Avaliação da tendência temporal da prevalência de hipertensão arterial em estudantes de 10-15 anos do Rio de Janeiro, em um período de 30 anos

Abstract

Data concerning Brazilian hypertension prevalence trends is inexistent among the pediatric population; hence, the objectives of this study were to describe hypertension trends among Brazilian students aged 10 to 15 years-old within a 30-year period and over the same geographical area. Time-trend analysis of two population samples of public school’s students from the city of Rio de Janeiro, Brazil, with ages between 10-15 years-old. Students were evaluated at school environment in 1987-1988 (Rio de Janeiro Study I [RJS I], n=3,456) and 2015-2016 (Rio de Janeiro Study II [RJS II], n=1,871). In RJS I, collected data included student’s identification, blood pressure, heart rate, weight, waist circunference, height and skin color classified by the observer; in RJS II, skin color was classified by the student and data also included a questionnaire encompassing students’ nutritional, health and epidemiological information. BP was measured by auscultatory method with a mercury sphygmomanometer in RJS I and by oscillometric method with OMROM HEM7120 automatic monitor in RJS II. Baseline characteristics of RJS II population showed higher mean values of age, height, weight and BMI (p<0.001) and higher obesity prevalence (10.3% [ERJ I] vs. 22.4% [ERJ II], OR 2.497; p<0.001). In the 30-year period, hypertension prevalence decreased from 11.1% in RSJ I to 8.5% in RJS II (OR 0.743; p=0.003) and obesity prevalence increased from 10.3% in RSJ I to 22.35% in RSJ II (OR 2.497; p<0.001). Among obese students, hypertension prevalence went from 29.1% in RJS I to 12.35% in RJS II (OR 0.338; p<0.001). Multivariate analysis demonstrated obesity to be independently associated with hypertension in both periods of time (RJS I: OR 4.874, p<0.001; RJS II: OR 1.757; p=0.002). Isolated systolic hypertension (ISH) was the most prevalent hypertension subtype in both periods of analysis, despite the decrease in prevalence (8.9% [ERJ I] vs. 4.7% [ERJ II]; OR 0.506; p <0.001); while isolated diastolic hypertension (IDH) showed an increase in prevalence (1.1% [ERJ I] vs. 2.1% [ERJ II]; OR 1.967; IC95% 1.250-3.096; p=0.003). In conclusion, over a 30-year period, hypertension prevalence among Brazilian students aged 10-15 years decreased, while obesity prevalence increased; hypertension remained statistically associated with obesity both in 1987-1988 and 2015-2016; among hypertension subtypes, ISH prevalence increased and IDH prevalence increased