Leandro Tibiriçá Burgos

Uma análise entre índices pressóricos, obesidade e capacidade cardiorrespiratória em escolares

FUNDAMENTO: Durante a infância e adolescencia, o sedentarismo, o excesso de peso e a alimentacao inadequada sao fatores de risco para doencas cronicas, sobretudo obesidade, hipertensao arterial sistemica e diabete melito. A intervencao precoce pode prevenir o desenvolvimento dessas complicacoes. OBJETIVO: Verificar a presenca de fatores de risco cardiovasculares (obesidade e hipertensao arterial) e suas possiveis interacoes com a capacidade cardiorrespiratoria. Metodos: Estudo transversal composto de amostra estratificada por conglomerados, de 1.666 escolares, com idades entre 7 e 17 anos, 873 (52,4%) do sexo masculino e 793 (47,6%) do sexo feminino. Avaliaram-se as pressoes arteriais sistolica (PAS) e diastolica (PAD), indice de massa corporal (IMC), percentual de gordura (%G) e capacidade cardiorrespiratoria. Ainda, PAS e PAD foram correlacionadas com circunferencia da cintura (CC), relacao cintura-quadril (RCQ), somatorio de dobras cutâneas (ΣDC) e capacidade cardiorrespiratoria. RESULTADOS: A avaliacao do IMC dos escolares evidenciou 26,7% de sobrepeso ou obesidade e 35,9% com o percentual de gordura acima de moderadamente alto. Com relacao aos niveis pressoricos, encontraram-se 13,9% e 12,1% de escolares limitrofes e hipertensos, para PAS e PAD, respectivamente. Houve associacao entre hipertensao, obesidade e capacidade cardiorrespiratoria. Observou-se correlacao significativa em relacao a PAS e PAD, para todas as variaveis analisadas, apresentando, ainda, uma relacao fraca a moderada com as variaveis idade, peso, estatura, IMC e circunferencia da cintura. CONCLUSAO: A presenca da hipertensao arterial associada a obesidade e seu reflexo na capacidade cardiorrespiratoria reforcam a importância de se propor, ja na infância, um estilo de vida mais ativo e saudavel.

Relationship between anthropometric measures and cardiovascular risk factors in children and adolescents.

Background Obesity has been identified as an important risk factor in the development of cardiovascular diseases; however, other factors, combined or not with obesity, can influence cardiovascular risk and should be considered in cardiovascular risk stratification in pediatrics. Objective To analyze the association between anthropometry measures and cardiovascular risk factors, to investigate the determinants to changes in blood pressure (BP), and to propose a prediction equation to waist circumference (WC) in children and adolescents. Methods We evaluated 1,950 children and adolescents, aged 7 to 18 years. Visceral fat was assessed by WC and waist hip relationship, BP and body mass index (BMI). In a randomly selected subsample of these volunteers (n = 578), total cholesterol, glucose and triglycerides levels were evaluated. Results WC was positively correlated with BMI (r = 0.85; p < 0.001) and BP (SBP r = 0.45 and DBP = 0.37; p < 0.001). Glycaemia and triglycerides showed a weak correlation with WC (r = 0.110; p = 0.008 e r = 0.201; p < 0.001, respectively). Total cholesterol did not correlate with any of the variables. Age, BMI and WC were significant predictors on the regression models for BP (p < 0.001). We propose a WC prediction equation for children and adolescents: boys: y = 17.243 + 0.316 (height in cm); girls: y = 25.197 + 0.256 (height in cm). Conclusion WC is associated with cardiovascular risk factors and presents itself as a risk factor predictor of hypertension in children and adolescents. The WC prediction equation proposed by us should be tested in future studies.

Prevalence of obesity and cardiovascular risk among children and adolescents in the municipality of Santa Cruz do Sul, Rio Grande do Sul

CONTEXT AND OBJECTIVE Studies have demonstrated that metabolic complications from child obesity, although silent, increase the risk of development of cardiovascular diseases in adulthood. The present paper sought to describe the prevalence of overweight/obesity and analyze the possible relationship between obesity and other cardiovascular risk factors among children and adolescents. DESIGN AND SETTING Cross-sectional study, conducted in a university. METHODS The study included 564 children and adolescents, aged 8 to 17 years. Body mass index and waist circumference were used to evaluate obesity. Other cardiovascular risk factors were evaluated, like systolic and diastolic blood pressure, glycemia, triglycerides and total cholesterol. Descriptive analysis was used for sample characterization, the chi-square test for categorical variables and Pearsons linear correlation for evaluating the relationship between obesity indicators and other cardiovascular risk factors. RESULTS High prevalence of overweight/obesity was found among the schoolchildren (25.3% among the boys and 25.6% among the girls), along with abdominal obesity (19.0%). The overweight/obese schoolchildren presented higher percentages for the pressure and biochemical indicators, compared with underweight and normal-weight schoolchildren. Body mass index and waist circumference showed a weak correlation with the variables of age and systolic and diastolic blood pressure (P < 0.001), but there was no correlation between these obesity indices and biochemical variables. CONCLUSION The high prevalence of overweight/obesity and its relationship with other cardiovascular risk factors demonstrate that it is necessary to develop intervention and prevention strategies from childhood onwards, in order to avoid development of chronic-degenerative diseases in adulthood.

Decreased erythrocyte NA+,K+-ATPase activity and increased plasma TBARS in prehypertensive patients.

The essential hypertension has been associated with membrane cell damage. The aim of the present study is investigate the relationship between erythrocyte Na+,K+-ATPase and lipoperoxidation in prehypertensive patients compared to normotensive status. The present study involved the prehypertensive patients (systolic: 136 ± 7 mmHg; diastolic: 86.8 ± 6.3 mmHg; n = 8) and healthy men with normal blood pressure (systolic: 110 ± 6.4 mmHg; diastolic: 76.1 ± 4.2 mmHg; n = 8) who were matched for age (35 ± 4 years old). The venous blood samples of antecubital vein (5 mL) were collected into a tube containing sodium heparin as anticoagulant (1000 UI), and erythrocyte ghosts were prepared for quantifying Na+,K+-ATPase activity. The extent of the thiobarbituric acid reactive substances (TBARS) was determined in plasma. The statistical analysis was carried out by Students t-test and Pearsons correlation coefficient. A P < 0.05 was considered significant. The Na+,K+-ATPase activity was lower in prehypertensive patients compared with normotensive subjects (4.9 versus 8.0 nmol Pi/mg protein/min; P < 0.05). The Na+,K+-ATPase activity correlated negatively with TBARS content (r = −0.6; P < 0.05) and diastolic blood pressure (r = −0.84; P < 0.05). The present study suggests that Na+,K+-ATPase activity reduction and elevation of the TBARS content may underlie the pathophysiological aspects linked to the prehypertensive status.

Estilo de vida: lazer e atividades lúdico-desportivas de escolares de Santa Cruz do Sul

Este estudo descritivo objetiva caracterizar o perfil do estilo de vida dos escolares de Santa Cruz do Sul- RS, nos aspectos: praticas de lazer em casa e fora dela e atividades ludico-desportivas, estratificados por sexo e regiao (centro, periferia e rural). Sao sujeitos deste estudo 2486 escolares do sexo masculino e feminino, com sete a 17 anos de idade, do centro, da periferia e do meio rural, sendo, na coleta de dados, utilizado o EVIA (estilo de vida). O nivel socioeconomico predominante esta na classe B e C. Os resultados revelam que os meninos (84,3%) praticam mais atividades desportivas que as meninas (72%). Na zona rural, o indice de pratica e maior (86,7%), seguindo-se o centro (78,9%) e a periferia (73,1%). As atividades de lazer predominantes em casa sao ver TV (centro e periferia), conversar/brincar com amigos (centro) e escutar musica (periferia e rural). Fora de casa, as principais atividades de lazer sao conversar/brincar com amigos (em todas as regioes), passear de carro (centro), jogar futebol (periferia e rural), andar de bicicleta (rural) e passear a pe (periferia). No esporte praticado (sexo masculino), predomina o futebol, principalmente na zona rural, seguido do basquete (centro), e entre as meninas, volei (centro e periferia) e futebol (rural). Conclui-se pelo estudo que os habitos estudados, tanto na zona rural, quanto urbana, sao pouco diversificados em relacao ao universo de todos os conteudos culturais do lazer. Conclui-se, tambem, que, em grande parte, os escolares sao sedentarios, principalmente os do sexo feminino, favorecendo o aparecimento de fatores de risco as doencas cardiovasculares, o que deve merecer a atencao da Educacao Fisica na escola e do poder publico, com oferta de mais espacos e atividades fisicas e esportivas de lazer.

High urate concentration is associated with elevated blood pressure in schoolchildren

Abstract Background Studies in adults have shown a relationship between high blood pressure and hyperuricemia, but few studies have investigated this association in children and adolescents. The aim of the present study was to associate urate concentration with systolic blood pressure (SBP) and diastolic blood pressure (DBP) in schoolchildren. Methods This cross-sectional study used a sample of 2335 schoolchildren in basic education between 7 and 17 years old. Blood pressure was classified by percentile according to Brazilian parameters for sex and age, reclassified into two categories: normal and borderline/hypertension. Blood collection to obtain serum for urate concentration analysis was performed after a 12-h fast. Values above 5.5 mg/dL were considered hyperuricemia. Descriptive data were presented in frequency and percentage. Linear regression and Poisson regression (prevalence ratio [PR]) was used to test the association between urate concentration and blood pressure. Results Urate concentration was weakly associated with SBP (β: 0.05; 95% CI: 0.02–0.08) and DBP (β: 0.03; 95% CI: 0.01–0.05) z-scores. Schoolchildren with hyperuricemia had a higher prevalence of high SBP (PR: 1.12; p<0.001) and DBP (PR: 1.08; p<0.001). Conclusions Elevated urate concentration is associated with altered blood pressure in schoolchildren.

Relationship between Cardiometabolic Parameters and Elevated Resting and Effort Heart Rate in Schoolchildren

Background Little has been studied on heart rate and its relationship with metabolic disorders. Objective To identify possible association between heart rate (HR) and metabolic disorders in children and adolescents. Methods This cross-sectional study evaluated 2.098 subjects, aged between 7 and 17 years. The variables evaluated were: HR, systolic (SBP) and diastolic blood pressure (DBP), pulse pressure (PP), double-product (DP), myocardial oxygen consumption (mVO2), lipids, glucose and uric acid levels, body mass index (BMI) and waist circumference (WC). The values of HR at rest and effort were divided into quartiles. The association between continuous values of HR and cardiometabolic indicators was tested by linear regression. Results LDL cholesterol presented a significantly higher mean (p = 0.003) in schoolchildren with resting HR greater or equal to 91 bpm, compared to students with less than 75 bpm. Compared with the quartiles of effort HR, SBP, DBP, glucose and uric acid presented high values when HR was greater or equal than 185 bpm. SBP, glucose and HDL cholesterol demonstrated a significant association with resting HR. Uric acid was observed as a predictor of increased effort HR. Conclusion Schoolchildren with a higher resting HR have higher mean of LDL cholesterol. For effort HR, there was an increase in blood pressure, glucose and uric acid levels. Uric acid has been shown to be a predictor of elevated effort HR.

Artigo originalObesidade e hipertensão arterial em escolares de Santa Cruz do Sul – RS, BrasilObesity and arterial hypertension in schoolchildren from Santa Cruz do Sul – RS, Brazil

OBJECTIVE To verify the prevalence of obesity and hypertension in schoolchildren from Santa Cruz do Sul - RS, Brazil, in 2005 and 2008. METHOD The study was performed with two consecutive cross-sectional measurements, consisting of a stratified cluster sample, totaling 414 students, aged between 7 and 17 years, of which 215 (51.9%) were males and 199 (48.1%) were females. Obesity was assessed by body mass index (BMI) and percentage of body fat (%BF). Hypertension was measured by blood pressure values, both systolic (SBP) and diastolic (DBP). RESULTS BMI assessment showed 18.6% and 22.3% of excess weight in males and 22.6% and 14.6% in females (in 2005 and 2008, respectively). Regarding obesity, the prevalence was 4.7% in both years for males and a reduction from 12.6% to 9.0% was observed in females. When analyzing the difference between assessments, there was significance in the BMI classification (p = 0.022) and %BF (p = 0.017) only in females. Statistically significant changes in SBP were found only in males (p < 0.001). CONCLUSION The levels of excess weight, obesity, and %BF in females, as well as the increased levels of systolic blood pressure in males, demonstrate the need for early intervention through more effective public health campaigns.