Author
Isabel Cristina Britto Guimarães
Bio: Isabel Cristina Britto Guimarães is an academic researcher from Federal University of Bahia. The author has contributed to research in topics: Population & Overweight. The author has an hindex of 14, co-authored 32 publications receiving 683 citations.
Topics: Population, Overweight, Rheumatic fever, Obesity, Medicine
Papers
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Universidade Federal de Goiás1, Pontifícia Universidade Católica de São Paulo2, Rio de Janeiro State University3, Federal University of Pernambuco4, Pontifícia Universidade Católica do Rio Grande do Sul5, Federal University of São Paulo6, University of São Paulo7, Federal University of Bahia8, Universidade Federal do Rio Grande do Sul9, Federal University of Paraná10, State University of Campinas11, Federal University of Rio de Janeiro12, State University of Santa Cruz13, Federal University of Pará14, University of Brasília15, Estácio S.A.16, Escola Bahiana de Medicina e Saúde Pública17, University of Caxias do Sul18, Universidade Federal de Santa Catarina19, Universidade Federal do Espírito Santo20, Sao Paulo State University21, Universidade Federal de Mato Grosso22, Pontifícia Universidade Católica do Paraná23, Pontifícia Universidade Católica de Goiás24, Universidade Federal de Juiz de Fora25, Universidade Estadual de Maringá26, Federal University of Uberlandia27
TL;DR: The Brazilian Guidelines of Hypertension -2020 as mentioned in this paper have been published for the first time in the year 2020, and are based on the definition, epidemiology, and primary prevention.
Abstract: Content 1. Definition, Epidemiology, and Primary Prevention 528 1.1 Definition of Hypertension 528 […] Brazilian Guidelines of Hypertension – 2020
293 citations
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Federal University of Rio de Janeiro1, Oswaldo Cruz Foundation2, Rio de Janeiro State University3, Universidade Federal do Rio Grande do Sul4, Brazilian Institute of Geography and Statistics5, Federal University of Pará6, University of São Paulo7, State University of Feira de Santana8, Universidade Federal de Minas Gerais9, Universidade Federal do Amapá10, Federal University of Amazonas11, Universidade Federal do Espírito Santo12, Universidade Federal de Santa Catarina13, Federal University of Rio Grande do Norte14, Universidade Federal de Mato Grosso15, Federal University of Bahia16, Pontifícia Universidade Católica do Paraná17, Federal University of Pernambuco18, University of Brasília19, Universidade Federal de Rondônia20, State University of Campinas21, Federal University of Piauí22, Universidade Federal de Goiás23, Federal University of Maranhão24, Federal University of Ceará25, Universidade Federal de Sergipe26, Federal University of Paraíba27, Federal University of Alagoas28, Sao Paulo State University29
TL;DR: The study indicates that the control of obesity would lower the prevalence of hypertension among Brazilian adolescents by 1/5 and the fractions of hypertension attributable to obesity in the population by 17.8%.
Abstract: OBJECTIVE To estimate the prevalence of arterial hypertension and obesity and the population attributable fraction of hypertension that is due to obesity in Brazilian adolescents. METHODS Data from participants in the Brazilian Study of Cardiovascular Risks in Adolescents (ERICA), which was the first national school-based, cross-section study performed in Brazil were evaluated. The sample was divided into 32 geographical strata and clusters from 32 schools and classes, with regional and national representation. Obesity was classified using the body mass index according to age and sex. Arterial hypertension was defined when the average systolic or diastolic blood pressure was greater than or equal to the 95th percentile of the reference curve. Prevalences and 95% confidence intervals (95%CI) of arterial hypertension and obesity, both on a national basis and in the macro-regions of Brazil, were estimated by sex and age group, as were the fractions of hypertension attributable to obesity in the population. RESULTS We evaluated 73,399 students, 55.4% female, with an average age of 14.7 years (SD = 1.6). The prevalence of hypertension was 9.6% (95%CI 9.0-10.3); with the lowest being in the North, 8.4% (95%CI 7.7-9.2) and Northeast regions, 8.4% (95%CI 7.6-9.2), and the highest being in the South, 12.5% (95%CI 11.0-14.2). The prevalence of obesity was 8.4% (95%CI 7.9-8.9), which was lower in the North region and higher in the South region. The prevalences of arterial hypertension and obesity were higher in males. Obese adolescents presented a higher prevalence of hypertension, 28.4% (95%CI 25.5-31.2), than overweight adolescents, 15.4% (95%CI 17.0-13.8), or eutrophic adolescents, 6.3% (95%CI 5.6-7.0). The fraction of hypertension attributable to obesity was 17.8%. CONCLUSIONS ERICA was the first nationally representative Brazilian study providing prevalence estimates of hypertension in adolescents. Regional and sex differences were observed. The study indicates that the control of obesity would lower the prevalence of hypertension among Brazilian adolescents by 1/5.
147 citations
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Federal University of Rio de Janeiro1, Rio de Janeiro State University2, Oswaldo Cruz Foundation3, Brazilian Institute of Geography and Statistics4, Sao Paulo State University5, Federal University of Pará6, Universidade Federal de Goiás7, State University of Feira de Santana8, Universidade Federal do Rio Grande do Sul9, Federal University of Amazonas10, Universidade Federal de Minas Gerais11, Universidade Federal do Amapá12, Universidade Federal do Espírito Santo13, University of São Paulo14, Universidade Federal de Santa Catarina15, Federal University of Rio Grande do Norte16, Universidade Federal de Mato Grosso17, State University of Campinas18, Federal University of Bahia19, Pontifícia Universidade Católica do Paraná20, Federal University of Pernambuco21, University of Brasília22, Universidade Federal de Rondônia23, Federal University of Piauí24, Universidade Federal do Acre25, Federal University of Maranhão26, Federal University of Ceará27, Universidade Federal de Sergipe28, Federal University of Paraíba29, Federal University of Alagoas30, Federal University of Roraima31
TL;DR: The study findings will be instrumental to the development of public policies aiming at the prevention of obesity, atherosclerotic diseases and diabetes in an adolescent population.
Abstract: The Study of Cardiovascular Risk in Adolescents (Portuguese acronym, “ERICA”) is a multicenter, school-based country-wide cross-sectional study funded by the Brazilian Ministry of Health, which aims at estimating the prevalence of cardiovascular risk factors, including those included in the definition of the metabolic syndrome, in a random sample of adolescents aged 12 to 17 years in Brazilian cities with more than 100,000 inhabitants. Approximately 85,000 students were assessed in public and private schools. Brazil is a continental country with a heterogeneous population of 190 million living in its five main geographic regions (North, Northeast, Midwest, South and Southeast). ERICA is a pioneering study that will assess the prevalence rates of cardiovascular risk factors in Brazilian adolescents using a sample with national and regional representativeness. This paper describes the rationale, design and procedures of ERICA.
143 citations
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TL;DR: In this paper, the effect of body mass index (BMI) and waist circumference (WC) on blood pressure (BP) of adolescents was evaluated using a simple linear regression analysis.
Abstract: BACKGROUND: Increased body mass index (BMI) and waist circumference (WC) have been associated with blood pressure elevation. OBJECTIVE: To evaluate the effect of BMI and WC on blood pressure (BP) of adolescents. METHODS: Cross-sectional analytical study including 536 adolescents from public and private schools. BMI was calculated and classified as high-normal (> 50th p and 85th p and 95th p). WC was measured and considered increased if > 75th p. BP was considered elevated if > 90th p. RESULTS: 319 (59.5%) adolescents were girls, the mean age was 14.0± 1.99 years, high-normal weight was found in 39.6%, overweight in 37.1% and obesity in 23.3%. The percentage of high SBP and DBP followed the increase in BMI (p=0.000), reaching 46.4% among boys and 39.3% among obese girls for SBP and 42.0% and 44.6% for DBP, respectively. High SBP and DBP were 3.9 and 3.4 times more frequent among boys and 2.2 to 2.0 times more frequent among girls with WC > 75th p, respectively. Using simple linear regression analysis, each increment in BMI would increase SBP by 1.198 mmHg, and in WC by 0.622 mmHg. The PR for elevated SBP and DBP in relation to BMI > 85th p was 3.9 (95% CI 2.0-7.4[p=0.000]) and 4.3(95% CI 2.2-8.5[p=0.000]), respectively; in relation to WC > 75th p was 1.8(95% CI 1.0 to 3.0 [p=0.036]) and 1.4 (95% CI 0.8 to 2.4). BP > 90th p with WC < 75th p was found in 16/181 (8.8%) of the adolescents with high-normal weight. CONCLUSION: BMI and WC values have a strong influence on BP values in adolescents.
116 citations
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Rio de Janeiro State University1, Federal University of Rio de Janeiro2, Oswaldo Cruz Foundation3, Universidade Federal do Rio Grande do Sul4, Brazilian Institute of Geography and Statistics5, Federal University of Pará6, University of São Paulo7, State University of Feira de Santana8, Federal University of Amazonas9, Universidade Federal de Minas Gerais10, Universidade Federal do Amapá11, Universidade Federal do Espírito Santo12, Universidade Federal de Santa Catarina13, Federal University of Rio Grande do Norte14, Universidade Federal de Mato Grosso15, Federal University of Bahia16, Pontifícia Universidade Católica do Paraná17, Federal University of Pernambuco18, University of Brasília19, Universidade Federal de Rondônia20, State University of Campinas21, Federal University of Piauí22, Universidade Federal do Acre23, Universidade Federal de Goiás24, Federal University of Maranhão25, Federal University of Ceará26, Universidade Federal de Sergipe27, Federal University of Paraíba28, Federal University of Alagoas29, Federal University of Roraima30, Sao Paulo State University31
TL;DR: Despite the prevalence of Metabolic Syndrome being low, the high prevalences of some components and participation of others in the syndrome composition shows the importance of early diagnosis of this changes, even if not grouped within the metabolic syndrome.
Abstract: OBJECTIVE To determine the prevalence of metabolic syndrome and its components in Brazilian adolescents. METHODS We evaluated 37,504 adolescents who were participants in the Study of Cardiovascular Risks in Adolescents (ERICA), a cross-sectional, school-based, national study. The adolescents, aged from 12 to 17 years, lived in cities with populations greater than 100,000 inhabitants. The sample was stratified and clustered into schools and classes. The criteria set out by the International Diabetes Federation were used to define metabolic syndrome. Prevalences of metabolic syndrome were estimated according to sex, age group, school type and nutritional status. RESULTS Of the 37,504 adolescents who were evaluated: 50.2% were female; 54.3% were aged from 15 to 17 years, and 73.3% were from public schools. The prevalence of metabolic syndrome was 2.6% (95%CI 2.3-2.9), slightly higher in males and in those aged from 15 to 17 years in most macro-regions. The prevalence was the highest in residents from the South macro-region, in the younger female adolescents and in the older male adolescents. The prevalence was higher in public schools (2.8% [95%CI 2.4-3.2]), when compared with private schools (1.9% [95%CI 1.4-2.4]) and higher in obese adolescents when compared with nonobese ones. The most common combinations of components, referring to 3/4 of combinations, were: enlarged waist circumference (WC), low HDL-cholesterol (HDL-c) and high blood pressure; followed by enlarged WC, low HDL-c and high triglycerides; and enlarged WC, low HDL-c, high triglycerides and blood pressure. Low HDL was the second most frequent component, but the highest prevalence of metabolic syndrome (26.8%) was observed in the presence of high triglycerides. CONCLUSIONS ERICA is the first Brazilian nation-wide study to present the prevalence of metabolic syndrome and describe the role of its components. Despite the prevalence of Metabolic Syndrome being low, the high prevalences of some components and participation of others in the syndrome composition shows the importance of early diagnosis of this changes, even if not grouped within the metabolic syndrome.
76 citations
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TL;DR: A review of epidemiological literature in PubMed from January 2004 to December 2013 illustrated the need for a greater attention to identifying and minimizing the effect of multicollinearity in analysis of data from epidemiologic studies.
Abstract: The adverse impact of ignoring multicollinearity on findings and data interpretation in regression analysis is very well documented in the statistical literature. The failure to identify and report multicollinearity could result in misleading interpretations of the results. A review of epidemiological literature in PubMed from January 2004 to December 2013, illustrated the need for a greater attention to identifying and minimizing the effect of multicollinearity in analysis of data from epidemiologic studies. We used simulated datasets and real life data from the Cameron County Hispanic Cohort to demonstrate the adverse effects of multicollinearity in the regression analysis and encourage researchers to consider the diagnostic for multicollinearity as one of the steps in regression analysis.
605 citations
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University of Barcelona1, Newcastle University2, Pontifical Catholic University of Chile3, University College London4, University of Paris5, University of Lisbon6, University of Florida7, University of Washington8, University of Antwerp9, University of Sydney10, Karolinska Institutet11, City University of New York12, King Fahd University Hospital13, University of California, San Diego14, University of California, Berkeley15, University Hospitals Birmingham NHS Foundation Trust16, College of Health Sciences, Bahrain17, Northwestern University18, The Graduate Center, CUNY19, University of Seville20, Royal Free Hospital21, University of Milan22, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico23, The Chinese University of Hong Kong24, Marmara University25, University of Haifa26
TL;DR: In this paper, a global Delphi study, a multidisciplinary group of experts developed consensus statements and recommendations, which a larger group of collaborators reviewed over three rounds until consensus was achieved.
Abstract: Non-alcoholic fatty liver disease (NAFLD) is a potentially serious liver disease that affects approximately one-quarter of the global adult population, causing a substantial burden of ill health with wide-ranging social and economic implications. It is a multisystem disease and is considered the hepatic component of metabolic syndrome. Unlike other highly prevalent conditions, NAFLD has received little attention from the global public health community. Health system and public health responses to NAFLD have been weak and fragmented, and, despite its pervasiveness, NAFLD is largely unknown outside hepatology and gastroenterology. There is only a nascent global public health movement addressing NAFLD, and the disease is absent from nearly all national and international strategies and policies for non-communicable diseases, including obesity. In this global Delphi study, a multidisciplinary group of experts developed consensus statements and recommendations, which a larger group of collaborators reviewed over three rounds until consensus was achieved. The resulting consensus statements and recommendations address a broad range of topics - from epidemiology, awareness, care and treatment to public health policies and leadership - that have general relevance for policy-makers, health-care practitioners, civil society groups, research institutions and affected populations. These recommendations should provide a strong foundation for a comprehensive public health response to NAFLD.
195 citations
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Federal University of Rio de Janeiro1, Oswaldo Cruz Foundation2, Rio de Janeiro State University3, Universidade Federal do Rio Grande do Sul4, Brazilian Institute of Geography and Statistics5, Federal University of Pará6, University of São Paulo7, State University of Feira de Santana8, Universidade Federal de Minas Gerais9, Universidade Federal do Amapá10, Federal University of Amazonas11, Universidade Federal do Espírito Santo12, Universidade Federal de Santa Catarina13, Federal University of Rio Grande do Norte14, Universidade Federal de Mato Grosso15, Federal University of Bahia16, Pontifícia Universidade Católica do Paraná17, Federal University of Pernambuco18, University of Brasília19, Universidade Federal de Rondônia20, State University of Campinas21, Federal University of Piauí22, Universidade Federal de Goiás23, Federal University of Maranhão24, Federal University of Ceará25, Universidade Federal de Sergipe26, Federal University of Paraíba27, Federal University of Alagoas28, Sao Paulo State University29
TL;DR: The study indicates that the control of obesity would lower the prevalence of hypertension among Brazilian adolescents by 1/5 and the fractions of hypertension attributable to obesity in the population by 17.8%.
Abstract: OBJECTIVE To estimate the prevalence of arterial hypertension and obesity and the population attributable fraction of hypertension that is due to obesity in Brazilian adolescents. METHODS Data from participants in the Brazilian Study of Cardiovascular Risks in Adolescents (ERICA), which was the first national school-based, cross-section study performed in Brazil were evaluated. The sample was divided into 32 geographical strata and clusters from 32 schools and classes, with regional and national representation. Obesity was classified using the body mass index according to age and sex. Arterial hypertension was defined when the average systolic or diastolic blood pressure was greater than or equal to the 95th percentile of the reference curve. Prevalences and 95% confidence intervals (95%CI) of arterial hypertension and obesity, both on a national basis and in the macro-regions of Brazil, were estimated by sex and age group, as were the fractions of hypertension attributable to obesity in the population. RESULTS We evaluated 73,399 students, 55.4% female, with an average age of 14.7 years (SD = 1.6). The prevalence of hypertension was 9.6% (95%CI 9.0-10.3); with the lowest being in the North, 8.4% (95%CI 7.7-9.2) and Northeast regions, 8.4% (95%CI 7.6-9.2), and the highest being in the South, 12.5% (95%CI 11.0-14.2). The prevalence of obesity was 8.4% (95%CI 7.9-8.9), which was lower in the North region and higher in the South region. The prevalences of arterial hypertension and obesity were higher in males. Obese adolescents presented a higher prevalence of hypertension, 28.4% (95%CI 25.5-31.2), than overweight adolescents, 15.4% (95%CI 17.0-13.8), or eutrophic adolescents, 6.3% (95%CI 5.6-7.0). The fraction of hypertension attributable to obesity was 17.8%. CONCLUSIONS ERICA was the first nationally representative Brazilian study providing prevalence estimates of hypertension in adolescents. Regional and sex differences were observed. The study indicates that the control of obesity would lower the prevalence of hypertension among Brazilian adolescents by 1/5.
147 citations
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TL;DR: The prevalence rates of NAFLD and obesity were highest in the United States, Belize, Barbados, and Mexico, while USA has the most people with type 2 diabetes mellitus and T2DM.
130 citations
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TL;DR: Whatever the definition used for abdominal obesity and whatever the methods used for anthropometric measurements, central body fat deposition in children and adolescents increases the risk of cardio-metabolic risk factors.
Abstract: Background: The adverse health effects of abdominal obesity are well documented in adults, but such association remains to be determined in the pediatric age group. This study aims to perform a systematic review on the association between abdominal obesity and cardio-metabolic factors such as dyslipidemia, hypertension, and hyperglycemia among children and adolescents.Materials and Methods: A systematic literature search was conducted using PubMed, Scopus and Google Scholar databases to May 2014. Two independent reviewers identified relevant papers in several steps. After studying the titles and texts of documents,repeated and irrelevant ones were excluded. The search was refined to the English language. We did not consider any time limitation.Studies with different measuring methods of abdominal obesity were included. Studies with abdominal obese patients secondary to other disease were excluded from the study. In final, the data of association of cardio-metabolic risk factors and abdominal obesity extracted from studies. Results: Overall, 3966 articles were reviewed, and 61 of them were studied according to the inclusion and exclusion criteria. Waist circumference (WC), waist-to-height ratio, and waist-to-hip ratio were the most common indexes used for defining abdominal obesity. The association of high blood pressure with increasing WC was seen in several studies. The association of other cardio-metabolic risk factors was seen in some studies. Conclusion: Whatever the definition used for abdominal obesity and whatever the methods used for anthropometric measurements, central body fat deposition in children and adolescents increases the risk of cardio-metabolic risk factors. Therefore, more attention should be paid to abdominal obesity of children and adolescents both in clinical practice and in epidemiological studies. Key words: Cardio-metabolic risk factors, central fat deposition, obesity, pediatric age group
126 citations