Aspectos psicológicos na prevenção da aterosclerose na infância e na adolescência

A aterosclerose na infância e na adolescencia, frequentemente associada a obesidade, tem sido o foco de estudos internacionais que procuram entender a sua ontogenese. Devido as graves consequencias possiveis, a aterosclerose na infância e na adolescencia nao so demanda acoes preventivas multidisciplinares capazes de reduzir os fatores de risco ja amplamente identificados, como obesidade, hipercolesterolemia familiar, tabagismo e sedentarismo, dentre outros, mas tambem clama pelo controle de fatores nao tao claramente identificados, mas que podem contribuir para a sua patogenese. Dentre as variaveis ainda pouco conhecidas, que poderiam estar envolvidas na ontogenese da aterosclerose, encontram-se os fatores psicologicos e o stress emocional. Neste artigo, os autores versam sobre os aspectos psicologicos envolvidos na prevencao da aterosclerose e enfatizam a necessidade de uma mudanca acentuada de estilo de vida, tanto no que se relaciona as atividades fisicas e nutricionais como tambem as relacionadas as medidas anti-stress. Habitos inadequados utilizados como estrategias de enfrentamento do stress emocional excessivo, como comer em excesso, entre outros, devem ser objeto de medidas preventivas na infância e na adolescencia, visando substitui-los por estrategias de coping adequadas que reduzam o risco envolvido. Profissionais da area da saude devem estar alertas para esses fatores subjacentes que podem contribuir para o desenvolvimento da doenca aterosclerotica. Este trabalho foi compilado durante as discussoes para a elaboracao das I Diretrizes de Prevencao da Aterosclerose na Infância e na Adolescencia e serviu de base para as recomendacoes incluidas na secao denominada "Aspectos Psicologicos na Prevencao da Aterosclerose" das Diretrizes. Childhood and adolescent atherosclerosis, frequently associated with obesity, has been the focus of international studies that try to understand its development. Given its serious consequences, childhood and adolescent atherosclerosis not only demands multidisciplinary preventive actions that are capable of reducing the already very well identified risk factors, such as obesity, smoking, inactivity and familial hypercholesterolemia - just to mention some - but also calls for the control of factors that have not been clearly identified but that can contribute to its pathogenesis. Psychological factors and emotional stress are among the variables that are not yet fully known but nevertheless could be involved in the development of atherosclerosis. In this article, the authors discuss the psychological aspects involved in the prevention of atherosclerosis and emphasize the need for a dramatic change in lifestyle, which includes changing the levels of physical activity and eating habits and finding ways to fight or avoid stress. Inadequate habits employed as strategies to cope with excessive emotional stress, such as binge eating and others, should be targeted for preventive actions in childhood and adolescence and substituted by adequate coping strategies that have lower levels of risk. Health care professionals need to be watchful for these additional factors that can contribute to the development of atherosclerotic disease. This work was compiled during the discussion phase of the "I Guideline for Preventing Atherosclerosis in Childhood and Adolescence" and served as the basis for the recommendations included in its "Psychological Aspects in Preventing Atherosclerosis" section.