Obesidade: principal fator de risco para hipertensão arterial sistêmica em adolescentes brasileiros participantes de um estudo de coorte

Abstract

RESUMOObjetivo: Identificar a prevalência e os fatores associados à hipertensão arterial sistêmica (HAS) em adolescentes de uma coorte. Sujeitos e métodos: Estudo transversal com 1.716 adolescentes, de 10 a 16 anos, participantes de um estudo de coorte. Os dados sociodemográficos, econômicos e de estilo de vida foram obtidos por meio de entrevista e os dados referentes ao nascimento e à infância foram obtidos na linha de base. Foram considerados hipertensos os adolescentes que apresentaram pressão arterial sistólica e/ou diastólica acima do percentil 95, segundo a classificação preconizada pelo Second Task Force High Blood Pressure in Children and Adolescents. O estado nutricional foi diagnosticado pelo índice de massa corporal (IMC), segundo o escore z. O perímetro da cintura foi medido ao nível da cintura natural. A associação da HAS com as variáveis explicativas foi estimada por regressão logística. Resultados: Os entrevistados correspondem a 71,4% dos avaliados na linha de base, sendo 50,7% do sexo masculino. A prevalência global de HAS foi de 11,7%. Na análise ajustada para idade, sexo e cor de pele, a hipertensão arterial associou-se à obesidade [OR = 2,27; IC (95%) = 1,64-3,14], mas não ao perímetro da cintura, que, após ajuste para o IMC, perdeu a associação. Os eventos precoces na vida não foram associados à HAS na adolescência. Conclusão: Os resultados enfatizam a obesidade como principal fator associado à HAS em adolescentes. Arq Bras Endocrinol Metab. 2013;57(7):520-6 Descritores Adolescentes; hipertensão; fatores de risco; obesidade ABSTRACT Objective: To identify the prevalence and factors associated with hypertension in adolescents. Subjects and methods: Cross-sectional study of 1,716 adolescents of a cohort study, aged from 10 to 16 years old sociodemographic, economic, and lifestyle characteristics were obtained from an interview, and birth weight from hospital records. Hypertension was defined as systolic or diastolic blood pressure above the 95 th percentile according to the classification recommended by the Second Task Force High Blood Pressure in Children and Adolescents. Nutritional status was diagnosed by body mass index (BMI), according to the z score from curves published by the World Health Organization. Waist circumference was measured at the natural waist. The association between hypertension and the explanatory variables was measured using logistic regression. Results: The adolescents interviewed represent 71.4% of the baseline, and 50.7% of them were males. The prevalence of hypertension was 11.7%. In the multivariate analysis, after adjustment for age sex and skin color, hypertension was associated with obesity [OR = 2.27, (95%) CI = 1.64 to 3.14] but not associated with waist circumference after adjusting for BMI. Early life factors were not associated with hypertension in adolescence. Conclusion: The results show an association between obesity and hypertension among adolescents. Arq Bras Endocrinol Metab. 2013;57(7):520-6

O sobrepeso e a obesidade não estão associados com a pressão arterial elevada em jovens praticantes de esportes

“…Although the relationship between physical activity and HBP has previously been discussed [16][17][18][19][20] , the largest body of evidence indicates no association between physical activity and HBP 24 . The results of the present study corroborated previous studies that indicated no association between practicing sports and HBP in young Brazilians 9,11,[21][22][23] . As already mentioned, the main determinant of HBP in young people is being overweight and obese 25 , and overweight young people are more likely to present HBP [9][10][11]18,22,26 .…”

“…When the total sample was analyzed the results of this study corroborated previous studies that showed no association between physical activity and HBP in young people 9,11,[21][22][23] . The present study examined the practice of sports because the physical activity of young people is largely performed through sports 15 .…”

“…Although no association was found between the practice of sports and HBP in young people, the present study showed a similar prevalence of HBP among young people sports practitioners who were overweight and obese compared to their eutrophic counterparts. This result may explain the lack of association between physical activity and HBP described in previous studies 9,11,[21][22][23] . Thus, the following two aspects should be considered in relation to the ways in which physical activity may protect young people from HBP: the protection independent of overweight 18,20 and the protection that only occurs in overweight and obese individuals who practice sports.…”

“…The literature contains controversial findings regarding the association between physical activity and HBP. Some studies have shown an inverse association between physical activity and blood pressure in young people 16-20 , while others have shown no such association 9,11,[21][22][23] . A systematic review showed that the number of studies that showed an association between physical activity with blood pressure was lower than the studies that showed no association 24 .…”

Association between adiposity indicators, metabolic parameters and inflammatory markers in a sample of female adolescents

“…Adolescents and children with higher levels of blood pressure, even within normal limits, tend to progress over a lifetime showing higher incidence of hypertension in adulthood (23)(24)(25). A national study of 1716 volunteers aged 10-16 years has shown that obesity detected by BMI, adjusted for sex, age and skin color increased by 27% the chance of a teenager presenting with hypertension; WC, despite its association with blood pressure, lost its effect after adjustment for BMI (26).…”