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Comparison of Cardiovascular Risk
Factors in Pediatric Age in Rural and
Urban Populations of Argentina

Fraix, Teresa; Tamagno, Beatriz; Pituelli, Norma;
Caferra, Digna; Rosillo, Irene; Corbera, Mirta;
Turco, Mirta; Seta, Francisco

Cátedra de Pediatría, Facultad de Medicina de Rosario,
Santa Fé, Argentina

SUMMARY
Introduction: The prevalence of arterial hypertension in developed population is 15 %.The study in pediatric age make a possibility to detect groups of risk in an early time to design useful prevention.
Objective: Of this work is to detect groups in risk in pediatric age in 2 distinct population and relate the result.
Material and Methods: In 156 children between 5 to 14 years old, were registered Systolic and Diastolic arterial pressure, with mercurial sphygmomanometer, in right arm, in a seat down position, in 2 opportunities each 3 minutes, (4 and 5 Korocoff. Sound for diastolic pressure, according to age),and we relate it to equal values in or over 90 percentile (High Normal Arterial Pressure). The antecedents of hypertension in parents and grandfathers its were obtained The children lipid profile were obtained.
Result: We considered 2 groups : Rural and Urban population:
Percentage of hypertensive families:
Rural: 69,73 %          Urban: 47,37 %
Percentage of children in or over 90 percentile:
Rural: 23,68 %          Urban: 15,78 %.
Relation between this children with the antecedents of theirs families.
Rural: 33,96 %          Urban : 33,33 %.
Discussion: The relation between groups of distinct geographical area , permits to know factors no genetics and genetics that influence in its appearance. This factors interact from 5 years old.
Is supposed that the environmental factors that influence in the appearance of hypertension, are more usually founded in the urban people. In spite of that, we find hypertension more common in a rural group, The relation between the children and theirs fathers is supported in the same values in two groups. We think that the environmental factors plays an important role in this result and we are study it.
Conclusion: The Arterial Hypertension is more common in rural people, that it is in opposition with the generally found in other country, and permit to establish a children group risk.

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   The prevalence of Arterial Hypertension (A.H.) in developed populations is 15%. The study of A.H. in pediatric ages allows the detection of risk groups and implement useful prevention strategies. The comparison of different ethnic groups allows the evaluation og non genetic and genetic factors, and the comparison of groups from different geographic areas and equal ethnia allows the evaluation of the environmental factors that influence in its appearance. In populations that adopt an urban lifestyle predominate environmental factors: obesity, sodium consume a stress.
The genetic and environmental factors interact from age 5 onwards.

   The rural populations in our zone share the urban lifestyle in great proportion.

OBJETIVES
   The objective of this study is to detect cardiovascular risk groups in pediatric age through its tensional numbers and lipid profile (the last one was offered in a separate study), and compare the discoveries in the 2 groups of children from different geographical areas: RURAL in populations of 800 to 1000 inhabitants, 200 km away from each other; and URBAN from the population of a city 190 km away, with 1 million inhabitants.

METHODS
   We studied 152 children. 76 rural and 76 urban (after that, in a second town, 115 children from age 5 to 14 were studied. This study will be presented separately, but its results are similar to the ones presented here). We registered Systolic (S.A.P.) and Diastolic Arterial Pressure (D.A.P.) with mercurial tensiometer, in the right arm, in sitting position, 2 times every 3 minutes (4th and 5th K.S. according to age), and we realted it with values equal to or over the 90 percentile of Normal High Arterial Pressure. We obtained: the children lipid profile and A.H. family antecedents in parents and grandparents.

RESULTS

Relation of Hypertensive Families with the population sample:
Rural: 69,73%          Urban: 47,36%
Percentage of children equal to or over the 90 percentile:
Rural: 23,68%          Urban: 15,78 %
Relation of this children with their family antecedents:
Rural: 33,96%          Urban: 33,33%
That is to say, both groups coincide in this last relation.

DISCUSSION
   From the 6th month of life, the child develops its tracking that will condition the future variations of its pressure. Keeping this in mind, we wanted to detect from age 5 its tensional values; this age is also the one in which genetic and environmental interactions begin to manifest.

   Generally, the rural environments are supposed as less prone to cardiovascular disease. However, it has been observed that cholesterol values in rural environments are larger than the ones in urban areas when the country's medium cholesterol value is over the acceptable values.

   We didn't find in the literature any data refering to arterial pressure.

   In our groups, the lipid profile as well as the arterial pressure percentiles were higher in rural children than in urban children. The percentage of hypertense families was also higher. The relation between these families and their children was the same in both groups, indicating that it existed the same posibility of children in risk.

   The cause of the apparent predominance of the tendency to high pressure values in rural environments is not clear and will be subject of new studies, but the environmental factor related to the feeding and the stress that has invaded the rural environments cannot be undone.

   The genetic factor is also important because small populations have more posibility of relationship between families. (Figure 1)

CONCLUSION
   The A.H. predominates in rural environment and 33,96% of these families has children with values equal to or over the 90 percentile of High Arterial Pressure, a risk factor of future hypertension. These children also have a lipid profile over the desirable values, constituting a risk group that must be approached with diet and lifestyle measures for the prevention of cardiovascular disease.

   The ethnic is the same; so in both groups must exist environmental factors that give reason to this predominance in the rural environment and that will be studied.

 

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2nd Virtual Congress of Cardiology

Dr. Florencio Garófalo
Steering Committee
President
Dr. Raúl Bretal
Scientific Committee
President
Dr. Armando Pacher
Technical Committee - CETIFAC
President
fgaro@fac.org.ar
fgaro@satlink.com
rbretal@fac.org.ar
rbretal@netverk.com.ar
apacher@fac.org.ar
apacher@satlink.com

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