Comportamento hemodinâmico durante o estresse mental de crianças e adolescentes obesos com histórico familiar para hipertensão arterial

Abstract

INTRODUCTION: Obese children or adolescents with a family history (FH) of arterial hypertension have higher blood pressure (BP) at rest and in stressful situations. It is unknown if the association of FH with hypertension and obesity adds damage to obese children and adolescents. OBJECTIVE: To compare the pressure behavior of obese children and adolescents with and without FH for arterial hypertension during mental stress. METHODS: Thirty-seven obese children and adolescents were divided into the groups with FH for hypertension (FH +, n = 15, 13 ± 2 years of age) and without FH for hypertension (FH-, n = 22, 12 ± 3 years age). FH was determined by self-reported presence of father and / or mother with hypertension. PA (oscillometric measurement, DIXTAL® 2020) and heart rate (Polar S810i® heart rate monitor) were recorded for 3 minutes at baseline followed by 3 minutes of the Stroop ColorWord Conflict Test. Two-way ANOVA followed by multiple comparisons using Bonferroni post hoc was used for data analysis. It was considered significant p <0.05. RESULTS: In both groups systolic BP (time effect: p=0.01), diastolic BP (time effect: p=0.01), mean BP (time effect: p=0.01) and heart rate (time effect: p=0.001) increased significantly within 3 minutes of mental stress compared to baseline. However, the systolic BP and mean BP were significantly higher in the FH + group compared to the FH- group throughout the experiment (systolic BP FH+: baseline=122±12, 1ºmin=128±13, 2º min=128±13 and 3º min=127±15mmHg; FH-: baseline=112±12, 1ºmin=117±13, 2ºmin=119±14 and 3ºmin=116±12mmHg, effect group: p=0,016), (mean BP FH+: baseline=81±9, 1ºmin=86±10, 2ºmin=86±9 and 3ºmin=85±10 mmHg; FH- baseline=75±8, 1ºmin=79±10, 2ºmin=79±10 and 3ºmin=78±9 mmHg, effect group: p=0,037). The levels of diastolic BP (FH+: baseline=60±8, 1ºmin=65±9, 2ºmin=65±9 and 3ºmin=64±9mmHg; FH-: baseline=57±7, 1ºmin=61±9, 2ºmin=60±9 and 3ºmin=59±9 mmHg, effect group: p=0,092) and heart rate were similar between groups (FH+: baseline=77±11, 1ºmin=80±11, 2ºmin=81±12 and 3ºmin=81±12bpm; FH-: baseline=78±11, 1ºmin=79±11, 2ºmin=80±11 and 3ºmin=80±11bpm, effect group: p=0,986). CONCLUSION: Obese children and adolescents with HF for hypertension had higher blood pressure levels at baseline and mental stress compared to their non-HF pairs for hypertension.