Risco cardiovascular em adolescentes com cardiopatias congênitas: associações transversais com fatores clínicos, comportamentais e fatores sociodemográficos

Abstract

Introduction: Introduction: Congenital heart disease (CHD) is a significant cardiac malformation associated with the risk of early development of atherosclerotic cardiovascular disease (CVD). Regular physical activity, recognized as a protective factor, improves cardiovascular health, functional capacity and quality of life. However, many adolescents with CHD have insufficient levels of physical activity and excessive sedentary behavior, aggravated by overprotection, socioeconomic barriers and lack of professional guidance. Conditions such as low income, limited education and regional inequalities increase the difficulties in accessing healthy practices and contribute to increased cardiovascular risk in this population. Objective: To analyze the relationship between clinical, behavioral and sociodemographic factors and cardiovascular risk in adolescents with congenital heart disease. Methodology: Cross-sectional study conducted at a referral outpatient clinic in Alagoas, with adolescents aged 10 to 18 years diagnosed with CHD. Sociodemographic and clinical data, physical activity levels and sedentary behavior were collected through validated questionnaires. Laboratory tests included lipid and glycemic profile, in addition to blood pressure and waist circumference measurements. Cardiovascular risk was estimated using the Pathobiological Determinants of Atherosclerosis in Youth (PDAY) score. For descriptive analysis, means, standard deviations, absolute and relative frequencies were calculated. Associations were tested by chi-square or Fisher's exact test for categorical variables and Student's t-test for continuous variables. Multivariate binary logistic regression was used by the backward method, adjusting the associations for significant confounding factors (p < 0.20). Results: A total of 75 adolescents participated, of which 62.6% had low cardiovascular risk. However, 82.7% exhibited excessive sedentary behavior and 90.7% were classified as physically inactive, both associated with lipid alterations. Females had a lower odd ratio (OR) 0.32 (95% CI = 0.11; 0.91) of higher RCV PDAY (p = 0.033), while high complexity of WC had an OR 4.38 (95% CI = 1.02; 18.69) of high LDL-c levels (p = 0.046). Lower-income adolescents had an OR of 3.29 (95% CI = 1.20; 9.08) for low HDL-c levels (p = 0.021). Conclusion: Although most adolescents presented low cardiovascular risk, high sedentary lifestyle and social inequalities have been shown to negatively influence cardiovascular health. Interventions that encourage physical activity and reduce socioeconomic barriers are essential to mitigate cardiovascular risk in this vulnerable population.