Prevalência de pressão arterial elevada e fatores associados em crianças de um Município rural do Espírito Santo

Abstract

Hypertension is the most prevalent cardiovascular risk factor in developed and developing countries. Epidemiological studies have shown an increased incidence of hypertension in children and a strong association between blood pressure (BP) in childhood with development of hypertension in adulthood. Due to the lack of data about the prevalence of hypertension in children living in rural areas, we decided to estimate the prevalence of high BP and associated factors in schoolchildren aged 7 to 10 years in a rural county of Espirito Santo, Brazil, as well as to compare prevalence rates by different protocols to determine casual BP. A cross sectional study was conducted in 901 school-based children aged 7 to 10 years enrolled in 45 schools of Santa Maria de Jetibá. BP was measured during a single visit using the oscillometric method (OmronHEM705CP). Determination of casual BP was obtained by three protocols. Mean value of two measures, according to the Brazilian Guidelines on Hypertension, mean of the two smallest of three measures and the lowest value obtained. It was determined the height percentile for age and sex and used the reference table of percentile for identification of high BP (> 95th). Data are presented as mean ±standard deviation. It was performed bivariate analysis (chi-square) and adopted a logistic regression model (significance of 0.05%). Significant difference between systolic (SBP) and diastolic (DBP) blood pressure mean were obtained by three different protocols. The prevalence of high BP was 16.2% (95% CI: 13.7, 18.6), the first protocol, 12.0% (95%CI 9.8, 14.2%) in the second and 8.4% (95%CI: 6.6,10.2) in the third protocol. Remained as factors associated with high blood pressure, excess weight (OR: 1.95, 95% CI: 1.07, 3.58) and rural area (OR: 2.15, 95% CI: 1.23, 3, 76). The prevalence of high BP differs when using different protocols for calculation of casual BP. Overweight and living in rural areas were two factors that increase the likelihood of the presence high blood pressure in children. We suggest the use of the lowest measure to estimate the prevalence of high BP when a single visit. Furthermore, health promotion should be undertaken to meet new challenges that emerge also in the context of life of rural populations.