Associa??o entre polui??o atmosf?rica e press?o arterial em crian?as e adolescentes : revis?o sistem?tica e metan?lise
Ano de defesa: | 2019 |
---|---|
Autor(a) principal: | |
Orientador(a): | |
Banca de defesa: | |
Tipo de documento: | Tese |
Tipo de acesso: | Acesso aberto |
Idioma: | por |
Instituição de defesa: |
Pontif?cia Universidade Cat?lica do Rio Grande do Sul
|
Programa de Pós-Graduação: |
Programa de P?s-Gradua??o em Medicina/Pediatria e Sa?de da Crian?a
|
Departamento: |
Escola de Medicina
|
País: |
Brasil
|
Palavras-chave em Português: | |
Palavras-chave em Inglês: | |
Área do conhecimento CNPq: | |
Link de acesso: | http://tede2.pucrs.br/tede2/handle/tede/9290 |
Resumo: | Background: Air pollution has been consistently considered a cardiovascular risk factor in adults. Autonomic disbalance and endothelial dysfunction are plausible mechanisms for induction and perpetuation of arterial hypertension after exposure to atmospheric pollutants. However, scientific information about air pollution effects on cardiovascular system and blood pressure in children are still lacking. Objectives: To systematically review the association between air pollutants and cardiovascular outcomes in children and adolescents. Methods: For this systematic review and meta-analysis, comprehensive search was conducted through MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Scientific Electronic Library Online, Latin American Caribbean Health Sciences Literature, Cumulative Index to Nursing and Allied Health Literature, Web of Science, and gray literature, with no date and language limit, to estimate the association between air pollutants and blood pressure in healthy children from zero to 18 years of age. Quality of evidence was assessed for all studies using the Cochrane Reviews standards. Meta-analysis was perfomed using random effects models in order to synthesize the associations. Results: A total of 13 studies accounting 45,059 participants were included in the systematic review, and three of these studies accounting 314 participants were included in the meta- analysis. In the comparison between the group of children resident in areas with higher level of air pollution and the ones exposed to lower level of air pollution, mean differences of systolic and diastolic blood pressure were 3.93 (95% CI: -0.29 to 8.14), I2 = 87%, and 2.61 (95% CI: 0.10 to 5.11), I2 = 78% respectively. In sensitive analysis, mean difference of systolic blood pressure between the higher exposure group and the lower exposure group was 6.08 (95% CI: 3.68 to 8.49), I2 = 50%, and mean difference of heart rate was -3.12 (95% IC: - 4.11 to -2.12), I2 = 0%. Nine studies (69.2%) were classified as poor or fair quality. Conclusion: Children exposed to higher levels of atmospheric pollution tend to present elevation of blood pressured and indirect signs of endothelial dysfunction, as compared to youngsters who reside in lower exposure areas. The exact dose-effect relationship of this association and the effects of different types of pollutants still need further studies, from childhood to adult life course. Policies to improve environmental health can contribute for primary cardiovascular prevention in the present and the future. |
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Mattiello, Ritahttp://lattes.cnpq.br/4920515067971772http://lattes.cnpq.br/9161438516859776Barbosa, Roberto Ramos2020-10-27T13:41:44Z2019-08-27http://tede2.pucrs.br/tede2/handle/tede/9290Background: Air pollution has been consistently considered a cardiovascular risk factor in adults. Autonomic disbalance and endothelial dysfunction are plausible mechanisms for induction and perpetuation of arterial hypertension after exposure to atmospheric pollutants. However, scientific information about air pollution effects on cardiovascular system and blood pressure in children are still lacking. Objectives: To systematically review the association between air pollutants and cardiovascular outcomes in children and adolescents. Methods: For this systematic review and meta-analysis, comprehensive search was conducted through MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Scientific Electronic Library Online, Latin American Caribbean Health Sciences Literature, Cumulative Index to Nursing and Allied Health Literature, Web of Science, and gray literature, with no date and language limit, to estimate the association between air pollutants and blood pressure in healthy children from zero to 18 years of age. Quality of evidence was assessed for all studies using the Cochrane Reviews standards. Meta-analysis was perfomed using random effects models in order to synthesize the associations. Results: A total of 13 studies accounting 45,059 participants were included in the systematic review, and three of these studies accounting 314 participants were included in the meta- analysis. In the comparison between the group of children resident in areas with higher level of air pollution and the ones exposed to lower level of air pollution, mean differences of systolic and diastolic blood pressure were 3.93 (95% CI: -0.29 to 8.14), I2 = 87%, and 2.61 (95% CI: 0.10 to 5.11), I2 = 78% respectively. In sensitive analysis, mean difference of systolic blood pressure between the higher exposure group and the lower exposure group was 6.08 (95% CI: 3.68 to 8.49), I2 = 50%, and mean difference of heart rate was -3.12 (95% IC: - 4.11 to -2.12), I2 = 0%. Nine studies (69.2%) were classified as poor or fair quality. Conclusion: Children exposed to higher levels of atmospheric pollution tend to present elevation of blood pressured and indirect signs of endothelial dysfunction, as compared to youngsters who reside in lower exposure areas. The exact dose-effect relationship of this association and the effects of different types of pollutants still need further studies, from childhood to adult life course. Policies to improve environmental health can contribute for primary cardiovascular prevention in the present and the future.Introdu??o: A polui??o atmosf?rica tem sido consistentemente considerada um fator de risco cardiovascular em adultos. Desequil?brio auton?mico e disfun??o endotelial s?o mecanismos plaus?veis para indu??o e perpetua??o da hipertens?o arterial ap?s exposi??o a poluentes atmosf?ricos. Entretanto, informa??es cient?ficas acerca dos efeitos da polui??o do ar sobre o sistema cardiovascular e a press?o arterial de crian?as ainda s?o escassas. Objetivos: Realizar uma revis?o sistem?tica e metan?lise acerca das evid?ncias sobre a associa??o entre a exposi??o a poluentes atmosf?ricos e eleva??o da press?o arterial em crian?as e adolescentes. M?todos: Foi conduzida uma pesquisa sistem?tica na literatura mediante as bases de dados MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Scientific Electronic Library Online, Latin American Caribbean Health Sciences Literature, Cumulative Index to Nursing and Allied Health Literature, Web of Science, e literatura cinzenta, sem limite de data ou idioma, para estimar a associa??o entre polui??o atmosf?rica e press?o arterial em indiv?duos saud?veis de zero a 18 anos de idade. A qualidade da evid?ncia foi analisada em todos os estudos por meio do padr?o estabelecido pela Cochrane Reviews. A metan?lise foi realizada utilizando modelos de efeitos rand?micos, a fim de sintetizar as associa??es. Resultados: Um total de 13 estudos contendo 45.059 participantes foram inclu?dos na revis?o sistem?tica, e tr?s destes estudos contendo 314 participantes na metan?lise. Na compara??o entre o grupo de crian?as residentes em ?reas de maior n?vel de polui??o do ar e o grupo exposto a menor n?vel de polui??o, as diferen?as m?dias de press?o arterial sist?lica e diast?lica foram, respectivamente, 3,93 (IC 95%: -0,29 a 8,14), I2 = 87% e 2,61 (IC 95%: 0,10 a 5,11), I2 = 78%. Na an?lise de sensibilidade, a diferen?a m?dia de press?o arterial sist?lica entre o grupo de maior exposi??o e o de menor exposi??o ? polui??o foi de 6,08 (IC 95%: 3,68 a 8,49), I2 = 50%, e a diferen?a m?dia de frequ?ncia card?aca foi de -3,12 (IC 95%: -4,11 a -2,12), I2 = 0%. Nove estudos (69,2%) foram classificados como de qualidade baixa ou razo?vel. Conclus?o: Crian?as expostas a maiores n?veis de polui??o atmosf?rica apresentam tend?ncia a eleva??o da press?o arterial e a apresentar sinais indiretos de disfun??o endotelial, quando comparadas com jovens que residem em locais com menor exposi??o. A exata rela??o dose-efeito desta associa??o e os efeitos dos diferentes tipos de poluentes ainda carecem de maiores estudos, desde a inf?ncia at? a vida adulta. Medidas para a melhoria da sa?de ambiental podem contribuir para a preven??o cardiovascular prim?ria no presente e no futuro.Submitted by PPG Pediatria e Sa?de da Crian?a (pediatria-pg@pucrs.br) on 2020-07-03T13:27:35Z No. of bitstreams: 1 Tese Doutorado 26-10-09 ROBERTO RAMOS BARBOSA.pdf: 1620277 bytes, checksum: a659e2e744ad458d24121231ef25908b (MD5)Approved for entry into archive by Caroline Xavier (caroline.xavier@pucrs.br) on 2020-10-27T13:39:22Z (GMT) No. of bitstreams: 1 Tese Doutorado 26-10-09 ROBERTO RAMOS BARBOSA.pdf: 1620277 bytes, checksum: a659e2e744ad458d24121231ef25908b (MD5)Made available in DSpace on 2020-10-27T13:41:44Z (GMT). No. of bitstreams: 1 Tese Doutorado 26-10-09 ROBERTO RAMOS BARBOSA.pdf: 1620277 bytes, checksum: a659e2e744ad458d24121231ef25908b (MD5) Previous issue date: 2019-08-27application/pdfhttp://tede2.pucrs.br:80/tede2/retrieve/179142/TES_ROBERTO_RAMOS_BARBOSA_CONFIDENCIAL.pdf.jpgporPontif?cia Universidade Cat?lica do Rio Grande do SulPrograma de P?s-Gradua??o em Medicina/Pediatria e Sa?de da Crian?aPUCRSBrasilEscola de MedicinaPolui??o Atmosf?ricaHipertens?oPress?o ArterialCrian?aAir PollutionHypertensionBlood PressureChildCIENCIAS DA SAUDE::MEDICINAAssocia??o entre polui??o atmosf?rica e press?o arterial em crian?as e adolescentes : revis?o sistem?tica e metan?liseinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/doctoralThesisTrabalho ser? publicado como artigo ou livro60 meses27/10/2025557290555552975733500500500-224747486637135387-969369452308786627info:eu-repo/semantics/openAccessreponame:Biblioteca Digital de Teses e Dissertações da PUC_RSinstname:Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS)instacron:PUC_RSTHUMBNAILTES_ROBERTO_RAMOS_BARBOSA_CONFIDENCIAL.pdf.jpgTES_ROBERTO_RAMOS_BARBOSA_CONFIDENCIAL.pdf.jpgimage/jpeg4102http://tede2.pucrs.br/tede2/bitstream/tede/9290/3/TES_ROBERTO_RAMOS_BARBOSA_CONFIDENCIAL.pdf.jpgad6eac871b7f8df5b340ca5ae3eb8056MD53TEXTTES_ROBERTO_RAMOS_BARBOSA_CONFIDENCIAL.pdf.txtTES_ROBERTO_RAMOS_BARBOSA_CONFIDENCIAL.pdf.txttext/plain1634http://tede2.pucrs.br/tede2/bitstream/tede/9290/4/TES_ROBERTO_RAMOS_BARBOSA_CONFIDENCIAL.pdf.txtb4182f042c7fb1ab7aa52c556f9b5504MD54ORIGINALTES_ROBERTO_RAMOS_BARBOSA_CONFIDENCIAL.pdfTES_ROBERTO_RAMOS_BARBOSA_CONFIDENCIAL.pdfapplication/pdf298308http://tede2.pucrs.br/tede2/bitstream/tede/9290/2/TES_ROBERTO_RAMOS_BARBOSA_CONFIDENCIAL.pdf7d43c996473cb2421fb49daeb918e334MD52LICENSElicense.txtlicense.txttext/plain; charset=utf-8590http://tede2.pucrs.br/tede2/bitstream/tede/9290/1/license.txt220e11f2d3ba5354f917c7035aadef24MD51tede/92902020-10-27 21:00:14.276oai:tede2.pucrs.br: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Biblioteca Digital de Teses e Dissertaçõeshttp://tede2.pucrs.br/tede2/PRIhttps://tede2.pucrs.br/oai/requestbiblioteca.central@pucrs.br||opendoar:2020-10-27T23:00:14Biblioteca Digital de Teses e Dissertações da PUC_RS - Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS)false |
dc.title.por.fl_str_mv |
Associa??o entre polui??o atmosf?rica e press?o arterial em crian?as e adolescentes : revis?o sistem?tica e metan?lise |
title |
Associa??o entre polui??o atmosf?rica e press?o arterial em crian?as e adolescentes : revis?o sistem?tica e metan?lise |
spellingShingle |
Associa??o entre polui??o atmosf?rica e press?o arterial em crian?as e adolescentes : revis?o sistem?tica e metan?lise Barbosa, Roberto Ramos Polui??o Atmosf?rica Hipertens?o Press?o Arterial Crian?a Air Pollution Hypertension Blood Pressure Child CIENCIAS DA SAUDE::MEDICINA |
title_short |
Associa??o entre polui??o atmosf?rica e press?o arterial em crian?as e adolescentes : revis?o sistem?tica e metan?lise |
title_full |
Associa??o entre polui??o atmosf?rica e press?o arterial em crian?as e adolescentes : revis?o sistem?tica e metan?lise |
title_fullStr |
Associa??o entre polui??o atmosf?rica e press?o arterial em crian?as e adolescentes : revis?o sistem?tica e metan?lise |
title_full_unstemmed |
Associa??o entre polui??o atmosf?rica e press?o arterial em crian?as e adolescentes : revis?o sistem?tica e metan?lise |
title_sort |
Associa??o entre polui??o atmosf?rica e press?o arterial em crian?as e adolescentes : revis?o sistem?tica e metan?lise |
author |
Barbosa, Roberto Ramos |
author_facet |
Barbosa, Roberto Ramos |
author_role |
author |
dc.contributor.advisor1.fl_str_mv |
Mattiello, Rita |
dc.contributor.advisor1Lattes.fl_str_mv |
http://lattes.cnpq.br/4920515067971772 |
dc.contributor.authorLattes.fl_str_mv |
http://lattes.cnpq.br/9161438516859776 |
dc.contributor.author.fl_str_mv |
Barbosa, Roberto Ramos |
contributor_str_mv |
Mattiello, Rita |
dc.subject.por.fl_str_mv |
Polui??o Atmosf?rica Hipertens?o Press?o Arterial Crian?a |
topic |
Polui??o Atmosf?rica Hipertens?o Press?o Arterial Crian?a Air Pollution Hypertension Blood Pressure Child CIENCIAS DA SAUDE::MEDICINA |
dc.subject.eng.fl_str_mv |
Air Pollution Hypertension Blood Pressure Child |
dc.subject.cnpq.fl_str_mv |
CIENCIAS DA SAUDE::MEDICINA |
description |
Background: Air pollution has been consistently considered a cardiovascular risk factor in adults. Autonomic disbalance and endothelial dysfunction are plausible mechanisms for induction and perpetuation of arterial hypertension after exposure to atmospheric pollutants. However, scientific information about air pollution effects on cardiovascular system and blood pressure in children are still lacking. Objectives: To systematically review the association between air pollutants and cardiovascular outcomes in children and adolescents. Methods: For this systematic review and meta-analysis, comprehensive search was conducted through MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Scientific Electronic Library Online, Latin American Caribbean Health Sciences Literature, Cumulative Index to Nursing and Allied Health Literature, Web of Science, and gray literature, with no date and language limit, to estimate the association between air pollutants and blood pressure in healthy children from zero to 18 years of age. Quality of evidence was assessed for all studies using the Cochrane Reviews standards. Meta-analysis was perfomed using random effects models in order to synthesize the associations. Results: A total of 13 studies accounting 45,059 participants were included in the systematic review, and three of these studies accounting 314 participants were included in the meta- analysis. In the comparison between the group of children resident in areas with higher level of air pollution and the ones exposed to lower level of air pollution, mean differences of systolic and diastolic blood pressure were 3.93 (95% CI: -0.29 to 8.14), I2 = 87%, and 2.61 (95% CI: 0.10 to 5.11), I2 = 78% respectively. In sensitive analysis, mean difference of systolic blood pressure between the higher exposure group and the lower exposure group was 6.08 (95% CI: 3.68 to 8.49), I2 = 50%, and mean difference of heart rate was -3.12 (95% IC: - 4.11 to -2.12), I2 = 0%. Nine studies (69.2%) were classified as poor or fair quality. Conclusion: Children exposed to higher levels of atmospheric pollution tend to present elevation of blood pressured and indirect signs of endothelial dysfunction, as compared to youngsters who reside in lower exposure areas. The exact dose-effect relationship of this association and the effects of different types of pollutants still need further studies, from childhood to adult life course. Policies to improve environmental health can contribute for primary cardiovascular prevention in the present and the future. |
publishDate |
2019 |
dc.date.issued.fl_str_mv |
2019-08-27 |
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2020-10-27T13:41:44Z |
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500 500 500 |
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Pontif?cia Universidade Cat?lica do Rio Grande do Sul |
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Programa de P?s-Gradua??o em Medicina/Pediatria e Sa?de da Crian?a |
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