Associated factors in high blood pressure among schoolchildren in a middle size city, southern Brazil

Abstract

Objective: To establish the prevalence of high blood pressure and associated factors among schoolchildren from Caxias do Sul, state of Rio Grande do Sul, Brazil. Methods:This school-based cross-sectional study assessed boys and girls aged 7 to 12 years from private and public schools. Three measurements of the children's blood pressure were taken during one visit to the schools. Weight, height, and waist circumference were measured. We also assessed the children's aerobic capacity (9-minute running test) and socioeconomic status. Statistical analysis was carried out using the chi-square test and logistic regression in order to control for confounding factors. Results:The sample included 1,413 children. Prevalence of schoolchildren with high blood pressure was 13.8% (systolic, diastolic, systolic/diastolic), and the proportion was higher (double) for obese and/or overweight children in comparison to normal-weight children. Children with increased waist circumference had 2.8 times greater chance of having high blood pressure levels than those with appropriate waist circumference (95% confidence interval 2.513-3.186 and p = 0.000). Individuals belonging to a high social class, defined according to the Brazilian National Economic Index, had 2.6 times greater chance of having high blood pressure. Conclusions:In the present study, schoolchildren aged 7 to 12 years from Caxias do Sul had high prevalence of high blood pressure levels; increased waist circumference, high socioeconomic status, and low physical capacity were associated with this condition. We suggest that measures be taken to promote the practice of physical activity and dietary control to improve blood pressure levels and thus reduce risk factors. J Pediatr (Rio J). 2009;85(4):335-340:Children, blood pressure, epidemiology, obesity, physical capacity. ResumoObjetivo: Verificar a prevalência de níveis pressóricos elevados e fatores associados em escolares de Caxias do Sul (RS).Métodos: Estudo transversal de base escolar avaliou crianças de 7 a 12 anos de ambos os sexos, provenientes das redes privada e pú-blica. Foram realizadas três medidas da pressão arterial em uma única situação. Mensurou-se peso, altura, circunferência da cintura, aptidão aeróbia (teste de corrida de 9 minutos) e situação socioeconômica. A estatística foi realizada através de teste do qui-quadrado e regressão logística para controle dos fatores de confusão.Resultados: Participaram do estudo 1.413 crianças. A prevalência de escolares com níveis pressóricos elevados foi de 13,8% (sistólico, diastó-lico, sistólico/diastólico), e a proporção foi maior (dobro) para as crianças obesas e/ou com sobrepeso do que para as com peso normal. Crianças com circunferência da cintura aumentada apresentaram 2,8 vezes mais chance de ter níveis pressóricos elevados do que as com circunferência adequada (intervalo de confiança de 95% 2,513-3,186 e p = 0,000). Já os indivíduos com nível alto no Índice Econômico Nacional apresentaram 2,6 vezes mais chance de terem pressão arterial elevada. Conclusõe...

Pressão arterial elevada em crianças e adolescentes com excesso de peso

“…The prevalences of high BP among children and adolescents found in various studies can vary according to the population, nutritional status, age group, and criterion adopted to the definition of this condition 6 .…”

“…Among the factors that can interfere with blood pressure values, literature shows that white children have a greater chance of having higher BP 21 than non-white children, since they tend to have higher fat percentage 6 . Although no association between BP and skin color was found in this study, high BP was present in most white individuals.…”

“…A cross-sectional study with obese and eutrophic children aged from 7 to 12 years found that individuals with increased WC were 2.8 times more likely to have high blood pressure than those with adequate waist circumference 6 . A study with eutrophic and obese adolescents showed that the elevation of SBP and DBP were 3.9 and 3.4 times more frequent among children with increased WC and 2.2 to 2.0 times among girls under the same condition 24 .…”

“…When present in overweight children and adolescents, high blood pressure (BP) may have values from two to six times higher than those found in eutrophic children and adolescents, with variations between 28.7% and 46.4%, respectively, for overweight and obesity 6,7 .…”

Relação entre índice de massa corporal, indicadores autonômicos da freqüência cardíaca e níveis de pressão arterial em crianças

“…3) a PAD e o componente LF, por sua vez, apresentaram correlação positiva significante, o que sugere uma relação entre o aumento da PAD e alteração no componente LF. Costanzi et al (2009) verificaram que os índices de PA eram significativamente maiores em grupos de crianças com sobrepeso em relação àquelas com peso normal. Os autores relatam que esses valores eram ainda maiores no grupo de crianças obesas.…”