Cardiovascular risk in adolescence



Katia Vergetti BlochI; Maria Cristina KuschnirII; Moyses SzkloIII

IInstituto de Estudos em Saúde Coletiva, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brasil. kbloch@globo.com
IINúcleo de Estudos da Saúde do Adolescente, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brasil. Instituto Nacional de Cardiologia, Rio de Janeiro, Brasil. cristina.kuschnir@gmail.com
IIIInstituto de Estudos em Saúde Coletiva, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brasil. mszklo@jhsph.edu



Brazilian newspapers recently published an important health diagnosis: "Nearly half of the Brazilian population is overweight." The news story was based on data from VIGITEL, the Telephone Survey for Surveillance of Chronic Non-Communicable Diseases and showed that from 2006 to 2011 the obesity rate increased from 11.4% to 15.8%, also highlighting that the excess weight problem begins at early ages. Among individuals 18 to 24 years of age, 29.4% of men and 25.4% of women are already above their ideal weight.

Insulin resistance and even type II diabetes have been reported in individuals younger than 18 years. Primary arterial hypertension is becoming increasingly frequent, reflecting the increase in excess weight. Other consequences of obesity in adolescents have also been observed: respiratory disorders like asthma and sleep apnea; joint involvement, especially knees and hips; and even mental disorders. Overweight and obese young individuals are also known to experience greater difficulty in entering the labor market.

The Ministry of Health has invested in promoting healthy habits aimed at the prevention of chronic diseases and improving quality of life for Brazilians. The reduction in salt intake and the successful anti-tobacco program are two examples of such initiatives. One of the objectives of the Strategic Action Plan to Fight Chronic Non-Communicable Diseases, launched in 2011, is to halt the increase in the proportion of overweight adults. One of the Plan's strategies is the Health Gym Program, aimed at increasing physical exercise in the population. The National School Health Survey (PeNSE) and School Health Program (PSE) are initiatives that focus specifically on the younger population groups.

The Department of Science and Technology in the Brazilian Ministry of Health has defined the cardiovascular and metabolic risk profile of Brazilian adolescents as a key health research priority. Through a call for projects issued in 2008 in partnership with the FINEP and CNPq research agencies, funding was approved for the Study on Cardiovascular Risk in Adolescents (ERICA, in Portuguese). The research has been planned for three years, and its pilot study is under way in five cities. The pilot study will evaluate the protocols for application of the instruments and logistics in this complex research. The principal objective of ERICA is to estimate the prevalence of obesity, insulin resistance, type II diabetes, arterial hypertension, dyslipidemia, and smoking in a sample of 75,000 adolescents from 12 to 17 years of age enrolled in public and private schools in Brazilian cities with more than 100,000 inhabitants.

The results of ERICA should depict the mosaic in the distribution of cardiovascular risk factors and some related factors, allowing regional comparisons and raising hypotheses on the determinants of the adolescents' current health status. Although existing knowledge already allows designing prevention and health promotion strategies such as those conducted by the Ministry of Health, obtaining more detailed information on weight, height, waist circumference, and blood pressure curves can back health policies and serve as a reference for future studies in the area of non-communicable diseases.

Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz Rio de Janeiro - RJ - Brazil
E-mail: cadernos@ensp.fiocruz.br