body mass index – ABC CARDIOL

IJCS

Original Article

Hypertension and Different Levels of Body Mass Index and Cardiorespiratory Fitness Amongst Adolescents

Cleiton Bertollo et al. Claúdia Daniela Barbian Letícia de Borba Schneiders João Francisco de Castro Silveira … Bruna Dahmer Vogt Elza Daniel de Mello Leandro Tibiriçá Burgos James Philip Hobkirk Cézane Priscila Reuter

Abstract

Background

Hypertension is an increasingly common problem in adolescents; amongst the associated factors, physical inactivity and obesity are increasing the risk of developing cardiovascular diseases.

Objective

To verify whether there is an association between higher blood pressure levels amongst adolescents with the relationship between different levels of body mass index (BMI) and cardiorespiratory fitness (CRF).

Method

Cross-sectional study consisting of 860 adolescents. Higher blood pressure (BP) was considered as borderline and hypertension as the classification. BMI was categorized as low-normal weight and overweight-obesity. The CRF was assessed by a nine-minute run/walk test and classified into low or appropriate levels (less and more favorable to health, respectively). Later, BMI and CRF were grouped into one categorical variable: (I) low/normal weight and appropriate CRF levels; (II) low/normal weight and low CRF levels; (III) overweight/obesity and appropriate CRF levels; and (IV) overweight/obesity and low CRF levels. Data were analyzed using Poisson regression, through the prevalence ratio (PR) and 95% confidence intervals (CI). The p-values of p <0.05 were considered significant.

Results

Adolescents with overweight/obesity and low CRF levels had a 22% higher BP prevalence. Moreover, children with overweight/obesity, but with appropriate CRF levels, have a 15% higher BP prevalence.

Conclusion

Adolescents with overweight/obesity had a higher prevalence of BP, regardless of CRF levels. It is suggested that maintaining normal BMI is a protective factor for less favorable BP.

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IJCS

Original Article

Lipoprotein(a) levels in children and adolescents: Ouro Preto Study

Ana Paula C Cândido et al. Alekson Mendonça-Mendes Débora RC Cândido Roney LC Nicolato George LL Machado-Coelho

Abstract

Background

Lipoprotein (a) is a cardiovascular risk factor in adult. Studies have shown the presence of this emergent risk factor in school children, which may contribute to the development of atherosclerosis in adulthood.

Objective

To evaluate the association between lipoprotein (a) and cardiovascular risk factors in school children.

Methods

Lipoprotein (a) levels were measured in 320 school children (6-14 years) selected from a population survey carried out in Ouro Preto (southeast of Brazil). Demographic (sex and age), biochemical (total cholesterol, high-density lipoprotein-cholesterol, low-density lipoprotein-cholesterol, triglycerides, and glucose), anthropometric (body mass index, waist circumference, body fat percentage), clinical (arterial blood pressure, pubertal stage and birth weight) and economic (family income) parameters, as well as family history (obese and/or hypertensive parents) were analyzed. Non-parametric analysis was used to evaluate lipoprotein (a) levels in each subgroup. Variables with p≤0.20 in the univariate analysis were included in binary regression logistic model. Differences with p < 0.05 were considered significant.

Results

Lipoprotein (a) levels were associated with total cholesterol (p=0.04), body fat (p=0.009), and mother´s systolic (p=0.02) and diastolic blood pressure (p=0.04). In a logistic regression analysis, children with high lipoprotein (a) levels and body fat, and children born from hypertensive mothers were, respectively, at 3.2(p=0.01) and 1.4 (p=0.03) times higher risk than other children. In clustering these factors, elevated lipoprotein (a) was 2.6 times more likely to be seen in school children with high body fat and born hypertensive mothers.

Conclusions

Lipoprotein (a) was correlated with cardiovascular risk factors in children and adolescents. Persistence of these risk factors in childhood suggests a contribution of elevated lipoprotein (a) to future cardiovascular disease. (Int J Cardiovasc Sci. 2020; [online].ahead print, PP.0-0)

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IJCS

Original Article

Relationship between Obesity and Coronary Artery Disease Defined by Coronary Computed Tomography Angiography

Lara Luiza Silvello Pereira et al. Gisele Marochi de Moraes Adriano Camargo de Castro Carneiro Valéria de Melo Moreira … Juliana Hiromi Silva Matsumoto Bello Carlos Eduardo Elias dos Prazeres Carlos Eduardo Rochitte Tiago Magalhaes

Abstract

Background:

Although associated with traditional cardiovascular risk factors, it is unclear whether obesity alone is associated with coronary artery disease (CAD).

Objective:

To investigate the role of obesity as a risk factor for CAD, defined by coronary computed tomography angiography (CCTA).

Methods:

This study retrospectively included 1,814 patients referred for CCTA in a hospital in São Paulo, from August 2010 to July 2012. CAD was identified by coronary calcium score and presence of coronary stenosis > 50%. Images were analyzed by two specialists, and the coronary findings were compared between obese and non-obese groups. A multivariate analysis model was used to assess obesity as an independent variable for the occurrence of obstructive CAD.

Results:

Among the study population, mean age was 58.5 +/- 11.5 years, 22.8% were obese (BMI = 30 kg/m2) and 66.3% were male. The prevalence of obstructive CAD was 18.4% in both groups. Obese patients had higher median calcium score compared to non-obese subjects (14.7 vs. 1.4, respectively, p = 0.019). In the multivariate analysis, obesity was not an independent factor for obstructive CAD (coefficient = -0.035, p = 0.102).

Conclusion:

Although no differences were observed in the prevalence of obstructive CAD between obese and non-obese individuals, coronary calcium scores were significantly in lower the latter group.

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ABC

Original Article

Self-perception and dissatisfaction with weight does not depend on the frequency of physical activity

Denise Sardinha Mendes Soares de Araújo et al. Claudio Gil Soares de Araújo

OBJECTIVE: To evaluate the level of satisfaction with body weight and the self-perception of the weight/height ratio and to verify the influence of the frequency of present and past physical activity on these variables. METHODS: Using questionnaires or interviews, we obtained height data, reported and desired weight, self-perception of the weight/height ratio, and the frequency of current physical activity in 844 adults (489 women). Of these, evaluated the frequency of physical activity during high school of 193 individuals,and we measured their height and weight. RESULTS: Less than 2/3 of the individuals had body mass index between 20 and 24.9 kg/m2. A tendency existed to overestimate height by less than 1 cm and to underestimate weight by less than 1kg. Desired weight was less than that reported (p<0.001), and only 20% were satisfied with their current weight. Only 42% of men and 25% of women exercised regularly. No association was found between the frequency of physical activity and the variables height, weight, and body mass index, and the level of satisfaction with current weight. CONCLUSION: Height and weight reported seem to be valid for epidemological studies, and great dissatisfaction with body weight and a distorted self-perception of height/weight ratio exists, especially in women, regardless of the frequency of physical activity.

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ABC

Original Article

Body Mass Index: A Scientific Evidence-Based Inquiry

Djalma Rabelo Ricardo et al. Claudio Gil Soares de Araújo

OBJECTVE: To objectively and critically assess body mass index and to propose alternatives for relating body weight and height that are evidence-based and that eliminate or reduce the limitations of the body mass index. METHODS: To analyze the relations involving weight and height, we used 2 databases as follows: 1) children and adolescents from Brazil, the United States, and Switzerland; and 2) 538 university students. We performed mathematical simulations with height data ranging from 115 to 190 cm and weight data ranging from 25 to 105 kg. We selected 3 methods to analyze the relation of weight and height as follows: body mass index – weight (kg)/height (m²); reciprocal of the ponderal index – height (cm)/weight1/3 (kg); and ectomorphy. Using the normal range from 20 to 25 kg/m² for the body mass index in the reference height of 170 cm, we identified the corresponding ranges of 41 to 44 cm/kg1/3 for the reciprocal of the ponderal index, and of 1.45 to 3.60 for ectomorphy. RESULTS: The mathematical simulations showed a strong association among the 3 methods with an absolute concordance to a height of 170 cm, but with a tendency towards discrepancy in the normal ranges, which had already been observed for the heights of 165 and 175 cm. This made the direct convertibility between the indices unfeasible. The reciprocal of the ponderal index and ectomorphy with their cut points comprised a larger age range in children and adolescents and a wider and more central range in the university students, both for the reported (current) and desired weights. CONCLUSION: The reciprocal of the ponderal index and ectomorphy are stronger and are more mathematically logical than body mass index; in addition, they may be applied with the same cut points for normal from the age of 5 ½ years on.

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Original Article

Analysis of the risk factors for allograft vasculopathy in asymptomatic patients after cardiac transplantation

Fernando Bacal et al. Viviane Cordeiro Veiga Alfredo Inácio Fiorelli Giovanni Bellotti … Edimar Alcides Bocchi Noedir Antonio Groppo Stolf José Antonio Franchini Ramires

OBJECTIVE: To study the influence of immune and nonimmune risk factors on the development of allograft vasculopathy after cardiac transplantation. METHODS: We studied 39 patients with a mean age of 46±12 years. The following variables were analyzed: weight (kg), body mass index (kg/m²), donor’s age and sex, rejection episodes in the first and second years after transplantation, systolic and diastolic blood pressures (mmHg), total cholesterol and fractions (mg/dL), triglycerides (mg/dL), diabetes, and cytomegalovirus infection. The presence of allograft vasculopathy was established through coronary angiography. RESULTS: Allograft vasculopathy was observed in 15 (38%) patients. No statistically significant difference was observed between the two groups in regard to hypertension, cytomegalovirus infection, diabetes, donor’s sex and age, rejection episodes in the first and second years after transplantation, and cholesterol levels. We observed a tendency toward higher levels of triglycerides in the group with disease. Univariate and multivariate analyses showed statistically significant differences between the two groups when we analyzed the body mass index (24.53±4.3 versus 28.11±4.6; p=0.019). CONCLUSION: Body mass index was an important marker of allograft vasculopathy in the population studied.

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