Prevalência de hipertensão arterial, pré-hipertensão e fatores associados em crianças e adolescentes de escolas municipais de Cuiabá, Mato Grosso

Abstract

Systemic arterial hypertension has been increasingly prevalent among Brazilian children and adolescents and follows the growing trend in cases of overweight, physical inactivity and inadequate nutrition in these populations. Because it is generally asymptomatic and underdiagnosed in childhood and adolescence, its detection, treatment and control are fundamental for the reduction of cardiovascular events in adulthood. Objective: to estimate the prevalence of hypertension, pre-hypertension (currently called High Blood Pressure) and associated factors in schoolchildren aged 6 to 12 years 11

months and 29 days, in public schools in Cuiabá. Methods: Observational, cross- sectional study with 818 children and adolescents aged 6 to 13 years old, enrolled in

municipal schools in Cuiabá in 2012. Data from the study “Determination of reference intervals for total cholesterol, HDL-cholesterol, non-HDL cholesterol, LDL-cholesterol and triglycerides in healthy children and adolescents in the city of Cuiabá, Mato Grosso, Brazil” (SLHESSARENKO, 2014). The dependent variables were arterial hypertension and prehypertension diagnosed by the criteria of The Fourth Report on the Diagnosis, Evaluation, and Treatment of High Blood Pressure in Children and Adolescents, 2004. The independent variables were: sociodemographic factors, style and habit of life, anthropometric and biological. To identify the factors associated with arterial hypertension, bivariate analyzes were performed, assessed using Pearson's chi-square test or Fisher's exact test and the prevalence ratio (PR) and multiple, to eliminate the potential confounding bias by Poisson regression. Results: Most individuals were female (51.59%), predominantly brown (65.89%), with an average age of 8.79 years, with exclusive breastfeeding until 6 months of age (80, 07%), whose parents had secondary education (52.44%). The general prevalence in the high blood pressure sample was 5.74% and arterial hypertension was 4.16%, significantly associated with increased neck circumference in overweight children and adolescent girls, waist circumference ≥ 90th percentile, HDL-cholesterol low, high triglycerides and family history of diabetes. The prevalence of hypertension was higher among children and adolescents with C-reactive protein ≥ 1.04mg / dl. Stratification by sex in children (6 to 9 years) and adolescents (10 to 12 years) revealed that girls had a higher prevalence of hypertension in both categories (4.74% and 6.30%, respectively), and male children (6 to 9 years old) had a higher prevalence of high blood pressure (5.38% vs 3.56%). Conclusions: The prevalence of hypertension was higher in female children and adolescents and the prevalence of high blood pressure was higher in female adolescents. CRP at high levels was associated with a greater risk of having high blood pressure levels and increased neck circumference was an indicator in girls with elevated blood pressure.