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2008, Number 4

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Arch Cardiol Mex 2008; 78 (4)

Blood pressure and associated cardiovascular risk factors in adolescents of Mexico City

Juárez-Rojas JG, Cardoso-Saldaña GC, Posadas-Sánchez R, Medina-Urrutia AX, Yamamoto-Kimura L, Posadas-Romero C

Language: English
References: 80
Page: 384-391
PDF size: 135.05 Kb.


ABSTRACT

Objetivo: Determinar la prevalencia de tensión arterial elevada y su asociación con factores de riesgo cardiovascular en adolescentes mexicanos. Métodos: Se realizó un estudio transversal en 770 hombres y 1,076 mujeres (12 a 16 años de edad) de ocho escuelas secundarias seleccionadas aleatoriamente de la Ciudad de México. Se determinaron las medidas antropométricas, la tensión arterial, los lípidos y las lipoproteínas. Resultados: Las mediciones de tensión arterial fueron ajustadas por edad, género y estatura. La tasa de prevalencia de hipertensión (tensión arterial sistólica y/o la tensión arterial diastólica ³ a la percentila 95) y la prevalencia de pre-hipertensión (tensión arterial sistólica y diastólica ³ percentila 90 y ‹ a la percentila 95) fueron 10.6% y 10.0%, respectivamente. Comparados con los adolescentes normotensos, los hipertensos mostraron una prevalencia significativamente elevada de obesidad, sobrepeso y dislipidemia. El análisis de regresión múltiple mostró que la cintura (18.3%), el Tanner (4.7%), la edad (2.1%), el género y el índice de masa corporal (0.9%) contribuyeron con 26% de la variación en la tensión arterial sistólica, mientras que el índice de masa corporal (8.7%), la edad (4.8%), el Tanner (1.7%), la cintura (0.4%) y el género (0.4) contribuyeron con el 15.9% de la variación en la presión arterial diastólica. Conclusiones: Estos resultados muestran una elevada prevalencia de hipertensión arterial en los adolescentes de la Ciudad de México. Los adolescentes pre-hipertensos e hipertensos mostraron una mayor prevalencia de factores de riesgo cardiovascular, lo que sugiere que, como adultos, estos adolescentes tendrán un mayor riesgo de desarrollar enfermedad cardiovascular.


REFERENCES

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  2. Williams CL, Hayman LL, Daniels SR, Robinson TN, Steinberger J, Paridon S, Bazzarre T: Cardiovascular health in childhood: A statement for health professionals from the Committee on Atherosclerosis, Hypertension, and Obesity in the Young (AHOY) of the Council on Cardiovascular Disease in the Young, American Heart Association. Circulation 2002; 106: 143-60.

  3. Lara A, Rosas M, Pastelin G, Aguilar C, Attie F, Velazquez Monroy O: Hipercolesterolemia e hipertensión arterial en México. Consolidación urbana actual con obesidad, diabetes y tabaquismo. Arch Cardiol Mex 2004; 74: 231-45.

  4. Berenson GS, Srinivasan SR, Bao W, Newman WP 3rd, Tracy RE, Wattigney WA: Association between multiple cardiovascular risk factors and atherosclerosis in children and young adults. The Bogalusa Heart Study. N Engl J Med 1998; 338: 1650-6.

  5. Newman WP 3rd, Freedman DS, Voors AW, Gard PD, Srinivasan SR, Cresanta JL, et al: Relation of serum lipoprotein levels and systolic blood pressure to early atherosclerosis. The Bogalusa Heart Study. N Engl J Med 1986; 314: 138-44.

  6. Bao W, Threefoot SA, Srinivasan SR, Berenson GS: Essential hypertension predicted by tracking of elevated blood pressure from childhood to adulthood: the Bogalusa Heart Study. Am J Hypertens 1995; 8: 657-65.

  7. Haffner SM, Miettinen H, Gaskill SP, Stern MP: Metabolic precursors of hypertension. The San Antonio Heart Study. Arch Intern Med 1996; 156: 1994-2001.

  8. Sorof J, Daniels S: Obesity hypertension in children: a problem of epidemic proportions. Hypertension 2002; 40: 441-7.

  9. Boreham C, Savage JM, Primrose D, Cran G, Strain J: Coronary risk factors in schoolchildren. Arch Dis Child 1993; 68: 182-6.

  10. Michel U, Riechers B: Cardiovascular risk factors in schoolchildren. J Am Coll Nutr 1992; 11: 36S-40S.

  11. Elcarte Lopez R, Villa Elizaga I, Sada Goni J, Gasco Eguiluz M, Oyarzabal Irigoyen M, Sola Mateos A, et al: The Navarra study. Prevalence of arterial hypertension, hyperlipidemia and obesity in the infant-child population of Navarra. Association of risk factors. An Esp Pediatr 1993; 38: 428-36.

  12. Del Rio-Navarro BE, Velazquez-Monroy O, Sanchez-Castillo CP, Lara-Esqueda A, Berber A, Fanghanel G, et al: Encuesta Nacional de Salud 2000 Working Group, National Health Survey 2000. The high prevalence of overweight and obesity in Mexican children. Obes Res 2004; 12: 215-23.

  13. Rosas M, Pastelin G, Martinez-Reding J, Herrera-Acosta J, Attie F: Comité Institucional para el Estudio y Prevención de la Hipertensión Arterial Sistémica. [Hypertension guidelines in Mexico]. Arch Cardiol Mex 2004; 74: 134-57.

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  15. Yamamoto-Kimura L, Posadas-Romero C, Posadas-Sanchez R, Zamora-Gonzalez J, Cardoso-Saldana G, Mendez Ramirez I: Prevalence and interrelations of cardiovascular risk factors in urban and rural Mexican adolescents. J Adolesc Health 2006; 38: 591-8.

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  25. Ennis IL, Gende OA, Cingolani HE: Prevalence of hypertension in 3154 young students. Medicina (B. Aires) 1998; 58: 483-91.

  26. Uscategui Penuela RM, Alvarez Uribe MC, Laguado Salinas I, Soler Terranova W, Martinez Maluendas L, Arias Arteaga R, et al: Cardiovascular risk factors in children and teenagers aged 6-18 years old from Medellin (Colombia). An Pediatr (Barc) 2003; 58: 411-7.

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  28. Ucar B, Kilic Z, Colak O, Oner S, Kalyoncu C: Coronary risk factors in Turkish schoolchildren: randomized cross-sectional study. Pediatr Int 2000; 42: 259-67.

  29. Sinaiko AR: Hypertension in children. N Engl J Med 1996; 335: 1968-73.

  30. Update on the 1987 Task Force Report on High Blood Pressure in Children and Adolescents: a working group report from the National High Blood Pressure Education Program. National High Blood Pressure Education Program Working Group on Hypertension Control in Children and Adolescents. Pediatrics 1996; 98(4 Pt 1): 649-58.

  31. Freedman DS, Dietz WH, Srinivasan SR, Berenson GS: The relation of overweight to cardiovascular risk factors among children and adolescents: the Bogalusa Heart Study. Pediatrics 1999; 103(6 Pt 1): 1175-82.

  32. Schmieder RE, Messerli FH, Ruddel H: Risks for arterial hypertension. Cardiol Clin 1986; 4: 57-66.

  33. Rosner B, Prineas R, Daniels SR, Loggie J: Blood pressure differences between blacks and whites in relation to body size among US children and adolescents. Am J Epidemiol 2000; 151: 1007-19.

  34. Sorof JM, Lai D, Turner J, Poffenbarger T, Portman RJ: Overweight, ethnicity, and the prevalence of hypertension in school-aged children. Pediatrics 2004; 113(3 Pt 1): 475-82.

  35. Gutin B, Owens S, Slavens G, Riggs S, Treiber F: Effect of physical training on heart-period variability in obese children. J Pediatr 1997; 130: 938-43.

  36. Tounian P, Aggoun Y, Dubern B, Varille V, Guy-Grand B, Sidi D, et al: Presence of increased stiffness of the common carotid artery and endothelial dysfunction in severely obese children: a prospective study. Lancet 2001; 358: 1400-4.

  37. Hergenroeder AC, Hill RB, Wong WW, Sangi-Haghpeykar H, Taylor W: Validity of self-assessment of pubertal maturation in African American and European American adolescents. J Adolesc Health 1999; 24: 201-5.

  38. Bonat S, Pathomvanich A, Keil MF, Field AE, Yanovski JA: Self-assessment of pubertal stage in overweight children. Pediatrics 2002; 110: 743-7.

  39. Duke PM, Litt IF, Gross RT: Adolescents’ self-assessment of sexual maturation. Pediatrics 1980; 66: 918-20.

  40. Brooks-Gunn J, Warren MP, Rosso J, Gargiulo J: Validity of self-report measures of girls’ pubertal status. Child Dev 1987; 58: 829-41.

  41. Kavey RE, Daniels SR, Lauer RM, Atkins DL, Hayman LL, Taubert K: American Heart Association. American Heart Association guidelines for primary prevention of atherosclerotic cardiovascular disease beginning in childhood. Circulation 2003; 107: 1562-6.

  42. Williams CL, Hayman LL, Daniels SR, Robinson TN, Steinberger J, Paridon S, Bazzarre T: Cardiovascular health in childhood: A statement for health professionals from the Committee on Atherosclerosis, Hypertension, and Obesity in the Young (AHOY) of the Council on Cardiovascular Disease in the Young, American Heart Association. Circulation 2002; 106: 143-60.

  43. Lara A, Rosas M, Pastelin G, Aguilar C, Attie F, Velazquez Monroy O: Hipercolesterolemia e hipertensión arterial en México. Consolidación urbana actual con obesidad, diabetes y tabaquismo. Arch Cardiol Mex 2004; 74: 231-45.

  44. Berenson GS, Srinivasan SR, Bao W, Newman WP 3rd, Tracy RE, Wattigney WA: Association between multiple cardiovascular risk factors and atherosclerosis in children and young adults. The Bogalusa Heart Study. N Engl J Med 1998; 338: 1650-6.

  45. Newman WP 3rd, Freedman DS, Voors AW, Gard PD, Srinivasan SR, Cresanta JL, et al: Relation of serum lipoprotein levels and systolic blood pressure to early atherosclerosis. The Bogalusa Heart Study. N Engl J Med 1986; 314: 138-44.

  46. Bao W, Threefoot SA, Srinivasan SR, Berenson GS: Essential hypertension predicted by tracking of elevated blood pressure from childhood to adulthood: the Bogalusa Heart Study. Am J Hypertens 1995; 8: 657-65.

  47. Haffner SM, Miettinen H, Gaskill SP, Stern MP: Metabolic precursors of hypertension. The San Antonio Heart Study. Arch Intern Med 1996; 156: 1994-2001.

  48. Sorof J, Daniels S: Obesity hypertension in children: a problem of epidemic proportions. Hypertension 2002; 40: 441-7.

  49. Boreham C, Savage JM, Primrose D, Cran G, Strain J: Coronary risk factors in schoolchildren. Arch Dis Child 1993; 68: 182-6.

  50. Michel U, Riechers B: Cardiovascular risk factors in schoolchildren. J Am Coll Nutr 1992; 11: 36S-40S.

  51. Elcarte Lopez R, Villa Elizaga I, Sada Goni J, Gasco Eguiluz M, Oyarzabal Irigoyen M, Sola Mateos A, et al: The Navarra study. Prevalence of arterial hypertension, hyperlipidemia and obesity in the infant-child population of Navarra. Association of risk factors. An Esp Pediatr 1993; 38: 428-36.

  52. Del Rio-Navarro BE, Velazquez-Monroy O, Sanchez-Castillo CP, Lara-Esqueda A, Berber A, Fanghanel G, et al: Encuesta Nacional de Salud 2000 Working Group, National Health Survey 2000. The high prevalence of overweight and obesity in Mexican children. Obes Res 2004; 12: 215-23.

  53. Rosas M, Pastelin G, Martinez-Reding J, Herrera-Acosta J, Attie F: Comité Institucional para el Estudio y Prevención de la Hipertensión Arterial Sistémica. [Hypertension guidelines in Mexico]. Arch Cardiol Mex 2004; 74: 134-57.

  54. Lorenzo C, Serrano-Rios M, Martinez-Larrad MT, Gabriel R, Williams K, Gonzalez-Villalpando C, et al: Prevalence of hypertension in Hispanic and non-Hispanic white populations. Hipertension 2002; 39: 203-8.

  55. Yamamoto-Kimura L, Posadas-Romero C, Posadas-Sanchez R, Zamora-Gonzalez J, Cardoso-Saldana G, Mendez Ramirez I: Prevalence and interrelations of cardiovascular risk factors in urban and rural Mexican adolescents. J Adolesc Health 2006; 38: 591-8.

  56. Kish L: Survey sampling, New York, John Wiley & Sons, 1965.

  57. Bewley BR, Day I, Ide L: Smoking by children in Great Britain. A review of the literature. Medical Research Council and Social Science Research Council, London, 1972.

  58. Salonen JT, Slater JS, Tuomilehto J, Rauhramee R: Leisure time and occupational physical activity. Risk of death from ischemic heart disease. Am J Epidemiol 1988; 127: 87-94.

  59. National High Blood Pressure Education Program Working Group on High Blood Pressure in Children and Adolescents: The Fourth Report on the Diagnosis, Evaluation, and Treatment of High Blood Pressure in Children and Adolescents. Pediatrics 2004; 114 (Suppl 2): 555-76.

  60. Cole TJ, Bellizzi MC, Flegal KM, Dietz WH: Establishing a standard definition for child overweight and obesity worldwide: international survey. BMJ 2000; 320: 1240-3.

  61. DeLong DM, DeLong ER, Wood PD, Lippel K, Rifkind BM: A comparison of methods for the estimation of plasma low- and very low-density lipoprotein cholesterol. The Lipid Research Clinics Prevalence Study. JAMA 1986; 256: 2372-7.

  62. Tanner JM: The Development of the reproductive system. In: Growth at Adolescence. (Tanner JM, ed.). Oxford. Blackwell Scientific. 1962; pp 28-39,

  63. Schmitz KE, Hovell MF, Nichols JF, Irvin VL, Keating K, Simon GM, et al: A Validation Study of Early Adolescents Pubertal Self-Assessments. Journal Early Adolescence 2004; 24: 357-84.

  64. Norero C, Vargas NA, Mayne D, Monti A, Kutz M, Saito R: Blood pressure levels in urban school-age population in Chile. Hypertension 1981; 3: 238-41.

  65. Ennis IL, Gende OA, Cingolani HE: Prevalence of hypertension in 3154 young students. Medicina (B. Aires) 1998; 58: 483-91.

  66. Uscategui Penuela RM, Alvarez Uribe MC, Laguado Salinas I, Soler Terranova W, Martinez Maluendas L, Arias Arteaga R, et al: Cardiovascular risk factors in children and teenagers aged 6-18 years old from Medellin (Colombia). An Pediatr (Barc) 2003; 58: 411-7.

  67. Singh AK, Maheshwari A, Sharma N, Anand K: Lifestyle associated risk factors in adolescents. Indian J Pediatr 2006; 73: 901-6.

  68. Ucar B, Kilic Z, Colak O, Oner S, Kalyoncu C: Coronary risk factors in Turkish schoolchildren: randomized cross-sectional study. Pediatr Int 2000; 42: 259-67.

  69. Sinaiko AR: Hypertension in children. N Engl J Med 1996; 335: 1968-73.

  70. Update on the 1987 Task Force Report on High Blood Pressure in Children and Adolescents: a working group report from the National High Blood Pressure Education Program. National High Blood Pressure Education Program Working Group on Hypertension Control in Children and Adolescents. Pediatrics 1996; 98(4 Pt 1): 649-58.

  71. Freedman DS, Dietz WH, Srinivasan SR, Berenson GS: The relation of overweight to cardiovascular risk factors among children and adolescents: the Bogalusa Heart Study. Pediatrics 1999; 103(6 Pt 1): 1175-82.

  72. Schmieder RE, Messerli FH, Ruddel H: Risks for arterial hypertension. Cardiol Clin 1986; 4: 57-66.

  73. Rosner B, Prineas R, Daniels SR, Loggie J: Blood pressure differences between blacks and whites in relation to body size among US children and adolescents. Am J Epidemiol 2000; 151: 1007-19.

  74. Sorof JM, Lai D, Turner J, Poffenbarger T, Portman RJ: Overweight, ethnicity, and the prevalence of hypertension in school-aged children. Pediatrics 2004; 113(3 Pt 1): 475-82.

  75. Gutin B, Owens S, Slavens G, Riggs S, Treiber F: Effect of physical training on heart-period variability in obese children. J Pediatr 1997; 130: 938-43.

  76. Tounian P, Aggoun Y, Dubern B, Varille V, Guy-Grand B, Sidi D, et al: Presence of increased stiffness of the common carotid artery and endothelial dysfunction in severely obese children: a prospective study. Lancet 2001; 358: 1400-4.

  77. Hergenroeder AC, Hill RB, Wong WW, Sangi-Haghpeykar H, Taylor W: Validity of self-assessment of pubertal maturation in African American and European American adolescents. J Adolesc Health 1999; 24: 201-5.

  78. Bonat S, Pathomvanich A, Keil MF, Field AE, Yanovski JA: Self-assessment of pubertal stage in overweight children. Pediatrics 2002; 110: 743-7.

  79. Duke PM, Litt IF, Gross RT: Adolescents’ self-assessment of sexual maturation. Pediatrics 1980; 66: 918-20.

  80. Brooks-Gunn J, Warren MP, Rosso J, Gargiulo J: Validity of self-report measures of girls’ pubertal status. Child Dev 1987; 58: 829-41.




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