Fatores de risco no desenvolvimento da aterosclerose na infância e adolescência

Abstract

SummaryCardiovascular diseases (CVD) are a major cause of death in developed countries as well as in developing countries. In general, the clinical manifestations of CVD, such as myocardial infarction, stroke and peripheral vascular disease, are caused by an atherosclerotic process with onset as from the middle age. However, current studies indicate that the atherosclerotic process starts to develop in childhood. The pathogenesis of atherosclerosis has been studied as to its inflammatory aspect. Among the inflammatory markers, C-reactive protein (CRP) has been extensively studied in individuals with CVD, including those apparently healthy. High CRP levels have been related to risk factors for atherosclerosis: family history of coronary artery disease (CAD), dyslipidemia, hypertension, diabetes mellitus, obesity, smoking and sedentary lifestyle. A great part of these risk factors may be influenced by lifestyle modifications, such as changes in eating habits and engagement in physical activities. The effects of physical activity on CRP levels in adulthood are documented in the literature, however little is known on the influence of an active or sedentary lifestyle of children and adolescents on CRP levels. Thus, the objective of this study is to review the impact of physical activity of children and adolescents on CRP levels and the risk factors for the development of CVD. IntroductionCardiovascular diseases (CVD) are a major cause of death in developed countries as well as in developing countries 1 . In general, the clinical manifestations of CVD start in the middle age. However, recent studies indicate that the atherosclerotic process starts to develop in childhood. Fatty streaks precursor of atherosclerotic plaques appear in the aortic intima at three years of age, and in the coronary arteries during adolescence 2 . Thus, atherosclerosis gradually changed from a model of a chronic degenerative disease exclusively affecting patients with advanced age to a model of a subclinical chronic inflammatory disease already existing in childhood 3 .The pathogenesis of atherosclerosis has been studied as to its inflammatory aspect. Inflammatory markers such as Creactive protein (CRP) have been studied in individuals with CVD, including those apparently healthy 4 . CRP has been a widely used inflammatory marker for the detection of CVD because its plasma concentration is easy to determine and it has the best clinical and epidemiological correlation to date. High blood CRP levels have been found in inflamed tissues, atherosclerotic vessels and infarcted myocardium 5 .Its utilization has been important for the possibility of identifying new pathways for the prevention and treatment of CVD and of risk factors for atherosclerosis 4,6 : family history of coronary artery disease (CAD), dyslipidemia, hypertension, diabetes mellitus, obesity, smoking and sedentary lifestyle 4 .A great part of these factors may be influenced by lifestyle changes, thus reducing cardiovascular events and increasing the individuals' life expectancy. Mo...

Síndrome da lipodistrofia e fatores de risco cardiovasculares em crianças e adolescentes infectados pelo HIV/AIDS em uso de terapia antirretroviral de alta potência

“…24 Such result reinforces the importance of physical activity according to the recommendations of the National Cholesterol Education…”

Excesso de peso, nível de atividade física e hábitos alimentares em escolares da cidade de Anápolis-GO

“…O estudo desenvolvido por Utecht, Soares e Serassuelo Junior (2008) confirma que os jovens com maior poder aquisitivo são os que mais sofrem com obesidade e sobrepeso, sem negar que o problema aflige, também, os estudantes de escolas públicas, onde, predominantemente, estudariam as crianças e jovens oriundos das classes sociais menos favorecidas. No que concerne à diferenciação entre meninos e meninas, foi constatada, neste estudo, a mesma tendência encontrada nos estudos realizados por Silva, Balaban e Motta, (2005) e Santos et al (2008), que é a predominância do excesso de peso entre os alunos do sexo masculino. Sendo assim, indispensável que se inicie a prática de exercício físico para a melhora da resposta inflamatória de obesos (PRADO et al, 2009).…”

“…Na atualidade, uma criança gasta, em média, 600 kcal diárias a menos do que há 50 anos e dedica 27 horas semanais do seu tempo a assistir à TV, o que constitui sua principal atividade (ALVES, 2003). Nesse sentido, Guinhouya (2007) chama a atenção para o fato de a TV compor um estilo de vida sedentário que, associado ao hábito de se alimentar em frente à televisão, desequilibra o balanço energético e se reflete na elevação dos índices de obesidade com todos os riscos para a saúde, onde se sobressaem as doenças cardiovasculares, o diabetes melitus e as dislipidemias (SANTOS et al, 2008;GUIDI et al, 2008).…”

Cardiovascular Risk Investigation: When Should It Start?

“…High levels of triglycerides are a key component of so-called metabolic syndrome (MS). (Johnson, et al 1999;Santos et al 2008;Cobayashi et al 2010).…”