Influência do índice de massa corporal e da circunferência abdominal na pressão arterial sistêmica de crianças

Abstract

RESUMOObjetivo: Avaliar os níveis pressóricos em crianças e relacioná-los ao índice de massa corporal e à circunferência abdominal.Métodos: Por meio de estudo prospectivo e transversal, avaliaram-se 1.408 escolares com idade entre cinco anos e dez anos e 11 meses, matriculados em escolas públicas do Município de Santo André. Foram coletados: peso ao nascer; peso e estatura, expressos como escore Z do índice de massa corporal (ZIMC) e estatura para idade (ZEI). A pressão arterial (medida única) foi aferida pelo mesmo examinador. Considerou-se: desnutrição quando ZIMC<-2, obesidade ZIMC>+2, baixa estatura se ZEI<-2; circunferência abdominal aumentada (ponto de corte >P90 para sexo e idade) e pressão arterial elevada quando superior ao percentil 90 para sexo, idade e estatura. A análise estatística incluiu o teste do qui-quadrado e o cálculo da Odds Ratio, adotando-se como significante o valor de p<0,05.Resultados: A mediana de idade foi de sete anos, sendo 51% do sexo feminino. Níveis elevados foram encontrados em 19 e 12% dos escolares para a pressão arterial sistólica e diastólica, respectivamente. Verificaram-se: baixa estatura, desnutrição, obesidade e aumento da circunferência abdominal em 2,6%, 3,1%, 7,3% e 13,4% da amostra, respectivamente. A presença de obesidade foi o fator mais fortemente associado ao aumento de pressão arterial sistólica (OR 2,1; IC95% 1,3-3,3; p<0,001) e diastólica (OR 2,6; IC95% 1,3; p<0,001). A circunferência abdominal também se associou com pressão arterial sistólica elevada (OR 1,6; IC95% 1,0-2,5; p=0,027). Conclusões:A pressão arterial sistêmica elevada em crianças associa-se à obesidade e ao aumento da circunferência abdominal.Palavras-chave: obesidade; circunferência abdominal; hipertensão; índice de massa corporal; criança. ABSTRACT Objective:To evaluate blood pressure levels in children, relating them to body mass index and abdominal circumference.Methods: This cross-sectional prospective study enrolled 1.408 school children, aged between five and ten years and 11 months, in the municipality of Santo Andre, São Paulo, Brazil. The following variables were evaluated: birth weight, weight and height, expressed as body mass index Z score (ZBMI) and height to age Z score (ZH), and waist circumference (WC). Blood pressure was measured once by the same physician. Malnutrition was considered when ZBMI <-2, obesity when ZBMI >+2, short stature when ZH <-2, increased abdominal circumference when >P90 for age and gender, and increased blood pressure when >P90 for age, gender and height. Statistical analysis included chi-square test and Odds Ratio, being significant p<0.05.Results: Mean age was seven years old, and 51% were females. High systolic blood pressure levels were observed in 19% and elevated diastolic blood pressure in 12%. Short stature, malnutrition, obesity and increased abdominal circumference were diagnosed in 2.6%, 3.1%, 7.3% and 13.4%, respectively, of the studied population. The presence

Association Between Abdominal Waist Circumference and Blood Pressure In Brazilian Adolescents With Normal Body Mass Index

“…However, it is mainly the excess of body fat that is related to the risk of chronic diseases, not being overweight [8]. BMI does not provide information on abdominal fat, which is metabolically more active and is well defined as an independent risk factor for CVDs in adults [9]. On the other hand, waist circumference (WC) is a better marker of abdominal fat and has a stronger association with CV risk factors [10].…”

Evaluation of Echocardiography as a Marker of Cardiovascular Risk in Obese Children and Adolescents

“…According to Iampolsky et al [26] the pathophysiology of changes in blood pressure due to increased body weight in children is not well understood. However, in adults, three related mechanisms are known: insulin resistance and hyperinsulinemia; increased sympathetic nervous system activity and changes in vascular structure and function.…”

“…Finally, Iampolsky et al [26] refer that is very important to include the measurement of blood pressure in the pediatric clinical examination, enabling early intervention, since elevated blood pressure in childhood is associated with the persistence of these in adulthood and thus increase the risk for cardiovascular diseases such as hypertension. And, they comment as the development of these diseases in adulthood increases risk as the number of measures changed during childhood and adolescence, there may be need to detect and intervene early.…”

Aleitamento materno exclusivo e adiposidade

“…The importance of this finding is due to the known effect of visceral adiposity as a predisposing factor for developing chronic diseases such as arterial hypertension, dyslipidemia, metabolic syndrome, type 2 diabetes mellitus, and others (24)(25)(26)(27)(28)(29) . This finding highlights a possible effect of breastfeeding on body fat distribution in childhood.…”