Risk factors for the development of atherosclerosis in childhood and adolescence. Cardiovascular diseases CVD are a major cause of death in developed countries as well as in developing countries. In general, the clinical manifestations of CVD, such as myocardial infarction, stroke and peripheral vascular disease, are caused by an atherosclerotic process with onset as from the middle age. However, current studies indicate that the atherosclerotic process starts to develop in childhood.
The pathogenesis of atherosclerosis has been studied as to its inflammatory aspect. Among the inflammatory
Floripondio droga yahoo dating, C-reactive protein CRP has been extensively studied in individuals with CVD, including those apparently healthy. High CRP levels have been related to risk factors for atherosclerosis: A great part of these risk factors may be influenced by lifestyle modifications, such "Floripondio droga yahoo dating" changes in eating habits and engagement in physical activities.
The effects of physical activity on CRP levels in adulthood are documented in the literature, however little is known on the influence of an active or sedentary lifestyle of children and adolescents on CRP levels.
Thus, the objective of this study is to review the impact of physical activity of children and adolescents on CRP levels and the risk factors for the development of CVD. Coronary arteriosclerosis; motor
Floripondio droga yahoo dating child; adolescent. Cardiovascular diseases CVD are a major cause of death in developed countries as well as in developing countries 1.
In general, the clinical manifestations of CVD start in the middle age. However, recent studies indicate that the atherosclerotic process starts to develop in childhood.
Fatty streaks precursor of atherosclerotic plaques appear in the aortic intima at three years of age, and in the coronary arteries during adolescence 2. Thus, atherosclerosis gradually changed from a model of a chronic degenerative disease exclusively affecting patients with advanced age to a model of a subclinical chronic inflammatory disease already existing in childhood 3.
CRP has been a widely used inflammatory marker for the detection of CVD because its plasma concentration is easy to determine and it has the best clinical and epidemiological correlation to date. High blood CRP levels have been found in inflamed tissues, atherosclerotic vessels and infarcted myocardium 5.
Its utilization has been important for the possibility of identifying new pathways for the prevention and treatment of CVD and of risk factors for atherosclerosis 4,6: A great part of these factors may be influenced by lifestyle changes, thus reducing cardiovascular events and increasing the individuals' life expectancy. Modifications in eating habits and practice of physical activities are lifestyle changes that may significantly diminish risk factors for CVD and reduce CRP 6. The strategies for CRP reduction were initially based on pharmacological treatments 4,7.
Although these studies prove the positive effect of these therapies on CRP reduction in adults, little is known of the effect of physical activity on CRP in childhood and adolescence. The demonstration that cardiovascular diseases may originate
Floripondio droga yahoo dating childhood and adolescence leads to the need that these risk factors be extensively investigated in these phases, with the purpose of planning increasingly earlier and possibly finding more effective interventions on these factors, thus further reducing morbidity and mortality.
The pathophysiology of CVD, the major causes of morbidity and mortality worldwide, starts at
Floripondio droga yahoo dating early age. CVD are part of the group of chronic non-communicable diseases that comprise the plurimetabolic syndrome obesity, hypertension, diabetes mellitus and dyslipidemia caused by risk factors resulting from changes "Floripondio droga yahoo dating" lifestyle habits 8. The likelihood of occurrence of CVD increases in the presence of multiple risk factors established for atherosclerosis.
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These may be modifiable or non-modifiable. The non-modifiable risk factors are age, gender and family history. The modifiable risk factors are dyslipidemia, hypertension, eating habits, smoking, diabetes mellitus, obesity and sedentary lifestyle 9. Non-modifiable risk factors for cardiovascular diseases.
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The risks for CVD increase with age, and at every 10 years there is a possibility of mortality from these diseases increasing by 2. The magnitude of the risk factors and the occurrence of clinical "Floripondio droga yahoo dating" emerge later in women than in men As regards genetic inheritance, detailed history taking of family diseases reveals a genetic susceptibility for the development of CAD In Romaldini et al study 12of children and adolescents with a premature CVD family history, Modifiable risk factors for cardiovascular diseases.
Hypertension is a modifiable risk factor considered very important for CVD in both genders, irrespective of ethnical group or age bracket. However, children with
Floripondio droga yahoo dating blood pressure levels tend to progress over life, maintaining higher blood pressure levels than their peers and showing a greater probability of becoming hypertensive adults The mechanism for this protective effect stems from the HDL ability to perform reverse cholesterol transport, that is, to remove it from the cells and transport it to the liver for further excretion.
HDL also prevents oxidation and aggregation of LDL particles in the arterial wall, thus diminishing the atherogenic potential of this lipoprotein Diabetes mellitus is one of the major public health problems worldwide, especially in developing countries 15, Its risk factors are hyperglycemia, lipoprotein alterations and hypertriglyceridemia,
Floripondio droga yahoo dating cause modifications in the vascular biology and accelerate molecular and cellular events which lead to atherosclerosis Obesity is also an important predictor of CVD, and arterial wall lesions are already observed in obese children The prevalence of obesity in childhood and adolescence has short and long-term consequences because it is associated with an abnormal lipid profile, with increased concentrations of total cholesterol, triglycerides and LDL, and decreased HDL In addition to being a risk Floripondio droga yahoo dating for low-birth weight, placental abruption and pulmonary diseases, smoking is also an important risk factor for CVD because it reduces blood HDL concentrations McGille et al study 18 suggests that secondhand smoke is related to low plasma HDL levels, which is associated with a significant endothelial dysfunction.
In relation to the direct effects, evidences demonstrate that a mild airway obstruction and slowed growth of lung function in adolescents are associated with smoking Another risk factor that has been pointed out as one of the factors responsible for the higher CVD prevalence is the change in eating habits, through a reduction in fruit and vegetable consumption and increase in the percentage of saturated and animal fat, thus leading to lower ingestion of antioxidant food micronutrients which are important for the control or reduction of the deleterious action of free radicals in the body; this delays or prevents their oxidation Finally,
Floripondio droga yahoo dating sedentary lifestyle has been pointed out as another risk factor for CVD, already existing in childhood and adolescence.
Also, children have been performing less recreational and sports activities in their free time, with increased sedentary activities such as watching television, playing videogames, and using the computer The practice of physical exercises is known to have a positive effect on cardiovascular risks in adults, and, in children, it had first been related to a strategy for physical development However, some data show that lower levels of physical activity and sedentary lifestyle are associated with a higher prevalence of childhood obesity, pointing out to a sedentary lifestyle as a risk factor present in early age The demonstration that CVD may originate in childhood and adolescence leads to the need that these risk factors be extensively investigated during this period, with the objective of planning increasingly earlier and, possibly, taking more effective interventions on these factors, thus reducing morbidity and mortality in the future.
Prevalence of risk factors for atherosclerosis in childhood and adolescence. Brazilian data on the risk factors for atherosclerosis in childhood and adolescence show that the prevalence of essential hypertension in these phases range from 0. A frequent association between hypertension and overweight or obesity is demonstrated.
IBGE data 27 in point out to an increase by 8. The prevalence of excess weight was higher among families with a higher income, except in the city of Porto Alegre, where girls from public schools had higher BMI than those from private schools. Another risk factor that is already present in childhood and adolescence
Floripondio droga yahoo dating smoking.
Researches conducted in 10 Brazilian capitals involving 24, elementary school and high school students
Floripondio droga yahoo dating the years of, and showed an increasing number of young people trying cigarettes in all capitals.
Another important conclusion of the research is related to the tendency of a balance in the consumption among students of both genders, unlike what occurred in the year ofwhen the male gender predominated As regards sedentary lifestyle, few studies on its prevalence among Brazilian children and
Floripondio droga yahoo dating are available, ranging from 42 to The pathogenesis most frequently found in CVD is atherosclerosis, which is a disease resulting from endothelial dysfunction and inflammation. [email protected] bowyer box box boxberry...
The vascular endothelium regulates vascular homeostasis, leading to adaptive functional changes with the release of several substances with clotting and anti-clotting activities - able to promote molecule adhesion - and with vasoactive actions.
Vascular homeostasis is the result of the dynamic regulation of these functions. Nitric oxide NO is the main antiatherogenic substance, that is, it has an endothelial protective action The loss of the endothelial protective action may occur in the presence of inflammatory factors and cardiovascular risk factors, with increased propensity towards vasoconstriction, thrombosis, inflammation, and cell proliferation in the vessel wall.
Thus, the loss of NO biological activity, known as endothelial dysfunction, may be the event triggering the atherosclerotic disease in humans, turning its assessment in an early marker of the risk for atherosclerosis Therefore, in "Floripondio droga yahoo dating" last few years, the role of inflammation in the
Floripondio droga yahoo dating of atherosclerosis and the occurrence of atherothrombotic events as determinants of CVD has been evidenced 4.
It has also been verified that this process may begin early in life. Aortic fatty streaks develop in childhood and fibrous plaques may be observed before 20 years of age Thus, atherosclerosis gradually changed from a model of a non-communicable chronic degenerative disease exclusively affecting patients with advanced age to a model of a subclinical chronic inflammatory disease already existing in childhood 3.
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The factors contributing to the development of atherosclerosis are hyperlipoproteinemia, increased platelet aggregation, decreased vascular endothelial cells, and increased smooth cell proliferation. Leukocytes, monocytes and macrophages are present in the atherosclerotic lesion, thus suggesting a developing
Floripondio droga yahoo dating reaction In the presence of oxidized LDL, of infectious agents in the vascular wall or of tissue lesion necrosis or ischemialeukocytes are activated.
Once activated, they start to produce different cytokines, interleukins, tumor
Floripondio droga yahoo dating factor alpha, and gamma interferon. Especially, interleukin-6 IL-6 stimulates the hepatocytes to produce RNAm for the production of acute phase proteins such as fibrinogen, CRP and serum amyloid A protein It has been demonstrated that atherosclerosis is not simply a lipid storage disease, and that inflammation has a key role in the initiation, progression and destabilization of atheroma A marker of the inflammatory activity is the increased circulation of acute phase proteins produced in the liver, such as CRP and fibrinogen.
CRP is one of the most sensitive acute phase proteins, and its concentration significantly increases during acute inflammation Acute phase reaction of inflammation. Living beings survive thanks to the maintenance of a dynamic and complex balance, which is often jeopardized by inner and outer forces. The maintenance of this balance is ensured by some physiological mechanisms, so that any factor disturbing the organism's integrity such as trauma or tissue infection is able to trigger a series of metabolic and systemic changes that aim to reestablish the homeostasis.
These changes comprise the inflammation process and the group of humoral and cell reactions initiated soon after the damage, and are collectively called acute phase reaction The acute phase reaction enables survival during the immediate post-tissue lesion period by triggering the synthesis and secretion of several cell mediators in the site of the damage, which mobilize the metabolic response of the entire organism.
The purpose of "Floripondio droga yahoo dating" these changes is to halt or destroy infectious agents, to prevent the maintenance of tissue damage, and to activate the repair mechanisms required for the organism to resume its normal functioning. Thus, the acute phase reaction is a homeostatic, dynamic and protective response that hosts make use of against the different aggressions they are subjected to Mostly, inflammatory mediators act locally to limit the consequences and extent of tissue damage.
Under conditions in which this local homeostatic capacity is exceeded, whether by the magnitude of the aggression or by failure of the regulating mechanisms, the inflammatory response goes beyond the limits of its microenvironment and may express itself systemically Molecular mechanisms of the acute phase reaction. Irrespective of the nature of the triggering stimulus, "Floripondio droga yahoo dating" activated cells of the mononuclear phagocytic system blood monocytes and tissue macrophages initiate a cascade of events of the acute phase response by secreting cytokines of the interleukin-1 IL-1 family and tumor necrosis factor TNF in an initial stage.
These molecules act both locally and systemically Locally, they act mainly on fibroblasts and endothelial cells, causing the release of a second set of cytokines that include IL-6, IL-8, and the inflammatory and chemotactic macrophage proteins, in addition
Floripondio droga yahoo dating IL-1 and TNF themselves. Main · Videos; Carmelina moscato...
The inflammatory and chemotactic macrophage
Floripondio droga yahoo dating along with IL-1 and IL-8 attract monocytes and neutrophils to the inflammation site; monocytes and neutrophils, in turn, secrete a third set of cytokines including TNF and other chemotactic factors that exert a feedback on the inflammatory process The vascular endothelium plays a central role in the communication between the inflammatory site and blood leukocytes, both via the expression of adhesion molecules that facilitate tissue Floripondio droga yahoo dating of monocytes and neutrophils, and via the modification of the vascular tonus mediated by metabolites of the arachidonic acid prostaglandins, thromboxane and leukotrienesby nitric oxide, and by kinins, thus causing vasodilation, increased vascular permeability and arterial hypotension Systemically, the liver is the main target of inflammatory mediators, supplying the essential metabolites for the stress response and the components required for the first-line defense in the inflammation site Using their specific receptors, the liver cells respond to four types of inflammatory response mediators.
These mediators are the ILtype cytokines IL-1 and TNF which stimulate liver production of CRP, of the C3 component of complement, and serum amyloid A protein SAAwhich comprise the type-1 acute phase proteins; type IL-6 cytokines IL-6 and IL which stimulate most of the type-1 acute phase proteins; glucocorticoids that act synergistically with type IL-1; and IL-6 cytokines stimulating the production of some acute phase proteins.
However, the most important action of glucocorticoids in the acute phase response is the inhibiton of cytokine production by macrophages and endothelial cells, thus preventing its continued activation from having harmful consequences to the tissues; and, finally, growth factors which, along with glucocorticoids, modulate
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