Dissertations / Theses on the topic 'Adolescent hypertension'
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Guo, Yuanjing M. S. "DASH Intervention Effects on Home Food Environment and Diet Quality among Adolescents with Pre-hypertension and Hypertension." University of Cincinnati / OhioLINK, 2016. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1470045434.
Full textTOUMI, SAMIR. "Etude cas-temoin et evolution des valeurs tensionnelles sur 3 ans chez 27 enfants et adolescents a pression arterielle elevee." Toulouse 3, 1988. http://www.theses.fr/1988TOU31141.
Full textHuprich, Madeline R. "Association of Post Intervention Fullness Factor and Dietary Intake, Blood Pressure, and BMI among Hypertensive Adolescents on a DASH Dietary Intervention." University of Cincinnati / OhioLINK, 2021. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1626357048879824.
Full textPinto, Sônia Lopes. "Fatores associados à pressão arterial elevada em crianças e adolescentes de Salvador/BA." Programa de Pós-Graduação em Alimentos, Nutrição e Saúde (PGNUT), 2010. http://www.repositorio.ufba.br/ri/handle/ri/9679.
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A hipertensão arterial sistêmica é uma síndrome clínica multifatorial caracterizada pela elevação dos níveis tensionais, podendo estar associada a diversas alterações fisiopatológicas. Assim, este trabalho teve como objetivo dimensionar o problema, identificar a magnitude e o conhecimento sobre os fatores associados na gênese da hipertensão arterial na infância e adolescência. As informações foram identificadas por meio de levantamento bibliográfico nas bases de dados LILACS e MEDLINE, livros técnicos e publicações de organizações internacionais e nacionais dos últimos 10 anos. Destaca-se, o aumento da ocorrência de hipertensão na infância e adolescência na última década. E dentre os fatores de exposição que explicam a ocorrência da hipertensão arterial, sobressai-se os fatores ambientais, representados pelo estilo de vida, especialmente alimentação inadequada e inatividade física. Estudos mostram que esses hábitos comportamentais correlacionam com excesso de peso, um dos principais preditores da hipertensão arterial. Desta forma, observa-se que o aumento na ocorrência da hipertensão arterial, nessa fase da vida, constitui evento de relevância epidemiológica, tanto pela magnitude, quanto pela contribuição para o desenvolvimento precoce de doenças crônicas não transmissíveis. Assim, ações voltadas para a promoção de estilo de vida saudável concorrem com a prevenção e o controle da hipertensão, especialmente nesta fase da vida.
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Ollberding, Nicholas Jay. "Changes in Food Sources of Fat, Cholesterol, and Protein in the Diets of Adolescents with Hypertension in Response to a Dietary Intervention Focusing on Fruits, Vegetables, and Low-fat Dairy Foods." University of Cincinnati / OhioLINK, 2008. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1211902693.
Full textBraxton, Juanita. "Health Care Provider Perceptions of High Blood Pressure Screening for Asymptomatic African American Teens." ScholarWorks, 2016. https://scholarworks.waldenu.edu/dissertations/3021.
Full textAlhassan, Abraham Basil. "Assessment of Social, Dietary and Biochemical Correlates of Cardiometabolic Risk in Pre-adolescent Hispanic Children." Digital Commons @ East Tennessee State University, 2017. https://dc.etsu.edu/etd/3245.
Full textFurusawa, Erika Arai. "Comparação das medidas de pressão arterial no consultório, no domicílio e pela monitorização ambulatorial da pressão arterial (MAPA) em crianças com hipertensão arterial." Universidade de São Paulo, 2008. http://www.teses.usp.br/teses/disponiveis/5/5141/tde-18122008-122329/.
Full textThe diagnosis and monitoring of hypertension in pediatric patients depend on the accuracy and reproducibility of blood pressure (BP) measurement. Ambulatory blood pressure monitoring (ABPM), despite its advantages over office BP, is costly and can cause discomfort to the patient. The blood pressure measured at home (HBP), although poorly studied in children, represents a potential alternative to ABPM. The objectives of this study were to compare BP measurement in four clinical conditions: office BP , casual BP measured at Liga de Hipertensão, HBP and ABPM, evaluate the effect of environment / observer and to determine the frequency of BP values compatible with the diagnosis of hypertension. This study was cross-sectional and prospective and included patients with arterial hypertension with/without properly controlled BP in the office. The means of systolic and diastolic BP were analyzed in the 4 clinical conditions. HBP was measured for 14 days using a validated fully automatic Omron HEM 705 CP device. ABPM was measured with SpaceLabs 90207 non-invasive portable oscilometric device. We analyzed data from 40 patients (14 girls and 26 boys), mean age 12.1 ± 3.6 (SD) years. There was no difference between systolic (ANOVA p = 0.3100) and diastolic (ANOVA p= 0.7700) BP in the office and daytime HBP nor with nightime systolic HBP ( ANOVA p = 0.8240) and diastolic HBP(ANOVA p = 0.1530). The average systolic and diastolic BP at the Liga de Hipertensão and ABPM were higher than office and HB P (p <0001), but there was no difference in the average systolic (p= 0.077) and diastolic (p = 0.962) BP between Liga and ABPM. The diastolic HBP was lower than office diastolic BP (p = 0001). The frequency of BP values compatible with hipertension was higher at the Liga de Hipertensão (Mc Nemar p <0005), while comparisons between officedaytime HBP, office- daytime ABPM and daytime HBP-ABPM were not significant (Mc Nemar p> 0.05). The BP measurements during nightime ABPM showed a higher frequency of values compatible with hypertension than the night HBP one. Ten patients were diagnosed hypertension in the office, ABPM confirmed the diagnosis in 7 / 10 (17.5%) patients, while 5 / 10 (12.5%) were confirmed by HBP. In this group, white-coat hypertension occurred in 3 / 10 (7.5%) patients as diagnosed by the ABPM and 5 / 10 (12.5%) as diagnosed by HBP.Thirty patients presented BP values within normal limits in the office, 24 / 30 (60%) patients confirmed this diagnosis by ABPM and 26/30 (65%) by HBP. Masked hypertension was diagnosed in 6 / 30 (15%) patients diagnosed by the ABPM and in 4 / 30 (10%) by HBP. This study confirmed a correlation between ABPM and HBP measurements (Mc Nemar test p <0.01) with good reproducibility as evaluated by the Kappa index (0.557).
Canabarro, Luciana. "Conhecimentos e percepções do jovem estudante do ensino médio sobre a hipertensão arterial e suas consequências." Pontifícia Universidade Católica de São Paulo, 2014. https://tede2.pucsp.br/handle/handle/9480.
Full textIntroduction: hypertension is a highly prevalent disease with serious personal consequences and for social and health care system. Risk factors for the disease are already present in adolescence and, at this age, the most commons are family history of hypertension and overweight. Many studies show that approximately 15% of young people already have high levels of blood pressure (BP) and BP values are associated with body mass index. Objectives: to identify the knowledge that young people who attend High School have on hypertension and to propose strategies to motivate their peers to have healthy attitudes reducing the risk of developing the disease in the future and, thus, leading to primary prevention of hypertension and health promotion. Methods: Forty-eight students participated in the study. We conducted two focus group sessions with second year High School students of three schools in Sorocaba-SP. A public school in the periphery, one technical public school located at down town and a private school located at city prime area, whose social indicators increased in that order. The interviews and discussions were recorded, transcribed and submitted to thematic analysis of Minayo. Results: In the three schools we found that students have a reasonably good knowledge of the disease, its risk factors and consequences. Many of them have relatives with hypertension. Students suggestions to motivate healthy behavior and prevent the disease varied according to the social level of the students and schools, however, all pointed to creative and participatory strategies. At the periphery school students suggested motivators games to be played at classrooms and rap contest with the prevention of hypertension as a central theme. At the technical school predominated suggestions developed in the social networks via the Internet, interactivity, reflection on the subject and the active participation of school and governmental and non-governmental organizations. Students from the private school suggested to use electronic games and challenges that have as subject hypertension and care involving the disease. Conclusions: The high school students make up a rich territory to work on health promotion and primary prevention of prevalent diseases. Students are highly motivated to participate in this educational process
Introdução: A hipertensão arterial (HA) é uma doença muito prevalente, com graves consequências pessoais, sociais e para o sistema de saúde. Os fatores predisponentes para a doença já estão presentes na adolescência e, nesta idade, os mais frequentes são os antecedentes familiares e o excesso de peso. Vários estudos evidenciam que aproximadamente 15% dos jovens já apresentam valores elevados da pressão arterial (PA) e os valores pressóricos estão associados ao índice de massa corporal. Objetivos: Identificar o conhecimento que os jovens que frequentam o ensino médio têm sobre a HA e que estratégias propõem para motivar seus pares a terem atitudes saudáveis reduzindo o risco de desenvolver a doença no futuro. Métodos: Participaram 48 alunos do segundo ano do ensino médio oriundos de três escolas de Sorocaba-SP. Uma estadual localizada na periferia, uma estadual técnica no centro e uma particular localizada em área nobre da cidade. Foram realizados dois Grupos Focais em cada escola. Os depoimentos e discussões foram gravadas, transcritas e submetidas à Análise Temática segundo Minayo. Resultados: Nas três escolas observamos que os alunos têm conhecimentos básicos de fisiologia, dos fatores de risco, das consequências e medidas de prevenção da HA. As sugestões para motivar o comportamento saudável e prevenir a doença variaram de acordo com as escolas e o nível social dos alunos, porém, todas apontaram para estratégias criativas e participativas. Na escola da periferia foram sugeridos jogos motivadores para serem realizados nas salas de aula e concurso de rap tendo a prevenção da HA como tema central. Na escola técnica predominaram as sugestões desenvolvidas nas redes sociais via internet, interatividade, reflexão sobre o tema e a participação ativa da escola e instituições governamentais e não governamentais. Na escola particular, os alunos sugerem utilizar os meios eletrônicos com jogos e desafios que tenham como tema a HA e os cuidados que envolvem a doença. Conclusões: Os alunos do ensino médio compõem um rico território para se trabalhar a promoção de saúde e a prevenção primária de doenças prevalentes. Os estudantes estão muito motivados a participar deste processo educativo
Bacelar, Eloisa Barreto. "Fatores associados ? s?ndrome hipertensiva da gesta??o em adolescentes e adultas jovens da Regi?o Nordeste do Brasil." Universidade Estadual de Feira de Santana, 2016. http://localhost:8080/tede/handle/tede/563.
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Pregnancy in adolescence, especially in younger age groups and vulnerable population groups, can lead to health risks due to clinical and obstetric complications for pregnant, mother and newborn, as well as psychological and socioeconomic repercussions. Objective: To evaluate the possible associations between Hypertensive Syndrome in Pregnancy (HSP) and socio-demographic, pre-natal, and delivery characteristics of teenage and young adults attended to in the public and private health system of Brazil. Methods: An epidemiologic cross-sectional study, hospital-based data and regional level, using data from 54 municipalities of the Northeast region of Brazil from 2011-2012. The records used were obtained from the database of the National Survey on Labor and Delivery, ?Born in Brazil?. The theoretical model used had a three-level hierarchy, and HSP. The distal level included socio-demographic variables: age range, marital status, race/skin color, adequate schooling for age, paid employment, funding for pre-natal visits. The intermediate level included pre-natal variables: Adequacy of prenatal care, previous clinical risk factors and smoking in the first five months. The proximal level consisted of variables related to delivery characteristics: Source of payment of the birth. A multivariate analysis was performed, based on the results of the bivariate analysis and respective p-values with a significance level of <0.20 using the Wald test. Results: Of the 2960 adolescents and young adults, 4,6% (135) presented with Hypertensive syndromes in pregnancy. The mothers without a partner had 1.5 times the odds of developing one of the types of HSP (OR=1.52); those with inadequate schooling had a 1.9 times greater chance of developing HSP (OR = 1.86); and having a previous clinical risk factor resulted in over 21 times the odds of HSP in teenagers and young adults (OR=21.72). Conclusions: These results indicate that HSP may be associated with several determinants. Social (marital status and schooling) and biological (previous clinical risk factors) risk factors were identified. This underscores the importance of guaranteeing women, family support and access to healthcare aiming to guarantee access to pre-natal and delivery care with early diagnosis and treatment, in order to avoid complications and consequently maternal and neonatal morbidity and mortality.
Gravidez na adolesc?ncia, principalmente nas faixas et?rias precoces e em grupos populacionais vulner?veis, pode representar um risco ? sa?de pelas intercorr?ncias cl?nicas ou obst?tricas na gestante, pu?rpera e rec?m-nascido, assim como, repercuss?es psicol?gicas e socioecon?micas. Objetivo: avaliar poss?veis associa??es entre S?ndrome Hipertensiva Espec?fica da Gesta??o (SHEG) e caracter?sticas sociodemogr?ficas, do pr?-natal e do parto de adolescentes e adultas jovens, atendidas no Sistema de Sa?de, P?blico e Privado. M?todo: estudo transversal, de base hospitalar, ocorrido em 54 munic?pios da Regi?o Nordeste do Brasil, no per?odo de 2011 e 2012. Os registros utilizados foram obtidos do Inqu?rito Nacional sobre Parto e Nascimento, ?Nascer no Brasil?. Foi estabelecido um modelo te?rico com tr?s n?veis de hierarquia, tendo a SHEG, como vari?vel desfecho. No n?vel distal, foram inclu?das vari?veis sociodemogr?ficas: faixa et?ria; situa??o conjugal; cor da pele; adequa??o da escolaridade com a idade; trabalho remunerado e financiamento para o pr?-natal; No n?vel intermedi?rio foram inclu?das vari?veis do pr?-natal: adequa??o da assist?ncia; antecedentes cl?nicos de risco e uso de fumo nos primeiros 05 meses. No n?vel proximal, ficaram vari?veis referentes ao parto: fonte de pagamento. An?lise multivariada foi realizada, a partir dos resultados das an?lises bivariadas e respectivos p valores, com n?vel de signific?ncia < 0,20, pelo teste de Wald. Resultados: Do total de 2960 adolescentes e adultas jovens, 4,6% (135) apresentaram SHEG. As pu?rperas sem companheiro apresentaram chance 1,5 vezes maior de desenvolver um dos tipos da SHEG (OR= 1,52); aquelas com escolaridade inadequada apresentaram chance 1,9 vezes maior de ocorr?ncia da SHEG (OR = 1,86); ter antecedente cl?nico de risco, aumentou em 21 vezes a chance de ocorrer SHEG nas adolescentes e adultas jovens (OR = 21,72). Conclus?es: os resultados apontaram que m?ltiplos determinantes podem estar associados ? SHEG. Foram identificados fatores de risco social (situa??o conjugal e escolaridade) e biol?gico (antecedentes cl?nicos de risco). Ressalta a import?ncia de garantir ?s mulheres, apoio familiar e assist?ncia ? sa?de, visando garantir o acesso ao pr?-natal e parto com diagn?stico e tratamento precoces, evitando complica??es e morbimortalidade materna e neonatal. Palavras-
Chaves, EmÃlia Soares. "Accompaniment of children and adolescents with family history of arterial hypertension." Universidade Federal do CearÃ, 2007. http://www.teses.ufc.br/tde_busca/arquivo.php?codArquivo=1041.
Full textThe presence of alterations of blood pression in children and adolescents has shown that arterial hypertension may have its initial history in this life stage. It is believed that the harmful effects of hypertension, when they exist, could be minimized if their presence was detected precociously, if the evaluation of blood pressure was done periodically and if it were a mandatory part of the consultations to children and adolescents. Epidemiologic studies about blood pressure in childhood also reveal that the persistence of high values in this stage of life reinforces the idea that hypertension in adulthood is a direct result of hypertension in childhood. One aimed to follow children and adolescents with family history of arterial hypertension for a long time, analyzing the evolution of percentage/classification of blood pressure in children and adolescents. The longitudinal/prospective study was developed in a poor community of Fortaleza-CearÃ. The blood pressure was evaluated in five meetings: first semester of 2004; first semester of 2005; second semester of 2005; first semester of 2006 and second semester of 2006. The data collection was conducted at home in pre-determined periods. By the data obtained, it was possible to confirm that children and adolescents can have high blood pressure, even without an specific cause and no sinthomatology. The group presented was composed by 141 participants, in the majority females (71). The ages varied from 6 to 21 years old in the period of accompaniment. The highest values of blood pressure were found in the male patients. A bigger percentage of the children and adolescents were relatives of second degree of arterial hypertension bearers (48.9%), and these showed the biggest average values of SBP and DBP. Out of 92 children, 30 remained with no alterations of the percentages of blood pressure in all evaluations; 42 presented alterations starting from the 3rd evaluation; eight showed alterations of the percentage only on the last evaluation conducted; 11 showed alterations of the percentages of blood pressure in all the evaluations and 20 presented alterations of the percentages in some evaluation, but in the last one showed normal percentage of blood pressure. Out of 49 adolescents, 32 remained with no alterations of the percentages of blood pressure in all evaluations; eight presented alterations starting from the 3rd evaluation; two individuals showed alterations of the percentages only on the last evaluation; six presented alterations of the percentages of blood pressure in all the evaluations and three presented alterations of percentages in some evaluation, but in the last one presented normal blood pressure percentage. It was not possible to identify statistic significance concerning the risk factors presented during the accompaniment, apparently being the family factor the biggest contribution to the high values of blood pressure. It is confirmed the necessity of a regular monitoring of children and adolescentsâ blood pressure and, even without significant statistic correlation, the precocious identification of risk factors such as overweight, obesity, sedentarism, positive history to hypertension, smoking and drinking in the prevention of future cardiovascular events.
A presenÃa das alteraÃÃes da pressÃo arterial em crianÃas e adolescentes tem evidenciado que a hipertensÃo arterial pode ter sua histÃria inicial nesta etapa de vida. Acredita-se que os efeitos deletÃrios da hipertensÃo, no caso de sua existÃncia, poderiam ser minimizados se a sua presenÃa fosse detectada precocemente, bastando para isso que a avaliaÃÃo da pressÃo arterial fosse feita periodicamente e constasse como parte obrigatÃria das consultas a crianÃas e adolescentes. Estudos epidemiolÃgicos sobre pressÃo arterial na infÃncia tambÃm revelam que a persistÃncia de valores elevados nesta fase da vida reforÃa a hipÃtese de que a hipertensÃo em adultos à resultado direto de hipertensÃo na infÃncia. Teve-se como propÃsito acompanhar por tempo prolongado crianÃas e adolescentes com histÃria familiar de hipertensÃo arterial, Analisando a evoluÃÃo dos percentis/classificaÃÃo de pressÃo arterial de crianÃas e adolescentes. O estudo longitudinal/prospectivo foi desenvolvido em uma comunidade da periferia de Fortaleza- CearÃ. A pressÃo arterial foi avaliada em cinco encontros: primeiro semestre de 2004; primeiro semestre de 2005; segundo semestre de 2005; primeiro semestre de 2006 e no segundo semestre de 2006. A coleta de dados foi realizada no domicÃlio em perÃodos prÃ-determinados. Pelos dados obtidos, foi possÃvel confirmar que crianÃas e adolescentes podem ter pressÃes arteriais elevadas, mesmo sem uma aparente causa especÃfica e sem sintomatologia. O grupo apresentado foi composto por 141 participantes, na sua maior parte do sexo feminino (71). As idades variaram de 6 a 21 anos no decorrer do perÃodo de acompanhamento. Os valores mais elevados de pressÃo arterial mostraram-se naqueles do sexo masculino. Um percentual maior das crianÃas e adolescentes tinha parentesco de 2 grau com o portador de hipertensÃo arterial (48,9%), sendo estes os que mostraram maiores valores mÃdios de PAS e de PAD. Das 92 crianÃas, 30 crianÃas permaneceram sem alteraÃÃes dos percentis de pressÃo arterial em todas as avaliaÃÃes; 42 apresentaram alteraÃÃes a partir da 3 avaliaÃÃo; oito mostraram alteraÃÃo dos percentis somente na Ãltima avaliaÃÃo realizada; 11 apresentaram alteraÃÃes dos percentis de pressÃo arterial em todas as avaliaÃÃes e 20 apresentaram alteraÃÃo dos percentis em alguma avaliaÃÃo, mas na Ãltima mostraram percentis normais de pressÃo arterial. Dos 49 adolescentes, 32 permaneceram sem alteraÃÃes dos percentis de pressÃo arterial em todas as avaliaÃÃes; oito apresentaram alteraÃÃes a partir da 3 avaliaÃÃo; dois indivÃduos mostraram alteraÃÃo dos percentis somente na Ãltima avaliaÃÃo; seis apresentaram alteraÃÃes dos percentis de pressÃo arterial em todas as avaliaÃÃes e trÃs apresentaram alteraÃÃo dos percentis em alguma avaliaÃÃo, mas na Ãltima mostraram percentis normais de pressÃo arterial. NÃo foi possÃvel identificar significÃncia estatÃstica em relaÃÃo aos fatores de risco apresentados ao longo do acompanhamento, parecendo ser o fator familiar o maior contribuinte para os valores elevados das pressÃes arteriais. Confirma-se a necessidade de monitoraÃÃo da pressÃo arterial rotineira de crianÃas e adolescentes e, mesmo sem correlaÃÃo estatÃstica significativa, a identificaÃÃo precoce de indicadores de risco como sobrepeso, obesidade, sedentarismo, histÃria positiva para hipertensÃo, uso de fumo e bebida alcoÃlica na prevenÃÃo de eventos cardiovasculares futuros.
Collese, Tatiana Sadalla. "Efeito do consumo de frutas, legumes e verduras na saúde cardiovascular em adolescentes: uma revisão sistemática." Universidade de São Paulo, 2017. http://www.teses.usp.br/teses/disponiveis/5/5137/tde-11052017-162605/.
Full textBackground: Fruit and vegetable consumption is infrequent among adolescents, and the possible effect of this consumption on cardiovascular health during this age group is undefined. Aim: To investigate the association between fruit and vegetable consumption on cardiovascular risk indicators in adolescents (abdominal obesity, hyperglycemia, hypertriglyceridemia, dyslipidemia, hypertension and metabolic syndrome). Methods: This systematic review was registered in PROSPERO (CRD42013004818), and a systematic review searching electronic databases (Biomed Central, CINAHL, MEDLINE, PsycINFO, Scopus, Web of Science) from inception to December 7, 2015 was conducted. The search strategy used the following sets of descriptors related to: age group; fruits and vegetables; cardiovascular risk indicators; cross-sectional and cohort studies. Eligibility criteria were: Articles in English, Spanish and Portuguese; original studies; sample of adolescents (10-19 year-old according to World Health Organization); descriptors according to the cardiovascular risk indicators. Potentially eligible articles were selected by two reviewers separately. Results: A total of 5632 articles were identified. After reading the titles and abstracts, 102 potentially relevant articles remained for full reviewed. After selection, 11 articles meeting the inclusion criteria were included (10 cross-sectional; 1 cohort). The main reasons for study exclusion were misclassifying adolescence, assessing fruits and vegetables as part of a food pattern (for example, together with fish, dairy, or cereal), and cardiovascular risk indicators that were not specified or that differed from the definitions established. Articles evaluated fruit and vegetable intake in diverse units, using food frequency questionnaires (54.5%), 24-hour-dietary-recalls (27.3%), and food records (18.2%). In addition, fruit and vegetable consumption were assessed separately (54.5%), together (36.4%), or only vegetables (9.1%); and 1 article included fruit juice (9.1%). A third of the studies showed significant inverse associations of fruit and vegetable intake with systolic blood pressure, abdominal obesity, triglycerides, HDL cholesterol, and metabolic syndrome. Conclusion: The associations between fruit and vegetable consumption and adolescent cardiovascular risk indicators are inconsistent. Since the benefits of this consumption are well established in adult cardiovascular health, further studies are necessary, addressing high methodological quality to better understand this phenomenon in adolescents
Simanauskas, Kazys. "Paauglių pirminės arterinės hipertenzijos sąsajos su fizine ir psichine sveikata bei širdies ir kraujagyslių ligų rizikos veiksniais." Doctoral thesis, Lithuanian Academic Libraries Network (LABT), 2013. http://vddb.laba.lt/obj/LT-eLABa-0001:E.02~2013~D_20130916_082410-88506.
Full textHypertension is one of the main causes of cardiovascular disease and the reason of early death in the world. Growing epidemiology data support a correlation between blood pressure at childhood and adolescence with the incidence of hypertension at adulthood. This is the first study in Lithuania presenting complex assessment of physical and mental health of healthy adolescents as well as of those with primary arterial hypertension. We found out that in case of primary arterial hypertension in adolescence development of early structural and functional changes of internal carotid artery takes place; these changes are determined by arterial hypertension, smoking, alcohol consumption and activity of inflammation process. The influence of arterial hypertension of the platelets aggregation function, reaction of degranulation and formation of platelets-monocytes complexes in adolescents was assessed for the first time. It was demonstrated in the study that arterial hypertension and increased body mass has an effect on behavioural and emotion disorders and may increase cardiovascular risk.
Thopy, Amanda J. "Effects of the DASH diet on brachial artery flow mediated dilation in adolescents with pre-hypertension and hypertension." University of Cincinnati / OhioLINK, 2011. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1307125200.
Full textZhu, Xinyu. "The Relationship between Parenting Practices around Eating and Adolescent’s Eating Behavior and Adherence to a Blood Pressure Lowering Diet among Adolescents with Hypertension." University of Cincinnati / OhioLINK, 2015. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1439309800.
Full textGraeter, Margaret. "The relationship between dietary self-monitoring and blood pressure changes in adolescents with pre-hypertension or hypertension participating in a nutrition intervention emphasizing the DASH diet." University of Cincinnati / OhioLINK, 2011. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1312483409.
Full textWoods, Rachel P. "Use of the Glycemic Index and the DASH diet to Lower Blood Pressure in Adolescents with Hypertension and Pre-Hypertension." University of Cincinnati / OhioLINK, 2009. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1259077919.
Full textBaba, Reizo, Masaaki Koketsu, Masami Nagashima, Akiko Tamakoshi, and Hiroshi Inasaka. "Role of Insulin Resistance in Non-Obese Adolescents." Nagoya University School of Medicine, 2010. http://hdl.handle.net/2237/14178.
Full textWilliams, Daniel Patrick 1964. "Body composition, blood pressure and their tracking in children and adolescents." Thesis, The University of Arizona, 1989. http://hdl.handle.net/10150/277028.
Full textGonçalves, Valdelice Maria. "Fatores de risco cardiovascular em adolescentes estudantes da rede pública municipal de ensino de Brodowski-SP." Universidade de São Paulo, 2012. http://www.teses.usp.br/teses/disponiveis/17/17139/tde-30072012-221211/.
Full textIntroduction: Metabolic abnormalities related to the cardiovascular system, specially coronary artery disease (CAD) secondary to atherosclerosis, are worldwide the main cause of morbidity and mortality. Similarly to what happens among adults, cardiovascular risk factors are also present in children and adolescents, as obesity, abdominal obesity and arterial hypertension. Objective: To investigate the presence of some variables classified as cardiovascular risk factors in adolescents, registered in public schools in the city of Brodowski-SP. Methodology: A cross-sectional study was carried out with 668 students aged 10 to 16 years from public schools of Brodowski-SP. Anthropometric data (weight, height and waist circumference) were collected. The adolescents were classified according to their nutritional status by the age-BMI scores; body composition was evaluated by bioimpedance and blood pressure by an automated equipment. Data were analyzed by the Fisher Exact Test and logistic regression (crude and adjusted odds ratio). Results: The predominant age-group was 11 to 13 years. Data about overweight and obesity were alarming and comprise 32.3% of the adolescents, being 22.6% with overweight and 9.7% obesity. Hypertension was found in 26 (3.6%) students and 116 (17.4%) were classified as pre-hypertension; in the overall, 142 (21.3%) students had elevated blood pressure. The excess of body fat detected by bioimpedance was found in 20.7% of the students. The logistic regression model (adjusted odds ratio) showed significant association between age-group (students from 14-16 years), abdominal obesity, presence of weight excess, and maternal level of education with blood pressure abnormality. Conclusion: Prevalence rates of weight excess, abnormal blood pressure, excess of body fat and abdominal obesity were relevant in the study population. There is a need for interventions focused in the control and prevention of these conditions considered cardiovascular risk factors.
Kampman, Katherine L. "Comparing Different Approaches to Promoting Adherence to a DASH Diet in Adolescents with Hypertension." University of Cincinnati / OhioLINK, 2011. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1307125122.
Full textPinto, Rafael Lavourinha. "Consumo de sódio e potássio e alteração da pressão arterial em adolescentes escolares do município de Niterói – RJ." Niterói, 2017. https://app.uff.br/riuff/handle/1/5042.
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Prefeitura da Cidade de Sumidouro. Secretaria Municipal de Saúde
INTRODUÇÃO: As doenças crônicas não transmissíveis (DCNT) são as principais causas de morte no mundo e a hipertensão arterial é reconhecida como principal fator de risco para morbidade e mortalidade. A hipertensão arterial ocorre em faixas etárias precoces, e evidências apontam que o padrão alimentar inadequado verificado entre adolescentes está associado à elevação dos níveis de pressão. OBJETIVO: Investigar a associação entre consumo alimentar e pressão arterial em adolescentes estudantes de escola pública do município de Niterói-RJ. MÉTODOS: Trata-se de um estudo transversal envolvendo escolares de uma escola municipal de Niterói-RJ. Para a análise do consumo alimentar, foi aplicado o recordatório de 24h em dois dias não consecutivos. Também foram coletados dados antropométricos e pressão arterial em um único momento. O consumo usual de nutrientes, sódio e potássio, foi estimado partindo-se de dados do consumo atual, utilizando-se o método proposto pelo National Cancer Institute (NCI), para lidar com a variabilidade intraindividual. Os itens alimentares foram classificados e agrupados em 31 grupos, de acordo com semelhanças nas características nutricionais. A associação entre consumo de nutrientes e pressão arterial foi investigada por modelos de regressão logística. O pacote estatístico SPSS (v. 21.0) e o software SAS (v. 9.3) foram utilizados para a análise dos dados. Foi considerada a significância estatística de <0,05 para todos os testes. RESULTADOS: A amostra foi constituída de 347 adolescentes, sendo 51% do sexo masculino com média de idade de 12,7 anos (DP=1,6). Meninas apresentaram maior média de pressão arterial diastólica (PAD) (p<0,05). Maior percentual de sobrepeso / obesidade foi observado nos adolescentes que apresentaram PA elevada (p<0,05), com prevalência de 38,8% de adolescentes acima da mediana para PAS (p<0,05) e 43,8% acima da mediana para PAD (p<0,05). O total de sódio (p=0,012) e potássio (p=0,0015) consumido pelos meninos foi superior ao consumo de sódio e potássio realizado pelas meninas. Com relação à razão Na/K, foi observada diferença estatisticamente significativa quando comparados os adolescentes com PAS abaixo e acima da mediana (p=0,0071). Os grupos arroz, feijão, bebidas, doces e açúcares, leite, pães, refrigerantes, carne bovina, aves e embutidos apresentaram maior percentual de contribuição de sódio. Os grupos arroz, feijão, bebidas, doces e açúcares, leite, pães, refrigerantes, carne bovina, aves e bolos e biscoitos doces e recheados apresentaram maior percentual de contribuição de potássio. Os grupos dos embutidos, dos pães e da carne bovina estão classificados com maior densidade de sódio/100g de alimento. Os grupos feijão, carne bovina e aves, estão classificados com maior densidade de potássio em sua composição. As bebidas adoçadas e os refrigerantes apresentaram o maior percentual de contribuição de sódio. Os grupos com maior percentual de contribuição de sódio foram consumidos em casa, exceto biscoitos salgados e pizzas, com maior consumo na escola. Os grupos que mais contribuem para o consumo total de potássio também são consumidos, em maior parte, no domicílio, com exceção do grupo dos pães, mais comumente consumido no ambiente escolar. As bebidas adoçadas e os refrigerantes se destacam pela alta contribuição para o consumo total de potássio. Além disso, são muito consumidos na escola. A razão de chance para a razão Na/K é 0,26 (p=0,0173). Ou seja, a cada aumento da Na/K em 1 unidade, há uma redução de 74% na chance de aumento da PAS acima da mediana (p=0,0173). Com relação ao sexo, nas meninas, o aumento de 1 unidade de sódio, potássio e razão Na/K está associado à chance duas vezes maior de apresentar PAD acima da mediana (p<0,05). Já em relação ao IMC, o aumento em 1 unidade está associado ao aumento de aproximadamente 12% na chance de apresentar PAS e PAD acima da mediana (p<0,05). CONCLUSÃO: A classificação de sobrepeso/obesidade está associada à elevação da pressão arterial. Os resultados encontrados sugerem que os níveis pressóricos devam ser monitorados em faixas etárias mais precoces, e políticas de educação nutricional para a promoção da alimentação saudável sejam implementadas para essa população
The noncommunicable diseases (NCD) are the main cause of death in the world, and the hypertension is known as the main risk factor to morbidity and mortality. Studies have characterized the emergence of the arterial hypertension in early age groups, and evidences show that the inadequate food pattern that was checked among adolescents is associated to the increase in levels of blood pressure. OBJECTIVE: Investigate the association between food consumption and arterial pressure in adolescents from a public school situated in Niterói-RJ. METHODS: A cross-sectional study involving students from a municipal school in Niterói-RJ. Food consumption was assessed using 24-hour dietary recall questionnaire, with replication in two non-consecutive days. Also, anthropometric and arterial pressure data were collected at once. The habitual consumption of nutrients, sodium and potassium, was estimated based on recent consumption data, using the method proposed by the National Cancer Institute (NCI), to deal with the intra-individual variability. The food items were classified and grouped in 31 groups, according to similarities in their nutritional characteristics. The association between nutrients consumption and arterial pressure was investigated using logistic regression models. The statistical package SPSS (v. 21.0) and the software SAS (v.9.3) were used to data analysis. The statistical significance of <0,05 was considered to all the tests. RESULTS: The sample was composed of 347 adolescents, being 51% male with average age of 12,7 years old (SD=1,6). Girls had higher diastolic arterial pressure mean (DAP) (p<0,05). A higher percentage of overweight /obesity was noticed in adolescents who had high arterial pressure (p<0,05), with prevalence of 38,8% of adolescents over the median to Systolic Arterial Pressure (SAP) (p<0,05) and 43,8% over the median to DAP (p<0,05). The total of sodium (p=0,012) and potassium (p=0,0015) consumed by the boys was higher than the total of sodium and potassium consumed by the girls. In relation to the Na/K ratio, a statistically significant difference was found when comparing the adolescents with SAP above and below the median (p=0,0071). The rice, beans, beverages, sweets and sugaries, milk, bread, soft drinks, beef, poultry and processed meat groups had higher sodium contribution percentage. The rice, beans, beverages, sweets and sugaries, milk, breads, soft drinks, beef, poultry, cakes and sweet and filled cookies groups had higher potassium contribution percentage. The groups of processed meat, breads and beef are classified with higher density of sodium /100g of food. The groups of beans, beef and poultry are classified with higher density of potassium in their composition. The sugary drinks and soft drinks had the higher contribution percentage of sodium. The groups with higher contribution percentage of sodium were consumed at home, except salty cookies and pizzas, which are mostly consumed at school. The groups that contribute the most to the total consumption of potassium are also mostly consumed at home, except the group of breads, which is mostly consumed at school. The sugary drinks and soft drinks stand out for their high contribution to the total consumption of potassium. Besides that, they are widely consumed at school. The odds ratio to the Na/K ratio is 0,26 (p=0,0173). In other words, in each increase of Na/K ratio in 1 unit, there is a decrease of 74% in the chance of an increase of SAP over de median (p=0,0173). In relation to the gender, in females, the increase of 1 unit of sodium, potassium and Na/K ratio is linked to a two times higher chance of having DAP over the median (p<0,05). In relation to the BMI, the increase in 1 unit is linked to the increase of approximately 12% in the chance of having SAP and DAP over the median (p<0,05). CONCLUSION: Overweight/obesity is associated to the increase in arterial pressure. The results found suggest that the pressoric levels are monitored in early age groups, and that nutritional education politics to promote health eating are implemented to this population
Lilly, Eamon C. "Change in Major Food Sources of Sodium in Response to a Dietary Intervention to Lower Blood Pressure in Adolescents." University of Cincinnati / OhioLINK, 2019. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1553250336047347.
Full textBlaut, Jessica A. "The relationship between diet self-monitoring and healthful dietary pattern changes in adolescents with elevated blood pressure." University of Cincinnati / OhioLINK, 2013. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1367937841.
Full textVallandro, Claudia Funck. "CAPACITAÇÃO PARA A AFERIÇÃO DA PRESSÃO ARTERIAL DURANTE CONSULTA PEDIÁTRICA: INSTRUMENTO AO DIAGNÓSTICO PRECOCE DA HIPERTENSÃO INFANTO-JUVENIL." Centro Universitário Franciscano, 2017. http://www.tede.universidadefranciscana.edu.br:8080/handle/UFN-BDTD/618.
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Blood pressure measure in children and adolescentes is recommended by relevant medical associations, but it isn´t performed in most of routine pediatric evaluations. Unknowing of its measure importance and specific thecnical questions are barriers for this procedure. This study aimed to capacitate and implement blood pressure measure in children and adolescents during routine evaluations in General Pediatric ambulatory of an educational hospital. A study was done using action-research as methodological tool for the professional capacitation. In conclusion, childhood arterial hypertension is a subject that is unnoticed, and health team that works with this social segment generally ignores it. With this study, it was possible to capacitate health professionals for blood pressure measurement during routine pediatric consultation, allowing the implementation of diagnostic triage routines, improving the medical assistance quality in health services.
A medida da pressão arterial em crianças e adolescentes é recomendada em Diretrizes de importantes entidades médicas, mas não é realizada na maioria das consultas pediátricas. O desconhecimento da importância desta medida, além de questões técnicas específicas da faixa etária, são barreiras para a sua implementação. Com este estudo, objetivou-se capacitar e implementar a aferição da pressão arterial em crianças e adolescentes durante consulta pediátrica de rotina no ambulatório de Pediatria Geral de um Hospital Universitário. A metodologia utilizada foi a pesquisa-ação, designada como ferramenta metodológica para a capacitação profissional. Concluindo, a hipertensão arterial na infância e na adolescência é um tema que passa despercebido, e a equipe de saúde que labora com esse segmento social praticamente o desconhece. Com este estudo, foi possível capacitar os profissionais de saúde para a aferição da pressão arterial durante consulta pediátrica de rotina, permitindo a implementação de rotinas de triagem diagnóstica, melhorando a qualidade da assistência médica nos serviços de saúde.
Souza, Maria Goretti Barbosa de [UNIFESP]. "Medida da pressão arterial em crianças e adolescentes: recomendações das diretrizes de hipertensão arterial e prática médica atual." Universidade Federal de São Paulo (UNIFESP), 2009. http://repositorio.unifesp.br/handle/11600/9808.
Full textConselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)
Fundação de Amparo à Pesquisa do Estado de Alagoas (FAPEAL)
Fundamento: As diretrizes de Hipertensão Arterial Sistêmica (HAS) recomendam a medida da pressão arterial em toda avaliação clínica após os três anos de idade. Objetivo: Identificar, em crianças e adolescentes (7 a 17 anos, rede pública e privada de ensino), a freqüência de indivíduos já submetidos à medida da pressão arterial (MPA), o número de vezes, os locais em que foi realizada a aferição e o resultado informado. Métodos: Estudo transversal. Amostragem por conglomerados em 40 escolas, nível fundamental e médio, sorteadas. Cálculo da amostra baseado na prevalência esperada de HAS em crianças e adolescentes. Protocolo: questionário sobre realização prévia de MPA (em caso afirmativo, quantas vezes, quando foi a última medida, o local e o resultado da medida) e duas MPA. Variáveis independentes: sexo; faixa etária; classe econômica; escola pública ou privada. Resultados: Amostra constituída de 1253 estudantes; 1215 responderam ao questionário (97%); 531 do sexo masculino; média de 12,4 ± 3 anos. Prevalência de HAS: 7,7%; 348 estudantes (29%) já haviam medido a PA (54% 1 vez; 35% 2 a 4 vezes; 11% 5 ou mais); 53% há menos de 1 ano. Posto de Saúde, residência, hospital e consultório foram os locais mais mencionados (27%, 16%, 15% e 14%, respectivamente). Houve associação significante entre prévia MPA com faixa etária de 15 a 17 anos, classes econômicas A e B e ser estudante de escola privada. Conclusões: Apesar das recomendações, há baixa freqüência de MPA (29%) em crianças e adolescentes, demonstrando que a mesma não foi ainda incorporada na prática clínica.
Rationale: There are pediatric consensus statements and guidelines recommendations to measure blood pressure of children and adolescents at every examination after age 3 years. Objective: To determine, in a school-based sample of children and adolescents, aged from 7 to 17 years, of both gender, in public and private schools, the frequency of students already submitted to blood pressure measure. Methods: A cross-sectional study was carried out, sampling from a population pool of elementary and middle schools, randomly selected. The sample was calculated based on the expected prevalence of hypertension for the age group. Data were collected through a questionnaire. Blood pressure was measured twice and hypertension was defined as mean systolic and/or diastolic blood pressure over the 95th percentile. Independent variables studied: sex; age groups; economic status; public/private school. Results: The final sample included 1253 students. The response rate was 97%: 1215 students; 531 males; mean age 12,4±3 years (236 from 7 to 9 years; 638 from 10 to 14 years; 341 from 15 to 17 years). Prevalence of hypertension was 7.7%; 348 students (29%) were already submitted to blood pressure measures (54% once; 35% 2 to 4 times; 11% 5 or more times). High economic status, private school and adolescent group were significantly associated to previous blood pressure measure. Conclusion: Despite of pediatric consensus statements and guidelines recommendations about importance of blood pressure measure at every examination after age 3 years, there is a very low frequency of this practice (29%) in children and adolescents.
TEDE
BV UNIFESP: Teses e dissertações
Ash, Kathleen. "The relationship between family history of disease and adherence to a DASH dietary pattern by adolescents with high blood pressure." University of Cincinnati / OhioLINK, 2013. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1377873666.
Full textThomas, Ingrid M. "Changes in Food Sources of Calcium, Potassium, and Magnesium in the Diets of Adolescents with Hypertension in Response to a Behavioral Nutrition Intervention Emphasizing Fruit, Vegetable, and Low-fat Dairy Foods." University of Cincinnati / OhioLINK, 2011. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1311775395.
Full textPóvoa, Thaís Inacio Rolim. "Diferentes métodos de medida da pressão arterial em adolescentes e sua correlação com perfil metabólico e aspectos ecocardiográficos." Universidade Federal de Goiás, 2013. http://repositorio.bc.ufg.br/tede/handle/tede/4278.
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Conselho Nacional de Pesquisa e Desenvolvimento Científico e Tecnológico - CNPq
Introduction: Blood pressure (BP) varies according to physiological and environmental stimulations and the office BP measurement, most utilized method, does not include this variation. Multiple measurement methods such as ambulatory BP monitoring (ABPM) and home BP monitoring (HBPM) have aided in the attempt of attaining higher diagnosis and prognosis accuracy. The knowledge of BP alterations in adolescents and their implications for target organs are even more limited, and these methods provide good perspectives regarding sustained hypertension and also more unusual types such as white-coat hypertension (WCHT). Objectives: To assess BP in adolescents through office measurement, HBPM, ABPM and test the agreement among these methods. To compare and investigate the correlation of blood pressure measurements with the metabolic profile and echocardiographic aspects between normotensives, patients with sustained HT and with WCHT. Method: the selection included adolescents from a representative sample (n=1025) aged 12 to 18, from Goiânia, Brazil, with office BP and/or home measurement percentile >90 and also a group of normotensives, according to normality values proposed by 4th Task Force. BP was measured twice in separate periods, considering the second measurements’ mean. HBPM (06 days, duplicated measures in the morning and in the evening, regarding the minimum of 12). The selected teenagers performed ABPM and were allocated in the following groups: sustained HT (percentage 95 in office measurement, HBPM and ABPM); WCHT (percentage 95 in office measurement, <90 HBPM and ABPM) and normotensives (percentage <90 in the three methods). Semi-automatic machines, OMRON, HEM-705CP (office and HBPM) and Spacelabs, 90207 (ABPM). Statistical analysis: Pearson’s chi-square, Kolmogorov Smirnov, paired Student’s-t test, Bland-Altman, Mountain Plots, ANOVA One Way with Bonferroni correction and Pearson’s coefficient. Considered significant: p<0.05. Results: in total samples (n=133), values of office measurement (SBP:127.3±13,8; DBP:74.4±9.5 mmHg); HBPM (SBP:120.3±12.6 DBP:69.4±7.7mmHg) and daytime ABPM (SBP:121.5±9.8; DBP: 70.2±6.6mmHg). Bland-Altman’s graphs show good agreement between HBPM and daytime ABPM. In the comparison of metabolic and echocardiographic aspects, being 65 adolescents evaluated, which 10 had HT, 22 had WCHT and 33 normotensives. BMI: HT (28.5±6.3), WCHT (22.1±3.7) and normotensives (20.7±3.5 kg/m2); HOMA-IR: HT (2.8±1.8), WCHT (2.6±1.2) and normotensives (1.8±1.1); Fasting glycaemia: HT (83.1±8.8), WCHT (88.7±8.7) and normotensives (83.2±6.7 cm); Total cholesterol: HT (183.1±57.8), WCHT (165.1±32.8) and normotensives (150.7±23.4mg/dL); Triglycerides: HT (156.6±107.1), WCHT (98.2±47.9) and normotensives (63.3±19.8 mg/dL); Left ventricular mass index (LVMI): HT (62.4±12.1), WCHT (51.1±12.1) and normotensives (53.6±13.0 g/m2). Differences found: LVMI (HT and WCHT, p=0.026); LV mass (HT and normotensives, p=0.006; HT and WCHT, p=0.014); fasting glycaemia (WCHT and normotensives, p=0.034); total cholesterol (HT and normotensives, p=0.029); triglycerides (HT and normotensives, p<0.001; HT and WCHT, Abstract xvi p=0.012). Conclusion: Office measurements must be used as screening method in adolescents with BP measurements above normal and the values must be confirmed through ABPM or HBPM. Sustained hypertension already harms the metabolic and cardiovascular health of teenagers and WCHP seems to be an intermediate situation, nevertheless, it deserves attention due to its metabolic risk.
Introdução: A pressão arterial (PA) varia em razão de estímulos fisiológicos e ambientais e a medida casual, método mais utilizado, não abrange esta variação. Métodos de múltiplas medidas como a Monitorização Ambulatorial da PA (MAPA) e a Monitorização Residencial da PA (MRPA) têm contribuído na busca por maior precisão ao diagnóstico e prognóstico. O conhecimento das alterações da PA em adolescentes e suas implicações para os órgãos alvo é ainda mais limitado e estes métodos abrem boas perspectivas, em relação à hipertensão sustentada e também a tipos menos comuns como a hipertensão do jaleco branco (HAJB). Objetivos: avaliar a PA em adolescentes pela medida casual, MRPA e MAPA e testar a concordância entre os métodos. Comparar e investigar a correlação dos valores pressóricos com perfil metabólico e aspectos ecocardiográficos entre sujeitos normotensos, com HA sustentada e HAJB. Método: a partir de amostra (n=1025) representativa dos adolescentes de 12 a 18 anos incompletos de Goiânia, Goiás, Brasil, foram selecionados aqueles com PA casual e/ou residencial com percentil >90 e ainda um grupo de normotensos, segundo os valores de normalidade propostos pela Fourth Task Force. PA casual aferida duas vezes em dois momentos distintos, e considerada a média das segundas medidas. MRPA (06 dias, medidas duplicadas no período matutino e noturno; considerado o mínimo de 12). Os adolescentes realizaram a MAPA e foram alocados nos grupos: HA sustentada (percentil 95 na casual, MRPA e MAPA); HAJB (percentil 95 na casual, <90 na MRPA e MAPA) e normotensos (percentis <90 nos três métodos). Aparelhos semiautomáticos, OMRON, HEM-705CP (casual e MRPA) e o Spacelabs, 90207 (MAPA). Análise estatística: Qui-quadrado de Pearson, Kolmogorov Smirnov, t-student pareado, Estratégia de Bland Altman, Mountain Plots, ANOVA One Way com correção de Bonferroni e coeficiente de Pearson. Significante: p<0,05. Resultados: na amostra total (n=133), valores da medida casual (PAS:127,3±13,8; PAD:74,4±9,5 mmHg); MRPA (PAS:120,3±12,6; PAD:69,4±7,7mmHg) e MAPA-diurna (PAS:121,5±9,8; PAD: 70,2±6,6mmHg). Os gráficos de Bland Altman mostraram boa concordância entre MRPA e MAPA-diurna. Na comparação dos aspectos metabólicos e ecocardiográficos, avaliados 65 adolescentes, sendo 10 com HA, 22 com HAJB e 33 normotensos. IMC: HA (28,5±6,3), HAJB (22,1±3,7) e normotensos (20,7±3,5 kg/m2); HOMA-IR: HA (2,8±1,8), HAJB (2,6±1,2) e normotensos (1,8±1,1); Glicemia de jejum: HA (83,1±8,8), HAJB (88,7±8,7) e normotensos (83,2±6,7 cm); Colesterol total: HA (183,1±57,8), HAJB (165,1±32,8) e normotensos (150,7±23,4mg/dL); Triglicérides: HA (156,6±107,1), HAJB (98,2±47,9) e normotensos (63,3±19,8 mg/dL); Índice de massa de ventrículo esquerdo (IMVE): HA (62,4±12,1), HAJB (51,1±12,1) e normotensos (53,6±13,0 g/m2). Diferenças encontradas: IMVE (HA e HAJB, p=0,026); massa de VE (HA e normotensos, p=0,006; HA e HAJB, p=0,014); glicemia de jejum (HAJB e normotensos, p=0,034); colesterol total (HA e normotensos, p=0,029); triglicérides (HA e normotensos, p<0,001; HA e HAJB, p=0,012). Conclusão: A medida casual deve ser usada como triagem em adolescentes com PA acima dos valores de normalidade e os Resumo xiv valores devem ser confirmados pela MAPA ou MRPA. A hipertensão sustentada já começa gerar prejuízos à saúde metabólica e cardiovascular de adolescentes e a HAJB parece ser uma situação intermediária, mas requer atenção por oferecer risco metabólico.
Moussa, Iman. "Behavioral Skills Compliance and Blood Pressure Outcomes in Adolescents with Elevated Blood Pressure Participating in a Dietary Intervention Focusing on the DASH Diet." University of Cincinnati / OhioLINK, 2009. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1249948606.
Full textGoins, Laura K. "The Effect of DASH Dietary Adherence and Participant Characteristics on CVD Risk Factor Response to a DASH Dietary Intervention in Adolescents with Elevated Blood Pressure." University of Cincinnati / OhioLINK, 2017. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1504871786313111.
Full textLee, Shirleatha T. "The effects of glucose tolerance, hypertension, and race on heart rate variability, QT interval duration, and left ventricular hypertrophy in overweight-obese adolescents." View the abstract Download the full-text PDF version, 2009. http://etd.utmem.edu/ABSTRACTS/2009-005-Lee-index.htm.
Full textTitle from title page screen (viewed on August 27, 2009). Research advisor: Patricia A. Cowan, Ph.D. Document formatted into pages (x, 71). Vita. Abstract. Includes bibliographical references (p. 56-70).
Pinto, Renata Paulino. "Prevalência da obesidade e hipertensão arterial em crianças e adolescentes no município de Ribeirão Preto - SP." Universidade de São Paulo, 2015. http://www.teses.usp.br/teses/disponiveis/17/17139/tde-29102015-142959/.
Full textIntroduction: In recent decades, deaths from CDNT increased three times in the Brazilian county. The objective of the study was to identify the prevalence of obesity and high blood pressure in the population of children and adolescents students of the county school of Ribeirão Preto/SP. Methods: A cross-sectional study was conducted with 505 children / adolescents, the age group 10-16 years who attended state schools in Ribeirão Preto/SP. Data collection was conducted through field research with visits to schools and interviews of selected students over the years 2013 and 2014. Anthropometric measurements (weight, height, waist, and hip) and blood pressure levels were measured for all participants. Results: Approximately 53% (n=265) of the students were male and 47 % (n 240) were female, with a mean age of 12.74 years. There was change in body weight in 30.9 % of the study population, and 18.22 % were overweight and 12.67 % were obese, with no statistical difference between genders. As for blood pressure levels, there was change to 8.71 % of the total population, being more frequent in the female group (4.95%). Children with normal BP levels admit spend less time off without energy expenditure compared with the amended BP [RP 0.92 (95% CI from 0.88 to 0.97)]. Found a significant association [RP 2.02(95% CI 1.28, 3.2)] BMI changed and menarche before 10 years of age. Simple linear regression analysis showed a positive association between BMI and both systolic BP levels (R² = 0.2244, y = 61.1770 + 1,8228x; p < 0.001) and diastolic (R² = 0.3450, y = 35 2008 x + 1.0726; p <0.0001). For the other behavioral and eating habits variables, there were no associations between obesity and BP levels. Conclusion: There was a high prevalence of obesity and hypertension in this population. There was a positive association between BMI and SAH. For behavioral and dietary variables were few associations. There was an association for the occurrence of menarche before age 10 and the changed BMI. Was associated also to increased blood pressure and the free time without energy expenditure. Significant associations between high consumption of sweets, soft drinks and physical activity lower than recommended were found. It emphasizes the importance of developing intervention strategies with the participation of multidisciplinary team, including schools and family for the prevention and control of obesity and high blood pressure in children and adolescents.
Baker, Rachel. "The Relationship between Physical Activity, Sleep Patterns and DASH dietary Adherence among Hypertensive Adolescents: The DASH-4-Teens Program." University of Cincinnati / OhioLINK, 2018. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1522419725606895.
Full textBraz, Marici 1. 1967. "Doenças crônicas e problemas de saúde em adolescentes do município de Campinas." [s.n.], 2011. http://repositorio.unicamp.br/jspui/handle/REPOSIP/308304.
Full textDissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas
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Resumo: A concepção de que os adolescentes raramente ficam doentes e o habito de justificar qualquer problema de saúde seja físico ou mental como "normal" ou característico desta etapa da vida tem limitado a atenção a saúde dos adolescentes e consequentemente as pesquisas nesta área. O controle das doenças infecto-contagiosas, das doenças respiratórias na infância, a maior sobrevida de neonatos extremos, a correção cirúrgica de cardiopatias congênitas, assim como as mudanças dos hábitos alimentares e de atividade física entre crianças e adolescentes podem estar aumentando a prevalência de doenças crônicas em adolescentes. O objetivo deste estudo transversal de base populacional foi estimar a prevalência de doenças crônicas diagnosticadas e de problemas de saúde referidos segundo variáveis demográficas e socioeconômicas e identificar as características demográficas e socioeconômicas dos adolescentes do município de Campinas. As informações de 929 adolescentes de 10 a 19 anos foram obtidas por meio de entrevistas domiciliares realizadas no Inquérito de Saúde do Município de Campinas, ISACamp 2008/09. Foram utilizadas estatísticas descritivas, teste de associação pelo ?2, razões de prevalência e intervalos de confiança de 95%. Para analise múltipla foi realizada Regressão de Poisson. Verificou-se que entre os adolescentes de Campinas a prevalência de ao menos uma doença cronica diagnosticada foi de 19,17% (IC 95%: 15,67 - 23,22), sendo asma a de maior prevalência 7,59% (IC95%: 6,01-9,54), hipertensão (1,07%) e diabetes (0,21%) foram pouco prevalentes nos adolescentes. Problemas de saúde referidos tiveram prevalência de 61,53% (IC95%: 54,61- 68,02), alergia 40,39% (IC 95%: 34,90-46,13) e dores de cabeça freqüente/enxaqueca 24,83% (IC95%: 20,35-29,92) foram os problemas de saúde referidos mais frequentes. Após análise ajustada para idade e sexo observou-se que faixa etária de 15 a 19 anos, não frequentar escola, ter filhos e ser obeso estavam associados a doença crônica diagnosticada. Somente sexo feminino apresentou associação a problemas de saúde referidos após a análise múltipla. A prevalência de problemas de saúde referidos entre os adolescentes de Campinas mostrou-se elevada e três vezes maior do que a prevalência de doenças crônicas diagnosticadas. A idéia de que a adolescência é uma fase da vida na qual pouco se adoece deve ser refutada
Abstract: The concept that adolescents are rarely ill and the habit of regarding any health problem they have, whether physical or mental, as normal or typical of that period of life, have limited the health care for them and, in consequence, research in that field. The control of childhood infectious diseases, respiratory system disorders, longer lifespan for extreme neonates, corrective surgery of congenital heart abnormalities, as well as changes in eating habits and physical activity among children and adolescents, may be increasing the prevalence of chronic diseases among adolescents. The aim of this population-based cross-sectional study was to identify the demographic and socioeconomic characteristics of adolescents in the municipality of Campinas, and analyze the prevalence of diagnosed chronic diseases and health problems reported using demographic and socioeconomic variables. The information from 929 adolescents aged between 10 and 19 was obtained through household interviews in a health survey conducted in the municipality of Campinas - ISACamp 2008/09. Descriptive statistics, the chi-squared test of association, prevalence proportions, and 95% confidence intervals were used. The multiples analysis was performed using Poisson Regression. It was verified that the prevalence of diagnosed chronic diseases among adolescents in Campinas was 19.17% (95% CI: 15.67-23.22), asthma being the most prevalent 7,59% (95% CI: 6.01-9.54), hypertension(1,07%) and diabetes (0,21) were less prevalent in adolescents. The prevalence of health problems reported was 60.99% (95% CI: 54.12-67.46), allergies 49,39% (95% CI: 34.90-46.13) and frequent headaches/migraine 24,83% (95% CI: 20.35-29.92) showing the highest frequency. After the adjusted analysis was conducted, it was observed that while the 15-19 age group, not attending school, having children and being obese were associated with diagnosed chronic diseases. Only female sex was associated with health problems reported after multiple analyses. The prevalence of health problems reported in adolescents from Campinas was significant, being three times higher than that of diagnosed chronic diseases. The concept that adolescence is the period of life during which illnesses are rare should be refuted
Mestrado
Pediatria
Mestre em Ciências
Ferreira, Clarissa Barros. "Prevalência de hipertensão pulmonar em crianças e adolescentes com hemoglobinopatias." reponame:Biblioteca Digital de Teses e Dissertações da UFRGS, 2014. http://hdl.handle.net/10183/98453.
Full textINTRODUCTION: The Hemoglobinopathies can be divided in Thalassemias and Sickle Cell Disease (SCD), but clinically both present with chronic hemolytic anemia, which leads to various complications, one of them being Pulmonary Hypertension (PH). About 20-40% of patients with SCD have PH, and this diagnosis is associated with a high risk of mortality. The objective of this study was to estimate the prevalence of this complication in the pediatric population, and associate clinical and laboratory characteristics. METHODS: A cross sectional descriptive study, with the evaluation of 45 patients with diagnosis of SCD or thalassemia major/intermedia between 3-18 years, which received treatment at the Hemoglobinopathies ambulatory at HCPA. The patients were submitted to an echocardiogram to estimate the pulmonary artery systolic pressure, being considered to have PH patients with a tricuspid regurgitate jet velocity (TRV) ≥ 2.5m/s. Clinical and laboratory data were obtained to evaluate hemolytic parameters, renal and liver function and compared between groups. RESULTS: 15% (6/40) of patients had a TRV ≥ 2.5m/s, suggestive of PH, of which all had Sickle Cell Anemia (SCA). Considering this group of patients alone the prevalence would be of 20% (6/30). Patients with TRV ≥ 2.5m/s had a higher median age, lower hemoglobin count, higher RDW, reticulocyte and DHL then patients with a TRV < 2.5m/s. The major clinical feature was the occurrence of priapism (p<0,05). CONCLUSIONS: Patients with diagnosis of hemoglobinopathies are at higher risk of developing PH since early childhood, especially those with SCA. These patients showed a higher level of hemolytic parameters, as well as symptoms associated with hemolysis, like priapism, when compared with patients with a normal TRV. Therefore, it would be indicated to submit these patients to an echocardiogram routinely in their early years.
Mexia, Ricardo. "Hipertensão arterial em adolescentes escolarizados da área de intervenção do Centro de Saúde de Queluz." Master's thesis, Escola Nacional de Saúde Pública. Universidade Nova de Lisboa, 2013. http://hdl.handle.net/10362/11541.
Full textABSTRACT - Hypertension is one of the major mortality and morbidity causes worldwide, causing 7,1 million deaths annually. Raised blood pressure in early life is associated with hypertension in adults, and adolescence is the ideal setting for lifestyle and behaviour changes that can reduce hypertension prevalence. Existing data on adolescent hypertension in Portugal is inconsistent, but there is an increasing trend. Between January and March 2007, a cross sectional study assessed the prevalence of hypertension among 7th grade students in the area of the Centro de Saúde de Queluz. Sex, age, blood pressure, height, weight, family history of hypertension and physical activity were assessed in 902 students. A prevalence of 25,3% hypertension was determined, with 30,3% among females and 19,6% among males. Half of the students with BMI above 25 kg/m2 had hypertension while only 21,2% of individuals with BMI under 25 kg/m2 presented hypertension. Adjusted Odds Ratio (for race, sex, age and shift of measurement) was calculated at 2,33 for students with BMI above 25 kg/m2 . Data shows the need for disease prevention and health promotion measures, enabling the reduction of this risk factors and diseases commonly associated with them.
Wagner, Allison. "Changes in knowledge, self efficacy and diet among adolescents with hypertension in response to a DASH diet Intervention utilizing the social cognitive theory." Cincinnati, Ohio : University of Cincinnati, 2005. http://www.ohiolink.edu/etd/view.cgi?acc%5Fnum=ucin1132255980.
Full textWAGNER, ALLISON M. "CHANGES IN KNOWLEDGE, SELF-EFFICACY AND DIET AMONG ADOLESCENTS WITH HYPERTENSION IN RESPONSE TO A DASH DIET INTERVENTION UTILIZING THE SOCIAL COGNITIVE THEORY." University of Cincinnati / OhioLINK, 2005. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1132255980.
Full textMeuser, Ashley R. "Changes in Social Cognitive Theory Constructs Influence Changes in Consumption of Fruits, Vegetables, Low-Fat Dairy Products, and High Fat/High Sodium Foods in Adolescents with Hypertension." University of Cincinnati / OhioLINK, 2010. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1282167496.
Full textWANSAPURA, ARSHANI N. "CHANGES IN FOOD SOURCES OF SODIUM IN THE DIETS OF ADOLESCENTS WITH HYPERTENSION IN RESPONSE TO A DIETARY INTERVENTION EMPHASIZING A DASH TYPE DIET." University of Cincinnati / OhioLINK, 2006. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1154703684.
Full textVAGEDES, KASEY M. "CHANGES IN DIET QUALITY AND BLOOD PRESSURE AMONG ADOLESCENTS WITH HYPERTENSION IN RESPONSE TO A DIETARY INTERVENTION EMPHASIZING FRUITS, VEGETABLES AND LOW-FAT DAIRY PRODUCTS." University of Cincinnati / OhioLINK, 2005. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1123090947.
Full textHeuck, Emily. "Macronutrient intake and BMI change as potential mediators of CVD risk factor response among hypertensive adolescents on a DASH dietary intervention." University of Cincinnati / OhioLINK, 2018. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1522312168801163.
Full textAlmeida, Mayara Maria Souza de. "Avaliação de fatores de risco para hipertensão arterial entre adolescentes de Goiânia – GO." Universidade Federal de Goiás, 2017. http://repositorio.bc.ufg.br/tede/handle/tede/7421.
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Conselho Nacional de Pesquisa e Desenvolvimento Científico e Tecnológico - CNPq
Adolescents present behaviors and important changes in the body, in the way of thinking, acting and in the performance of social roles, and especially exposure to behavioral risk factors. The objective of this study was to evaluate the risk factors for hypertension among adolescents from Goiânia - Go. This was a cross-sectional study, data collection was performed between 2013-2014, with the participation of 1,586 adolescents from 36 schools (public and Private schools) of 108 classes in Goiânia-GO. All adolescents were interviewed about socio-demographic and behavioral characteristics such as tobacco use, alcohol and other cardiovascular risk factors and also had blood pressure measured and weight and height measured. Data records were made on a digital device (PDA). There was a high prevalence of hypertension among adolescents: 6.2% (95% CI: 4.6-8.2%) in girls and 14.0% (95% CI: 10.2 -18.8%) In the boys. The prevalence of hypertension was twice as high in boys compared to girls (p <0.001). Overweight was independently associated with hypertension in girls. Obesity was a risk factor for hypertension in both sexes. Tobacco use was not a factor associated with arterial hypertension; tobacco use among boys was 19.3% (95% CI: 14.9; 24.5) and girls 19.1% (95% CI: : 15.8; 22.8) both with similar results to the use. Alcohol use in the last 30 days was not a factor associated with arterial hypertension; however, statistically significant results were found for binge drinking among boys (5.0%; 95% CI: 3.3; , 5) and in girls 6.8% (95% CI: 4.9, 9.3) (p <0.277). The results of this investigation indicate the need to implement strategies for the prevention and control of hypertension and risk factors, especially in the school context, with actions to promote health and training of professionals in the areas of education and health.
Os adolescentes apresentam comportamentos e importantes transformações no corpo, no modo de pensar, agir e no desempenho dos papéis sociais e, sobretudo exposição a fatores de riscos comportamentais. O objetivo deste estudo foi avaliar os fatores de risco para hipertensão arterial entre adolescentes de Goiânia – Go. Trata-se de um estudo transversal, foi realizada coleta de dados entre 2013-2014, com a participação de 1.586 adolescentes de 36 escolas (públicas e privadas) de 108 turmas em Goiânia-GO. Todos os adolescentes foram entrevistados sobre características sociodemográficas e comportamentais como uso do tabaco, álcool e outros fatores de riscos cardiovasculares e também tiveram a pressão arterial aferida e peso e altura medidos. Os registros dos dados foram feitos em um dispositivo digital (PDA). Verificou-se elevada prevalência de hipertensão arterial entre os adolescentes: 6,2% (IC 95%: 4,6-8,2%) nas meninas e14,0% (IC 95%: 10,2 -18,8%) nos meninos. A prevalência de hipertensão arterial foi duas vezes superior nos meninos em comparação com as meninas (p<0,001). Sobrepeso foi independentemente associado à hipertensão nas meninas. Obesidade foi fator de risco para hipertensão em ambos os sexos. O uso do tabaco não foi um fator associado a hipertensão arterial, o uso do tabaco na vida entre os meninos foi de 19,3% (IC 95%:14,9; 24,5) e meninas 19,1% (IC95%:15,8; 22,8) ambos com resultados similares ao uso. O uso do álcool na vida/nos últimos 30 dias, não foi um fator associado á hipertensão arterial, no entanto, encontrou-se resultados estatisticamente significativos para binge drinking, entre os meninos 5,0% (IC95%: 3,3; 7,5) e nas meninas 6,8% (IC95%: 4,9; 9,3) (p<0,277). Os resultados dessa investigação indicam a necessidade de implementação de estratégias de prevenção e controle da hipertensão arterial e os fatores de risco, sobretudo, no contexto escolar, com ações de promoção da saúde e capacitação de profissionais das áreas da educação e saúde.
Ballestero, Matheus Fernando Manzolli. "Avaliação de método não invasivo para monitorização da pressão intracraniana em crianças e adolescentes portadores de hidrocefalia." Universidade de São Paulo, 2016. http://www.teses.usp.br/teses/disponiveis/17/17137/tde-29032017-101744/.
Full textHydrocephalus is still a challenge regarding diagnosis, treatment and monitoring in the pediatric population. Currently, treatments by ventricular or endoscopic ventriculostomies are well established. However, to date, the diagnosis of malfunctioning shunts associated with intracranial hypertension remains a problem, especially in young children and without patent fontanelles. Radiological examinations, such as ultrasonography, computerized tomography and magnetic resonance, allow only an indirect access to the intracranial pressure, whilst methods for direct assessment may present risks and therefore are rarely used in children. The aim of this study was to evaluate a noninvasive device to assess some parameters of the intracranial pressure curve in children with hydrocephalus. For this, we performed a prospective and non-experimental descriptive-analytic study. The sample consisted of children (under 18 years), including 28 patients with hydrocephalus and 28 children following routine child care (control group). Participants were divided into four groups; Group A: children with clinically compensated hydrocephalus; B: patients with hydrocephalus, but with no clinical signs of intracranial hypertension and no history of medical surgery for the treatment of hydrocephalus; C: patients with acute intracranial hypertension due to hydrocephalus, and D: children without neurological disease (control). Data were collected between 2014 and 2016, through the installation of an extracranial deformation sensor, coupled to the children\'s scalp, which allowed registration of non-invasive intracranial pressure curves. Data analysis was performed using Freemat® 4, Origin Pro® 8 and R® 3.1.3 software. Parameters obtained from the intracranial pressure curves were analyzed, such as \"ratio P2 / P1\", \"classification P1 and P2\" (P1> P2 or P2> P1) and \"P1 slope.\" The results showed that P2>P1 index had a sensitivity of 80% and specificity of 100%, while the \"classification of P1 and P2\" had 100% of sensitivity and 80% of specificity for predicting intracranial hypertension. \"P1 slope\" presented no statistical difference. In summary, despite some operational limitations, this study showed an useful and non-invasive method for monitoring intracranial pressure, which was able to indicate the intracranial hypertension in children with hydrocephalus and, thus, should be further investigated for clinical applications.
Noronha, Juliana Andreia Fernandes. "Pressão arterial elevada em crianças e adolescentes com excesso de peso: associação com biomarcadores hormonais e inflamatório." Universidade Estadual da Paraíba, 2011. http://tede.bc.uepb.edu.br/tede/jspui/handle/tede/1690.
Full textINTRODUCTION: Childhood obesity is a concern and it is associated with the main metabolic and cardiovascular diseases. Its prevalence has been increasing, in all age groups, significantly so in developing countries, and has become a Public Health problem. The risk of a child or adolescent presenting hypertension is also associated with the degree of obesity, levels of leptin, insulin and high-sensitivity c- reactive protein. OBJECTIVES: To check on the prevalence of high blood pressure in obese or overweight children and adolescents and its association with leptin, insulin and high-sensitivity C-reactive protein. METHODOLOGY: A cross-sectional study with a sample of 200 children and adolescents aged between 2 and 18 years old, diagnosed as being overweight or obese. Anthropometric data were obtained: body mass index, waist circumference and blood pressure were measured. The systolic or diastolic blood pressure was classified as normal below the 90th percentile for gender, age and stature, and high at or above the 90 percentile. Laboratory tests on leptin, insulin and high-sensitivity c- reactive protein were conducted after the subjects had fasted for 12 hours. Insulin resistance was assessed using the homeostasis model assessment for insulin resistance (HOMA-IR) index, with HOMA-IR ≥ 2.5 being considered abnormal. To evaluate the cardiovascular risk, high-sensitivity c-reactive protein was used, with values greater than 3mg/L considered as indicating a high risk of cardiovascular event. The systolic and diastolic blood pressures were divided into quartiles, and assessing the association between blood pressure, clinical and laboratory variables was conducted using the chi-square and ANOVA Oneway tests. Data were analyzed with an SPSS version 17 program and a confidence interval of 95% was considered. RESULTS: Of the 200 children and adolescents, 128 (64%) were female, 123 (61.5%) were adolescents, 132 (66%) had severe obesity and 159 (79.5%) had an abnormal waist circumference. Most of the 170 individuals (89%) had a history of hypertension. High systolic and/or diastolic blood pressure was observed in 141 (70.5%) of the population studied, the prevalence of high diastolic blood pressure (64.5%) being greater than high systolic blood pressure (37.5%). The average values of leptin and high-sensitivity c- reactive protein were significantly higher in adolescents with high systolic blood pressure than those with normal systolic blood pressure. High-sensitivity c-reactive protein > 3mg/dl was associated with high systolic blood pressure (p=0.031), in the adolescents, with a 2-fold greater chance of their having abnormal systolic blood pressure than those with normal high-sensitivity c-reactive protein [OR=2.350 (1.075 - 5.141)]. The average value of insulin (p=0.009), leptin (p <0.000), high-sensitivity c-reactive protein (p=0.058), and of HOMA-IR (p=0.006) increased significantly in accordance with the quartiles of systolic blood pressure, a fact which was not observed in those for diastolic blood pressure. CONCLUSION: High blood pressure was markedly present among overweight children and adolescents, indicating that the high level of body fat is altering the mechanisms responsible for the proper functioning of the cardiovascular system. Only systolic blood pressure was shown to be associated with hormonal biomarkers (leptin and insulin) and inflammatory ones (high-sensitivity c- reactive protein). Interventions to control obesity can represent one of the major actions aimed at preventing and controlling high BP, and thus at minimizing the cardiovascular consequences in this population.
INTRODUÇÃO: A obesidade infantil é preocupante e está relacionada com as principais doenças metabólicas e cardiovasculares. Sua prevalência vem aumentando, em todas as faixas etárias, de forma significante nos países emergentes, tornando-se um problema de Saúde Pública. O risco de uma criança ou adolescente apresentar hipertensão pode também estar associado ao grau de obesidade, níveis de leptina, insulina e proteína c-reativa ultra-sensível. OBJETIVOS: Verificar a prevalência de pressão arterial elevada em crianças e adolescentes obesos ou com sobrepeso e sua associação com leptina, insulina e proteína c-reativa ultrasensível. METODOLOGIA: Estudo transversal com uma amostra de 200 crianças e adolescentes, entre 2 e 18 anos, com diagnóstico de sobrepeso ou obesidade. Foram obtidos dados antropométricos, índice de massa corpórea, circunferência abdominal e aferido a pressão arterial. A pressão arterial sistólica ou diastólica foi classificada como normal abaixo do percentil 90 para gênero, idade e estatura; e elevada acima ou no percentil 90. Os exames laboratoriais, leptina, insulina e proteína c-reativa ultra-sensível, foram realizados após jejum de 12 horas. A resistência insulínica foi avaliada através do índice homeostasis model assessment for insulin resistance (HOMA-IR), sendo considerado alterado HOMA-IR ≥ 2,5. Para avaliação do risco cardiovascular foi utilizado o proteína c-reativa ultra-sensível, sendo considerado risco elevado para evento cardiovascular os valores maiores que 3mg/L. A pressão arterial sistólica e diastólica foram distribuídas em quartis e a avaliação da associação entre pressão arterial, as variáveis clínicas e laboratoriais foram realizadas através do teste qui-quadrado e do ANOVA Oneway. Os dados foram analisados no SPSS versão 17 e foi considerado um intervalo de confiança de 95%. RESULTADOS: Das 200 crianças e adolescentes, 128 (64%) eram do gênero feminino, 123 (61,5%) eram adolescentes, 132 (66%) tinham obesidade grave e 159 (79,5%) tinham circunferência abdominal alterada. A maioria dos indivíduos 170 (89%) tinha antecedentes de hipertensão. A pressão arterial sistólica e/ou diastólica elevada foi observada em 141 (70,5%) da população estudada, sendo a prevalência de pressão arterial diastólica (64,5%) elevada maior do que a pressão arterial sistólica (37,5%). Os valores médio de leptina e de proteína c-reativa ultra-sensível foram significamente maiores nos adolescentes com pressão arterial sistólica elevada do que os com pressão arterial sistólica normal. A proteína c-reativa ultra-sensível > 3mg/dl esteve associado a pressão arterial sistólica elevada (p=0,031), nos adolescentes, apresentando uma chance 2 vezes maior de terem a pressão arterial sistólica alterada, do que aqueles com proteína creativa ultra-sensível normal [OR=2,350 (1,075 5,141)]. O valor médio da insulina (p=0,009), leptina (p<0,000), proteína c-reativa ultra-sensível (p=0,058), e do HOMA-IR (p=0,006) aumentaram significativamente de acordo com os quartis da pressão arterial sistólica, fato este não observado na pressão arterial diastólica. CONCLUSÃO: A pressão arterial elevada se fez presente de forma marcante entre crianças e adolescentes com excesso de peso, indicando que o elevado nível de gordura corporal esteja alterando os mecanismos responsáveis pelo funcionamento adequado do aparelho cardiovascular. Apenas a pressão arterial sistólica mostrou-se associada aos biomarcadores hormonais (leptina e insulina) e inflamatórios (proteína c-reativa ultra-sensível). Intervenções para o controle da obesidade podem representar uma das principais ações voltadas à prevenção e controle da PA elevada minimizando as consequências cardiovasculares nessa população.
Oliveira, Iza de Castro. "Prevalencia da sindrome metabolica, avaliação de fatores de risco e composição corporal em crianças e adolescentes com sindrome nefrotica." [s.n.], 2009. http://repositorio.unicamp.br/jspui/handle/REPOSIP/312245.
Full textDissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas
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Resumo: A síndrome nefrótica (SN) é definida pela perda maciça de proteína pela urina associada à hipoalbuminemia, edema e dislipidemia. O tratamento específico em crianças e adolescentes com síndrome nefrótica é realizado com medicações imunossupressoras. Sabe-se que a terapia prolongada de corticoesteróides ocasiona efeitos colaterais como: hipertensão arterial, alterações no crescimento e fácies cunshigóides (caracterizada por distribuição atípica de gordura corporal). Estudou-se retrospectivamente e transversalmente todos os pacientes com síndrome nefrótica córtico dependente (SNCD) e córtico resistente (SNCR), acompanhados no Ambulatório de Nefropediatria da FCM-Unicamp, com o objetivo de avaliar a evolução de parâmetros clínicos e laboratoriais. O estudo foi dividido em duas etapas: a primeira com o objetivo de avaliar a prevalência de síndrome metabólica em pacientes com SNCD e SNCR, a partir do prontuário foram obtidos: idade do início da SN, o tempo de tratamento, o total de doses de esteróides (mg/kg/dia), uso prévio de ciclosporina. Peso, estatura, circunferência da cintura, glicemia e isulinemia foram determinados no início do presente estudo. A SM foi definida utilizando quatro definições anteriormente publicadas sendo estas: Cook et al (2003), Weiss et al (2004), Silva et al (2005) e Jollife et al (2007), no qual foram estudados 21 pacientes, com idade média de 12,38±3,4 anos. A prevalência de síndrome metabólica variou de 14,2% a 23,8%, dependendo da definição utilizada, A freqüência de sobrepeso foi de 19,0% (4 / 21) e de obesidade foi de 23,5% (5 / 21). Na avaliação de fatores predisponentes para síndrome metabólica somente foram estatisticamente significativos os seguintes: uso prévio de ciclosporina (p=0,042) e síndrome nefrótica secundária à doença sistêmica (p=0,041). O segundo fetapa teve como objetivo avaliar o crescimento e a composição corporal em crianças e adolescentes com SNCD, no qual foram estudados crianças e adolescentes, em acompanhamento no ambulatório de Nefropediatria da FCM-Unicamp. A partir do prontuário foram obtidos: idade do início da SN, o tempo de tratamento, o total de doses de esteróides (mg/kg e mg/kg/d), peso e estatura da primeira visita, e os valores da albuminemia, proteinemia total, colesterol total, a cada seis meses em todo o tempo de seguimento. Determinou-se a dose total do uso de corticosteróide. As avaliações antropométricas (circunferência muscular do braço, dobra tricipital) foram determinadas quando os pacientes não tinham edema clínico. Estatística não paramétrica foi utilizada com significância de p <0,05. Dezoito pacientes, onze do sexo masculino, com idades de 12,22 ± 2,98 anos. Os z-escore de estatura/idade inicial e final foram significativamente diferentes (-0,69 ± 0,80 e -2,07 ± 1,61 (p = 0.003)). A média de perda de z-escore de estaura/idade foi de -1,37 ± 1, 55. Apenas quatro pacientes mantiveram seu crescimento dentro da normalidade. Neste grupo, os valores de proteinúria residual foi menor do que aqueles que tinham um déficit de crescimento. A circunferência muscular do braço foi significativamente pior neste último grupo. Concluiu-se que a alta prevalência de sobrepeso e obesidade pode estar relacionada com a elevada prevalência da SM. Além disso, o uso de ciclosporina e à presença do de doenças sistêmicas também são fatores predisponentes para o SM. O beneficio da corticoterapia na SNCD para obtenção da melhora da proteinúria e da hipoalbuminemia deve ser questionado em função dos seus efeitos colaterais irreversíveis sobre o crescimento e comprometimento da massa magra nesses pacientes, pois outros problemas como alterações de vitamina D e de insuficiência renal crônica pode ser minimizada durante o tratamento
Abstract: Nephrotic syndrome is characterized for massive proteinuria, edema and hyperlipidemia. The basis of treatment is immunosuppressive drugs meanly corticosteroids and cyclosporine. As the disease recurs, the treatment is prolonged and many collateral effects can be met. So arterial hypertension, growth failure and Cushing syndrome exogenous are common. Patients with cortico-depedent and cortico resistant were evaluated regardless to clinical and laboratorial aspects. The study was made in two fases: the first had as objective to evaluate the prevalence of metabolic syndrome (MS) in children and adolescents with steroid dependent (SDNS) and steroid resistant (SRNS) nephritic syndrome (NS). All children followed at the Pediatric Nephrology Unit, aged from five to eighteen with SDNS or SRNS. From the medical records were gotten: age of the start of NS, time of treatment, total doses of steroids (mg/kg/dial), previous use of cyclosporine. Weight, stature, waist circumference, glicemia and isulinemia were determined in the beginning of this study. The MS was defined using four previous published definitions by: Cook et al (2003); Weiss et al (2004); Silva et al (2005) e Jollife et al (2007). Twenty one patients, twelve male, media of age of 12.4±3.4 years old. The prevalence of MS varied from 14.28% (3/21) to 23.8% (5/21) according the MS definition. The frequency of overweight was 19.0% (4/21) and the obesity was 23.5% (5/21). In the assessment of predispose factors associated with MS only were statically significant the previous use of cyclosporine (p=0.042), the presence of NS due to systemic disease (p=0.041) and obesity (p=0.008). In the second part the objective was to evaluate the growth and body composition in children and adolescents with steroid-dependent nephrotic syndrome (SDNS). All children followed at the Pediatric Nephrology Unit, aged from five to eighteen with SDNS. From the medical records were gotten: age of the start of NS, time of treatment, total doses of steroids (mg/kg and mg/kg/d), weight and stature of the first visit and the values of albuminemia, total proteinemia, total cholesterol, every six months in all time of the follow-up. It was determined the total dosis of the use of corticosteroid. The anthropometric evaluations (arm muscle circumference, triceps skinfold) were determined when the patients had no clinical edema. Non parametric statistics was used with significance of p<0,05. Eighteen patients, eleven male, aged of 12,22±2,98 years old. Initial and final z score stature/age were significantly different (-0,69 ± 0,80 and -2,07 ± 1,61 (p=0,003). The media of loss of z score was -1,37±1,55. Only four patients keep their growth rate. In these group, the values of residual proteinuria was less than those one that had growth deficit. The arm muscle circunference was significantly worse in this last group. It was concluded that the high prevalence of overweight and obesity could be evolved in the high prevalence of MS. Besides that, the use of cyclosporine and the presence of system disease are also predispose factors to MS. For steroid dependent patients the use of steroids must be used with concerning the adverse effects upon growth since that is the most important cause of failure to thrive, because other problems like alterations of vitamin D and chronic renal failure can be minimized
Mestrado
Saude da Criança e do Adolescente
Mestre em Saude da Criança e do Adolescente
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