ABC | Volume 115, Nº1, July 2020

Original Article Hypertensive Measures In Schoolchildren: Risk Of Central Obesity And Protective Effect Of Moderate-To-Vigorous Physical Activity Tatiana Affornali Tozo, 1, 2 Beatriz Oliveira Pereira, 1 Francisco José de Menezes Junior, 2 Cristianne Morgado Montenegro, 1 Carla Marisa Maia Moreira, 3 Neiva Leite, 2 Universidade do Minho, 1 Braga - Portugal Universidade Federal do Paraná, 2 Curitiba, PR - Brazil Universidade do Porto, 3 Porto - Portugal Mailing Address: Tatiana Tozo • Rua Paulino Siqueira Cortes 1986, São José dos Pinhais, PR - Brazil; Postal code: 83005-030 E-mail: tatinali@yahoo.com.br Manuscript received December 03, 2018, revised manuscript June 18, 2019, accepted July 17, 2019 DOI: https://doi.org/10.36660/abc.20180391 Abstract Background: The proportion of arterial hypertension (AH) has increased in children and adolescents and is associated with several comorbidities. Objective: To verify the association of arterial hypertension with central and general obesity as well as according to the level of physical activity in schoolchildren. Methods: 336 children and adolescents aged 11 to 17 participated in the study. Height, body weight, waist circumference (WC) and blood pressure (BP) were measured. The body mass index z-score (BMI-z) was calculated. The level of physical activity was assessed by the short form of the International Physical Activity Questionnaire (IPAQ) according to the practice of moderate-to-vigorous physical activities (AF-mv). Students with systolic (SBP) and/or diastolic blood pressure (DBP) higher than the 95 th percentile according to sex, age and height or ≥120/80 were considered hypertensive. Statistical tests of t-Student, Chi-square, Mann-Whitney and binary logistic regression model were used, considering the significance level of p<0.05. Results: It was found that 40.5% of the students had AH, 35.11% were overweight (12.5% obese), 13.39% had high WC and 40.2% were considered insufficiently active in AF-mv. The chances of AH were related to high WC (OR = 6.11; 95% CI: 2.59¬–14.42) and overweight (OR = 2.91; 95% CI: 1.76–4.79). In addition, adolescents who practiced AF-mv had a lower risk of high DBP (OR = 0.33; 95% CI: 0.15–0.72). Conclusion: Central obesity was the best predictor of AH in children and adolescents, as well as general obesity and males. The practice of AF-mv demonstrated a protective effect on high DBP in schoolchildren. (Arq Bras Cardiol. 2020; 115(1):42-49) Keywords: Child; Adolescent; School Children; Physical Activity; Waist Circumference; Body Mass Index; Hipertension; Blood Pressure. Introduction The frequency of arterial hypertension (AH) has increased in all age groups and in several countries, 1 affecting children and adolescents, and tends to persist over time, with a high probability of progressing into adulthood, 2 mainly due to the increasing prevalence of obesity, 3 which is associated with the appearance of several comorbidities. 4 The joint analysis of lifestyle habits that may predispose to the onset of cardiovascular diseases in adulthood plays an important role in preventing hypertension in children and adolescents. 5 Obesity has a multifactorial origin, involving aspects of behavior related to diet, physical activity and psychological factors. 6 Therefore, early diagnosis of AH in children and adolescents is relevant to prevent the disease from advancing into adulthood, reduce the risk of cardiovascular problems 7 and recommend therapeutic programs to stop the process. 8 Thus, anthropometric measures such as body mass index (BMI) and waist circumference (WC) are efficient low-cost indicators for identifying cardiovascular risks. 9 BMI classified as overweight demonstrates general obesity, 10 while the largest WC is related to central obesity, 11 the latter being more associated with inflammation in adults and appearance of cardiometabolic comorbidities. 12 Blood pressure should be measured on three different occasions 13 to confirm the diagnosis of AH, whereas in epidemiological studies it is usually measured on one day and the term hypertensive measures has been used. 14 Therefore, in children and adolescents, some studies show greater associations between AH with central obesity 15 and with general obesity, 16 which generates controversy 42