ERICA: prevalences of hypertension and obesity in Brazilian adolescents

Abstract

OBJECTIVE To estimate the prevalence of arterial hypertension and obesity and the population attributable fraction of hypertension that is due to obesity in Brazilian adolescents.METHODS Data from participants in the Brazilian Study of Cardiovascular Risks in Adolescents (ERICA), which was the first national school-based, cross-section study performed in Brazil were evaluated. The sample was divided into 32 geographical strata and clusters from 32 schools and classes, with regional and national representation. Obesity was classified using the body mass index according to age and sex. Arterial hypertension was defined when the average systolic or diastolic blood pressure was greater than or equal to the 95th percentile of the reference curve. Prevalences and 95% confidence intervals (95%CI) of arterial hypertension and obesity, both on a national basis and in the macro-regions of Brazil, were estimated by sex and age group, as were the fractions of hypertension attributable to obesity in the population.RESULTS We evaluated 73,399 students, 55.4% female, with an average age of 14.7 years (SD = 1.6). The prevalence of hypertension was 9.6% (95%CI 9.0-10.3); with the lowest being in the North, 8.4% (95%CI 7.7-9.2) and Northeast regions, 8.4% (95%CI 7.6-9.2), and the highest being in the South, 12.5% (95%CI 11.0-14.2). The prevalence of obesity was 8.4% (95%CI 7.9-8.9), which was lower in the North region and higher in the South region. The prevalences of arterial hypertension and obesity were higher in males. Obese adolescents presented a higher prevalence of hypertension, 28.4% (95%CI 25.5-31.2), than overweight adolescents, 15.4% (95%CI 17.0-13.8), or eutrophic adolescents, 6.3% (95%CI 5.6-7.0). The fraction of hypertension attributable to obesity was 17.8%.CONCLUSIONS ERICA was the first nationally representative Brazilian study providing prevalence estimates of hypertension in adolescents. Regional and sex differences were observed. The study indicates that the control of obesity would lower the prevalence of hypertension among Brazilian adolescents by 1/5.

Factors Associated with Excess Weight in a Sample Population of School Adolescents

“…In less developed regions or states, the proportion of overweight rises with higher economic class, in this study, overweight was significantly higher in the classes A and B. These results confirm the findings of other studies, that indicate that smaller and less economically favoured regions have a higher prevalence of overweight 5,17 . In developed countries the situation is reversed, with lower classes being more affected by being overweight 1,2 .…”

“…Among girls, in the same period, the growth in overweight was 7.6% to 19.4% 4 . A study of Cardiovascular Risk in Adolescents (ERICA) 5 with an estimated population of 73,399 people found an overall prevalence of overweight and obesity of 17.6% and 7.6% for girls, and for boys 16.6% and 9.2%, being lower in the Northern region, girls 15.5% and 5.6%, boys 15.1% and 7.6%, and higher in the Southern region where girls showed 20.3% and 9.8%, boys 17.0% and 12.4%, respectively. The national prevalence of overweight and obesity in adolescents seems to be higher in the population of southern Brazil than in other regions.…”

Systemic arterial hypertension, blood pressure levels and associated factors in schoolchildren

“…The 15.2% prevalence of high blood pressure found in our study was higher than the 9.6% demonstrated by Bloch et al 23 in their ERICA study (Study of Cardiovascular Risk Factors in Adolescents) with Brazilian adolescent students in 2016, and also higher than the 13.8% found by Costanzi et al 24 in 2009, who evaluated children aged 7-12 years from Caxias do Sul, in the state of Rio Grande do Sul, as well as other studies. 25,26 Nevertheless, the HBP range found in our study was within the variation between 2 and 13% described by Gomes and Alves 27 in 2009, in their study with high school students in the State of Pernambuco, Brazil.…”

“…However, HBP prevalence proved to be slightly below 16.6% when using the first measurement, as demonstrated by Rezende et al in 2003 among schoolchildren aged 7-14 years in Barbacena, in the state of Minas Gerais. 28 The prevalence of pre-hypertensive individuals found in our study was also lower than the 14.5% reported by Bloch et al 23 The Brazilian Society of Cardiology highlights instances in which the prevalence of pre-hypertension was 12-17%, in single measurements, especially in overweight and obese adolescents, 8 a value that was higher than that found in the present study for borderline BP, which was 9.5%.…”

Geolocalização de casos de sobrepeso/obesidade e pressão arterial alterada em escolares

“…11 Estudo, recente no Brasil, demonstrou que a prevalência de hipertensão em adolescentes foi de 9,6%, sendo a mais elevada, na região Sul do país (12,5%). 12 Neste sentido, pesquisa internacional revelou que, na faixa etária de oito a 17 anos, existe uma prevalência de pré-hipertensão e hipertensão de 10% e 4%, respectivamente, sendo que a hipertensão aumenta proporcionalmente, à medida que aumenta a obesidade infantil. 13 O mapeamento de doenças é de suma importân-cia, quando se quer uma vigilância sobre esta, pois o conhecimento da distribuição espacial da área, onde esta ocorre, possibilita determinar padrões da situação de saúde, evidenciando disparidades geográficas.…”