Clinical ResearchLongitudinal Evaluation of the Prevalence of Overweight/Obesity in Children With Congenital Heart Disease
Section snippets
Study participants
Patients managed at The Hospital for Sick Children, Toronto, Ontario between 1995 and 2005 were reviewed. Patients were eligible for the study if they had 1 of the following 6 diagnoses: isolated atrial septal defect (ASD), ventricular septal defect (VSD), atrioventricular septal defect (AVSD), tetralogy of Fallot (TOF)/double-outlet right ventricle (DORV), transposition of the great arteries (TGA), or single-ventricle anatomy amenable to a Fontan procedure. Patients were identified from the
Patient characteristics
A total of 725 patients were included in this study (sampled 27% of 2703 patients eligible), and 4153 height and weight measurements were available for analysis (average 6 ± 5 measurements per patient). Median follow-up was 7.1 years (interquartile range, 1.9-12.8 years), and 193 (27%) patients were followed for longer than 10 years. Of included patients, 56% were boys and 14% had Down syndrome. Cardiac diagnosis distribution was ASD, 16%; VSD, 21%; AVSD, 16%; TGA, 19%; TOF/DORV, 18%; and
Discussion
This study demonstrated that patients with CHD had a significant risk of being overweight/obese over time, similar to the general population. Patients who underwent exercise testing as clinically indicated demonstrated that overweight/obese patients had lower exercise capacity and higher blood pressure response, which may contribute an additional cardiovascular risk factor in the future. There are no previous longitudinal large studies that evaluate serial measurements over time for pediatric
Conclusions
This study defines an important prevalence and some of the factors associated with overweight/obesity in this vulnerable population and the adverse consequences of being overweight/obese regarding exercise capacity. Health care providers should balance the benefits and risks of allowing patients with CHD to participate in physical activity according to the current recommendations/guidelines while also minimizing risk.19, 25 Patients with CHD require appropriate evaluation in terms of nutrition,
Funding Sources
Supported in part by the CIBC World Markets Endowed Chair in Child Health Research.
Disclosures
The authors have no conflicts of interest to disclose.
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See editorial by St-Pierre and Poirier, pages 109-111 of this issue.
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