Cardiovascular Risk in Adolescents With Congenital Heart Disease Living in a Low-income Region: Cross-sectional Associations With Clinical, Behavioral and Sociodemographic Factors

Background Adolescents with congenital heart disease (CHD) have high cardiovascular risk (CVR), related to clinical, behavioral and socioeconomic factors. A sedentary lifestyle, physical inactivity and unfavorable socioeconomic conditions can aggravate this risk, while regular physical activity, a healthy diet and lipid profile control are protective factors. Objective To determine the relationship among clinical, behavioral, and socioeconomic factors and CVR in adolescents with CHD. Methods Cross-sectional study with 75 adolescents, aged 10 to 18 years old, attending a reference outpatient service in Alagoas, Brazil. The Physical Activity Questionnaire for Children, Questionnaire for Screen Time of Adolescents, lipid and glycemic profile and Pathobiological Determinants of Atherosclerosis in Youth score were used. 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 non-conditional method, adjusted for significant confounding factors (p < 0.20). Results A total of 75 adolescents were recruited, 62.6% showed low CVR, 82.7% exhibited excessive sedentary behavior and 90.7% were physically inactive, both associated with lipid alterations. Females had a lower odds ratio (OR) of 0.32 (95% CI = 0.11; 0.91) for higher CVR, while high complexity of CHD had an OR of 4.38 (95% CI = 1.02; 18.69) for high LDL-c levels. Adolescents with lower income had an OR of 3.29 (95% CI = 1.20; 9.08) for low HDL-c levels. Conclusion Adolescents with CHD have a high sedentary lifestyle, low levels of physical activity and clinical and socioeconomic factors that increase cardiovascular risk.