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Andriolo V, Dietrich S, Knüppel S, Bernigau W, Boeing H. Traditional risk factors for essential hypertension: analysis of their specific combinations in the EPIC-Potsdam cohort. Sci Rep 2019; 9:1501. [PMID: 30728434 PMCID: PMC6365562 DOI: 10.1038/s41598-019-38783-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Accepted: 01/03/2019] [Indexed: 11/30/2022] Open
Abstract
Appropriate interventions might improve the prevention of essential hypertension. This requires a comprehensive view of modifiable lifestyle factors (MLFs) distribution and effect. To determine how six MLFs (general adiposity, abdominal adiposity, alcohol consumption, smoking, diet, physical inactivity) for risk of hypertension are distributed and how their combinations affect the risk, a prospective study cohort of 11,923 healthy participants from the population-based European Prospective Investigation into Cancer and Nutrition (EPIC)-Potsdam Study was used. Of these, 1,635 developed hypertension during a mean follow-up of 10.3 years. Mutually exclusive combinations, clustering and interactions of MLFs were then investigated stratifying by sex, Hazard Ratios (HRs) and Population Attributable Risks (PARs%) were calculated. General adiposity alone was sufficient to increase the risk of hypertension (HR = 1.86, PAR% 3.36), and in this cohort it played a major role in enhancing the risk of hypertension, together with smoking and physical inactivity. MLFs had a different impact and a different modulation of risk in women and men, and they showed a remarkable tendency to occur in specific patterns with higher prevalence than expected. This indication can help to promote a holistic approach through multifactorial preventive strategies addressing more than a factor at a time. For prevention of hypertension addressing adiposity together with smoking, promoting at the same time physical activity should be the first choice.
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Affiliation(s)
- Violetta Andriolo
- Department of Epidemiology, German Institute of Human Nutrition, Potsdam-Rehbrücke (DIfE), Germany.
| | - Stefan Dietrich
- Department of Molecular Epidemiology, German Institute of Human Nutrition, Potsdam-Rehbrücke (DIfE), Germany
| | - Sven Knüppel
- Department of Epidemiology, German Institute of Human Nutrition, Potsdam-Rehbrücke (DIfE), Germany
| | - Wolfgang Bernigau
- Department of Epidemiology, German Institute of Human Nutrition, Potsdam-Rehbrücke (DIfE), Germany
| | - Heiner Boeing
- Department of Epidemiology, German Institute of Human Nutrition, Potsdam-Rehbrücke (DIfE), Germany
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Mak HW, Kim J, Wang S. The Role of Parent-Adolescent Relationships in the Development of (Pre)Hypertension in Young Adulthood in the U.S. J Adolesc Health 2019; 64:258-264. [PMID: 30528520 DOI: 10.1016/j.jadohealth.2018.08.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2018] [Revised: 08/05/2018] [Accepted: 08/07/2018] [Indexed: 11/15/2022]
Abstract
BACKGROUND Hypertension is a strong factor for stroke and coronary disease, and it has been found that 1 in 4 young adults are experiencing pre-hypertension in the United States This study was designed to examine the role of parent-adolescent relationships in the risk of developing (pre)hypertension in young adulthood, and to explore potential mediator(s). METHODS Our analysis was based on the data from the National Longitudinal Study of Adolescent to Adult Health, Wave 1 (aged 13-18) and Wave 4 (aged 25-32) (N = 3,350). Three parent-adolescent relationships were extracted from a factor analysis, and four different specifications of (pre)hypertension were generated and tested individually. We applied generalised structural equation modelling to perform path analysis estimations. RESULTS We found that mother-reported relationship quality had both a direct and an indirect effect via alcohol consumption, on the likelihood of (pre)hypertension in young adulthood. The path from relationship quality to (pre)hypertension via alcohol consumption was consistent with three different specifications of hypertension (pre-hypertension, clinical/experienced hypertension, and experienced hypertension), suggesting the path relation was evident. Our study also showed that both relationship quality and adolescent-reported maternal warmth/responsiveness were associated with the risk of clinical/experienced hypertension via mental health problems. Parental control was found to have a direct and protective effect on clinical/experienced hypertension. CONCLUSIONS Early family relationships in adolescence predict (pre)hypertension in young adulthood. Initiatives related to parent-adolescent relationships, and the associated effects on later alcohol consumption and mental health problems, may have a long implication on the risk of (pre)hypertension in adulthood.
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Affiliation(s)
- Hei Wan Mak
- Department of Sociology, University of Cambridge, Cambridge, United Kingdom.
| | - Joeun Kim
- Department of Sociology and Criminology, Pennsylvania State University, State College, Pennsylvania
| | - Senhu Wang
- Department of Sociology, University of Cambridge, Cambridge, United Kingdom
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Bae J, Yi YH, Kim YJ, Lee JG, Tak YJ, Lee SH, Hwang HR, Lee SY, Cho YH, Ro EJ. Time to First Cigarette and the Risk of Hypertension: A Nationwide Representative Study in Korea. Am J Hypertens 2019; 32:202-208. [PMID: 30452540 DOI: 10.1093/ajh/hpy170] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Accepted: 11/09/2018] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Although previous studies have explored the effect of smoking on blood pressure, little is still known about the role of time to first cigarette (TTFC)-an indicator of nicotine dependence-in hypertension. Therefore, we evaluated this association using representative nationwide data. METHODS Current daily smokers (N = 941; aged 19-79 years) who participated in the 7th version of the Korea National Health and Nutrition Examination Survey I (2016) were included. We categorized participants into 4 groups according to their TTFC. Furthermore, we categorized participants into hypertensive and nonhypertensive groups based on whether they were taking antihypertensive medications or had high blood pressure (≥140/90 mm Hg). The association of daily TTFC and hypertension was examined without adjusting for any covariates; after adjusting for smoking behaviors; and after adjusting for demographic characteristics, socioeconomic status, health-related behaviors, and comorbidities. RESULTS In the fully adjusted weighted regression analysis, participants reporting TTFC ≤ 5 minutes (vs. >60 minutes) had roughly twice the odds of having hypertension (95% confidence interval [CI] = 1.07-4.16) and the adjusted odds ratios compared with TTFC of >60 minutes were 1.53 (95% CI = 0.81-2.86) for 6-30 minutes and 1.31 (95% CI = 0.68-2.50) for 31-60 minutes (Ptrend = 0.03). CONCLUSIONS Hypertension risk increases with shorter TTFC. Especially, TTFC of ≤5 minutes may prove valuable in assessing the risk of hypertension. Screening smokers based on their TTFC might be useful in assessing their risk of hypertension and smoking cessation programs.
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Affiliation(s)
- Jinok Bae
- Department of Family Medicine, Pusan National University Hospital, Busan, South Korea
| | - Yu Hyeon Yi
- Department of Family Medicine, Pusan National University Hospital, Busan, South Korea
- Busan Tobacco Control Center, Busan, South Korea
- Biomedical Research Institute, Pusan National University Hospital, Busan, South Korea
| | - Yun Jin Kim
- Department of Family Medicine, Pusan National University Hospital, Busan, South Korea
- Biomedical Research Institute, Pusan National University Hospital, Busan, South Korea
| | - Jeong Gyu Lee
- Department of Family Medicine, Pusan National University Hospital, Busan, South Korea
- Busan Tobacco Control Center, Busan, South Korea
- Biomedical Research Institute, Pusan National University Hospital, Busan, South Korea
| | - Young Jin Tak
- Department of Family Medicine, Pusan National University Hospital, Busan, South Korea
- Biomedical Research Institute, Pusan National University Hospital, Busan, South Korea
| | - Seung Hoon Lee
- Department of Family Medicine, Pusan National University Hospital, Busan, South Korea
- Busan Tobacco Control Center, Busan, South Korea
- Biomedical Research Institute, Pusan National University Hospital, Busan, South Korea
| | - Hye Rim Hwang
- Department of Family Medicine, Pusan National University Hospital, Busan, South Korea
- Biomedical Research Institute, Pusan National University Hospital, Busan, South Korea
| | - Sang Yeoup Lee
- Family Medicine Clinic, Obesity, Metabolism and Nutrition Center and Research Institute of Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, South Korea
- Medical Education Unit and Medical Research Institute, Pusan National University School of Medicine, Yangsan, South Korea
| | - Young Hye Cho
- Family Medicine Clinic, Obesity, Metabolism and Nutrition Center and Research Institute of Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, South Korea
| | - Ei Jin Ro
- Department of Family Medicine, Pusan National University Hospital, Busan, South Korea
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Relationship of Smoking to Hypertension in a Developing Country. Glob Heart 2018; 13:285-292. [DOI: 10.1016/j.gheart.2018.01.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Revised: 01/13/2018] [Accepted: 01/23/2018] [Indexed: 01/21/2023] Open
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Terho A, Bloigu R, Bloigu A, Niemelä O, Tulppo M, Kesäniemi YA, Ukkola O. Life style habits, biochemical factors and their interaction in the prediction of incident hypertension during 21-year follow-up. Blood Press 2018; 28:40-48. [PMID: 30479170 DOI: 10.1080/08037051.2018.1540923] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
BACKGROUND Hypertension is a global health threat and major cardiovascular risk. Various risk-prediction models for incident hypertension have been developed but not many of them have studied the risk-predictive value of life style factors in combination with cardiovascular biomarkers during long-term period of over 10 years. METHODS We examined differences in several classical variables for 299 subjects in OPERA (Oulu Project Elucidating Risk of Atherosclerosis) cohort in subjects with no or new hypertension during a follow-up period of 21 years. Effect of both various life style habits and biomarkers were investigated. RESULTS Baseline blood pressure, being overweight and smoking actively were independent predictors of new hypertension in majority of multivariate models during long-term follow-up of 21 years in subjects without previous hypertension. Increased high-sensitive C-reactive protein (hsCRP) level (> 3 mg/L) was the strongest predictor of incident hypertension in univariate model. Subjects with two or all three of main risk factors (being overweight, smoking actively and having high hsCRP) had 4-fold risk for incident hypertension. CONCLUSIONS Smoking, overweight and increased hsCRP level had risk-predictive value in incident hypertension prediction during long-term follow-up of 21 years. Assessment and measurement of these parameters could be used in help of detecting high risk subjects and primary prevention of hypertension very early on. In addition, the study shows that blood pressure at the middle-age should be followed and treated intensively to prevent hypertension in the older age. KEY MESSAGES Baseline blood pressure, being overweight and smoking actively are independent predictors of new hypertension during a long-term follow-up of 21 years. Having two or all three risk factors (smoking actively, body mass index over 25 kg/m2, high-sensitive C-reactive protein (hsCRP) level over 3 mg/L) indicates a 4-fold risk for incident hypertension within 21-year follow-up.
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Affiliation(s)
- Aleksi Terho
- a Medical Research Center Oulu, Oulu University Hospital , University of Oulu , Oulu , Finland
| | - Risto Bloigu
- a Medical Research Center Oulu, Oulu University Hospital , University of Oulu , Oulu , Finland
| | - Aini Bloigu
- a Medical Research Center Oulu, Oulu University Hospital , University of Oulu , Oulu , Finland
| | - Onni Niemelä
- a Medical Research Center Oulu, Oulu University Hospital , University of Oulu , Oulu , Finland
| | - Mikko Tulppo
- a Medical Research Center Oulu, Oulu University Hospital , University of Oulu , Oulu , Finland
| | - Y Antero Kesäniemi
- a Medical Research Center Oulu, Oulu University Hospital , University of Oulu , Oulu , Finland
| | - Olavi Ukkola
- a Medical Research Center Oulu, Oulu University Hospital , University of Oulu , Oulu , Finland
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Aune D, Schlesinger S, Norat T, Riboli E. Tobacco smoking and the risk of heart failure: A systematic review and meta-analysis of prospective studies. Eur J Prev Cardiol 2018; 26:279-288. [DOI: 10.1177/2047487318806658] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Background We conducted a systematic review and meta-analysis to clarify the association between smoking and the risk of developing heart failure. Methods PubMed and Embase databases were searched up to 24 July 2018. Prospective studies were included if they reported adjusted relative risk (RR) estimates and 95% confidence intervals (CIs) of heart failure associated with smoking. Summary RRs and 95% CIs were estimated using a random effects model. Results Twenty-six studies were included. The summary RR was 1.75 (95% CI: 1.54–1.99, I2 = 81%, n = 10) for current smokers, 1.16 (95% CI: 1.08–1.24, I2 = 51%, n = 9) for former smokers, and 1.44 (1.34–1.55, I2 = 83%, n = 10) for ever smokers compared with never smokers. The summary RR was 1.41 (95% CI: 1.01–1.96, I2 = 82%, n = 2) per 10 cigarettes per day, 1.11 (95% CI: 1.04–1.18, I2 = 70%, n = 3) and 1.08 (95% CI: 1.02–1.14, I2 = 34%, n = 2) per 10 pack-years among ever smokers and former smokers, respectively, and 0.79 (95% CI: 0.63–1.00, I2 = 96%, n = 2) per 10 years since quitting smoking. The association between smoking cessation and heart failure reached significance at 15 years of smoking cessation, and at 30 years the summary RR was 0.72 (95% CI: 0.57–0.90), only slightly higher than the summary RR for never smokers (0.64 (95% CI: 0.57–0.72)) when compared with current smokers. Conclusion Smoking is associated with increased risk of heart failure, but the risk decreases with increasing duration since smoking cessation. Any further studies should investigate the association between number of cigarettes per day, duration, pack-years and time since quitting smoking and risk of heart failure.
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Affiliation(s)
- Dagfinn Aune
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
- Department of Nutrition, Bjørknes University College, Oslo, Norway
- Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Oslo, Norway
| | - Sabrina Schlesinger
- Institute for Biometry and Epidemiology, German Diabetes Center, Leibniz Institute for Diabetes Research at the Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Teresa Norat
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Elio Riboli
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
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Kim SH, Lee JS. The association of smoking and hypertension according to cotinine-verified smoking status in 25,150 Korean adults. Clin Exp Hypertens 2018; 41:401-408. [DOI: 10.1080/10641963.2018.1489548] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Sung Hoon Kim
- Department of Pediatrics, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea
| | - Ju Suk Lee
- Department of Pediatrics, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea
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Aune D, Schlesinger S, Norat T, Riboli E. Tobacco smoking and the risk of atrial fibrillation: A systematic review and meta-analysis of prospective studies. Eur J Prev Cardiol 2018; 25:1437-1451. [DOI: 10.1177/2047487318780435] [Citation(s) in RCA: 66] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background Epidemiological studies on smoking and atrial fibrillation have been inconsistent, with some studies showing a positive association while others have found no association. It is also unclear whether there is a dose–response relationship between the number of cigarettes smoked or pack-years and the risk of atrial fibrillation. We conducted a systematic review and meta-analysis to clarify the association. Design Systematic review and meta-analysis. Methods We searched the PubMed and Embase databases for studies of smoking and atrial fibrillation up to 20 July 2017. Prospective studies and nested case–control studies within cohort studies reporting adjusted relative risk estimates and 95% confidence intervals (CIs) of atrial fibrillation associated with smoking were included. Summary relative risks (95% CIs) were estimated using a random effects model. Results Twenty nine prospective studies (22 publications) were included. The summary relative risk was 1.32 (95% CI 1.12–1.56, I2 = 84%, n = 11 studies) for current smokers, 1.09 (95% CI 1.00–1.18, I2 = 33%, n = 9) for former smokers and 1.21 (95% CI 1.12–1.31, I2 = 80%, n = 14) for ever smokers compared to never smokers. Comparing current versus non-current smokers the summary relative risk was 1.33 (95% CI 1.14–1.56, I2 = 78%, n = 10). The summary relative risk was 1.14 (95% CI 1.10–1.20, I2 = 0%, n = 3) per 10 cigarettes per day and 1.16 (95% CI 1.09–1.25, I2 = 49%, n = 2) per 10 pack-years and there was no evidence of a non-linear association for cigarettes per day, Pnon-linearity = 0.17. Conclusions The current meta-analysis suggests that smoking is associated with an increased risk of atrial fibrillation in a dose-dependent matter, but the association is weaker among former smokers compared to current smokers.
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Affiliation(s)
- Dagfinn Aune
- Department of Epidemiology and Biostatistics, Imperial College London, UK
- Department of Nutrition, Bjørknes University College, Norway
- Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Norway
| | - Sabrina Schlesinger
- Institute for Biometry and Epidemiology, German Diabetes Center, Leibniz Institute for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Teresa Norat
- Department of Epidemiology and Biostatistics, Imperial College London, UK
| | - Elio Riboli
- Department of Epidemiology and Biostatistics, Imperial College London, UK
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Affiliation(s)
- Toshiaki Ebina
- Department of Laboratory Medicine and Clinical Investigation/Division of Cardiology, Yokohama City University Medical Center
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Hieshima K, Suzuki T, Sugiyama S, Kurinami N, Yoshida A, Miyamoto F, Kajiwara K, Jinnouchi T, Jinnouchi H. Smoking Cessation Ameliorates Microalbuminuria With Reduction of Blood Pressure and Pulse Rate in Patients With Already Diagnosed Diabetes Mellitus. J Clin Med Res 2018; 10:478-485. [PMID: 29707089 PMCID: PMC5916536 DOI: 10.14740/jocmr3400w] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Accepted: 03/21/2018] [Indexed: 12/23/2022] Open
Abstract
Background Smoking cessation in newly diagnosed type 2 diabetes patients is reported to be associated with amelioration of metabolic parameters and blood pressure (BP), and the reduction of microalbuminuria. The aim of this study is to demonstrate changes in BP, pulse rate (PR), and microalbuminuria in already diagnosed diabetes patients who quit smoking. Methods We retrospectively evaluated diabetes outpatients who were habitual smokers, and who visited to our smoking cessation clinic. Patients were divided into two groups based on their smoking status at the termination of a 3-month smoking cessation program (smoking cessation group and smoking group), and analyzed systolic and diastolic BPs, PR, HbA1c, and body weight at the start date, and at 1, 3, 6, and 12 months thereafter. The urinary albumin-to-creatinine ratio was also measured at the start date and at 12 months. Results Thirty-five patients met our criteria. Mean diabetes duration was 12 years. Eighteen patients (52%) quit smoking. Success or failure of smoking cessation depended on nicotine dependence rather than good or bad glycemic control. Both BP and PR decreased significantly after 1 month or later in the smoking cessation group without worsening HbA1c, while both parameters did not show any changes in the smoking group. Microalbuminuria was also ameliorated significantly at 12 months compared with that at the start date in the smoking cessation group (95.8 ± 92.9 mg/gCr vs. 75.5 ± 96.3 mg/gCr, P = 0.0059), while it did not show a significant change in the smoking group. (61.9 ± 43.5 mg/gCr vs. 97.7 ± 90.4 mg/gCr, P = 0.1039). Conclusions Smoking cessation might cause a reduction in chronic kidney disease progression through ameliorating microalbuminuria without metabolic adverse effects in patients already diagnosed with diabetes mellitus.
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Affiliation(s)
- Kunio Hieshima
- Diabetes Care Center, Jinnouchi Hospital, Kumamoto, Japan
| | - Tomoko Suzuki
- Diabetes Care Center, Jinnouchi Hospital, Kumamoto, Japan
| | - Seigo Sugiyama
- Diabetes Care Center, Jinnouchi Hospital, Kumamoto, Japan.,Cardiovascular Division, Diabetes Care Center, Jinnouchi Hospital, Kumamoto, Japan
| | | | - Akira Yoshida
- Diabetes Care Center, Jinnouchi Hospital, Kumamoto, Japan
| | - Fumio Miyamoto
- Diabetes Care Center, Jinnouchi Hospital, Kumamoto, Japan
| | - Keizo Kajiwara
- Diabetes Care Center, Jinnouchi Hospital, Kumamoto, Japan.,Cardiovascular Division, Diabetes Care Center, Jinnouchi Hospital, Kumamoto, Japan
| | - Tomio Jinnouchi
- Diabetes Care Center, Jinnouchi Hospital, Kumamoto, Japan.,Cardiovascular Division, Diabetes Care Center, Jinnouchi Hospital, Kumamoto, Japan.,Division of Preventive Cardiology, Department of Cardiovascular Medicine, Kumamoto University Hospital, Kumamoto, Japan
| | - Hideaki Jinnouchi
- Diabetes Care Center, Jinnouchi Hospital, Kumamoto, Japan.,Cardiovascular Division, Diabetes Care Center, Jinnouchi Hospital, Kumamoto, Japan.,Division of Preventive Cardiology, Department of Cardiovascular Medicine, Kumamoto University Hospital, Kumamoto, Japan
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Aune D, Schlesinger S, Norat T, Riboli E. Tobacco smoking and the risk of sudden cardiac death: a systematic review and meta-analysis of prospective studies. Eur J Epidemiol 2018; 33:509-521. [PMID: 29417317 PMCID: PMC5995997 DOI: 10.1007/s10654-017-0351-y] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Accepted: 12/22/2017] [Indexed: 12/27/2022]
Abstract
Smoking is an established risk factor for cardiovascular disease including coronary heart disease and stroke, however, data regarding smoking and sudden cardiac death have not been summarized in a meta-analysis previously. We therefore conducted a systematic review and meta-analysis to clarify this association. We searched the PubMed and Embase databases for studies of smoking and sudden cardiac death up to July 20th 2017. Prospective studies were included if they reported adjusted relative risk (RR) estimates and 95% confidence intervals (CIs) for smoking and sudden cardiac death. Summary RRs were estimated by use of a random effects model. Twelve prospective studies were included. The summary RR was 3.06 (95% CI 2.46–3.82, I2 = 41%, pheterogeneity = 0.12, n = 7) for current smokers and 1.38 (95% CI 1.20–1.60, I2 = 0%, pheterogeneity = 0.55, n = 7) for former smokers compared to never smokers. For four studies using non-current (never + former) smokers as the reference category the summary RR among current smokers was 2.08 (95% CI 1.70–2.53, I2 = 18%, pheterogeneity = 0.30). The results persisted in most of the subgroup analyses. There was no evidence of publication bias. These results confirm that smoking increases the risk of sudden cardiac death. Any further studies should investigate in more detail the effects of duration of smoking, number of cigarettes per day, pack-years, and time since quitting smoking and sudden cardiac death.
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Affiliation(s)
- Dagfinn Aune
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, St. Mary's Campus, Norfolk Place, Paddington, London, W2 1PG, UK. .,Bjørknes University College, Oslo, Norway. .,Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Oslo, Norway.
| | - Sabrina Schlesinger
- Institute for Biometrics and Epidemiology, German Diabetes Center (DDZ) at Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Teresa Norat
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, St. Mary's Campus, Norfolk Place, Paddington, London, W2 1PG, UK
| | - Elio Riboli
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, St. Mary's Campus, Norfolk Place, Paddington, London, W2 1PG, UK
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Thankappan KR, Mini GK, Sarma PS. Risk of progression to hypertension from prehypertension and normal blood pressure: Results from a prospective cohort study among industrial workers in Kerala, India. HEART AND MIND 2018. [DOI: 10.4103/hm.hm_21_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Mikhailova OO, Litvin AY, Rogoza AN. [Influence of modifiable cardiovascular risk factors on antihypertensive therapy efficiency escape]. TERAPEVT ARKH 2017; 89:10-14. [PMID: 29039824 DOI: 10.17116/terarkh201789910-14] [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: 01/26/2023]
Abstract
AIM To evaluate the influence of cardiovascular risk factors on antihypertensive therapy (AHT) efficiency escape (EE). SUBJECTS AND METHODS Data on 59 patients with grades 1-3 hypertension (Stages I-II) were analyzed. During chosen AHT, 24-hour blood pressure monitoring was done at baseline, 1 and 3 months after beginning the observation to identify/rule out the AHT EE phenomenon. RESULTS The AHT EE group (Group 1) as compared with the group that needed no therapy correction within 3 months (Group 2) was observed to have the following: elevated fasting blood glucose levels (FBGL) (5.8±0.8 vs 5.3±0.7 mmol/l; p=0.008) and higher impaired glucose tolerance (IGT) rates (8 (27.6%) vs 4 (13.3%) cases (p=0.03)); a more number of smoking patients (8 (27.6%) vs 3 (10%) cases; p=0.02); a larger number of patients with a compromised family history of cardiovascular diseases (17 (58.6%) vs 11 (36%); p=0.02). Furthermore, in Group 1 baseline average systolic blood pressure during 24 hours (SBP-24) proved to be higher than that in Group 2 (127.4±4.2 vs 122.4±6.8 mm Hg; p=0.002). Odds ratio (OR) for developing the EE phenomenon increased by 60% with a rise of 0.5 mmol in FBGL (OR, 1.60; 95% confidence interval (CI), 1.06 to 2.4; p=0.02) and by 18% with an increase of 1 mm Hg in baseline SBP-24 (OR, 1.18; 95% CI, 1.05 to 1.33; p=0.004). Multivariate analysis indicated that the independent predictors of AHT EE were a compromised family history (OR, 3.7; 95% CI, 1.1 to 12.1; p=0.03) and IGT (OR, 4.1; 95% CI, 1.02 to 16.4; p=0.04). CONCLUSION AHT EE was influenced by FBGL, IGT, smoking, a compromised family history, and baseline SBP-24 level.
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Affiliation(s)
- O O Mikhailova
- A.L. Myasnikov Institute of Cardiology, Russian Cardiology Research and Production Complex, Ministry of Health of the Russian Federation, Moscow, Russia
| | - A Yu Litvin
- A.L. Myasnikov Institute of Cardiology, Russian Cardiology Research and Production Complex, Ministry of Health of the Russian Federation, Moscow, Russia
| | - A N Rogoza
- A.L. Myasnikov Institute of Cardiology, Russian Cardiology Research and Production Complex, Ministry of Health of the Russian Federation, Moscow, Russia
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Li G, Wang H, Wang K, Wang W, Dong F, Qian Y, Gong H, Hui C, Xu G, Li Y, Pan L, Zhang B, Shan G. The association between smoking and blood pressure in men: a cross-sectional study. BMC Public Health 2017; 17:797. [PMID: 29017534 PMCID: PMC5634904 DOI: 10.1186/s12889-017-4802-x] [Citation(s) in RCA: 69] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2016] [Accepted: 09/27/2017] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Cigarette smoking is a known risk factor for cardiovascular disease (CVD), but the association between smoking and blood pressure is unclear. Thus, the current study examined the association between cigarette smoking and blood pressure in men. METHODS Systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP) and pulse pressure (PP) were examined using digital blood pressure measuring device, and smoking status was determined with China National Health Survey. RESULTS The ANCOVA showed that the adjusted DBP and MAP were lower in current smokers versus nonsmokers and the adjusted SBP was lower in current smokers versus former smokers (P < 0.05). Additionally, the adjusted PP tend to be decreased steadily as the pack·years increased in current smokers. In a fully adjusted logistic regression model, former smokers had increased ORs (95% CI) of 1.48 (1.01, 2.18) of hypertension and current smokers had not increased ORs (95% CI) of 0.83 (0.61, 1.12), compared with never smokers. CONCLUSIONS The findings revealed that the adjusted blood pressure were lower in current smokers versus nonsmokers and former smokers. No significant dose-dependent effect of current smoking on blood pressure indices except PP was observed. Smoking cessation was significantly associated with an increased risk of hypertension. However, current smoking was not a risk factor of hypertension.
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Affiliation(s)
- Guoju Li
- Qingdao Women and Children's Hospital, Qingdao University, Qingdao, Shandong, 266011, China
| | - Hailing Wang
- Inner Mongolia Center for Disease Control and Prevention, Hohhot, China
| | - Ke Wang
- National Office for Maternal and Child Health Surveillance of China, Department of Obstetrics, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Wenrui Wang
- Inner Mongolia Center for Disease Control and Prevention, Hohhot, China
| | - Fen Dong
- China-Japan Friendship Hospital, Beijing, China
| | - Yonggang Qian
- Inner Mongolia Center for Disease Control and Prevention, Hohhot, China
| | - Haiying Gong
- Fangshan District Center for Disease Control and Prevention, Beijing, China
| | - Chunxia Hui
- Inner Mongolia Center for Disease Control and Prevention, Hohhot, China
| | - Guodong Xu
- China-Japan Friendship Hospital, Beijing, China
| | - Yanlong Li
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, School of Basic Medicine, Peking Union Medical College, Beijing, China
| | - Li Pan
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, School of Basic Medicine, Peking Union Medical College, Beijing, China
| | - Biao Zhang
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, School of Basic Medicine, Peking Union Medical College, Beijing, China
| | - Guangliang Shan
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, School of Basic Medicine, Peking Union Medical College, Beijing, China.
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Koizumi H, Hoshi K, Yamamoto D, Asari Y, Kumabe T. Relationship between Stroke Events during Pachinko Play and Prognosis. J Stroke Cerebrovasc Dis 2017; 26:2971-2975. [PMID: 28939050 DOI: 10.1016/j.jstrokecerebrovasdis.2017.07.022] [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: 04/24/2017] [Revised: 07/08/2017] [Accepted: 07/23/2017] [Indexed: 10/18/2022] Open
Abstract
BACKGROUND This study investigated whether pachinko play influences the outcome of stroke events, and identified the significant variables affecting outcomes. METHODS We reviewed the medical and imaging records of 2075 consecutive patients with stroke from January 2003 through June 2012. The remaining patients were divided into 2 groups, the pachinko players group (PP) and the non-pachinko players group (NPP). Background factors were recorded on admission. Multivariate logistic regression analysis was used to identify the factors significantly correlated with Glasgow Outcome Scale (GOS) score and risk of death at the time of discharge. RESULTS The PP group exhibited higher prevalence of hypertension and current smoking compared with the NPP group. However, no difference was found in outcomes between the PP and NPP groups. Multivariate analysis identified the dependent predictive variables for GOS as age (adjusted β = -.18, 95% confidence interval [CI]: -.22 to -.14, P <.001), Glasgow Coma Scale (GCS) score on admission (adjusted β = .64, 95% CI: .60 to .68, P <.001), and history of hypertension (adjusted β = -.06, 95% CI: -.10 to -.02, P = .007). Logistic regression analysis showed that age (odds ratio = 1.02, 95% CI: 1.01 to 1.04, P <.001) and GCS score on admission (odds ratio = .72, 95% CI: .69 to .75, P <.001) were significantly associated with death at the time of discharge. CONCLUSIONS Patients with stroke during playing pachinko have higher prevalence of hypertension and higher smoking rate, but pachinko play itself was not a critical factor determining the outcome of patients with stroke in our emergency center.
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Affiliation(s)
- Hiroyuki Koizumi
- Department of Neurosurgery, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan; Department of Emergency and Critical Care Medicine, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan.
| | - Keika Hoshi
- Department of Hygiene, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan
| | - Daisuke Yamamoto
- Department of Neurosurgery, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan
| | - Yasushi Asari
- Department of Emergency and Critical Care Medicine, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan
| | - Toshihiro Kumabe
- Department of Neurosurgery, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan
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Isaka Y, Moriyama T, Kanda K. The SONG (Salt intake and OrigiN from General foods) Study - A Large-scale Survey of the Eating Habits and Dietary Salt Intake in the Working-age Population. Intern Med 2017; 56:2423-2430. [PMID: 28824058 PMCID: PMC5643168 DOI: 10.2169/internalmedicine.8370-16] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Objective Dietary salt reduction is important for the prevention and treatment of lifestyle-related diseases, including hypertension. Thus, in order to follow a strict low-salt diet, it is necessary to assess one's salt intake and to become aware of the importance of salt reduction. Methods More than 2,000 employees of a company, who received a periodic health checkup, participated in the present study. They assessed their day-to-day diet-related lifestyle, using the Salt Check Sheet, and we analyzed the correlations among the Salt Check Sheet scores, the daily salt intake (as estimated by a spot urine sample), and the results of the periodic health checkup. Results In the overall survey population, we only found a weak correlation between the salt check scores and the salt intake. In a subgroup analysis, significant correlations between these two variables were observed among untreated hypertensive participants, but not among treated hypertensive participants. We examined the association between 13 individual questionnaire items and the estimated daily salt intake using a multivariate linear regression model and found that only 5 of the 13 questionnaire items were correlated with the daily salt intake. Conclusion We found that a Salt Check Sheet composed of the 5 items that showed a strong correlation with the salt intake might be more useful for periodic health checks of the working-age population.
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Affiliation(s)
- Yoshitaka Isaka
- Department of Nephrology, Osaka University Graduate School of Medicine, Japan
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Li G, Guo G, Wang W, Wang K, Wang H, Dong F, Qian Y, Gong H, Xu G, Li Y, Pan L, Zhang B, Shan G. Association of prehypertension and cardiovascular risk factor clustering in Inner Mongolia: a cross-sectional study. BMJ Open 2017; 7:e015340. [PMID: 28667215 PMCID: PMC5734362 DOI: 10.1136/bmjopen-2016-015340] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
OBJECTIVES To assess the clustering of cardiovascular disease (CVD) risk factors in Han and Mongolian adults with prehypertension or hypertension in Northern China. METHODS We selected 3227 Han and Mongolian participants (20-80 years old) using a multistage cluster sampling method in 2014. The participants were interviewed by standard questionnaires and underwent anthropometric measurement and biochemical testing. Han and Mongolian participants were divided into optimal, prehypertension, and hypertension groups based on blood pressure. A multinomial logit analysis was performed to explore relationships between CVD risk factor clustering and prehypertension or hypertension, and the heterogeneity between Han and Mongolian was evaluated by the Cochran Q test. The differences between the ethnic groups in the proportions of risk factors was tested with the χ2 test. RESULTS The clustering of two or three CVD risk factors in the prehypertension or hypertension groups was consistently higher than in the optimal group (Bonferroni, p<0.0167). The odds ratios (ORs) of prehypertension and hypertension increased with the number of CVD risk factors (ptrend <0.0001). In multivariate modelling, the adjusted ORs of one, two, and ≥3 CVD risk factors versus no risk factors was, respectively, 1.95, 2.25, and 2.28 in Han prehypertensive participants, and 1.73, 2.83, and 3.69 in Mongolian prehypertensive participants. In addition, the adjusted ORs were 3.15, 4.75, and 6.49 in Han hypertensive participants, and 1.90, 5.29, and 8.13 in Mongolian hypertensive participants (all p<0.05). There was no significant heterogeneity between Han and Mongolian participants in the prehypertension or hypertension groups. The age-standardised prevalence of ≥3 risk factors was 38.30% in Han men and 39.79% in Mongolian men. The rate was significantly lower in Han women than Mongolian women (9.18% vs 14.55%, p=0.002). CONCLUSIONS These findings showed clustering of CVD risk factors in prehypertensive Han and Mongolian adults, and showed prehypertension may be a useful target for intervention.
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Affiliation(s)
- Guoju Li
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, School of Basic Medicine, Peking Union Medical College, Beijing, China
| | - Guanghong Guo
- Department of Clinical Biochemistry, Chinese PLA General Hospital, Beijing, China
| | - Wenrui Wang
- Inner Mongolia Center for Disease Control and Prevention, Hohhot, China
| | - Ke Wang
- Department of Obstetrics, Key Laboratory of 9 Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, West China 10 Second University Hospital, Sichuan University, Chengdu, China
| | - Hailing Wang
- Inner Mongolia Center for Disease Control and Prevention, Hohhot, China
| | - Fen Dong
- China-Japan Friendship Hospital, Beijing, China
| | - Yonggang Qian
- Inner Mongolia Center for Disease Control and Prevention, Hohhot, China
| | - Haiying Gong
- Fangshan District Center for Disease Control and Prevention, Beijing, China
| | - Guodong Xu
- China-Japan Friendship Hospital, Beijing, China
| | - Yanlong Li
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, School of Basic Medicine, Peking Union Medical College, Beijing, China
| | - Li Pan
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, School of Basic Medicine, Peking Union Medical College, Beijing, China
| | - Biao Zhang
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, School of Basic Medicine, Peking Union Medical College, Beijing, China
| | - Guangliang Shan
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, School of Basic Medicine, Peking Union Medical College, Beijing, China
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Low fruit consumption and omission of daily meals as risk factors for increased blood pressure in adults. Br J Nutr 2017; 116:683-91. [PMID: 27464462 DOI: 10.1017/s0007114516002397] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
A population-based cross-sectional survey with cluster sampling design and with inverse sampling was conducted in 2010, in a sample of 1590 adults (19-60 years old) exposed to a high prevalence of food insecurity, in the municipality of Duque de Caxias, metropolitan region of Rio de Janeiro, Brazil. The objective of the study was to evaluate the association of socio-demographic factors, the consumption of fruits and vegetables and the number of meals with increased blood pressure (BP). A hierarchical model that considered variables related to the basic, intermediate and immediate determinants of increased BP was adopted. By using Poisson's regression, univariate models were tested to obtain the prevalence ratio (PR) and its respective 95 % CI. After fitting the model, age (age group 50-59 years) (PR 1·62; 95 % CI 1·09, 2·41), low consumption of fruits in a week (PR 1·37; 95 % CI 1·07, 1·74), fewer meals per day (PR 1·72; 95 % CI 1·21, 2·43) and overweight (PR 1·78; 95 % CI 1·31, 2·20) remained significantly associated with increased BP. Therefore, the results found here reinforce the importance of encouraging and developing strategies that ensure access to healthy foods to minimise increased BP in similar populations.
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Ikeda H, Kubo T, Izawa S, Takahashi M, Tsuchiya M, Hayashi N, Kitagawa Y. Impact of Daily Rest Period on Resting Blood Pressure and Fatigue. J Occup Environ Med 2017. [DOI: 10.1097/jom.0000000000000968] [Citation(s) in RCA: 63] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Cadmium body burden and increased blood pressure in middle-aged American Indians: the Strong Heart Study. J Hum Hypertens 2016; 31:225-230. [PMID: 27629244 PMCID: PMC5299034 DOI: 10.1038/jhh.2016.67] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2015] [Revised: 04/13/2016] [Accepted: 05/09/2016] [Indexed: 01/11/2023]
Abstract
Cadmium (Cd) is an environmental pollutant that has been associated with cardiovascular disease in populations, but the relationship of Cd with hypertension has been inconsistent. We studied the association between urinary Cd concentrations, a measure of total body burden, and blood pressure in American Indians, a US population with above national average Cd burden. Urinary Cd was measured using inductively coupled plasma mass spectrometry, and adjusted for urinary creatinine concentration. Among 3714 middle-aged American Indian participants of the Strong Heart Study (mean age 56 years, 41% male, 67% ever-smokers, 23% taking antihypertensive medications), urinary Cd ranged from 0.01 to 78.48 μg g-1 creatinine (geometric mean=0.94 μg g-1) and it was correlated with smoking pack-year among ever-smokers (r2=0.16, P<0.0001). Participants who were smokers were on average light-smokers (mean 10.8 pack-years), and urinary Cd was similarly elevated in light- and never-smokers (geometric means of 0.88 μg g-1 creatinine for both categories). Log-transformed urinary Cd was significantly associated with higher systolic blood pressure in models adjusted for age, sex, geographic area, body mass index, smoking (ever vs never, and cumulative pack-years) and kidney function (mean blood pressure difference by lnCd concentration (β)=1.64, P=0.002). These associations were present among light- and never-smokers (β=2.03, P=0.002, n=2627), although not significant among never-smokers (β=1.22, P=0.18, n=1260). Cd was also associated with diastolic blood pressure among light- and never-smokers (β=0.94, P=0.004). These findings suggest that there is a relationship between Cd body burden and increased blood pressure in American Indians, a population with increased cardiovascular disease risk.
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Igarashi R, Fujihara K, Heianza Y, Ishizawa M, Kodama S, Saito K, Hara S, Hanyu O, Honda R, Tsuji H, Arase Y, Sone H. Impact of individual components and their combinations within a family history of hypertension on the incidence of hypertension: Toranomon hospital health management center study 22. Medicine (Baltimore) 2016; 95:e4564. [PMID: 27661014 PMCID: PMC5044884 DOI: 10.1097/md.0000000000004564] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Although a family history (FH) of hypertension is a risk factor for the development of hypertension, only a few studies have investigated in detail the impact of individual components of an FH on incident hypertension. We investigated the impact of individual components and their combinations on the presence or development of hypertension considering obesity, smoking habits, physical activity, and other metabolic parameters.Studied were 12,222 Japanese individuals without hypertension (n = 9,766) and with hypertension (n = 2,456) at the baseline examination. The presence or incidence of hypertension during 5 years after a baseline examination was assessed by the presence of systolic blood pressure ≥140 mmHg and/or diastolic blood pressure ≥90 mmHg or a self-reported history of clinician-diagnosed hypertension. In this prospective study, the odds ratio for incident hypertension was 1.39 (95% confidence interval [CI], 1.22, 1.59) for individuals with any FH of hypertension compared with those without such an FH. Individuals with an FH of hypertension in both parents and one or more grandparents had an odds ratio of 3.05 (95% CI 1.74, 5.36) for hypertension compared with those without an FH of hypertension. FH was associated with incident hypertension independently of other modifiable risk factors such as obesity, smoking, physical inactivity, hyperglycemia, hyperuricemia, and hypertriglyceridemia.A parental history of hypertension was an essential component within an FH for incident hypertension. FH of hypertension over two generations with both parents affected was the most important risk factor for incident hypertension. Although an FH is not a modifiable risk factor, modifying other risk factors could contribute to reducing the risk of hypertension even among individuals with a family history of hypertension.
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Affiliation(s)
- Risa Igarashi
- Department of Internal Medicine, Niigata University Faculty of Medicine, Niigata
| | - Kazuya Fujihara
- Department of Internal Medicine, Niigata University Faculty of Medicine, Niigata
| | - Yoriko Heianza
- Department of Internal Medicine, Niigata University Faculty of Medicine, Niigata
| | - Masahiro Ishizawa
- Department of Internal Medicine, Niigata University Faculty of Medicine, Niigata
| | - Satoru Kodama
- Department of Internal Medicine, Niigata University Faculty of Medicine, Niigata
- Health Management Center, Toranomon Hospital
| | - Kazumi Saito
- Department of Internal Medicine, Niigata University Faculty of Medicine, Niigata
- Health Management Center, Toranomon Hospital
| | - Shigeko Hara
- Health Management Center, Toranomon Hospital
- Okinaka Memorial Institute for Medical Research, Tokyo, Japan
| | - Osamu Hanyu
- Department of Internal Medicine, Niigata University Faculty of Medicine, Niigata
| | | | - Hiroshi Tsuji
- Health Management Center, Toranomon Hospital
- Okinaka Memorial Institute for Medical Research, Tokyo, Japan
| | - Yasuji Arase
- Health Management Center, Toranomon Hospital
- Okinaka Memorial Institute for Medical Research, Tokyo, Japan
| | - Hirohito Sone
- Department of Internal Medicine, Niigata University Faculty of Medicine, Niigata
- Health Management Center, Toranomon Hospital
- Correspondence: Hirohito Sone, Health Management Center, Toranomon Hospital, 2-2-2 Toranomon, Minato-ku, Tokyo 105-8470, Japan (e-mail: )
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Ohta Y, Kawano Y, Hayashi S, Iwashima Y, Yoshihara F, Nakamura S. Effects of cigarette smoking on ambulatory blood pressure, heart rate, and heart rate variability in treated hypertensive patients. Clin Exp Hypertens 2016; 38:510-3. [DOI: 10.3109/10641963.2016.1148161] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Yuko Ohta
- Division of Hypertension and Nephrology, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
- Department of Internal Medicine, Moji Ekisaikai Hospital, Kita-Kyushu, Fukuoka, Japan
| | - Yuhei Kawano
- Division of Hypertension and Nephrology, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
- Department of Medical Technology, Teikyo University Fukuoka, Omuta, Fukuoka, Japan
| | - Shinichiro Hayashi
- Division of Hypertension and Nephrology, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Yoshio Iwashima
- Division of Hypertension and Nephrology, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Fumiki Yoshihara
- Division of Hypertension and Nephrology, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Satoko Nakamura
- Division of Hypertension and Nephrology, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
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Lafortune L, Martin S, Kelly S, Kuhn I, Remes O, Cowan A, Brayne C. Behavioural Risk Factors in Mid-Life Associated with Successful Ageing, Disability, Dementia and Frailty in Later Life: A Rapid Systematic Review. PLoS One 2016; 11:e0144405. [PMID: 26845035 PMCID: PMC4742275 DOI: 10.1371/journal.pone.0144405] [Citation(s) in RCA: 97] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2015] [Accepted: 10/18/2015] [Indexed: 12/13/2022] Open
Abstract
Background Smoking, alcohol consumption, poor diet and low levels of physical activity significantly contribute to the burden of illness in developed countries. Whilst the links between specific and multiple risk behaviours and individual chronic conditions are well documented, the impact of these behaviours in mid-life across a range of later life outcomes has yet to be comprehensively assessed. This review aimed to provide an overview of behavioural risk factors in mid-life that are associated with successful ageing and the primary prevention or delay of disability, dementia, frailty and non-communicable chronic conditions. Methods A literature search was conducted to identify cohort studies published in English since 2000 up to Dec 2014. Multivariate analyses and a minimum follow-up of five years were required for inclusion. Two reviewers screened titles, abstracts and papers independently. Studies were assessed for quality. Evidence was synthesised by mid-life behavioural risk for a range of late life outcomes. Findings This search located 10,338 individual references, of which 164 are included in this review. Follow-up data ranged from five years to 36 years. Outcomes include dementia, frailty, disability and cardiovascular disease. There is consistent evidence of beneficial associations between mid-life physical activity, healthy ageing and disease outcomes. Across all populations studied there is consistent evidence that mid-life smoking has a detrimental effect on health. Evidence specific to alcohol consumption was mixed. Limited, but supportive, evidence was available relating specifically to mid-life diet, leisure and social activities or health inequalities. Conclusions There is consistent evidence of associations between mid-life behaviours and a range of late life outcomes. The promotion of physical activity, healthy diet and smoking cessation in all mid-life populations should be encouraged for successful ageing and the prevention of disability and chronic disease.
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Affiliation(s)
- Louise Lafortune
- Institute of Public Health, Forvie Site, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Cambridge, United Kingdom
- * E-mail:
| | - Steven Martin
- Institute of Public Health, Forvie Site, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Cambridge, United Kingdom
| | - Sarah Kelly
- Institute of Public Health, Forvie Site, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Cambridge, United Kingdom
| | - Isla Kuhn
- University of Cambridge Medical Library, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Cambridge, United Kingdom
| | - Olivia Remes
- Institute of Public Health, Forvie Site, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Cambridge, United Kingdom
| | - Andy Cowan
- Institute of Public Health, Forvie Site, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Cambridge, United Kingdom
| | - Carol Brayne
- Institute of Public Health, Forvie Site, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Cambridge, United Kingdom
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Lifestyle Factors and Metabolic Syndrome among Workers: The Role of Interactions between Smoking and Alcohol to Nutrition and Exercise. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015; 12:15967-78. [PMID: 26694434 PMCID: PMC4690971 DOI: 10.3390/ijerph121215035] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/11/2015] [Revised: 12/10/2015] [Accepted: 12/11/2015] [Indexed: 12/14/2022]
Abstract
This study aimed to investigate (1) relations of smoking and alcohol to metabolic syndrome (MetS) and its components, with nutrition and exercise controlled; and (2) interactions between smoking/alcohol and nutrition/exercise on MetS. This cross-sectional study enrolled 4025 workers. Self-reported lifestyles, anthropometric values, blood pressure (BP), and biochemical determinations were obtained. Among males, smoking significantly increased the risk of low high-density lipoprotein cholesterol (HDL-C), high triglyceride, abdominal obesity (AO), and MetS. Additionally, smoking showed significant interaction effects with nutrition on high BP, AO, and MetS; after further analysis, nutrition did not decrease above-mentioned risks for smokers. However, there was no significant interaction of smoking with exercise on any metabolic parameter. Alcohol increased the risk of AO, but decreased low HDL-C. It also showed an interaction effect with exercise on AO; after further analysis, exercise decreased AO risk for drinkers. Among females, alcohol significantly decreased the risk of high fasting blood glucose, but did not show significant interaction with nutrition/exercise on any metabolic parameter. In conclusion, in males, smoking retained significant associations with MetS and its components, even considering benefits of nutrition; exercise kept predominance on lipid parameters regardless of smoking status. Alcohol showed inconsistencies on metabolic parameters for both genders.
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Almeida AHSD, Santos SAGD, Rodrigues Filho EDA, Carvalho PRC, Batista GR. Somatotipo, fatores de risco e razão cintura-estatura em indivíduos fisicamente ativos. REV BRAS MED ESPORTE 2015. [DOI: 10.1590/1517-869220152104133477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
INTRODUÇÃO: A relação entre o tipo físico e o risco cardiovascular vem sendo estudada em diversas populações do mundo. No Brasil, estudos que avaliam esta relação são escassos, principalmente quando se trata de indivíduos que praticam atividades físicas. Objetivo: Analisar a relação do somatotipo com fatores de risco cardiovascular e razão cintura-estatura (RCEst) em praticantes de atividade física.MÉTODOS: Trata-se de uma pesquisa descritiva com delineamento transversal. A amostra foi constituída por 280 sujeitos, usuários da pista de Cooper da Universidade Federal de Pernambuco, na cidade de Recife, PE, Brasil. Para identificação do nível de atividade física, utilizou-se a versão curta do International Physical Activity Questionnaire(IPAQ). Os indivíduos classificados como muito ativos, ativos ou irregularmente ativos A ou B, foram incluídos na amostra. Excluíram-se os sujeitos inativos fisicamente. O somatotipo foi estimado através do protocolo antropométrico de Carter e Heath (1990). Determinaram-se como fatores de risco cardiovascular o tabagismo, o consumo de bebida alcoólica e a pressão arterial (PA). Empregou-se a estatística descritiva para caracterização da amostra, em seguida, utilizou-se a Análise de Variância Multivariada (MANOVA), com nível de significância de p < 0,05.RESULTADOS: Não foi identificada relação significativa para as variáveis tabagismo e consumo de bebida alcoólica. Na análise da PA (Pillai's trace = 0,082; F = 8,187; p < 0,05) e da RCEst (Pillai's trace = 0,298; F = 39,081; p < 0,05), verificou-se significância estatística com o somatotipo.CONCLUSÃO: O tipo físico foi positivo e significativamente relacionado com a PA e com a RCEst, demonstrando que esse indicador antropométrico pode ser utilizado para predizer precocemente o risco de desenvolvimento de doenças cardiovasculares.
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Momtaz YA, Ibrahim R, Hamid TA, Chai ST. Smoking and cognitive impairment among older persons in Malaysia. Am J Alzheimers Dis Other Demen 2015; 30:405-11. [PMID: 25260596 PMCID: PMC10852561 DOI: 10.1177/1533317514552318] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Previous studies have shown conflicting results on the association between smoking and cognitive function. This study aims to examine the relationship of smoking with cognitive function. METHODOLOGY Data for the study, consisting of 2553 older adults aged 60 years and older, were drawn from a nationwide household survey entitled "Determinants of Wellness among Older Malaysians: A Health Promotion Perspective" conducted in 2010. RESULTS Current smokers had lower rates of cognitive impairment compared to never smokers (17.4% vs 25.9%), while cognitive function in former or ex-smokers was almost similar to that of the never smokers. Findings from multiple logistic regression analysis showed that current smokers were 37% less likely to be cognitively impaired, compared to the never smokers (odds ratio [OR] = .63; 95% confidence interval [CI]: .46-.86) while controlling for potential confounders. No difference in cognitive function was observed between former smokers and never smokers (OR = .94; 95% CI: .71-1.25). CONCLUSION Although the findings indicated a negative association between cigarette smoking and cognitive impairment, we are unable to conclude whether this relationship is causal or affected by other unmeasured confounding factors, especially survival bias.
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Affiliation(s)
- Yadollah Abolfathi Momtaz
- Institute of Gerontology, Universiti Putra Malaysia, Serdang, Selangor, Malaysia Iranian Research Center on Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Rahimah Ibrahim
- Institute of Gerontology, Universiti Putra Malaysia, Serdang, Selangor, Malaysia Department of Human Development and Family Studies, Faculty of Human Ecology, Institute of Gerontology, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Tengku Aizan Hamid
- Institute of Gerontology, Universiti Putra Malaysia, Serdang, Selangor, Malaysia Department of Human Development and Family Studies, Faculty of Human Ecology, Institute of Gerontology, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Sen Tyng Chai
- Institute of Gerontology, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
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Wu XY, Zhou SY, Niu ZZ, Liu T, Xie CB, Chen WQ. CHRNA3 rs6495308 genotype as an effect modifier of the association between daily cigarette consumption and hypertension in Chinese male smokers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015; 12:4156-69. [PMID: 25874685 PMCID: PMC4410239 DOI: 10.3390/ijerph120404156] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/09/2015] [Revised: 04/05/2015] [Accepted: 04/09/2015] [Indexed: 01/18/2023]
Abstract
Cigarette smoking is an important risk factor for hypertension. However, the effects on hypertension of the interaction between smoking and the genotype of the nicotinic acetylcholine receptor gene are unclear. The purpose of this study is to determine whether the CHRNA3 rs6495308 genotype affects the association between daily cigarette consumption and hypertension. We recruited 947 male smokers in southern China and used a questionnaire administered in face to face interviews to obtain information on their socio-demographic characteristics and smoking behavior. Blood samples were collected to test for CHRNA3 rs6495308 genotype variations. Three blood-pressure measurements were taken for each participant, and the average values recorded. We found that, compared with light smoking (<15 cigarettes per day), heavy smoking (≥15 cigarettes per day) yielded a greater risk of hypertension. We also observed that the interaction between daily cigarette consumption and the CHRNA3 rs6495308 genotype may affect hypertension. Heavy smokers with the homozygous mutant CHRNA3 rs6495308 genotype exhibited a significantly greater risk of hypertension than light smokers with wild-type CHRNA3 rs6495308 genotypes. The positive interaction between heavy smoking and the homozygous mutant CHRNA3 rs6495308 genotype was found to affect the likelihood of hypertension in Chinese male smokers.
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Affiliation(s)
- Xiao-Ying Wu
- Department of Biostatistics and Epidemiology, School of Public Health, Sun Yat-Sen University, Guangzhou, Guangdong 510080, China.
| | - Shan-Yu Zhou
- Guangdong Prevention and Treatment Center for Occupational Diseases, Guangzhou, Guangdong 510000, China.
| | - Zhong-Zheng Niu
- Department of Biostatistics and Epidemiology, School of Public Health, Sun Yat-Sen University, Guangzhou, Guangdong 510080, China.
| | - Tao Liu
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, Guangdong 510000, China.
| | - Chuan-Bo Xie
- Division of Behavioral Medicine, School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, New York, NY 14228, USA.
| | - Wei-Qing Chen
- Department of Biostatistics and Epidemiology, School of Public Health, Sun Yat-Sen University, Guangzhou, Guangdong 510080, China.
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Development of a risk prediction model for incident hypertension in a working-age Japanese male population. Hypertens Res 2014; 38:419-25. [PMID: 25391458 DOI: 10.1038/hr.2014.159] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2014] [Revised: 08/28/2014] [Accepted: 09/11/2014] [Indexed: 02/07/2023]
Abstract
The aim of this study was to develop a risk prediction model for incident hypertension in a Japanese male population. Study participants included 15,025 nonhypertensive Japanese male workers (mean age, 38.8±8.9 years) who underwent an annual medical checkup at a company. The participants were followed-up for a median of 4.0 years to determine new-onset hypertension, defined as a systolic blood pressure (BP) ⩾140 mm Hg, a diastolic BP ⩾90 mm Hg, or the initiation of antihypertensive medication. Participants were divided into the following two cohorts for subsequent analyses: the derivation cohort (n=12,020, 80% of the study population) and the validation cohort (n=3005, the remaining 20% of the study population). In the derivation cohort, a multivariate Cox proportional hazards model demonstrated that age, body mass index, systolic and diastolic BP, current smoking status, excessive alcohol intake and parental history of hypertension were independent predictors of incident hypertension. Using these variables, a risk prediction model was constructed to estimate the 4-year risk of incident hypertension. In the validation cohort, the risk prediction model demonstrated high discrimination ability and acceptable calibration, with a C-statistic of 0.861 (95% confidence interval 0.844, 0.877) and a modified Hosmer-Lemeshow χ2 statistic of 15.2 (P=0.085). A risk score sheet was constructed to enable the simple calculation of the approximate 4-year probability of incident hypertension. In conclusion, a practical risk prediction model for incident hypertension was successfully developed in a working-age Japanese male population.
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80
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Sneed RS, Cohen S. Negative social interactions and incident hypertension among older adults. Health Psychol 2014; 33:554-65. [PMID: 24884909 DOI: 10.1037/hea0000057] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
OBJECTIVE To determine if negative social interactions are prospectively associated with hypertension among older adults. METHOD This is a secondary analysis of data from the 2006 and 2010 waves of the Health and Retirement Study, a survey of community-dwelling older adults (age > 50 years). Total average negative social interactions were assessed at baseline by averaging the frequency of negative interactions across 4 domains (partner, children, other family, friends). Blood pressure was measured at both waves. Individuals were considered to have hypertension if they reported use of antihypertensive medications, had measured average resting systolic blood pressure of 140 mmHg or higher, or measured average resting diastolic blood pressure of 90 mmHg or higher. Analyses excluded those who were hypertensive at baseline and controlled for demographics, personality, positive social interactions, and baseline health. RESULTS Twenty-nine percent of participants developed hypertension over the 4-year follow-up. Each 1-unit increase in the total average negative social interaction score was associated with a 38% increased odds of developing hypertension. Sex moderated the association between total average negative social interactions and hypertension, with effects observed among women but not men. The association of total average negative interactions and hypertension in women was attributable primarily to interactions with friends, but also to negative interactions with family and partners. Age also moderated the association between total average negative social interactions and hypertension, with effects observed among those ages 51-64 years, but not those ages 65 or older. CONCLUSION In this sample of older adults, negative social interactions were associated with increased hypertension risk in women and the youngest older adults.
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Affiliation(s)
| | - Sheldon Cohen
- Department of Psychology, Carnegie Mellon University
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81
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Babiker FA, Elkhalifa LA, Moukhyer ME. Awareness of hypertension and factors associated with uncontrolled hypertension in Sudanese adults. Cardiovasc J Afr 2014; 24:208-12. [PMID: 24217260 PMCID: PMC3767941 DOI: 10.5830/cvja-2013-035] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2012] [Accepted: 05/10/2013] [Indexed: 11/21/2022] Open
Abstract
Background The incidence of hypertension (HTN) has increased rapidly in the Sudan in the last few years. The aim of this study was to determine the prevalence of uncontrolled HTN and the risk factors associated with it in Sudanese adults. Methods This study was cross sectional. Data were collected using structured questionnaires filled in during interviews with subjects visiting referral clinics in Khartoum, the capital city of Sudan. Blood pressure (BP) was measured using a digital sphygmomanometer. A digital balance was used for determination of body weight and a traditional cloth tape measure was used for measuring height, for calculation of body mass index. Results This study included 200 subjects, 46% male and 54% female. In the whole study, 82% of subjects (p < 0.001) were on hypertension drug treatment. Of these, 64% had their BP controlled to normal standards set by the World Health Organistion (< 140/90 mmHg). The prevalence of uncontrolled BP was significantly (p < 0.001) higher in males (61%) compared to females (15%). When the risk factors of HTN were considered, 54% of the subjects had a positive family history of HTN and 52% were smokers. Uncontrolled BP was found to be significantly (p < 0.001) higher in smoking males (43%) compared to females (4%). It was also high in people with higher education (55%) and workers (41%). In these groups, when genders were considered separately, uncontrolled hypertension was significantly (p < 0.01) higher in males than females with higher education (67 and 40%, respectively), and in workers (86 and 10%, respectively). Uncontrolled HTN was associated with overweight and obesity in 45 and 29% of the subjects, respectively. Most of the interviewed subjects were not aware of the consequences of HTN and its associated risk factors. Conclusions Uncontrolled HTN was associated with risk factors of HTN and lifestyle, and was more prominent in the male gender. The ignorance of the interviewed subjects about HTN, its associated risk factors, changes in lifestyle and adherence to taking the medication may have been a major factor in the prevalence of uncontrolled HTN.
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Affiliation(s)
- Fawzi A Babiker
- Department of Physiology, Faculty of Medicine, Kuwait University, Kuwait
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Xia S, Lin S. Detecting longitudinal effects of haplotypes and smoking on hypertension using B-splines and Bayesian LASSO. BMC Proc 2014; 8:S85. [PMID: 25519413 PMCID: PMC4143712 DOI: 10.1186/1753-6561-8-s1-s85] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
The behavior of a gene can be dynamic; thus, if longitudinal data are available, it is important that we study the dynamic effects of genes on a trait over time. The effect of a haplotype can be expressed by time-varying coefficients. In this paper, we use the natural cubic B-spline to express these coefficients that capture the trends of the effects of haplotypes, some of which may be rare, over time; that is, at different ages. More specifically, to capture disease-associated common and rare haplotypes and environmental factors for data from unrelated individuals, we developed a method of time-varying coefficients that uses the logistic Bayesian LASSO methodology and B-spline by setting proper prior distributions. Haplotype and environmental effect coefficients are obtained by using Markov chain Monte Carlo methods. We applied the method to analyze the MAP4 gene on chromosome 3 and have identified several haplotypes that are associated with hypertension with varying effect sizes in the range of 55 to 85 years of age.
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Affiliation(s)
- Shuang Xia
- Department of Statistics, The Ohio State University, 1958 Neil Avenue, Columbus, OH 43210-1247, USA
| | - Shili Lin
- Department of Statistics, The Ohio State University, 1958 Neil Avenue, Columbus, OH 43210-1247, USA
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Malekzadeh MM, Etemadi A, Kamangar F, Khademi H, Golozar A, Islami F, Pourshams A, Poustchi H, Navabakhsh B, Naemi M, Pharoah PD, Abnet CC, Brennan P, Boffetta P, Dawsey SM, Esteghamati A, Malekzadeh R. Prevalence, awareness and risk factors of hypertension in a large cohort of Iranian adult population. J Hypertens 2013; 31:1364-71; discussion 1371. [PMID: 23673348 PMCID: PMC3766446 DOI: 10.1097/hjh.0b013e3283613053] [Citation(s) in RCA: 76] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
BACKGROUND There is considerable variation in hypertension prevalence and awareness, and their correlates, across different geographic locations and ethnic groups. We performed this cross-sectional analysis on data from the Golestan Cohort Study (GCS). METHODS Enrollment in this study occurred in 2004-2008, and included 50,045 healthy individuals from Golestan Province in northeastern Iran. Hypertension was defined as a SBP at least 140 mmHg, a DBP at least 90 mmHg, a prior diagnosis of hypertension, or the use of antihypertensive drugs. Potential correlates of hypertension and its awareness were analyzed by logistic regression adjusted for sex, age, BMI, place of residence, literacy, ethnicity, physical activity, smoking, black and green tea consumption and wealth score. RESULTS Of the total cohort participants, 21,350 (42.7%) were hypertensive. Age-standardized prevalence of hypertension, using the 2001 WHO standard world population, was 41.8% (95% confidence interval: 38.3-45.2%). Hypertension was directly associated with female sex, increased BMI, Turkmen ethnicity, and lack of physical activity, and inversely associated with drinking black tea and wealth score. Among hypertensive patients, 46.2% were aware of their disease, 17.6% were receiving antihypertensive medication, and 32.1% of the treated patients had controlled hypertension. Hypertension awareness was greater among women, the elderly, overweight and obese patients, and those with a higher wealth score. CONCLUSION Hypertension is highly prevalent in rural Iran, many of the affected individuals are unaware of their disease, and the rate of control by antihypertensive medications is low. Increasing hypertension awareness and access to health services, especially among less privileged residents are recommended.
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Affiliation(s)
- Masoud M Malekzadeh
- Digestive Disease Research Center, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
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85
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Thawornchaisit P, de Looze F, Reid CM, Seubsman SA, Sleigh AC. Health risk factors and the incidence of hypertension: 4-year prospective findings from a national cohort of 60 569 Thai Open University students. BMJ Open 2013; 3:e002826. [PMID: 23801711 PMCID: PMC3696868 DOI: 10.1136/bmjopen-2013-002826] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2013] [Accepted: 05/31/2013] [Indexed: 01/21/2023] Open
Abstract
OBJECTIVE This study evaluates the impact of a number of demographic, biological, behavioural and lifestyle health risk factors on the incidence of hypertension in Thailand over a 4-year period. DESIGN A 4-year prospective study of health risk factors and their effects on the incidence of hypertension in a national Thai Cohort Study from 2005 to 2009. SETTING As Thailand is transitioning from a developing to a middle-income developed country, chronic diseases (particularly cardiovascular disease) have emerged as major health issues. Hypertension is a major risk factor for heart attack and stroke and cross-sectional studies have indicated that the prevalence is increasing. STUDY PARTICIPANTS A total of 57 558 Sukhothai Thammathirat Open University students who participated in both the 2005 and 2009 questionnaire surveys and who were normotensive in 2005 were included in the analysis. MEASURES Adjusted relative risks associating each risk factor and incidence of hypertension by sex, after controlling for confounders such as age, socioeconomic status, body mass index (BMI) and underlying diseases. RESULTS The overall 4-year incidence of hypertension was 3.5%, with the rate in men being remarkably higher than that in women (5.2% vs 2.1%). In both sexes, hypertension was associated with age, higher BMI and comorbidities but not with income and education. In men, hypertension was associated with physical inactivity, smoking, alcohol and fast food intake. In women, hypertension was related to having a partner. CONCLUSIONS In both men and women, hypertension was strongly associated with age, obesity and comorbidities while it had no association with socioeconomic factors. The cohort patterns of socioeconomy and hypertension reflect that the health risk transition in Thais is likely to be at the middle stage. Diet and lifestyle factors associate with incidence of hypertension in Thais and may be amenable targets for hypertension control programmes.
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Affiliation(s)
- Prasutr Thawornchaisit
- Faculty of Health Sciences, School of Medicine, University of Queensland, Brisbane, Queensland, Australia
| | - Ferdinandus de Looze
- Faculty of Health Sciences, School of Medicine, University of Queensland, Brisbane, Queensland, Australia
| | - Christopher M Reid
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Sam-ang Seubsman
- School of Human Ecology, Sukhothai Thammathirat Open University, Nonthaburi, Thailand
- National Centre for Epidemiology and Population Health, ANU College of Medicine, Biology and Environment, The Australian National University, Canberra, Australian Capital Territory, Australia
| | - Adrian C Sleigh
- National Centre for Epidemiology and Population Health, ANU College of Medicine, Biology and Environment, The Australian National University, Canberra, Australian Capital Territory, Australia
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Olomu AB, Gourineni V, Huang JL, Pandya N, Efeovbokhan N, Samaraweera J, Parashar K, Holmes-Rovner M. Rate and predictors of blood pressure control in a federal qualified health center in Michigan: a huge concern? J Clin Hypertens (Greenwich) 2013; 15:254-63. [PMID: 23551725 PMCID: PMC8033927 DOI: 10.1111/jch.12067] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2012] [Revised: 12/04/2012] [Accepted: 12/13/2012] [Indexed: 12/24/2022]
Abstract
Hypertension (HTN) is particularly burdensome in low-income groups. Federal-qualified health centers (FQHCs) provide care for low-income and medically underserved populations. To assess the rates and predictors of blood pressure (BP) control in an FQHC in Michigan, a retrospective analysis of all patients with HTN, coronary artery disease, and/or diabetes mellitus (DM) seen between January 2006 and December 2008 was conducted. Of 212 patients identified, 154 had a history of HTN and 122 had DM. BP control was achieved in 38.2% of the entire cohort and in 31.1% of patients with DM. The mean age was lower in patients with controlled BP in both the total population (P=.05) and the DM subgroup (P=.02). A logistic regression model found only female sex (odds ratio, 2.27; P=.02) to be associated with BP control and a trend towards an association of age with uncontrolled BP (odds ratio, 0.97; P=.06). BP control in nondiabetics was 47.8% vs 31.1% in diabetic patients (P=.02). We found that patients who attended the FQHC had a lower rate of BP control compared with the national average. Our study revealed a male sex disparity and significantly lower rate of BP control among DM patients.
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Affiliation(s)
- Adesuwa B Olomu
- College of Human Medicine, Michigan State University, East Lansing, MI, USA.
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Abraham I, MacDonald K, Song M, Ciesielski G, Pacheco C, Lee C, Cholette M, Kinsey K, Speaks P, Hermans C, Brié H, Reel S, Van der Niepen P, Yee B, Vancayzeele S. Patient- and physician-level determinants of blood pressure response to treatment in normal weight and overweight patients (the PREVIEW study). Nutr Metab Cardiovasc Dis 2013; 23:314-322. [PMID: 21930367 DOI: 10.1016/j.numecd.2011.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2011] [Revised: 06/13/2011] [Accepted: 06/20/2011] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND AIMS Obesity combined with hypertension places patients at greater risk for target-organ damage and cardiovascular disease. The purpose of this secondary analysis was to identify physician- and patient-levels determinants of blood pressure (BP) values and predictors of uncontrolled BP through subgroup analysis by body mass index (BMI). METHODS AND RESULTS We conducted a subgroup analysis of 3006 patients with High-BMI (BMI >25 kg/m(2); n=2124) and Normal-BMI (BMI<25 kg/m(2); n=882) treated by 504 physicians and enrolled in PREVIEW, a Belgian prospective, multi-center, pharmaco-epidemiological study of 90-day second-line treatment with valsartan. Physician- and patient-level determinants of BP values and BP control were identified by means of hierarchical linear and logistic regression. Blood pressure values and control after 90 days of treatment were consistently lower for the High-BMI group. The 25.5% of variance in 90-day systolic and 28.3% of the variance in 90-day diastolic BP were attributable to physician-level determinants for the High-BMI group; versus 27.3% and 29.8% for the Normal-BMI group (ICC=0.273 and 0.298, respectively). Determinants of 90-day BP values and predictors of uncontrolled BP varied considerably by BMI status. CONCLUSION Several common and unique patient- and physician-level determinants of BP values and control were identified for the High-BMI and Normal-BMI groups. These findings highlight the need for differentiating healthcare interventions to account for patient and physician variables, particularly with respect to effective BP management in vulnerable populations.
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Affiliation(s)
- I Abraham
- Center for Health Outcomes and PharmacoEconomic Research, and Department of Pharmacy Practice and Science, College of Pharmacy, University of Arizona, 1295 N. Martin, Tucson, AZ 85721, USA.
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D'Elia L, De Palma D, Rossi G, Strazzullo V, Russo O, Iacone R, Fazio V, Strazzullo P, Galletti F. Not smoking is associated with lower risk of hypertension: results of the Olivetti Heart Study. Eur J Public Health 2013; 24:226-30. [PMID: 23543678 DOI: 10.1093/eurpub/ckt041] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Few epidemiological investigations evaluated the role of smoking cessation on blood pressure (BP), and the results are not univocal. Therefore, the aim of this study was to assess the effect of smoking cessation on the risk to develop hypertension (HPT) and on BP values. METHODS This longitudinal study, with a follow-up period of 8 years, included the participants of the Olivetti Heart Study. Participants were 430 untreated normotensive non-diabetic men with normal renal function, examined twice in 1994-95 and in 2002-04. The sample included current smokers (S, n = 212), former smokers (ES, n = 145) and never smokers (NS, n = 73) at baseline. RESULTS Basal body mass index (BMI), systolic blood pressure (SBP) and diastolic blood pressure (DBP) were significantly higher in ES than in S (ES vs. S; BMI: 27.0 ± 2.5 vs. 26.1 ± 2.9 kg/m2; P < 0.01; SBP/DBP: 121.2 ± 9.3/80.0 ± 5.8 vs. 19.1 ± 9.9/77.4 ± 6.7 mm Hg; P < 0.05; M ± SD). After 8 years of follow-up, BP changes (Δ) were significantly lower in ES than in S (ΔSBP/DBP: 12.6 ± 13.4/7.9 ± 8.1 vs. 16.0 ± 14.9/10.3 ± 10.1 mm Hg; P < 0.05; M ± SD), also after adjustment for potential confounders. Moreover, at the last examination, the overall HPT prevalence was 33%, with lower values in ES than in S (25 vs. 38%, P = 0.01). After accounting for age, BP and BMI at baseline, and changes in smoking habit over the 8-year period, ES still had significant lower risk of HPT than S (odds ratio 0.30, 95% confidence interval 0.15-0.58; P < 0.01). CONCLUSIONS In this sample of healthy men, smoking cessation was associated with lower BP increment and minor HPT risk, independently of potential confounders.
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Affiliation(s)
- Lanfranco D'Elia
- Department of Clinical and Experimental Medicine, ESH Excellence Centre of Hypertension, "Federico II" University of Naples Medical School, Naples, Italy
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Gopal DM, Kalogeropoulos AP, Georgiopoulou VV, Smith AL, Bauer DC, Newman AB, Kim L, Bibbins-Domingo K, Tindle H, Harris TB, Tang WWH, Kritchevsky SB, Butler J. Cigarette smoking exposure and heart failure risk in older adults: the Health, Aging, and Body Composition Study. Am Heart J 2012; 164:236-42. [PMID: 22877810 DOI: 10.1016/j.ahj.2012.05.013] [Citation(s) in RCA: 75] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2011] [Accepted: 05/19/2012] [Indexed: 11/15/2022]
Abstract
BACKGROUND Although there is evidence linking smoking and heart failure (HF), the association between lifetime smoking exposure and HF in older adults and the strength of this association among current and past smokers is not well known. METHODS We examined the association between smoking status, pack-years of exposure, and incident HF risk in 2,125 participants of the Health, Aging, and Body Composition Study (age 73.6 ± 2.9 years, 69.7% women, 54.2% whites) using proportional hazard models. RESULTS At inception, 54.8% of participants were nonsmokers, 34.8% were past smokers, and 10.4% were current smokers. During follow-up (median 9.4 years), HF incidence was 11.4 per 1,000 person-years in nonsmokers, 15.2 in past smokers (hazard ratio [HR] vs nonsmokers 1.33, 95% CI 1.01-1.76, P = .045), and 21.9 in current smokers (HR 1.93, 95% CI 1.30-2.84, P = .001). After adjusting for HF risk factors, incident coronary events, and competing risk for death, a dose-effect association between pack-years of exposure and HF risk was observed (HR 1.09, 95% CI 1.05-1.14, P < .001 per 10 pack-years). Heart failure risk was not modulated by pack-years of exposure in current smokers. In past smokers, HR for HF was 1.05 (95% CI 0.64-1.72) for 1 to 11 pack-years, 1.23 (95% CI 0.82-1.83) for 12 to 35 pack-years, and 1.64 (95% CI 1.11-2.42) for >35 pack-years of exposure in fully adjusted models (P < .001 for trend) compared with nonsmokers. CONCLUSIONS In older adults, both current and past cigarette smoking increase HF risk. In current smokers, this risk is high irrespective of pack-years of exposure, whereas in past smokers, there was a dose-effect association.
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Jansen L, Below J, Chang-Claude J, Brenner H, Hoffmeister M. Beta blocker use and colorectal cancer risk. Cancer 2012; 118:3911-9. [DOI: 10.1002/cncr.26727] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2011] [Revised: 10/11/2011] [Accepted: 11/07/2011] [Indexed: 12/31/2022]
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Bateman BT, Shaw KM, Kuklina EV, Callaghan WM, Seely EW, Hernández-Díaz S. Hypertension in women of reproductive age in the United States: NHANES 1999-2008. PLoS One 2012; 7:e36171. [PMID: 22558371 PMCID: PMC3340351 DOI: 10.1371/journal.pone.0036171] [Citation(s) in RCA: 86] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2012] [Accepted: 04/02/2012] [Indexed: 01/13/2023] Open
Abstract
Objective To examine the epidemiology of hypertension in women of reproductive age. Methods Using NHANES from 1999–2008, we identified 5,521 women age 20–44 years old. Hypertension status was determined using blood pressure measurements and/or self-reported medication use. Results The estimated prevalence of hypertension in women of reproductive age was 7.7% (95% confidence interval (CI): 6.9%–8.5%). The prevalence of anti-hypertensive pharmacologic therapy was 4.2% (95% CI 3.5%–4.9%). The prevalence of hypertension was relatively stable across the study period; the age and race adjusted odds of hypertension in 2007–2008 did not differ significantly from 1999–2000 (odds ratio 1.2, CI 0.8 to 1.7, p = 0.45). Significant independent risk factors associated with hypertension included older age, non-Hispanic black race (compared to non-Hispanic whites), diabetes mellitus, chronic kidney disease, and higher body mass index. The most commonly used antihypertensive medications included diuretics, angiotensin-converting enzyme inhibitors (ACE), and beta blockers. Conclusion Hypertension occurs in about 8% of women of reproductive age. There are remarkable differences in the prevalence of hypertension between racial/ethnic groups. Obesity is a risk factor of particular importance in this population because it affects over 30% of young women in the U.S., is associated with more than 4 fold increased risk of hypertension, and is potentially modifiable.
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Affiliation(s)
- Brian T Bateman
- Division of Obstetric Anesthesia, Department of Anesthesia, Critical Care, and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.
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92
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Kaneko M, Oda E, Kayamori H, Nagao S, Watanabe H, Abe T, Ishizawa M, Uemura Y, Aizawa Y. Smoking was a Possible Negative Predictor of Incident Hypertension After a Five-Year Follow-up Among a General Japanese Population. Cardiol Res 2012; 3:87-93. [PMID: 28348677 PMCID: PMC5358146 DOI: 10.4021/cr95w] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/27/2011] [Indexed: 01/08/2023] Open
Abstract
BACKGROUNDS The association between cigarette smoking and hypertension is controversial. The aim of this study is to investigate the association between smoking and incident hypertension. METHODS This is a post-hoc five-year follow-up study in a general Japanese population. Logistic regressions were performed using incident hypertension as an outcome and smoking status as an independent predictor adjusting for sex, age, body mass index (BMI), total cholesterol, high-density lipoprotein (HDL) cholesterol, triglycerides, fasting plasma glucose (FPG), drinking status, and diabetes in 1,297 subjects without hypertension at baseline. RESULTS The incidence of hypertension was 16.9% vs. 27.6% (smokers vs. nonsmokers, P = 0.01) in men and 0.0% vs. 16.9% (smokers vs. nonsmokers, P = 0.03) in women. The odds ratio (OR) (95% confidence interval (CI)) of incident hypertension was 0.38 (0.19 - 0.76) (P = 0.006) for smokers at baseline, 0.33 (0.16 - 0.68) (P = 0.003) for continuing smokers, and 2.11 (0.33 - 13.45) (P = 0.4) for ex-smokers. Age (OR = 1.52, P < 0.0001), BMI (OR = 1.46, P < 0.0001), and FPG (OR = 1.23, P = 0.007) were other independent predictors of incident hypertension. CONCLUSIONS Smoking was a possible significant negative predictor of incident hypertension in a general Japanese population.
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Affiliation(s)
- Masanori Kaneko
- Department of Internal Medicine, Tachikawa Medical Center, Kanda 3-2-11, Nagaoka, Niigata, Japan
| | - Eiji Oda
- Medical Check-up Center, Tachikawa Medical Center, Nagachou 2-2-16, Nagaoka, Niigata, Japan
| | - Hiromi Kayamori
- Department of Cardiology, Niigata University Graduate School of Medical and Dental Sciences, Asahimachidoori 1-757, Niigata, Japan
| | - Satomi Nagao
- Department of Cardiology, Niigata University Graduate School of Medical and Dental Sciences, Asahimachidoori 1-757, Niigata, Japan
| | - Hiroshi Watanabe
- Department of Cardiology, Niigata University Graduate School of Medical and Dental Sciences, Asahimachidoori 1-757, Niigata, Japan
| | - Takahiro Abe
- Department of endocrinology and metabolism, Niigata University Graduate School of Medical and Dental Sciences, Asahimachidoori 1-757, Niigata, Japan
| | - Masahiro Ishizawa
- Department of endocrinology and metabolism, Niigata University Graduate School of Medical and Dental Sciences, Asahimachidoori 1-757, Niigata, Japan
| | - Yasuyuki Uemura
- Department of endocrinology and metabolism, Niigata University Graduate School of Medical and Dental Sciences, Asahimachidoori 1-757, Niigata, Japan
| | - Yoshifusa Aizawa
- Department of Research and Development, Tachikawa Medical Center, Kanda 3-2-11, Nagaoka, Niigata, Japan
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93
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Lin Y, Lai X, Chen G, Xu Y, Huang B, Chen Z, Zhu S, Yao J, Jiang Q, Huang H. Prevalence and risk factors associated with prehypertension and hypertension in the Chinese She population. Kidney Blood Press Res 2012; 35:305-13. [PMID: 22377586 DOI: 10.1159/000336085] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2011] [Accepted: 12/27/2011] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Little is known about the prevalence and cardiovascular risk factors for prehypertension and hypertension in the She ethnic minority population of Fujian province in China. METHODS AND RESULTS Between April 2009 and September 2009, 5,523 participants of She nationality aged between 20 and 80 years participated in this survey and 5,357 were eventually enrolled in analyses. The survey was carried out to assess blood pressure and cardiovascular risk factors. The prevalence of prehypertension and hypertension was 35.87 and 38.42%, respectively, in all participants. Only 26.63% of the subjects with hypertension were aware of their diagnosis. Multivariate logistic regression showed that age, gender, overweight/obesity, dyslipidemia and alcohol use were risk factors for prehypertension, and age, overweight/obesity, dyslipidemia, alcohol use, family history of hypertension and hyperuricemia were risk factors for hypertension. The clustering of 2 and ≥ 3 risk factors was in higher proportion for subjects with hypertension and prehypertension when compared with those with prehypertension and normotension, respectively. After adjusting for other confounding factors, multivariable logistic regression showed that the greater the number of clustering cardiovascular risk factors, the greater the odds ratios for prehypertension and hypertension are. CONCLUSION Hypertension and prehypertension were common in the She population of Fujian province. Cardiovascular risk factors cluster during prehypertension and awareness of hypertension was minimal. Early lifestyle modifications could be advocated to prevent the transition from prehypertension to hypertension and cardiovascular disease.
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Affiliation(s)
- Yinghua Lin
- Department of Endocrinology, Ningde Municipal Hospital, Ningde, PR China
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94
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Association between daily cigarette consumption and hypertension moderated by CYP2A6 genotypes in Chinese male current smokers. J Hum Hypertens 2012; 27:24-30. [PMID: 22217675 DOI: 10.1038/jhh.2011.111] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The purpose of this study was to assess whether cytochrome P450 enzyme 2A6 (CYP2A6) genotypes moderate the association between smoking and hypertension. In this study, 954 Chinese male current smokers from a community-based chronic disease screening project in Guangzhou were interviewed with a structured questionnaire about socio-demographic status, smoking and other health-related behaviors. Blood was collected for DNA extraction and CYP2A6 genotyping. Hypertension was defined according to 2007 ESH-ESC Practice Guidelines. A multivariate logistic regression was performed to examine the interaction between smoking quantity and CYP2A6 genotypes on hypertension after adjusting for age, education level and other potential confounders. Multivariate analyses indicated that smoking more than 15 cigarettes per day significantly increased the risk of hypertension (odds ratio (OR)=1.59, 95% confidence interval (CI)=1.21-2.10) compared with smoking 1-15 cigarettes per day, and further suggested that smoking interacted with normal CYP2A6 metabolizer genotype to increase the risk of hypertension. Smokers consuming more than 15 cigarettes per day with normal CYP2A6 metabolizer genotypes had the highest risk of hypertension (OR=2.04, 95% CI=1.11-3.75) compared with those consuming 1-15 cigarettes per day with slower CYP2A6 metabolizer genotypes. These findings demonstrated that smoking quantity was positively associated with hypertension and that CYP2A6 genotypes may moderate this relationship.
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95
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The relatively small contribution of birth weight to blood pressure at age 49-51 years in the Newcastle Thousand Families Study. J Hypertens 2011; 29:1077-84. [PMID: 21505348 DOI: 10.1097/hjh.0b013e328346d76c] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Whereas a large number of previous studies suggest an association between birth weight and later blood pressure, others do not. Controversy surrounds the relative importance of these associations, in particular in relation to more modifiable factors in later life. The aim of this study was to investigate the relative contributions of a range of factors from across life to variations in SBP and DBP in the Newcastle Thousand Families Study. METHODS AND RESULTS Detailed information was collected prospectively during childhood, including birth weight, duration breast fed and socioeconomic conditions. At age 49-51 years, 574 study members returned self-completion questionnaires and 412 underwent clinical examination, including measurement of DBP and SBP. These data were analysed using linear regression and path analyses. After adjustment for all other significant variables, decreased birth weight, standardized for sex and gestational age (P = 0.035), increased BMI (P < 0.001) and being male (P = 0.034) were independently associated with raised SBP and DBP. Social class at birth (P = 0.044) was also independently associated with DBP. BMI was found to be the most important predictor, with a small relative contribution of standardized birth weight. CONCLUSION Adult blood pressure is influenced by numerous factors, acting both directly and indirectly during an individual's lifetime. Inverse associations of standardized birth weight, although statistically significant, were of relatively small importance, with the majority of variation being explained by more modifiable factors in adulthood, in particular adult BMI.
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96
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Kochar J, Gaziano JM, Djoussé L. Breakfast cereals and risk of hypertension in the Physicians' Health Study I. Clin Nutr 2011; 31:89-92. [PMID: 21868140 DOI: 10.1016/j.clnu.2011.08.001] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2011] [Revised: 07/27/2011] [Accepted: 08/02/2011] [Indexed: 02/07/2023]
Abstract
BACKGROUND & AIMS Hypertension is a major public health problem. While many dietary factors affect the risk of developing hypertension, limited data are available on the association between consumption of breakfast cereal and incident hypertension. We examined the association between breakfast cereal consumption and the risk of hypertension. METHODS We prospectively analyzed data from 13,368 male participants of the Physicians' Health Study I. Consumption of breakfast cereals was estimated using an abbreviated food frequency questionnaire and incident hypertension was ascertained through yearly follow-up questionnaires. RESULTS The average age of study participants was 52.4 ± 8.9 years (range 39.7-85.9) during the initial assessment of cereal intake (1981-1983). During a mean follow up of 16.3 years, 7267 cases of hypertension occurred. The crude incidence rates of hypertension were 36.7, 34.0, 31.7, and 29.6 cases/1000 person-years for people reporting breakfast cereal intake of 0, ≤1, 2-6, and ≥7 servings/week, respectively. In a Cox regression model adjusting for age, smoking, body mass index, alcohol consumption, fruit and vegetable consumption, physical activity, and history of diabetes mellitus, hazard ratios (95% CI) for hypertension were 1.0 (reference), 0.93 (0.88-0.99), 0.88 (0.83-0.94), and 0.81 (0.75-0.86) from the lowest to the highest category of cereal consumption, respectively (p for trend <0.0001). This association was strongest for whole grain cereals and was observed in lean as well as overweight or obese participants. CONCLUSIONS The results of this longitudinal cohort study suggest that whole grain breakfast cereal consumption confers a lower risk of hypertension in middle-aged adult males.
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Affiliation(s)
- Jinesh Kochar
- Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA.
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97
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Segura-Egea JJ, Castellanos-Cosano L, Velasco-Ortega E, Ríos-Santos JV, Llamas-Carreras JM, Machuca G, López-Frías FJ. Relationship between Smoking and Endodontic Variables in Hypertensive Patients. J Endod 2011; 37:764-7. [DOI: 10.1016/j.joen.2011.03.004] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2011] [Revised: 03/17/2011] [Accepted: 03/17/2011] [Indexed: 11/26/2022]
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98
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Goncharov A, Pavuk M, Foushee HR, Carpenter DO. Blood pressure in relation to concentrations of PCB congeners and chlorinated pesticides. ENVIRONMENTAL HEALTH PERSPECTIVES 2011; 119:319-25. [PMID: 21362590 PMCID: PMC3059993 DOI: 10.1289/ehp.1002830] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/05/2010] [Accepted: 11/01/2010] [Indexed: 05/17/2023]
Abstract
BACKGROUND Residents of Anniston, Alabama, live near a Monsanto plant that manufactured polychlorinated biphenyls (PCBs) from 1929 to 1971 and are relatively heavily exposed. OBJECTIVES The goal of this study was to determine the relationship, if any, between blood pressure and levels of total serum PCBs, several PCB groups with common actions or structure, 35 individual PCB congeners, and nine chlorinated pesticides. METHODS Linear regression analysis was used to determine the relationships between blood pressure and serum levels of the various contaminants after adjustment for age, body mass index, sex, race, smoking, and exercise in 394 Anniston residents who were not taking antihypertensive medication. RESULTS Other than age, total serum PCB concentration was the strongest determinant of blood pressure of the covariates studied. We found the strongest associations for those PCB congeners that had multiple ortho chlorines. We found the associations over the full range of blood pressure as well as in those subjects whose blood pressure was in the normal range. The chlorinated pesticides showed no consistent relationship to blood pressure. CONCLUSIONS In this cross-sectional study, serum concentrations of PCBs, especially those congeners with multiple ortho chlorines, were strongly associated with both systolic and diastolic blood pressure.
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Affiliation(s)
- Alexey Goncharov
- Department of Environmental Health Sciences, School of Public Health and
- Institute for Health and the Environment, University at Albany, Rensselaer, New York, USA
| | - Marian Pavuk
- Agency for Toxic Substances and Disease Registry, Atlanta, Georgia, USA
| | - Herman R. Foushee
- Survey Research Unit, University of Alabama–Birmingham, Birmingham, Alabama, USA
| | - David O. Carpenter
- Department of Environmental Health Sciences, School of Public Health and
- Institute for Health and the Environment, University at Albany, Rensselaer, New York, USA
- Address correspondence to D.O. Carpenter, Institute for Health and the Environment, 5 University Place, Rensselaer, NY 12144 USA. Telephone: (518) 525-2660. Fax: (518) 525-2665. E-mail:
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Redmond N, Baer HJ, Hicks LS. Health behaviors and racial disparity in blood pressure control in the national health and nutrition examination survey. Hypertension 2011; 57:383-9. [PMID: 21300667 DOI: 10.1161/hypertensionaha.110.161950] [Citation(s) in RCA: 115] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Minorities have a higher prevalence of hypertension, a major risk factor for cardiovascular disease, which contributes to racial/ethnic disparities in morbidity and mortality in the United States. Many modifiable health behaviors have been associated with improved blood pressure control, but it is unclear how racial/ethnic differences in these behaviors are related to the observed disparities in blood pressure control. Cross-sectional analyses were conducted among 21 489 US adults aged >20 years participating in the National Health and Nutrition Examination Survey from 2001 to 2006. Secondary analyses were conducted among those with a self-reported diagnosis of hypertension. Blood pressure control was defined as systolic values <140 mm Hg and diastolic values <90 mm Hg (or <130 mm Hg and <80 mm Hg among diabetics, respectively). In primary analyses, non-Hispanic blacks had 90% higher odds of poorly controlled blood pressure compared with non-Hispanic whites after adjustment for sociodemographic and clinical characteristics (P<0.001). In secondary analyses among hypertensive subjects, non-Hispanic blacks and Mexican Americans had 40% higher odds of uncontrolled blood pressure compared with non-Hispanic whites after adjustment for sociodemographic and clinical characteristics (P<0.001). For both analyses, the racial/ethnic differences in blood pressure control persisted even after further adjustment for modifiable health behaviors, which included medication adherence in secondary analyses (P<0.001 for both analyses). Although population-level adoption of healthy behaviors may contribute to reduction of the societal burden of cardiovascular disease in general, these findings suggest that racial/ethnic differences in some health behaviors do not explain the disparities in hypertension prevalence and control.
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Affiliation(s)
- Nicole Redmond
- Division of General Internal Medicine and Primary Care, Brigham and Women's Hospital, 1620 Tremont St, Boston, MA 02120-1613, USA
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100
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Self-rated hypertension and anthropometric indicators of body fat in elderly. Rev Assoc Med Bras (1992) 2011. [DOI: 10.1016/s0104-4230(11)70011-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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