Sex, Age, BMI, and C-Reactive Protein Impact the Odds of Developing Hypertension-Findings Based on Data From the Health and Retirement Study (HRS)

Correlation between weight-adjusted-waist index and hypertension in the US population: based on data from NHANES 2005-2018

Objectives

This study aimed to investigate the association between the weight-adjusted waist index (WWI) and the prevalence of hypertension in U.S. adults.

Methods

Data were sourced from the National Health and Nutrition Examination Survey (NHANES) spanning 2005-2018. In our cross-sectional study, we focused on the non-institutional U.S. population over the age of 18 from various communities in the United States. WWI is derived by dividing waist circumference by the square root of body weight. The definition of hypertension was based on self-reported history of hypertension, antihypertensive drug use, and blood pressure measurements. Participants without complete information on WWI and hypertension were excluded. The independent relationship and consistency between WWI and hypertension were assessed through weighted multivariate regression. The Pearson correlation test was used to detect the association between WWI and BMI. Subgroup analyses were used to verify the stability of the relationship between WWI and the prevalence of hypertension, and interaction tests were also conducted by gender, age, smoking, and triglycerides.

Results

Among the 37,299 participants included, the hypertension prevalence was 33.9%. After adjusting for confounding variables, WWI demonstrated a significant association with hypertension. Individuals in the top quarter of WWI had a 2.27fold higher chance of hypertension prevalence compared with the bottom quarter (OR = 2.27, 95% CI 1.97-2.61; P < 0.0001). Subgroup analysis highlighted that this association was particularly pronounced in males aged ≤60 years.

Conclusion

The findings underscore a robust correlation between elevated WWI and a heightened risk of hypertension, especially in males aged ≤60 years.

Nutritional Discrepancies Among Inpatients and Outpatients Diagnosed with Hypertension

Objectives: Arterial hypertension (AH) is one of the most common disorders affecting the human population. The diet of patients with AH can influence the course of the disease and prognosis. The aim of this study was to investigate the differences in nutrition in hospitalised and non-hospitalised hypertensive patients, compared to control groups of non-hypertensive patients from the same medical centres. Methods: Patients from nine centres-six hospitals and three ambulatory care centres-were surveyed. The Questionnaire for the Assessment of Dietary Habits, Lifestyle, and Nutrition Knowledge (KomPAN) was administered by interviewers. Results: Complete results were obtained from 172 hospitalised and 63 non-hospitalised patients. A significantly higher mean body mass index was found for the hypertensive patients (p < 0.001), and a higher unhealthy diet index score was also shown for the hypertensive patients (p = 0.003). Over and above this, a lower mean health-promoting diet index score was found in the hospitalised group (who were on a hospital diet) for the hypertensive patients (p = 0.018). Summary: The study highlights a strong positive correlation between body mass index (BMI) and arterial hypertension (AH), with patients exhibiting higher BMI levels compared to a control group. A BMI of over 25 significantly increases the likelihood of developing AH, and obesity is associated with a higher risk in both men and women. Conclusions: The study indicates that a hospital diet may not be suitable for people with AH. Further research should be conducted to obtain reliable results. Clinical implications: The study showed which factors should be considered when composing a diet for people with hypertension, the relevance of which was demonstrated in the discussion. The study shows that the problem that clinicians have been struggling with for years is still present and inadequately remedied.

Sex-specific relationships of inflammatory biomarkers with blood pressure in older adults

Emerging evidence indicates an association between blood pressure and inflammation, yet this relationship remains unclear in older adults, despite the elevated prevalence of hypertension. We investigated the association between blood pressure, high sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6), and white blood cell (WBC) count in a cohort of 3571 older adults aged 65 and above, and 587 middle-aged participants (55-59 years old). In women aged 65 and above, the relationship between inflammatory markers and blood pressure was consistent, with hs-CRP and WBC emerging as predictors of high blood pressure. For hs-CRP, the adjusted odds ratio (OR) was 1.5 (95% CI, 1.07 to 2.10, P = 0.02), and for WBC, the adjusted OR was 1.41 (95% CI, 1.02 to 1.94, P = 0.04), comparing the highest to the lowest quartiles. In men, only the WBC count was significantly associated with an increased OR for high BP (adjusted OR 1.49, 95% CI, 1.09 to 2.02, P = 0.01) across quartiles. Across the entire study population, in a fully adjusted model, all inflammatory markers were modestly associated with blood pressure levels, while the effect of being over 65 years was the most significant predictor of high blood pressure (OR 1.84, 95% CI, 1.50 to 2.25, P < 0.001). The link between key inflammation markers and blood pressure in older adults varies by sex and biomarker type and may differ from the relationship observed in younger individuals. These relationships are likely to be affected by factors linked to age.

Mediterranean Diet and Ultra-Processed Food Intake in Older Australian Adults-Associations with Frailty and Cardiometabolic Conditions

Dietary patterns contribute to overall health and diseases of ageing but are understudied in older adults. As such, we first aimed to develop dietary indices to quantify Mediterranean Diet Score (MDS) utilisation and Ultra-processed Food (UPF) intake in a well-characterised cohort of relatively healthy community-dwelling older Australian adults. Second, we aimed to understand the relationship between these scores and the association of these scores with prevalent cardiometabolic disease and frailty. Our major findings are that in this population of older adults, (a) pre-frailty and frailty are associated with reduced MDS and increased UPF intake; (b) adherence to MDS eating patterns does not preclude relatively high intake of UPF (and vice versa); and (c) high utilisation of an MDS eating pattern does not prevent an increased risk of frailty with higher UPF intakes. As such, the Mediterranean Diet pattern should be encouraged in older adults to potentially reduce the risk of frailty, while the impact of UPF intake should be further explored given the convenience these foods provide to a population whose access to unprocessed food may be limited due to socioeconomic, health, and lifestyle factors.

Cognitive impairment in cerebral small vessel disease induced by hypertension

ABSTRACT

Hypertension is a primary risk factor for the progression of cognitive impairment caused by cerebral small vessel disease, the most common cerebrovascular disease. However, the causal relationship between hypertension and cerebral small vessel disease remains unclear. Hypertension has substantial negative impacts on brain health and is recognized as a risk factor for cerebrovascular disease. Chronic hypertension and lifestyle factors are associated with risks for stroke and dementia, and cerebral small vessel disease can cause dementia and stroke. Hypertension is the main driver of cerebral small vessel disease, which changes the structure and function of cerebral vessels via various mechanisms and leads to lacunar infarction, leukoaraiosis, white matter lesions, and intracerebral hemorrhage, ultimately resulting in cognitive decline and demonstrating that the brain is the target organ of hypertension. This review updates our understanding of the pathogenesis of hypertension-induced cerebral small vessel disease and the resulting changes in brain structure and function and declines in cognitive ability. We also discuss drugs to treat cerebral small vessel disease and cognitive impairment.

A Bayesian network for estimating hypertension risk due to occupational aluminum exposure

Background

The correlation between metals and hypertension, such as sodium, zinc, potassium, and magnesium, has been confirmed, while the relationship between aluminum and hypertension is not very clear. This study aimed to evaluate the correlation between plasma aluminum and hypertension in electrolytic aluminum workers by the Bayesian networks (BN).

Methods

In 2019, 476 male workers in an aluminum factory were investigated. The plasma aluminum concentration of workers was measured by inductively coupled plasma mass spectrometry. The influencing factors on the prevalence of hypertension were analyzed by the BN.

Results

The prevalence of hypertension was 23.9% in 476 male workers. The risk of hypertension from plasma aluminum in the Q2, Q3, and Q4 groups was 5.20 (1.90-14.25), 6.92 (2.51-19.08), and 7.33 (2.69-20.01), respectively, compared with that in the Q1 group. The risk of hypertension from the duration of exposure to aluminum of >10 years was 2.23 (1.09-4.57), compared without aluminum exposure. Area under the curve was 0.80 of plasma aluminum and the duration of exposure to aluminum was based on covariates, indicating that aluminum exposure had important predictive value in the prevalence of hypertension in the occupational population. The results of the study using the BN model showed that if the plasma aluminum of all participants was higher than Q4 (≥47.86 µg/L) and the participants were drinking, smoking, diabetes, central obesity, dyslipidemia, and aged >50 years, the proportion of hypertension was 71.2%.

Conclusions

The prevalence of hypertension increased significantly with the increase of plasma aluminum level.

Association between systemic immunity-inflammation index and hypertension in US adults from NHANES 1999-2018

Hypertension is a disease closely related to inflammation, and the systemic immunity-inflammation index (SII) is a new and easily detectable inflammatory marker. We aimed to investigate the association between SII and hypertension risk in a adult population in the US. We utilized data from the National Health and Nutrition Examination Survey spanning from 1999 to 2018, incorporating comprehensive information from adults reporting hypertension. This included details on blood pressure monitoring, complete blood cell counts, and standard biochemical results. The SII was computed as the platelet count multiplied by the neutrophil count divided by the lymphocyte count. We employed a weighted multivariate logistic regression model to examine the correlation between SII and hypertension. Subgroup analyses were conducted to explore potential influencing factors. Furthermore, smooth curve fitting and two-piecewise logistic regression analysis were employed to describe non-linear relationships and identify inflection points. This population-based study involved 44,070 adults aged 20-85 years. Following Ln-transformation of the SII, multivariable logistic regression revealed that, in a fully adjusted model, participants in the highest quartile of Ln(SII) had a 12% increased risk of hypertension compared to those in the lowest quartile, which was statistically significant (OR:1.12; 95% CI 1.01, 1.24; P < 0.001), with a P for trend = 0.019. Subgroup analysis indicated no significant interactions between Ln(SII) and specific subgroups except for the body mass index subgroup (all P for interaction > 0.05). Additionally, the association between Ln(SII) and hypertension displayed a U-shaped curve, with an inflection point at 5.89 (1000 cells/μl). Based on this research result, we found a U-shaped correlation between elevated SII levels and hypertension risk in American adults, with a inflection point of 5.89 (1000 cells)/μl). To validate these findings, larger scale prospective surveys are needed to support the results of this study and investigate potential mechanisms.

Sex-specific difference in the relationship between body fat percentage and arterial stiffness: Results from Fuzhou study

Obesity and overweight are closely related to cardiovascular mortality. Arterial stiffness is one of the important risks for cardiovascular diseases and is strongly related with the cardiovascular mortality. However, the relationship between obesity and arterial stiffness is still controversial. A cross-sectional study was performed to examine the relationship of body fat percentage (BFP), an indicator of obesity, with carotid-femoral pulse wave velocity (cfPWV) in 2603 subjects (aged 58.62 ± 11.27 years, male 71.07%, hypertension 64.89%). All participants were divided into four groups according to the gender and the presence of arterial stiffening based on a value ≥10 m/s of cfPWV(group1 : male with cfPWV <10 m/s, group2 : male with cfPWV ≥10 m/s, group3 : female with cfPWV <10 m/s, group4 : female with cfPWV ≥10 m/s). Body weight, height, waist circumference, blood pressure were measured and clinical biochemical tests were recorded. cfPWV was measured using a non-invasive automatic device (Complior Analysis, France). BFP were calculated by CUN-BAE equation. The level of cfPWV was significantly increased with the increasing trend of BFP in both males and females. Stepwise multiple regression analysis revealed that SBP, DBP, HR, Hcy, BFP, FPG were independent associated with cfPWV in females and SBP, eGFR, FPG, BFP, DBP were independent associated with cfPWV in males. In the subgroups stratified by age, BFP was correlated with cfPWV only in females over 60 years old, but not in female those aged under 60 years old and males. In addition to the age and blood pressure, BFP was one of important predictor of arterial stiffening special in females aged over 60 years old.

The relationship between serum C-reactive protein and senile hypertension

BACKGROUND

Hypertension has become an important health risk factor in the twenty-first century, especially for the elderly. Studies have confirmed that inflammation is involved in the development of hypertension and that the inflammatory marker C-reactive protein(CRP) is significantly associated with hypertension. Therefore, in this study, we aimed to explore the CRP correlation with hypertension in the elderly.

METHODS

Serum CRP levels were measured in 196 hospitalized patients, and the CRP level was used as a criterion to divide them into the group with elevated CRP (> 10 mmol/L, n = 120) and the group with normal CRP (0 < CRP ≤ 10 mmol/L, n = 76). and the patient's baseline characteristics were collected and compared between the groups, and the correlation between CRP and other factors and hypertension in the elderly was analyzed by multi-factor logistic regression.

RESULTS

The prevalence of hypertension, coronary artery disease and joint reactive inflammation was significantly higher in the group with elevated CRP. There was also a significant association between the use of alcohol, low density lipoprotein cholesterol (LDL-C) and steroids and elevated CRP; logistic regression showed that elevated CRP (OR = 2.13, 95% CI: 1.14-3.99, p = 0.019), body mass index (BMI) (OR = 1.10, 95% CI:1.01-1.90, p = 0.030), diabetes (OR = 2.68, 95% CI:1.24-5.79, p = 0.012) were positively associated with hypertension, while statins use was negatively associated with hypertension (OR = 0.49, 95% CI: 0.25-0.94, p = 0.013).

CONCLUSIONS

Elevated CRP, BMI, and diabetes are positively associated with hypertension in the elderly, and early screening for CRP and initiation of treatment may help prevent further inflammatory responses in hypertension.

Impact of Physical Activity on Adiposity and Risk Markers for Cardiovascular and Metabolic Disease

The main aim of the present study was to investigate the impact of physical activity (PA) on adiposity and for cardiovascular and metabolic disease risk markers (CMDRMs). In total, 55 adults (33 lean [L] and 22 overweight/obesity [O/O]) visited the laboratory on two occasions. During the first session, body composition and anthropometric measurements were taken as well as resting blood pressure (BP). Free-living PA intensity was monitored using an ActiGraph accelerometer, which the participants wore for a period of 6 days. During the second visit, blood samples for the analysis of disease risk markers were obtained from the participants in the morning after overnight fasting (≥10 hr). There was no significant difference between groups in the percentage of time spent in PA levels (54.5% ± 1.2% and 54.9% ± 2.1% for L and O/O, respectively). Although, the O/O group was within recommended PA level, they had higher leptin, insulin, homeostatic model assessment of insulin resistance (HOMA-IR), and high-sensitivity C-reactive protein (hsCRP) levels than the L group (all p < .01). The O/O group had higher levels of triglycerides, low-density lipoprotein (LDL), and very low-density lipoprotein (VLDL) and lower levels of high-density lipoprotein (HDL; all p < .01). Interestingly, vigorous activity was positively correlated with HDL (r = .30, p < .05) and negatively with LDL (r = -.26, p = .05) levels and the arachidonic acid to eicosapentaenoic acid (ARA/EPA) ratio (r = -.30, p < .05). Only the O/O group had elevated CMDRMs. However, vigorous activity may improve health-related blood lipids such as HDL, LDL, and ARA/EPA ratio. Regardless of body composition status, low active participants were more likely to have higher level of leptin and hsCRP. Further exploration of the beneficial effects of vigorous exercise on adiposity and CMDRMs is warranted.