Prevalence of ideal cardiovascular health in young adults: A birth cohort from southern Brazil.

BACKGROUND: Ideal cardiovascular health (ICH) aims at primordial prevention of cardiovascular diseases in the population. However, there is a lack of research describing ICH in youth from middle-income countries. The aims of this study were to describe the prevalence of ICH at 18- and 22-year-old and to investigate the influence of socioeconomic status. METHODS: The sample consisted of participants from the Pelotas 1993 birth-cohort followed-up at 18- (n = 4,106) and 22-year-old (n = 3,810). Ideal metrics were created for diet, smoking, body mass index, physical activity, blood pressure, total cholesterol, and blood glucose. The presence of 4 or more ideal metrics was defined as ICH. Socioeconomic status was obtained using wealth quintiles calculated with factor analysis based on analysis based on the ownership of household and education. The impact of socioeconomic status on ICH metrics was statistically measured using the slope index of inequality. RESULTS: The prevalence of ICH was 84.5% (95% confidence interval [CI] = 82.7-86.2%) and 84.1% (82.3-85.8%) at 18-year-old and decreased to 61.1% (58.4-63.7%) and 68.7% (66.2-71.2%) at 22-years old, for male and female, respectively. Socioeconomic status influenced ICH and its components differently in males and females. Wealthiest females had ICH prevalence 19 percentage points (pp) (11-27 pp) higher compared to the poorest, whereas poorest males had ICH prevalence 12 pp (1-21 pp) higher compared to the wealthiest. Longitudinal decreases in ICH components were mostly present in the poorest females. CONCLUSIONS: In middle-income countries, the prevalence of ICH is high at 18-year-old and decreases in a 4-year follow-up. Socioeconomic status influences differently individuals' ICH between sexes. Efforts are needed to maintain ICH in youth and different strategies may be required between the social status.

Maternal depression symptoms and use of child health-care services at The Pelotas 2004 Birth Cohort.

OBJECTIVE: To investigate the influence of maternal depression on child health-care services utilization. METHODOLOGY: Data from The Pelotas 2004 Birth Cohort collected at birth and at 12- and 24-month follow-ups were used. Four outcomes occurring in the second year of life were investigated: number of well-baby visits, number of medical appointments, number of visits to emergency rooms, and number of hospitalizations. The main exposure was maternal depression symptoms at 12-month post-partum as assessed by the Edinburgh Postpartum Depression Scale (EPDS). Adjusted prevalence ratios (PR) with 95% confidence intervals (95% CI) were calculated by Poisson regression. RESULTS: The prevalence of mothers with depressive symptoms was 27.6% (95% CI: 26.2-29.0%). These mothers showed a 10% lower probability of taking their children to well-baby visits (0.90; 0.85-0.95; p = 0.001); 16% higher probability to seek medical consultations (1.16; 1.09-1.25, p = 0.001); and they sought emergency services for their children more often (1.30; 1.17-1.45, p < 0.001) as compared to mothers who did not present depressive symptoms. Although the PR for hospitalizations was 26% higher for children from mothers with depressive symptoms, the association did not achieve statistical significance (1.26; 0.98-1.63; p = 0.072). CONCLUSION: Children from mothers with depressive symptoms attend fewer number of preventive consultations. In contrast, they are taken to medical and emergency care more often, suggesting that these children are given healthcare when they are at more advanced stages of their illnesses.

Overweight trajectory and cardio metabolic risk factors in young adults.

BACKGROUND: Obesity is one of the conditions that increases the risk of cardiovascular disease. Studies about obesity trajectory and cardio metabolic outcomes at adulthood are still scarce. Therefore, we aimed to assess the association between patterns of overweight over the life-course and cardio metabolic risk factors in young adults. METHODS: In 1982, the maternity hospitals in Pelotas were visited daily and those newborns whose family lived in the urban area of the city were identified (n = 5914), and have prospectively followed for several occasions. Weight and height were measured at every visit. BMI-for-age z-score was calculated using the WHO Child Growth Standards. Overweight and obesity were defined as a BMI greater than or equal to 25 kg/m2 and 30 kg/m2 respectively. This was the definition adopted for evaluations overweight and obesity at 30 years. The participants were divided into eight groups according to the presence of overweight or obesity in childhood, adolescence and adulthood. Blood pressure, random blood glucose, HDL cholesterol, LDL cholesterol triglycerides and fat mass were measured. RESULTS: From 2219 participants with anthropometric data in childhood, adolescence and adulthood, 25% never had been overweight, whereas 11.6% were overweight in the three periods. Random blood glucose, SBP and DBP were higher among those subjects who were always overweight/ obese or only overweight/obese during adolescence and adulthood. The participants who were never overweight/obese or only in childhood or adolescence had a lower cardiovascular risk profile (higher HDL cholesterol, lower blood pressure, lower random glucose, lower LDL cholesterol) at 30 years. Fat mass captured from 25 to 100% of the association of overweight and obesity trajectory with cardiometabolic risk factors. CONCLUSIONS: The tracking of overweight/obesity is associated with an adverse cardio metabolic profile and this association is largely mediated by fat mass in adulthood.

Determinantes da pressão arterial elevada em crianças: um estudo caso-controle em área rural do Espírito Santo / Determinación de la presión arterial alta en niños: un estudio caso-control en zona rural del Espírito Santo / Determinants of high blood pressure in children: a case-control study in a rural area of the Espírito Santo State

Objective: this study aims to identify and analyze the predictor factors of the occurrence of High Blood Pressure (HBP) in children aged from 7 to 10 years old from a rural municipality in Espírito Santo State. Methods: The subjects were divided into two groups, as follows: cases (SBP or DBP ≥ P95) and controls (BP < P90). The subjects were paired by sex and age. The sampling has been built from subject random selection, where were evaluated 395 children, 79 cases and 316 controls. Results: The prevalence of overweight in the cases was 8.9% and 11.1% in controls; the sedentary lifestyle was present in 88.1% of the cases and 87.9% of the controls; the average screen time was 97.7 minutes and106.6 minutes per day in cases and controls, respectively. Conclusion: It has been observed the need to create public policies aimed at health promotion in order to vulnerable groups can be receiving assistance since childhood.

Objetivo: identificar e analisar os fatores preditores da ocorrência da pressão arterial elevada em crianças de 7 a 10 anos de um município rural no Espírito Santo. Métodos: Foram constituídos dois grupos de estudo: os casos (PAS ou PAD ≥ P95) e os controles (PA

Objetivo: identificar y analizar los factores predictivos de la aparición de la hipertensión arterial en niños de 7 a 10 años de un municipio rural en el Espírito Santo. Métodos: Se construyeron dos grupos: los casos (PAS o PAD ≥ 95) y controles (PA