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Pan X, Chen Y, Yang Y, Kidambi S, Liang M, Liu P. Mediating effects of BMI on the association between DNA methylation regions and 24-h blood pressure in African Americans. J Hypertens 2024; 42:1750-1756. [PMID: 38973536 PMCID: PMC11361834 DOI: 10.1097/hjh.0000000000003796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/09/2024]
Abstract
BACKGROUND DNA methylation is an important epigenetic mechanism that may influence blood pressure (BP) regulation and hypertension risk. Obesity, a major lifestyle factor associated with hypertension, may interact with DNA methylation to affect BP. However, the indirect effect of DNA methylation on 24-h BP measurements mediated by obesity-related phenotypes such as BMI has not been investigated. METHODS Causal mediation analysis was applied to examine the mediating role of BMI in the relation between DNA methylation and 24-h BP phenotypes, including SBP, DBP and mean arterial blood pressure (MAP), in 281 African American participants. RESULTS Analysis of 38 215 DNA methylation regions, derived from 1 549 368 CpG sites across the genome, identified up to 138 methylation regions that were significantly associated with 24-h BP measurements through BMI mediation. Among them, 38 (19.2%) methylation regions were concurrently associated with SBP, DBP and MAP. Genes associated with BMI-mediated methylation regions are potentially involved in various chronic diseases such as coronary artery disease and renal disease, which are often caused or exacerbated by hypertension. Notably, three genes ( CDH4 , NOTCH1 and COLGALT1 ) showed both direct associations with 24-h BP measurements and indirect associations through BMI after adjusting for age and sex covariates. CONCLUSION Our findings suggest that DNA methylation may contribute to the regulation of 24-h BP in African Americans both directly and indirectly through BMI mediation.
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Affiliation(s)
- Xiaoqing Pan
- Department of Mathematics, Shanghai Normal University, Shanghai, China
| | - Yuru Chen
- Department of Mathematics, Shanghai Normal University, Shanghai, China
| | - Yifan Yang
- Department of Mathematics, Shanghai Normal University, Shanghai, China
- Transwarp Technology Co., LTD, Shanghai, China
| | - Srividya Kidambi
- Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Mingyu Liang
- Department of Physiology, University of Arizona, Tucson, AZ, USA
| | - Pengyuan Liu
- Department of Respiratory Medicine, Sir Run Run Shaw Hospital and Institute of Translational Medicine, Zhejiang University School of Medicine, Hangzhou, China
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Yuan L, Qu C, Zhao J, Lu L, Chen J, Xu Y, Li X, Mao T, Yang G, Zhen S, Liu S. Dose-response relationship between body mass index and hypertension: A cross-sectional study from Eastern China. Prev Med Rep 2024; 46:102852. [PMID: 39238781 PMCID: PMC11372613 DOI: 10.1016/j.pmedr.2024.102852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2024] [Revised: 07/16/2024] [Accepted: 08/02/2024] [Indexed: 09/07/2024] Open
Abstract
Background A high body mass index (BMI) increases the risk of hypertension. However, little is known about the dose-dependent association between BMI and hypertension. Therefore, this study investigated the prevalence of hypertension in 7568 subjects from the Jiangsu Province, Eastern China, and analyzed the dose-response relationship between BMI and hypertension risk. Methods The eligible subjects completed a structured questionnaire and clinical biochemical indicators were measured according to standardized protocols. Multivariate logistic regression models were used to evaluate the association between BMI and hypertension. Restricted cubic spline (RCS) analysis was used to analyze the dose-response relationship between BMI and hypertension risk. Moreover, sensitivity analysis was performed to verify the robustness of our findings. Results The prevalence of hypertension was 35.3 % in the total population. BMI was significantly associated with systolic and diastolic blood pressure. The fully-adjusted odds ratio (OR) with 95 % confidence interval (CI) for hypertension was 1.17 (1.15, 1.19) for every 1 kg/m2 increase in BMI. Furthermore, the OR (95 % CI) for hypertension in the highest BMI group (Obesity) was 4.14 (3.45, 4.96) after adjusting for covariates compared with the normal group. Multivariable adjusted RCS analysis showed a positive and linear dose-response relationship between BMI and hypertension risk both in male and female populations (all P for non-linearity > 0.05). Conclusion Our study demonstrated a positive and linear dose-response relationship between BMI and the risk of hypertension. The results of this study provide evidence for BMI-related clinical interventions to reduce the risk of hypertension.
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Affiliation(s)
- Lei Yuan
- Department of Social Medicine and Health Education, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu Province 211166, China
| | - Chen Qu
- Department of Health Education, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, Jiangsu Province 210009, China
| | - Jinhang Zhao
- Department of Social Medicine and Health Education, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu Province 211166, China
| | - Lijun Lu
- Department of Social Medicine and Health Education, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu Province 211166, China
| | - Jiaping Chen
- Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu Province 211166, China
| | - Yan Xu
- Department of Health Education, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, Jiangsu Province 210009, China
| | - Xiaoning Li
- Department of Health Education, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, Jiangsu Province 210009, China
| | - Tao Mao
- Department of Health Education, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, Jiangsu Province 210009, China
| | - Guoping Yang
- Department of Health Education, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, Jiangsu Province 210009, China
| | - Shiqi Zhen
- Department of Health Education, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, Jiangsu Province 210009, China
| | - Sijun Liu
- Department of Social Medicine and Health Education, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu Province 211166, China
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Wang Y, Hu Z, Ding Y, Sun Y, Meng R, He Y. Delay Discounting and BMI in Hypertensives: Serial Mediations of Self-Efficacy, Physical Activity and Sedentary Behavior. J Multidiscip Healthc 2024; 17:4319-4334. [PMID: 39246561 PMCID: PMC11380850 DOI: 10.2147/jmdh.s481425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2024] [Accepted: 08/29/2024] [Indexed: 09/10/2024] Open
Abstract
Objective Our study aimed to examine the association between delay discounting (DD) and body mass index (BMI) in individuals with hypertension. Additionally, we sought to explore and compare the potential mediating effects of self-efficacy, physical activity and sedentary behavior in this association. Methods A cross-sectional survey was conducted in two cities in the Jiangsu province of China, specifically Nanjing and Yangzhou, from March to June 2023. A total of 972 hypertensive patients completed the questionnaire (M age = 64.7 years, SD age = 8.2 years, 54.2% female). Participants engaged in a money choice experiment on computers, provided their height and weight, and completed the International Physical Activity Questionnaire-Short Form (IPAQ-SF) and General Self-Efficacy Scale (GSES). The experimental program was generated using the programming software E-Prime version 2.0. Multiple hierarchical regression analysis was conducted to identify potential covariates. Two serial mediation models were conducted using PROCESS macro 4.1 in SPSS 27.0. Physical activity and sedentary behavior were designated as M2 to investigate and contrast their respective mediating effects in the association between delay discounting and body mass index. Results Self-efficacy, physical activity, and sedentary behavior served as mediators in the relationship between delay discounting and BMI. Self-efficacy accounted for 14.9% and 14.3% of the total effect in Models 1 and 2, respectively, while physical activity and sedentary behavior each accounted for 14.9% and 9.5% of the total effect, respectively. The serial mediation effects of self-efficacy and physical activity, as well as self-efficacy and sedentary behavior, were significant (B = 0.01, 95% CI [0.01, 0.02]; B = 0.01, 95% CI [0.002, 0.01]), collectively contributing 2.1% and 2.4% of the total effect. Sedentary behavior played a smaller mediating role compared to physical activity in this association. Conclusion The results indicated that self-efficacy, physical activity and sedentary behavior could act as mediators in the association between delay discounting and BMI, thus potentially mitigating the risk of obesity in hypertensive individuals.
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Affiliation(s)
- Yiping Wang
- School of Nursing, Nanjing Medical University, Nanjing, People's Republic of China
| | - Zhiqing Hu
- Institute of Medical Humanities, Nanjing Medical University, Nanjing, People's Republic of China
- School of Marxism, Nanjing Medical University, Nanjing, People's Republic of China
| | - Yueming Ding
- Institute of Medical Humanities, Nanjing Medical University, Nanjing, People's Republic of China
- School of Marxism, Nanjing Medical University, Nanjing, People's Republic of China
| | - Yanjun Sun
- Institute of Medical Humanities, Nanjing Medical University, Nanjing, People's Republic of China
- School of Marxism, Nanjing Medical University, Nanjing, People's Republic of China
| | - Rui Meng
- School of Nursing, Nanjing Medical University, Nanjing, People's Republic of China
| | - Yuan He
- School of Nursing, Nanjing Medical University, Nanjing, People's Republic of China
- Institute of Medical Humanities, Nanjing Medical University, Nanjing, People's Republic of China
- School of Marxism, Nanjing Medical University, Nanjing, People's Republic of China
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Fatima H, Sohail Rangwala H, Mustafa MS, Shafique MA, Abbas SR, Sohail Rangwala B. Analyzing and evaluating the prevalence and metabolic profile of lean NAFLD compared to obese NAFLD: a systemic review and meta-analysis. Ther Adv Endocrinol Metab 2024; 15:20420188241274310. [PMID: 39234426 PMCID: PMC11372778 DOI: 10.1177/20420188241274310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Accepted: 07/15/2024] [Indexed: 09/06/2024] Open
Abstract
Background Non-alcoholic fatty liver disease (NAFLD) is a common liver condition affecting 25%-40% of the worldwide population. NAFLD is traditionally related to obesity and metabolic disorders. NAFLD can also affect non-obese individuals, termed "lean NAFLD" (LN), who exhibit a paradoxical combination of physical leanness and metabolic obesity. Factors contributing to LN remain unclear, necessitating further research. This analysis aims to understand LN's prevalence and metabolic characteristics compared to obese NAFLD (ON) populations. Methods This meta-analysis searched various databases until August 1, 2023. Inclusion criteria involved observational studies comparing LN with overweight/obese NAFLD. Data extraction included baseline characteristics, disease occurrence, metabolic profile, and clinical parameters-statistical analysis employed calculating risk ratios (RR) and standard mean differences. Results Twenty-five studies were analyzed. LN is associated with lower prevalence in both NAFLD (RR 0.27, 95% confidence interval (CI) 0.14-0.52, p = <0.0001) and total (RR 0.27, 95% CI 0.15-0.51, p < 0.0001) population. LN had lower diabetes mellitus (RR 0.78, 95% CI 0.71-0.87, p < 0.00001), dyslipidemia (RR 0.87, 95% CI 0.79-0.95, p = 0.002), hypertension (RR 0.80, 95% CI 0.74-0.87, p < 0.00001), and metabolic syndrome (RR 0.45, 95% CI 0.31-0.64, p < 0.00001) compared to those with ON. The LN group's lipid profile, blood pressure, and other clinical parameters were favorable compared to ON. Conclusion The prevalence of NAFLD among lean and non-lean individuals varies by region. Our analysis revealed that LN is associated with lower metabolic diseases, fasting blood sugar, blood pressure, and a more favorable lipid profile compared to ON.
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Affiliation(s)
- Hareer Fatima
- Department of Medicine, Jinnah Sindh Medical University, Karachi, Pakistan
| | | | | | - Muhammad Ashir Shafique
- Department of Medicine, Jinnah Sindh Medical University, Rafiqi H J Shaheed Road, Karachi 75510, Pakistan
| | - Syed Raza Abbas
- Department of Medicine, Dow University of Health Sciences, Karachi, Pakistan
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Cseh D, Middlemiss JE, Mäki-Petäjä KM, Hubsch A, Wilkinson IB, McEniery CM. Cardiovascular responses to experimental weight gain in humans: a feasibility study. J Hypertens 2024:00004872-990000000-00517. [PMID: 39119814 DOI: 10.1097/hjh.0000000000003830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/10/2024]
Abstract
OBJECTIVE Obesity and hypertension share a well known association. However, the mechanisms underlying their relationship are not well understood. Our goal was to assess the feasibility of a longitudinal, interventional weight gain study with detailed cardiovascular measurements in humans. METHODS Sixteen healthy, normotensive, young, male volunteers (28 ± 7 years) were enrolled. Body composition, biochemical and cardiovascular data were obtained at baseline, and after an 8-week period of overfeeding (800-1000 kcal/day). Blood pressure (BP), cardiac output (CO) and peripheral vascular resistance (PVR) were determined, as were the minimum forearm vascular resistance (MFVR), forearm blood flow (FBF) response to mental stress and heart rate variability (HRV) parameters. RESULTS Overfeeding resulted in a median weight gain of 5.6 kg [interquartile range (IQR) 4.6-6.4 kg; P < 0.001]. Seated systolic and diastolic BP were significantly increased by 10 ± 9 and 4 ± 6 mmHg, respectively after weight gain (P < 0.001 and P = 0.011, respectively). CO also increased and PVR decreased significantly as a result of weight gain (P = 0.032 and P = 0.044, respectively). MFVR was also significantly decreased after weight gain (P = 0.023). The FBF response to mental stress was blunted significantly (P = 0.002), and sympathovagal balance and responsiveness to orthostatic challenge altered moderately after weight gain. CONCLUSION Our overfeeding regimen resulted in moderate weight gain and significant increases in BP. An increase in CO is likely to be the dominant mechanism underlying the observed BP changes, with decreases in PVR partially compensating for these effects. Experimental weight gain, coupled with detailed cardiovascular phenotyping, is a feasible model to examine potential mechanisms underlying obesity-associated hypertension in young adults.
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Affiliation(s)
- Domonkos Cseh
- Division of Experimental Medicine and Immunotherapeutics, Department of Medicine, University of Cambridge, Cambridge, United Kingdom
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Lin H, Xiao N, Lin S, Liu M, Liu GG. Associations of hypertension, diabetes and heart disease risk with body mass index in older Chinese adults: a population-based cohort study. BMJ Open 2024; 14:e083443. [PMID: 38986550 PMCID: PMC11268030 DOI: 10.1136/bmjopen-2023-083443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 06/04/2024] [Indexed: 07/12/2024] Open
Abstract
OBJECTIVE Obesity is a well-established risk factor for disease. Controversy exists regarding the relative risk of morbidity and mortality in individuals who are overweight or underweight compared with individuals with a normal body mass index (BMI). In this study, we investigated the associations between BMI and three non-communicable diseases (hypertension, diabetes and heart disease) in older adults. DESIGN Cohort study. SETTING This study used data from the China Health and Retirement Longitudinal Study. The baseline survey was carried out in 2011, and follow-up surveys were conducted in 2013, 2015 and 2018. PARTICIPANTS Participants who reported having no doctor-diagnosed chronic disease at baseline were included in this study. MAIN OUTCOME MEASURES We analysed the association between baseline BMI and disease incidence using Cox proportional hazards models. Disease information included self-reported diagnosed conditions. BMI was categorised according to the standard Chinese criteria: underweight (<18.5 kg/m2), normal body weight (18.5-23.9 kg/m2), overweight (24.0-27.9 kg/m2) and obese (≥28.0 kg/m2). RESULTS A total of 5605 participants were included at baseline. Based on the Kaplan-Meier estimation, the participants who were obese had the highest incidence of all three diseases. Compared with normal weight participants, overweight participants had a greater disease incidence (log-rank tests are p<0.01). Cox regression models showed that with increasing BMI, the HRs of diseases increased accordingly (eg, for hypertension, compared with the BMI group <18.5 kg/m2, the HRs for the BMI groups 18.5-23.9, 24.0-27.9 and ≥28.0 were 1.43 (95% CI 1.00 to 2.05), 2.19 (95% CI 1.51 to 3.18) and 2.89 (95% CI 1.91 to 4.36), respectively). CONCLUSION A higher BMI was associated with an increased risk of hypertension, diabetes and heart disease in the population aged 45 years and older. Even within normal BMI ranges, a higher BMI was associated with an increased risk of disease. Actions are urgently needed at the population level to address the growing public health challenge of excess weight in the context of an ageing population.
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Affiliation(s)
- Haoxiang Lin
- Peking University Institute for Global Health and Development, Beijing, China
| | - Nan Xiao
- Peking University Institute for Global Health and Development, Beijing, China
| | - Shujun Lin
- Peking University Institute for Global Health and Development, Beijing, China
| | - Meng Liu
- Peking University Institute for Global Health and Development, Beijing, China
| | - Gordon G Liu
- Peking University Institute for Global Health and Development, Beijing, China
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Choudhary N, Gopal K, Naqvi W, Kandakurti PK, Hazari A. Relationship between the level of physical activity and body mass index to blood pressure among overweight and obese young adults in the Northern Emirates city: A cross-sectional study. PLoS One 2024; 19:e0304360. [PMID: 38900755 PMCID: PMC11189183 DOI: 10.1371/journal.pone.0304360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Accepted: 05/11/2024] [Indexed: 06/22/2024] Open
Abstract
BACKGROUND Obesity affects both adults and children all over the world and it is a major causative factor for diabetes, cardiovascular disease, different types of cancer, and even death. Therefore, this study aimed to assess the level of PA and BMI to the risk of developing high BP among overweight and obese young adults. METHODOLOGY A cross-sectional study was carried out in the Thumbay Medi-city Northern Emirates, Ajman, UAE. Participants enrolled in the study under the convenient sampling method and inclusion criteria: young overweight and obese individuals, male and female, aged between 18 to 30 years. Approval was obtained from the Institutional Review Board (CoHS, GMU (IRB-COHS-STD-110-JUNE-2023). The blood pressure and body mass index were clinically measured using standard tools whereas the GPAQ questionnaire was used to determine the level of physical activity of all participants. RESULTS Out of 206 participants, 139 were overweight and 67 were obese. Further, 89 were found to have high normal BP, 93 normal BP, and 24 were found to have optimal blood pressure. The mean GPA scores were 322.8±62.28 in overweight individuals and 301.17±49.05 in obese individuals. Furthermore, among overweight and obese participants there is a weak correlation between PA & BMI (r = 0.06, p = 0.88) and (r = 0.15, p = 0.44) and the BP and BMI (r = 0.18, p = 1.02) and (r = 0.16, p = 0.90) were found. CONCLUSION Although PA, BMI, and BP are assumed to be related variables leading to various non-communicable diseases the present study showed a weak correlation between the level of PA and BMI to the risk of developing BP among overweight and obese young adults in the Northern Emirates.
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Affiliation(s)
- Naina Choudhary
- Department of Physiotherapy, College of Health Sciences, Gulf Medical University, Ajman, UAE
| | - Kumaraguruparan Gopal
- Department of Physiotherapy, College of Health Sciences, Gulf Medical University, Ajman, UAE
| | - Waqar Naqvi
- Department of Physiotherapy, College of Health Sciences, Gulf Medical University, Ajman, UAE
| | | | - Animesh Hazari
- Department of Physiotherapy, College of Health Sciences, Gulf Medical University, Ajman, UAE
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Li Y, Xie Y, Li J, Chang Z, Zhang J, Zhou Z, Ren R, Chen Y. Diastolic and systolic blood pressure and gout: a Mendelian randomization study. Front Endocrinol (Lausanne) 2024; 15:1367621. [PMID: 38841306 PMCID: PMC11150642 DOI: 10.3389/fendo.2024.1367621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Accepted: 05/06/2024] [Indexed: 06/07/2024] Open
Abstract
Background Although there is solid epidemiological evidence supporting the connection between hypertension and gout, little has been said about the relationship between diastolic and systolic blood pressure and gout, the causal relationship and direction associated are uncertain, so we aim to research the causal relationship between diastolic and systolic blood pressure and gout. Methods We conducted a two-sample Mendelian randomization (MR) analysis to assess the causal effect between 2 blood pressure phenotypes (including diastolic blood pressure and systolic blood pressure) and 5 gout phenotypes (including gout, drug-induced gout, idiopathic gout, unspecified gout, and strictly defined gout) using genome-wide association study statistics. The inverse variance weighting method was used to generate the main results, while sensitivity analyses using MR-Egger, weighted median, Cochran's Q test, Egger intercept test, and leave-one-out analysis, were performed to assess the stability and reliability of the results. Results After the screening, we found a causal relationship between diastolic blood pressure and gout, idiopathic gout, unspecified gout, and strictly defined gout, and a causal relationship between systolic blood pressure and gout, idiopathic gout, unspecified gout, and strictly defined gout. Conclusion From a genetic predisposition, controlling blood pressure may reduce the risk of gout.
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Affiliation(s)
- Yanfang Li
- Shenzhen Hospital of Guangzhou University of Chinese Medicine (Futian), Shenzhen, China
- The Sixth Clinical Medical College, Guangzhou University of Chinese Medicine, Shenzhen, China
| | - Yufeng Xie
- Shenzhen Hospital of Guangzhou University of Chinese Medicine (Futian), Shenzhen, China
- The Sixth Clinical Medical College, Guangzhou University of Chinese Medicine, Shenzhen, China
- Faculty of Chinese Medicine and State Key Laboratory of Quality Research in Chinese Medicines, Macau University of Science and Technology, Macao, Macao SAR, China
| | - Jun Li
- Shenzhen Hospital of Guangzhou University of Chinese Medicine (Futian), Shenzhen, China
- The Sixth Clinical Medical College, Guangzhou University of Chinese Medicine, Shenzhen, China
| | - Zhichun Chang
- Shenzhen Hospital of Guangzhou University of Chinese Medicine (Futian), Shenzhen, China
- The Sixth Clinical Medical College, Guangzhou University of Chinese Medicine, Shenzhen, China
| | - Jianmei Zhang
- Shenzhen Hospital of Guangzhou University of Chinese Medicine (Futian), Shenzhen, China
- The Sixth Clinical Medical College, Guangzhou University of Chinese Medicine, Shenzhen, China
| | - Zunming Zhou
- The Sixth Clinical Medical College, Guangzhou University of Chinese Medicine, Shenzhen, China
| | - Rong Ren
- The Sixth Clinical Medical College, Guangzhou University of Chinese Medicine, Shenzhen, China
| | - Yun Chen
- The Sixth Clinical Medical College, Guangzhou University of Chinese Medicine, Shenzhen, China
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Zhao Q, Wu Q, Zhong H, Yan B, Wu J, Guo W. Association of dietary habits with body mass index and waist circumference, and their interaction effect on hypertension. Medicine (Baltimore) 2024; 103:e38178. [PMID: 38758876 PMCID: PMC11098196 DOI: 10.1097/md.0000000000038178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Accepted: 04/18/2024] [Indexed: 05/19/2024] Open
Abstract
Dietary modifications play a crucial role in blood pressure management, and although body mass index (BMI) and waist circumference (WC) are significant predictors of hypertension, limited studies have explored their relationship with dietary habits. This cross-sectional study conducted in Ganzhou, China, focused on middle-aged and elderly residents to investigate the correlation between dietary habits and BMI, WC, and their interaction impact on hypertension. The study found that salty and sweet intake correlated positively with BMI and WC, whereas bean and coarse grain intake were negatively correlated. A significant interaction effect was showed between dietary habits, and BMI and WC on hypertension. Specifically, individuals with obesity or central obesity combined with poor dietary habits had higher odds of hypertension. This study aims to provide a theoretical basis for nutritional interventions for middle-aged and elderly residents with varying obesity levels for the prevention and treatment of hypertension at the community level. The study concluded that dietary habits are significantly associated with BMI and WC, and poor dietary habits coexistence with obesity or central obesity can increase the prevalence rate of hypertension. Understanding these relationships can help develop strategies to address hypertension through dietary and lifestyle changes, providing valuable insights for healthcare professionals and policymakers to develop effective interventions addressing this growing global health concern.
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Affiliation(s)
- Qing Zhao
- School of Nursing, Guangdong Medical University, Donguan, China
| | - Qiong Wu
- Department of Spine Surgery, Ganzhou People’s Hospital, Ganzhou, China
| | - Honghui Zhong
- Department of Anesthesiology, The People’s Hospital of Yudu County, Ganzhou, China
| | - Bin Yan
- Department of Internal Medicine, The Third Affiliated Hosptial of Gannan Medical University, Ganzhou, China
| | - Jiajian Wu
- Department of Internal Medicine, The Third Affiliated Hosptial of Gannan Medical University, Ganzhou, China
| | - Wentao Guo
- School of Basic Medicine, Guangdong Medical University, Donguan, China
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Charles JA, Habibullah NK, Bautista S, Davis B, Joshi S, Hull SC. Planting the Seed for Blood Pressure Control: The Role of Plant-Based Nutrition in the Management of Hypertension. Curr Cardiol Rep 2024; 26:121-134. [PMID: 38526748 PMCID: PMC10990999 DOI: 10.1007/s11886-023-02008-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/26/2023] [Indexed: 03/27/2024]
Abstract
PURPOSE OF REVIEW Hypertension results in significant morbidity, mortality, and healthcare expenditures. Fortunately, it is largely preventable and treatable by implementing dietary interventions, though these remain underutilized. Here, we aim to explore the role of healthy dietary patterns in hypertension management and describe approaches for busy clinicians to address nutrition effectively and efficiently with patients. RECENT FINDINGS DASH, Mediterranean, vegetarian, and vegan diets that include minimally processed, plant-based foods as core elements have consistently shown positive effects on hypertension. Recommendations that distill the most healthful components of these diets can significantly impact patient outcomes. Clinicians can harness evidence-based dietary assessment and counseling tools to implement and support behavioral changes, even during brief office visits. Healthful plant-based dietary patterns can often effectively prevent and treat hypertension. Clinicians may help improve patient outcomes by discussing evidence-based nutrition with their patients. Future work to promote infrastructural change that supports incorporating evidence-based nutrition into medical education, clinical care, and society at large can support these efforts.
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Affiliation(s)
- Justin A Charles
- Department of Family Medicine and Public Health, UC San Diego Health, San Diego, CA, USA.
| | | | - Saul Bautista
- Ethos Farm to Health/Ethos Primary Care, Long Valley, NJ, USA
| | - Brenda Davis
- Brenda Davis, Nutrition Consultations, Calgary, AB, Canada
| | - Shivam Joshi
- Department of Veterans Affairs, Orlando, FL, USA
- Department of Medicine, New York University Grossman School of Medicine, New York, NY, USA
| | - Sarah C Hull
- Section of Cardiovascular Medicine, Yale School of Medicine, New Haven, CT, USA
- Program for Biomedical Ethics, Yale School of Medicine, New Haven, CT, USA
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Naqvi WM, Naqvi I, Mishra GV, Vardhan V. The Dual Importance of Virtual Reality Usability in Rehabilitation: A Focus on Therapists and Patients. Cureus 2024; 16:e56724. [PMID: 38646260 PMCID: PMC11032731 DOI: 10.7759/cureus.56724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2024] [Accepted: 03/22/2024] [Indexed: 04/23/2024] Open
Abstract
Virtual reality (VR) has advanced in medical education and rehabilitation from basic graphical applications due to its ability to generate a virtual three-dimensional (3D) environment. This environment is mostly used to practice professional skills, plan surgery procedures, simulate surgeries, display 3D anatomy, and rehabilitate various disorders. VR has transformed the field of rehabilitation therapy by providing immersive and engaging experiences that go beyond traditional bounds, significantly improving patient care and therapeutic results. Considering the direct impact of VR on the efficacy of the treatment for both therapists and patients, its dual significance for usability and user experience cannot be overstated. The purpose of this article is to determine the synergistic association between VR accessibility and the rehabilitation process, highlighting the significance of VR technology in designing the future of rehabilitation therapy and demonstrating how advancing VR technology can improve therapeutic outcomes despite overcoming obstacles encountered during VR usage. In conclusion, VR offers a personalized, efficient, interesting, and engaging rehabilitative environment for patients, while also assisting therapists in cultivating empathy and efficiency and encouraging innovative approaches in treatment procedures.
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Affiliation(s)
- Waqar M Naqvi
- Interdisciplinary Sciences, Datta Meghe Institute of Higher Education and Research, Wardha, IND
- Physiotherapy, College of Health Sciences, Gulf Medical University, Ajman, ARE
| | - Ifat Naqvi
- Physiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Higher Education and Research, Nagpur, IND
| | - Gaurav V Mishra
- Radiodiagnosis, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Vishnu Vardhan
- Physiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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Ma LL, Xiao HB, Zhang J, Liu YH, Hu LK, Chen N, Chu X, Dong J, Yan YX. Association between systemic immune inflammatory/inflammatory response index and hypertension: A cohort study of functional community. Nutr Metab Cardiovasc Dis 2024; 34:334-342. [PMID: 38000992 DOI: 10.1016/j.numecd.2023.09.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Revised: 09/24/2023] [Accepted: 09/25/2023] [Indexed: 11/26/2023]
Abstract
BACKGROUND AND AIMS In prospective studies, there is limited evidence of the association between inflammation and hypertension. We aimed to explore the relationship between systemic immune inflammatory index (SII)/systemic inflammatory response index (SIRI) and hypertension in a prospective cohort study to identify the best inflammatory cell markers that predict hypertension. METHODS AND RESULTS This study was conducted in a functional community cohort in Beijing. In 2015, a total of 6003 individuals without hypertension were recruited and followed up until 2021. Using a restriction cubic spline with baseline SII/SIRI as a continuous variable, the dose-response relationship between hypertension and SII/SIRI was explored. Logistic regression was used to analyze the correlation between hypertension and SII/SIRI trajectory groups. At a mean follow-up of 6 years, 970 participants developed hypertension. SII showed a significant nonlinear dose-response relationship with hypertension (P < 0.05). Higher SII/SIRI was associated with an increased risk of hypertension (SII: RR = 1.003, 95%CI: 1.001-1.004; SIRI: RR = 1.228, 95%CI: 1.015-1.486). Both SII and SIRI were more predictive in males than females (SII: 0.698 vs. 0.695; SIRI: 0.686 vs. 0.678). CONCLUSION Both systemic immune inflammatory index (SII) and systemic inflammatory response Index (SIRI) independently increased the risk of hypertension, and both were effective inflammatory cell indicators that predict the risk of hypertension.
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Affiliation(s)
- Lin-Lin Ma
- Department of Epidemiology and Biostatistics, and Municipal Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, China
| | - Huan-Bo Xiao
- Department of Preventive Medicine, Yanjing Medical College, Capital Medical University, Beijing, China
| | - Jie Zhang
- Department of Epidemiology and Biostatistics, and Municipal Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, China
| | - Yu-Hong Liu
- Department of Epidemiology and Biostatistics, and Municipal Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, China
| | - Li-Kun Hu
- Department of Epidemiology and Biostatistics, and Municipal Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, China
| | - Ning Chen
- Department of Epidemiology and Biostatistics, and Municipal Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, China
| | - Xi Chu
- Health Management Center, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Jing Dong
- Health Management Center, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Yu-Xiang Yan
- Department of Epidemiology and Biostatistics, and Municipal Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, China.
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Prasad N, Jain A, Bronheim RS, Marrache M, Njoku DB, Sponseller PD. Elevated preoperative blood pressure and its relationship to intraoperative mean arterial pressure and blood loss in posterior spinal fusion for adolescent idiopathic scoliosis. EUROPEAN JOURNAL OF ORTHOPAEDIC SURGERY & TRAUMATOLOGY : ORTHOPEDIE TRAUMATOLOGIE 2024; 34:339-345. [PMID: 37498351 PMCID: PMC11070198 DOI: 10.1007/s00590-023-03652-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 07/15/2023] [Indexed: 07/28/2023]
Abstract
PURPOSE The relationship between preoperative blood pressure (BP) and intraoperative mean arterial pressure (MAP) and estimated blood loss (EBL) in pediatric spine surgery is currently unknown. The objectives of this study were to determine if elevated preoperative BP is associated with elevated intraoperative MAP, EBL, and percentage estimated blood volume (EBV) lost, and to determine if intraoperative MAP is associated with percentage of EBV lost during posterior spinal fusion (PSF) for adolescent idiopathic scoliosis (AIS). METHODS This is a retrospective cohort analysis of 209 patients undergoing PSF for AIS between 2016 and 2019 by a single surgeon. Data extracted included demographic characteristics, preoperative systolic and diastolic BP, continuous intraoperative MAP measured by arterial line, EBL, radiographic, and surgical characteristics. Time points of interest for MAP included incision and exposure. Elevated BP was defined as > 1 standard deviation above the mean BP of patients included in the study, and elevated MAP was defined as > 65 mmHg. RESULTS Elevated preoperative systolic BP was associated with elevated MAP at incision (p = 0.002). Patients with elevated preoperative diastolic BP had significantly higher MAP at exposure and throughout the procedure (p = 0.04). MAP > 65 at incision was associated with a 5% increase in EBV lost (p < 0.001). CONCLUSIONS Patients with elevated preoperative BP parameters have increased MAPs at incision, exposure, and throughout surgery. Elevated MAP at incision is associated with an increased percentage of EBV lost in a small number of patients undergoing PSF for AIS.
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Affiliation(s)
- Niyathi Prasad
- Department of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, 1800 Orleans Street, Baltimore, MD, 21287, USA
| | - Amit Jain
- Department of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, 1800 Orleans Street, Baltimore, MD, 21287, USA
| | - Rachel S Bronheim
- Department of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, 1800 Orleans Street, Baltimore, MD, 21287, USA.
| | - Majd Marrache
- Department of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, 1800 Orleans Street, Baltimore, MD, 21287, USA
| | - Dolores B Njoku
- Department of Anesthesiology and Critical Care Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Anesthesiology and Pain Medicine, Washington University in St. Louis, St. Louis, MO, USA
| | - Paul D Sponseller
- Department of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, 1800 Orleans Street, Baltimore, MD, 21287, USA
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Mera-Gallego I, Tous i Trepat S, Prats-Mas R, Molinero A, Fornos-Pérez JA, Andrés-Rodríguez NF. [May Measurement Month 2019: Screening Analysis In Spanish Community Pharmacies and Detection of Masked Hypertension]. FARMACEUTICOS COMUNITARIOS 2023; 15:13-25. [PMID: 39156979 PMCID: PMC11326689 DOI: 10.33620/fc.2173-9218.(2023).27] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 08/16/2023] [Indexed: 08/20/2024]
Abstract
Aim To know within the scope of the May Measurement Month (MMM) project, the blood pressure (BP) situation in the Spanish population, disseminate the importance of its periodic measurement and estimate the prevalence of masked hypertension (MH). Methods Transversal descriptive study in Spanish community pharmacies during May 2019. Variables Systolic blood pressure (SBP), diastolic blood pressure (DBP) in millimetres of mercury (mmHg), heart rate (HR) in beats per minute (bpm).Subjects with BP ≥130/85 and <149/90 were offered the possibility of home blood pressure monitor- ing (HBPM) to confirm MH. Results A total of 3402 valid records performed by 491 pharmacists. In all 61.9% women, mean age 56.6 years. A total of 143 (4.2%) had never measured BP and 918 (27.0%) had not measured BP in the last year; 1047 were taking anti-hypertensives, of whom 45.7% had high BP.A total of 780 (22.9%) subjects had high BP values; both, 252 (7.4%). mSBP and mDBP was 125.0 mmHg and 76.5 mmHg, respectively; higher in men (P<0.001). mHR was 72.6 bpm..A direct relationship was detected between SBP and DBP and BMI (P<0.0001). mSBP and mHR were higher in smokers (P<0.0001). In diabetic patients, SBP, DBP and HR were greater.A total of 61 subjects with suspected MH agreed to undergo HBPM. A total of 25 (40.1%) resulted in BP ≥135/85 mmHg. Conclusions Almost a quarter of subjects had BP ≥140/90 mmHg. The risk factors most closely related to high BP were overweight, diabetes and age; 40% of suspected cases of MH were confirmed by means of HBPM.
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Affiliation(s)
- Inés Mera-Gallego
- Miembro del grupo de Diabetes de SEFACSociedad Española de Farmacia Clínica, Familiar y ComunitariaEspaña
| | - Salvador Tous i Trepat
- Miembro del grupo de HTA y RV de SEFACSociedad Española de Farmacia Clínica, Familiar y ComunitariaEspaña
| | - Rosa Prats-Mas
- Doctora en Farmacia. Farmacéutica comunitaria en Denia (Alicante)España
| | - Ana Molinero
- Doctora en Farmacia. Miembro del grupo de HTA y RV de SEFACSociedad Española de Farmacia Clínica, Familiar y ComunitariaEspaña
| | - José Antonio Fornos-Pérez
- Doctor en Farmacia. Miembro del grupo de Diabetes de SEFAC. Profesor Asociado USC.Sociedad Española de Farmacia Clínica, Familiar y ComunitariaEspaña
| | - N. Floro Andrés-Rodríguez
- Doctor en Farmacia. Miembro del grupo de Diabetes de SEFACSociedad Española de Farmacia Clínica, Familiar y ComunitariaEspaña
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Iddrisu A, Adam M. Assessing body mass index stages, individual diabetes and hypertension history effects on the risk of developing hypertension among Ghanaians: A cross-sectional study. Health Sci Rep 2023; 6:e1650. [PMID: 37900089 PMCID: PMC10600335 DOI: 10.1002/hsr2.1650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 09/26/2023] [Accepted: 10/10/2023] [Indexed: 10/31/2023] Open
Abstract
Background and Aims This study aimed to understand the relationship between body mass index (BMI), diabetes and hypertension history, and other risk of hypertension among Ghanaians. Methods The BMI data are categorized according to the World Health Organization (WHO) definition. The data were obtained from the WHO Study on global AGEing and adult health (WHO SAGE) Ghana Wave 2. Descriptive statistics were used to summarize the variables, and the association between these variables and hypertension was assessed using the χ². Multivariable logistic regression was used to examine the relationship between hypertension and different BMI levels and other variables. Results Obesity class II individuals have about a 4-fold higher risk of developing hypertension compared to underweight individuals. Obesity class III, class I, and preobesity individuals have approximately a 3-fold higher risk. Normal weight is associated with increased hypertension risk. Both males and females show a significant increase in hypertension risk across all BMI categories. History of hypertension is linked to a 2.2-fold increased risk. Diabetes history is associated with hypertension when considering other factors. Elevated hypertension risk is observed among married, divorced, and widowed males then never married males. Only widowed females showed an increased risk. Older age significantly increases hypertension risk, particularly in females. Vegetable servings reduce hypertension risk, while fruit servings are associated with an increased risk. Vigorous exercise increases hypertension risk, particularly in females. Conclusion Regular check-ups are recommended for married, divorced, and widowed males, focusing on blood pressure (BP) levels. Regular exercise from young age helps lower BP in later years. Individuals with a history of hypertension should follow BP control measures. Encouraging the consumption of the right combination of vegetables and fruits can help lower BP. Female tobacco smoking should be strongly discouraged due to a 54% increased risk of developing hypertension.
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Affiliation(s)
- Abdul‐Karim Iddrisu
- Department of Mathematics and StatisticsUniversity of Energy and Natural ResourcesSunyaniGhana
| | - Mohammed Adam
- Department of Mathematics and StatisticsUniversity of Energy and Natural ResourcesSunyaniGhana
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16
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Passinho RS, Bressan J, Hermsdorff HHM, Oliveira FLPD, Pimenta AM. The 30-year cardiovascular risk trajectories and their independently associated factors in participants of a Brazilian cohort (CUME Study). CAD SAUDE PUBLICA 2023; 39:e00041323. [PMID: 37792815 PMCID: PMC10552817 DOI: 10.1590/0102-311xen041323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 05/19/2023] [Accepted: 06/23/2023] [Indexed: 10/06/2023] Open
Abstract
We aimed to analyze the different trajectories of 30-year cardiovascular risk (CVR) and its independently associated factors in participants of the CUME Study, a prospective study with alumni from federal universities of Minas Gerais State, Brazil. In this study, 1,286 participants who answered the baseline (2016) and follow-up (2018 and 2020) questionnaires were included. Trajectories of CVR, according to the Framingham score, were identified with the latent class growth modelling technique with the use of the censored normal model. Analysis of the factors independently associated with each of the trajectories was conducted with multinomial logistic regression technique. Three CVR trajectories were identified: Low-Low (68.3%), Medium-Medium (26.2%), and High-High (5.5%). Male sex, living in a stable union, and having moderate and high intakes of ultra-processed foods were positively associated with the Medium-Medium and High-High CVR trajectories. Having non-healthcare professional training and working were positively associated with the Medium-Medium CVR trajectory, whereas being physically active was negatively associated with the High-High CVR trajectory. In conclusion, more than one-third of participants had CVR trajectories in the Medium-Medium and High-High categories. Food consumption and physical activity are modifiable factors that were associated with these trajectories; thus, implementing health promotion measures could help prevent the persistence or worsen of CVR. On the other hand, sociodemographic and labor characteristics are non-modifiable factors that were associated with Medium-Medium and High-High trajectories, which could help identify people who should be monitored with more caution by health services.
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Affiliation(s)
- Renata Soares Passinho
- Universidade Federal do Sul da Bahia, Teixeira de Freitas, Brasil
- Universidade Federal de Minas Gerais, Belo Horizonte, Brasil
| | - Josefina Bressan
- Departamento de Nutrição e Saúde, Universidade Federal de Viçosa, Viçosa, Brasil
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Li J, Jia H, Zhou J, Huang X, Xu L, Jia S, Gao Z, Yao K, Li D, Zhang B, Liu Y, Huang Y, Hu Y, Zhao G, Xu Z, Li J, Yiu CK, Gao Y, Wu M, Jiao Y, Zhang Q, Tai X, Chan RH, Zhang Y, Ma X, Yu X. Thin, soft, wearable system for continuous wireless monitoring of artery blood pressure. Nat Commun 2023; 14:5009. [PMID: 37591881 PMCID: PMC10435523 DOI: 10.1038/s41467-023-40763-3] [Citation(s) in RCA: 24] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Accepted: 08/07/2023] [Indexed: 08/19/2023] Open
Abstract
Continuous monitoring of arterial blood pressure (BP) outside of a clinical setting is crucial for preventing and diagnosing hypertension related diseases. However, current continuous BP monitoring instruments suffer from either bulky systems or poor user-device interfacial performance, hampering their applications in continuous BP monitoring. Here, we report a thin, soft, miniaturized system (TSMS) that combines a conformal piezoelectric sensor array, an active pressure adaptation unit, a signal processing module, and an advanced machine learning method, to allow real wearable, continuous wireless monitoring of ambulatory artery BP. By optimizing the materials selection, control/sampling strategy, and system integration, the TSMS exhibits improved interfacial performance while maintaining Grade A level measurement accuracy. Initial trials on 87 volunteers and clinical tracking of two hypertension individuals prove the capability of the TSMS as a reliable BP measurement product, and its feasibility and practical usability in precise BP control and personalized diagnosis schemes development.
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Affiliation(s)
- Jian Li
- Department of Biomedical Engineering, City University of Hong Kong, Hong Kong, China
- Hong Kong Centre for Cerebro-Cardiovascular Health Engineering (COCHE), Hong Kong, China
| | - Huiling Jia
- Department of Biomedical Engineering, City University of Hong Kong, Hong Kong, China
- Hong Kong Centre for Cerebro-Cardiovascular Health Engineering (COCHE), Hong Kong, China
| | - Jingkun Zhou
- Department of Biomedical Engineering, City University of Hong Kong, Hong Kong, China
- Hong Kong Centre for Cerebro-Cardiovascular Health Engineering (COCHE), Hong Kong, China
| | - Xingcan Huang
- Department of Biomedical Engineering, City University of Hong Kong, Hong Kong, China
| | - Long Xu
- School of Mechanical and Aerospace Engineering, Jilin University, 130012, Changchun, China
| | - Shengxin Jia
- Department of Biomedical Engineering, City University of Hong Kong, Hong Kong, China
- Hong Kong Centre for Cerebro-Cardiovascular Health Engineering (COCHE), Hong Kong, China
| | - Zhan Gao
- Department of Biomedical Engineering, City University of Hong Kong, Hong Kong, China
| | - Kuanming Yao
- Department of Biomedical Engineering, City University of Hong Kong, Hong Kong, China
| | - Dengfeng Li
- Department of Biomedical Engineering, City University of Hong Kong, Hong Kong, China
- Hong Kong Centre for Cerebro-Cardiovascular Health Engineering (COCHE), Hong Kong, China
| | - Binbin Zhang
- Department of Biomedical Engineering, City University of Hong Kong, Hong Kong, China
- Hong Kong Centre for Cerebro-Cardiovascular Health Engineering (COCHE), Hong Kong, China
| | - Yiming Liu
- Department of Biomedical Engineering, City University of Hong Kong, Hong Kong, China
| | - Ya Huang
- Department of Biomedical Engineering, City University of Hong Kong, Hong Kong, China
- Hong Kong Centre for Cerebro-Cardiovascular Health Engineering (COCHE), Hong Kong, China
| | - Yue Hu
- Department of Biomedical Engineering, City University of Hong Kong, Hong Kong, China
| | - Guangyao Zhao
- Department of Biomedical Engineering, City University of Hong Kong, Hong Kong, China
| | - Zitong Xu
- Department of Biomedical Engineering, City University of Hong Kong, Hong Kong, China
| | - Jiyu Li
- Department of Biomedical Engineering, City University of Hong Kong, Hong Kong, China
- Hong Kong Centre for Cerebro-Cardiovascular Health Engineering (COCHE), Hong Kong, China
| | - Chun Ki Yiu
- Department of Biomedical Engineering, City University of Hong Kong, Hong Kong, China
- Hong Kong Centre for Cerebro-Cardiovascular Health Engineering (COCHE), Hong Kong, China
| | - Yuyu Gao
- Department of Biomedical Engineering, City University of Hong Kong, Hong Kong, China
| | - Mengge Wu
- Department of Biomedical Engineering, City University of Hong Kong, Hong Kong, China
- State Key Laboratory of Electronic Thin Films and Integrated Devices, School of Optoelectronic Science and Engineering, University of Electronic Science and Technology of China (UESTC), 610054, Chengdu, China
| | - Yanli Jiao
- Department of Biomedical Engineering, City University of Hong Kong, Hong Kong, China
- Hong Kong Centre for Cerebro-Cardiovascular Health Engineering (COCHE), Hong Kong, China
| | - Qiang Zhang
- Department of Biomedical Engineering, City University of Hong Kong, Hong Kong, China
| | - Xuecheng Tai
- Hong Kong Centre for Cerebro-Cardiovascular Health Engineering (COCHE), Hong Kong, China
- Department of Mathematics, Hong Kong Baptist University, Hong Kong, China
| | - Raymond H Chan
- Department of Biomedical Engineering, City University of Hong Kong, Hong Kong, China
- Hong Kong Centre for Cerebro-Cardiovascular Health Engineering (COCHE), Hong Kong, China
| | - Yuanting Zhang
- Department of Biomedical Engineering, City University of Hong Kong, Hong Kong, China
- Hong Kong Centre for Cerebro-Cardiovascular Health Engineering (COCHE), Hong Kong, China
| | - Xiaohui Ma
- Department of vascular and endovascular surgery, The first medical center of Chinese PLA General Hospital, 100853, Beijing, China.
| | - Xinge Yu
- Department of Biomedical Engineering, City University of Hong Kong, Hong Kong, China.
- Hong Kong Centre for Cerebro-Cardiovascular Health Engineering (COCHE), Hong Kong, China.
- City University of Hong Kong Shenzhen Research Institute, 518057, Shenzhen, China.
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Vriend EMC, Wever BE, Bouwmeester TA, Agyemang C, Franco OH, Galenkamp H, Moll van Charante EP, Zwinderman AH, Collard D, van den Born BJH. Ethnic differences in blood pressure levels over time: the HELIUS study. Eur J Prev Cardiol 2023; 30:978-985. [PMID: 36971109 DOI: 10.1093/eurjpc/zwad089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Revised: 03/16/2023] [Accepted: 03/20/2023] [Indexed: 06/18/2023]
Abstract
AIMS Hypertension is an important global health burden with major differences in prevalence among ethnic minorities compared with host populations. Longitudinal research on ethnic differences in blood pressure (BP) levels provides the opportunity to assess the efficacy of strategies aimed at mitigating gaps in hypertension control. In this study, we assessed the change in BP levels over time in a multi-ethnic population-based cohort in Amsterdam, the Netherlands. METHODS AND RESULTS We used baseline and follow-up data from HELIUS to assess differences in BP over time between participants of Dutch, South Asian Surinamese, African Surinamese, Ghanaian, Moroccan, and Turkish descent. Baseline data were collected between 2011 and 2015 and follow-up data between 2019 and 2021. The main outcome was ethnic differences in systolic BP (SBP) over time determined by linear mixed models adjusted for age, sex, and use of antihypertensive medication. We included 22 109 participants at baseline, from which 10 170 participants had complete follow-up data. The mean follow-up time was 6.3 (1.1) years. Compared with the Dutch population, the mean SBP increased significantly more from baseline to follow-up in Ghanaians [1.78 mmHg, 95% confidence interval (CI) 0.77-2.79], Moroccans (2.06 mmHg, 95% CI 1.23-2.90), and the Turkish population (1.30 mmHg, 95% CI 0.38-2.22). Systolic blood pressure differences were in part explained by differences in body mass index (BMI). No differences in SBP trajectory were present between the Dutch and Surinamese population. CONCLUSION Our findings indicate a further increase of ethnic differences in SBP among Ghanaian, Moroccan, and Turkish populations compared with the Dutch reference population that are in part attributable to differences in BMI.
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Affiliation(s)
- Esther M C Vriend
- Department of Internal Medicine, Section of Vascular Medicine, Amsterdam Cardiovascular Sciences, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam Zuidoost, The Netherlands
- Department of Public and Occupational Health, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health Research Institute, Meibergdreef 9, 1105 AZ, Amsterdam Zuidoost, The Netherlands
| | - Britt E Wever
- Department of Internal Medicine, Section of Vascular Medicine, Amsterdam Cardiovascular Sciences, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam Zuidoost, The Netherlands
| | - Thomas A Bouwmeester
- Department of Internal Medicine, Section of Vascular Medicine, Amsterdam Cardiovascular Sciences, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam Zuidoost, The Netherlands
| | - Charles Agyemang
- Department of Public and Occupational Health, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health Research Institute, Meibergdreef 9, 1105 AZ, Amsterdam Zuidoost, The Netherlands
| | - Oscar H Franco
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Universiteitsweg 100, 3584 CX, Utrecht, The Netherlands
| | - Henrike Galenkamp
- Department of Public and Occupational Health, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health Research Institute, Meibergdreef 9, 1105 AZ, Amsterdam Zuidoost, The Netherlands
- Health Behaviours and Chronic Diseases, Amsterdam Public Health Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam Zuidoost, The Netherlands
| | - Eric P Moll van Charante
- Department of Public and Occupational Health, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health Research Institute, Meibergdreef 9, 1105 AZ, Amsterdam Zuidoost, The Netherlands
- Department of General Practice, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam Zuidoost, The Netherlands
| | - Aeilko H Zwinderman
- Department of Epidemiology, Biostatistics & Bioinformatics, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam Zuidoost, The Netherlands
| | - Didier Collard
- Department of Internal Medicine, Section of Vascular Medicine, Amsterdam Cardiovascular Sciences, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam Zuidoost, The Netherlands
| | - Bert-Jan H van den Born
- Department of Internal Medicine, Section of Vascular Medicine, Amsterdam Cardiovascular Sciences, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam Zuidoost, The Netherlands
- Department of Public and Occupational Health, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health Research Institute, Meibergdreef 9, 1105 AZ, Amsterdam Zuidoost, The Netherlands
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Jalal SM, Alsebeiy SH, Aleid HA, Alhamad SA. Effect of Arabic Qahwa on Blood Pressure in Patients with Stage One Hypertension in the Eastern Region of Saudi Arabia. J Pers Med 2023; 13:1011. [PMID: 37374000 DOI: 10.3390/jpm13061011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 06/13/2023] [Accepted: 06/16/2023] [Indexed: 06/29/2023] Open
Abstract
Hypertension (HT), which is a condition of increased blood pressure (BP), is a major health problem globally. In Saudi Arabia, morbidity and mortality rates are increasing due to HT. Arabic Qahwa (AQ) is a commonly consumed beverage in Saudi Arabia and has numerous health benefits. We conducted a randomized control trial to investigate the effect of AQ on BP among patients with HT (Stage 1). Based on the inclusion criteria, 140 patients were randomly selected, and 126 patients were followed up. After obtaining demographic information, we assessed the BP, heart rate, and lipid profile before and after the intervention of consuming four cups of AQ daily for four weeks. A paired 't' test was used with a significance level of 5%. In the AQ group, there were significant changes (p = 0.009) in systolic blood pressure (SBP), with means of 134.72 ± 3.23 and 133.14 ± 3.69 observed pre and post-test, respectively. Similarly, the diastolic blood pressure (DBP) pre- and post-test mean scores were 87.08 ± 1.8 and 85.98 ± 1.95, respectively, which also showed significance (p = 0.001). There were also significant changes (p = 0.001) observed in the lipid profile of the AQ group. In conclusion, AQ is effective in reducing SBP and DBP in patients with stage one HT.
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Affiliation(s)
- Sahbanathul Missiriya Jalal
- Department of Nursing, College of Applied Medical Sciences, King Faisal University, Al-Ahsa 31982, Saudi Arabia
| | - Saad Hamoud Alsebeiy
- Department of Nursing, College of Applied Medical Sciences, King Faisal University, Al-Ahsa 31982, Saudi Arabia
- Primary Health Centre, Health Cluster, Al-Ahsa 31982, Saudi Arabia
| | - Hamida Ali Aleid
- Department of Nursing, College of Applied Medical Sciences, King Faisal University, Al-Ahsa 31982, Saudi Arabia
- Primary Health Centre, Health Cluster, Al-Ahsa 31982, Saudi Arabia
| | - Sukinah Ali Alhamad
- Department of Nursing, College of Applied Medical Sciences, King Faisal University, Al-Ahsa 31982, Saudi Arabia
- Prince Saud bin Jalawy Hospital, Al Mubarraz 36424, Saudi Arabia
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Seo MW, Cho W, Kim JY. The single point insulin sensitivity estimator (SPISE) index as a predictor of metabolic syndrome in Korean adults. Obes Res Clin Pract 2023:S1871-403X(23)00040-6. [PMID: 37246046 DOI: 10.1016/j.orcp.2023.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 05/04/2023] [Indexed: 05/30/2023]
Abstract
PURPOSE Recently, the single-point insulin sensitivity estimator (SPISE) has been developed as a simple surrogate of insulin resistance based on BMI, triglycerides (TG), and HDL-C. However, no studies have focused on the predictive power of the SPISE index for identifying metabolic syndrome (MetSyn) in Korean adults. Here, this study aimed to estimate the predictive power of the SPISE index for determining MetSyn and to compare its predictive power with other insulin sensitivity/resistance indices in South Korean adults. METHODS A total of 7837 participants from the 2019 and 2020 Korean National Health and Nutrition Examination Surveys were analyzed in the present study. MetSyn was defined by the AHA/NCEP criteria. In addition, HOMA-IR, inverse insulin, TG/HDL, TyG index (triglyceride-glucose index), and SPISE index were calculated based on the previous literature. RESULTS Predictive power of the SPISE index for determining MetSyn (ROC-AUC [95 % CI] = 0.90 [0.90-0.91], sensitivity = 83.4 %, specificity = 82.2 %, cut-off point = 6.14, p < .001) was higher than that of HOMA-IR (ROC-AUC: 0.81), inverse insulin (ROC-AUC: 0.76), TG/HDL-C (ROC-AUC: 0.87), and TyG index (ROC-AUC: 0.88), the P value for ROC-AUC comparison < .001. CONCLUSION SPISE index has demonstrated superior predictive value for diagnosing MetSyn regardless of sex and is strongly correlated with blood pressure compared with other surrogate indices of insulin resistance, attesting to its utility as a reliable indicator of insulin resistance and MetSyn in Korean adults.
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Affiliation(s)
- Myong-Won Seo
- Departments of Exercise Science, David B. Falk College of Sport and Human Dynamics, Syracuse University, Syracuse, NY, USA
| | - Wonhee Cho
- Departments of Exercise Science, David B. Falk College of Sport and Human Dynamics, Syracuse University, Syracuse, NY, USA
| | - Joon Young Kim
- Departments of Exercise Science, David B. Falk College of Sport and Human Dynamics, Syracuse University, Syracuse, NY, USA.
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21
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Chen BY, Li YL, Lin WZ, Bi C, Du LJ, Liu Y, Zhou LJ, Liu T, Xu S, Zhang J, Liu Y, Zhu H, Zhang WC, Zhang ZY, Duan SZ. Integrated Omic Analysis of Human Plasma Metabolites and Microbiota in a Hypertension Cohort. Nutrients 2023; 15:2074. [PMID: 37432207 DOI: 10.3390/nu15092074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Revised: 04/16/2023] [Accepted: 04/23/2023] [Indexed: 07/12/2023] Open
Abstract
Hypertension is closely related to metabolic dysregulation, which is associated with microbial dysbiosis and altered host-microbiota interactions. However, plasma metabolite profiles and their relationships to oral/gut microbiota in hypertension have not been evaluated in depth. Plasma, saliva, subgingival plaques, and feces were collected from 52 hypertensive participants and 24 healthy controls in a cross-sectional cohort. Untargeted metabolomic profiling of plasma was performed using high-performance liquid chromatography-mass spectrometry. Microbial profiling of oral and gut samples was determined via 16S rRNA and metagenomic sequencing. Correlations between metabolites and clinic parameters/microbiota were identified using Spearman's correlation analysis. Metabolomic evaluation showed distinct clusters of metabolites in plasma between hypertensive participants and control participants. Hypertensive participants had six significantly increased and thirty-seven significantly decreased plasma metabolites compared to controls. The plasma metabolic similarity significantly correlated with the community similarity of microbiota. Both oral and gut microbial community composition had significant correlations with metabolites such as Sphingosine 1-phosphate, a molecule involved in the regulation of blood pressure. Plasma metabolites had a larger number of significant correlations with bacterial genera than fungal genera. The shared oral/gut bacterial genera had more correlations with metabolites than unique genera but shared fungal genera and metabolites did not show clear clusters. The hypertension group had fewer correlations between plasma metabolites and bacteria/fungi than controls at species level. The integrative analysis of plasma metabolome and oral/gut microbiome identified unreported alterations of plasma metabolites in hypertension and revealed correlations between altered metabolites and oral/gut microbiota. These observations suggested metabolites and microbiota may become valuable targets for therapeutic and preventive interventions of hypertension.
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Affiliation(s)
- Bo-Yan Chen
- Department of Oral and Maxillofacial-Head and Neck Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
- Laboratory of Oral Microbiota and Systemic Diseases, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai 200125, China
- National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology, Shanghai 200125, China
| | - Yu-Lin Li
- Laboratory of Oral Microbiota and Systemic Diseases, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai 200125, China
- National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology, Shanghai 200125, China
| | - Wen-Zhen Lin
- Laboratory of Oral Microbiota and Systemic Diseases, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai 200125, China
- National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology, Shanghai 200125, China
| | - Chao Bi
- Department of Stomatology, First Affiliated Hospital, Anhui Medical University, Hefei 230022, China
| | - Lin-Juan Du
- Laboratory of Oral Microbiota and Systemic Diseases, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai 200125, China
- National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology, Shanghai 200125, China
| | - Yuan Liu
- Laboratory of Oral Microbiota and Systemic Diseases, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai 200125, China
- National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology, Shanghai 200125, China
| | - Lu-Jun Zhou
- Laboratory of Oral Microbiota and Systemic Diseases, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai 200125, China
- National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology, Shanghai 200125, China
- Department of General Dentistry, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
| | - Ting Liu
- Laboratory of Oral Microbiota and Systemic Diseases, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai 200125, China
- National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology, Shanghai 200125, China
| | - Shuo Xu
- Laboratory of Oral Microbiota and Systemic Diseases, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai 200125, China
- National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology, Shanghai 200125, China
| | - Jun Zhang
- Laboratory of Oral Microbiota and Systemic Diseases, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai 200125, China
- National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology, Shanghai 200125, China
| | - Yan Liu
- Laboratory of Oral Microbiota and Systemic Diseases, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai 200125, China
- National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology, Shanghai 200125, China
| | - Hong Zhu
- Laboratory of Oral Microbiota and Systemic Diseases, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai 200125, China
- National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology, Shanghai 200125, China
| | - Wu-Chang Zhang
- Laboratory of Oral Microbiota and Systemic Diseases, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai 200125, China
- National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology, Shanghai 200125, China
| | - Zhi-Yuan Zhang
- Department of Oral and Maxillofacial-Head and Neck Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
- National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology, Shanghai 200125, China
| | - Sheng-Zhong Duan
- Laboratory of Oral Microbiota and Systemic Diseases, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai 200125, China
- National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology, Shanghai 200125, China
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22
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Yu X, Li YT, Cheng H, Zhu S, Hu XJ, Wang JJ, Mohammed BH, Xie YJ, Hernandez J, Wu HF, Wang HHX. Longitudinal changes in blood pressure and fasting plasma glucose among 5,398 primary care patients with concomitant hypertension and diabetes: An observational study and implications for community-based cardiovascular prevention. Front Cardiovasc Med 2023; 10:1120543. [PMID: 37077741 PMCID: PMC10106827 DOI: 10.3389/fcvm.2023.1120543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Accepted: 03/06/2023] [Indexed: 04/05/2023] Open
Abstract
AimsTo assess longitudinal changes in blood pressure (BP) and fasting plasma glucose (FPG) in primary care patients with concomitant hypertension and type 2 diabetes mellitus (T2DM), and to explore factors associated with patients' inability to improve BP and FPG at follow-up.MethodsWe constructed a closed cohort in the context of the national basic public health (BPH) service provision in an urbanised township in southern China. Primary care patients who had concomitant hypertension and T2DM were retrospectively followed up from 2016 to 2019. Data were retrieved electronically from the computerised BPH platform. Patient-level risk factors were explored using multivariable logistic regression analysis.ResultsWe included 5,398 patients (mean age 66 years; range 28.9 to 96.1 years). At baseline, almost half [48.3% (2,608/5,398)] of patients had uncontrolled BP or FPG. During follow-up, more than one-fourth [27.2% (1,467/5,398)] of patients had no improvement in both BP and FPG. Among all patients, we observed significant increases in systolic BP [2.31 mmHg, 95% confidence interval (CI): 2.04 to 2.59, p < 0.001], diastolic BP (0.73 mmHg, 0.54 to 0.92, p < 0.001), and FPG (0.12 mmol/l, 0.09 to 0.15, p < 0.001) at follow-up compared to baseline. In addition to changes in body mass index [adjusted odds ratio (aOR)=1.045, 1.003 to 1.089, p = 0.037], poor adherence to lifestyle advice (aOR = 1.548, 1.356 to 1.766, p < 0.001), and unwillingness to actively enrol in health-care plans managed by the family doctor team (aOR = 1.379, 1.128 to 1.685, p = 0.001) were factors associated with no improvement in BP and FPG at follow-up.ConclusionA suboptimal control of BP and FPG remains an ongoing challenge to primary care patients with concomitant hypertension and T2DM in real-world community settings. Tailored actions aiming to improve patients' adherence to healthy lifestyles, expand the delivery of team-based care, and encourage weight control should be incorporated into routine healthcare planning for community-based cardiovascular prevention.
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Affiliation(s)
- Xiao Yu
- School of Public Health, Sun Yat-Sen University, Guangzhou, China
| | - Yu Ting Li
- Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China
| | - Hui Cheng
- School of Public Health, Sun Yat-Sen University, Guangzhou, China
| | - Sufen Zhu
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Xiu-Jing Hu
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Jia Ji Wang
- Centre for General Practice, The Seventh Affiliated Hospital, Southern Medical University, Foshan, China
- Guangdong-provincial Primary Healthcare Association, Guangzhou, China
| | - Bedru H. Mohammed
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong SAR
| | - Yao Jie Xie
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Hong Kong SAR
| | - Jose Hernandez
- Faculty of Medicine and Health, EDU, Digital Education Holdings Ltd., Kalkara, Malta
- Green Templeton College, University of Oxford, Oxford, United Kingdom
| | - Hua-Feng Wu
- Shishan Community Health Centre of Nanhai, Foshan, China
- Correspondence: Harry H.X. Wang Hua-Feng Wu
| | - Harry H. X. Wang
- School of Public Health, Sun Yat-Sen University, Guangzhou, China
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR
- Usher Institute, Deanery of Molecular, Genetic & Population Health Sciences, The University of Edinburgh, Edinburgh, United Kingdom
- Correspondence: Harry H.X. Wang Hua-Feng Wu
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23
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Deng D, Chen C, Wang J, Luo S, Feng Y. Association between triglyceride glucose-body mass index and hypertension in Chinese adults: A cross-sectional study. J Clin Hypertens (Greenwich) 2023; 25:370-379. [PMID: 36929716 PMCID: PMC10085812 DOI: 10.1111/jch.14652] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 02/03/2023] [Accepted: 02/10/2023] [Indexed: 03/18/2023]
Abstract
The triglyceride glucose-body mass index (TyG-BMI) has been considered an alternative marker of insulin resistance (IR). This cross-sectional study was designed to mainly investigate the association between TyG-BMI, triglyceride glucose combined with body mass index, and hypertension in Chinese adults. The relationship between TyG-BMI and hypertension was examined by multivariate logistic regression and restricted cubic spline model. Multiple logistic regression models were also performed to examine the associations between the individual components of TyG-BMI (BMI, TyG index, TG and FBG) and hypertension. The incremental ability of TyG-BMI versus its individual components for hypertension discrimination was evaluated by C-statistic and net reclassification index. Subgroup analysis was performed to examine potential interactions. A total of 92,545 participants (38.9% men, mean age 53.7 years) were included for final analysis. Logistic regression models showed TyG-BMI and its individual components were all significantly associated with the odds of hypertension (p for trend < .001). The restricted cubic spline regression manifested a linear association between TyG-BMI and hypertension (p for non-linear = .062). The addition of TyG-BMI, in comparison with each individual component, exhibited the maximum incremental value for the discrimination of hypertension on the basis of base model (C-statistic: 0.679, 95% CI: 0.675-0.683 for base model vs. 0.695, 95% CI: 0.691-0.699 for base model + TyG-BMI; net reclassification index: 0.226, 95% CI: 0.215-0.234). TyG-BMI was significantly associated with the odds of hypertension and can be a better discriminator of hypertension.
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Affiliation(s)
- Danying Deng
- School of Biology and Biological Engineering, South China University of Technology, Guangzhou, China.,Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
| | - Chaolei Chen
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
| | - Jiabin Wang
- Global Health Research Center, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Songyuan Luo
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
| | - Yingqing Feng
- School of Biology and Biological Engineering, South China University of Technology, Guangzhou, China.,Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
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24
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Wang Q, Song X, Du S, Du W, Su C, Zhang J, Zhang X, Jia X, Ouyang Y, Li L, Zhang B, Wang H. Multiple Trajectories of Body Mass Index and Waist Circumference and Their Associations with Hypertension and Blood Pressure in Chinese Adults from 1991 to 2018: A Prospective Study. Nutrients 2023; 15:751. [PMID: 36771457 PMCID: PMC9919034 DOI: 10.3390/nu15030751] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Revised: 01/22/2023] [Accepted: 01/27/2023] [Indexed: 02/05/2023] Open
Abstract
Body mass index (BMI) and waist circumference (WC) have been suggested to be involved in the etiology of hypertension. The present study aimed to determine multiple trajectories of BMI and WC, then examined their associations with the risks of hypertension and high blood pressure in Chinese adults. The study used China Health and Nutrition Survey data from 1991 to 2018. The sample included 9651 adults aged 18 years or older. We used group-based multi-trajectory modeling to identify trajectories. We estimated the relationships between the trajectories and the risks of hypertension with a Cox proportional hazards regression model and the trajectories' relationships with blood pressure levels with a generalized linear model. We identified four trajectories for each gender: low stable BMI, low increasing WC (group 1); medium increasing BMI, medium increasing WC (group 2); increasing BMI to overweight, increasing WC to central obesity (group 3), increasing BMI to obesity, increasing central obesity WC (group 4). Group 1 was the reference group. Among males in groups 2, 3, and 4, the adjusted hazard ratios (HR) and 95% confidence intervals (95% CI) of hypertension were 1.30 (1.15-1.48), 1.86 (1.58-2.18), and 2.60 (2.02-3.34), respectively. The systolic blood pressure (SBP) and diastolic blood pressure (DBP) of males in group 4 increased by 11.90 mm of mercury (mmHg) and 7.75 mmHg, respectively. Among females in groups 2, 3, and 4, the HR and 95% CI of hypertension were 1.35 (1.18-1.54), 1.92 (1.62-2.26), and 2.37 (1.85-3.03), respectively. The SBP and DBP of females in group 4 increased by 8.84 mmHg and 5.79 mmHg, respectively. These data indicated that increases in BMI and WC were associated with unfavorable hypertension risks. Attention to both BMI and WC trajectories has the potential to prevent hypertension.
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Affiliation(s)
- Qi Wang
- Key Laboratory of Trace Element Nutrition of National Health Commission of China, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Xiaoyun Song
- Department of Food, School Hygiene, Dalian Centre for Disease Control and Prevention, Dalian 116035, China
| | - Shufa Du
- Department of Nutrition and Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Wenwen Du
- Key Laboratory of Trace Element Nutrition of National Health Commission of China, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Chang Su
- Key Laboratory of Trace Element Nutrition of National Health Commission of China, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Jiguo Zhang
- Key Laboratory of Trace Element Nutrition of National Health Commission of China, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Xiaofan Zhang
- Key Laboratory of Trace Element Nutrition of National Health Commission of China, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Xiaofang Jia
- Key Laboratory of Trace Element Nutrition of National Health Commission of China, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Yifei Ouyang
- Key Laboratory of Trace Element Nutrition of National Health Commission of China, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Li Li
- Key Laboratory of Trace Element Nutrition of National Health Commission of China, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Bing Zhang
- Key Laboratory of Trace Element Nutrition of National Health Commission of China, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Huijun Wang
- Key Laboratory of Trace Element Nutrition of National Health Commission of China, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China
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25
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He Z, Yang P, Lin Q, Thio CHL, Zhang F, Wang R, Wang Y, Snieder H, Zhang Q. Blood biomarkers for new-onset hypertension in midlife women: a nested case-control study. Menopause 2023; 30:156-164. [PMID: 36696640 DOI: 10.1097/gme.0000000000002100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
OBJECTIVE Midlife in women is associated with an increase in prevalence of hypertension. Little is known on the risk factors of new-onset hypertension among middle-aged women. METHODS In this nested case-control study, 1,430 women aged 40 to 60 years with repeated physical examinations between 2009 and 2019 were recruited. Data included age, body mass index, blood pressure (BP), and a series of blood biomarkers. Participants with hypertension were divided into two case-control samples: 388 cases with episodic new-onset hypertension (ie, one normal BP at the first visit and one abnormal BP during follow-up) each with two age-matched controls (n = 776) and 151 cases with regular new-onset hypertension (ie, normal BP at the first two visits and abnormal BP at two or more follow-up visits) each with three age-matched controls (n = 453). Multivariable-adjusted logistic regression was used to analyze the data. RESULTS Our data showed very consistent results for episodic and regular new-onset hypertension, respectively, and verified known associations (odds ratio [95% confidence interval], per SD increase) with obesity (body mass index, 1.72 [1.49-1.98] and 1.81 [1.45-2.26]), inflammation (white blood cell count, 1.39 [1.23-1.58] and 1.38 [1.13-1.69]), and metabolic dysregulation (triglycerides, 1.25 [1.09-1.44] and 1.31 [1.08-1.58]; glucose, 1.46 [1.23-1.73] and 1.27 [1.05-1.54]) but, more surprisingly, also revealed positive associations with red blood cell count (1.27 [1.11-1.44] and 1.38 [1.14-1.68]), hemoglobin (1.18 [1.03-1.35] and 1.31 [1.05-1.64]), and platelet count (1.39 [1.20-1.61] and 1.33 [1.09-1.63]). CONCLUSIONS In addition to obesity and metabolic dysregulation, increased hemoglobin and counts of platelets, and red and white blood cells are associated with hypertension in this period. Future study may verify whether these associations are causal in nature and whether these variables are useful in risk stratification.
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Affiliation(s)
| | - Peixuan Yang
- Department of Physical Examination, The First Affiliated Hospital of Shantou University Medical College, Shantou, China
| | - Qiuqiang Lin
- Department of Internal Medicine, Chenghai People's Hospital, Shantou, China
| | - Chris H L Thio
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | | | - Ruifeng Wang
- Department of Physical Examination, Chenghai People's Hospital, Shantou, China
| | - Yue Wang
- From the Department of Public Health and Preventive Medicine, Shantou University Medical College, Shantou, China
| | - Harold Snieder
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Qingying Zhang
- From the Department of Public Health and Preventive Medicine, Shantou University Medical College, Shantou, China
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26
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Davis K, Moorhouse L, Maswera R, Mandizvidza P, Dadirai T, Museka T, Nyamukapa C, Smit M, Gregson S. Associations between HIV status and self-reported hypertension in a high HIV prevalence sub-Saharan African population: a cross-sectional study. BMJ Open 2023; 13:e067327. [PMID: 36635037 PMCID: PMC9843216 DOI: 10.1136/bmjopen-2022-067327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
OBJECTIVES This study examined whether HIV status and antiretroviral therapy (ART) exposure were associated with self-reported hypertension in Zimbabwe. DESIGN Study data were taken from a cross-sectional, general population survey, which included HIV testing (July 2018-December 2019). SETTING The data were collected in Manicaland Province, Zimbabwe. PARTICIPANTS 9780 people aged 15 years and above were included. OUTCOME MEASURE Self-reported hypertension was the outcome measure. This was defined as reporting a previous diagnosis of hypertension by a doctor or nurse. After weighting of survey responses by age and sex using household census data, χ2 tests and logistic regression were used to explore whether HIV status and ART exposure were associated with self-reported hypertension. RESULTS The weighted prevalence of self-reported hypertension was 13.6% (95% CI 12.9% to 14.2%) and the weighted prevalence of HIV was 11.1% (10.4% to 11.7%). In univariable analyses, there was no evidence of a difference in the weighted prevalence of self-reported hypertension between people living with HIV (PLHIV) and HIV-negative people (14.1%, 11.9% to 16.3% vs 13.3%, 12.6% to 14.0%; p=0.503) or between ART-exposed and ART-naive PLHIV (14.8%, 12.0% to 17.7% vs 12.8%, 9.1% to 16.4%,p=0.388). Adjusting for socio-demographic variables in logistic regression did not alter this finding (ORs:HIV status:0.88, 0.70 to 1.10, p=0.261; ART exposure:0.83, 0.53 to 1.30, p=0.411). CONCLUSIONS Approximately one in seven PLHIV self-reported having hypertension, highlighting an important burden of disease. However, no associations were found between HIV status or ART exposure and self-reported hypertension, suggesting that it will be valuable to focus on managing other risk factors for hypertension in this population. These findings should be fully accounted for as Zimbabwe reorients its health system towards non-communicable disease control and management.
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Affiliation(s)
- Katherine Davis
- MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, Imperial College London, London, UK
| | - Louisa Moorhouse
- MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, Imperial College London, London, UK
| | | | | | - Tawanda Dadirai
- Biomedical Research and Training Institute, Harare, Zimbabwe
| | - Tafadzwa Museka
- Biomedical Research and Training Institute, Harare, Zimbabwe
| | - Constance Nyamukapa
- MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, Imperial College London, London, UK
- Biomedical Research and Training Institute, Harare, Zimbabwe
| | - Mikaela Smit
- MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, Imperial College London, London, UK
| | - Simon Gregson
- MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, Imperial College London, London, UK
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27
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Mohamed SF, Macharia T, Asiki G, Gill P. A socio-ecological framework examination of drivers of blood pressure control among patients with comorbidities and on treatment in two Nairobi slums; a qualitative study. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0001625. [PMID: 36963082 PMCID: PMC10021823 DOI: 10.1371/journal.pgph.0001625] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 01/31/2023] [Indexed: 03/12/2023]
Abstract
Despite the known and effective treatments to control blood pressure, there is limited information on why there are high uncontrolled hypertension rates in urban slum settings. The aim of this paper is to explore the views of treated people with uncontrolled hypertension and other key stakeholders on the facilitators and barriers to blood pressure control among people with comorbid conditions in two Nairobi slums. The study was conducted in two Nairobi slums namely, Korogocho and Viwandani. This study used a qualitative methodology using interviews and focus group discussions. Barriers and facilitators to blood pressure control were explored using the Social Ecological Model (SEM) framework. A total of 57 participants were interviewed for this study. There were 31 in-depth interviews and two focus group discussions among participants with uncontrolled hypertension and with comorbidities. Additionally, 16 key informant interviews were conducted with healthcare providers and decision/policymakers. All interviews were audio-recorded, transcribed verbatim and analysed thematically. This study identified barriers and facilitators to blood pressure control among patients with uncontrolled hypertension at the patient/individual level, family and community level, health system level and at the policy level. High cost of hypertension medicines, the constant unavailability of medicines at the health facilities, unsupportive family and environment, poor medicines supply chain management, availability and use of guidelines were among the barriers reported. The results show that uncontrolled hypertension is a major public health issue in slums of Nairobi and they highlight barriers to blood pressure control at different levels of the socio-ecological model. These findings can be used to design holistic interventions to improve blood pressure control by addressing factors operating at multiple levels of the socio-ecological framework.
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Affiliation(s)
- Shukri F Mohamed
- Division of Health Sciences and the NIHR Global Health Research Unit on Improving Health in Slums, Warwick Medical School, University of Warwick, Coventry, United Kingdom
- Chronic Disease Management Unit, African Population and Health Research Center (APHRC), Nairobi, Kenya
- Department of Global Health and Population, Lown Scholars Program, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
| | | | - Gershim Asiki
- Chronic Disease Management Unit, African Population and Health Research Center (APHRC), Nairobi, Kenya
| | - Paramjit Gill
- Academic Unit of Primary Care (AUPC) and the NIHR Global Health Research Unit on Improving Health in Slums, University of Warwick, Coventry, United Kingdom
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Diabetes, Hypertension, and Comorbidity among Bangladeshi Adults: Associated Factors and Socio-Economic Inequalities. J Cardiovasc Dev Dis 2022; 10:jcdd10010007. [PMID: 36661902 PMCID: PMC9863699 DOI: 10.3390/jcdd10010007] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Revised: 12/19/2022] [Accepted: 12/21/2022] [Indexed: 12/29/2022] Open
Abstract
Diabetes, hypertension, and comorbidity are still crucial public health challenges that Bangladeshis face. Nonetheless, very few studies have been conducted to examine the associated factors, especially the socioeconomic inequalities in diabetes, hypertension, and comorbidity in Bangladesh. This study explored the prevalence of, factors connected with, and socioeconomic inequalities in diabetes, hypertension, and comorbidity among Bangladeshi adults. We used the Bangladesh Demographic and Health Survey (BDHS) data set of 2017−2018. A total of 12,136 (weighted) Bangladeshi adults with a mean age of 39.5 years (±16.2) participated in this study. Multilevel (mixed-effect) logistic regression analysis was employed to ascertain the determinants of diabetes, hypertension, and comorbidity, where clusters were considered as a level-2 factor. The concentration curve (CC) and concentration index (CIX) were utilized to investigate the inequalities in diabetes, hypertension, and comorbidity. The weighted prevalence of diabetes, hypertension, and comorbidity was 10.04%, 25.70%, and 4.47%, respectively. Age, body mass index, physical activity, household wealth status, and diverse administrative divisions were significantly associated with diabetes, hypertension, and comorbidity among the participants. Moreover, participants’ smoking statuses were associated with hypertension. Women were more prone to hypertension and comorbidity than men. Diabetes (CIX: 0.251, p < 0.001), hypertension (CIX: 0.071, p < 0.001), and comorbidity (CIX: 0.340, p < 0.001) were higher among high household wealth groups. A pro-wealth disparity in diabetes, hypertension, and comorbidity was found. These inequalities in diabetes, hypertension, and comorbidity emphasize the necessity of designing intervention schemes geared towards addressing the rising burden of these diseases.
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Damianaki A, Theiler K, Beaney T, Wang W, Burnier M, Wuerzner G. High blood pressure screening in pharmacies during May Measurement Month campaigns in Switzerland. Blood Press 2022; 31:129-138. [PMID: 35699311 DOI: 10.1080/08037051.2022.2086531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
PURPOSE May Measurement Month (MMM) is an international screening campaign for arterial hypertension (HT) organised by the International Society of Hypertension and the World Hypertension League. It aims at raising the awareness of elevated blood pressure (BP) in the population. The goal of this analysis was to assess the results obtained in Swiss pharmacies during a 3-year campaign. MATERIAL AND METHODS Swiss data from the MMM17 to MMM19 campaigns were extracted from the global MMM database. The analysis was conducted specifically on measures taken in pharmacies. BP and a questionnaire including demographical and clinical information were recorded for each participant. To assess BP control, ESH 2018 thresholds of <140/90 mmHg and ESH 2021 pharmacy-thresholds of <135/85 mmHg were used. RESULTS From an initial sample of 3634 Swiss participants included during this 3-year campaign, 2567 participants (73.2%women and 26.8% men, p<.001) had their BP measured in triplicates in pharmacies. The first BP measurement was associated with 2.0 ± 4.9 mmHg effect on systolic blood pressure (SBP) (p<.001) and 0.7 ± 3.7 mmHg on diastolic blood pressure (DBP) (p<.001) compared to the mean of the second and third measurements. Based on the ESH 2018 and the ESH 2021 pharmacy thresholds, prevalence of HT (mean of second and third measurements) increased from 29.5% to 38.3%, respectively. In treated participants, 58.3% (279) had an average BP < 140/90 mmHg and 40.3% (193) had an average BP < 135/85 mmHg. CONCLUSIONS HT screening campaigns in pharmacies recruits mainly women. It helps the detection of untreated hypertensive participants and uncontrolled treated participants. Our data suggest that the average BP should be calculated on the second and third measurements due to a significant first measure effect in pharmacies measurement. SummaryHigh blood pressure (BP) is a major global public health issue as the leading risk factor of global death.World-wide initiatives like May Measurement Month (MMM) aim to screen thousands of people each year to raise awareness of hypertension (HT).Switzerland participated in MMM 2017-2019 and screened more than 2500 participants in pharmacies.When adopting the recent proposed thresholds of HT diagnosis in pharmacies (ESH 2021 > 135/85 mmHg), HT prevalence in Switzerland is high (38.3%) with only 2/3 of treated hypertensive achieving the BP goals.Women are more likely to participate in such campaigns taking place in pharmacies.A first measurement effect (FME) was also present in pharmacies, highlighting that taking three BP measurements in pharmacies and discarding the first should be also considered in the pharmacy setting.Involving a routine pharmacy-based health care of patients would help to identify more hypertensive patients and uncontrolled treated patients, who may not have had access to BP measurement.
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Affiliation(s)
- Aikaterini Damianaki
- Service of Nephrology and Hypertension, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
| | - Kenji Theiler
- Service of Nephrology and Hypertension, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
| | - Thomas Beaney
- Imperial Clinical Trials Unit, Imperial College London, London, UK.,Department of Primary Care and Public Health, Imperial College London, London, UK
| | - Wei Wang
- Imperial Clinical Trials Unit, Imperial College London, London, UK
| | - Michel Burnier
- Service of Nephrology and Hypertension, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
| | - Grégoire Wuerzner
- Service of Nephrology and Hypertension, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
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Ang CW, Tan MM, Bärnighausen T, Reininghaus U, Reidpath D, Su TT. Mental distress along the cascade of care in managing hypertension. Sci Rep 2022; 12:15910. [PMID: 36151113 PMCID: PMC9508187 DOI: 10.1038/s41598-022-20020-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 09/07/2022] [Indexed: 12/04/2022] Open
Abstract
Hypertension might be a contributing factor of mental illness. The aim of this study was to investigate the association between different levels of hypertension care and mental distress among hypertensive individuals in Malaysia. We constructed a hypertension care cascade using data of 6531 hypertensive individuals aged ≥ 35 years that were collected as part of the community health survey conducted in 2013 in the South East Asia Community Observatory. We examined the association between the status of hypertension care and mental distress using multiple logistic regressions. Respondents who had not been screened for hypertension and those who had uncontrolled blood pressure (BP) had higher odds of depression, anxiety and, stress compared to those who had been screened and those who had controlled BP, respectively. Respondents who were not taking antihypertensive medication had lower odds of depression and anxiety compared to those who were on medication. There was an association between different levels of hypertension care and mental distress. The application of a hypertension care cascade may help improve the provision of mental health support in primary care clinics. Specific mental health interventions could be provided for patients with particular needs along the cascade.
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Affiliation(s)
- Chiew Way Ang
- South East Asia Community Observatory (SEACO) & Global Public Health, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Subang Jaya, Selangor, Malaysia
| | - Min Min Tan
- South East Asia Community Observatory (SEACO) & Global Public Health, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Subang Jaya, Selangor, Malaysia
| | - Till Bärnighausen
- Heidelberg Institute of Global Health, Faculty of Medicine, University of Heidelberg, Heidelberg, Baden-Württemberg, Germany.,Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Ulrich Reininghaus
- Department of Public Mental Health, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany.,ESRC Centre for Society and Mental Health, King's College London, London, UK.,Centre for Epidemiology and Public Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Daniel Reidpath
- Institute for Global Health and Development, Queen Margaret University, Edinburgh, EH21 6UU, UK
| | - Tin Tin Su
- South East Asia Community Observatory (SEACO) & Global Public Health, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Subang Jaya, Selangor, Malaysia. .,Heidelberg Institute of Global Health, Faculty of Medicine, University of Heidelberg, Heidelberg, Baden-Württemberg, Germany.
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Zhao S, Tang J, Zhao Y, Xu C, Xu Y, Yu S, Zhang Y. The impact of body composition and fat distribution on blood pressure in young and middle-aged adults. Front Nutr 2022; 9:979042. [PMID: 36118739 PMCID: PMC9478411 DOI: 10.3389/fnut.2022.979042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 08/16/2022] [Indexed: 11/24/2022] Open
Abstract
Background The relative contributions of each component of body composition to blood pressure (BP) remain unclear. Objective We aimed to comprehensively investigate the impact of body composition and fat distribution on BP and quantify their relative contributions to BP in a large cohort with young and middle-aged adults. Methods 14,412 participants with available data on whole-body DXA measurement from the National Health and Nutrition Examination Survey were included. Multiple stepwise linear regressions of BP on components of body composition and fat distribution were built. Then, relative importance analysis was performed to quantify the contributions of each component to BP. Results The median age of participants was 36 years and there were 50.7% women. Linear regression with mutual adjustment showed that total fat mass, total muscle mass, and trunk fat mass significantly and positively associated with BP; however, arm and leg fat mass significantly and negatively associated with BP. In men, after further adjusted for potential covariates, SBP were significantly determined by trunk fat mass (β = 0.33, P < 0.001), leg fat mass (β = − 0.12, P < 0.001), and total muscle mass (β = 0.10, P < 0.001); and DBP were significantly determined by trunk fat mass (β = 0.52, P < 0.001), leg fat mass (β = −0.15, P < 0.001), arm fat mass (β = −0.23, P < 0.001), and total muscle mass (β = 0.06, P < 0.001). Similar results were observed in women. Relative importance analysis showed that trunk fat mass was the major contributor (38–61%) to both SBP and DBP; meanwhile, total muscle mass also made relatively great contribution (35–43%) to SBP. Conclusion Both fat mass and muscle mass independently associated with and substantially contributed to SBP in both men and women. After full adjustment, trunk fat mass positively associated with both SBP and DBP, and was the most dominant contributor to BP; however, leg fat mass negatively associated with both SBP and DBP.
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Long-term variability and change trend of systolic blood pressure and risk of type 2 diabetes mellitus in middle-aged Japanese individuals: findings of the Aichi Workers' Cohort Study. Hypertens Res 2022; 45:1772-1780. [PMID: 35982266 DOI: 10.1038/s41440-022-00993-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Revised: 06/06/2022] [Accepted: 07/07/2022] [Indexed: 11/08/2022]
Abstract
Studies have reported that short-term blood pressure (BP) variability (BPV) is associated with type 2 diabetes mellitus (T2DM) incidence, but the association with long-term BPV remains unclear. The present study investigated the associations of long-term BPV as well as the time trend of BP changes over time with the incidence of T2DM. This study followed a cohort of 3017 Japanese individuals (2446 male, 571 female) aged 36-65 years from 2007 through March 31, 2019. The root-mean-square error (RMSE) and the slope of systolic BP (SBP) change regressed on year were calculated individually using SBP values obtained from 2003 to baseline (2007). A multivariable Cox proportional hazard model was applied to estimate hazard ratios (HRs) and corresponding 95% confidence intervals (CIs) for tertiles of SBP RMSE and continuous SBP slopes adjusted for age, sex, smoking status, regular exercise, sodium intake, family history of diabetes, sleep disorder, body mass index (BMI), SBP, and fasting blood glucose (FBG) at baseline, and BMI slope from 2003 to 2007. The highest RMSE tertile compared to the lowest was associated with a significantly higher incidence of T2DM after adjusting for covariates (HR: 1.79, 95% CI: 1.15, 2.78). The slope was also significantly associated with T2DM incidence until baseline SBP and FBG were adjusted (HR: 1.03, 95% CI: 0.99, 1.07). In conclusion, long-term SBP variability was significantly associated with an increased incidence of T2DM independent of baseline age, sex, BMI, SBP, FBG, lifestyle factors and BMI slope from 2003 until baseline.
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Tang A, Ng CH, Phang PH, Chan KE, Chin YH, Fu CE, Zeng RW, Xiao J, Tan DJH, Quek J, Lim WH, Mak LY, Wang JW, Chew NWS, Syn N, Huang DQ, Siddiqui MS, Sanyal A, Muthiah M, Noureddin M. Comparative Burden of Metabolic Dysfunction in Lean NAFLD vs Non-lean NAFLD - A Systematic Review and Meta-analysis. Clin Gastroenterol Hepatol 2022:S1542-3565(22)00669-3. [PMID: 35863685 DOI: 10.1016/j.cgh.2022.06.029] [Citation(s) in RCA: 46] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 06/02/2022] [Accepted: 06/05/2022] [Indexed: 02/06/2023]
Abstract
BACKGROUND & AIMS Nonalcoholic fatty liver disease (NAFLD) is traditionally associated with obesity. However, there is a subtype of NAFLD, namely NAFLD in lean, that occurs without obesity. However, a recent call to redefine NAFLD to metabolic-associated fatty liver disease focuses on obesity and metabolic dysfunction. Criticism has arisen from the perceived over emphasis on systemic comorbidities, which may disadvantage the lean. The current analysis seeks to quantify the degree of metabolic dysfunction in NAFLD in lean and compare with NAFLD in overweight and obese and non-NAFLD. METHODS Medline and Embase databases were searched from inception to March 3, 2022. The inclusion criteria were articles with NAFLD in lean patients presenting with baseline metabolic parameters. Comparisons were conducted with subgroup analysis. RESULTS Eighty-five articles were included in the meta-analysis. NAFLD in lean accounted for 13.11% (95% confidence interval [CI], 10.26%-16.62%) of the global population and 14.55% (95% CI, 11.32%-18.51%) in Asia. The degree of metabolic dysfunction was weight dependent with significantly less metabolic dysfunction in NAFLD in lean subjects as compared with NAFLD in overweight counterparts. For NAFLD in lean, only 19.56% (95% CI, 15.28%-24.69%) of the subjects were diabetic, whereas 45.70% (95% CI, 35.01%-56.80%) of obese subjects with NAFLD had diabetes (P < .01). Fasting blood glucose and systolic and diastolic blood pressure values were significantly lower in subjects with NAFLD in lean than in overweight and obese. CONCLUSION The current analysis highlights the weight-dependent nature of metabolic dysfunction in NAFLD. Lean subjects with NAFLD were significantly less metabolically unhealthy than were obese and overweight persons with NAFLD. An overreliance on metabolic dysfunction in defining fatty liver will be a flaw in potentially excluding previously characterized NAFLD.
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Affiliation(s)
- Ansel Tang
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Cheng Han Ng
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
| | - Poh Hui Phang
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Kai En Chan
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Yip Han Chin
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Clarissa Elysia Fu
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | | | - Jieling Xiao
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Darren Jun Hao Tan
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Jingxuan Quek
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Wen Hui Lim
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Lung Yi Mak
- Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong
| | - Jiong-Wei Wang
- Department of Surgery, Cardiovascular Research Institute, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Nanomedicine Translational Research Programme, Centre for NanoMedicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Nicholas W S Chew
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Department of Cardiology, National University Heart Centre, National University Hospital, Singapore
| | - Nicholas Syn
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Daniel Q Huang
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore; National University Centre for Organ Transplantation, National University Health System, Singapore; Division of Gastroenterology and Hepatology, Department of Medicine, National University Hospital, Singapore
| | - Mohammad Shadab Siddiqui
- Division of Gastroenterology, Hepatology, and Nutrition, Department of Internal Medicine, Virginia Commonwealth University, Richmond, Virginia
| | - Arun Sanyal
- Division of Gastroenterology, Hepatology, and Nutrition, Department of Internal Medicine, Virginia Commonwealth University, Richmond, Virginia
| | - Mark Muthiah
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore; National University Centre for Organ Transplantation, National University Health System, Singapore; Division of Gastroenterology and Hepatology, Department of Medicine, National University Hospital, Singapore
| | - Mazen Noureddin
- Cedars-Sinai Fatty Liver Program, Division of Digestive and Liver Diseases, Department of Medicine, Comprehensive Transplant Center, Cedars-Sinai Medical Centre, Los Angeles, California.
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Zhao Y, Ma Y, Zhao C, Lu J, Jiang H, Cao Y, Xu Y. The effect of integrated health care in patients with hypertension and diabetes: a systematic review and meta-analysis. BMC Health Serv Res 2022; 22:603. [PMID: 35513809 PMCID: PMC9074341 DOI: 10.1186/s12913-022-07838-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 03/23/2022] [Indexed: 11/18/2022] Open
Abstract
Background A growing number of studies show that integrated health care provides comprehensive and continuous care to patients with hypertension or diabetes. However, there is still no consensus about the effect of integrated health care on patients with hypertension or diabetes. The objective of this study was to verify the effectiveness of integrated health care for patients with hypertension or diabetes by using a systematic review and meta-analysis. Methods The study searched multiple English and Chinese electronic databases. The search period was from database inception to 31 October 2020. Systematic reviews and meta-analyses were conducted after assessing the risk of bias of each study. Results Sixteen studies that involved 5231 patients were included in this study. The results of the systematic review revealed that systolic blood pressure (SBP), diastolic blood pressure (DBP), body mass index (BMI) and glycosylated haemoglobin (HbA1c) are commonly used indicators for patients with hypertension or diabetes. Individual models and group- and disease-specific models are the most commonly used models of integrated health care. All the studies were from high-income and middle-income countries. Meta-analysis showed that integrated health care significantly improved SBP, DBP and HbA1c but not BMI. A comparison of interventions lasting 6 and 12 months for diabetes was conducted, and HbA1c was decreased after 12 months. The changes in SBP and DBP were statistically significant after using group- and disease-specific model but not individual models. HbA1c was significantly improved after using group- and disease-specific models and individual models. Conclusion Integrated health care is a useful tool for disease management, and individual models and group- and disease-specific models are the most commonly used models in integrated health care. Group- and disease-specific models are more effective than individual models in the disease management of hypertension patients. The duration of intervention should be considered in the disease management of patients with diabetes, and interventions longer than 12 months are recommended. The income level may affect the model of integrated health care in selecting which disease to intervene, but this point still needs support from more studies.
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Affiliation(s)
- Yan Zhao
- Department of Nursing, Huashan Hospital, Fudan University, 12 Middle Urumqi Road, Shanghai, China
| | - Yue Ma
- Department of Nursing, Huashan Hospital, Fudan University, 12 Middle Urumqi Road, Shanghai, China
| | - Chongbo Zhao
- Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China
| | - Jiahong Lu
- Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China
| | - Hong Jiang
- Department of Nursing, Huashan Hospital, Fudan University, 12 Middle Urumqi Road, Shanghai, China
| | - Yanpei Cao
- Department of Nursing, Huashan Hospital, Fudan University, 12 Middle Urumqi Road, Shanghai, China.
| | - Yafang Xu
- Department of Nursing, Huashan Hospital, Fudan University, 12 Middle Urumqi Road, Shanghai, China. .,School of Nursing, Fudan University, Shanghai, China.
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Li W, Fang W, Huang Z, Wang X, Cai Z, Chen G, Wu W, Chen Z, Wu S, Chen Y. Association between age at onset of overweight and risk of hypertension across adulthood. Heart 2022; 108:683-688. [PMID: 35190372 PMCID: PMC8995813 DOI: 10.1136/heartjnl-2021-320278] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2021] [Accepted: 01/26/2022] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVE The aim of this study was to examine the association between age at onset of overweight and incident hypertension. METHODS We analysed 4742 participants with new-onset overweight from the Kailuan study between 2006 and 2015 and and 4742 age-matched and sex-matched controls selected randomly from the same cohort but with normal weight. Participants were compared with respect to subsequent risk of hypertension, with sub-HR calculated with the Fine and Gray model, according to age of onset of overweight. RESULTS Over a mean follow-up period of 5.17 years, 1642 overweight participants (34.6%) and 1293 normal-weight controls (27.3%) were subsequently diagnosed with hypertension. The median age at onset of overweight was 49.1 years. Compared with normal-weight controls, the multivariable-adjusted sub-HR for hypertension among participants with onset of overweight at 18-39 years of age, 40-49 years of age, 50-59 years of age and ≥60 years of age was 1.38 (95% CI 1.11 to 1.72), 1.27 (95% CI 1.09 to 1.49), 1.23 (95% CI 1.09 to 1.38) and 1.14 (95% CI 0.99 to 1.32), respectively. Onset of overweight in each age range was significantly associated with increased risk of hypertension, except for the group with onset at ≥60 years of age. The risk increased with each decade of attenuation of age at onset, peaking at 18-39 years of age. CONCLUSIONS Younger age at onset of overweight across adulthood was associated with significantly increased risk of hypertension, with the highest relative risk among participants with onset of overweight at 18-39 years of age.
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Affiliation(s)
- Weijian Li
- Shantou University Medical College, Shantou, China
| | - Wei Fang
- Shantou University Medical College, Shantou, China
| | - Zegui Huang
- Shantou University Medical College, Shantou, China
| | | | - Zefeng Cai
- Department of Cardiology, Second Affiliated Hospital of Shantou University Medical College, Shantou, China
| | | | - Weiqiang Wu
- Department of Cardiology, Second Affiliated Hospital of Shantou University Medical College, Shantou, China
| | - Zhichao Chen
- Department of Cardiology, Second Affiliated Hospital of Shantou University Medical College, Shantou, China
| | - Shouling Wu
- Department of Cardiology, Kailuan General Hospital, Tangshan, China
| | - Youren Chen
- Department of Cardiology, Second Affiliated Hospital of Shantou University Medical College, Shantou, China
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Trends in the association between body mass index and blood pressure among 19-year-old men in Korea from 2003 to 2017. Sci Rep 2022; 12:6767. [PMID: 35473938 PMCID: PMC9043188 DOI: 10.1038/s41598-022-10570-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 04/11/2022] [Indexed: 11/08/2022] Open
Abstract
The strength of association between the body mass index (BMI) and blood pressure (BP) varies with population and time. Therefore, identifying the trends in BMI-BP association in adolescents can help predict the upcoming metabolic and cardiovascular disease burden. For this reason, from physical examination data collected from 2003 to 2017, a total of 5,133,246 Korean men aged 19 years were assessed for the annual trends and changes in the BMI-BP association. During the 15-year period, the mean BMI increased from 22.5 to 23.5 kg/m2, and the prevalence of obesity increased from 16.7 to 21.4%. Meanwhile, the mean systolic BP (SBP) decreased from 122.8 to 122.3 mmHg in the first year and gradually increased to 125.9 mmHg afterward. The diastolic BP (DBP) decreased from 71.5 to 70.0 mmHg in the first 4 years and then rose to 74.8 mmHg in the following years. The association analysis between BMI and SBP resulted in an annual increase in the correlation coefficient (SBP: 0.257-0.495, DBP: 0.164-0.413). The regression coefficient similarly increased between 2003 and 2015 but slightly decreased between 2015 and 2017 (SBP: 0.896-1.569, DBP: 0.405-0.861). The BMI-BP association increased over time (coefficient of the interaction term > 0, P < 0.001). Moreover, as the BMI increased, the annual increase in BP and BP per unit BMI also increased. In conclusion, this study emphasized a continuous shift towards obesity in BMI distribution and intensifying BMI-BP association over time in young men. Further research on factors affecting this BMI-BP association is needed to fully validate the potential applications of this hypothesis.
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Defining the role of the hypothalamic-pituitary-adrenal axis in the relationship between fetal growth and adult cardiometabolic outcomes. J Dev Orig Health Dis 2022; 13:683-694. [PMID: 35445653 DOI: 10.1017/s2040174422000186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Animal and human data demonstrate independent relationships between fetal growth, hypothalamic-pituitary-adrenal axis function (HPA-A) and adult cardiometabolic outcomes. While the association between fetal growth and adult cardiometabolic outcomes is well-established, the role of the HPA-A in these relationships is unclear. This study aims to determine whether HPA-A function mediates or moderates this relationship. Approximately 2900 pregnant women were recruited between 1989-1991 in the Raine Study. Detailed anthropometric data was collected at birth (per cent optimal birthweight [POBW]). The Trier Social Stress Test was administered to the offspring (Generation 2; Gen2) at 18 years; HPA-A responses were determined (reactive responders [RR], anticipatory responders [AR] and non-responders [NR]). Cardiometabolic parameters (BMI, systolic BP [sBP] and LDL cholesterol) were measured at 20 years. Regression modelling demonstrated linear associations between POBW and BMI and sBP; quadratic associations were observed for LDL cholesterol. For every 10% increase in POBW, there was a 0.54 unit increase in BMI (standard error [SE] 0.15) and a 0.65 unit decrease in sBP (SE 0.34). The interaction between participant's fetal growth and HPA-A phenotype was strongest for sBP in young adulthood. Interactions for BMI and LDL-C were non-significant. Decomposition of the total effect revealed no causal evidence of mediation or moderation.
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Amponsem-Boateng C, Oppong TB, Zhang W, Boakye-Yiadom J, Wang L, Acheampong K, Opolot G. Screening of hypertension, risks, knowledge/awareness in second-cycle schools in Ghana. A national cross-sectional study among students aged 12-22. J Hum Hypertens 2022; 36:405-415. [PMID: 33790406 DOI: 10.1038/s41371-021-00502-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
In Ghana, the management of hypertension in primary health care is a cost-effective way of addressing premature deaths from vascular disorders that include hypertension. There is little or no evidence of large-scale studies on the prevalence, risk, and knowledge/awareness of hypertension in students aged 12-22 years in Ghana. In a cross-sectional study, blood pressure, anthropometric indices, and knowledge/awareness assessment of students at second-cycle schools were recorded from 2018 to 2020 in three regions of Ghana. Multistage cluster sampling was used in selecting regions and the schools. Prevalence of prehypertension and hypertension was categorized by the Joint National Committee 7, where appropriate, chi-square, scatter plots, and correlations were used in showing associations. A total of 3165 students comprising 1776 (56.1%) females and 1389 (43.9%) males participated in this study within three regions of Ghana. The minimum age was 12 years and the maximum age was 22 years. The mean age was 17.21 with standard deviation (SD: 1.59) years. A 95% confidence interval was set for estimations and a P value < 0.05 was set as significant. The prevalence rate of overall hypertension was 19.91% and elevated (prehypertension) was 26.07%. Risk indicators such as weight, BMI, waist circumference, physical activity, and form of the diet were positively correlated with hypertension. Among Ghanaian students currently in second-cycle educational institutions, 19.91% were hypertensive and 26.07% were prehypertensive. This may indicate a probable high prevalence of hypertension in the future adult population if measures are not taken to curb the associated risks.
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Affiliation(s)
- Cecilia Amponsem-Boateng
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Timothy Bonney Oppong
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Weidong Zhang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China.
| | | | - Lianke Wang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Kwabena Acheampong
- Department of Epidemiology and Health Statistics, Central South University, Changsha, PR China
| | - Godfrey Opolot
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
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Yusni Y, Yusuf H. The Effect of Green Coffee on Blood Pressure, Liver and Kidney Functions in Obese Model Rats. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.8134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND: The effect of green coffee (GC) on blood pressure (BP) is still debated, but GC is thought to improve liver and kidney function.
AIM: This study aimed to analyze the effect of the GC intervention on BP, liver, and kidney functions in obese model rats.
METHODS: The research was a pre-clinical trial of pretest-posttest with control group design. Animals were divided into four groups: obese rats (G1), obese rats and GC (G2), obese rats and physical exercise (PE) (G3), and a combination of interventions (PE+GC) (G4). Data analysis used an independent sample t-test and analysis of variance; (p < 0.05).
RESULTS: There was a different effect of the GC, PE, and PE+GC intervention on BP (186.50 ± 3.45 vs. 91.33 ± 1.96 p = 0.001*; 189.17 ± 2.93 vs. 119.50 ± 3.73 p = 0.001*; 191.8 3 ± 2.64 vs. 98.83 ± 3.76 p = 0.001*) in obese rats. There was a significant difference in Serum Glutamic Oxaloacetic Transaminase (SGOT) (p=0.001*), Serum Glutamic Pyruvic Transaminase (SGPT) (p = 0.001*), Blood urea nitrogen (BUN) (p = 0.001*), and Creatinine (p = 0.001*) before and after the intervention in the three groups (G2, G3, and G4). SGOT, SGPT, and Creatinine levels decreased significantly after PE, GC, and PE+GC intervention. On the other hand, BUN levels decreased significantly after GC and its combination intervention. Meanwhile, in the control group and the intervention of PE, it increased significantly.
CONCLUSIONS: GC is more effective in lowering BP without causing impaired liver and kidney function in obese rats.
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Recalibrating the Non-Communicable Diseases risk prediction tools for the rural population of Western India. BMC Public Health 2022; 22:376. [PMID: 35193546 PMCID: PMC8862298 DOI: 10.1186/s12889-022-12783-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 02/16/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The aim of the present study was to recalibrate the effectiveness of Indian Diabetes Risk Score (IDRS) and Community-Based Assessment Checklist (CBAC) by opportunistic screening of Diabetes Mellitus (DM) and Hypertension (HT) among the people attending health centres, and estimating the risk of fatal and non-fatal Cardio-Vascular Diseases (CVDs) among them using WHO/ISH charts. METHODS All the people aged ≥ 30 years attending the health centers were screened for DM and HT. Weight, height, waist circumference, and hip circumferences were measured, and BMI and Waist-Hip Ratio (WHR) were calculated. Risk categorization of all participants was done using IDRS, CBAC, and WHO/ISH risk prediction charts. Individuals diagnosed with DM or HT were started on treatment. The data was recorded using Epicollect5 and was analyzed using SPSS v.23 and MedCalc v.19.8. ROC curves were plotted for DM and HT with the IDRS, CBAC score, and anthropometric parameters. Sensitivity (SN), specificity (SP), Positive Predictive Value (PPV), Negative Predictive Value (NPV), Accuracy and Youden's index were calculated for different cut-offs of IDRS and CBAC scores. RESULTS A total of 942 participants were included for the screening, out of them, 9.2% (95% CI: 7.45-11.31) were diagnosed with DM for the first time. Hypertension was detected among 25.7% (95% CI: 22.9-28.5) of the participants. A total of 447 (47.3%) participants were found with IDRS score ≥ 60, and 276 (29.3%) with CBAC score > 4. As much as 26.1% were at moderate to higher risk (≥ 10%) of developing CVDs. Area Under the Curve (AUC) for IDRS in predicting DM was 0.64 (0.58-0.70), with 67.1% SN and 55.2% SP (Youden's Index 0.22). While the AUC for CBAC was 0.59 (0.53-0.65). For hypertension both the AUCs were 0.66 (0.62-0.71) and 0.63 (0.59-0.67), respectively. CONCLUSIONS IDRS was found to have the maximum AUC and sensitivity thereby demonstrating its usefulness as compared to other tools for screening of both diabetes and hypertension. It thus has the potential to expose the hidden NCD iceberg. Hence, we propose IDRS as a useful tool in screening of Diabetes and Hypertension in rural India.
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Time-varying association between body mass index and all-cause mortality in patients with hypertension. Int J Obes (Lond) 2022; 46:316-324. [PMID: 34697410 DOI: 10.1038/s41366-021-00994-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 09/21/2021] [Accepted: 10/11/2021] [Indexed: 12/20/2022]
Abstract
BACKGROUND Relationship between BMI and all-cause mortality in patients with hypertension remains controversial. This study aimed to evaluate the time-varying association between BMI in patients with hypertension and all-cause mortality. METHODS This population-based cohort study included 212,394 Chinese adults with hypertension from 2007 to 2015 and was followed up until death, loss-to-follow-up, or December 31, 2018. According to the World Health Organization criteria for Asians, BMI was categorized into five groups: underweight (BMI < 18.5 kg/m2), normal weight (18.5-22.9 kg/m2), overweight (23-24.9 kg/m2), class I obesity (25-29.9 kg/m2) and class II obesity (BMI ≥ 30 kg/m2). Cox model was used to estimate the time-varying association of BMI on the risk of mortality by including the interaction term between BMI and time using restricted cubic spline. RESULTS Compared with normal weight, underweight and class II obesity were associated with higher mortality (Hazard ratio [HRs] at 1 and 10 years of follow-up: 1.51 [95% CI: 1.39-1.65], and 1.27 (1.15-1.41) for underweight, respectively; 1.08 (0.96-1.21), and 1.16 (1.03-1.30) for class II obesity, respectively). However, overweight and class I obesity were associated with lower mortality, although the protective effects gradually attenuated over time (HRs at 1 and 10 years of follow-up: 0.85 (0.81-0.90), and 0.96 (0.91-1.02) for overweight, respectively; 0.80 (0.76-0.84), and 1.04 (0.99-1.10) for class I obesity, respectively). CONCLUSIONS We found increased mortality among hypertensive patients with underweight and class II obesity while decreased mortality with overweight and class I obesity was observed during the first 5 years of follow-up. Management efforts for hypertension may target controlling body weight in a reasonable range for patients, and probably more attention should be given to underweight patients.
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Tang N, Ma J, Tao R, Chen Z, Yang Y, He Q, Lv Y, Lan Z, Zhou J. The effects of the interaction between BMI and dyslipidemia on hypertension in adults. Sci Rep 2022; 12:927. [PMID: 35042940 PMCID: PMC8766602 DOI: 10.1038/s41598-022-04968-8] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Accepted: 01/05/2022] [Indexed: 12/04/2022] Open
Abstract
Body mass index (BMI) and dyslipidemia are indicators of human health and are often associated with high blood pressure. In this study,we explored the relationship between BMI or dyslipidemia and the risk of hypertension and further verified the possible interacting influences of BMI with dyslipidemia on the risk of hypertension. The aim is to explore the possible risk factors of hypertension and to provide scientific basis for the prevention and treatment of hypertension. Eligible subjects were selected from a cross-sectional survey in Changsha City, and we collected relevant data and clinical indicators for each participant. Body mass index (BMI) was calculated as weight (kg)/height2 (m2), and divided into four categories according to the Chinese standard. Dyslipidemia is defined according to Chinese guideline. Unconditional logistic regression models were used for dichotomous variables to determine the risk or protective factors of dependent variables. Multivariate Logistic model was used to study the influence of BMI and dyslipidemia on hypertension. The following indicators were used to assess the interaction effects: (1) Relative excess risk due to interaction (RERI); (2) Attributable proportion due to interaction(AP); (3) Synergy index (SI). SPSS software was used for statistical analysis. A total of 2740 eligible participants were enrolled in the cross-sectional study, of which 765 subjects (27.9%) were diagnosed with hypertension. Multivariate Logistic model showed that overweight (OR: 1.70, 95%CI: 1.39–2.09) or obese (OR: 2.60, 95%CI: 1.84–3.66) subjects had a significantly higher risk of hypertension than normal weight people, and underweight was a protective factor for hypertension(OR: 0.52, 95%CI: 0.29–0.93). People with dyslipidemia have a higher risk of hypertension than those with normal lipids (OR: 3.05, 95%CI: 2.36–3.90). In addition,there was a significant potentiating interaction effect between overweight or obesity and dyslipidemia(overweight: RERI (1.91, 95%CI: 0.17–3.66), AP (0.40, 95%CI:0.14–0.66), SI (2.03, 95%CI:1.11–3.74) and obesity: RERI (2.20, 95%CI:1.01–3.40), AP (0.38, 95%CI:0.18–0.58), SI (1.84, 95%CI:1.18–2.89), while no interaction was found between underweight and dyslipidemia. Low body weight is an independent protective factor for hypertension, but overweight, obesity and dyslipidemia are risk factors for hypertension, and dyslipidemia significantly shared interactions with overweight and obesity that influenced the risk of hypertension.
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Affiliation(s)
- Na Tang
- Key Laboratory of Molecular Epidemiology of Hunan Province, School of Medicine, Hunan Normal University, Changsha, 410013, Hunan, China
| | - Jian Ma
- Key Laboratory of Molecular Epidemiology of Hunan Province, School of Medicine, Hunan Normal University, Changsha, 410013, Hunan, China
| | - Rongqin Tao
- Tianxin District Center for Disease Control and Prevention, Changsha, 410009, Hunan, China
| | - Zhijun Chen
- Key Laboratory of Molecular Epidemiology of Hunan Province, School of Medicine, Hunan Normal University, Changsha, 410013, Hunan, China
| | - Yide Yang
- Key Laboratory of Molecular Epidemiology of Hunan Province, School of Medicine, Hunan Normal University, Changsha, 410013, Hunan, China
| | - Quanyuan He
- Key Laboratory of Molecular Epidemiology of Hunan Province, School of Medicine, Hunan Normal University, Changsha, 410013, Hunan, China
| | - Yuan Lv
- Key Laboratory of Molecular Epidemiology of Hunan Province, School of Medicine, Hunan Normal University, Changsha, 410013, Hunan, China
| | - Zelong Lan
- Tianxin District Center for Disease Control and Prevention, Changsha, 410009, Hunan, China.
| | - Junhua Zhou
- Key Laboratory of Molecular Epidemiology of Hunan Province, School of Medicine, Hunan Normal University, Changsha, 410013, Hunan, China.
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Mbhatsani HV, Mabapa NS, Ayuk TB, Mandiwana TC, Mushaphi LF, Mohlala M, Mbhenyane XG. Food security and related health risk among adults in the Limpopo Province of South Africa. S AFR J SCI 2021. [DOI: 10.17159/sajs.2021/8848] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Food insecurity, obesity and hypertension remain major public health issues related to nutrition in South Africa. The purpose of this study was to determine household food security and the health risk of the adult population in the Limpopo Province using cross-sectional designs. A stratified random sampling method was used to recruit adults aged 18 to 65 years in the Limpopo Province of South Africa. Data were collected using a validated, structured questionnaire. All data were analysed using SPSS version 25.0. The study included 640 participants with an average age of 36.2±17.6 years and a household size of five persons; 74.5% of participants fell in the low monthly income bracket (≤ZAR3000). The mean dietary diversity score was 3.99 (CI: 2.79–5.19). The prevalence of food insecurity was 31.3%, obesity 35.2% and hypertension 32.3%. Being a woman, older and married significantly positively influenced obesity and hypertension. Also, a healthy eating lifestyle such as high dietary diversity was found to positively influence obesity status, while daily eating of fruit and vegetables positively significantly influenced the hypertension status of participants (p<0.05). Food insecurity, obesity and hypertension rates remain high among adults in the Limpopo Province of South Africa with consumption of a diet low in dietary variety. Aged and married women were more likely to be obese and hypertensive, while daily fruit and vegetable intake were found to be a protective factor. Educational and nutritional intervention should be designed and geared towards promoting fruit and vegetable intake in the community.
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Affiliation(s)
| | - Ngoako S. Mabapa
- Department of Nutrition, University of Venda, Thohoyandou, South Africa
| | - Tambe B. Ayuk
- Division of Human Nutrition, Stellenbosch University, Stellenbosch, South Africa
| | | | | | - Merriam Mohlala
- Centre for Biokinetics, Recreation and Sport Science, University of Venda, Thohoyandou, South Africa
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Short-Term Cumulative Exposure to Ambient Traffic-Related Black Carbon and Blood Pressure: MMDA Traffic Enforcers' Health Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182212122. [PMID: 34831878 PMCID: PMC8619089 DOI: 10.3390/ijerph182212122] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 10/22/2021] [Accepted: 10/25/2021] [Indexed: 12/19/2022]
Abstract
Exposure to traffic-related air pollution is linked with acute alterations in blood pressure (BP). We examined the cumulative short-term effect of black carbon (BC) exposure on systolic (SBP) and diastolic (DBP) BP and assessed effect modification by participant characteristics. SBP and DBP were repeatedly measured on 152 traffic enforcers. Using a linear mixed-effects model with random intercepts, quadratic (QCDL) and cubic (CCDL) constrained distributed lag models were fitted to estimate the cumulative effect of BC concentration on SBP and DBP during the 10 hours (daily exposure) and 7 days (weekly exposure) before the BP measurement. Ambient BC was related to increased BP with QCDL models. An interquartile range change in BC cumulative during the 7 days before the BP measurement was associated with increased BP (1.2% change in mean SBP, 95% confidence interval (CI), 0.1 to 2.3; and 0.5% change in mean DBP, 95% CI, −0.8 to 1.7). Moreover, the association between the 10-h cumulative BC exposure and SBP was stronger for female (4.0% change, 95% CI: 2.1–5.9) versus male and for obese (2.9% change, 95% CI: 1.0–4.8) vs. non-obese traffic enforcers. Short-term cumulative exposure to ambient traffic-related BC could bring about cardiovascular diseases through mechanisms involving increased BP.
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Kulthinee S, Nernpermpisooth N, Poomvanicha M, Satiphop J, Chuang-Ngu T, Kaleeluan N, Thawnashom K, Manin A, Kongchan R, Yinmaroeng K, Kitipawong P, Chotimol P. Cold Pressor Test Influences the Cardio-Ankle Vascular Index in Healthy Overweight Young Adults. Pulse (Basel) 2021; 9:30-37. [PMID: 34722353 DOI: 10.1159/000517617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Accepted: 05/29/2021] [Indexed: 11/19/2022] Open
Abstract
Objective The cold pressor test (CPT) has been shown a potential sympathoexcitatory stimulus which increases aortic pulse wave velocity and the aortic augmentation index, suggesting that noninvasively, arterial stiffness parameters are altered by the CPT. The cardio-ankle vascular index (CAVI) is widely used for reflecting arterial stiffness, and the ankle-brachial index (ABI) for evaluating peripheral artery disease in obesity. We aimed to assess CAVI and ABI in overweight young adults in the context of sympathetic activation by using the CPT. Methods 160 participants were divided into 2 groups: 86 normal-weight (body mass index [BMI] 18.50-22.99 kg/m2) and 74 overweight (BMI ≥23 kg/m2). The CPT was performed by immersing a participant's left hand into cold water (3-5°C) for 3 min, and CAVI and ABI assessment. Results At baseline, the CAVI in the overweight group was significantly less than that in the normal-weight group (5.79 ± 0.85 vs. 6.10 ± 0.85; p < 0.05). The mean arterial pressure (MAP) for overweight was significantly greater than that for normal-weight subjects (93.89 ± 7.31 vs. 91.10 ± 6.72; p < 0.05). During the CPT, the CAVI increased in both normal-weight and overweight subjects, the CAVI value was greater during the CPT in overweight subjects by 14.36% (6.62 ± 0.95 vs. 5.79 ± 0.85, p < 0.05) and in normal-weight subjects by 8.03% (6.59 ± 1.20 vs. 6.10 ± 0.85, p < 0.05) than those baseline values. The CPT evoked an increase in systolic blood pressure (SBP), diastolic BP (DBP), heart rate (HR,) and pulse pressure (PP) in both groups. After a 4-min CPT period, the CAVI returned values similar to the baseline values in both groups, and the SBP, DBP, MAP, and PP in overweight participants were significantly higher than those in normal-weight participants. However, there was no significant difference in the ABI at baseline, during CPT, and post-CPT in either group. Conclusions Our results indicated that the CAVI was influenced by sympathetic activation response to the CPT in both normal-weight and overweight young adults. Specifically, during the CPT, the percentage change of the CAVI in overweight response was greater in normal-weight participants than baseline values in each group. The ABI was not found significantly associated with CPT. These findings suggesting that sympathoexcitatory stimulus by CPT influence CAVI results.
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Affiliation(s)
- Supaporn Kulthinee
- Chulabhorn International College of Medicine, Thammasat University, Pathum Thani, Thailand
| | - Nitirut Nernpermpisooth
- Department of Cardio-Thoracic Technology, Faculty of Allied Health Sciences, Naresuan University, Phitsanulok, Thailand
| | - Montatip Poomvanicha
- Department of Cardio-Thoracic Technology, Faculty of Allied Health Sciences, Naresuan University, Phitsanulok, Thailand
| | - Jidapa Satiphop
- Department of Cardio-Thoracic Technology, Faculty of Allied Health Sciences, Naresuan University, Phitsanulok, Thailand
| | - Thizanamadee Chuang-Ngu
- Department of Cardio-Thoracic Technology, Faculty of Allied Health Sciences, Naresuan University, Phitsanulok, Thailand
| | - Napaporn Kaleeluan
- Department of Cardio-Thoracic Technology, Faculty of Allied Health Sciences, Naresuan University, Phitsanulok, Thailand
| | - Kittisak Thawnashom
- Department of Medical Technology, Faculty of Allied Health Sciences, Naresuan University, Phitsanulok, Thailand
| | - Anuchit Manin
- Cardiac Centre, Naresuan University Hospital, Faculty of Medicine, Naresuan University, Phitsanulok, Thailand
| | - Rosarin Kongchan
- Cardiac Centre, Naresuan University Hospital, Faculty of Medicine, Naresuan University, Phitsanulok, Thailand
| | - Kingkarn Yinmaroeng
- Chulabhorn International College of Medicine, Thammasat University, Pathum Thani, Thailand
| | - Peerapong Kitipawong
- Chulabhorn International College of Medicine, Thammasat University, Pathum Thani, Thailand
| | - Phatiwat Chotimol
- Department of Cardio-Thoracic Technology, Faculty of Allied Health Sciences, Naresuan University, Phitsanulok, Thailand
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Talbot D, Diop A, Lavigne-Robichaud M, Brisson C. The change in estimate method for selecting confounders: A simulation study. Stat Methods Med Res 2021; 30:2032-2044. [PMID: 34369220 PMCID: PMC8424612 DOI: 10.1177/09622802211034219] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
BACKGROUND The change in estimate is a popular approach for selecting confounders in epidemiology. It is recommended in epidemiologic textbooks and articles over significance test of coefficients, but concerns have been raised concerning its validity. Few simulation studies have been conducted to investigate its performance. METHODS An extensive simulation study was realized to compare different implementations of the change in estimate method. The implementations were also compared when estimating the association of body mass index with diastolic blood pressure in the PROspective Québec Study on Work and Health. RESULTS All methods were susceptible to introduce important bias and to produce confidence intervals that included the true effect much less often than expected in at least some scenarios. Overall mixed results were obtained regarding the accuracy of estimators, as measured by the mean squared error. No implementation adequately differentiated confounders from non-confounders. In the real data analysis, none of the implementation decreased the estimated standard error. CONCLUSION Based on these results, it is questionable whether change in estimate methods are beneficial in general, considering their low ability to improve the precision of estimates without introducing bias and inability to yield valid confidence intervals or to identify true confounders.
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Affiliation(s)
- Denis Talbot
- Département de médecine sociale et préventive, Université Laval, Québec, Canada
- Unité santé des populations et pratiques optimales en santé, CHU de Québec – Université Laval research center, Québec, Canada
| | - Awa Diop
- Département de médecine sociale et préventive, Université Laval, Québec, Canada
- Unité santé des populations et pratiques optimales en santé, CHU de Québec – Université Laval research center, Québec, Canada
- Département de mathématiques et de statistique, Université Laval, Université Laval, Québec, Canada
| | - Mathilde Lavigne-Robichaud
- Département de médecine sociale et préventive, Université Laval, Québec, Canada
- Unité santé des populations et pratiques optimales en santé, CHU de Québec – Université Laval research center, Québec, Canada
| | - Chantal Brisson
- Département de médecine sociale et préventive, Université Laval, Québec, Canada
- Unité santé des populations et pratiques optimales en santé, CHU de Québec – Université Laval research center, Québec, Canada
- Centre de recherche sur les soins et les services de première ligne de l’Université Laval, Québec, Canada
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Chen S, Deng L. Risk factors for radiological hip involvement in patients with ankylosing spondylitis. Rev Assoc Med Bras (1992) 2021; 67:1293-1298. [PMID: 34816923 DOI: 10.1590/1806-9282.20210585] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Accepted: 07/18/2021] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVE Our study aimed to explore the potential risk factors for radiological hip joint involvement in patients with ankylosing spondylitis (AS). METHODS This cross-sectional convey collected the clinical data, laboratory indicators, and radiographic data of patients with AS. Radiographic hip joint involvement was defined as a Bath Ankylosing Spondylitis Radiology Hip Index (BASRI-hip) score ≥2. Multivariate logistic regression analyses were conducted to explore the potential risk factors for radiological hip involvement in patients with AS. RESULTS Based on BASRI-hip score, all enrolled 386 patients with AS were classified as patients involving with radiological hip joint involvement (BASRI-hip ≥2; n=203) and those without it (BASRI-hip ≤1; n=183). Mean age of enrolled patients with AS were 36.7±11.9 years, and 320 (82.9%) patients were male. Mean course of disease was 10.7±8.3 years, and 349 (90.4%) patients were with a positive HLAB27. Multivariate analyses indicated that Juvenile onset (onset age ≤16 years) (odds ratio [OR]=4.159, 95% confidence interval [CI], 1.779-9.721, p<0.001), body mass index (BMI) <18.5 kg/m2 (OR=1.986, 95%CI 1.187-3.323, p=0.009), continuous nonsteroidal anti-inflammatory drug (NSAID) use (OR=0.351, 95%CI 0.155-0.794, p=0.012), and bone mass below the expected range for age (Z score ≤-2) (OR=2.791, 95%CI 1.456-5.352, p=0.002) were independently associated with radiological hip joint involvement in patients with AS. CONCLUSIONS The potential risk factors for radiological hip joint involvement were juvenile onset, lower BMI, and bone mass below the expected range for age. Furthermore, continuous NSAID use was the protective factor for radiological hip joint involvement in these population.
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Affiliation(s)
- Shijun Chen
- Ankang Central Hospital, Department of Hematology and Rheumatology - Shaanxi Province, China
| | - Lei Deng
- Ankang Central Hospital, Department of Hematology and Rheumatology - Shaanxi Province, China
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Korhonen PE, Mikkola T, Kautiainen H, Eriksson JG. Both lean and fat body mass associate with blood pressure. Eur J Intern Med 2021; 91:40-44. [PMID: 33994250 DOI: 10.1016/j.ejim.2021.04.025] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 04/09/2021] [Accepted: 04/23/2021] [Indexed: 12/30/2022]
Abstract
High body mass index (BMI) is known to be associated with elevated blood pressure (BP). The present study aims to determine the relative importance of the two components of BMI, fat mass and lean body mass index, on BP levels. We assessed body composition with bioimpedance and performed 24 hour ambulatory BP measurements in 534 individuals (mean age 61 ± 3 years) who had no cardiovascular medication. Fat mass index and lean mass index were calculated analogously to BMI as fat mass or lean body mass (kg) divided by the square of height (m2). Both fat mass index and lean mass index showed a positive, small to moderate relationship with all 24 hour BP components independently of age, sex, smoking, and leisure-time physical activity. There were no interaction effects between fat mass index and lean mass index on the mean BP levels. Adult lean body mass is a significant determinant of BP levels with an equal, albeit small to moderate magnitude as fat mass. Relatively high amount of muscle mass may not be beneficial to cardiovascular health.
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Affiliation(s)
- Päivi E Korhonen
- Department of General Practice, Turku University and Turku University Hospital, Turku, Finland.
| | - Tuija Mikkola
- Folkhälsan Research Center, Helsinki, Finland; Clinicum, Faculty of Medicine, University of Helsinki, Finland
| | - Hannu Kautiainen
- Folkhälsan Research Center, Helsinki, Finland; Unit of Primary Health Care, Kuopio University Hospital, Kuopio, Finland
| | - Johan G Eriksson
- Folkhälsan Research Center, Helsinki, Finland; Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland; Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore; Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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Kang NL. Association Between Obesity and Blood Pressure in Common Korean People. Vasc Health Risk Manag 2021; 17:371-377. [PMID: 34234445 PMCID: PMC8253898 DOI: 10.2147/vhrm.s316108] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Accepted: 06/14/2021] [Indexed: 12/12/2022] Open
Abstract
Purpose The aim of this study was to investigate the associations of high blood pressure (BP) and wide pulse pressure (PP) with obesity among common Korean people. Materials and Methods This study analyzed data from the Seventh Korean National Health and Nutrition Examination Survey (2017). The associations of BP with body mass index (BMI) and waist-to-height ratio (WHT2R) were investigated using their lump mean values. Results The BPs of males and females increased with BMI, the PP of females increased with BMI and then decreased, and the PP of males is nearly independent of BMI. The BPs of males and females increased to their maximum values with WHT2R and then decreased. The PPs of males and females increased with WHT2R. Conclusion BMI can be used as a useful predictor for high BP, and WHT2R can be used as a useful predictor for wide PP.
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Affiliation(s)
- Nam Lyong Kang
- Department of Nanomechatronics Engineering, Pusan National University, Miryang, 50463, Republic of Korea
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Iqbal A, Ahsan KZ, Jamil K, Haider MM, Khan SH, Chakraborty N, Streatfield PK. Demographic, socioeconomic, and biological correlates of hypertension in an adult population: evidence from the Bangladesh demographic and health survey 2017-18. BMC Public Health 2021; 21:1229. [PMID: 34174868 PMCID: PMC8235611 DOI: 10.1186/s12889-021-11234-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Accepted: 06/08/2021] [Indexed: 02/08/2023] Open
Abstract
Background Bangladesh is well advanced in the epidemiologic transition from communicable to noncommunicable diseases, which now account for two out of three deaths annually. This paper examines the latest nationally representative hypertension prevalence estimates, awareness, treatment, and control—to identify their association with potential correlates. Methods The analyses are based on the recent Bangladesh Demographic and Health Survey 2017–18 data. Univariate analyses and bivariate analyses between the outcome variables and individual covariates were carried out. Then chi-square tests were done to see the proportional differences between them. To examine the demographic, socioeconomic and biological factors affecting hypertension, awareness, treatment and control, we used multivariate logistic regression models. Results We found that prevalence of hypertension for females and males together aged 35 or more has risen by half between 2011 (25.7%) to 2017 (39.4%). With the broader age range used in 2017, the prevalence is now 27.5% in the population aged 18 years or more. The factors associated with hypertension included older age, being female, urban residence, higher wealth status, minimal education, higher body mass index and high blood glucose level. Following multivariate analyses, many of these characteristics were no longer significant, leaving only age, being female, nutritional status and elevated blood glucose level as important determinants. Over half (58%) of females and males who were found to be hypertensive were not aware they had the condition. Only one in eight (13%) had the condition under control. Conclusion In the coming years, a rising trend in hypertension in Bangladeshi adults is expected due to demographic transition towards older age groups and increase in overweight and obesity among the population of Bangladesh. With more women being hypertensive than men, a targeted approach catering to high risk groups should be thoroughly implemented following the Multisectoral NCD Action Plan 2018–2025. Acting in close collaboration with other ministries/relevant sectors to bring an enabling environment for the citizens to adopt healthy lifestyle choices is a prerequisite for adequate prevention. While screening the adult population is essential, the public sector cannot possibly manage the ever-expanding numbers of hypertensives. The private sector and NGOs need to be drawn into the program to assist. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-11234-5.
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Affiliation(s)
- Afrin Iqbal
- Maternal and Child Health Division, icddr,b, Dhaka, Bangladesh.
| | - Karar Zunaid Ahsan
- Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, USA
| | - Kanta Jamil
- IAP, World Services, Alexandria, Virginia, USA
| | - M Moinuddin Haider
- Health Systems and Population Studies Division, icddr,b, Dhaka, Bangladesh
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