Blood pressure and adiposity: A comparative study of socioeconomically diverse groups of Andhra Pradesh, India

Prevalence of hypertension in Indian tribes: a systematic review and meta-analysis of observational studies

INTRODUCTION

In India there is an increasing trend in hypertension prevalence among the general population. Studies have shown that tribal populations in India are also experiencing this burden.

OBJECTIVE

The aim was to estimate the pooled prevalence of primary hypertension among adult tribal populations of India.

METHODS

A systematic search was conducted in MEDLINE, IndMed, Web of Science, Google Scholar and major journals for studies published between 1981 and 2011. Two authors independently reviewed the studies, did quality assessment and extracted data in pre-coded spread-sheets. Pooled estimates of prevalence of hypertension were calculated using DerSimonian-Laird random effects model. Subgroup and sensitivity analyses and meta-regression were performed.

RESULTS

Twenty studies or 53 subpopulations with 64 674 subjects were included in final review. The pooled estimate of hypertension prevalence was 16.1% (95% CI: 13.5, 19.2). There was significant heterogeneity among the studies (I2 = 99% and Q = 4624.0, df  = 53, p<0.001). Subgroup analyses showed that year of study, acculturation status, special features, and BP measurement techniques significantly influenced prevalence, but after meta-regression analyses, 'decade of study' remained the only covariate that significantly and independently influenced prevalence (R2 = 0.57, Q = 119.2, df  = 49, p value <0.001).

CONCLUSION

An increasing trend was found in the prevalence of hypertension in adult tribal populations across three decades. Although acculturation was probably the underlying agent that caused this increase, other unmeasured factors that need further research were also important. Concerned policy makers should focus on the changing health needs of tribal communities.

Classification of Interdental Space for Different Quadrants on the Basis of Standardization through Threshold Data and Its Comparison with BMI and Socioeconomic Status

BACKGROUND

A better knowledge about the Interdental space is important since it provides insights on the prevalence of malocclusion. To date, there is conflicting evidence on the impact of body mass index (BMI) and Socioeconomic status (SES) on interdental space. A recent review concluded that a greater understanding is required of the interdental space. Therefore, there is a need for a more comprehensive and rigorous assessments of the interdental space and impacts of BMI and SES.

AIM

BMI and SES can be associated with the interdental spacing in deciduous dentition.

DESIGN

The present cross-sectional study was carried out on 448 children of age group of 3 to 5 years out of which 392 were meeting our criteria. Research assessment questionnaire on demographic data was completed by the parents. Study model cast of 392 children free from malocclusion were analyzed.

RESULTS

A statistically significant association between interdental spacing and BMI category was observed. Comparison of BMI with above threshold interdental space revealed that after an optimum weight there is no effect on interdental space. A significant association between SES and interdental spacing was observed for all the four locations (p < 0.01).

CONCLUSION

Evolved normative value can be taken as a standard and the occlusion and interdental spaces are not two completely separate entities and they are interdependent. How to cite this article: Singh T, Singh R, Singh JP. Classification of Interdental Space for Different Quadrants on the Basis of Standardization through Threshold Data and Its Comparison with BMI and Socioeconomic Status. Int J Clin Pediatr Dent 2013;6(1):16-21.

Migration and Hypertension: A Cross-Sectional Study Among Neo-Migrants and Settled-Migrants in Delhi, India

Understanding the blood pressure (BP) distribution within populations is fundamental to an understanding of the etiology of cardiovascular diseases and to develop effective preventive strategies. This study focuses on whether the BP levels and hypertension prevalence differ between neo-migrants and settled-migrants in the city of Delhi. Data on BP, anthropometry, social variables, and demographic variables were collected from a cross-sectional sample of 226 settled-migrants and 227 neo-migrants. Men possessed significantly higher BP levels than women. Settled-migrants possessed higher BP levels, except diastolic BP in males. The prevalence of hypertension ranges from 15% (neo-migrant women) to 25% (settled-migrant men), with no significant gender differences. Group differences were significant for men. Hypertension was more prevalent in older settled-migrants and younger neo-migrants. Recent migration was found to be a significant contributor to hypertension prevalence. Age contributed significantly to BP variation in both groups except in neo-migrant men. Pulse rate also contributed to systolic BP among neo-migrant women and settled-migrant men. Thus, urban residence and migration to urban areas can be a leading cause of increased prevalence of hypertension. Neo-migrants were subjected to more lifestyle insults and the stress generated during the adjustment process may be contributing to rise of BP even at younger ages.

Age variation in blood pressure: effect of sex and urbanization in a genetically homogeneous caste population of Andhra Pradesh

Age variation in blood pressure and prevalence of hypertension were studied in relation to sex and urbanization in a caste population of southern Andhra Pradesh living in rural, semi-urban, and urban locales. There is an increase in mean blood pressure from rural to semi-urban areas, and a slight but insignificant decline in urban men. Sex differences in mean blood pressure are significant only in the urban and semi-urban environments. However, the increase in blood pressure with age is sharper in women than in men, and age effects are more perceptible in the urban setting compared to the other two environments. Similarly, age influences SBP more strongly than DBP. The prevalence of hypertension is greater in urban than in rural areas, at older ages (> or = 45 years), and in men compared to women. Results of multiple logistic regression suggest that urban residence and alcohol consumption are associated with increased risk of hypertension in men. Higher risk for hypertension in women is more significantly associated with older age (> or = 45) and obesity (BMI > 25). The results indicate that blood pressure and hypertension are more strongly correlated with the indices of modernization and associated lifestyle patterns in men than in women.

Body size, composition, and blood pressure of high-altitude Quechua from the Peruvian Central Andes (Huancavelica, 3,680 m)

Although much information is available about the effects of high altitude on physiological characteristics, less is know about its effect on body composition. In the present study, anthropometric and body composition variables were investigated in a sample of 77 adult Quechua males from the Peruvian Central Andes (Huancavelica, 3,680 m). The subjects are shorter in relation to body weight than other ethnic groups, whereas body proportions are macrocormic (indicating a long trunk relative to the lower extremities), with intermediate values of the acromial-iliac index. All skinfold thicknesses are low (approximately 15th percentiles of NHANES reference values for the triceps and subscapular skinfolds), but tend to be higher than in the other Quechua populations. Similar results are obtained when percentage fat is estimated. Somatotypes are dominant in mesomorphy with very low ectomorphy. Comparison with a sample of high-altitude Kirghiz (3,200 m), previously studied with the same methods, shows higher values in the Peruvian sample for all variables related to adiposity. The presence of low adiposity in the Quechua population could be associated with stresses of the high-altitude environment. Mean values of blood pressure are very low and there is no correlation with age.

Endogamy and variation in blood pressure levels in Croatian island isolates

Blood pressure variation was investigated among populations inhabiting islands and peninsula of Middle Dalmatia, Croatia. The number of previous anthropological studies pointed to isolation and different genetic population structure in this environmentally fairly homogeneous area. Variation in blood pressure (systolic and diastolic) among the populations of the islands of Brac, Hvar, Korcula, and the Peljesac peninsula was assessed at three levels involving village populations, regional (western and eastern) populations and the entire island populations. The blood pressure data were collected from 3834 adult individuals inhabiting 37 rural communities and were adjusted for age and body mass index. Variation in blood pressure levels existed among regions and villages. Due to the history of differential settlement, small village sizes and high levels of reproductive isolation, the observed blood pressure variation could be attributed to founder effect, genetic drift and inbreeding. The involvement of genetic factors was tested by relating blood pressure variation among villages to degree of isolation among them. Blood pressure means and proportions of hypertensives increased with endogamy levels in males. In females, this effect could not be observed. However, in both sexes the highest proportions of hypertensives (more than 40%) were found in villages that are most reproductively closed (endogamy greater than 80%). These populations are considered particularly promising for further genetic epidemiological research.

Anthropometric changes in urban Sardinian children 7 to 10 years between 1975-1976 and 1996

This study is a comparison of several anthropometric variables in school children of the same age (7-10 years) and sex measured in two primary schools in Cagliari (Sardinia, Italy) at an interval of 20 years (1996 vs. 1975-1976). For both males and females of each age-class, there are significant differences in the following dimensions: weight, stature, estimated lower limb length, biacromial breadth, xiphoid chest circumference, xiphoid chest depth, and bicristal breadth, and also in relative sitting height, cephalic index, and facial index. The means of the relative sitting height, cephalic, and facial indexes are higher in the children measured in 1975-1976 than in those measured in 1996. There are no significant differences in sitting height and arm length. In addition, the estimated BMIs of the 1975-1976 sample are, on average, lower than those of the 1996 sample. The results suggest that urban Sardinian children sampled in 1996 are generally taller, heavier, and larger and have a longer head and wider face than their peers of 20 years earlier. The increase in stature is due more to an increase in lower limb length than in sitting height. Am J. Hum. Biol. 12:782-791, 2000. Copyright 2000 Wiley-Liss, Inc.

Modernisation and children's blood pressure: On and off the tourist trail in Nepal

Blood pressure and anthropometric measurements were taken for 231 children between 11 and 14 years in the Annapurna area of Central Nepal, a popular tourist destination. Children from villages on the tourist trail, whose lifestyles were generally more modernised, were compared with children from nearby villages off the tourist trail. Indications of greater modernisation on the trail included the findings that fathers of children living on the trail were less likely to work as farmers than fathers of those off the trail (P = 0.003), and children living on the trail were much more likely to have seen television (P < 0.001). Children on the tourist trail were taller and heavier (P < 0.001), and had higher body mass indices (P = 0.003) and biceps skinfolds (P = 0.005). They also had higher diastolic blood pressure than children living off the trail (P = 0.02). The differences in weight appeared to account for the effect of living on the trail on diastolic blood pressure, since when weight was added to the model it showed a significant association with diastolic blood pressure (P = 0.02) and the effect of location became nonsignificant. For the biceps skinfold and systolic blood pressure, there was a significant sex difference in the effect of living on the trail (P = 0.04 and P = 0.05 respectively), such that among girls there were greater increases associated with living on the trail than there were among boys. The findings suggest that lifestyle changes linked to the development of tourism in Nepal are associated from an early age with potentially deleterious changes in cardiovascular characteristics and demonstrate that such socioeconomic changes can have quite local effects. Am. J. Hum. Biol. 12:478-486, 2000. Copyright 2000 Wiley-Liss, Inc.

Comparison of anthropometric characteristics between normotensive and hypertensive individuals among a population of Bengalee Hindu elderly men in Calcutta, India

A comparative investigation of 99 normotensive and 111 hypertensive Bengalee Hindu elderly men (aged 55 years and above) of Kalighat, South Calcutta, India, was undertaken to study differences in levels of adiposity, body fat distribution and body composition between these two groups. Results revealed that there were significant differences between normotensive (NT) and hypertensive (HT) subjects in the mean values for weight (p < 0.05), body mass index (BMI, p < 0.01); waist (p < 0.001) and hip circumferences (p < 0.05); waist-hip ratio (WHR, p < 0.001), conicity index (CI, p < 0.01) and fat free mass (FFM, p < 0.001). Percentile distributions for all these variables and indices showed consistently higher values among the HT patients as compared with NT subjects. However, the frequency of obesity (BMI > or = 25) was similar (NT = 6.1%, HT = 11.7%) in both groups. Thus, these results indicated that there existed significant differences in central adiposity and FFM between NT and HT subjects although their level of obesity was similar. Hypertensive individuals have significantly enhanced levels of central body fat distribution.

Relationships between blood pressure, anthropometric characteristics and blood lipids in high- and low-altitude populations from Central Asia

We studied the relationships between blood pressure, anthropometric characteristics and blood lipids in 72 low altitude (LA) Uighurs (600 m), 91 LA-Kirghizs (900 m), 117 medium altitude (MA) Kazakhs (2100 m) and 94 high altitude (HA) Kirghizs (3200 m). All subjects were male and had a similar age (p = ns, ANOVA; range for all 374 subjects: 18-66 yr). Body weight (Wt), body mass index (BM1) and the sum of four skinfolds (4SF) were significantly lower in HA-Kirghizs than the remaining groups (p < 0.0005, p < 0.0005 and p < 0.05 respectively, ANOVA). However, no difference was found in body fat distribution as detected by waist:hip circumference (WHR) and triceps:subscapular skinfold ratios (TSR; p = ns, ANOVA). Stage 1 hypertension was detected in 18% of LA-Uighurs, 2% of LA-Kirghizs, 4% of MA-Kazakhs and 1% of HA-Kirghizs; stage 2 hypertension was detected in 2% of LA-Uighurs and none of the remaining groups; no subject had stage 3 hypertension (The Joint National Committee on Prevention. Detection, Evaluation and Treatment of High Blood Pressure 1997). Blood cholesterol (CH) and triglycerides (TG) did not differ between groups (p = ns, ANOVA). The relationships between systolic (SBP) or diastolic (DBP) blood pressure and age, Wt, BMI, 4SF, WHR, TSR, CH and TG were independent from altitude (p = ns, ANCOVA). In the pooled sample (n = 374), age explained 1 and 3% of SBP (p < 0.05) and DBP (p < 0.005) variance respectively, Wt was the best predictor of SBP and DBP explaining 11 and 10% of their variance respectively (p < 0.0001) and CH explained 5% of DBP variance (p < 0.0001). In conclusion, hypertension is more frequent in LA- than MA- and HA-subjects from Central Asia. However, anthropometric characteristics and blood lipids do similarly contribute to explain blood pressure in these subjects.