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      Prevalencia de factores de riesgo cardiovascular en adolescentes de instituciones educativas Translated title: Cardiovascular risk factors prevalence in adolescents in educational institutions

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          Abstract

          Objetivos: Determinar la prevalencia de los factores de riesgo cardiovascular (FRC) en adolescentes. Diseño: Descriptivo y transversal, mediante muestreo aleatorio polietápico. Lugar: Doce instituciones educativas estatales de nivel secundario, distrito de San Juan de Lurigancho, Lima, Perú. Participantes: Adolescentes. Intervenciones: Se estudió una muestra de 277 adolescentes de 12 a 17 años de edad, 49,1% del sexo masculino, durante los meses de agosto y noviembre de 2007. Los FRC estudiados fueron la hipertensión arterial sistólica/diastólica (≥95p según edad, sexo y talla), dislipidemia (hipercolesterolemia ≥200 mg/dL, hipertrigliceridemia ≥130 mg/dL, LDL-c alto ≥130 mg/dL y HDL-c bajo <40mg/dL), tabaquismo, sedentarismo, obesidad/obesidad abdominal (índice de masa corporal ≥95 p y circunferencia de la cintura ≥90 p según edad y sexo), dieta poco saludable, glucosa en ayuna alterada (≥110 mg/dL) y antecedente familiar de enfermedad cardiovascular. La medida de la presión arterial, análisis bioquímicos y datos antropométricos se realizó según las recomendaciones internacionales. La determinación de la prevalencia de tabaquismo, sedentarismo, dieta poco saludable y antecedente familiar de enfermedad cardiovascular empleó cuestionarios previamente validados. Principales medidas de resultados: Prevalencia de los factores de riesgo cardiovascular. Resultados: La prevalencia de hipertensión arterial, tabaquismo, sedentarismo, obesidad, dieta poco saludable y antecedente familiar de enfermedad cardiovascular fueron 1,5%, 35%, 62,8%, 7,6%, 41%, y 19,1%, respectivamente. La frecuencia de dislipidemia (se realizó en una submuestra a 39 adolescentes) fue alta (85%) y se dio principalmente por niveles bajos de HDL-c (76,9%), seguido de niveles altos de LDL-c (28,2%), hipertrigliceridemia (17,9%) e hipercolesterolemia (7,7%). No se encontró adolescentes con glucosa en ayuna alterada. Conclusiones: La prevalencia y/o frecuencia de FRC encontrada en los adolescentes estudiados sugiere la necesidad de diseñar programas de intervención, con el fin de modificar el estilo de vida y prevenir la posible presencia de enfermedades cardiovasculares en la vida adulta.

          Translated abstract

          Objectives: To determine the prevalence of cardiovascular risk factors (CRF) in adolescents. Design: Descriptive and cross-sectional, multistage random sampling. Setting: Twelve state secondary schools, district of San Juan de Lurigancho, Lima-Peru. Participants: Adolescents. Interventions: We studied a sample of 277 adolescents 12 to 17 years old, 49,1% male, during August and November 2007. CRF studied were systolic / diastolic hypertension (≥95p by age, sex and height), dyslipidemia (hypercholesterolemia ≥200 mg /dL, hypertriglyceridemia ≥130 mg/dL, high LDL-c ≥130 mg/dL and low HDL-c <40mg/dL), smoking, sedentary lifestyle, obesity/abdominal obesity (body mass index ≥ 95p and waist circumference ≥90p by age and sex), inadequate diet, impaired fasting glucose (≥110 mg/dL) and family history of cardiovascular disease (CVD). Blood pressure measurement, anthropometric data and biochemical analysis were performed according to international recommendations. Smoking prevalence, sedentary lifestyle, unhealthy diet and family history of cardiovascular disease were determined by previously validated questionnaires. Main outcome measures: Cardiovascular risk factors prevalence. Results: Hypertension, smoking, sedentary lifestyle, obesity, unhealthy diet and family history of CVD prevalence were respectively 1,5%, 35%, 62,8%, 7,6%, 41% and 19,1%. Dyslipidemia (determined in a 39 adolescents subsample) was prevalent (85%) due mainly to low HDL-c levels (76,9%), high LDL-c levels (28,2%), hypertriglyceridemia (17,9%) and hypercholesterolemia (7,7%). No adolescent showed fasting blood sugar alteration. Conclusions: CRFs prevalence and/or frequency in adolescents surveyed suggest the need for intervention programs that modify lifestyle in order to prevent cardiovascular disease in adulthood.

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          Most cited references56

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          Prevalence of the metabolic syndrome in American adolescents: findings from the Third National Health and Nutrition Examination Survey.

          Metabolic syndrome (MetS) is defined by the Third Report of the Adult Treatment Panel (ATP III) using criteria easily applied by clinicians and researchers. There is no standard pediatric definition. We defined pediatric MetS using criteria analogous to ATP III as > or =3 of the following: (1) fasting triglycerides > or =1.1 mmol/L (100 mg/dL); (2) HDL or =6.1 mmol/L (110 mg/dL); (4) waist circumference >75th percentile for age and gender; and (5) systolic blood pressure >90th percentile for gender, age, and height. MetS prevalence in US adolescents was estimated with the Third National Health and Nutritional Survey 1988 to 1994. Among 1960 children aged > or =12 years who fasted > or =8 hours, two thirds had at least 1 metabolic abnormality, and nearly 1 in 10 had MetS. The racial/ethnic distribution was similar to adults: Mexican-Americans, followed by non-Hispanic whites, had a greater prevalence of MetS compared with non-Hispanic blacks (12.9%, [95% CI 10.4% to 15.4%]; 10.9%, [95% CI 8.4% to 13.4%]; and 2.5%, [95% CI 1.3% to 3.7%], respectively). Nearly one third (31.2% [95% CI 28.3% to 34.1%]) of overweight/obese adolescents had MetS. Our definition of pediatric MetS, designed to be closely analogous to ATP III, found MetS is common in adolescents and has a similar racial/ethnic distribution to adults in this representative national sample. Because childhood MetS likely tracks into adulthood, early identification may help target interventions to improve future cardiovascular health.
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            The relation of childhood BMI to adult adiposity: the Bogalusa Heart Study.

            Although many studies have found that childhood levels of body mass index (BMI; kg/m(2)) are associated with adult levels, it has been reported that childhood BMI is not associated with adult adiposity. We further examined these longitudinal associations. Cohort study based on examinations between 1973 and 1996. Bogalusa, Louisiana. Children (2610; ages 2-17 years old) who were followed to ages 18 to 37 years; the mean follow-up was 17.6 years. BMI-for-age and triceps skinfold thickness (SF) were measured in childhood. Subscapular and triceps SFs were measured among adults, and the mean SF was used as an adiposity index. Adult obesity was defined as a BMI >or= 30 kg/m(2) and adult overfat as a mean SF in the upper (gender-specific) quartile. Childhood levels of both BMI and triceps SF were associated with adult levels of BMI and adiposity. The magnitude of these longitudinal associations increased with childhood age, but the BMI levels of even the youngest (ages 2-5 years) children were moderately associated (r = 0.33-0.41) with adult adiposity. Overweight (BMI-for-age >or= 95th centile) 2- to 5-year-olds were >4 times as likely to become overfat adults (15 of 23 [65%]), as were children with a BMI < 50th centile (30 of 201 [15%]). Even after accounting for the triceps SF of children, BMI-for-age provided additional information on adult adiposity. Childhood BMI is associated with adult adiposity, but it is possible that the magnitude of this association depends on the relative fatness of children.
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              Effects of the amount and intensity of exercise on plasma lipoproteins.

              Increased physical activity is related to reduced risk of cardiovascular disease, possibly because it leads to improvement in the lipoprotein profile. However, the amount of exercise training required for optimal benefit is unknown. In a prospective, randomized study, we investigated the effects of the amount and intensity of exercise on lipoproteins. A total of 111 sedentary, overweight men and women with mild-to-moderate dyslipidemia were randomly assigned to participate for six months in a control group or for approximately eight months in one of three exercise groups: high-amount-high-intensity exercise, the caloric equivalent of jogging 20 mi (32.0 km) per week at 65 to 80 percent of peak oxygen consumption; low-amount-high-intensity exercise, the equivalent of jogging 12 mi (19.2 km) per week at 65 to 80 percent of peak oxygen consumption; or low-amount-moderate-intensity exercise, the equivalent of walking 12 mi per week at 40 to 55 percent of peak oxygen consumption. Subjects were encouraged to maintain their base-line body weight. The 84 subjects who complied with these guidelines served as the basis for the main analysis. Detailed lipoprotein profiling was performed by nuclear magnetic resonance spectroscopy with verification by measurement of cholesterol in lipoprotein subfractions. There was a beneficial effect of exercise on a variety of lipid and lipoprotein variables, seen most clearly with the high amount of high-intensity exercise. The high amount of exercise resulted in greater improvements than did the lower amounts of exercise (in 10 of 11 lipoprotein variables) and was always superior to the control condition (11 of 11 variables). Both lower-amount exercise groups always had better responses than the control group (22 of 22 comparisons). The highest amount of weekly exercise, with minimal weight change, had widespread beneficial effects on the lipoprotein profile. The improvements were related to the amount of activity and not to the intensity of exercise or improvement in fitness. Copyright 2002 Massachusetts Medical Society
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                Author and article information

                Journal
                afm
                Anales de la Facultad de Medicina
                An. Fac. med.
                Universidad Nacional Mayor de San Marcos. Facultad de Medicina (Lima, , Peru )
                1025-5583
                December 2009
                : 70
                : 4
                : 259-265
                Affiliations
                [02] Lima orgnameUniversidad Nacional Mayor de San Marcos orgdiv1Facultad de Medicina orgdiv2Centro de Investigación Bioquímica y Nutrición Perú
                [01] Lima orgnameUniversidad Nacional Mayor de San Marcos orgdiv1Facultad de Medicina Perú
                Article
                S1025-55832009000400006 S1025-5583(09)07000406
                89ae86e0-c5f5-440c-8e9a-f92ae62886cc

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

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                Figures: 0, Tables: 0, Equations: 0, References: 35, Pages: 7
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                SciELO Peru

                Self URI: Texto completo solamente en formato PDF (ES)
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                Artículos originales

                cardiovascular diseases,Adolescente,factores de riesgo,enfermedades cardiovasculares,Adolescent,risk factors

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