ABC | Volume 113, Nº4, October 2019

Updated Updated Cardiovascular Prevention Guideline of the Brazilian Society Of Cardiology – 2019 Arq Bras Cardiol. 2019; 113(4):787-891 Table 11.6 – Recommendations for approaching children and adolescents Recommendation Recommendation class Level of evidence Reference Blood pressure classification in children and adolescents Up to 13 years old Systolic or diastolic blood pressure percentile Normal (1-13 years old) < 90 High blood pressure ≥ 90 to < 95 or PA 120 x 80 mmHg at < 95 (whichever is lower) SAH stage 1 ≥ 95 to < 95 + 12 mmHg or 130 x 80 mmHg to 139 x 89 mmHg (whichever is lower) SAH stage 2 ≥ 95 + 12 mmHg or ≥ 140 x 90 mmHg (whichever is lower) I B 590-593 Antihypertensives most frequently used in the treatment of hypertension in children and adolescents in Brazil: captopril, enalapril, hydrochlorothizide, amlodipine and losartan in children over 6 years old I A 590-593 Reference values for lipids and lipoproteins in children and adolescents Lipids Fasting (mg/dL) Not fasting (mg/dL) Total cholesterol < 170 < 170 HDL-cholesterol > 45 > 45 Triglycerides (0-9 years old) (10-19 years old) < 75 < 90 < 85 < 100 LDL-cholesterol < 110 < 110 Non-HDL-cholesterol > 145 > 145 I!a C 590-593 LDL-cholesterol targets in children and adolescents according to cardiovascular risk profile LDL-cholesterol levels Risk < 190 mg/dL without another risk factor < 160 mg/dL Early coronary insufficiency in the family Or other risk factor < 130 mg/dL Established coronary insufficiency OR 2 diseases or high risk factors OR 1 disease or high risk factor AND 2 diseases or moderate risk factors (Table 11.3) IIa C 590-593 Drugs used to treat dyslipidemia in childhood and adolescence Medicine Dose Observations Lovastatin, pravastatin, simvastatin and atorvastatin 10-40 mg/day Pravastatin for HIV and atorvastatin for HF (> 7years) Rosuvastatin 5-20 mg/day Mainly in HF (> 7 years) Cholestyramine 4-16 g/day Any age Ezetimibe 10 mg/day > 4 years old Bezafibrate, fenofibrate 200-600 mg/day TG persistently > 500 mg/dL Omega 3 2-4 g/day Variable effect Phytosterols 1,2-1,5 g/day Variable effect IIa A 590-593 LDL-a: low-density lipoprotein cholesterol; SAH: systemic arterial hypertension. 859