Obesity, hypertension, and mental health evaluation in adolescents: A comprehensive approach

Abstract

The global epidemic of childhood and adolescent obesity in developing and developed countries has become a major public health concern. Given the relation between obesity and hypertension as documented in several landmark studies, it is no surprise that as the prevalence of obesity has increased in the pediatric population, the rates of hypertension have also increased substantially. Hypertension is one of the most important risk factors for cardiovascular diseases and stroke; therefore, evaluation and initiation of appropriate treatment are extremely important in the pediatric population. Evaluation for secondary causes of hypertension, including renovascular, renoparenchymal, and endocrine disease is the approach most commonly used in healthcare settings, with the goal to detect abnormalities that already have or might, if left unrecognized, affect the physical health of the child in the future. Children and adolescents are commonly evaluated for organic disease even in situations in which secondary hypertension is unlikely and overweight or obesity is most likely the primary factor contributing to hypertension. Psychological and psychosocial factors, which may play an important role in the etiology of obesity and related blood pressure elevation, are often addressed inadequately or completely ignored, potentially reducing long-term therapy success and increasing the incidence of avoidable complications. It is proposed that a comprehensive evaluation by a behavioral health provider will improve outcomes and potentially reduce long-term morbidity and hypertension-related end organ disease. A framework for mental health evaluation is provided.

Tornar-se obeso na adolescência pode trazer consequências à saúde mental?

“…No entanto, ainda existem controvérsias acerca do impacto da obesidade sobre a saúde mental dos indivíduos 2,3 . Alguns estudos sugerem que a obesidade pode levar a problemas de saúde mental 4 , enquanto outros mostram que adolescentes que apresentam problemas de saúde mental são mais propensos à obesidade 5 . Para estabelecer essa relação, são necessários estudos prospectivos, os quais ainda são escassos 3,6 .…”

How to simplify the diagnostic criteria of hypertension in adolescents

“…There is evidence that hypertension in children and adolescents can lead to adult hypertension. 2,3 Hypertension is known as a risk factor for coronary artery disease in adults, and the presence of hypertension in children and adolescents may contribute to the early development of coronary artery disease. Previous reports have shown that early development of atherosclerosis does exist in children and adolescents and may be associated with childhood hypertension.…”

The Menstrual Disorders in Women of Reproductive Age with Obesity

“…По данным Всемирной организации здравоохранения, за по-следнее десятилетие XX века распространенность ожирения в мире в среднем увеличилась на 50 %. В Узбекистане среди населения частота ожирения со-ставляет 24,1 % [4].…”

“…В результате проведенных европейскими учеными исследований было выяснено, что при повышении ин-декса массы тела (ИМТ) более 29 кг/м 2 возможность за-беременеть снижается на 4 % по сравнению с теми жен-щинами, чей ИМТ находится в пределах 21-29 кг/м 2 [4]. У пациенток, которые страдают выраженным ожирени-ем (ИМТ составляет 35-40 кг/м 2 ), вероятность забереме-неть без дополнительного медицинского вмешательства снижается на 7 %.…”

“…Подобно многим патологическим состояниям, ожирение способствует развитию других заболеваний, в том числе нарушения репродуктивной функции, и отягощает уже имеющиеся нарушения фертильности [4]. Несмотря на это, функциональное состояние поло-вых желез при ожирении до сих пор изучено недоста-точно.…”