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CARDIOVASCULAR JOURNAL OF AFRICA • Volume 27, No 5, September/October 2016
AFRICA
315
Cardiovascular risk factors in pre-pubertal
schoolchildren in Angola
Amílcar BT Silva, Daniel P Capingana, Pedro Magalhães, Mauer AA Gonçalves, Maria del Carmen B
Molina, Sérgio L Rodrigues, Marcelo P Baldo, Miguel SB Mateus, José Geraldo Mill
Abstract
Methods:
The incidence of obesity is increasing worldwide, espe-
cially in countries with accelerated economic growth. We deter-
mined the prevalence of and associations between overweight/
obesity and cardiovascular risk factors in pre-pubertal (seven- to
11-year-old) schoolchildren (both genders,
n
=
198) in Luanda,
Angola. Biochemical (fasting blood) and clinical examinations
were obtained in a single visit. Data are reported as prevalence
(95% confidence intervals) and association (
r
, Pearson).
Results:
Prevalence of overweight/obesity was 17.7% (12.4–
23.0%), high blood pressure (BP
>
90% percentile) was 14.6%
(9.7–19.5%), elevated glucose level was 16.7% (11.5–21.9%)
and total cholesterol level
>
170 mg/dl (4.4 mmol/l) was 69.2%
(62.8–75.6%). Significant associations between body mass
index (BMI) and systolic and diastolic BP (
r
=
0.46 and 0.40,
respectively;
p
<
0.05) were found. No association between
BMI and elevated glucose or cholesterol levels was found.
Conclusion:
The prevalence of cardiovascular risk factors was
high in pre-pubertal schoolchildren in Angola and fat accu-
mulation was directly associated with blood pressure increase
but not with other cardiovascular risk factors.
Keywords:
obesity, overweight, children, blood pressure, cardio-
vascular risk
Submitted 28/10/14, accepted 8/3/16
Cardiovasc J Afr
2016;
27
: 315–321
www.cvja.co.zaDOI: 10.5830/CVJA-2016-029
Cardiovascular disease (CVD) is the leading cause of death
worldwide. Although its most overt manifestations, such as
hypertension, myocardial infarction and stroke, appear more
frequently in adulthood, there is growing evidence that the
risk factors for these events can appear precociously in the
course of life, even in childhood.
1-3
Some studies suggest that
the pathophysiological processes leading to the onset of CVD
in earlier phases of adult life could be detected as early as the
foetal period.
4-6
Hypertension and obesity are two cardiovascular risk factors
with a high prevalence in the adult population in virtually all
countries. Their incidence is occurring at increasingly younger
ages; today, these conditions affect a significant proportion
of children and adolescents.
7-9
Therefore early evaluation of
predisposing factors for these disorders, such as low birth
weight
10
and inadequate diet,
11,12
may contribute to the adoption
of early interventions for CVD prevention in adulthood.
13
Obesity in adults has become a global pandemic, affecting
both developed and developing countries.
14
Given that the
accumulation of body fat is due in large part to the adoption
of inadequate dietary and lifestyle habits, it appears that the
prevalence of obesity is increasing systematically in children and
adolescents around the world.
Following the overweight and obesity pandemic, an increased
incidence of hypertension, type 2 diabetes and dyslipidaemia
is to be expected.
2,8
Dyslipidaemia, in parallel with insulin
resistance, is one of the most important risk factors for the onset
and progression of atherosclerosis, and probably has a direct
relationship with obesity because both processes involve similar
lifestyle predictors.
14
The prevalence of dyslipidaemia in children and adolescents
worldwide varies between 2.9 and 33%, depending on the cut-off
points used and the age range of individuals included in the study.
15
However, there is now strong evidence of an increased incidence
of these conditions in the pre- and post-pubertal periods.
16-18
Most
studies, however, have been conducted in developed countries
with few studies performed in Africa to date.
19
Obesity and cardiovascular risk factors tend to increase in
countries with rapid economic and social transformation. Angola
is an African country that has experienced rapid economic growth
over the last 15 years, following the end of the civil war. However,
no existing studies have examined cardiovascular risk in Angolan
children. Therefore the aim of this study was to determine
the prevalence and severity of cardiovascular risk factors in
pre-pubertal schoolchildren in Luanda, Angola, and to determine
the contribution of excessive body weight to these findings.
Methods
A cross-sectional, observational and descriptive study was
conducted in a sample of children enrolled in the first cycle of
Department of Physiological Sciences, Federal University
of Espírito Santo, Espírito Santo, Brazil
Amílcar BT Silva, MD
Sérgio L Rodrigues, MD
Marcelo P Baldo, MD
José Geraldo Mill, MD,
josegmill@gmail.comDepartment of Physiological Sciences, School of Medicine,
Agostinho Neto University, Luanda, Angola
Amílcar BT Silva, MD
Daniel P Capingana, MD
Pedro Magalhães, MD
Mauer AA Gonçalves, MD
Miguel SB Mateus, MD
Department of Public Health, Federal University of Espírito
Santo, Espírito Santo, Brazil
Maria del Carmen B Molina, MD