Arquivos Brasileiros de Cardiologia (Jun 2010)
Relação da obesidade com a pressão arterial elevada em crianças e adolescentes Relationship of obesity with high blood pressure in children and adolescents
Abstract
FUNDAMENTO: Excessos de peso e de gordura corporal são atualmente reconhecidos como os maiores determinantes da elevação da pressão arterial em crianças e adolescentes. OBJETIVO: Identificar associação e correlação entre obesidade - identificada por meio da circunferência da cintura (CC), da prega cutânea do tríceps (PCT) e do índice de massa corporal (IMC) - pressão arterial elevada (PAE) em crianças e adolescentes. MÉTODOS: Estudo epidemiológico transversal, de base populacional escolar, em crianças e adolescentes de ambos os sexos, com idades entre 7 e 17 anos, selecionados aleatoriamente. Protocolo: questionário estruturado; medidas de peso, altura, espessura da prega tricipital, circunferência da cintura, pressão arterial; diagnóstico de obesidade por meio de IMC, PCT e CC; diagnóstico de PAE. Análise estatística: qui-quadrado. RESULTADOS: Foram avaliados 1.253 estudantes (547 do sexo masculino, média de idade 12,4 ± 2,9 anos), e identificou-se uma prevalência de obesidade (IMC, PCT, CC), respectivamente, de 13,7%, 14,8% e 9,3%. A PAE foi identificada em 7,7% dos jovens. Houve associação significante de obesidade (IMC, PCT, CC) com PAE (*p BACKGROUND: Excess weight and body fat are currently recognized as the major determinants of high blood pressure in children and adolescents. OBJECTIVE: To identify the relationship between obesity - identified by waist circumference (WC), triceps skinfold thickness (TSF) and body mass index (BMI) - high blood pressure (HBP) in children and adolescents. METHODS: A cross-sectional epidemiological study based on school population in children and adolescents of both sexes, aged between 7 and 17 years, randomly selected. Protocol: a structured questionnaire; measures of weight, height, triceps skinfold thickness, waist circumference, blood pressure, diagnosis of obesity through BMI, TSF thickness and waist circumference; diagnosis of HBP. Statistical analysis: Chi-square. RESULTS: A total of 1,253 students (547 males, mean age 12.4 ± 2.9 years), were assessed. A prevalence of obesity (BMI, TSF thickness, WC) of 13.7%, 14,8% and 9.3% respectively were identified. HBP was identified in 7.7% of young people. There was a significant association between obesity (BMI, TSF thickness, WC) with HBP (*p < 0.0001). There was a strong correlation (*p < 0.01) between WC and BMI, a moderate correlation between WC and TSF thickness, WC and SBP, BMI and SBP (*p < 0.01); weak correlation between DBP and WC, TSF thickness and BMI, and between SBP and TSF thickness (*p < 0.05). CONCLUSION: The significant correlation and association between HBP and excess body fat by any of the methods used establish the importance of its use in evaluating children and adolescents, aiming at preventing hypertension in this age group, suggesting, for this, the use of BMI associated to at least another anthropometric method.