Correlates of high-density lipoprotein cholesterol in black and white women

Correlates of serum high-density lipoprotein cholesterol: a community-based study of middle-aged and older men and women in Japan

The authors examined the relationships of high-density lipoprotein (HDL) cholesterol with sex, age, body composition, and lifestyle related factor including dietary patterns, alcohol consumption, smoking, and physical activity in a community-based sample from Mie prefecture, Japan. The study population comprised of 463 men (65.7+/-8.6 years) and 845 women (61.9+/-10.1 years) who participated in an annual healthy examination and a lifestyle related survey in 2001. Using factor analysis based on data from the lifestyle-related questionnaires, three dietary patterns were identified: prudent, Western, and high-salt dietary patterns. Univariate and multivariate analyses indicated that important predictors of higher HDL cholesterol levels were being female and a higher frequency of alcohol consumption. Less strongly related were age and a prudent dietary pattern. Smoking and body mass index (BMI) were strongly negatively related to HDL cholesterol levels. We suggested that efforts to reduce coronary heart disease risks focus on weight control and good daily lifestyles in middle-aged and older Japanese population.

Socioeconomic status and the prevalence of coronary heart disease risk factors

South Asian countries have a high prevalence of coronary heart disease (CHD) in line with their economic development. India, in particular, has a high burden of CHD. Hence, the aim of the present study was to assess the prevalence of CHD risk factors in a semiurban population of Andhra Pradesh, India, in different socioeconomic status (SES) groups. Information was collected on socioeconomic status, physical activity, cigarette smoking, body mass, blood pressure (BP) and serum lipid profiles among a healthy sample of 440 men and 210 women with an age range of 20-70 years. Mean levels of serum cholesterol (SC), high density lipoprotein cholesterol (HDLC), low density lipoprotein cholesterol (LDLC) and skinfold ratio were found to be higher among women, whereas triglycerides (TG), systolic BP and diastolic BP were higher in men. No statistically significant differences in body mass index (BMI) or pulse rate were observed between the sexes. In men, a significant positive rank correlation (rho = P < 0.05) was observed between SES and SC, TG, systolic and diastolic BP, pulse rate and BMI, but in women, the same trend was found only with SC, TG, skinfold ratio and age. The prevalence (age standardized to the world population of Segi, 95% CI) of obesity was 14.37% (11.06-17.68), hypertension 13.13% (9.11-17.15), hypercholesterolemia 18.56% (13.88-23.24), hypertriglyceridemia 45.98% (36.47-55.49) and low HDLC 31.01% (24.25-37.77). In both sexes, the prevalence of hypercholesterolemia, hypertriglyceridemia and sedentary life style increased among higher SES groups (P < 0.05). Also, an increase in the level of social class was positively associated with mean levels of serum cholesterol and triglycerides in both men and women. The results demonstrate that higher SES groups have greater prevalence of CHD risk factors than lower SES groups. Preventive measures are required to reduce the risk factors among higher SES groups.

Physical activity and ethnic differences in hypertension prevalence in the United States

BACKGROUND

In the United States, non-Hispanic blacks have higher rates of hypertension than other ethnic groups. In addition, they have higher rates of physical inactivity, a behavior linked to high blood pressure. We examined associations between ethnicity, leisure-time physical activity (LTPA), and hypertension prevalence in a representative sample of U.S. adults.

METHODS

Using data on 16,246 adults in the third National Health and Nutrition Examination Survey, hypertension prevalence was determined for non-Hispanic white, non-Hispanic black, and Mexican Americans at various levels of LTPA (none, 0.1-4.9 bouts/week at any intensity, 5+ bouts/week of moderate-to-vigorous activity). Logistic regression was used to examine relationships between hypertension prevalence, race, LTPA, and other variables.

RESULTS

Hypertension prevalence was significantly less in the most active group, compared with their sedentary peers (odds ratio = 0.73, CI 0.59 to 0.90). Blacks had an odds ratio for hypertension of 1.77 (CI 1.49 to 2.10) compared with non-Hispanic whites, after adjusting for gender, age, income, LTPA, smoking, BMI, salt intake, rural/urban dwelling, and alcohol intake. Mexican Americans had an adjusted odds ratio of 0.75 (CI 0.62 to 0.89), relative to non-Hispanic whites.

CONCLUSION

Ethnicity and LTPA are both associated with hypertension prevalence after controlling for each other, as well as other confounders. Thus, race and physical activity are important independent contributors to hypertension prevalence.

Progressive strength training in sedentary, older African American women

PURPOSE

This study investigated effects of an 8-wk, low-frequency and low-volume, supervised, progressive strength training program emphasizing free weight, multijoint movements on the muscular power, strength, endurance, and flexibility of African American women 44 to 68 yr of age.

METHODS

Nineteen sedentary African American women were randomly assigned to a strength training (ST) only group (N = 12; mean age, 51 yr) or a nonexercise control (C) group (N = 7; mean age, 52 yr). Maximal power, strength, absolute endurance, and flexibility were assessed before and after training. Subjects trained 2 d x wk(-1) using free weight (barbells and dumbbells) and machine (plate loaded) exercises for two to three sets of 8 to 10 repetitions on both primary and assistance exercises.

RESULTS

Upper body power (medicine ball put distance) significantly increased statistically (P = 0.002), but gains possibly lacked practical significance because of measurement variation. Lower body power (peak watts on bicycle) experienced a small, nonsignificant increase in the ST group. Significant increases (P = 0.000) in 1RM muscle strength occurred in the ST group (leg press, +99.8%; bench press, +34.4%). Absolute endurance significantly increased (P = 0.000) in the ST group (leg press repetitions to failure at 70% pretest 1RM, +221%; bench press repetitions to failure at 50% pretest 1RM, +112%). Significant flexibility gains occurred in the ST group (sit-and-reach test, +8.2%; P = 0.017). No significant changes occurred in power, strength, absolute endurance, or flexibility in the C group.

CONCLUSION

This study demonstrates that 8 wk of low-frequency, supervised, progressive strength training emphasizing free weight, multijoint movements can safely cause significant gains in muscle strength, absolute endurance, and flexibility in older African American women.

Population frequency distribution of non-high-density lipoprotein cholesterol (Third National Health and Nutrition Examination Survey [NHANES III], 1988-1994)

The objective of this study was to provide population frequency distribution data for non-high-density lipoprotein (HDL) cholesterol (total cholesterol minus HDL cholesterol) concentrations and to evaluate whether differences exist by gender, ethnicity, or level of education. Serum levels of non-HDL cholesterol and sociodemographic characteristics were determined for 3,618 black, 3,528 Mexican-American, and 6,043 white women and men, aged >/=25 years, from a national cross-sectional survey of the US population (National Health And Nutrition Examination Survey III, 1988-1994). Age-adjusted non-HDL cholesterol concentrations were lower in women than men (154.1 vs 160.4 mg/dL, p <0.001). In women and men, age was positively associated with non-HDL cholesterol in the 25 to 64-year age range, and the slope of the association was steeper for women. For women and men >/=65 years, age was negatively associated with non-HDL cholesterol, and the slope of the association was steeper for men. Black women and men had lower non-HDL cholesterol levels than either Mexican-American or white women and men (women, p <0.02; men, p <0.001, for both ethnic contrasts). Women with less education had higher levels of non-HDL cholesterol than women with more education (p <0.01). These nationally representative population frequency distribution data provide non-HDL cholesterol reference levels for clinicians and investigators and indicate that there are significant variations in non-HDL cholesterol by gender, age, ethnicity, and level of education.

Associations of obesity markers, insulin, and sex hormones with HDL-cholesterol levels in Turkish and German individuals

Turkish men and women have about 20% lower mean levels of HDL-C and apoA-I than German individuals. To obtain some information on the metabolic basis of this difference, we compared anthropometric data as well as serum levels of leptin, insulin, testosterone (T), estradiol (E2), and sex hormone binding globuline (SHBG) in 289 German and 120 Turkish men as well as in 108 German and 182 Turkish women aged 20-60. Individuals who smoke, take hormones, have overt diabetes mellitus, BMI > 30 kg/m2, triglycerides > 400 mg/dl, or LDL-cholesterol > 200 mg/dl were excluded. In both sexes, Turks had significantly lower levels of HDL-C, apoA-I, Lp(a), and SHBG than Germans. Moreover, German men had a larger waist circumference, lower levels of E2 and a lower ratio of T/SHBG. German women also had a lower BMI, smaller waist circumference, lower insulin levels and higher T levels. Mean values of age, waist-hip-ratio (WHR), leptin, triglycerides, LDL-C, and apoB did not differ significantly among Germans and Turks. Upon univariate analysis HDL-C had inverse correlations with BMI, waist circumference, WHR, leptin, and insulin as well as positive correlations with SHBG in both sexes. Upon multivariate analysis, most of the different levels of HDL-C and apoA-I between Germans and Turks were explained by ethnicity, independently of obesity markers, insulin, and sex hormones.

Coronary heart disease risk factors and cigarette smoking among rural African Americans

Cigarette smoking has been reported to worsen high-density lipoprotein (HDL) cholesterol and other cardiac risk factors, yet no studies have examined this issue among rural African Americans. This study examines the association between cigarette smoking and cardiac risk factors among rural African Americans. A population-based sample of 403 African-American adults from two rural Virginia counties underwent total cholesterol (TC), HDL, systolic and diastolic blood pressure (SBP and DBP), body mass index (BMI), serum glucose, and glycosylated hemoglobin (GlyHb) measurements. Cross-sectional multivariate analyses were used to compare risk factors across categories of cigarette use. Age, BMI, alcohol consumption, and the use of antihypertensive medications were covariates in the analysis. Results indicated that female light smokers had significantly lower SBP and DBP, and lower HDL. Female heavy smokers had significantly lower HDL and BMI and significantly higher TC/HDL ratios. Male heavy smokers had significantly higher SBP. More than 33% of males and more than 50% of females were overweight, and increasing BMI was associated with significantly or nearly significantly worsening of all other risk factor levels. Both cigarette smoking and obesity adversely affect other cardiac risk factors. Novel approaches are needed to decrease both smoking and obesity in this difficult to reach population.

Correlates of high-density lipoprotein cholesterol in Black girls and White girls: the NHLBI Growth and Health Study

To determine the correlates of serum high-density lipoprotein cholesterol (HDL-C) in 9- and 10-year-old girls, data were examined from 624 Black girls and 773 White girls. Black girls had, on average, 3.6 mg/dL higher levels than White girls. Each 10-mm increase in sum of skinfolds was associated with a decrease of 1.4 mg/dL; each unit increase in the tricep/suprailiac skinfold ratio was associated with an increase of 2 mg/dL; and each 10% increase in polyunsaturated fat intake was associated with an increase of 3.4 mg/dL. The associations of sedentary activity and sexual maturation with HDL were mediated by differences in adiposity. Interventions to decrease adiposity may be important for the primary prevention of heart disease in women.