Estudo epidemiológico da pressão arterial elevada e hipertensão arterial de crianças e adolescentes quilombolas.

Abstract

Arterial Hypertension (AH) is a clinical condition of high prevalence in the world, caused by a combination of factors and characterized by elevated blood pressure levels. In the last decade, the prevalence of High Blood Pressure (HBP) and AH in children and adolescents varied between 9.4% and 14.5% for the first and 1.9% and 4% for the second. Elevations in blood pressure in children and adolescents are observed when systolic or diastolic blood pressure percentiles are equal to or greater than 90, or even when the pressure is 120/80 mmMg. It is known that the prevalence of hypertension is higher among black and brown people, that the emergence of high blood pressure levels in a hypertensive adult, most likely, started in childhood or adolescence, as well as the occurrence of this clinical condition among quilombola adults is high. Such aspects attribute relevance to the investigation of arterial hypertension in quilombola remnants at earlier ages. From this perspective, the objective of this study was to analyze the prevalence of PAE and AH in quilombola children and adolescents from the Recôncavo Baiano and the associated factors. To this end, the following methodological strategies were used: Systematic Review, which showed a general prevalence of HBP and AH, respectively, of 12% (95%CI= 5-19; I²=99.97%) and 11% (95%CI=10-13 ; I²= 99.91%) and, when evaluated by race-color, 11% were identified for blacks (95%CI 2-19), 10% for whites (95%CI 6-14, I² 99.95%) and the group of blacks and white (95%CI 8-11, I² 99.70%), as well as in the presence of excess weight, the prevalence of altered blood pressure was 2.5 times higher (95%CI 2.1-2.9; I²= 90.9% ); Cross-sectional study, showed that the prevalence of general hypertension in quilombola children and adolescents was 29.4%, children presented, respectively, PAE and AH of 12.7% and 14.3%, while adolescents, in the same order, showed 12.5% and 15.4%; and, Case-Control, which found an association between waist-to-height ratio (WHR) ≥0.5 (OR 2.62; CI 1.89 - 7.518) and Bolsa Família (OR 2.35; CI 1.14 - 4, 01) with changes in blood pressure (APA) for children with Population Attributable Fraction (FAP) of 13% and 9.0%. There was also an association with male gender (OR 1.80; CI 1.02-3.18), obesity (OR 4.07; CI 1.60-10.34), and family history of hypertension (OR 1.91; CI 1.09-3.33) among adolescents with Population Attributable Fraction (FAP), in that order, 18%, 12%, and 23%. We conclude that black children and adolescents have a higher prevalence of hypertension, the remaining quilombolas in these stages of life have a high prevalence of the outcomes studied, and that the factors associated with increased blood pressure differed between children and adolescents. It is suggested the expansion of actions to prevent arterial hypertension among children and adolescents remaining from quilombolas to reduce the prevalence and eliminate the exposure of this population to the factors that determine AH and, in the long term, the reduction of morbidity and mortality due to arterial hypertension in this population specific black population.