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March 14, 2026Pediatric Cardiology0 citationsOpen Access

Cardiovascular Risk in Adolescents with Congenital Heart Disease Living in a Low-Income Region: Cross-Sectional Associations with Clinical, Behavioral and Sociodemographic Factors

MPMarylia Santos PereiraACAna Carla CavalcanteAPAdrielly Suely Santos Pereira

Key Result

Adolescents with congenital heart disease exhibited a 37.3% prevalence of intermediate to high cardiovascular risk, with male adolescents at greater risk compared to females.

Key Points

  • This research aims to identify the connections between clinical, behavioral, and socioeconomic factors and cardiovascular risk among adolescents with congenital heart disease.
  • Conducted a cross-sectional study with 75 adolescents aged 10 to 18 years.
  • Utilized various questionnaires to assess physical activity, screen time, lipid, and glycemic profiles.
  • Analyzed associations using chi-square, Student’s t-test, and multivariate binary logistic regression.
  • 62.6% of adolescents exhibited low cardiovascular risk.
  • 82.7% showed excessive sedentary behavior and 90.7% were physically inactive, linked to lipid abnormalities.
  • Females had a reduced odds ratio of 0.32 for higher cardiovascular risk, while high complexity of congenital heart disease increased odds for high LDL levels.

Study Design

Type

Cross-Sectional (n=75)

Multicenter

No

Structured PICO

P
Population
75 adolescents (aged 10 to 18 years) with congenital heart disease (CHD) attending a reference outpatient service in Alagoas, Brazil. Mean age 12.70, 42.67% male. Key inclusion: diagnosed with CHD, with medical records and followed at the referral clinic. Exclusions: inability to stand/move/speak/hear, Down syndrome, pregnancy, dwarfism, refusal of blood collection.
O
Outcome
Cardiovascular risk assessed by the Pathobiological Determinants of Atherosclerosis in Youth (PDAY) score, lipid profile, glycemic profile, blood pressure, and anthropometric measurementssurrogate

Adolescents with congenital heart disease in low-income regions exhibit high rates of physical inactivity and sedentary behavior, which are significantly associated with adverse lipid profiles and increased cardiovascular risk.

Limitations

  • Cross-sectional design limits causality establishment
  • Lack of family history data on cardiovascular diseases
  • PDAY score applicability questioned for younger adolescents

Abstract

Abstract 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 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.

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Cite This Study

Pereira et al. (2026) conducted a cross-sectional in Congenital Heart Disease (n=75). Physical Activity and Sedentary Behavior Monitoring vs. None was evaluated on Cardiovascular risk based on PDAY score. Adolescents with congenital heart disease exhibited a 37.3% prevalence of intermediate to high cardiovascular risk, with male adolescents at greater risk compared to females.

synapsesocial.com/papers/69b4fbc1b39f7826a300c2f7https://doi.org/10.1007/s00246-026-04218-y
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