Factores de riesgo cardiovascular en una población pediátrica

Resumen Se evaluaron 194 pacientes que consultaron en la policlinica de factores de riesgo cardiovascular en ninos y adolescentes en el periodo 2000-2004 del Servicio de Cardiologia Pediatrica del Centro Hospitalario Pereira Rossell. Se valoraron diagnostico de hipertension arterial, estado nutricional, sedentarismo, alteraciones de lipidos en sangre y antecedentes familiares de hipertension arterial, cardiopatia isquemica en menores de 55 anos y sobrepeso. Se realizo un trabajo en equipo con pediatra, cardiologo pediatra, nutricionista, psicologo y enfermera. En 152 pacientes (78%) se realizo diagnostico de prehipertension o hipertension arterial. De estos, 75% presento sintomas al momento de la consulta, siendo la cefalea el mas frecuente. El 25% tenian hipertrofia ventricular izquierda y/o alteraciones en el fondo de ojo. El 77,7% de los pacientes presentaron hipertension arterial esencial, 16,4% secundaria y en el 5,9% no se realizo diagnostico etiologico. La etiologia secundaria mas frecuente fue la renal en el 50%, cardiovasculares 20%, endocrinas 20%, por farmacos 8% y otras 2%. El tratamiento de los ninos con presion arterial mayor al percentil 90 (P90) fue no farmacologico en el 61% de los casos, 39% recibieron tratamiento farmacologico. En los ninos con presion arterial mayor al P90 se encontraron cargados factores de riesgo de enfermedades cardiovasculares: riesgo de sobrepeso-sobrepeso 37%, sedentarismo 65%, alteraciones de los lipidos en sangre en 23,5% y antecedentes familiares de: hipertension arterial en 78%, cardiopatia isquemica en menores de 55 anos en 35%, sobrepeso 38%. Los factores de riesgo cardiovascular existen ya en la edad pediatrica. El factor de riesgo predominante fue la hipertension arterial, siendo la esencial la etiologia mas frecuente y entre las causas secundarias las renales prevalecieron, aunque con menor frecuencia que en las series internacionales. Las repercusiones de la hipertension aparecen a ...(AU) Summary 194 patients who attended the Cardiovascular Risk Factors Policlinic for children and tenagers of the Pediatric Cardiology Service of Pereira Rossell Hospital during the period 2002-2004 were considered. High blood pressure diagnosis, nutritional, sedentary lifestyle, alterations in the lipid blood level, family history of high blood pressure (HBP), ischemic heart disease in people under 55 and overweight, were evaluated, with the pediatrician, the cardiology pediatrician, the nutritionist, the psychologist and the nurse working as a team. 152 patients (78%) were diagnosed with pre high blood pressure or high blood pressure. 75% of them had symptoms at the time of consultation, being headache the most frequent one. 25% of them has left ventricular hypertrophy and/or fundoscopy alterations. 77,7% of the patients has essential high blood pressure, 16,4% has secondary high blood pressure. 5,9% of them don’t have an etiologic diagnosis. The most common secondary etiology was renal, in 50% of the cases, followed by cardiovascular (20%), endocrine (20%), pharmacological (8%) and others (2%). 60% of the children whose blood pressure was over percentile 90 (P90), received non-pharmacologic treatment, 39% of them did receive pharmacologic treatment. In children whose blood pressure levels were over P90, strong cardiovascular risk factors were found: overweight risk-overweight (37%), sedentari lifestyle (65%), lipid blood level alterations (23,5%) and family history of HBP (78%), ischemic heart disease in patients under 55 (35%) and overweight (38%). Cardiovascular risk factors already exist in childhood. The prevailing risk factor is HBP, being the essential one the most prevalent and among the secondary ones, the most frequent is the one of renal etiology, but less frequently than in international series. The consequences of HBP can be seen at an early age, in which early and adequate treatment is important. The association with ...(AU)