Miriam Beatris Reckziegel

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.

The influence of active and passive smoking on the cardiorespiratory fitness of adults

BackgroundThe aim of this study was to analyze the influence of active and passive smoking on cardiorespiratory responses in asymptomatic adults during a sub-maximal-exertion incremental test.MethodsThe participants (n = 43) were divided into three different groups: active smokers (n = 14; aged 36.5 ± 8 years), passive smokers (n = 14; aged 34.6 ± 11.9 years) and non-smokers (n = 15; aged 30 ± 8.1 years). They all answered the Test for Nicotine Dependence and underwent anthropometric evaluation, spirometry and ergospirometry according to the Bruce Treadmill Protocol.ResultsVO2max differed statistically between active and non-smokers groups (p < 0.001) and between non-smokers and passive group (p=0.022). However, there was no difference between the passive and active smokers groups (p=0.053). Negative and significant correlations occurred between VO2max and age (r = - 0.401, p = 0.044), percentage of body fat (r = - 0.429, p = 0.011), and waist circumference (WC) (r = - 0.382, p = 0.025).ConclusionVO2max was significantly higher in non-smokers compared to active smokers and passive smokers. However, the VO2max of passive smokers did not differ from active smokers.

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.

DNA damage in children and adolescents with cardiovascular disease risk factors

The risk of developing cardiovascular disease (CVD) is related to lifestyle (e.g. diet, physical activity and smoking) as well as to genetic factors. This study aimed at evaluating the association between CVD risk factors and DNA damage levels in children and adolescents. Anthropometry, diet and serum CVD risk factors were evaluated by standard procedures. DNA damage levels were accessed by the comet assay (Single cell gel electrophoresis; SCGE) and cytokinesis-blocked micronucleus (CBMN) assays in leukocytes. A total of 34 children and adolescents selected from a population sample were divided into three groups according to their level of CVD risk. Moderate and high CVD risk subjects showed significantly higher body fat and serum CVD risk markers than low risk subjects (P<0.05). High risk subjects also showed a significant increase in DNA damage, which was higher than that provided by low and moderate risk subjects according to SCGE, but not according to the CBMN assay. Vitamin C intake was inversely correlated with DNA damage by SCGE, and micronucleus (MN) was inversely correlated with folate intake. The present results indicate an increase in DNA damage that may be a consequence of oxidative stress in young individuals with risk factors for CVD, indicating that the DNA damage level can aid in evaluating the risk of CVD.

Cardiovascular risk in rural workers and its relation with body mass index

Objective Evaluate the propensity of cardiovascular risk in rural workers and, through the Framingham Risk Score (FRS), relate this risk with the classification of Body Mass Index (BMI). Subjects and methods This study is characterized as descriptive and exploratory, with the participation of 138 subjects, ranging between 25-73 years old. Clinical and laboratory analysis of the risk factors contained in the FRS were performed, in addition to the determination of BMI, blood pressure, smoking and physical inactivity. Results The procedures indicated a low risk of a coronary event in 10 years with 70.3% of the population. In contrast, 88.4% of the subjects were overweight. It was evidenced a risk improvement as the BMI increased, since 96.4% of high-risk cases were overweight or obese. Conclusion Results suggest larger prevalence of intermediary or high FRS for women with higher BMI, which was not observed in men.

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.