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Kataria N, Kalyani VC, Gulia S, G K. Knowledge Regarding Hypertension and Amount of Diet Consumption Among Adults From Uttarakhand: A Comparative Survey. Cureus 2023; 15:e39065. [PMID: 37323337 PMCID: PMC10267604 DOI: 10.7759/cureus.39065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/15/2023] [Indexed: 06/17/2023] Open
Abstract
BACKGROUND Hypertension is becoming more common worldwide, and by 2025, its incidence is predicted to rise by 32.4%. The present study aims to assess the knowledge related to hypertension and the amount of diet consumption among adults at risk of developing hypertension in both rural and urban areas of Uttarakhand. METHODS A cross-sectional survey was conducted on 667 adults at risk of hypertension. The study sample included adults selected from the rural and urban communities of Uttarakhand. A semi-structured questionnaire on knowledge regarding hypertension and self-reported amount of diet consumption was used as a tool for data collection. RESULTS The mean age of participants in this study was 51.46 ± 1.44 years, and the majority of the participants had poor knowledge regarding hypertension as a disease and its consequences as well as preventive measures. The mean days for consumption of fruits were three days, four days for green vegetables, two days for eggs, and two days for a well-balanced diet, and the mean ± SD of a non-vegetarian diet consumption was 128 ± 182 gm. Another highlighted significant mean difference was found between knowledge of raised blood pressure with the amount of consumption of fruits, green leafy vegetables, a non-vegetarian diet, and a well-balanced diet. CONCLUSION In the present study, knowledge of blood pressure and raised blood pressure with its related factors was poor among all participants. The average consumption of all types of diet was two to three days a week, which was borderline, based on recommended dietary allowances. The knowledge related to raised blood pressure and its associated factors had significant mean differences for the mean consumption of fruits, non-vegetarian diet, and well-balanced diet.
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Affiliation(s)
- Neetu Kataria
- Neurosciences Nursing, All India Institute of Medical Sciences, Rishikesh, IND
| | - Vasantha C Kalyani
- Medical Surgical Nursing, All India Institute of Medical Sciences, Deoghar, IND
| | - Sonia Gulia
- Medical Surgical Nursing, All India Institute of Medical Sciences, Rishikesh, IND
| | - Kaleeswari G
- Medical Surgical Nursing, All India Institute of Medical Sciences, Rishikesh, IND
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Morvaridzadeh M, Qorbani M, Shokati Eshkiki Z, Estêvão MD, Mohammadi Ganjaroudi N, Toupchian O, Abdollahi S, Pizarro AB, Abu-Zaid A, Zadro JR, Heshmati J, Ziaei S. The effect of almond intake on cardiometabolic risk factors, inflammatory markers, and liver enzymes: A systematic review and meta-analysis. Phytother Res 2022; 36:4325-4344. [PMID: 36331011 DOI: 10.1002/ptr.7622] [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: 05/29/2021] [Revised: 07/06/2022] [Accepted: 08/20/2022] [Indexed: 11/06/2022]
Abstract
Almond intake may be correlated with improvements in several cardiometabolic parameters, but its effects are controversial in the published literature, and it needs to be comprehensively summarized. We conducted a systematic search in several international electronic databases, including MEDLINE, EMBASE, Scopus, Web of Science, Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov until April 2021 to identify randomized controlled trials that examined the effects of almond consumption on cardiometabolic risk factors, inflammatory markers, and liver enzymes. Data were pooled using the random-effects model method and presented as standardized mean differences (SMDs) with 95% confidence intervals (CIs). Twenty-six eligible trials were analyzed (n = 1750 participants). Almond intake significantly decreased diastolic blood pressure, total cholesterol, triglyceride, low-density lipoprotein (LDL), non-high-density lipoprotein (HDL), and very LDL (p < 0.05). The effects of almond intake on systolic blood pressure, fasting blood glucose, insulin, hemoglobin A1c, homeostatic model assessment of insulin resistance, C-peptide, alanine aminotransferase, aspartate aminotransferase, gamma-glutamyl transferase, C-reactive protein (CRP), hs-CRP (high sensitivity C-reactive protein), interleukin 6, tumor necrosis factor-α, ICAM (Intercellular Adhesion Molecule), VCAM (Vascular Cell Adhesion Molecule), homocysteine, HDL, ox-LDL, ApoA1, ApoB, and lipoprotien-a were not statistically significant (p > .05). The current body of evidence supports the ingestion of almonds for their beneficial lipid-lowering and antihypertensive effects. However, the effects of almonds on antiinflammatory markers, glycemic control, and hepatic enzymes should be further evaluated via performing more extensive randomized trials.
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Affiliation(s)
- Mojgan Morvaridzadeh
- Songhor Healthcare Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mostafa Qorbani
- Non-communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran.,Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Shokati Eshkiki
- Alimentary Tract Research Center, Clinical Science Reseaech Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - M Dulce Estêvão
- Escola Superior de Saúde, Universidade do Algarve, Faro, Portugal
| | | | - Omid Toupchian
- Department of Nutrition and Public Health, School of Health, North Khorasan University of Medical Sciences, Bojnurd, Iran
| | - Shima Abdollahi
- Department of Nutrition and Public Health, School of Health, North Khorasan University of Medical Sciences, Bojnurd, Iran
| | | | - Ahmed Abu-Zaid
- Department of Pharmacology, College of Graduate Health Sciences, University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Joshua R Zadro
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia
| | - Javad Heshmati
- Songhor Healthcare Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Somayeh Ziaei
- Anesthesiologist, ICU Department, Emam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
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Humbert X, Licaj I, Fedrizzi S, Alexandre J, Menotti A, Manrique A, Allouche S, Touzé E, Terradura-Vagnarelli O, Puddu PE. Relationship between lifestyle factors and hypertension: a cross-sectional analysis from the Gubbio study. Acta Cardiol 2022:1-9. [PMID: 35727257 DOI: 10.1080/00015385.2022.2088170] [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: 11/01/2022]
Abstract
BACKGROUND Hypertension (HTN) is a well-established and a major risk factor for cardiovascular disease. Lifestyle behaviours for its prevention and control are recommended within worldwide guidelines. Their relationship with HTN need more investigations. AIM We aimed to investigate the associations between lifestyle, anthropometric and biological measurements and BP in the Gubbio residential study. METHODS Cross-sectional analyses were performed using data from Gubbio study. Information concerning lifestyle factors were collected using self-reported questionnaire and were further completed with a baseline clinical examination and blood exams. Three BP measurements were performed following a standard protocol. Age-adjusted and multivariable logistic regressions were used to examine the relationships between lifestyle parameters and HTN separately for each sex. We used heterogeneity test to observe sex differences. RESULTS There were 3,183 persons included (48% men, 43 ± 17 years old). Mean systolic BP (SBP) was 119 ± 16 mmHg and 10.6% were hypertensives. Age [OR: 129.70 (95%CI: 18.57-905.79) in women and OR: 8.37 (95%CI: 4.01-17.48) (p < 0.0001) in men] and BMI [OR: 2.14 (95%CI: 1.32-3.46) (p = 0.006) in women and OR: 1.81 (95%CI: 1.05-3.12), p = 0.03 in men], were positively associated with SBP in both sexes. Serum uric acid [OR: 3.86 (95%CI: 2.03-7.26), p = 0.04] was positively associated with HTN in women while fasting blood glucose [OR: 3.04 (95%CI: 1.55-5.97), p < 0.001] were associated to HTN only in men. DISCUSSION In addition to age, BMI is associated with HTN in both sexes while sex differences were observed in the associations between serum uric acid, fasting blood glucose and HTN.
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Affiliation(s)
- Xavier Humbert
- Department of General Medicine, Medical School, UNICAEN, Normandie Université, Caen, France
| | - Idlir Licaj
- Department of Community Medicine, Faculty of Health Sciences, The UiT Arctic University of Norway, Tromsø, Norway
| | - Sophie Fedrizzi
- Department of Pharmacology, UNICAEN, Normandie Université, Caen, France
| | - Joachim Alexandre
- Department of Pharmacology, UNICAEN, Normandie Université, Caen, France
| | | | - Alain Manrique
- Department of Nuclear Medicine, CHU Caen, EA 4650UNICAEN, Normandie Université, Caen, France
| | - Stéphane Allouche
- Department of Biochemistry, CHU Caen, EA 4650, UNICAEN, Normandie Université, Caen, France
| | - Emmanuel Touzé
- Department of Neurology, CHU Caen, INSERM U 1237. UNICAEN, Normandie Université, Caen, France
| | | | - Paolo E Puddu
- EA 4650, UNICAEN, Normandie Université, Caen, France
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Jenzer H, Sadeghi-Reeves L. Nutrigenomics-Associated Impacts of Nutrients on Genes and Enzymes With Special Consideration of Aromatase. Front Nutr 2020; 7:37. [PMID: 32328497 PMCID: PMC7161344 DOI: 10.3389/fnut.2020.00037] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Accepted: 03/11/2020] [Indexed: 12/16/2022] Open
Abstract
Interactions are occurring in the course of liberation, absorption, distribution, metabolism, and excretion of active ingredients, or at the target receptors. They are causing therapy failures and undesirable events. Forty-seven of fifty-seven human hepatic isoenzymes are specific and relevant in hormone and vitamin metabolism and biosynthesis. Aromatase (syn. CYP19A1) is one of the specific CYP450 isoenzymes so far not elucidated in detail. As aromatase-inhibiting phytochemicals are currently recommended for breast cancer prevention and as add-on accompanying aromatase-inhibitor pharmacotherapy, it was the aim of this literature review to assess whether a common interpretation on genetic and -omics basis could be found. Articles retrieved showed that traditional antioxidation diet is one of the most approved explanations of inhibition of aromatase by phytonutrients of flavonoid derivatives. Flavonoids compete for the oxygen provided by the heme moiety of aromatase in the course of aromatase-catalyzed conversion of steroid precursors to estrogens. Flavonoids are therefore promoted for breast cancer prevention. A further explanation of flavonoids' mechanism of action proposed was related to enzymatic histone deacetylation. By keeping DNA-structure wide through a high acetylation degree, acetylated histones favor transcription and replication. This mechanism corresponds to a procedure of switching genes on. Inhibiting acetylation and therefore switching genes off might be an important regulation of repressing cancer genes. Aromatase expression depends on the genotype and phenotype of a person. Aromatase itself depends on the expression of the heme moiety encoded in the genotype. Biosynthesis of porphyrins in turn depends on the substrates succinate and glycine, as well as on a series of further enzymes, with ALA synthetase as the rate-limiting step. The effect of the heme moiety as prosthetic group of aromatase further depends on the absorption of iron as a function of pH and redox state. To assess the function of aromatase precisely, multiple underlying biochemical pathways need to be evaluated. As a conclusion, the genetic regulation of metabolism is a complex procedure affecting multiple pathways. To understand a metabolic step, multiple underlying individually performing reactions need to be considered if personalized (nutritional) medicine should bring an advantage for a patient. Nutrition sciences need to consider the genome of an individual to truly find answers to nutrition-derived non-communicable diseases. With current GWAS (genome-wide association study) approaches, inherited errors of metabolism are identified and ideally treated effectively. It is much more difficult to get a precise genetic profile for non-communicable diseases stemming from multifactorial causes. Polygenic risks evaluation is feasible but diagnostic tools are not yet available in a desired extent. Neither flavonoid researchers nor providers of genetic testing kits are going into the details needed for a truly personalized nutritional medicine. The next step with profiling the exome and then the whole genome is on the threshold of becoming routine diagnosis and of bringing the desired details.
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Affiliation(s)
- Helena Jenzer
- Department of Health Professions, aR&D in Nutrition and Dietetics, Bern University of Applied Sciences BFH, Bern, Switzerland
- Internistic Service, Hospital Pharmacy, Hospital of Psychiatry, University of Zurich, Zurich, Switzerland
| | - Leila Sadeghi-Reeves
- Department of Health Professions, aR&D in Nutrition and Dietetics, Bern University of Applied Sciences BFH, Bern, Switzerland
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Salvador MR, Cunha Gonçalves S, Quinaz Romana G, Nunes B, Kislaya I, Matias Dias C, Rodrigues AP. Effect of lifestyle on blood pressure in patients under antihypertensive medication: An analysis from the Portuguese Health Examination Survey. Rev Port Cardiol 2020; 38:697-705. [PMID: 31955972 DOI: 10.1016/j.repc.2018.12.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Revised: 12/21/2018] [Accepted: 12/27/2018] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION AND OBJECTIVES Hypertension is one of the main risk factors for disability and death from cardiovascular disease. Current guidelines include initiatives to control blood pressure in hypertensive patients that focus on lifestyle changes. The main objective of this study was to analyze the association between lifestyle and blood pressure in patients under antihypertensive medication. METHODS Data collected in the Portuguese National Health Examination Survey (INSEF) were analyzed. Individuals who met INSEF inclusion criteria and reported being under antihypertensive medication in the two weeks prior to the questionnaire were studied. Lifestyle variables (alcohol consumption, smoking, added salt intake, fruit and vegetable consumption, and physical activity) were assessed by questionnaire, and systolic and diastolic blood pressure were measured by physical examination. Associations between lifestyle factors and blood pressure, stratified by gender and adjusted for sociodemographic variables and obesity, were estimated through a multiple linear regression model. RESULTS Alcohol consumption (beta=6.31, p=0.007) and smoking (beta=4.72, p=0.018) were positively associated with systolic blood pressure in men. Added salt intake, fruit and vegetable consumption, and physical activity were not associated with blood pressure in men. In women, no association was observed for any behavioral variable. CONCLUSIONS These conclusions highlight the need in the population under antihypertensive medication, particularly in men, to focus on the fight against high systolic blood pressure in the two modifiable and preventable behaviors of smoking and alcohol consumption.
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Affiliation(s)
- Mário Rui Salvador
- Unidade de Saúde Pública, ACES Dão Lafões, Viseu, Portugal; Departamento de Epidemiologia, Instituto Nacional de Saúde Doutor Ricardo Jorge, Lisboa, Portugal.
| | - Susana Cunha Gonçalves
- Unidade de Saúde Pública, ACES Médio Tejo, Alcanena, Portugal; Departamento de Epidemiologia, Instituto Nacional de Saúde Doutor Ricardo Jorge, Lisboa, Portugal
| | - Guilherme Quinaz Romana
- Unidade de Saúde Pública, ACES Lisboa Norte, Lisboa, Portugal; Departamento de Epidemiologia, Instituto Nacional de Saúde Doutor Ricardo Jorge, Lisboa, Portugal
| | - Baltazar Nunes
- Departamento de Epidemiologia, Instituto Nacional de Saúde Doutor Ricardo Jorge, Lisboa, Portugal
| | - Irina Kislaya
- Departamento de Epidemiologia, Instituto Nacional de Saúde Doutor Ricardo Jorge, Lisboa, Portugal
| | - Carlos Matias Dias
- Departamento de Epidemiologia, Instituto Nacional de Saúde Doutor Ricardo Jorge, Lisboa, Portugal
| | - Ana Paula Rodrigues
- Departamento de Epidemiologia, Instituto Nacional de Saúde Doutor Ricardo Jorge, Lisboa, Portugal
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Salvador MR, Cunha Gonçalves S, Quinaz Romana G, Nunes B, Kislaya I, Matias Dias C, Rodrigues AP. Effect of lifestyle on blood pressure in patients under antihypertensive medication: An analysis from the Portuguese Health Examination Survey. REVISTA PORTUGUESA DE CARDIOLOGIA (ENGLISH EDITION) 2019. [DOI: 10.1016/j.repce.2020.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Vallée A, Perrine AL, Deschamps V, Blacher J, Olié V. Relationship Between Dynamic Changes in Body Weight and Blood Pressure: The ESTEBAN Survey. Am J Hypertens 2019; 32:1003-1012. [PMID: 31219160 DOI: 10.1093/ajh/hpz096] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2019] [Revised: 05/20/2019] [Accepted: 06/07/2019] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Obesity is one of the main determinants of blood pressure. The aim of this study was to evaluate and quantify the relations between the different anthropometric indices and blood pressure (BP) stratified by gender. METHODS Cross-sectional analyses were performed using data from 2,105 adults from the ESTEBAN survey, a representative sample of the French population. Partial Pearson correlation analysis was used to assess the correlation between BP and anthropometric indices. Regressions were adjusted on age, antihypertensive therapies, socioeconomic levels, dietary intakes, and cardiovascular risk factors. A weight variation index, as adjusted weight variation/year, was calculated as (weight maximum - weight minimum) / (age of weight max - age of weight min). This index was adjusted on the BMI reported during the inclusion and time elapsed since weight variation from the moment of inclusion. RESULTS In the Esteban population stratified by gender, this weight index had the highest r-value of correlation with all BP parameters compared with all anthropometric indices (WC, WHR, WHtR) in both genders. In men, weight variation more than +1 kg/year is associated with 5.5 mm Hg increase in systolic BP and with 1.8 mm Hg increase in diastolic BP. In women, more than +1 kg/year is associated with 3.3 mm Hg increase in systolic BP and with 1.0 mm Hg increase in diastolic BP. CONCLUSION A dynamic view of body weight change appears more predictive in BP change than a static view expressed by BMI. Public health initiatives to maintain a youthful body weight during life course are majors to prevent hypertension. REGISTRATION The study was registered in the French National Agency for Medicines and Health Products Safety (no. 2012-A00456-34) and was approved by the Advisory Committee for Protection of Persons in Biomedical Research.
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Affiliation(s)
- Alexandre Vallée
- Paris-Descartes University, Paris, France
- Diagnosis and Therapeutic Center, Hypertension and Cardiovascular Prevention Unit, Hôtel-Dieu Hospital, Paris, France
- AP-HP, Paris, France
| | - Anne-Laure Perrine
- Santé Publique France, the French Public Health Agency, Saint-Maurice, France
| | - Valérie Deschamps
- Santé Publique France, the French Public Health Agency, Saint-Maurice, France
| | - Jacques Blacher
- Paris-Descartes University, Paris, France
- Diagnosis and Therapeutic Center, Hypertension and Cardiovascular Prevention Unit, Hôtel-Dieu Hospital, Paris, France
- AP-HP, Paris, France
| | - Valérie Olié
- Santé Publique France, the French Public Health Agency, Saint-Maurice, France
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Zhang Y, Shi F, Yu Z, Yang A, Zeng M, Wang J, Yin H, Zhang B, Ma X. A cross-sectional study on factors associated with hypertension and genetic polymorphisms of renin-angiotensin-aldosterone system in Chinese hui pilgrims to hajj. BMC Public Health 2019; 19:1223. [PMID: 31484569 PMCID: PMC6727391 DOI: 10.1186/s12889-019-7357-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Accepted: 07/22/2019] [Indexed: 01/11/2023] Open
Abstract
Background Hypertension is the leading risk factor for cardiovascular disease (CVD), however, the studies on lifestyle and genetic risks in Chinese pilgrims to Hajj was limited. The aim of this study is to examine the prevalence and associated lifestyle and genetic risks for hypertension among Hui Hajj pilgrims in China. Methods We performed a cross-sectional analysis of data in 1,465 participants aged 30–70 years who participated in a medical examination for Hui Hajj pilgrims from Gansu province, China in 2017. Multiple logistic regression was used to evaluate the association of potential risk factors with hypertension. Deoxyribonucleic acid (DNA) polymorphism was examined at sites in the renin-angiotensin-aldosterone system (RAAS). Results The prevalence of hypertension was 47% among this population. Lifestyle factors such as fried food preference (like vs. dislike: odds ratio [OR]: =1.53, 95% confidence interval [CI]: 1.13–2.09) and barbecued food preference (like vs. dislike: OR = 1.45, 95% CI: 1.06–1.97) were associated with elevated risk of hypertension among Hui pilgrims. Comparing with Angiotensin converting enzyme (ACE) rs4425 AA genotype, TT genotype was associated with hypertension risk (OR = 2.16, 95% CI: 1.17–4.00). Similar results were also observed for ACE rs4437 CC genotype (OR = 1.95, 95% CI: 1.07–3.55), Angiotensin II receptor (ATR) rs129876 AA genotype (OR = 4.10, 95% CI: 2.30–7.32) and Aldosterone synthase (CYP11B2) rs1912 TT genotype (OR = 2.82, 95% CI: 1.57–5.06) genotypes. Conclusions Unhealthy lifestyle and genetic factors were associated with the prevalence of hypertension in Chinese Hui pilgrims and their interactions were also observed. Electronic supplementary material The online version of this article (10.1186/s12889-019-7357-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Yinxia Zhang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, 610000, China.,Northwest Minzu University, Lanzhou, 730030, China
| | - Fangfang Shi
- Center for Disease Control and Prevention, Kongtong District, Pingliang, Gansu, China
| | - Zhanbiao Yu
- Qingyang People's Hospital, Qingyang, 745000, China
| | - Aimin Yang
- Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Kowloon, Hong Kong SAR
| | - Maolan Zeng
- Northwest Minzu University, Lanzhou, 730030, China
| | - Jiaoyue Wang
- Gansu International Travel Healthcare Center, Lanzhou, 730000, China
| | - Haiping Yin
- Gansu International Travel Healthcare Center, Lanzhou, 730000, China
| | - Benzhong Zhang
- School of Public Health, Lanzhou University, Lanzhou, 730000, China
| | - Xiao Ma
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, 610000, China.
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Lelong H, Blacher J, Baudry J, Adriouch S, Galan P, Fezeu L, Hercberg S, Kesse-Guyot E. Combination of Healthy Lifestyle Factors on the Risk of Hypertension in a Large Cohort of French Adults. Nutrients 2019; 11:nu11071687. [PMID: 31340445 PMCID: PMC6683281 DOI: 10.3390/nu11071687] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 07/18/2019] [Accepted: 07/19/2019] [Indexed: 02/07/2023] Open
Abstract
Background: Healthy lifestyle factors are widely recommended for hypertension prevention and control. Nevertheless, little is known about their combined impact on hypertension, in the general population. Our aim was to compute a Healthy Lifestyle Index (HLI) comprising the main non-pharmacological measures usually recommended to improve hypertension prevention: normal weight, regular physical activity, limited alcohol consumption, adoption of a healthy diet; to evaluate their combined impact on hypertension incidence. Methods: We prospectively followed the incidence of hypertension among 80,426 French adults participating in the NutriNet-Santé cohort study. Self-reported dietary, socio-demographic, lifestyle and health data were assessed at baseline and yearly using a dedicated website; the association between HLI and hypertension risk was assessed by multivariable Cox proportional hazards models adjusted for age, sex, family history of hypertension, socio-demographic and lifestyle factors. Hypothetical Population Attributable Risks associated to each factor were estimated. Results: During a median follow-up of 3.5 years (IQR: 1.5–5.3), 2413 incident cases of hypertension were identified. Compared with no or one healthy lifestyle factor, the hazard ratios (HR) for hypertension were 0.76 (95% CI, 0.67–0.85) for two factors, 0.47 (95% CI, 0.42–0.53) for three factors and 0.35 (95% CI, 0.30–0.41) for all healthy lifestyle factors (p-trend <0.0001). Compared with adhering to 0, 1, 2 or 3 healthy lifestyles, adhering to all of them was found associated with a reduction of the hypertension risk of half (HR = 0.55 (95% CI, 0.46–0.65)). Conclusion: Active promotion of healthy lifestyle factors at population level is a key leverage to fight the hypertension epidemic.
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Affiliation(s)
- Helene Lelong
- AP-HP, Diagnosis and Therapeutic Center, Faculty of Medicine, Hôtel-Dieu Hospital, Paris-Descartes University, 75004 Paris, France.
- UREN (Nutritional Epidemiology Research Unit)-U557 INSERM, U1125 INRA, CNAM, CRNH IdF, Paris 13, Sorbonne Paris Cité University, 93000 Bobigny, France.
| | - Jacques Blacher
- AP-HP, Diagnosis and Therapeutic Center, Faculty of Medicine, Hôtel-Dieu Hospital, Paris-Descartes University, 75004 Paris, France
- UREN (Nutritional Epidemiology Research Unit)-U557 INSERM, U1125 INRA, CNAM, CRNH IdF, Paris 13, Sorbonne Paris Cité University, 93000 Bobigny, France
| | - Julia Baudry
- UREN (Nutritional Epidemiology Research Unit)-U557 INSERM, U1125 INRA, CNAM, CRNH IdF, Paris 13, Sorbonne Paris Cité University, 93000 Bobigny, France
| | - Solia Adriouch
- UREN (Nutritional Epidemiology Research Unit)-U557 INSERM, U1125 INRA, CNAM, CRNH IdF, Paris 13, Sorbonne Paris Cité University, 93000 Bobigny, France
| | - Pilar Galan
- UREN (Nutritional Epidemiology Research Unit)-U557 INSERM, U1125 INRA, CNAM, CRNH IdF, Paris 13, Sorbonne Paris Cité University, 93000 Bobigny, France
| | - Leopold Fezeu
- UREN (Nutritional Epidemiology Research Unit)-U557 INSERM, U1125 INRA, CNAM, CRNH IdF, Paris 13, Sorbonne Paris Cité University, 93000 Bobigny, France
| | - Serge Hercberg
- UREN (Nutritional Epidemiology Research Unit)-U557 INSERM, U1125 INRA, CNAM, CRNH IdF, Paris 13, Sorbonne Paris Cité University, 93000 Bobigny, France
- Department of Public Health, Avicenne Hospital, 93000 Bobigny, France
| | - Emmanuelle Kesse-Guyot
- UREN (Nutritional Epidemiology Research Unit)-U557 INSERM, U1125 INRA, CNAM, CRNH IdF, Paris 13, Sorbonne Paris Cité University, 93000 Bobigny, France
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Relationship between Nutrition and Alcohol Consumption with Blood Pressure: The ESTEBAN Survey. Nutrients 2019; 11:nu11061433. [PMID: 31242675 PMCID: PMC6627946 DOI: 10.3390/nu11061433] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Revised: 06/19/2019] [Accepted: 06/24/2019] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Dietary interventions are recommended for the prevention of hypertension. The aim of this study was to evaluate and quantify the relationship between alcohol consumption and the DASH (Dietary Approaches to Stop Hypertension) score with blood pressure (BP) stratified by gender. METHODS Cross-sectional analyses were performed using data from 2105 adults from the ESTEBAN survey, a representative sample of the French population. Pearson correlation analyses were used to assess the correlation between the DASH score and alcohol with BP. Regressions were adjusted by age, treatment, socio-economic level, tobacco, exercise, Body mass index (BMI), and cardiovascular risk factors and diseases. RESULTS The DASH score was negatively correlated with systolic (SBP) and diastolic BP (DBP) (p < 0.0001). Alcohol was positively associated with increased BP only in men. The worst quintile of the DASH score was associated with an 1.8 mmHg increase in SBP and an 0.6 mmHg increase in SBP compared to the greatest quintile in men and with a 1.5 mmHg increase in SBP and an 0.4 mmHg increase in SBP in women. Male participants in the worst quintile of alcohol consumption showed an increase of 3.0 mmHg in SBP and 0.8 mmHg in DBP compared to those in the greatest quintile. CONCLUSION A high DASH score and a reduction in alcohol consumption could be effective nutritional strategies for the prevention of hypertension.
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Yasutake K, Umeki Y, Horita N, Morita R, Murata Y, Ohe K, Tsuchihashi T, Enjoji M. A self-monitoring urinary salt excretion level measurement device for educating young women about salt reduction: A parallel randomized trial involving two groups. J Clin Hypertens (Greenwich) 2019; 21:730-738. [PMID: 31058457 DOI: 10.1111/jch.13545] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2019] [Revised: 03/19/2019] [Accepted: 04/02/2019] [Indexed: 11/29/2022]
Abstract
To prevent and treat hypertension, it is important to restrict salt in one's diet since adolescence. However, an effective salt-reduction education system has yet to be established. Besides accurate evaluation, we believe that the frequent usage of a measurement device may motivate individuals to avoid high salt intake. The present study evaluated the use of a urinary salt excretion measurement device for salt-reduction education in a parallel randomized trial of two groups. The sample comprised 100 university students who provided consent to participate. A survey with 24-hour home urine collection and blood pressure measurement was conducted. Participants in the self-monitoring group measured their own urinary salt excretion level for 4 weeks, using the self-measurement device. Analyses were conducted on 51 participants in the control group and 49 in the self-monitoring group. At baseline, there was no significant difference between the two groups in terms of their characteristics and 24-hour urinary salt excretion levels. After intervention, 24-hour urinary sodium/potassium ratio showed no change in the control group [baseline score: 4.1 ± 1.5; endline score: 4.2 ± 2.0; P = 0.723], but it decreased significantly in the self-monitoring group [baseline score: 4.0 ± 1.7; endline score: 3.5 ± 1.4; P = 0.044]. This change was significant even after adjusting for baseline and endline differences between groups using analysis of covariance (P = 0.045). The self-monitoring urinary salt excretion measurement device improved the 24-hour urinary sodium/potassium ratio. The device is a useful and practical tool for educating young individuals about dietary salt reduction.
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Affiliation(s)
- Kenichiro Yasutake
- Department of Nutritional Sciences, Faculty of Nutritional Sciences, Nakamura Gakuen University, Fukuoka, Japan
| | - Yoko Umeki
- Department of Food of Health Sciences, International College of Arts and Sciences, Fukuoka Women's University, Fukuoka, Japan
| | - Noriko Horita
- Department of Health and Nutrition Sciences, Faculty of Health and Nutrition Sciences, Nishikyushu University, Kanzaki, Japan
| | - Rieko Morita
- Department of Food of Health Sciences, International College of Arts and Sciences, Fukuoka Women's University, Fukuoka, Japan
| | - Yusuke Murata
- Health Care Center, Fukuoka University, Fukuoka, Japan
| | - Kenji Ohe
- Health Care Center, Fukuoka University, Fukuoka, Japan
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Kimani S, Mirie W, Chege M, Okube OT, Muniu S. Association of lifestyle modification and pharmacological adherence on blood pressure control among patients with hypertension at Kenyatta National Hospital, Kenya: a cross-sectional study. BMJ Open 2019; 9:e023995. [PMID: 30782721 PMCID: PMC6340423 DOI: 10.1136/bmjopen-2018-023995] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
OBJECTIVE Association of lifestyle modification and pharmacological adherence among patients with hypertension attending a national referral hospital in Kenya. DESIGN Descriptive, cross-sectional. SETTING Medical wards and outpatient clinic of a national referral hospital. PARTICIPANTS Patients (n=229) diagnosed with primary hypertension for at least 6 months. PRIMARY OUTCOMES Clinical makers, cholesterol levels, anthropometrics, lifestyle/dietary habits adjusted for age, gender and education; antihypertensive adherence; views on prevention of hypertension and adequacy of hypertension information. RESULTS Ageing was associated with elevated diastolic blood pressure (BP) (p<0.05), heart rate (HR) and cholesterol. Females had higher body mass index (BMI). More males reported drinking alcohol and smoking (p<0.001), especially the highly educated. Higher BPs were observed in smokers and drinkers (p<0.05). Daily vegetables and fruits intake were linked to lower BP, HR and BMI (p<0.05). Intake of foods high in saturated fat and cholesterol were associated with raised HR (p<0.05). Respondents on antihypertensive medication, those engaged in healthy lifestyle and took their prescribed medications had lower mean BPs than those on medication only (138/85 vs 140/90). Few respondents (30.8%) considered hypertension as preventable, mainly the single and highly educated (p<0.05). Respondents (53.6%) believed they should stop taking their antihypertensive medication once hypertension is controlled. CONCLUSION Missed targets for BP control and hypertension-related risks are associated with ageing, female gender, fast food and animal fat intake. Alcohol and smoking is common in males associated with poor BP control. Daily vegetables and fruits intake are associated with better BP control and overall hypertension risk reduction. Observed suboptimal BP control despite pharmacological adherence suggests lifestyle modification is needed besides antihypertensive medication. Interventions should address modifiable risk factors aggravated by age and adverse lifestyles through adopting combined lifestyle modification, pharmacological adherence and tailored expert delivered hypertension-related information.
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Affiliation(s)
- Samuel Kimani
- School of Nursing Sciences, University of Nairobi, Nairobi, Kenya
| | - Waithira Mirie
- School of Nursing Sciences, University of Nairobi, Nairobi, Kenya
| | - Margaret Chege
- School of Nursing Sciences, University of Nairobi, Nairobi, Kenya
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Wodschow K, Hansen B, Schullehner J, Ersbøll AK. Stability of Major Geogenic Cations in Drinking Water-An Issue of Public Health Importance: A Danish Study, 1980⁻2017. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15061212. [PMID: 29890707 PMCID: PMC6024924 DOI: 10.3390/ijerph15061212] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Revised: 06/01/2018] [Accepted: 06/04/2018] [Indexed: 02/02/2023]
Abstract
Concentrations and spatial variations of the four cations Na, K, Mg and Ca are known to some extent for groundwater and to a lesser extent for drinking water. Using Denmark as case, the purpose of this study was to analyze the spatial and temporal variations in the major cations in drinking water. The results will contribute to a better exposure estimation in future studies of the association between cations and diseases. Spatial and temporal variations and the association with aquifer types, were analyzed with spatial scan statistics, linear regression and a multilevel mixed-effects linear regression model. About 65,000 water samples of each cation (1980–2017) were included in the study. Results of mean concentrations were 31.4 mg/L, 3.5 mg/L, 12.1 mg/L and 84.5 mg/L for 1980–2017 for Na, K, Mg and Ca, respectively. An expected west-east trend in concentrations were confirmed, mainly explained by variations in aquifer types. The trend in concentration was stable for about 31–45% of the public water supply areas. It is therefore recommended that the exposure estimate in future health related studies not only be based on a single mean value, but that temporal and spatial variations should also be included.
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Affiliation(s)
- Kirstine Wodschow
- National Institute of Public Health, University of Southern Denmark, 1455 Copenhagen K, Denmark.
- Department of Groundwater and Quaternary Geological Mapping, Geological Survey of Denmark and Greenland, 8000 Aarhus C, Denmark.
| | - Birgitte Hansen
- Department of Groundwater and Quaternary Geological Mapping, Geological Survey of Denmark and Greenland, 8000 Aarhus C, Denmark.
| | - Jörg Schullehner
- Department of Groundwater and Quaternary Geological Mapping, Geological Survey of Denmark and Greenland, 8000 Aarhus C, Denmark.
- National Centre for Register-based Research, Department of Economics and Business Economics, Aarhus BSS, Aarhus University, 8210 Aarhus V, Denmark.
| | - Annette Kjær Ersbøll
- National Institute of Public Health, University of Southern Denmark, 1455 Copenhagen K, Denmark.
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15
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Lalji R, Tullus K. What's new in paediatric hypertension? Arch Dis Child 2018; 103:96-100. [PMID: 28818842 DOI: 10.1136/archdischild-2016-311662] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Revised: 05/31/2017] [Accepted: 06/12/2017] [Indexed: 11/04/2022]
Abstract
Paediatric hypertension predisposes to hypertension and cardiovascular disease in adult life. Despite clear guidelines, there remains a lack of screening. Diagnosis remains challenging given the high rate of false-positive high blood pressure (BP) readings at a single visit; thus, multiple visits are required to confirm the diagnosis. Depending on the normative data sets used, hypertension in overweight and obese children can be underestimated by up to 20%. Specific BP targets are required for subgroups such as adolescents, children with chronic kidney disease (CKD) and type 1 diabetes. High dietary salt intake is a risk factor for cardiovascular disease. Given the rise in processed food consumption, children in developed nations are likely to benefit from salt restriction at a population-based level.
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Affiliation(s)
- Rowena Lalji
- Departmentof Paediatric Nephrology, Great Ormond Street Hospital for Children, London, UK.,Departmentof Paediatric Nephrology, Lady Cilento Children's Hospital, South Brisbane, Queensland, Australia
| | - Kjell Tullus
- Departmentof Paediatric Nephrology, Great Ormond Street Hospital for Children, London, UK
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16
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Preuss HG, Clouatre D, Swaroop A, Bagchi M, Bagchi D, Kaats GR. Blood Pressure Regulation: Reviewing Evidence for Interplay Between Common Dietary Sugars and Table Salt. J Am Coll Nutr 2017; 36:677-684. [PMID: 28960144 DOI: 10.1080/07315724.2017.1345338] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
A popular concept is that the significant global progression in prevalence and intensification of elevated blood pressure (BP) levels is due in part to dietary indiscretions. Excess intake of several food sources causing overweight/obesity plays an important role in BP perturbations. However, certain nutrients are involved in ways other than via body fat accumulation, particularly table salt (sodium chloride) and popular refined carbohydrates like dietary sugars (sucrose, fructose, high fructose corn syrup). In nondiabetics and diabetics, several functions of salt and sugar influence BP and metabolism. For example, salt intake is linked to volume expansion, insulin resistance, and hypertension, while sugar intake is associated with enhanced salt sensitivity via urinary sodium retention, insulin resistance, and hypertension. The key postulate evaluated here is that when two popular nutrients-salt and dietary sugars-are consumed together in adequate amounts, their respective individual BP effects are significantly amplified. In previous laboratory studies, a sugar challenge did not increase BP in the face of marked sodium depletion, and combining sugar and salt challenges caused a synergistic BP elevation. Among examples of amplification on the clinical side, the greatest increases in BP following sugar challenges were seen in diabetic subjects having the highest sodium excretion. Interplay between table salt and common dietary sugars in BP regulation is a reasonable postulate and should be carefully considered when developing optimal prevention and treatment regimens to ameliorate the worldwide crisis arising from harmful elevated BP levels.
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Affiliation(s)
- Harry G Preuss
- a Department of Biochemistry , Georgetown University Medical Center , Washington , DC , USA
| | | | - Anand Swaroop
- c Cepham Research Center , Piscataway , New Jersey , USA
| | | | - Debasis Bagchi
- c Cepham Research Center , Piscataway , New Jersey , USA.,e Department of Pharmacological and Pharmaceutical Services , University of Houston , Houston , Texas , USA
| | - Gilbert R Kaats
- f Integrative Health Technologies , San Antonio , Texas , USA
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17
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Mehta V. Addictive salt may not be solely responsible for causing hypertension: A sweet and fatty hypothesis. HIPERTENSION Y RIESGO VASCULAR 2017; 35:S1889-1837(17)30060-0. [PMID: 28927660 DOI: 10.1016/j.hipert.2017.08.002] [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: 02/18/2017] [Revised: 05/11/2017] [Accepted: 08/07/2017] [Indexed: 10/18/2022]
Abstract
In literature, since many decades, it is often believed and condoned that excessive common salt (Nacl) ingestion can lead to hypertension. Hence, every health organisation, agencies and physicians have been advising salt restriction to hypertensive patients. However, there is no concrete evidence suggesting that salt restriction can reduce the risk of hypertension (HTN). The present article is based on the current literature search which was performed using MEDLINE, EMBASE, Google Scholar and PubMed. The meta-analysis, randomised control trials, clinical trials and review articles were chosen. The present review article suggests that consumption of high salt diet does not lead to hypertension and there are other factors which can lead to hypertension, sugar and fats being the main reasons. Salt can however lead to addiction and generally, these salty food items have a larger proportion of sugar and fats, which if over-consumed has a potential to cause obesity, hyperlipidaemia and subsequently, hypertension and other cardiovascular disorders. Hence, through the present review, I would like to suggest all the physicians to ask the hypertensive patients to cut down the intake of sugar and fat containing food items and keep a check on addiction of salty food items.
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Affiliation(s)
- V Mehta
- Mount Sinai Hospital, New York, US; MGM Medical College, Navi Mumbai, India.
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18
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Adriouch S, Lelong H, Kesse-Guyot E, Baudry J, Lampuré A, Galan P, Hercberg S, Touvier M, Fezeu LK. Compliance with Nutritional and Lifestyle Recommendations in 13,000 Patients with a Cardiometabolic Disease from the Nutrinet-Santé Study. Nutrients 2017; 9:nu9060546. [PMID: 28587108 PMCID: PMC5490525 DOI: 10.3390/nu9060546] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2017] [Revised: 05/02/2017] [Accepted: 05/22/2017] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND A healthy diet has been shown to prevent cardiovascular diseases complications. The objective of this study was to assess dietary intakes and compliance with nutritional and lifestyle recommendations in French adults diagnosed with hypertension, diabetes, dyslipidaemia or cardiovascular disease compared with healthy individuals. METHODS Data was collected from 26,570 subjects aged 35 to 70 years (13,285 patients and 13,285 controls matched by sex and age) of the French cohort NutriNet-Santé. Dietary intakes were assessed using three 24-h records. Mean food and nutrient intakes of patients were compared to those of healthy subjects using multivariable mixed logistic and linear regressions. RESULTS Compared to healthy controls, adults reporting cardiometabolic diseases had lower intakes of sweetened products, higher intakes of fish and seafood and a better compliance with dairy products. However, overall, they reported unhealthier lifestyles and dietary habits. Indeed, they were less often physically active and had similar habits regarding alcohol and tobacco consumption. They also had lower intakes of fruit, higher intakes of meat, processed meat and added fats. It is noteworthy that diabetic subjects tended to show the highest compliance with certain dietary recommendations (vegetables, pulses and whole grain products). CONCLUSION Our study brings into focus the fact that some nutritional aspects still need to be improved among individuals with a cardiometabolic disease. We should encourage higher intakes of fruits and vegetables, whole grain products, and lower intakes of meat and sodium, as well as healthy lifestyle (physical activity, no-smoking and limited intake of alcohol) in order to encourage a healthier management after being diagnosed.
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Affiliation(s)
- Solia Adriouch
- Université Paris 13, Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre de Recherche en Epidémiologie et Statistiques, Inserm (U1153), Inra (U1125), Cnam, COMUE Sorbonne Paris Cité, F-93017 Bobigny, France.
| | - Hélène Lelong
- Université Paris 13, Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre de Recherche en Epidémiologie et Statistiques, Inserm (U1153), Inra (U1125), Cnam, COMUE Sorbonne Paris Cité, F-93017 Bobigny, France.
| | - Emmanuelle Kesse-Guyot
- Université Paris 13, Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre de Recherche en Epidémiologie et Statistiques, Inserm (U1153), Inra (U1125), Cnam, COMUE Sorbonne Paris Cité, F-93017 Bobigny, France.
| | - Julia Baudry
- Université Paris 13, Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre de Recherche en Epidémiologie et Statistiques, Inserm (U1153), Inra (U1125), Cnam, COMUE Sorbonne Paris Cité, F-93017 Bobigny, France.
| | - Aurélie Lampuré
- Université Paris 13, Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre de Recherche en Epidémiologie et Statistiques, Inserm (U1153), Inra (U1125), Cnam, COMUE Sorbonne Paris Cité, F-93017 Bobigny, France.
| | - Pilar Galan
- Université Paris 13, Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre de Recherche en Epidémiologie et Statistiques, Inserm (U1153), Inra (U1125), Cnam, COMUE Sorbonne Paris Cité, F-93017 Bobigny, France.
- Département de Santé Publique, Hôpital Avicenne, F-93017 Bobigny, France.
| | - Serge Hercberg
- Université Paris 13, Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre de Recherche en Epidémiologie et Statistiques, Inserm (U1153), Inra (U1125), Cnam, COMUE Sorbonne Paris Cité, F-93017 Bobigny, France.
- Département de Santé Publique, Hôpital Avicenne, F-93017 Bobigny, France.
| | - Mathilde Touvier
- Université Paris 13, Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre de Recherche en Epidémiologie et Statistiques, Inserm (U1153), Inra (U1125), Cnam, COMUE Sorbonne Paris Cité, F-93017 Bobigny, France.
| | - Léopold K Fezeu
- Université Paris 13, Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre de Recherche en Epidémiologie et Statistiques, Inserm (U1153), Inra (U1125), Cnam, COMUE Sorbonne Paris Cité, F-93017 Bobigny, France.
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19
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Relationship between urinary sodium with blood pressure and hypertension among a Kazakh community population in Xinjiang, China. J Hum Hypertens 2017; 31:333-340. [PMID: 28054572 DOI: 10.1038/jhh.2016.83] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Revised: 10/02/2016] [Accepted: 10/21/2016] [Indexed: 01/11/2023]
Abstract
Urinary sodium levels are reported to be associated with blood pressure in clinical trials and epidemiology studies. Nevertheless, the public health message of reducing sodium intake in free-living community populations remains under debate. Based on an ongoing prospective study initiated in 2012 with a community-based design in Xinjiang, China, 1668 adults (⩾30 years old) were assessed in the current study for associations between urinary sodium and blood pressure and hypertension in a free-living population of Kazakh people. After excluding 223 people on antihypertensive medication, 1445 participants were analyzed. Second urine samples after waking were used to estimate 24-h urinary sodium excretion, which is a marker for sodium intake. Following analyses, we found that the distribution of systolic and diastolic blood pressures moved upward with increasing quartiles of urinary sodium. After adjusting for age, differences in median systolic blood pressure were 8.5 mm Hg for men and 8.0 mm Hg for women between the top and bottom urinary sodium quartiles, and differences for diastolic blood pressure were 4.7 mm Hg for men and 4.3 mm Hg for women. A significant increased risk for hypertension was observed for the top quartile of urinary sodium after adjusting for age, body mass index, smoking, alcohol consumption, fruit and vegetable consumption, with corresponding odds ratios being 1.61 (95% confidence interval (CI): 1.02-2.54) for men and 1.92 (95% CI: 1.13-3.27) for women. Improving education about reducing salt intake is of particular public importance to reduce blood pressure and the risk for hypertension among the Kazakh people.
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Vamvakis A, Gkaliagkousi E, Triantafyllou A, Gavriilaki E, Douma S. Beneficial effects of nonpharmacological interventions in the management of essential hypertension. JRSM Cardiovasc Dis 2017; 6:2048004016683891. [PMID: 28228940 PMCID: PMC5308526 DOI: 10.1177/2048004016683891] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2016] [Revised: 10/14/2016] [Accepted: 11/02/2016] [Indexed: 12/31/2022] Open
Abstract
Essential hypertension is a major health problem causing excess cardiovascular morbidity and mortality. Management of essential hypertension consists of pharmacological and nonpharmacological interventions. In order to prevent and/or treat hypertension, parameters like nutrition, body weight, and physical exercise should be evaluated and taken under consideration for improvement. A large body of evidence clearly support that the role of salt, alcohol, fruits, and vegetables is important for high blood pressure. Furthermore, maintaining a normal body weight should be succeeded along with physical activity few times per week if not daily. Nonpharmacological intervention is rather a dynamic procedure that takes a multilevel approach with repeated training of the hypertensives by a team of expert physicians, rather than a single based guidance. Additionally, it should be based on a profile customization and personalized approach. Intensive interventions aiming at lifestyle changes through educational meetings are considered more effective in lowering high blood pressure. This consists of a lifestyle modification with a permanent basis for patient’s daily schedule and eventually should become a philosophy for a better quality of life through improvement of nutritional and exercise behavior. Further studies are needed so intervention guideline models can be even more effective for patients with essential hypertension.
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Affiliation(s)
- Anastasios Vamvakis
- 3rd Department of Internal Medicine, Aristotle University of Thessaloniki, Greece
| | - Eugenia Gkaliagkousi
- 3rd Department of Internal Medicine, Aristotle University of Thessaloniki, Greece
| | - Areti Triantafyllou
- 3rd Department of Internal Medicine, Aristotle University of Thessaloniki, Greece
| | - Eleni Gavriilaki
- 3rd Department of Internal Medicine, Aristotle University of Thessaloniki, Greece
| | - Stella Douma
- 3rd Department of Internal Medicine, Aristotle University of Thessaloniki, Greece
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Gottwald-Hostalek U, Sun N, Barho C, Hildemann S. Management of Hypertension With a Fixed-Dose (Single-Pill) Combination of Bisoprolol and Amlodipine. Clin Pharmacol Drug Dev 2016; 6:9-18. [DOI: 10.1002/cpdd.309] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2016] [Accepted: 09/14/2016] [Indexed: 11/06/2022]
Affiliation(s)
| | - Ningling Sun
- Department of Hypertension & Heart Center; Peking University People's Hospital; Beijing China
| | | | - Steven Hildemann
- Merck KGaA; Darmstadt, Germany; and Universitäts-Herzzentrum Freiburg-Bad Krozingen; Bad Krozingen Germany
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22
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Ruiz-Castell M, Kandala NB, Kuemmerle A, Schritz A, Barré J, Delagardelle C, Krippler S, Schmit JC, Stranges S. Hypertension burden in Luxembourg: Individual risk factors and geographic variations, 2013 to 2015 European Health Examination Survey. Medicine (Baltimore) 2016; 95:e4758. [PMID: 27603374 PMCID: PMC5023897 DOI: 10.1097/md.0000000000004758] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2016] [Revised: 08/04/2016] [Accepted: 08/09/2016] [Indexed: 12/19/2022] Open
Abstract
Hypertension is a modifiable risk factor for cardiovascular disease, but it remains the main cause of death in Luxembourg. We aimed to estimate the current prevalence of hypertension, associated risk factors, and its geographic variation in Luxembourg.Cross-sectional, population-based data on 1497 randomly selected Luxembourg residents aged 25 to 64 years were collected as part of the European Health Examination Survey from 2013 to 2015. Hypertension was defined as systolic/diastolic blood pressure ≥140/90 mm Hg, self-report of a physician diagnosis or on antihypertensive medication. Standard and Bayesian regressions were used to examine associations between hypertension and covariates, and also geographic distribution of hypertension across the country.Nearly 31% of Luxembourg residents were hypertensive, and over 70% of those were either unaware of their condition or not adequately controlled. The likelihood of hypertension was lower in men more physically active (odds ratio [95% credible region] 0.6 [0.4, 0.9]) and consuming alcohol daily (0.3 [0.1, 0.8]), and higher in men with a poor health perception (1.6 [1.0, 2.7]) and in women experiencing depressive symptoms (1.8 [1.3, 2.7]). There were geographic variations in hypertension prevalence across cantons and municipalities. The highest odds ratio was observed in the most industrialized region (South-West) (1.2 [0.9, 1.6]) with a positive effect at 90% credible region.In Luxembourg, the vast majority of people with hypertension are either unaware of their condition or not adequately controlled, which constitutes a major, neglected public health challenge. There are geographic variations in hypertension prevalence in Luxembourg, hence the role of individual and regional risk factors along with public health initiatives to reduce disease burden should be considered.
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Affiliation(s)
- Maria Ruiz-Castell
- Epidemiology and Public Health Research Unit, Department of Population Health, Luxembourg Institute of Health, Strassen, Luxembourg
| | - Ngianga-Bakwin Kandala
- Health Economics and Evidence Synthesis Research Unit, Department of Population Health, Luxembourg Institute of Health, Strassen, Luxembourg
- Department of Mathematics and Information sciences, Faculty of Engineering and Environment, Northumbria University, Newcastle upon Tyne, UK
| | - Andrea Kuemmerle
- Epidemiology and Public Health Research Unit, Department of Population Health, Luxembourg Institute of Health, Strassen, Luxembourg
| | - Anna Schritz
- Competence Center in Methodology and Statistics, Luxembourg Institute of Health, Strassen, Luxembourg
| | - Jessica Barré
- Competence Center in Methodology and Statistics, Luxembourg Institute of Health, Strassen, Luxembourg
| | | | - Serge Krippler
- Lycée technique pour professions de santé, Luxembourg
- Directorate of Health, Luxembourg
| | | | - Saverio Stranges
- Epidemiology and Public Health Research Unit, Department of Population Health, Luxembourg Institute of Health, Strassen, Luxembourg
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23
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Lelong H, Blacher J, Menai M, Galan P, Fezeu L, Hercberg S, Kesse-Guyot E. Association Between Blood Pressure and Adherence to French Dietary Guidelines. Am J Hypertens 2016; 29:948-58. [PMID: 26908464 DOI: 10.1093/ajh/hpw017] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Accepted: 01/29/2016] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Adopting a healthy diet like the Dietary Approach to Stop Hypertension (DASH) or Mediterranean diet (MD) represents a major lifestyle for blood pressure (BP) control in general population. Nutritional policies, such as the French Nutrition and Health Program (Programme National Nutrition Santé or PNNS), have been implemented in several countries with the aims of preventing chronic diseases. The objective of our study was to investigate association between BP and adherence to PNNS guidelines compared with adherence to DASH or MD. METHODS We conducted a cross-sectional study in 11,302 untreated participants from the NutriNet-Santé study, a French web-based cohort study. Three validated scores reflecting adherence to PNNS guidelines, DASH diet, and MD were calculated from repeated 24-hour records. Three BP measurements using a standardized protocol were collected. Multivariate linear models were used to assess the associations between the dietary scores and BP. RESULTS In women, independent of age, socioeconomic status, body mass index, tobacco use, alcohol consumption, and physical activity, adherence to PNNS guidelines was inversely significantly associated with systolic BP (β = -0.63, P < 0.0001). This association was of similar amplitude that between BP and adherence to DASH-style diet (β = -0.66, P < 0.0001) or MD (β = -0.63, P = 0.0002). No significant association was found in men. CONCLUSION Adherence to French nutritional recommendations was found negatively associated with BP at the same magnitude as adherence to well-known dietary pattern in the prevention and treatment of hypertension.
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Affiliation(s)
- Helene Lelong
- Paris-Descartes University, Faculty of Medicine, Hôtel-Dieu Hospital, AP-HP, Diagnosis and Therapeutic Center, Paris, France; Paris 13, Sorbonne Paris Cité University, UREN (Nutritional Epidemiology Research Unit) - U557 INSERM, U1125 INRA, CNAM, CRNH IdF , Bobigny, France;
| | - Jacques Blacher
- Paris-Descartes University, Faculty of Medicine, Hôtel-Dieu Hospital, AP-HP, Diagnosis and Therapeutic Center, Paris, France; Paris 13, Sorbonne Paris Cité University, UREN (Nutritional Epidemiology Research Unit) - U557 INSERM, U1125 INRA, CNAM, CRNH IdF , Bobigny, France
| | - Mehdi Menai
- Paris 13, Sorbonne Paris Cité University, UREN (Nutritional Epidemiology Research Unit) - U557 INSERM, U1125 INRA, CNAM, CRNH IdF , Bobigny, France
| | - Pilar Galan
- Paris 13, Sorbonne Paris Cité University, UREN (Nutritional Epidemiology Research Unit) - U557 INSERM, U1125 INRA, CNAM, CRNH IdF , Bobigny, France
| | - Leopold Fezeu
- Paris 13, Sorbonne Paris Cité University, UREN (Nutritional Epidemiology Research Unit) - U557 INSERM, U1125 INRA, CNAM, CRNH IdF , Bobigny, France
| | - Serge Hercberg
- Paris 13, Sorbonne Paris Cité University, UREN (Nutritional Epidemiology Research Unit) - U557 INSERM, U1125 INRA, CNAM, CRNH IdF , Bobigny, France; Department of Public Health, Avicenne Hospital, Bobigny, France
| | - Emmanuelle Kesse-Guyot
- Paris 13, Sorbonne Paris Cité University, UREN (Nutritional Epidemiology Research Unit) - U557 INSERM, U1125 INRA, CNAM, CRNH IdF , Bobigny, France
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Lee SK, Yoon DW, Lee SW, Kim JY, Kim JK, Cho NH, Shin C. Association of Sasang Constitutional Types with Incident Hypertension: A 12-Year Follow-Up Study. J Altern Complement Med 2016; 22:706-12. [PMID: 27454325 DOI: 10.1089/acm.2015.0052] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVES Sasang constitutional types (SCTs) are four distinct classifications of people based on physiologic and physical characteristics. The different types have been reported to have different disease susceptibility, but there are no studies reporting the association of SCT and hypertension (HTN) over a long-term follow-up period. This study prospectively investigated the association between SCT and incidence of HTN. DESIGN This was a prospective study in a population-based cohort study in Korea. SUBJECTS Data from two independent population-based cohorts that are embedded within the Korean Genome and Epidemiology Study were used. A total of 2083 subjects who were free of HTN at baseline were selected for the analysis. OUTCOME MEASURES HTN was diagnosed as systolic blood pressure (BP) ≥140 mmHg and diastolic BP ≥90 mmHg, use of antihypertensive medication, or diagnosis by doctor. The SCTs were classified using an integrated diagnostic method that included facial features, body shape, voice, and questionnaire responses. The association between the SCT and the incidence of HTN was investigated by Cox proportional hazard regression analysis and calculation of estimated survival functions. RESULTS The Tae-eum (TE) type showed a significantly increased risk for HTN (hazard ratio [HR] = 1.55, 95% confidence interval [CI] 1.15-2.10; p = 0.005), even after adjusting for all possible confounders. In a stratified analysis by body mass index (BMI) conducted only in the TE type, even those in the TE type with normal BMI had a significantly higher risk for HTN (HR = 1.47, 95% CI 1.07-2.03; p = 0.016). Furthermore, survival analysis showed that the TE type had a higher rate of developing HTN than the So-eum and So-yang types had, regardless of obesity status. CONCLUSIONS These results show that the TE type is an independent risk factor for HTN. Thus, early prevention and treatment for HTN in this type are needed.
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Affiliation(s)
- Seung Ku Lee
- 1 Institute of Human Genomic Study, College of Medicine, Korea University Ansan Hospital , Danwon-gu, Republic of Korea
| | - Dae Wui Yoon
- 1 Institute of Human Genomic Study, College of Medicine, Korea University Ansan Hospital , Danwon-gu, Republic of Korea
| | - Si Woo Lee
- 2 Constitutional Medicine and Diagnosis Research Group, Korea Institute of Oriental Medicine , Yuseong-gu, Republic of Korea
| | - Jong Yeol Kim
- 3 Medical Research Division, Korea Institute of Oriental Medicine , Yuseong-gu, Republic of Korea
| | - Jin Kwan Kim
- 4 Department of Biomedical Laboratory Science, Jungwon University , Goesan-eup, Republic of Korea
| | - Nam Han Cho
- 5 Department of Preventive Medicine, Ajou University School of Medicine , Youngtong Gu, Republic of Korea
| | - Chol Shin
- 1 Institute of Human Genomic Study, College of Medicine, Korea University Ansan Hospital , Danwon-gu, Republic of Korea.,6 Department of Pulmonary, Sleep and Critical Care Medicine, College of Medicine, Korea University Ansan Hospital , Danwon-gu, Republic of Korea
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Morgenstern LB, Sánchez BN, Conley KM, Morgenstern MC, Sais E, Skolarus LE, Levine DA, Brown DL. The Association between Changes in Behavioral Risk Factors for Stroke and Changes in Blood Pressure. J Stroke Cerebrovasc Dis 2016; 25:2116-21. [PMID: 27342699 DOI: 10.1016/j.jstrokecerebrovasdis.2016.06.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2016] [Revised: 05/23/2016] [Accepted: 06/03/2016] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND High blood pressure (BP) is the leading risk factor for stroke. Data on the association of physical activity (PA), fruit and vegetable (F&V) consumption, and dietary sodium with hypertension are lacking in Hispanic communities. In the current report, we provide data on the association between changes in these stroke behavioral risk factors and BP change. METHODS Participants were recruited from participating Catholic churches in Nueces County, Texas. BP was measured, and self-reported validated scales of F&V consumption, dietary sodium, and PA were collected at baseline and at 12 months. Linear mixed models were used to examine the associations between tertiles of improvement in the 3 behavior outcomes and BP change, adjusted for demographic characteristics. The association between the binary measure of at least 5 mmHg diastolic blood pressure (DBP) or 10 mmHg systolic blood pressure (SBP) reduction and behavior change was estimated with multilevel logistic regression models. RESULTS Of 586 participants, 66% were female and 82% were Mexican American (MA), and the mean age was 54 years. High compared with low change in PA was significantly associated with DBP change (P = .022), and high compared with low change in F&V intake was significantly associated with SBP change (P = .032). For the binary changes in DBP or SBP, there was a borderline association of PA (P = .054); all other variables were not associated (P > .10). CONCLUSIONS PA and F&V consumption are potential stroke prevention targets in predominantly MA populations.
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Affiliation(s)
- Lewis B Morgenstern
- Stroke Program, University of Michigan Health System; Department of Epidemiology, University of Michigan School of Public Health.
| | - Brisa N Sánchez
- Department of Biostatistics, University of Michigan School of Public Health
| | - Kathleen M Conley
- School of Health Promotion and Human Performance, Eastern Michigan University
| | | | - Emma Sais
- Stroke Program, University of Michigan Health System
| | | | - Deborah A Levine
- Department of Medicine, University of Michigan Health System and VA Ann Arbor Health System
| | - Devin L Brown
- Stroke Program, University of Michigan Health System
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Yuan M, Chen W, Teng B, Fang Y. Occupational Disparities in the Association between Self-Reported Salt-Eating Habit and Hypertension in Older Adults in Xiamen, China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:ijerph13010148. [PMID: 26805865 PMCID: PMC4730539 DOI: 10.3390/ijerph13010148] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/26/2015] [Revised: 01/14/2016] [Accepted: 01/15/2016] [Indexed: 01/19/2023]
Abstract
Blood pressure responses to sodium intake are heterogeneous among populations. Few studies have assessed occupational disparities in the association between sodium intake and hypertension in older people. We used cross-sectional data from 14,292 participants aged 60 years or older in Xiamen, China, in 2013. Self-reported salt-eating habit was examined with three levels: low, medium, and high. The main lifetime occupation was classified into indoor laborer and outdoor laborer. Multivariable logistic regression was used to examine associations of hypertension with self-reported salt-eating habit, main lifetime occupation, and their interactions by adjusting for some covariates, with further stratification by sex. Overall, 13,738 participants had complete data, of whom 30.22% had hypertension. The prevalence of hypertension was 31.57%, 28.63%, and 31.97% in participants who reported to have low, medium, and high salt-eating habit, respectively. Outdoor laborers presented significantly lower prevalence of hypertension than indoor laborers (26.04% vs. 34.26%, p < 0.001). Indoor laborers with high salt-eating habit had the greatest odds of hypertension (OR = 1.32, 95% CI [1.09–1.59]). An increased trend of odds in eating habit as salt-heavier was presented in indoor laborers (p-trend = 0.048), especially for women (p-trend = 0.001). No clear trend presented in men. Conclusively, sex-specific occupational disparities exist in the association between self-reported salt-eating habit and hypertension in older individuals. Overlooking the potential moderating role of sex and occupation might affect the relationship between sodium intake and hypertension.
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Affiliation(s)
- Manqiong Yuan
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiang'an Nan Road, Xiang'an District, Xiamen 361102, Fujian, China.
- Key Laboratory of Health Technology Assessment of Fujian Province University, School of Public Health, Xiamen University, Xiang'an Nan Road, Xiang'an District, Xiamen 361102, Fujian, China.
| | - Wei Chen
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiang'an Nan Road, Xiang'an District, Xiamen 361102, Fujian, China.
- Key Laboratory of Health Technology Assessment of Fujian Province University, School of Public Health, Xiamen University, Xiang'an Nan Road, Xiang'an District, Xiamen 361102, Fujian, China.
| | - Bogang Teng
- School of Public Health, Xiamen University, Xiang'an Nan Road, Xiang'an District, Xiamen 361102, Fujian, China.
| | - Ya Fang
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiang'an Nan Road, Xiang'an District, Xiamen 361102, Fujian, China.
- Key Laboratory of Health Technology Assessment of Fujian Province University, School of Public Health, Xiamen University, Xiang'an Nan Road, Xiang'an District, Xiamen 361102, Fujian, China.
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Suter WN, Suter PM. How Research Conclusions Go Wrong. HOME HEALTH CARE MANAGEMENT AND PRACTICE 2015. [DOI: 10.1177/1084822315586557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Home health clinicians work in a climate of increasing concern about evidence-based care arising from scientific research and program evaluation. Inconsistent research findings pose challenges for those creating and implementing research-based best practice guidelines. This challenge is intensified by the claim from world-renowned scholar John P. A. Ioannidis that “most published research findings are false.” We believe that many conclusions are false and many are true. This article provides a framework for understanding why many research conclusions are indeed false. We examine problems such as ransacking, bias, senseless comparisons, threats to conclusion validity, and statistical influences that lead to wrong conclusions. Understanding sources of influence that foster wrong conclusions enables the critical consumer of home health research to make sound judgments that translate into true evidence-based care.
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Shafieyan Z, Qorbani M, Rastegari Mehr B, Mahboubi M, Rezapour A, Safari O, Ansari H, Esmaeli Kia M, Asayesh H, Mansourian M. Association Between Lifestyle and Hypertension in Patients Referred to Health Care Centers of Ilam City in 2014. Glob J Health Sci 2015; 8:161-7. [PMID: 26755476 PMCID: PMC4954904 DOI: 10.5539/gjhs.v8n6p161] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2015] [Accepted: 10/26/2015] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION Lifestyle is referred to an individual's healthy and unhealthy behaviors that can affect their health statues. The present study aim was association between lifestyle and hypertension in patients referred to healthcare centers of Ilam city in 2014. MATERIALS & METHODS This research study was a case-control study. The data were collected through a standard questionnaire of health-promoting lifestyle profile (HPLPII) as well as the researcher's direct visit to the health care centers in the city of Ilam. After the questionnaires were collected and classified, the data were entered into SPSS software and analyzed by descriptive statistics, chi-square tests, T-Tests and logistic regression. RESULTS The mean and the standard deviation of the age of the main and the control groups were 57.1 (2.22) and 56.5 (2.99) years old, respectively. 10.9%of the control group and 25.5. % of the cases was smoking cigarettes or hookah. The results of the data analysis showed that the mean scores obtained by the main and the control groups on measures of physical activity, psychological growth, stress and total lifestyleare significantly different, so that the obtained score in the dimensions in patients with hypertension was significantly lower than the score obtained among the healthy individuals. CONCLUSIONS According to the results it seems that educational interventions in the field of healthy lifestyle for individuals with hypertension risk can have an effect on controlling this disease and reducing its incidence.
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Affiliation(s)
- Zahra Shafieyan
- Student Research Committee, Ilam University of Medical Sciences, Ilam, Iran.
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Change in the association of body mass index and systolic blood pressure in Germany - national cross-sectional surveys 1998 and 2008-2011. BMC Public Health 2015. [PMID: 26209098 PMCID: PMC4514940 DOI: 10.1186/s12889-015-2023-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Background A recent weakening and even decoupling of the association of body mass index (BMI) and systolic blood pressure (SBP) in population data was reported, i. a. for Western Europe. Methods The association of BMI and SBP in recent cross-sectional population data from Germany was investigated in participants aged 18–79 years with BMI 17.5-40 kg/m2 from national health examination surveys 1998 (n = 6,931) and 2008–2011 (n = 6,861) in Germany. The association was analyzed both in the overall samples and in participants without antihypertensive medication. Results From 1998 to 2008–11, age- and sex-standardized mean SBP decreased from 129.0 (CI 128.2-129.7) to 124.1 (123.5-124.6) mmHg in all participants and from 126.0 (125.4-126.7) to 122.3 (121.7-122.8) mmHg among persons not on antihypertensive medication. The proportion of persons treated with antihypertensives augmented from 19.2 % (17.7-20.8) to 25.3 % (24.0-26.6). Mean BMI remained constant at around 27 kg/m2 with a slight increase in obesity prevalence. BMI was positively associated with SBP both in 1998 and 2008–11, yet the association tended to level out with increasing BMI suggesting a non-linear association. The strength of the BMI-SBP-association decreased over time in all and untreated men. In women, the association weakened in the overall sample, but remained similarly strong in untreated women. The unadjusted linear regression models were used to estimate the increase in SBP within 5-unit BMI increases. E. g. for men in 1998, SBP was higher by 7.0 mmHg for a BMI increase from 20 to 25 kg/m2 and by 3.6 mmHg for BMI 30 to 35 kg/m2. The corresponding values for 2008–11 were 3.8 mmHg and 1.7 mmHg. Conclusions The cross-sectional association of BMI and SBP decreased between 1998 and 2008–11 in Germany, however it did not disappear and it is in part explained by improvements in the diagnosis and treatment of high blood pressure. Electronic supplementary material The online version of this article (doi:10.1186/s12889-015-2023-8) contains supplementary material, which is available to authorized users.
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