Abdominal obesity is characterized by higher pulse pressure: possible role of free triiodothyronine

Pestilent relationship between smoking and hypertension or pulse pressure among males over 15 years in India: NFHS-5 Survey

OBJECTIVE

The Global Adult Tobacco Survey conducted in India has divulged that 28.6% of the populace aged 15 years and above partakes in tobacco consumption in various modalities. Despite the availability of numerous studies on the correlation between smoking and hypertension, the nexus between tobacco smoking and hypertension remains enigmatic. Smoking has predominantly been linked to blood pressure, with scant investigations exploring the plausible association that may subsist between smoking and pulse pressure.

METHODOLOGY

This study is based on secondary data analysis from the fifth National Family Health Survey (NFHS-5). 17 Field Agencies gathered information from 636,699 households, 724,115 women, and 101,839 men. The data related to only men was included and analysed in this present study.

RESULTS

Male participants had a mean age of 32.2+1.2 years, an average waist circumference of 80.4+12.2 cm, and mean systolic and diastolic blood pressure of 123.4+13.8 mmHg and 80.5+10.2 mmHg. Daily smokers had a slightly higher likelihood of hypertension compared to non-smokers (OR = 1.2, p <0.001). Male quitters had significantly lower odds of hypertension (OR = 0.9, p <0.001). Quitters had reduced odds of narrow pulse pressure but increased odds of wide pulse pressure (OR = 0.81 and 1.14, respectively).

CONCLUSION

The study found that regular smoking was associated with hypertension, while factors such as age, obesity, urban dwelling, wealth, and tribal residence were linked to increased blood pressure. Male quitters had a lower likelihood of hypertension, and middle-aged men and those with central obesity showed distinct associations with deranged pulse pressure.

Pulse pressure and its association with body composition among Chinese men and women without diagnosed hypertension: the China Kadoorie Biobank

BACKGROUND

Wide brachial pulse pressure (PP) has been associated with cardiovascular events, while its population distribution and association with body composition were poorly characterized in large populations.

METHODS

We evaluated the age and sex distributions of PP and its associations with body composition using baseline data from the China Kadoorie Biobank. A total of 434 200 participants without diagnosed hypertension were included in the analysis. Wide PP was defined as PP above 65 mmHg. Body composition variables, including BMI, waist circumference, waist-to-hip ratio (WHR), fat mass index (FMI), fat-free mass index (FFMI), and body fat percentage (BF%), were obtained from bioelectrical impedance analysis.

RESULTS

Overall, 14.3% of the participants had wide PP. Older age was consistently associated with wider PP in women but only after the andropause stage in men. The independent associations of BMI with wide PP were stronger than other body composition measures. The adjusted differences (men/women, mmHg) in PP per standard deviation (SD) increase in BMI (1.55/1.47) were higher than other body composition (BF%: 0.32/0.64, waist circumference: 0.33/0.39; WHR: 0.49/0.42). In addition, sex differences were observed. In men, the per SD difference in PP was higher for FFMI than for FMI (0.91 vs. 0.67, P  < 0.05), whereas in women, it was higher for FMI than for FFMI (1.01 vs. 0.72, P  < 0.05).

CONCLUSION

Our nationwide population-based study presented the sex-specific distribution of PP over age and identified differential associations of PP with fat and fat-free mass in men and women.

Age-specific risk factors for the prediction of obesity using a machine learning approach

Machine Learning is a powerful tool to discover hidden information and relationships in various data-driven research fields. Obesity is an extremely complex topic, involving biological, physiological, psychological, and environmental factors. One successful approach to the topic is machine learning frameworks, which can reveal complex and essential risk factors of obesity. Over the last two decades, the obese population (BMI of above 23) in Korea has grown. The purpose of this study is to identify risk factors that predict obesity using machine learning classifiers and identify the algorithm with the best accuracy among classifiers used for obesity prediction. This work will allow people to assess obesity risk from blood tests and blood pressure data based on the KNHANES, which used data constructed by the annual survey. Our data include a total of 21,100 participants (male 10,000 and female 11,100). We assess obesity prediction by utilizing six machine learning algorithms. We explore age- and gender-specific risk factors of obesity for adults (19-79 years old). Our results highlight the four most significant features in all age-gender groups for predicting obesity: triglycerides, ALT (SGPT), glycated hemoglobin, and uric acid. Our findings show that the risk factors for obesity are sensitive to age and gender under different machine learning algorithms. Performance is highest for the 19-39 age group of both genders, with over 70% accuracy and AUC, while the 60-79 age group shows around 65% accuracy and AUC. For the 40-59 age groups, the proposed algorithm achieved over 70% in AUC, but for the female participants, it achieved lower than 70% accuracy. For all classifiers and age groups, there is no big difference in the accuracy ratio when the number of features is more than six; however, the accuracy ratio decreased in the female 19-39 age group.

Association of Pulse Pressure Difference and Diabetes Mellitus in Chinese People: A Cohort Study

Purpose

Here, we sought to determine the association between pulse pressure difference and the incidence of type 2 diabetes mellitus (T2DM) in Chinese people.

Methods

This study involved 211,814 participants among whom 4156 had been diagnosed with T2DM. The correlation between pulse pressure difference and T2DM incidence in Chinese people was determined by multivariate analysis. A smooth curve fitting diagram was then used to explore correlation between pulse pressure difference and T2DM incidence. Finally, the inflection point in the correlation between pulse pressure difference and the T2DM incidence was located by piecewise linear regression.

Results

To understand the relationship, adjustments were made for sex, age, total serum cholesterol (TC), fasting blood glucose (FPG), triglyceride (TG), alanine aminotransferase (ALT), family history of diabetes, body mass index (BMI), blood urea nitrogen (BUN), drinking status, and smoking status. Diabetes incidence increased by 0.3% [HR 1.003 (1.001, 1.005), p = <0.05] for every 1mmHg increase in pulse pressure difference. Smooth curve analysis showed that, when pulse pressure difference was ≤35mmHg, diabetes incidence negatively correlated to pulse pressure difference [HR 0.972 (0.953, 0.972) p = 0.053]. However, when pulse pressure difference was >35mmHg, diabetes incidence increased with increasing pulse pressure difference [HR 1.044 (1.042, 1.047) p = <0.001]. And between pulse pressure difference and fasting blood glucose in the final visit, the blood glucose level increased with the elevation of pulse pressure.

Conclusion

The risk of diabetes was lowest at about 35mmHg pulse pressure difference.

Moderate Physical Training Ameliorates Cardiovascular Dysfunction Induced by High Fat Diet After Cessation of Training in Adult Rats

We aimed to test whether moderate physical training can induce long-lasting protection against cardiovascular risk factors induced by high fat diet (HFD) intake, even after cessation of training. 90-days-old Wistar rats were submitted to a sedentary lifestyle or moderate physical training, three times a week, for 30 days. Following this, at 120 days-of age, sedentary and trained rats received a hypercaloric diet (HFD) or a commercial diet normal fat diet (NFD) for 30 days. Body weight (BW) and food intake were evaluated weekly. At 150 days-of age, hemodynamic measures (systolic, diastolic, mean blood pressure, pulse pressure, pulse interval and heart rate) were made via an indwelling femoral artery catheter. Beat-to-beat data were analyzed to calculate power spectra of systolic blood pressure (SBP) and pulse interval. After euthanasia, mesenteric fat pads were removed and weighted and total blood was stored for later analysis of lipid profile. Consumption of a HFD increased blood pressure (BP), pulse pressure, low frequency BP variability, BW gain, fat pad stores and induced dyslipidemia. Interestingly, prior physical training was able to partially protect against this rise in BP and body fat stores. Prior physical training did not totally protect against the effects of HFD consumption but previously trained animals did demonstrate resistance to the development of cardiometabolic alterations, which illustrate that the benefits of physical training may be partially maintained even after 30 days of detraining period.

Pulse pressure is more relevant than systolic and diastolic blood pressure in patients with type 2 diabetes and cardiovascular disease

Background and aims

The parameters evaluated during 24-hour ambulatory blood pressure monitoring were reported to be predictors of cardiovascular events. We aimed to investigate mean blood pressure, blood pressure variability and pulse pressure during 24-hour ambulatory blood pressure monitoring in type 2 diabetes patients and to establish their relationship with the presence of atherosclerotic cardiovascular disease (CVD).

Methods

The observational study included type 2 diabetes patients randomly selected and distributed in 2 study groups depending on the presence of atherosclerotic cardiovascular disease: CVD(−), n=90, and CVD(+), n=87. Daytime, nighttime and 24-hour systolic and diastolic blood pressure were monitored and mean blood pressure, blood pressure variability and pulse pressure were calculated.

Results

The study groups were comparable as age, gender ratio, smoking status, body mass index and abdominal circumference. Diabetes and hypertension duration were significantly higher in the CVD(+) group. Mean systolic and diastolic blood pressure, blood variability, dipper prevalence did not differ between study groups. Pulse pressure was significantly higher in the CVD(+) group compared to CVD(−) group (daytime pulse pressure 56.2±13.1 vs. 50.6±11.3 mmHg, p=0.003; nighttime pulse pressure 56.5±14.2 vs. 50.7±12.4 mmHg, p=0.005; 24-hour pulse pressure 54.7±13.6 vs. 49.0±12.0 mmHg, p=0.003).

Conclusions

Ambulatory pulse pressure was significantly higher in patients with type 2 diabetes and atherosclerotic cardiovascular disease compared to those without cardiovascular disease, although mean systolic and diastolic blood pressure and blood pressure variability were similar.

Waist Circumference and Subclinical Thyroid Dysfunction in a Large Cohort of Chinese Men and Women

OBJECTIVE

The association between subclinical thyroid dysfunction and waist circumference (WC) is still controversial, especially from the perspective of sex differences. We aimed to explore the impact of sex on this relationship in a large Chinese cohort.

METHODS

This cross-sectional study recruited 13,505 healthy participants (8,346 males, 5,159 females) who were enrolled in a health check program. Clinical data were collected. The association between subclinical thyroid dysfunction and WC of both sexes was analyzed separately after dividing WC into quartiles. Odds ratios (ORs) were calculated by binary logistic regression models, and linear regression analysis was also performed.

RESULTS

The prevalence rates of subclinical hyper-and hypothyroidism were significantly lower in males. Binary logistic regression models showed that WC in females with subclinical hypothyroidism had a detrimental effect with an OR of 1.011, but the effect disappeared when we included other covariates. The other ORs indicated no significant effects. The weak negative relationship between WC and thyrotropin was also indicated by linear regression analyses with very low R² values.

CONCLUSION

The current research did not show WC as a risk factor for subclinical thyroid dysfunction in either sex. Regional and ancestral origin differences may account for the variations with other studies.

ABBREVIATIONS

ALT = alanine aminotransferase; BMI = body mass index; FT3 = free triiodothyronine; FT4 = free thyroxine; TG = triglycerides; TSH = thyroid-stimulating hormone; UA = uric acid; WC = waist circumference.

Body weight-dependent relationships between alcohol consumption and pulse pressure in middle-aged Japanese women

High pulse pressure is a risk factor for cardiovascular disease, and excessive alcohol drinking increases the risk of hypertension. The purpose of this study was to elucidate the relationship between alcohol intake and pulse pressure in women and to determine whether body weight influences their relationship. The subjects were 18,791 Japanese middle-aged women, and they were divided into tertile groups for body weight or three different body mass index (BMI, kg/m²) groups (low BMI <22; middle BMI ≥22 and <25; high BMI ≥25). The subjects in each group were further divided into four groups of nondrinkers, occasional drinkers, regular light drinkers, and regular heavy drinkers by habitual alcohol consumption. Pulse pressure levels were compared between nondrinkers and drinkers in each group for body weight or BMI. Pulse pressure was significantly higher in regular heavy drinkers than in nondrinkers in the first tertile group for body weight and in the low BMI group but not in the second and third tertile groups for body weight and in the middle and high BMI groups. In all tertile groups and all BMI groups, pulse pressure was not significantly different in occasional drinkers and regular light drinkers than in nondrinkers. In women with lower body weight, heavy drinking was positively associated with pulse pressure, while this association was not found in women with middle or higher body weight. Thus, body weight potently confounds the relationship between alcohol consumption and pulse pressure.

Abnormalities of Anthropometric, Hemodynamic, and Autonomic Variables in Offspring of Hypertensive Parents

Young adult offspring of hypertensive parents (pHTN⊕) are a good model for assessing abnormalities of anthropometric, cardiometabolic, and autonomic variables prior to clinical hypertension. The objectives of this study were to determine whether these variables and autonomic responses to oral carbohydrates were altered in offspring of pHTN⊕. Two hundred consecutive patients, including 100 pHTN⊕, were evaluated, with 29 patients, including 14 pHTN⊕, given a 70-gram carbohydrate load. The pHTN⊕ group had higher blood pressure, pulse pressure, abdominal circumference (AC), weight, body mass index, and basal metabolic rate than offspring of normotensive parents (pHTN∅). At baseline, the low-frequency (LF, sympathetic) to high-frequency (HF, parasympathetic) ratio, assessed by spectral analysis of heart rate variability, was similar in both groups. After the carbohydrate load, the LF/HF ratio was greater in offspring of pHTN⊕. pHTN⊕ individuals have abnormalities of anthropometric and hemodynamic variables at baseline and autonomic responses to oral carbohydrates before developing hypertension.

Multivariate modeling of body mass index, pulse pressure, systolic and diastolic blood pressure in Chinese twins

Systolic and diastolic blood pressure, pulse pressure (PP), and body mass index (BMI) are heritable traits in human metabolic health but their common genetic and environmental backgrounds are not well investigated. The aim of this article was to explore the phenotypic and genetic associations among PP, systolic blood pressure (SBP), diastolic blood pressure (DBP), and BMI. The studied sample contained 615 twin pairs (17-84 years) collected in the Qingdao municipality. Univariate and multivariate structural equation models were fitted for assessing the genetic and environmental contributions. The AE model combining additive genetic (A) and unique environmental (E) factors produced the best fit for each four phenotypes. Heritability estimated in univariate analysis ranged from 0.42 to 0.74 with the highest for BMI (95% CI 0.70-0.78), and the lowest for PP (95% CI 0.34-0.49). The multivariate model estimated (1) high genetic correlations for DBP with SBP (0.87), PP with SBP (0.75); (2) low-moderate genetic correlations between PP and DBP (0.32), each BP component and BMI (0.24-0.37); (3) moderate unique environmental correlation for PP with SBP (0.68) and SBP with DBP (0.63); (4) there was no significant unique environmental correlation between PP and BMI. Overall, our multivariate analyses revealed common genetic and environmental backgrounds for PP, BP, and BMI in Chinese twins.