e comparar a prevalencia de fatores de riscos cardiovasculares em adolescentes escolares de diferentes classes economicas. METODOS: Foram avaliados 1.021 adolescentes. Os individuos foram pesados e tiveram sua altura e circunferencia abdominal medidos, alem da sua pressao arterial aferida. A pratica de atividade fisica e condicao socioeconomica foram relatadas. Os resultados foram avaliados pela utilizacao da frequencia das variaveis e pelo teste do qui-quadrado. RESULTADOS: Observou-se menor prevalencia de sedentarismo (p < 0,001) e maiores prevalencias de obesidade abdominal (p = 0,038) e de sobrepeso (p = 0,010) entre adolescentes da classe economica alta. Nao houve diferenca de prevalencia de pressao arterial elevada entre adolescentes da classe economica baixa e alta. Quando os fatores de risco cardiovasculares foram agregados, a prevalencia tambem foi maior na classe economica alta para um ou dois fatores de risco. CONCLUSAO: Com excecao do sedentarismo e da pressao arterial elevada, a prevalencia de fatores de risco para doencas cardiovasculares foi maior na classe economica alta.

Prevalência de pressão arterial elevada em crianças e adolescentes: revisão sistemática

OBJECTIVES: to identify the prevalence of high blood pressure in children and adolescents in studiespublished in the past 30 years. METHODS: a search was carried out in the Medline/PubMed, Lilacs, Web of Science, Embase and Scielo databases for articles published between 1980 and 2009. Articles were included if they were original studies of the prevalence of high arterial blood pressure or hypertension in a sample of more than 500 subjects. RESULTS: the prevalence of high blood pressure (in individuals aged between 4 and 20 years) varied from 0.46% to 20.6%. The lower prevalence of high blood pressure was found in studies where the majority ofthe sample was aged between 4 and 7 years. Theprotocols most commonly used for evaluation of blood pressure were those developed by the Task Force and National High Blood Pressure Education Program. In all, 52.4% of studies used auscultation to determine blood pressure and 47.6% used oscillometry. CONCLUSIONS: despite the great discrepancy between the values for prevalence found in the studies, it is clear that there has been a growth in the prevalence of high blood pressure in children and adolescents all over the world.

Resposta da frequência cardíaca durante sessão de treinamento de karatê

Karate practice can promote beneficial adaptations on the health-related components of physical fitness. Among the components, the maximum oxygen uptake (VO2max) is an important indicator of cardiorespiratory fitness, as it is also a strong and independent predictor of the risk of death from cardiovascular disease and all other causes. Previous studies have evaluated the heart rate (HR) responses in the karate modality during protocols elaborated by researchers who simulated training. However, the results should be carefully interpreted, since elaborated protocols can compromise the ecological validity of the HR behavior. Thus, the aim of the study was to monitor the HR to investigate the distribution of intensity during a karate training session (TS) with ecological validity preserved. Nine athletes (M (SD) = 22 (5.2) years; 60.3 (12.9) weight; 170.0 (0.10) height; 170.0 (0.10) cm; 11.6 (5.7) % fat) performed a maximal incremental test (IT) and one TS with continuous HR monitoring, subsequently distributed by Edward´s method. The mean TS duration was 91.3 (11.9) min (IC95% = 82.0 - 100.5). The values of average and maximum HR of the TS were equivalent to 72 % (IC95% = 66 - 78 %) and 94 % (IC95% = 89 - 99 %) respectively, of maximum HR reached in the incremental test (HRmax). During 79.9 % (IC95% = 65.7 - 94.1 %) of the total time of TS the athletes remained at intensity above 60% of HRmax. Thus, it was concluded that the TS lies within the ACSM recommendations concerning intensity, duration and weekly frequency, presenting itself as an interesting alternative of exercise to promote cardiorespiratory fitness.

Socioeconomic status as determinant of risk factors for overweight in adolescents

OBJECTIVES To analyze risk factors for overweight among adolescents grouped in three different socioeconomic levels. METHODS This cross-sectional study included 1779 adolescents aged 11 to 17 years, grouped according to socioeconomic status (low, middle, and high). Parents reported their own anthropometric data and the adolescents had their anthropometric data taken by trained researchers, and completed three questionnaires. RESULTS The prevalence of overweight was 16.7%, 23.8%, and 26.3% in low, middle and high socioeconomic status, respectively (P= 0.001). In all socioeconomic status, parents overweight was associated with adolescent overweight (all P< 0.05). The students in both high (PR= 1.90) and middle socioeconomic status (PR= 2.00) from private schools were associated with overweight, and the students from low socioeconomic level to sedentary behavior (PR= 2.25) and high ingestion of fried food (PR= 2.35). CONCLUSION In each socioeconomic status the overweight was associated with different risk factors in different ways, except for parents overweight.

Effects of walking and strength training on walking capacity in individuals with claudication: meta-analysis

CONTEXT: Over the past few years, several clinical trials have been performed to analyze the effects of exercise training on walking ability in patients with intermittent claudication (IC). However, it remains unclear which type of physical exercise provides the maximum benefits in terms of walking ability. OBJECTIVE: To analyze, by means of a meta-analysis, the effects of walking and strength training on the walking capacity in patients with IC. METHODS: Papers analyzing the effects of walking and strength training programs in patients with IC were browsed on the Medline, Lilacs, and Cochrane databases. Randomized clinical trials scoring >4 on the Physiotherapy Evidence Database (PEDro) scale and assessing claudication distance (CD) and total walking distance (TWD) were included in the review. RESULTS: Walking and strength training yielded increases in CD and TWD (P < 0.05). However, walking training yielded greater increases than strength training (P = 0.02). CONCLUSION: Walking and strength training improve walking capacity in patients with IC. However, greater improvements in TWD are obtained with walking training.