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CC&#44; g&#234;nero&#44; idade e zona residencial de crian&#231;as de seis anos completos a nove anos incompletos&#44; de munic&#237;pios do Vale do Taquari&#44; Rio Grande do Sul&#44; Brasil&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Metodologia</span><p id="par0100" class="elsevierStylePara elsevierViewall">Trata&#8208;se de um estudo de base populacional de modelo transversal&#44; com escolares da rede municipal de munic&#237;pios do Vale do Taquari&#44; no Rio Grande do Sul&#46; Os dados foram extra&#237;dos de um banco de dados secund&#225;rio&#44; cuja coleta foi realizada nos anos de 2012 e 2013&#46; A coleta de dados foi realizada com crian&#231;as e adolescentes&#44; por&#233;m&#44; para o presente estudo&#44; foram extra&#237;dos somente os dados referentes &#224;s crian&#231;as de seis anos completos a nove anos incompletos&#44; matriculadas nas escolas municipais&#44; perfazendo uma amostra de 709 crian&#231;as de ambos os g&#234;neros&#46; Destes alunos&#44; foram inclu&#237;dos no estudo aqueles que tivessem o termo de consentimento livre e esclarecido &#40;TCLE&#41; devidamente assinado pelos respons&#225;veis&#46; Foram exclu&#237;dos da pesquisa os alunos que n&#227;o estavam presentes na escola no dia da coleta de dados e que se recusaram ou desistiram de participar de alguma etapa da pesquisa&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">A estatura foi aferida em cent&#237;metros &#40;cm&#41;&#44; com precis&#227;o de 1<span class="elsevierStyleHsp" style=""></span>mm&#44; com estadi&#244;metro port&#225;til da marca AVANUTRI&#46; O IMC foi classificado de acordo com a Organiza&#231;&#227;o Mundial da Sa&#250;de &#40;OMS&#41;<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">7</span></a>&#44; em quatro grupos&#58; magreza&#44; eutrofia&#44; sobrepeso e obesidade&#46; A classifica&#231;&#227;o foi realizada atrav&#233;s de percentil e os pontos de corte tamb&#233;m analisados conforme as tabelas da OMS para a faixa et&#225;ria&#46; A CC foi medida no ponto m&#233;dio do tronco&#44; entre a &#250;ltima costela e a crista il&#237;aca&#44; com fita m&#233;trica flex&#237;vel e inextens&#237;vel&#44; com precis&#227;o de uma casa decimal&#46; Para CC foram considerados os percentis 50&#44; classificados de acordo com a recomenda&#231;&#227;o de Mc Carthy et al&#46; para faixa et&#225;ria como CC normal ou elevada<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">8</span></a>&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">A PA foi realizada pelo m&#233;todo oscilom&#233;trico&#44; com aparelho autom&#225;tico marca OMROM &#40;OMROM Eletr&#244;nica do Brasil&#44; S&#227;o Paulo&#44; Brasil&#41;&#44; modelo Hem&#8208;742INT&#46; Foram utilizados manguitos OMROM de tamanho apropriado &#224; circunfer&#234;ncia dos bra&#231;os das crian&#231;as&#46; A medida foi realizada uma &#250;nica vez&#44; no ambiente escolar&#44; seguindo as orienta&#231;&#245;es das V Diretrizes de Hipertens&#227;o Arterial<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">9</span></a>&#44; para a classifica&#231;&#227;o da PA sist&#243;lica &#40;PAS&#41; e press&#227;o arterial diast&#243;lica &#40;PAD&#41;&#46; Consideraram&#8208;se as curvas para determina&#231;&#227;o do percentil da estatura dos escolares de acordo com a idade e g&#234;nero&#44; segundo a OMS<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">7</span></a>&#44; e a tabela de percentil da PA&#44; referenciada pelas V Diretrizes de Hipertens&#227;o Arterial<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">9</span></a>&#44; para crian&#231;as com PAS e&#47;ou PAD igual ou acima do percentil 95 para g&#234;nero&#44; idade e estatura foram classificados na condi&#231;&#227;o de PA elevada&#46; Pr&#233;&#8208;hipertenso s&#227;o considerados os percentis 90&#8208;95 ou PA &#62; 120&#47;80 mmHg&#44; hipertens&#227;o est&#225;gio um &#40;HAS 1&#41; os percentis 95&#8208;99 &#43; 5 mmHg&#44; e para a hipertens&#227;o est&#225;gio dois &#40;HAS 2&#41;&#44; &#62; percentil 99 &#43; 5 mmHg&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">O presente estudo foi aprovado pelo Comit&#234; de &#201;tica em Pesquisa do Centro Universit&#225;rio UNIVATES em 10 de abril de 2014&#44; sob o n&#250;mero de registro 612&#46;030&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">Os dados foram analisados atrav&#233;s de tabelas&#44; estat&#237;sticas descritivas&#44; e para os testes estat&#237;sticos utilizou&#8208;se o <span class="elsevierStyleItalic">exato de Fisher</span>&#44; <span class="elsevierStyleItalic">qui&#8208;quadrado</span>&#44; teste n&#227;o&#8208;param&#233;trico <span class="elsevierStyleItalic">Mann&#8208;Whitney</span>&#44; teste n&#227;o&#8208;param&#233;trico <span class="elsevierStyleItalic">Kruskal&#8208;Wallis</span> e an&#225;lise de correla&#231;&#227;o de <span class="elsevierStyleItalic">Pearson</span>&#46; Os resultados foram considerados significativos a um n&#237;vel de signific&#226;ncia m&#225;ximo de 5&#37; &#40;p<span class="elsevierStyleHsp" style=""></span>&#8804;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#41; e o <span class="elsevierStyleItalic">software</span> utilizado para esta an&#225;lise foi o <span class="elsevierStyleItalic">Statistical Package for Social Sciences</span> &#40;SPSS&#41; vers&#227;o 13&#44;0&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Resultados</span><p id="par0125" class="elsevierStylePara elsevierViewall">Foram avaliados no presente trabalho 709 escolares&#44; classificados segundo o estado nutricional&#44; PAD e PAS e CC&#44; dos quais 55&#37; eram do g&#234;nero masculino e 54&#44;4&#37; residiam na zona rural&#46; O resultado da an&#225;lise descritiva em rela&#231;&#227;o &#224;s m&#233;dias demonstrou que a m&#233;dia de IMC foi de 30&#44;92<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3&#44;2<span class="elsevierStyleHsp" style=""></span>Kg&#47;m<span class="elsevierStyleSup">2</span>&#44; da PAD 150<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>11&#44;96<span class="elsevierStyleHsp" style=""></span>mmHg&#44; da PAS 170<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>14&#44;57<span class="elsevierStyleHsp" style=""></span>mmHg e da CC 103<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>8&#44;97<span class="elsevierStyleHsp" style=""></span>cm&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">Com rela&#231;&#227;o ao estado nutricional&#44; 22&#44;1&#37; apresentavam sobrepeso e 19&#44;7&#37; obesidade ou obesidade grave&#44; mas a maioria dos indiv&#237;duos eram eutr&#243;ficos &#40;58&#44;1&#37;&#41;&#46; A PAD e PAS foi classificada separadamente&#44; 9&#44;2 e 24&#44;4&#37;&#44; respectivamente&#44; classificaram&#8208;se com hipertens&#227;o &#40;HAS 1 ou 2&#41; e 26&#44;5&#37; foram classificadas como HAS 1 ou 2 para PAS&#47;PAD&#44; al&#233;m disso&#44; 26&#37; apresentarem CC elevada&#46;</p><p id="par0135" class="elsevierStylePara elsevierViewall">Os indiv&#237;duos residentes na zona urbana apresentaram m&#233;dias de PAS superiores aos que residiam na zona rural&#46; Somam&#8208;se a isso&#44; os indiv&#237;duos que possu&#237;am m&#233;dias de PAS e PAD elevadas tamb&#233;m apresentavam a CC aumentada&#44; conforme observado na <a class="elsevierStyleCrossRef" href="#tbl0005">tabela 1</a>&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0140" class="elsevierStylePara elsevierViewall">Na <a class="elsevierStyleCrossRef" href="#tbl0010">tabela 2</a> compara&#8208;se o estado nutricional com a CC e a classifica&#231;&#227;o PAD e PAS&#46; Crian&#231;as eutr&#243;ficas e com CC normal&#44; associada positivamente com a classifica&#231;&#227;o da PAD e PAS normal&#46; A obesidade foi significativamente associada &#224; pr&#233;&#8208;hipertens&#227;o&#44; HAS grau um e HAS grau dois em rela&#231;&#227;o a PAD e PAS&#59; a CC elevada foi significativamente associada &#224; classifica&#231;&#227;o da PAD de pr&#233;&#8208;hipertens&#227;o e HAS grau um e de PAS HAS grau um e dois&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0145" class="elsevierStylePara elsevierViewall">A <a class="elsevierStyleCrossRef" href="#tbl0015">tabela 3</a> demonstra que a PAS e PAD apresentaram diferen&#231;as significativas entre as idades&#46; Observou&#8208;se que&#44; para PAS&#44; na idade de seis anos apresentou as menores m&#233;dias&#44; seguida pelas idades sete e oito anos&#44; que n&#227;o diferem entre si&#44; e os maiores valores de PAS foram observadas nas idades de nove e dez anos&#46; J&#225; para a PAD&#44; verificou&#8208;se que a idade de seis anos apresentou as menores m&#233;dias em rela&#231;&#227;o &#224;s demais idades e que estas n&#227;o diferiam entre si&#46; Em rela&#231;&#227;o &#224;s m&#233;dias de IMC&#44; verificou&#8208;se que as m&#233;dias de PAS e PAD apresentaram diferen&#231;as significativas entre as classifica&#231;&#245;es de IMC&#44; ou seja&#44; a classifica&#231;&#227;o de eutrofia apresentou as menores m&#233;dias de PAS e PAD&#44; seguida pela classifica&#231;&#227;o sobrepeso&#44; e por fim&#44; com os maiores valores&#44; a classifica&#231;&#227;o obesidade&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0150" class="elsevierStylePara elsevierViewall">A <a class="elsevierStyleCrossRef" href="#tbl0020">tabela 4</a> relaciona a idade&#44; IMC e CC com PAS e PAD&#46; Cabe salientar que os valores de PA variam de acordo com a idade&#44; sexo e altura&#44; sendo os valores do ponto de corte tomados como refer&#234;ncia para o estudo&#46; Verificou&#8208;se que todas as correla&#231;&#245;es apresentaram resultados significativos&#44; com exce&#231;&#227;o da correla&#231;&#227;o entre a idade e a PAD&#46; Para o restante das correla&#231;&#245;es significativas&#44; observa&#8208;se uma correla&#231;&#227;o do tipo direta&#44; ou seja&#44; &#224; medida que aumentam as m&#233;dias de idade&#44; IMC e CC&#44; as m&#233;dias da PAS e PAD tendem a aumentar tamb&#233;m&#46;</p><elsevierMultimedia ident="tbl0020"></elsevierMultimedia></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Discuss&#227;o</span><p id="par0155" class="elsevierStylePara elsevierViewall">Neste estudo&#44; demonstrou&#8208;se que 22&#44;1&#37; das crian&#231;as estavam em sobrepeso e 19&#44;7&#37; em obesidade ou obesidade grave&#44; resultados superiores aos estudos de Pedersoli et al&#46;<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">10</span></a>&#44; realizado com crian&#231;as de 7&#8208;10 anos de idade em Porto Velho&#44; que encontraram 16&#44;5&#37; de sobrepeso e 11&#44;2&#37; de obesidade&#44; Lima et al&#46;<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">11</span></a>&#44; onde 15&#44;1&#37; apresentaram sobrepeso e 12&#44;3&#37; obesidade&#44; e Passos et al&#46;<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">12</span></a>&#44; que encontraram 26&#37; de sobrepeso e 25&#37; de obesidade em ambos os g&#234;neros&#44; e inferiores a Moraes et al&#46;<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">2</span></a>&#44; que observaram 21&#37; de sobrepeso e 27&#37; de obesidade em crian&#231;as de ambos os g&#234;neros&#44; de escolas da cidade de S&#227;o Paulo&#46; No estudo de Burgos et al&#46;<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">4</span></a>&#44; 26&#44;6&#37; das crian&#231;as foram classificadas com sobrepeso&#47;obesidade&#59; Lee et al&#46;<a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">13</span></a> mostraram que 28&#44;9&#37; das crian&#231;as tinham sobrepeso&#47;obesidade&#44; percentuais inferiores ao atual estudo&#46;</p><p id="par0160" class="elsevierStylePara elsevierViewall">A obesidade &#233; um problema crescente na inf&#226;ncia&#44; chegando a atingir entre 25&#8208;30&#37; da popula&#231;&#227;o infantil&#46; Tem sido atribu&#237;da principalmente a fatores ambientais e socioculturais&#44; tais como incentivo a uma dieta pouco saud&#225;vel&#44; com alta propor&#231;&#227;o de gorduras&#44; e a uma atitude sedent&#225;ria<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">14</span></a>&#46; A OMS estima que&#44; em 2015&#44; tenham existido 700 milh&#245;es de indiv&#237;duos com problemas de sa&#250;de decorrentes da obesidade e&#44; destes&#44; 43 milh&#245;es eram crian&#231;as&#44; com idades abaixo de cinco anos&#44; com sobrepeso<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">15</span></a>&#46;</p><p id="par0165" class="elsevierStylePara elsevierViewall">Observando&#8208;se este crescente aumento de sobrepeso e obesidade em crian&#231;as cada vez mais jovens&#44; Gabriel et al&#46;<a class="elsevierStyleCrossRef" href="#bib0245"><span class="elsevierStyleSup">16</span></a> destacaram o Programa Nacional de Alimenta&#231;&#227;o Escolar &#40;PNAE&#41; como uma importante ferramenta para influenciar positivamente no crescimento e o desenvolvimento biopsicossocial&#44; na aprendizagem&#44; no rendimento escolar e a forma&#231;&#227;o de h&#225;bitos alimentares saud&#225;veis dos alunos de toda a educa&#231;&#227;o b&#225;sica p&#250;blica&#44; por meio de a&#231;&#245;es de educa&#231;&#227;o alimentar e nutricional e da oferta de refei&#231;&#245;es saud&#225;veis&#46;</p><p id="par0170" class="elsevierStylePara elsevierViewall">No presente estudo&#44; 26&#37; das crian&#231;as encontraram&#8208;se com a CC elevada&#44; resultados inferiores ao estudo de Iampolsky et al&#46;<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">17</span></a>&#44; com escolares de Santo Andr&#233;&#8208;SP&#44; no qual encontraram uma preval&#234;ncia de 30&#44;2&#37;&#44; e ao estudo de Souza et al&#46;<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">18</span></a>&#44; que demonstrou 42&#37; das crian&#231;as com CC elevada&#46; Neste sentido&#44; a CC pode ser usada efetivamente para a avalia&#231;&#227;o cl&#237;nica da presen&#231;a ou n&#227;o de fatores de risco para DCV em crian&#231;as e adolescentes<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">19</span></a>&#46; Friedemann et al&#46;<a class="elsevierStyleCrossRef" href="#bib0265"><span class="elsevierStyleSup">20</span></a> d&#227;o &#234;nfase a CC como preditora relevante de n&#237;veis alterados de lip&#237;deos&#44; lipoprote&#237;nas e apolipoprote&#237;nas em indiv&#237;duos jovens<a class="elsevierStyleCrossRef" href="#bib0270"><span class="elsevierStyleSup">21</span></a>&#46; O risco cardiovascular vem aumentando ao longo dos anos&#44; sendo considerado um importante problema de sa&#250;de p&#250;blica por causar elevadas taxas de morbidade e mortalidade&#44; al&#233;m do impacto negativo na qualidade de vida destes pacientes<a class="elsevierStyleCrossRef" href="#bib0275"><span class="elsevierStyleSup">22</span></a>&#46; Atualmente&#44; sabe&#8208;se que a localiza&#231;&#227;o abdominal de gordura mostra&#8208;se mais associada &#224;s dislipidemias&#44; hipertens&#227;o arterial e altera&#231;&#245;es no metabolismo glic&#234;mico&#44; sendo o per&#237;metro da cintura considerado bom indicador da adiposidade corporal e do risco cardiovascular<a class="elsevierStyleCrossRef" href="#bib0280"><span class="elsevierStyleSup">23</span></a>&#44; assim como o IMC&#44; que tem apresentado concord&#226;ncia com indicadores de adiposidade<a class="elsevierStyleCrossRef" href="#bib0285"><span class="elsevierStyleSup">24</span></a>&#46;</p><p id="par0175" class="elsevierStylePara elsevierViewall">Das crian&#231;as estudadas&#44; 11&#44;8&#37; foram classificadas como pr&#233;&#8208;hipertensas e 26&#44;5&#37; como HAS1 ou HAS2 para PAS&#47;PAD&#44; resultados superiores ao estudo de Moraes et al&#46;<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">2</span></a>&#44; onde demonstrou&#8208;se que 3&#44;4&#37; das crian&#231;as apresentam o diagn&#243;stico de pr&#233;&#8208;hipertens&#227;o&#44; e 3&#44;9&#37; com o diagn&#243;stico de HAS1 e HAS2 para PAD&#47;PAS e ao estudo de Rosini et al&#46;<a class="elsevierStyleCrossRef" href="#bib0190"><span class="elsevierStyleSup">5</span></a>&#44; com escolares de Guabiruba&#44; que observaram 6&#44;1&#37; das crian&#231;as classificadas como pr&#233;&#8208;hipertensas e 4&#44;5&#37; como hipertensas&#46; J&#225; o estudo de Rinaldi et al&#46;<a class="elsevierStyleCrossRef" href="#bib0290"><span class="elsevierStyleSup">25</span></a> demonstrou que 26&#37; das crian&#231;as apresentaram eleva&#231;&#227;o de PAS&#47;PAD&#44; e Lima et al&#46;<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">11</span></a> constataram n&#237;veis press&#243;ricos elevados em 20&#44;4&#37; das crian&#231;as&#46; Portanto&#44; como &#233; sabido que a HAS do adulto tem in&#237;cio na inf&#226;ncia&#44; e em decorr&#234;ncia da falta da medi&#231;&#227;o de PA em crian&#231;as&#44; ainda com a cren&#231;a de que a HAS n&#227;o ocorre nesta faixa et&#225;ria&#44; muitas vezes deixa&#8208;se de fazer o diagn&#243;stico j&#225; nesta faixa et&#225;ria&#44; onde a interven&#231;&#227;o precoce poderia prevenir o agravamento desta patologia no futuro<a class="elsevierStyleCrossRef" href="#bib0295"><span class="elsevierStyleSup">26</span></a>&#46;</p><p id="par0180" class="elsevierStylePara elsevierViewall">Monego e Jardim<a class="elsevierStyleCrossRef" href="#bib0300"><span class="elsevierStyleSup">27</span></a>&#44; Moraes et al&#46;<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">2</span></a>&#44; Carvalho et al&#46;<a class="elsevierStyleCrossRef" href="#bib0305"><span class="elsevierStyleSup">28</span></a> e Lima et al&#46;<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">11</span></a> observaram associa&#231;&#227;o significativa entre excesso de peso e HAS&#44; resultado semelhante ao atual estudo&#44; onde a obesidade foi significativamente associada &#224; pr&#233;&#8208;hipertens&#227;o&#44; HAS1 e HAS2&#46; Assim como&#44; neste estudo&#44; a classifica&#231;&#227;o de eutrofia associou&#8208;se significativamente a classifica&#231;&#227;o da PAS e PAD normal&#44; da mesma forma que no estudo de Batista et al&#46;<a class="elsevierStyleCrossRef" href="#bib0310"><span class="elsevierStyleSup">29</span></a>&#46; Independentemente do crit&#233;rio de classifica&#231;&#227;o nutricional utilizado&#44; os percentuais de PA aumentam &#224; medida que se progride de classe nutricional&#44; de baixo peso a obesidade<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">2</span></a>&#46;</p><p id="par0185" class="elsevierStylePara elsevierViewall">Visto que IMC e CC t&#234;m rela&#231;&#227;o com a PA em crian&#231;as&#44; &#233; importante salientar que a presen&#231;a de n&#237;veis press&#243;ricos elevados n&#227;o &#233; t&#227;o rara quanto antes imaginado&#44; e crian&#231;as com excesso de peso&#44; hist&#243;ria familiar positiva e&#47;ou baixo peso ao nascer merecem aten&#231;&#227;o redobrada quanto ao risco da doen&#231;a&#46; A baixa ades&#227;o m&#233;dica &#224;s atuais recomenda&#231;&#245;es&#44; para avalia&#231;&#227;o rotineira da PA em crian&#231;as acima dos tr&#234;s anos de idade&#44; &#233; um problema que merece aten&#231;&#227;o especial por parte das pol&#237;ticas de sa&#250;de p&#250;blica&#44; uma vez que permite o subdiagn&#243;stico&#44; com consequ&#234;ncias futuras possivelmente irrevers&#237;veis para esses indiv&#237;duos<a class="elsevierStyleCrossRef" href="#bib0315"><span class="elsevierStyleSup">30</span></a>&#46;</p><p id="par0190" class="elsevierStylePara elsevierViewall">No estudo de Batista et al&#46;<a class="elsevierStyleCrossRef" href="#bib0310"><span class="elsevierStyleSup">29</span></a>&#44; a principal caracter&#237;stica cl&#237;nica das crian&#231;as estudadas foi o estado nutricional&#44; onde 39&#37; das crian&#231;as apresentaram excesso de peso e maiores m&#233;dias de PA&#44; tanto para PAD tanto para PAS&#46;</p><p id="par0195" class="elsevierStylePara elsevierViewall">Observou&#8208;se&#44; no atual estudo&#44; uma correla&#231;&#227;o significativa do tipo direta&#44; ou seja&#44; &#224; medida que aumentam as m&#233;dias de idade&#44; IMC e CC&#44; as m&#233;dias da PAS e PAD tendem a aumentar tamb&#233;m&#44; resultado semelhante ao estudo de Burgos et al&#46;<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">4</span></a> e Batista et al&#46;<a class="elsevierStyleCrossRef" href="#bib0310"><span class="elsevierStyleSup">29</span></a>&#46; Paschoal et al&#46;<a class="elsevierStyleCrossRef" href="#bib0315"><span class="elsevierStyleSup">30</span></a>&#44; em seu estudo com crian&#231;as de sete e oito anos&#44; demonstraram que a m&#233;dia da PAS foi menor no grupo eutr&#243;fico&#44; comparado ao obeso&#46; J&#225; no estudo de Nobre et al&#46;<a class="elsevierStyleCrossRef" href="#bib0320"><span class="elsevierStyleSup">31</span></a>&#44; ao desenvolverem pesquisa avaliando o efeito do IMC sobre a PA&#44; observaram que o percentual de crian&#231;as com PAS&#44; PAD e PAS&#47;PAD elevadas foi significativamente mais alta entre aqueles com CC elevada&#44; em ambos os g&#234;neros&#46;</p><p id="par0200" class="elsevierStylePara elsevierViewall">O estudo atual demonstrou que a PAS apresentou m&#233;dia significativamente inferior aos seis anos de idade&#44; seguida das idades de sete e oito anos&#59; j&#225; na PAD&#44; verificou&#8208;se que a idade de seis anos apresentou as menores m&#233;dias em rela&#231;&#227;o &#224;s demais idades e que estas n&#227;o diferem entre si&#46; No estudo de Moraes et al&#46;<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">2</span></a> n&#227;o houve associa&#231;&#227;o significativa entre a presen&#231;a de PA elevada e a idade&#46;</p><p id="par0205" class="elsevierStylePara elsevierViewall">A &#250;nica correla&#231;&#227;o identificada quanto ao g&#234;nero foi &#224; presen&#231;a de maiores n&#237;veis de press&#227;o diast&#243;lica no g&#234;nero masculino &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;02&#41;<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">2</span></a>&#46; Diferentemente do estudo de Rosa et al&#46;<a class="elsevierStyleCrossRef" href="#bib0325"><span class="elsevierStyleSup">32</span></a>&#44; que demonstrou n&#227;o haver associa&#231;&#227;o significativa entre a presen&#231;a de PA elevada e a idade para PAS e PAD&#46; J&#225; nos trabalhos de Rinaldi et al&#46;<a class="elsevierStyleCrossRef" href="#bib0290"><span class="elsevierStyleSup">25</span></a> e Santos et al&#46;<a class="elsevierStyleCrossRef" href="#bib0330"><span class="elsevierStyleSup">33</span></a>&#44; defendem a ideia de que a medida que aumenta a idade&#44; aumentam tamb&#233;m os valores de PAS e PAD&#46;</p><p id="par0210" class="elsevierStylePara elsevierViewall">Todas as crian&#231;as que apresentaram obesidade ou PA foram encaminhadas a unidade b&#225;sica de sa&#250;de&#44; para receberem atendimento m&#233;dico e nutricional&#46; Cabe destacar que as vari&#225;veis estudadas no presente trabalho est&#227;o sendo verificadas em outros munic&#237;pios&#44; para posterior an&#225;lise&#46;</p><p id="par0215" class="elsevierStylePara elsevierViewall">Como limita&#231;&#227;o do estudo podemos citar o n&#250;mero de avalia&#231;&#245;es de PA ter sido realizado em triplicata&#44; somente quando as duas primeiras medi&#231;&#245;es apresentavam diferen&#231;a expressiva entre os valores&#46; Al&#233;m disso&#44; o presente trabalho n&#227;o considerou a estatura como fator que justificasse o aumento da PAS de crian&#231;as obesas ou com CC aumentada&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Conclus&#227;o</span><p id="par0220" class="elsevierStylePara elsevierViewall">Concluiu&#8208;se que as crian&#231;as residentes na zona urbana apresentaram m&#233;dias de PAS significativamente superiores &#224;s que residiam na zona rural&#44; possivelmente em virtude de uma alimenta&#231;&#227;o mais industrializada e rica em s&#243;dio&#46; Al&#233;m disso&#44; as que apresentavam CC elevada possu&#237;am m&#233;dias de PAS e PAD significativamente superiores em rela&#231;&#227;o &#224;s crian&#231;as com CC normal&#46; Assim&#44; a obesidade foi significativamente associada &#224; pr&#233;&#8208;hipertens&#227;o&#44; HAS1 e HAS2&#44; tanto para PAS quanto para a PAD&#46; A CC elevada foi significativamente associada &#224; classifica&#231;&#227;o da PAD de pr&#233;&#8208;hipertens&#227;o e HAS1&#44; e de HAS1 e HAS2 para PAS&#46;</p><p id="par0225" class="elsevierStylePara elsevierViewall">As crian&#231;as de nove a dez anos apresentaram as m&#233;dias de PAS e PAD maiores em rela&#231;&#227;o &#224;s crian&#231;as de seis e oito anos&#44; assim como as crian&#231;as obesas demonstraram as maiores m&#233;dias de PAS e PAD&#44; em rela&#231;&#227;o &#224;s com sobrepeso e eutrofia&#46; Observou&#8208;se ainda que &#224; medida que as m&#233;dias de idade&#44; IMC e CC aumentam&#44; as m&#233;dias da PAS e PAD tendem a aumentar tamb&#233;m&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Responsabilidades &#233;ticas</span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Prote&#231;&#227;o de pessoas e animais</span><p id="par0230" class="elsevierStylePara elsevierViewall">Os autores declaram que os procedimentos seguidos estavam de acordo com os regulamentos estabelecidos pelos respons&#225;veis da Comiss&#227;o de Investiga&#231;&#227;o Cl&#237;nica e &#201;tica e de acordo com os da Associa&#231;&#227;o M&#233;dica Mundial e da Declara&#231;&#227;o de Helsinki&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Confidencialidade dos dados&#46;</span><p id="par0235" class="elsevierStylePara elsevierViewall">Os autores declaram ter seguido os protocolos do seu centro de trabalho acerca da publica&#231;&#227;o dos dados de pacientes&#46;</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Direito &#224; privacidade e consentimento escrito&#46;</span><p id="par0240" class="elsevierStylePara elsevierViewall">Os autores declaram ter recebido consentimento escrito dos pacientes e&#47; ou sujeitos mencionados no artigo&#46; O autor para correspond&#234;ncia deve estar na posse deste documento&#46;</p></span></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Conflito de interesses</span><p id="par0245" class="elsevierStylePara elsevierViewall">Os autores declaram n&#227;o haver conflito de interesses&#46;</p></span></span>"
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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Introdu&#231;&#227;o</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A hipertens&#227;o arterial sist&#234;mica &#40;HAS&#41; destaca&#8208;se como um dos principais fatores de risco para doen&#231;as cardiovasculares &#40;DCV&#41;&#46; O diagn&#243;stico e tratamento precoce da hipertens&#227;o na inf&#226;ncia tem potencial de causar grande impacto contra desfechos adversos futuros&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Objetivo</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Verificar a rela&#231;&#227;o da press&#227;o arterial diast&#243;lica &#40;PAD&#41; e sist&#243;lica &#40;PAS&#41; com avalia&#231;&#227;o antropom&#233;trica e a zona residencial de crian&#231;as de munic&#237;pios do Rio Grande do Sul&#44; Brasil&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">M&#233;todos</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Trata&#8208;se de um estudo de modelo transversal&#44; realizado com 709 crian&#231;as de seis anos completos a nove anos incompletos&#46; Foram aferidas a press&#227;o arterial&#44; peso corporal&#44; altura e circunfer&#234;ncia da cintura &#40;<span class="elsevierStyleSmallCaps">CC</span>&#41;&#46; Utilizaram&#8208;se testes estat&#237;sticos&#44; com n&#237;vel de signific&#226;ncia m&#225;ximo de 5&#37; &#40;p<span class="elsevierStyleHsp" style=""></span>&#8804;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#41; e o <span class="elsevierStyleItalic">software</span> utilizado para esta an&#225;lise foi o SPSS vers&#227;o 13&#44;0&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Resultados</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">A obesidade foi significativamente associada &#224; pr&#233;&#8208;hipertens&#227;o&#44; HAS grau um e dois&#46; A CC elevada foi significativamente associada &#224; classifica&#231;&#227;o da PAD de pr&#233;&#8208;hipertens&#227;o e HAS grau 1 e de PAS HAS grau um e dois &#40;&#8804; 0&#44;01&#41;&#46;</p></span> <span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Conclus&#227;o</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">As crian&#231;as residentes na zona urbana apresentaram m&#233;dias de PAS significativamente superiores &#224;s que residiam na zona rural&#46; Aquelas com CC elevada apresentaram m&#233;dias de PAS e PAD superiores em rela&#231;&#227;o &#224;s crian&#231;as com CC normal&#46; As crian&#231;as obesas demonstraram as maiores m&#233;dias de PAS e PAD&#44; em rela&#231;&#227;o &#224;s com sobrepeso e &#224;s eutr&#243;ficas e&#44; &#224; medida que aumentaram as m&#233;dias de idade&#44; &#237;ndice de massa corporal e CC&#44; as m&#233;dias da PAS e PAD aumentaram tamb&#233;m&#46;</p></span>"
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        "resumen" => "<span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Introduction</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Systemic hypertension is one of the main risk factors for cardiovascular disease &#40;CVD&#41;&#46; Early diagnosis and treatment of hypertension in childhood can potentially have a significant impact on future adverse outcomes&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Objective</span><p id="spar0095" class="elsevierStyleSimplePara elsevierViewall">To investigate the relationship of diastolic &#40;DBP&#41; and systolic blood pressure &#40;SBP&#41; with anthropometric data and area of residence of children in municipalities of Rio Grande do Sul state&#44; Brazil&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Methods</span><p id="spar0100" class="elsevierStyleSimplePara elsevierViewall">This is a cross&#8208;sectional study of 709 children between six and nine years of age&#46; Blood pressure&#44; weight&#44; height and waist circumference &#40;WC&#41; were measured&#46; Statistical tests had a maximum significance level of 5&#37; &#40;p&#8804;0&#46;05&#41; and the software used was SPSS version 13&#46;0&#46;</p></span> <span id="abst0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Results</span><p id="spar0105" class="elsevierStyleSimplePara elsevierViewall">Obesity was significantly associated with pre&#8208;hypertension&#44; and stage 1 and 2 hypertension as assessed by DBP and SBP &#40;&#8804;0&#46;05&#41;&#59; high WC was significantly associated with a classification of pre&#8208;hypertension and stage 1 hypertension based on DBP and a classification of stage 1 and 2 hypertension based on SBP &#40;&#8804;0&#46;01&#41;&#46;</p></span> <span id="abst0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Conclusion</span><p id="spar0110" class="elsevierStyleSimplePara elsevierViewall">Children living in urban areas had significantly higher mean SBP than those living in rural areas&#46; Those with high WC presented higher SBP and DBP compared to children with normal WC&#46; Obese children showed higher mean SBP and DBP compared to those who were overweight or normal weight and mean SBP and DBP also increased with older age and higher mean body mass index and WC&#46;</p></span>"
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">62&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">10&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " rowspan="4" align="left" valign="top">G&#234;nero</td><td class="td" title="table-entry  " rowspan="2" align="left" valign="top">PAS</td><td class="td" title="table-entry  " align="left" valign="top">Masculino&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">390&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">108&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">13&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;181&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Feminino&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">320&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">106&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">15&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " rowspan="2" align="left" valign="top">PAD</td><td class="td" title="table-entry  " align="left" valign="top">Masculino&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">390&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">63&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">11&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;566&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Feminino&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">320&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">63&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">12&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " rowspan="4" align="left" valign="top">CC</td><td class="td" title="table-entry  " rowspan="2" align="left" valign="top">PAS</td><td class="td" title="table-entry  " align="left" valign="top">Normal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">526&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">104&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">13&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8804;<span class="elsevierStyleHsp" style=""></span>0&#44;01&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">CC elevada&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">184&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">116&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">14&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " rowspan="2" align="left" valign="top">PAD</td><td class="td" title="table-entry  " align="left" valign="top">Normal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">526&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">61&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">11&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8804;<span class="elsevierStyleHsp" style=""></span>0&#44;01&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">CC elevada&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">184&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">68&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">12&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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          "pt" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Compara&#231;&#227;o das m&#233;dias PAS e PAD entre as vari&#225;veis&#58; zona&#44; g&#234;nero e classifica&#231;&#227;o CC</p>"
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          "leyenda" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">CC&#58; circunfer&#234;ncia da cintura&#59; DP&#58; desvio padr&#227;o&#59; EN&#58; estado nutricional&#59; IMC&#58; &#237;ndice de massa corporal&#59; HAS1&#58; hipertens&#227;o arterial sist&#234;mica grau 1&#59; HAS2&#58; hipertens&#227;o arterial sist&#234;mica grau 2&#59; N&#58; n&#250;mero de casos&#59; PAD&#58; press&#227;o arterial diast&#243;lica&#59; PAS&#58; press&#227;o arterial sist&#243;lica&#46;</p>"
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                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col">Vari&#225;vel&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col">Resposta&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " colspan="8" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Classifica&#231;&#227;o PAD</th><th class="td" title="table-head  " align="left" valign="top" scope="col">p<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="" valign="top" scope="col">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " colspan="2" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Normal</th><th class="td" title="table-head  " colspan="2" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Pr&#233;&#8208;hipertens&#227;o</th><th class="td" title="table-head  " colspan="2" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">HAS1</th><th class="td" title="table-head  " colspan="2" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">HAS2</th><th class="td" title="table-head  " align="" valign="top" scope="col">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " rowspan="3" align="left" valign="top">EN</td><td class="td" title="table-entry  " align="left" valign="top">Eutrofia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">378&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">61&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">28&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">17&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">39&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">36&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8804;<span class="elsevierStyleHsp" style=""></span>0&#44;05&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Sobrepeso&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">131&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">21&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">28&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">11&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">25&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">27&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Obesidade&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">103&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">16&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">14&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">43&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">15&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">34&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">36&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " rowspan="2" align="left" valign="top">CC</td><td class="td" title="table-entry  " align="left" valign="top">Normal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">471&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">76&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">15&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">46&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">26&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">60&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">14&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">63&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8804;<span class="elsevierStyleHsp" style=""></span>0&#44;01&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">CC elevada&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">142&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">23&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">17&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">53&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">17&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">39&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">36&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="center" valign="top" scope="col">Vari&#225;vel&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="center" valign="top" scope="col">Resposta&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " colspan="8" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Classifica&#231;&#227;o PAS</th><th class="td" title="table-head  " align="left" valign="top" scope="col">p&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</th><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " colspan="2" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Normal</th><th class="td" title="table-head  " colspan="2" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Pr&#233;&#8208;hipertens&#227;o</th><th class="td" title="table-head  " colspan="2" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">HAS1</th><th class="td" title="table-head  " colspan="2" align="left" valign="top" scope="col" style="border-bottom: 2px solid black">HAS2</th><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " rowspan="3" align="left" valign="top">EN</td><td class="td" title="table-entry  " align="left" valign="top">Eutrofia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">314&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">68&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">36&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">45&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">42&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">39&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">20&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">29&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8804;<span class="elsevierStyleHsp" style=""></span>0&#44;05&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Sobrepeso&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">91&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">19&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">21&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">26&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">28&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">26&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">17&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">25&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Obesidade&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">51&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">11&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">23&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">28&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">36&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">34&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">30&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">44&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " rowspan="2" align="left" valign="top">CC</td><td class="td" title="table-entry  " align="left" valign="top">Normal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">378&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">82&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">54&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">67&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">64&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">60&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">30&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">44&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8804;<span class="elsevierStyleHsp" style=""></span>0&#44;01&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">CC elevada&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">79&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">17&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">26&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">32&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">42&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">39&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">37&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">55&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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              "nota" => "<p class="elsevierStyleNotepara" id="npar0010">Qui&#8208;quadrado&#46; p &#40;ausente&#41;&#58; representa valores n&#227;o significativos&#46;</p>"
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          "pt" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Compara&#231;&#227;o da classifica&#231;&#227;o do estado nutricional e da circunfer&#234;ncia da cintura com classifica&#231;&#227;o PAD e PAS</p>"
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          "leyenda" => "<p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">DP&#58; desvio padr&#227;o&#59; IMC&#58; &#237;ndice de massa corporal&#59; N&#58; n&#250;mero de casos&#59; PAD&#58; press&#227;o arterial diast&#243;lica&#59; PAS&#58; press&#227;o arterial sist&#243;lica&#46;</p>"
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            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col">Idade&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col">n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " colspan="3" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">PAS</th><th class="td" title="table-head  " colspan="3" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">PAD</th></tr><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">M&#233;dia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">DP&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">p<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">M&#233;dia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">DP&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">p<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Seis anos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">44&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">98&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">13&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8804;<span class="elsevierStyleHsp" style=""></span>0&#44;01&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">59&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">11&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8804;<span class="elsevierStyleHsp" style=""></span>0&#44;01&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Sete anos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">175&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">106&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">15&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">63&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">13&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Oito anos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">196&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">106&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">14&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">62&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">12&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Nove anos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">247&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">109&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">14&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">63&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">10&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Dez anos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">48&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">111&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">11&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">64&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col">IMC&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col">n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " colspan="3" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">PAS</th><th class="td" title="table-head  " colspan="3" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">PAD</th></tr><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">M&#233;dia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">DP&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">p<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
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Artigo Original
Fatores de risco cardiovascular em crianças
Cardiovascular risk factors in children
Marisete Inês Fraporti, Fernanda Scherer Adami
Autor para correspondência
, Michele Dutra Rosolen
Centro Universitário Univates, Centro de Ciências Biológicas e da Saúde, Curso de Nutrição, Lajeado, Brasil
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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Introdu&#231;&#227;o</span><p id="par0070" class="elsevierStylePara elsevierViewall">As doen&#231;as cardiovasculares &#40;DCV&#41; s&#227;o a primeira causa de incapacidade e morte prematura no mundo&#46; A hipertens&#227;o arterial sist&#234;mica &#40;HAS&#41;&#44; por sua vez&#44; &#233; um dos fatores de risco mais importantes para desenvolvimento dessas doen&#231;as<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">1</span></a>&#46; A obesidade &#233; vista como uma epidemia mundial&#44; acompanhada do aumento de fatores de risco cardiovasculares&#44; como a HAS&#46; N&#237;veis press&#243;ricos elevados em crian&#231;as preveem HAS do adulto e contribuem para a ocorr&#234;ncia de eventos cardiovasculares&#46; Assim&#44; a identifica&#231;&#227;o e o tratamento precoce da hipertens&#227;o na inf&#226;ncia tem potencial de causar grande impacto contra desfechos adversos futuros<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">2</span></a>&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">Nas &#250;ltimas d&#233;cadas&#44; a preval&#234;ncia de press&#227;o arterial &#40;PA&#41; elevada tem aumentado entre as crian&#231;as e a falta de diagn&#243;stico pode levar ao n&#227;o tratamento da enfermidade e sua persist&#234;ncia at&#233; a maioridade<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">3</span></a>&#46; A presen&#231;a de PA elevada em crian&#231;as pode antecipar o aparecimento de les&#245;es em &#243;rg&#227;os&#8208;alvo&#44; como hipertrofia do ventr&#237;culo esquerdo&#44; aumento da espessura das art&#233;rias car&#243;tidas&#44; altera&#231;&#245;es vasculares na retina e at&#233; mesmo sutis altera&#231;&#245;es cognitivas<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">1</span></a>&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">Atualmente se considera obrigat&#243;ria a medida da PA a partir dos tr&#234;s anos de idade&#44; anualmente&#44; ou antes disso&#44; quando houver fatores de risco&#46; No entanto&#44; a metodologia complexa exigida para a verifica&#231;&#227;o da PA em crian&#231;as faz com que muitos profissionais a excluam de sua rotina ou interpretem os valores aferidos de forma incorreta&#44; o que pode resultar em subdiagn&#243;stico e consequ&#234;ncias incorrig&#237;veis para esses indiv&#237;duos<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">2</span></a>&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">O excesso de peso&#44; avaliado pelo &#237;ndice de massa corp&#243;rea &#40;IMC&#41;&#44; &#233; um importante preditor da PA elevada em crian&#231;as&#46; Assim&#44; a classifica&#231;&#227;o adequada do estado nutricional em crian&#231;as &#233; um instrumento de alerta para o risco de hipertens&#227;o&#46; A obesidade tem sido identificada como um importante fator de risco para o desenvolvimento de DCV&#44; no entanto&#44; outros fatores&#44; aliados &#224; obesidade ou n&#227;o&#44; tamb&#233;m exercem influ&#234;ncia sobre este risco<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">4</span></a>&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">A circunfer&#234;ncia da cintura &#40;CC&#41; &#233; a medida que reflete obesidade abdominal e pode ser utilizada de forma isolada para a determina&#231;&#227;o de risco de altera&#231;&#245;es metab&#243;licas e DCV&#44; em crian&#231;as e adolescentes<a class="elsevierStyleCrossRef" href="#bib0190"><span class="elsevierStyleSup">5</span></a>&#46; Na faixa et&#225;ria infantil&#44; estudos mostram que a CC est&#225; relacionada ao excesso de gordura abdominal e a fatores de risco para DCV&#44; como colesterol total&#44; <span class="elsevierStyleItalic">Low Density Lipoprotein</span> &#40;LDL&#41;&#44; colesterol aumentado e <span class="elsevierStyleItalic">High&#8208;density lipoprotein</span> &#40;HDL&#41; colesterol baixo<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">6</span></a>&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">O objetivo deste estudo foi verificar a rela&#231;&#227;o da PA &#40;diast&#243;lica e sist&#243;lica&#41;&#44; avalia&#231;&#227;o antropom&#233;trica&#44; CC&#44; g&#234;nero&#44; idade e zona residencial de crian&#231;as de seis anos completos a nove anos incompletos&#44; de munic&#237;pios do Vale do Taquari&#44; Rio Grande do Sul&#44; Brasil&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Metodologia</span><p id="par0100" class="elsevierStylePara elsevierViewall">Trata&#8208;se de um estudo de base populacional de modelo transversal&#44; com escolares da rede municipal de munic&#237;pios do Vale do Taquari&#44; no Rio Grande do Sul&#46; Os dados foram extra&#237;dos de um banco de dados secund&#225;rio&#44; cuja coleta foi realizada nos anos de 2012 e 2013&#46; A coleta de dados foi realizada com crian&#231;as e adolescentes&#44; por&#233;m&#44; para o presente estudo&#44; foram extra&#237;dos somente os dados referentes &#224;s crian&#231;as de seis anos completos a nove anos incompletos&#44; matriculadas nas escolas municipais&#44; perfazendo uma amostra de 709 crian&#231;as de ambos os g&#234;neros&#46; Destes alunos&#44; foram inclu&#237;dos no estudo aqueles que tivessem o termo de consentimento livre e esclarecido &#40;TCLE&#41; devidamente assinado pelos respons&#225;veis&#46; Foram exclu&#237;dos da pesquisa os alunos que n&#227;o estavam presentes na escola no dia da coleta de dados e que se recusaram ou desistiram de participar de alguma etapa da pesquisa&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">A estatura foi aferida em cent&#237;metros &#40;cm&#41;&#44; com precis&#227;o de 1<span class="elsevierStyleHsp" style=""></span>mm&#44; com estadi&#244;metro port&#225;til da marca AVANUTRI&#46; O IMC foi classificado de acordo com a Organiza&#231;&#227;o Mundial da Sa&#250;de &#40;OMS&#41;<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">7</span></a>&#44; em quatro grupos&#58; magreza&#44; eutrofia&#44; sobrepeso e obesidade&#46; A classifica&#231;&#227;o foi realizada atrav&#233;s de percentil e os pontos de corte tamb&#233;m analisados conforme as tabelas da OMS para a faixa et&#225;ria&#46; A CC foi medida no ponto m&#233;dio do tronco&#44; entre a &#250;ltima costela e a crista il&#237;aca&#44; com fita m&#233;trica flex&#237;vel e inextens&#237;vel&#44; com precis&#227;o de uma casa decimal&#46; Para CC foram considerados os percentis 50&#44; classificados de acordo com a recomenda&#231;&#227;o de Mc Carthy et al&#46; para faixa et&#225;ria como CC normal ou elevada<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">8</span></a>&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">A PA foi realizada pelo m&#233;todo oscilom&#233;trico&#44; com aparelho autom&#225;tico marca OMROM &#40;OMROM Eletr&#244;nica do Brasil&#44; S&#227;o Paulo&#44; Brasil&#41;&#44; modelo Hem&#8208;742INT&#46; Foram utilizados manguitos OMROM de tamanho apropriado &#224; circunfer&#234;ncia dos bra&#231;os das crian&#231;as&#46; A medida foi realizada uma &#250;nica vez&#44; no ambiente escolar&#44; seguindo as orienta&#231;&#245;es das V Diretrizes de Hipertens&#227;o Arterial<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">9</span></a>&#44; para a classifica&#231;&#227;o da PA sist&#243;lica &#40;PAS&#41; e press&#227;o arterial diast&#243;lica &#40;PAD&#41;&#46; Consideraram&#8208;se as curvas para determina&#231;&#227;o do percentil da estatura dos escolares de acordo com a idade e g&#234;nero&#44; segundo a OMS<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">7</span></a>&#44; e a tabela de percentil da PA&#44; referenciada pelas V Diretrizes de Hipertens&#227;o Arterial<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">9</span></a>&#44; para crian&#231;as com PAS e&#47;ou PAD igual ou acima do percentil 95 para g&#234;nero&#44; idade e estatura foram classificados na condi&#231;&#227;o de PA elevada&#46; Pr&#233;&#8208;hipertenso s&#227;o considerados os percentis 90&#8208;95 ou PA &#62; 120&#47;80 mmHg&#44; hipertens&#227;o est&#225;gio um &#40;HAS 1&#41; os percentis 95&#8208;99 &#43; 5 mmHg&#44; e para a hipertens&#227;o est&#225;gio dois &#40;HAS 2&#41;&#44; &#62; percentil 99 &#43; 5 mmHg&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">O presente estudo foi aprovado pelo Comit&#234; de &#201;tica em Pesquisa do Centro Universit&#225;rio UNIVATES em 10 de abril de 2014&#44; sob o n&#250;mero de registro 612&#46;030&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">Os dados foram analisados atrav&#233;s de tabelas&#44; estat&#237;sticas descritivas&#44; e para os testes estat&#237;sticos utilizou&#8208;se o <span class="elsevierStyleItalic">exato de Fisher</span>&#44; <span class="elsevierStyleItalic">qui&#8208;quadrado</span>&#44; teste n&#227;o&#8208;param&#233;trico <span class="elsevierStyleItalic">Mann&#8208;Whitney</span>&#44; teste n&#227;o&#8208;param&#233;trico <span class="elsevierStyleItalic">Kruskal&#8208;Wallis</span> e an&#225;lise de correla&#231;&#227;o de <span class="elsevierStyleItalic">Pearson</span>&#46; Os resultados foram considerados significativos a um n&#237;vel de signific&#226;ncia m&#225;ximo de 5&#37; &#40;p<span class="elsevierStyleHsp" style=""></span>&#8804;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#41; e o <span class="elsevierStyleItalic">software</span> utilizado para esta an&#225;lise foi o <span class="elsevierStyleItalic">Statistical Package for Social Sciences</span> &#40;SPSS&#41; vers&#227;o 13&#44;0&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Resultados</span><p id="par0125" class="elsevierStylePara elsevierViewall">Foram avaliados no presente trabalho 709 escolares&#44; classificados segundo o estado nutricional&#44; PAD e PAS e CC&#44; dos quais 55&#37; eram do g&#234;nero masculino e 54&#44;4&#37; residiam na zona rural&#46; O resultado da an&#225;lise descritiva em rela&#231;&#227;o &#224;s m&#233;dias demonstrou que a m&#233;dia de IMC foi de 30&#44;92<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3&#44;2<span class="elsevierStyleHsp" style=""></span>Kg&#47;m<span class="elsevierStyleSup">2</span>&#44; da PAD 150<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>11&#44;96<span class="elsevierStyleHsp" style=""></span>mmHg&#44; da PAS 170<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>14&#44;57<span class="elsevierStyleHsp" style=""></span>mmHg e da CC 103<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>8&#44;97<span class="elsevierStyleHsp" style=""></span>cm&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">Com rela&#231;&#227;o ao estado nutricional&#44; 22&#44;1&#37; apresentavam sobrepeso e 19&#44;7&#37; obesidade ou obesidade grave&#44; mas a maioria dos indiv&#237;duos eram eutr&#243;ficos &#40;58&#44;1&#37;&#41;&#46; A PAD e PAS foi classificada separadamente&#44; 9&#44;2 e 24&#44;4&#37;&#44; respectivamente&#44; classificaram&#8208;se com hipertens&#227;o &#40;HAS 1 ou 2&#41; e 26&#44;5&#37; foram classificadas como HAS 1 ou 2 para PAS&#47;PAD&#44; al&#233;m disso&#44; 26&#37; apresentarem CC elevada&#46;</p><p id="par0135" class="elsevierStylePara elsevierViewall">Os indiv&#237;duos residentes na zona urbana apresentaram m&#233;dias de PAS superiores aos que residiam na zona rural&#46; Somam&#8208;se a isso&#44; os indiv&#237;duos que possu&#237;am m&#233;dias de PAS e PAD elevadas tamb&#233;m apresentavam a CC aumentada&#44; conforme observado na <a class="elsevierStyleCrossRef" href="#tbl0005">tabela 1</a>&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0140" class="elsevierStylePara elsevierViewall">Na <a class="elsevierStyleCrossRef" href="#tbl0010">tabela 2</a> compara&#8208;se o estado nutricional com a CC e a classifica&#231;&#227;o PAD e PAS&#46; Crian&#231;as eutr&#243;ficas e com CC normal&#44; associada positivamente com a classifica&#231;&#227;o da PAD e PAS normal&#46; A obesidade foi significativamente associada &#224; pr&#233;&#8208;hipertens&#227;o&#44; HAS grau um e HAS grau dois em rela&#231;&#227;o a PAD e PAS&#59; a CC elevada foi significativamente associada &#224; classifica&#231;&#227;o da PAD de pr&#233;&#8208;hipertens&#227;o e HAS grau um e de PAS HAS grau um e dois&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0145" class="elsevierStylePara elsevierViewall">A <a class="elsevierStyleCrossRef" href="#tbl0015">tabela 3</a> demonstra que a PAS e PAD apresentaram diferen&#231;as significativas entre as idades&#46; Observou&#8208;se que&#44; para PAS&#44; na idade de seis anos apresentou as menores m&#233;dias&#44; seguida pelas idades sete e oito anos&#44; que n&#227;o diferem entre si&#44; e os maiores valores de PAS foram observadas nas idades de nove e dez anos&#46; J&#225; para a PAD&#44; verificou&#8208;se que a idade de seis anos apresentou as menores m&#233;dias em rela&#231;&#227;o &#224;s demais idades e que estas n&#227;o diferiam entre si&#46; Em rela&#231;&#227;o &#224;s m&#233;dias de IMC&#44; verificou&#8208;se que as m&#233;dias de PAS e PAD apresentaram diferen&#231;as significativas entre as classifica&#231;&#245;es de IMC&#44; ou seja&#44; a classifica&#231;&#227;o de eutrofia apresentou as menores m&#233;dias de PAS e PAD&#44; seguida pela classifica&#231;&#227;o sobrepeso&#44; e por fim&#44; com os maiores valores&#44; a classifica&#231;&#227;o obesidade&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0150" class="elsevierStylePara elsevierViewall">A <a class="elsevierStyleCrossRef" href="#tbl0020">tabela 4</a> relaciona a idade&#44; IMC e CC com PAS e PAD&#46; Cabe salientar que os valores de PA variam de acordo com a idade&#44; sexo e altura&#44; sendo os valores do ponto de corte tomados como refer&#234;ncia para o estudo&#46; Verificou&#8208;se que todas as correla&#231;&#245;es apresentaram resultados significativos&#44; com exce&#231;&#227;o da correla&#231;&#227;o entre a idade e a PAD&#46; Para o restante das correla&#231;&#245;es significativas&#44; observa&#8208;se uma correla&#231;&#227;o do tipo direta&#44; ou seja&#44; &#224; medida que aumentam as m&#233;dias de idade&#44; IMC e CC&#44; as m&#233;dias da PAS e PAD tendem a aumentar tamb&#233;m&#46;</p><elsevierMultimedia ident="tbl0020"></elsevierMultimedia></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Discuss&#227;o</span><p id="par0155" class="elsevierStylePara elsevierViewall">Neste estudo&#44; demonstrou&#8208;se que 22&#44;1&#37; das crian&#231;as estavam em sobrepeso e 19&#44;7&#37; em obesidade ou obesidade grave&#44; resultados superiores aos estudos de Pedersoli et al&#46;<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">10</span></a>&#44; realizado com crian&#231;as de 7&#8208;10 anos de idade em Porto Velho&#44; que encontraram 16&#44;5&#37; de sobrepeso e 11&#44;2&#37; de obesidade&#44; Lima et al&#46;<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">11</span></a>&#44; onde 15&#44;1&#37; apresentaram sobrepeso e 12&#44;3&#37; obesidade&#44; e Passos et al&#46;<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">12</span></a>&#44; que encontraram 26&#37; de sobrepeso e 25&#37; de obesidade em ambos os g&#234;neros&#44; e inferiores a Moraes et al&#46;<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">2</span></a>&#44; que observaram 21&#37; de sobrepeso e 27&#37; de obesidade em crian&#231;as de ambos os g&#234;neros&#44; de escolas da cidade de S&#227;o Paulo&#46; No estudo de Burgos et al&#46;<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">4</span></a>&#44; 26&#44;6&#37; das crian&#231;as foram classificadas com sobrepeso&#47;obesidade&#59; Lee et al&#46;<a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">13</span></a> mostraram que 28&#44;9&#37; das crian&#231;as tinham sobrepeso&#47;obesidade&#44; percentuais inferiores ao atual estudo&#46;</p><p id="par0160" class="elsevierStylePara elsevierViewall">A obesidade &#233; um problema crescente na inf&#226;ncia&#44; chegando a atingir entre 25&#8208;30&#37; da popula&#231;&#227;o infantil&#46; Tem sido atribu&#237;da principalmente a fatores ambientais e socioculturais&#44; tais como incentivo a uma dieta pouco saud&#225;vel&#44; com alta propor&#231;&#227;o de gorduras&#44; e a uma atitude sedent&#225;ria<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">14</span></a>&#46; A OMS estima que&#44; em 2015&#44; tenham existido 700 milh&#245;es de indiv&#237;duos com problemas de sa&#250;de decorrentes da obesidade e&#44; destes&#44; 43 milh&#245;es eram crian&#231;as&#44; com idades abaixo de cinco anos&#44; com sobrepeso<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">15</span></a>&#46;</p><p id="par0165" class="elsevierStylePara elsevierViewall">Observando&#8208;se este crescente aumento de sobrepeso e obesidade em crian&#231;as cada vez mais jovens&#44; Gabriel et al&#46;<a class="elsevierStyleCrossRef" href="#bib0245"><span class="elsevierStyleSup">16</span></a> destacaram o Programa Nacional de Alimenta&#231;&#227;o Escolar &#40;PNAE&#41; como uma importante ferramenta para influenciar positivamente no crescimento e o desenvolvimento biopsicossocial&#44; na aprendizagem&#44; no rendimento escolar e a forma&#231;&#227;o de h&#225;bitos alimentares saud&#225;veis dos alunos de toda a educa&#231;&#227;o b&#225;sica p&#250;blica&#44; por meio de a&#231;&#245;es de educa&#231;&#227;o alimentar e nutricional e da oferta de refei&#231;&#245;es saud&#225;veis&#46;</p><p id="par0170" class="elsevierStylePara elsevierViewall">No presente estudo&#44; 26&#37; das crian&#231;as encontraram&#8208;se com a CC elevada&#44; resultados inferiores ao estudo de Iampolsky et al&#46;<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">17</span></a>&#44; com escolares de Santo Andr&#233;&#8208;SP&#44; no qual encontraram uma preval&#234;ncia de 30&#44;2&#37;&#44; e ao estudo de Souza et al&#46;<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">18</span></a>&#44; que demonstrou 42&#37; das crian&#231;as com CC elevada&#46; Neste sentido&#44; a CC pode ser usada efetivamente para a avalia&#231;&#227;o cl&#237;nica da presen&#231;a ou n&#227;o de fatores de risco para DCV em crian&#231;as e adolescentes<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">19</span></a>&#46; Friedemann et al&#46;<a class="elsevierStyleCrossRef" href="#bib0265"><span class="elsevierStyleSup">20</span></a> d&#227;o &#234;nfase a CC como preditora relevante de n&#237;veis alterados de lip&#237;deos&#44; lipoprote&#237;nas e apolipoprote&#237;nas em indiv&#237;duos jovens<a class="elsevierStyleCrossRef" href="#bib0270"><span class="elsevierStyleSup">21</span></a>&#46; O risco cardiovascular vem aumentando ao longo dos anos&#44; sendo considerado um importante problema de sa&#250;de p&#250;blica por causar elevadas taxas de morbidade e mortalidade&#44; al&#233;m do impacto negativo na qualidade de vida destes pacientes<a class="elsevierStyleCrossRef" href="#bib0275"><span class="elsevierStyleSup">22</span></a>&#46; Atualmente&#44; sabe&#8208;se que a localiza&#231;&#227;o abdominal de gordura mostra&#8208;se mais associada &#224;s dislipidemias&#44; hipertens&#227;o arterial e altera&#231;&#245;es no metabolismo glic&#234;mico&#44; sendo o per&#237;metro da cintura considerado bom indicador da adiposidade corporal e do risco cardiovascular<a class="elsevierStyleCrossRef" href="#bib0280"><span class="elsevierStyleSup">23</span></a>&#44; assim como o IMC&#44; que tem apresentado concord&#226;ncia com indicadores de adiposidade<a class="elsevierStyleCrossRef" href="#bib0285"><span class="elsevierStyleSup">24</span></a>&#46;</p><p id="par0175" class="elsevierStylePara elsevierViewall">Das crian&#231;as estudadas&#44; 11&#44;8&#37; foram classificadas como pr&#233;&#8208;hipertensas e 26&#44;5&#37; como HAS1 ou HAS2 para PAS&#47;PAD&#44; resultados superiores ao estudo de Moraes et al&#46;<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">2</span></a>&#44; onde demonstrou&#8208;se que 3&#44;4&#37; das crian&#231;as apresentam o diagn&#243;stico de pr&#233;&#8208;hipertens&#227;o&#44; e 3&#44;9&#37; com o diagn&#243;stico de HAS1 e HAS2 para PAD&#47;PAS e ao estudo de Rosini et al&#46;<a class="elsevierStyleCrossRef" href="#bib0190"><span class="elsevierStyleSup">5</span></a>&#44; com escolares de Guabiruba&#44; que observaram 6&#44;1&#37; das crian&#231;as classificadas como pr&#233;&#8208;hipertensas e 4&#44;5&#37; como hipertensas&#46; J&#225; o estudo de Rinaldi et al&#46;<a class="elsevierStyleCrossRef" href="#bib0290"><span class="elsevierStyleSup">25</span></a> demonstrou que 26&#37; das crian&#231;as apresentaram eleva&#231;&#227;o de PAS&#47;PAD&#44; e Lima et al&#46;<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">11</span></a> constataram n&#237;veis press&#243;ricos elevados em 20&#44;4&#37; das crian&#231;as&#46; Portanto&#44; como &#233; sabido que a HAS do adulto tem in&#237;cio na inf&#226;ncia&#44; e em decorr&#234;ncia da falta da medi&#231;&#227;o de PA em crian&#231;as&#44; ainda com a cren&#231;a de que a HAS n&#227;o ocorre nesta faixa et&#225;ria&#44; muitas vezes deixa&#8208;se de fazer o diagn&#243;stico j&#225; nesta faixa et&#225;ria&#44; onde a interven&#231;&#227;o precoce poderia prevenir o agravamento desta patologia no futuro<a class="elsevierStyleCrossRef" href="#bib0295"><span class="elsevierStyleSup">26</span></a>&#46;</p><p id="par0180" class="elsevierStylePara elsevierViewall">Monego e Jardim<a class="elsevierStyleCrossRef" href="#bib0300"><span class="elsevierStyleSup">27</span></a>&#44; Moraes et al&#46;<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">2</span></a>&#44; Carvalho et al&#46;<a class="elsevierStyleCrossRef" href="#bib0305"><span class="elsevierStyleSup">28</span></a> e Lima et al&#46;<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">11</span></a> observaram associa&#231;&#227;o significativa entre excesso de peso e HAS&#44; resultado semelhante ao atual estudo&#44; onde a obesidade foi significativamente associada &#224; pr&#233;&#8208;hipertens&#227;o&#44; HAS1 e HAS2&#46; Assim como&#44; neste estudo&#44; a classifica&#231;&#227;o de eutrofia associou&#8208;se significativamente a classifica&#231;&#227;o da PAS e PAD normal&#44; da mesma forma que no estudo de Batista et al&#46;<a class="elsevierStyleCrossRef" href="#bib0310"><span class="elsevierStyleSup">29</span></a>&#46; Independentemente do crit&#233;rio de classifica&#231;&#227;o nutricional utilizado&#44; os percentuais de PA aumentam &#224; medida que se progride de classe nutricional&#44; de baixo peso a obesidade<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">2</span></a>&#46;</p><p id="par0185" class="elsevierStylePara elsevierViewall">Visto que IMC e CC t&#234;m rela&#231;&#227;o com a PA em crian&#231;as&#44; &#233; importante salientar que a presen&#231;a de n&#237;veis press&#243;ricos elevados n&#227;o &#233; t&#227;o rara quanto antes imaginado&#44; e crian&#231;as com excesso de peso&#44; hist&#243;ria familiar positiva e&#47;ou baixo peso ao nascer merecem aten&#231;&#227;o redobrada quanto ao risco da doen&#231;a&#46; A baixa ades&#227;o m&#233;dica &#224;s atuais recomenda&#231;&#245;es&#44; para avalia&#231;&#227;o rotineira da PA em crian&#231;as acima dos tr&#234;s anos de idade&#44; &#233; um problema que merece aten&#231;&#227;o especial por parte das pol&#237;ticas de sa&#250;de p&#250;blica&#44; uma vez que permite o subdiagn&#243;stico&#44; com consequ&#234;ncias futuras possivelmente irrevers&#237;veis para esses indiv&#237;duos<a class="elsevierStyleCrossRef" href="#bib0315"><span class="elsevierStyleSup">30</span></a>&#46;</p><p id="par0190" class="elsevierStylePara elsevierViewall">No estudo de Batista et al&#46;<a class="elsevierStyleCrossRef" href="#bib0310"><span class="elsevierStyleSup">29</span></a>&#44; a principal caracter&#237;stica cl&#237;nica das crian&#231;as estudadas foi o estado nutricional&#44; onde 39&#37; das crian&#231;as apresentaram excesso de peso e maiores m&#233;dias de PA&#44; tanto para PAD tanto para PAS&#46;</p><p id="par0195" class="elsevierStylePara elsevierViewall">Observou&#8208;se&#44; no atual estudo&#44; uma correla&#231;&#227;o significativa do tipo direta&#44; ou seja&#44; &#224; medida que aumentam as m&#233;dias de idade&#44; IMC e CC&#44; as m&#233;dias da PAS e PAD tendem a aumentar tamb&#233;m&#44; resultado semelhante ao estudo de Burgos et al&#46;<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">4</span></a> e Batista et al&#46;<a class="elsevierStyleCrossRef" href="#bib0310"><span class="elsevierStyleSup">29</span></a>&#46; Paschoal et al&#46;<a class="elsevierStyleCrossRef" href="#bib0315"><span class="elsevierStyleSup">30</span></a>&#44; em seu estudo com crian&#231;as de sete e oito anos&#44; demonstraram que a m&#233;dia da PAS foi menor no grupo eutr&#243;fico&#44; comparado ao obeso&#46; J&#225; no estudo de Nobre et al&#46;<a class="elsevierStyleCrossRef" href="#bib0320"><span class="elsevierStyleSup">31</span></a>&#44; ao desenvolverem pesquisa avaliando o efeito do IMC sobre a PA&#44; observaram que o percentual de crian&#231;as com PAS&#44; PAD e PAS&#47;PAD elevadas foi significativamente mais alta entre aqueles com CC elevada&#44; em ambos os g&#234;neros&#46;</p><p id="par0200" class="elsevierStylePara elsevierViewall">O estudo atual demonstrou que a PAS apresentou m&#233;dia significativamente inferior aos seis anos de idade&#44; seguida das idades de sete e oito anos&#59; j&#225; na PAD&#44; verificou&#8208;se que a idade de seis anos apresentou as menores m&#233;dias em rela&#231;&#227;o &#224;s demais idades e que estas n&#227;o diferem entre si&#46; No estudo de Moraes et al&#46;<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">2</span></a> n&#227;o houve associa&#231;&#227;o significativa entre a presen&#231;a de PA elevada e a idade&#46;</p><p id="par0205" class="elsevierStylePara elsevierViewall">A &#250;nica correla&#231;&#227;o identificada quanto ao g&#234;nero foi &#224; presen&#231;a de maiores n&#237;veis de press&#227;o diast&#243;lica no g&#234;nero masculino &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;02&#41;<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">2</span></a>&#46; Diferentemente do estudo de Rosa et al&#46;<a class="elsevierStyleCrossRef" href="#bib0325"><span class="elsevierStyleSup">32</span></a>&#44; que demonstrou n&#227;o haver associa&#231;&#227;o significativa entre a presen&#231;a de PA elevada e a idade para PAS e PAD&#46; J&#225; nos trabalhos de Rinaldi et al&#46;<a class="elsevierStyleCrossRef" href="#bib0290"><span class="elsevierStyleSup">25</span></a> e Santos et al&#46;<a class="elsevierStyleCrossRef" href="#bib0330"><span class="elsevierStyleSup">33</span></a>&#44; defendem a ideia de que a medida que aumenta a idade&#44; aumentam tamb&#233;m os valores de PAS e PAD&#46;</p><p id="par0210" class="elsevierStylePara elsevierViewall">Todas as crian&#231;as que apresentaram obesidade ou PA foram encaminhadas a unidade b&#225;sica de sa&#250;de&#44; para receberem atendimento m&#233;dico e nutricional&#46; Cabe destacar que as vari&#225;veis estudadas no presente trabalho est&#227;o sendo verificadas em outros munic&#237;pios&#44; para posterior an&#225;lise&#46;</p><p id="par0215" class="elsevierStylePara elsevierViewall">Como limita&#231;&#227;o do estudo podemos citar o n&#250;mero de avalia&#231;&#245;es de PA ter sido realizado em triplicata&#44; somente quando as duas primeiras medi&#231;&#245;es apresentavam diferen&#231;a expressiva entre os valores&#46; Al&#233;m disso&#44; o presente trabalho n&#227;o considerou a estatura como fator que justificasse o aumento da PAS de crian&#231;as obesas ou com CC aumentada&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Conclus&#227;o</span><p id="par0220" class="elsevierStylePara elsevierViewall">Concluiu&#8208;se que as crian&#231;as residentes na zona urbana apresentaram m&#233;dias de PAS significativamente superiores &#224;s que residiam na zona rural&#44; possivelmente em virtude de uma alimenta&#231;&#227;o mais industrializada e rica em s&#243;dio&#46; Al&#233;m disso&#44; as que apresentavam CC elevada possu&#237;am m&#233;dias de PAS e PAD significativamente superiores em rela&#231;&#227;o &#224;s crian&#231;as com CC normal&#46; Assim&#44; a obesidade foi significativamente associada &#224; pr&#233;&#8208;hipertens&#227;o&#44; HAS1 e HAS2&#44; tanto para PAS quanto para a PAD&#46; A CC elevada foi significativamente associada &#224; classifica&#231;&#227;o da PAD de pr&#233;&#8208;hipertens&#227;o e HAS1&#44; e de HAS1 e HAS2 para PAS&#46;</p><p id="par0225" class="elsevierStylePara elsevierViewall">As crian&#231;as de nove a dez anos apresentaram as m&#233;dias de PAS e PAD maiores em rela&#231;&#227;o &#224;s crian&#231;as de seis e oito anos&#44; assim como as crian&#231;as obesas demonstraram as maiores m&#233;dias de PAS e PAD&#44; em rela&#231;&#227;o &#224;s com sobrepeso e eutrofia&#46; Observou&#8208;se ainda que &#224; medida que as m&#233;dias de idade&#44; IMC e CC aumentam&#44; as m&#233;dias da PAS e PAD tendem a aumentar tamb&#233;m&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Responsabilidades &#233;ticas</span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Prote&#231;&#227;o de pessoas e animais</span><p id="par0230" class="elsevierStylePara elsevierViewall">Os autores declaram que os procedimentos seguidos estavam de acordo com os regulamentos estabelecidos pelos respons&#225;veis da Comiss&#227;o de Investiga&#231;&#227;o Cl&#237;nica e &#201;tica e de acordo com os da Associa&#231;&#227;o M&#233;dica Mundial e da Declara&#231;&#227;o de Helsinki&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Confidencialidade dos dados&#46;</span><p id="par0235" class="elsevierStylePara elsevierViewall">Os autores declaram ter seguido os protocolos do seu centro de trabalho acerca da publica&#231;&#227;o dos dados de pacientes&#46;</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Direito &#224; privacidade e consentimento escrito&#46;</span><p id="par0240" class="elsevierStylePara elsevierViewall">Os autores declaram ter recebido consentimento escrito dos pacientes e&#47; ou sujeitos mencionados no artigo&#46; O autor para correspond&#234;ncia deve estar na posse deste documento&#46;</p></span></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Conflito de interesses</span><p id="par0245" class="elsevierStylePara elsevierViewall">Os autores declaram n&#227;o haver conflito de interesses&#46;</p></span></span>"
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    "resumen" => array:2 [
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        "titulo" => "Resumo"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Introdu&#231;&#227;o</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A hipertens&#227;o arterial sist&#234;mica &#40;HAS&#41; destaca&#8208;se como um dos principais fatores de risco para doen&#231;as cardiovasculares &#40;DCV&#41;&#46; O diagn&#243;stico e tratamento precoce da hipertens&#227;o na inf&#226;ncia tem potencial de causar grande impacto contra desfechos adversos futuros&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Objetivo</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Verificar a rela&#231;&#227;o da press&#227;o arterial diast&#243;lica &#40;PAD&#41; e sist&#243;lica &#40;PAS&#41; com avalia&#231;&#227;o antropom&#233;trica e a zona residencial de crian&#231;as de munic&#237;pios do Rio Grande do Sul&#44; Brasil&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">M&#233;todos</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Trata&#8208;se de um estudo de modelo transversal&#44; realizado com 709 crian&#231;as de seis anos completos a nove anos incompletos&#46; Foram aferidas a press&#227;o arterial&#44; peso corporal&#44; altura e circunfer&#234;ncia da cintura &#40;<span class="elsevierStyleSmallCaps">CC</span>&#41;&#46; Utilizaram&#8208;se testes estat&#237;sticos&#44; com n&#237;vel de signific&#226;ncia m&#225;ximo de 5&#37; &#40;p<span class="elsevierStyleHsp" style=""></span>&#8804;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#41; e o <span class="elsevierStyleItalic">software</span> utilizado para esta an&#225;lise foi o SPSS vers&#227;o 13&#44;0&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Resultados</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">A obesidade foi significativamente associada &#224; pr&#233;&#8208;hipertens&#227;o&#44; HAS grau um e dois&#46; A CC elevada foi significativamente associada &#224; classifica&#231;&#227;o da PAD de pr&#233;&#8208;hipertens&#227;o e HAS grau 1 e de PAS HAS grau um e dois &#40;&#8804; 0&#44;01&#41;&#46;</p></span> <span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Conclus&#227;o</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">As crian&#231;as residentes na zona urbana apresentaram m&#233;dias de PAS significativamente superiores &#224;s que residiam na zona rural&#46; Aquelas com CC elevada apresentaram m&#233;dias de PAS e PAD superiores em rela&#231;&#227;o &#224;s crian&#231;as com CC normal&#46; As crian&#231;as obesas demonstraram as maiores m&#233;dias de PAS e PAD&#44; em rela&#231;&#227;o &#224;s com sobrepeso e &#224;s eutr&#243;ficas e&#44; &#224; medida que aumentaram as m&#233;dias de idade&#44; &#237;ndice de massa corporal e CC&#44; as m&#233;dias da PAS e PAD aumentaram tamb&#233;m&#46;</p></span>"
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        "resumen" => "<span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Introduction</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Systemic hypertension is one of the main risk factors for cardiovascular disease &#40;CVD&#41;&#46; Early diagnosis and treatment of hypertension in childhood can potentially have a significant impact on future adverse outcomes&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Objective</span><p id="spar0095" class="elsevierStyleSimplePara elsevierViewall">To investigate the relationship of diastolic &#40;DBP&#41; and systolic blood pressure &#40;SBP&#41; with anthropometric data and area of residence of children in municipalities of Rio Grande do Sul state&#44; Brazil&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Methods</span><p id="spar0100" class="elsevierStyleSimplePara elsevierViewall">This is a cross&#8208;sectional study of 709 children between six and nine years of age&#46; Blood pressure&#44; weight&#44; height and waist circumference &#40;WC&#41; were measured&#46; Statistical tests had a maximum significance level of 5&#37; &#40;p&#8804;0&#46;05&#41; and the software used was SPSS version 13&#46;0&#46;</p></span> <span id="abst0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Results</span><p id="spar0105" class="elsevierStyleSimplePara elsevierViewall">Obesity was significantly associated with pre&#8208;hypertension&#44; and stage 1 and 2 hypertension as assessed by DBP and SBP &#40;&#8804;0&#46;05&#41;&#59; high WC was significantly associated with a classification of pre&#8208;hypertension and stage 1 hypertension based on DBP and a classification of stage 1 and 2 hypertension based on SBP &#40;&#8804;0&#46;01&#41;&#46;</p></span> <span id="abst0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Conclusion</span><p id="spar0110" class="elsevierStyleSimplePara elsevierViewall">Children living in urban areas had significantly higher mean SBP than those living in rural areas&#46; Those with high WC presented higher SBP and DBP compared to children with normal WC&#46; Obese children showed higher mean SBP and DBP compared to those who were overweight or normal weight and mean SBP and DBP also increased with older age and higher mean body mass index and WC&#46;</p></span>"
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                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Press&#227;o&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">M&#233;dia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">DP&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">p<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " rowspan="4" align="left" valign="top">Zona</td><td class="td" title="table-entry  " rowspan="2" align="left" valign="top">PAS</td><td class="td" title="table-entry  " align="left" valign="top">Rural&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">387&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">106&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">14&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;033&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Urbano&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">323&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">108&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">14&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " rowspan="2" align="left" valign="top">PAD</td><td class="td" title="table-entry  " align="left" valign="top">Rural&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">387&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">63&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">13&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;874&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Urbano&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">323&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">62&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">10&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " rowspan="4" align="left" valign="top">G&#234;nero</td><td class="td" title="table-entry  " rowspan="2" align="left" valign="top">PAS</td><td class="td" title="table-entry  " align="left" valign="top">Masculino&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">390&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">108&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">13&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;181&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Feminino&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">320&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">106&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">15&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " rowspan="2" align="left" valign="top">PAD</td><td class="td" title="table-entry  " align="left" valign="top">Masculino&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">390&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">63&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">11&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;566&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Feminino&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">320&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">63&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">12&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " rowspan="4" align="left" valign="top">CC</td><td class="td" title="table-entry  " rowspan="2" align="left" valign="top">PAS</td><td class="td" title="table-entry  " align="left" valign="top">Normal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">526&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">104&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">13&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8804;<span class="elsevierStyleHsp" style=""></span>0&#44;01&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">CC elevada&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">184&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">116&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">14&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " rowspan="2" align="left" valign="top">PAD</td><td class="td" title="table-entry  " align="left" valign="top">Normal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">526&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">61&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">11&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8804;<span class="elsevierStyleHsp" style=""></span>0&#44;01&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">CC elevada&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">184&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">68&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">12&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
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          "pt" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Compara&#231;&#227;o das m&#233;dias PAS e PAD entre as vari&#225;veis&#58; zona&#44; g&#234;nero e classifica&#231;&#227;o CC</p>"
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          "leyenda" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">CC&#58; circunfer&#234;ncia da cintura&#59; DP&#58; desvio padr&#227;o&#59; EN&#58; estado nutricional&#59; IMC&#58; &#237;ndice de massa corporal&#59; HAS1&#58; hipertens&#227;o arterial sist&#234;mica grau 1&#59; HAS2&#58; hipertens&#227;o arterial sist&#234;mica grau 2&#59; N&#58; n&#250;mero de casos&#59; PAD&#58; press&#227;o arterial diast&#243;lica&#59; PAS&#58; press&#227;o arterial sist&#243;lica&#46;</p>"
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                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col">Vari&#225;vel&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col">Resposta&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " colspan="8" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Classifica&#231;&#227;o PAD</th><th class="td" title="table-head  " align="left" valign="top" scope="col">p<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="" valign="top" scope="col">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " colspan="2" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Normal</th><th class="td" title="table-head  " colspan="2" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Pr&#233;&#8208;hipertens&#227;o</th><th class="td" title="table-head  " colspan="2" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">HAS1</th><th class="td" title="table-head  " colspan="2" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">HAS2</th><th class="td" title="table-head  " align="" valign="top" scope="col">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " rowspan="3" align="left" valign="top">EN</td><td class="td" title="table-entry  " align="left" valign="top">Eutrofia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">378&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">61&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">28&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">17&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">39&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">36&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8804;<span class="elsevierStyleHsp" style=""></span>0&#44;05&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Sobrepeso&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">131&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">21&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">28&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">11&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">25&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">27&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Obesidade&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">103&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">16&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">14&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">43&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">15&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">34&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">36&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " rowspan="2" align="left" valign="top">CC</td><td class="td" title="table-entry  " align="left" valign="top">Normal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">471&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">76&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">15&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">46&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">26&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">60&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">14&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">63&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8804;<span class="elsevierStyleHsp" style=""></span>0&#44;01&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">CC elevada&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">142&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">23&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">17&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">53&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">17&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">39&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">36&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
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            1 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="center" valign="top" scope="col">Vari&#225;vel&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="center" valign="top" scope="col">Resposta&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " colspan="8" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Classifica&#231;&#227;o PAS</th><th class="td" title="table-head  " align="left" valign="top" scope="col">p&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " colspan="2" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Normal</th><th class="td" title="table-head  " colspan="2" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Pr&#233;&#8208;hipertens&#227;o</th><th class="td" title="table-head  " colspan="2" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">HAS1</th><th class="td" title="table-head  " colspan="2" align="left" valign="top" scope="col" style="border-bottom: 2px solid black">HAS2</th><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " rowspan="3" align="left" valign="top">EN</td><td class="td" title="table-entry  " align="left" valign="top">Eutrofia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">314&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">68&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">36&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">45&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">42&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">39&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">20&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">29&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8804;<span class="elsevierStyleHsp" style=""></span>0&#44;05&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Sobrepeso&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">91&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">19&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">21&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">26&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">28&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">26&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">17&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">25&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Obesidade&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">51&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">11&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">23&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">28&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">36&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">34&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">30&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">44&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " rowspan="2" align="left" valign="top">CC</td><td class="td" title="table-entry  " align="left" valign="top">Normal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">378&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">82&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">54&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">67&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">64&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">60&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">30&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">44&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8804;<span class="elsevierStyleHsp" style=""></span>0&#44;01&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">CC elevada&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">79&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">17&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">26&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">32&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">42&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">39&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">37&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">55&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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            0 => array:3 [
              "identificador" => "tblfn0010"
              "etiqueta" => "a"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0010">Qui&#8208;quadrado&#46; p &#40;ausente&#41;&#58; representa valores n&#227;o significativos&#46;</p>"
            ]
          ]
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        "descripcion" => array:1 [
          "pt" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Compara&#231;&#227;o da classifica&#231;&#227;o do estado nutricional e da circunfer&#234;ncia da cintura com classifica&#231;&#227;o PAD e PAS</p>"
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        "identificador" => "tbl0015"
        "etiqueta" => "Tabela 3"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
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        "detalles" => array:1 [
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            "identificador" => "at3"
            "detalle" => "Tabela "
            "rol" => "short"
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        ]
        "tabla" => array:3 [
          "leyenda" => "<p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">DP&#58; desvio padr&#227;o&#59; IMC&#58; &#237;ndice de massa corporal&#59; N&#58; n&#250;mero de casos&#59; PAD&#58; press&#227;o arterial diast&#243;lica&#59; PAS&#58; press&#227;o arterial sist&#243;lica&#46;</p>"
          "tablatextoimagen" => array:2 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col">Idade&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col">n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " colspan="3" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">PAS</th><th class="td" title="table-head  " colspan="3" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">PAD</th></tr><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">M&#233;dia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">DP&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">p<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">M&#233;dia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">DP&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">p<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Seis anos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">44&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">98&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">13&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8804;<span class="elsevierStyleHsp" style=""></span>0&#44;01&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">59&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">11&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8804;<span class="elsevierStyleHsp" style=""></span>0&#44;01&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Sete anos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">175&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">106&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">15&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">63&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">13&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Oito anos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">196&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">106&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">14&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">62&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">12&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Nove anos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">247&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">109&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">14&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">63&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">10&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Dez anos&nbsp;\t\t\t\t\t\t\n
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ISSN: 08702551
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