Association between alcohol consumption and hypertension in Chinese adults: Findings from the CHNS

Effectiveness of the knowledge, attitude, practice intervention model in the management of hypertension in the elderly

This study illustrated the effectiveness of the knowledge, attitude, practice (KAP) intervention model for community hypertension in the elderly by the community physician-led, describing the study design and baseline data. The aim of the study was to compare the changes in the elderly hypertensive population before and after the KAP intervention model by managing the elderly hypertensive patients for a period of 1 year. Basic information and risk factors affecting blood pressure control based on baseline data of recruited elderly hypertensive patients. The management approach consists of two parts: (1) the unified management of the community physician to whom the patient belongs; and (2) the management of the contracted patient by the community physician. The aim was to demonstrate the anti-hypertensive effectiveness (control rate, blood pressure reduction, and pulse pressure), the distribution of blood pressure types, and the change of the KAP in elderly hypertensive patients before and after the intervention. The KAP intervention model was administered to 2660 elderly hypertensive patients in a 1-year period. The blood pressure control rate improved by 54.03%. Mean values of overall systolic and diastolic blood pressure decreased by 16.00 and 5.31 mmHg, respectively. The proportion of isolated systolic hypertension (ISH) and systolic-diastolic hypertension (SDH) decreased by 29.14% and 24.81%, respectively. The KAP compliance improved significantly. These results suggest that the community physician-led KAP intervention model is effective in the management of hypertension in the elderly.

Exploring factors influencing farmers' health self-assessment in China based on the LASSO method

As the main force and practice subject of rural revitalisation, farmers' health is intricately linked to agricultural production and the rural economy. This study utilizes open data from the 2015 China Nutrition and Health Survey and employs the Least Absolute Shrinkage and Selection Operator (LASSO) method to explore the factors influencing farmers' self-assessment of health. The findings reveal that education level, proactive nutrition knowledge seeking, healthy dietary preferences and habits, and the use of clean cooking fuel positively impact farmers' health self-assessment. Conversely, age, history of illness or injury, and participation in medical insurance negatively affect their self-assessment. Furthermore, factors influencing farmers' health self-assessment exhibit heterogeneity across regions. Our findings suggest that promoting health education, disseminating nutritional dietary knowledge, and enhancing rural household infrastructure play an important role in improving farmers' self-evaluation of health. Therefore, policymakers should design more targeted health interventions and infrastructure improvement plans based on farmers' self-assessment of health and the level of regional economic development.

Association Between Alcohol Consumption and Blood Pressure Levels Among HIV Sero-Positive and Sero-Negative Cohorts: A Secondary Analysis of the Vukuzazzi Study

BACKGROUND

The effect of hypertension is aggravated by lifestyle factors such as alcohol consumption. This study sought to determine the association between alcohol consumption and the level of blood pressures among HIV seronegative and seropositive cohorts.

METHODS

This secondary analysis was performed on a cross-sectional survey data of 17 922 participants during the period between 2018 and 2020. A questionnaire was used to obtain participants' alcohol consumption history, which was categorized into non-alcohol consumers, non-heavy alcohol consumers, and heavy alcohol consumers. A linear regression model was used to establish relationships among participants with raised blood pressure (BP ≥ 140/90 mmHg).

RESULTS

Out of the total participants, 3553 (19.82%) were hypertensives. Almost 13% of the hypertensives (n = 458; 12.89%) were undiagnosed, and 12.44 % (442) had uncontrolled hypertension. About 14.52% of the hypertensives (3553) were not on any antihypertensive medication. Male non-consumers of alcohol had the highest systolic and diastolic BP; uncontrolled systolic BP (165.53 ± 20.87 mmHg), uncontrolled diastolic BP (102.28 ± 19.21mmHg). Adjusted for covariates, moderate alcohol consumption was associated with HTN among participants who were HIV seropositive [unadjusted (RR = 1.772, P = .006, 95% CI (1.178-2.665)], [RR = 1.772, P = .005, 95% CI (1.187-2.64)]. [unadjusted RR = 1.876, P = .036, 95% CI (1.043-3.378)], adjusted RR = 1.876, P = .041, 95% CI (1.024-3.437). Both moderate and heavy alcohol consumption were significantly related to hypertension among HIV sero-negative [unadjusted model, moderate consumption RR = 1.534 P = .003, 95% CI (1.152-2.044)], [adjusted model, moderate alcohol consumption RR = 1.535, P = .006, 95% CI (1.132-2.080)], [unadjusted model, heavy alcohol consumption, RR = 2.480, P = .030, 95% CI (1.091-5.638)], [adjusted model RR = 2.480, P = .034, 95% CI (1.072-5.738)].

CONCLUSION

Alcohol consumption is significantly related to increase BP regardless of HIV infection.

The Link between Overweight/Obesity and Noncommunicable Diseases in Ethiopia: Evidences from Nationwide WHO STEPS Survey 2015

Background

Noncommunicable diseases (NCDs) are the leading cause of death worldwide. Each year, 15 million adults die from NCDs; more than 85% of these premature deaths occur in low- and middle-income nations. Evidence indicates that overweight and obesity are the main risk factors for NCDs. Although the literature indicates that the burden of NCDs is increasing in Ethiopia, no research has been conducted to demonstrate a link between overweight/obesity and NCDs. Therefore, the aim of this study is to examine the association between overweight/obesity and the common NCDs while adjusting for other important factors.

Methods

We analysed data from the 2015 Ethiopia WHO STEPS survey, which was conducted in 2015. A total weighted sample of 9,800 participants (15-69 years) was included. The relationship between nutritional status and NCDs was assessed using bivariate and multivariable logistic regression models while adjusting for covariates.

Results

Among the 9,800 participants, 2053 (21% with (95% CI: 19.8-22.1) had hypertension and 1368 (14% with (95% CI: 13.1-15.0) had high cholesterol levels. According to the multivariable logistic regression analysis, being overweight/obese (AOR = 2.0; 95% CI: 1.7-2.3), alcohol consumption, received lifestyle advice, being female, living in urban areas, increased age, having government occupation, and living in SNNP region were positively associated with hypertension. While being underweight (AOR = 0.6; 95% CI: 0.5-0.7), living in the Afar, Somali, and Tigray regions were negatively associated with hypertension. Being overweight/obese (AOR = 1.4; 95% CI: 1.1-1.7), being female, having older age, and living in Somali region were positively associated with a high cholesterol level. Whereas being underweight (AOR = 0.7; 95% CI: 0.6-0.9), received lifestyle advice, reside in rural areas, being farmer, student, and housewife, and living in Gambela region were negatively associated with a high cholesterol level.

Conclusion

This study found a statistically positive association between the common NCDs, namely, overweight/obesity, hypertension, and high cholesterol levels. Our findings imply that there is a need for effective interventions to prevent overweight/obesity by encouraging people to increase physical activity, minimize sedentary behavior, and maintain a healthy dietary pattern in order to reduce the risk of hypertension and high cholesterol levels.

Susceptibility to hypertension based on MTHFR rs1801133 single nucleotide polymorphism and MTHFR promoter methylation

Background

The aetio-pathologenesis of hypertension is multifactorial, encompassing genetic, epigenetic, and environmental factors. The combined effect of genetic and epigenetic changes on hypertension is not known. We evaluated the independent and interactive association of MTHFR rs1801133 single nucleotide polymorphism (SNP) and MTHFR promoter methylation with hypertension among Taiwanese adults.

Methods

We retrieved data including, MTHFR promoter methylation, MTHFR rs1801133 genotypes (CC, CT, and TT), basic demography, personal lifestyle habits, and disease history of 1,238 individuals from the Taiwan Biobank (TWB).

Results

The distributions of hypertension and MTHFR promoter methylation quartiles (β < 0.1338, 0.1338 ≤ β < 0.1385, 0.1385 ≤ β < 0.1423, and β ≥ 0.1423 corresponding to

Conclusion

Independently, rs1801133 TT was associated with a higher risk of hypertension, but methylation was not. Based on genotypes, lower methylation was dose-dependently associated with a higher risk of hypertension in individuals with the CC genotype. Our findings suggest that MTHFR rs1801133 and MTHFR promoter methylation could jointly influence hypertension susceptibility.

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Key Words

• MTHFR
• hypertension
• interaction
• promoter methylation
• rs1801133
• susceptibility

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MESH Headings Collapse

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Affiliation(s)

Ming-Huang Chiu Department of Pulmonology and Respiratory Care, Cathay General Hospital, Taipei City, Taiwan
Chia-Hsiu Chang Cardiovascular Center, Cathay General Hospital, Taipei City, Taiwan
Disline Manli Tantoh Department of Medical Imaging, Chung Shan Medical University Hospital, Taichung City, Taiwan Department of Public Health and Institute of Public Health, Chung Shan Medical University, Taichung City, Taiwan
Tsui-Wen Hsu Superintendent Office, Institute of Medicine, Cathay General Hospital, Taipei City, Taiwan
Chih-Hsuan Hsiao Department of Public Health and Institute of Public Health, Chung Shan Medical University, Taichung City, Taiwan
Ji-Han Zhong Department of Public Health and Institute of Public Health, Chung Shan Medical University, Taichung City, Taiwan
Yung-Po Liaw Department of Medical Imaging, Chung Shan Medical University Hospital, Taichung City, Taiwan Department of Public Health and Institute of Public Health, Chung Shan Medical University, Taichung City, Taiwan Institute of Medicine, Chung Shan Medical University, Taichung City, Taiwan

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Hypertension in China: epidemiology and treatment initiatives

The past two to three decades have seen a steady increase in the prevalence of hypertension in China, largely owing to increased life expectancy and lifestyle changes (particularly among individuals aged 35-44 years). Data from the China hypertension survey conducted in 2012-2015 revealed a high prevalence of grade 3 hypertension (systolic blood pressure ≥180 mmHg and diastolic blood pressure ≥110 mmHg) in the general population, which increased with age to up to 5% among individuals aged ≥65 years. The risk profile of patients with hypertension in China has also been a subject of intense study in the past 30 years. Dietary sodium and potassium intake have remained largely the same in China in the past three decades, and salt substitution strategies seem to be effective in reducing blood pressure levels and the risk of cardiovascular events and death. However, the number of individuals with risk factors for hypertension and cardiovascular disease in general, such as physical inactivity and obesity, has increased dramatically in the same period. Moreover, even in patients diagnosed with hypertension, their disease is often poorly managed owing to a lack of patient education and poor treatment compliance. In this Review, we summarize the latest epidemiological data on hypertension in China, discuss the risk factors for hypertension that are specific to this population, and describe several ongoing nationwide hypertension control initiatives that target these risk factors, especially in the low-resource rural setting.

Consumption frequencies of beverages and the hypertension risk in adults: a cohort study in China

OBJECTIVE

To explore the associations between the consumption frequencies of alcohol, tea and sugar-sweetened beverages (SSBs) and the hypertension risk among Chinese adults.

DESIGN

A longitudinal study of the effect of beverage consumption on hypertension risk.

SETTING

Nine provinces in China, including Jiangsu, Hubei, Hunan, Guangxi, Guizhou, Liaoning, Heilongjiang, Shandong and Henan.

PARTICIPANTS

The longitudinal data of the China Health and Nutrition Survey from 2004 to 2015 were used. A total of 4427 participants from 9 provinces were included at baseline.

OUTCOME

First incidence of hypertension.

RESULTS

During a mean follow-up of 8.7 years, 1478 participants developed hypertension. Alcohol consumption more than twice a week in young men (HR 1.86, 95% CI 1.09 to 3.18) or middle-aged men (HR 1.37, 95% CI 1.01 to 1.87) was associated with a higher hypertension risk. Middle-aged women who consumed tea frequently (HR 0.71, 95% CI 0.52 to 0.97), or young women who consumed SSBs less than once a week (HR 0.31, 95% CI 0.14 to 0.67) had a lower risk of hypertension.

CONCLUSIONS

High-frequency alcohol consumption increased the risk of hypertension in men, and frequent tea consumption and low-frequency SSBs consumption were associated with lower risk of hypertension in women. Consumption frequency of beverages was also suggested to be considered in the prevention and control of hypertension.

Factors influencing the progression from prehypertension to hypertension among Chinese middle-aged and older adults: a 2-year longitudinal study

BACKGROUND

This study aimed to investigate the proportion of prehypertension cases progressing to hypertension among Chinese middle-aged and elderly populations over a 2-year period and related influencing factors.

METHODS

Data were obtained from the China Health and Retirement Longitudinal Study, and 2,845 individuals who were ≥ 45 years old and prehypertensive at baseline were followed from 2013-2015. Structured questionnaires were administered, and blood pressure (BP) and anthropometric measurements were performed by trained personnel. Multiple logistic regression analysis was done to investigate factors associated with prehypertension progressing to hypertension.

RESULTS

Over the 2-year follow-up, 28.5% experienced progression of prehypertension to hypertension; this occurred more frequently in men than women (29.7% vs. 27.1%). Among men, older age (55-64 years: adjusted odds ratio [aOR] = 1.414, 95% confidence interval [CI]:1.032-1.938; 65-74 years: aOR = 1.633, 95%CI: 1.132-2.355; ≥ 75 years: aOR = 2.974, 95%CI: 1.748-5.060), obesity (aOR = 1.634, 95%CI: 1.022-2.611), and number of chronic diseases (1: aOR = 1.366, 95%CI: 1.004-1.859; ≥ 2: aOR = 1.568, 95%CI: 1.134-2.169) were risk factors for progression to hypertension whereas being married/cohabiting (aOR = 0.642, 95% CI: 0.418-0.985) was a protective factor. Among women, risk factors included older age (55-64 years: aOR = 1.755, 95%CI: 1.256-2.450; 65-74 years: aOR = 2.430, 95%CI: 1.605-3.678; ≥ 75 years: aOR = 2.037, 95% CI: 1.038-3.995), married/cohabiting (aOR = 1.662, 95%CI: 1.052-2.626), obesity (aOR = 1.874, 95%CI: 1.229-2.857), and longer naps (≥ 30 and < 60 min: aOR = 1.682, 95%CI: 1.072-2.637; ≥ 60 min: aOR = 1.387, 95%CI: 1.019-1.889).

CONCLUSIONS

Chinese middle-aged and elderly individuals experienced a risk of prehypertension progressing to hypertension over a 2-year period, although the influencing factors differed by sex; this should be considered in interventions.

Associations of parental attitudes and health behaviors with children's screen time over four years

BACKGROUND

Parents are significantly important in shaping the screen use of children within a family system. This study aimed to examine the associations of Chinese children's screen time (ST) over four years with parents' attitudes toward their own screen use and physical activities (PA) and health behaviors including their ST, PA, cigarette smoking, and alcohol drinking.

METHODS

The current study utilized data from two waves (2011 and 2015) of the China Health and Nutrition Survey (CHNS), including 1,941 mother-father-child triads in 2011 and 2,707 mother-father-child triads in 2015 (with children aged 0-17-years-old). The ST of children and the parental attitudes and health behaviors were measured via self-report or proxy-report (for children under 6 years old) questionnaires. Pool-OLS regression models were used to assess the associations of parental attitudes and health behaviors with the ST of children. Moderation models were built to assess whether these associations depended on the gender, age, and family income of children, as well as whether paternal and maternal influences were moderated by the other parent. A multilevel cross-lagged panel model (CLPM) was used to assess parental influences on children's ST over four years.

RESULTS

Paternal ST (β = 0.09, p < 0.001), maternal ST (β = 0.10, p < 0.001), and paternal alcohol drinking (β = 0.30, p < 0.05) were positively associated with children's ST. In addition, maternal smoking had a positive association with girls' ST (β = 0.53, p < 0.05). Moreover, the association between maternal ST and children's ST was observed to decline as family income increased (β = -0.03, p < 0.001). Paternal ST had a larger positive association with children's ST when the ST of mothers exceeded 14 h/week (β = 0.06, p < 0.05). Furthermore, lagged associations were found between paternal attitudes toward PA (β = -1.63, p < 0.05) or maternal cigarette smoking (β = 1.46, p < 0.05) and children's ST measured four years later.

CONCLUSION

Children establish a healthy lifestyle within the family system. From the perspective of the healthy family climate, the current study suggests that future programs for reducing children's ST should be built through an integrative approach with special attention to parental attitudes and health behaviors.

Sex-specific differences in the association between metabolically healthy overweight/obesity and the risk of hypertension in Chinese ethnic minorities

OBJECTIVE

To estimate and compare sex-specific differences between metabolically healthy overweight/obesity (MHOO) and the risk of hypertension among Dong, Bouyei, and Miao adults in southwest China.

METHODS

MHOO was diagnosed when the patient had a body mass index ≥24 kg/m² and the presence of ≤1 component of metabolic syndrome. The main outcome was the occurrence of hypertension after the diagnosis or measurement by a physician at the baseline survey. Multivariate logistic regression models were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) between MHOO and the risk of hypertension.

RESULTS

We enrolled 16,433 Chinese Dong, Bouyei, and Miao adults. Using the metabolically healthy normal weight (MHNW) as a reference and after adjusting for confounders, the association between MHOO and the risk of hypertension was stronger in Dong (OR = 1.46, 95% CI: 1.07-2.00) and Miao (OR = 2.05, 95% CI: 1.48-2.85) men and did not exist in Bouyei men (OR = 1.14, 95% CI: 0.81-1.60). After adjusting for the age, the association between MHOO and the risk of hypertension was stronger in men than in women among Dong adults aged 30-59 years (OR = 1.64, 95% CI: 1.12-2.40) and did not differ between men and women among Dong adults aged 60-79 years or among Miao or Bouyei adults.

CONCLUSION

The results of this study demonstrated sex-specific differences in the association between MHOO and the risk of hypertension and that sex-specific differences further differed among Dong, Bouyei, and Miao adults.

Interaction effect between overweight/obesity and alcohol consumption on hypertension risk in China: a longitudinal study

OBJECTIVE

To explore the interaction effect between overweight/obesity and alcohol consumption on hypertension risk.

DESIGN

A longitudinal study of the independent and combined effects of hypertension risk factors.

SETTING

Twelve provinces in China, including Beijing Liaoning, Heilongjiang, Shanghai, Jiangsu, Shandong, Henan, Hubei, Hunan, Guangxi, Guizhou and Chongqing.

PARTICIPANTS

Longitudinal data of China Health and Nutrition Survey, collected between 2011 and 2015, were used in this study. A total of 13 121 residents from 12 provinces were included and completed physical examinations and questionnaires at baseline.

OUTCOME

First incidence of hypertension.

RESULTS

Over a mean follow-up of 4 years, 690 incident hypertension cases were reported. After adjusting for age, gender, education level, marital status, physical activity, diabetes and smoking, high body mass index (BMI) and light drinking (OR=5.07, 95% CI 3.06 to 8.41), high waist circumference (WC) and light drinking (OR=4.81, 95% CI 2.92 to 7.91), high waist hip ratio and light drinking (OR=2.85, 95% CI 1.84 to 4.42) were the highest risk of all participants in the three combinations. Multiplicative interaction measures were statistically significant in overweight/obesity and drinking/light drinking/heavy drinking categories in men (p<0.05). Additive interactions were observed between high BMI and drinking in men (relative excess risk due to interaction=1.75, 95% CI 0.85 to 2.65, attributable proportion due to interaction=0.56, 95% CI 0.36 to 0.76, synergy index=6.43, 95% CI 1.02 to 28.84).

CONCLUSIONS

Measures of body weight and size, particularly BMI and WC, appear to interact synergistically with alcohol consumption to increase the risk of hypertension in the Chinese population. Given that approximately 245 million people in China have hypertension, and that hypertension is a major cause of cardiovascular disease worldwide, our results may have implications for chronic disease prevention.

Serum 25-hydroxyvitamin D might be negatively associated with hyperuricemia in U.S. adults: an analysis of the National Health and Nutrition Examination Survey 2007-2014

PURPOSE

The results of previous studies on the relationship between serum 25-hydroxyvitamin D [25(OH)D] and hyperuricemia are controversial. We hypothesized that serum 25(OH)D concentrations of U.S. adults would negatively correlate with the risk of hyperuricemia.

METHOD

Data came from the National Health and Nutrition Examination Survey 2007-2014 were used, after excluding those who met at least one of the exclusion criteria, a total of 9096 male individuals and 9500 female individuals aged 18 years or older were included. Binary logistic regression analysis and restricted cubic spline with fully adjusted confounding factors were applied to evaluate the association between serum 25(OH)D and hyperuricemia. We further performed stratified analysis and sensitivity analysis to minimize the influence of gender, metabolic syndrome, obesity and renal dysfunction on the above association.

RESULTS

We found a negative correlation between serum 25(OH)D and hyperuricemia. In the binary logistic regression analysis, compared with the highest serum 25(OH)D quartile [Q4: 25(OH)D > 77.10 nmol/L] group, the odds ratios (95% confidence intervals) in the lowest quartile [Q1: 25(OH)D ≤ 43.20 nmol/L] was 1.46 (1.22-1.75) in the fully adjusted model. Restricted cubic spline analysis showed L-shaped and non-linear relationships between 25(OH)D and hyperuricemia. In sensitivity analysis, after restricting to participants without significant renal dysfunction and obesity, the above association remained significant. After restricting to participants who were diagnosed as metabolic syndrome, above association remained significant in the fully adjusted model. In stratified analysis by gender, the association remained significant among males and females.

CONCLUSIONS

Serum 25(OH)D might be inversely associated with hyperuricemia in general U.S. adults. From our study, for people with unexplained hyperuricemia, screening for serum Vitamin D concentration might be necessary.

Serum Uric Acid Might Be Positively Associated With Hypertension in Chinese Adults: An Analysis of the China Health and Nutrition Survey

Background: Previous studies have clarified the relationship between serum uric acid (SUA) and hypertension; most of previous studies suggest that elevated uric acid levels are associated with an increased risk of hypertension, while in China, there are relatively few studies to explore above association. The objective of this longitudinal study is to investigate the correlation of SUA and hypertension in Chinese adults with a nationwide large-scale sample.

Methods: Data from the China Health and Nutrition Survey 2009, 2011, and 2016 were used; a total of 8,469 participants (3,973 men and 4,496 women) were involved. This study was conducted separately by gender. Clinical characteristics of the participants among different uric acid groups are compared. The binary logistic regression analysis was conducted to examine the association between SUA and hypertension. Restricted cubic spline analysis with three knots of the SUA concentration were used to characterize the dose-response relationship. Additionally, we compared the incidence of hypertension in the different baseline uric acid groups during follow-up in 2011 and 2015.

Results: After the covariates were fully adjusted, we found that elevated uric acid levels were correlated with increased risk of hypertension in both males (p < 0.01) and females (p < 0.01). With 2-year or 6-year of follow-up, we found participants with higher baseline uric acid levels had a higher incidence of hypertension (p < 0.01). In stratified analysis by obesity, above relationship remained significant in nonobesity population (males: p < 0.05, females: p < 0.01) and became nonsignificant in obesity people. In stratified analysis by age, above positively correlation remained significant in middle-aged men (p < 0.05) and elderly women (p < 0.01). Restricted cubic spline revealed the dose-response relationship between SUA and hypertension; we also found that above relationship was much stronger in females.

Conclusion: This study suggests that elevated SUA levels might be positively associated with an increased risk of hypertension in general Chinese adults.

Association Between Serum Calcium and the Prevalence of Hypertension Among US Adults

Background: Hypertension is a significant risk factor of cardiovascular diseases, posing a serious threat to global health. Calcium plays an important role in regulating body homeostasis. The association of calcium with hypertension remains uncertain in the general population.

Methods and Results: Cross-sectional data from the 2007–2018 National Health and Nutrition Examination Survey (NHANES) were analyzed. Adjusted multivariable logistic regression analysis and restricted cubic spline were used to investigate the association of serum calcium with the prevalence of hypertension. A total of 26,778 participants were included. The increase in calcium levels showed a positive association with the prevalence of hypertension in all three models with ORs of 1.347 (1.249–1.454), 1.522 (1.401–1.654), and 1.438 (1.306–1.583). The further subgroup analysis demonstrated a robust trend across all categories by sex, age, race, BMI, and eGFR. The restricted cubic spline plot exhibited an S-curve relationship between calcium and hypertension.

Conclusion: Our cross-sectional study demonstrated a positive association between higher serum calcium level and the prevalence of hypertension. Our findings highlighted serum calcium level in hypertensive patients.

Cardiometabolic syndrome and associated factors among Ethiopian public servants, Addis Ababa, Ethiopia

Non-communicable diseases (NCDs) are increasingly becoming the global cause of premature death encompassing cardiovascular diseases (CVDs), cancer, respiratory diseases and diabetes mellitus. However, cardiometabolic risk factors in the general population, especially among the high-risk groups have rarely been assessed in Ethiopia. The study aimed to assess the prevalence of metabolic syndrome, its components and associated factors among staff in the Ethiopian Public Health Institute (EPHI). An institutional-based cross-section study was conducted from March to June 2018 among EPHI staff members. A total of 450 study participants were involved in the study, and the World Health Organization NCD STEPS survey instrument version 3.1 was used for the assessment. The biochemical parameters were analyzed by using COBAS 6000 analyzer. Statistical package for the social science (SPSS) version 20 was used for data analysis. Both bivariate and multivariate logistic regression analyses were used to identify associated risk factors. p value < 0.05 was considered for statistical significance. The overall prevalence of metabolic syndrome was 27.6% and 16.7% according to IDF and NCEP criteria respectively, with males having greater prevalence than females (35.8% vs 19.4%). Central obesity, low high-density lipoprotein (HDL) and hypertension had a prevalence of 80.2%, 41.3%, and 23.6%, respectively. In multivariate analysis increasing age and having a higher body mass index (25-29.9) were significantly associated with metabolic syndromes. The magnitude of metabolic syndrome was relatively high among public employees. Preventive intervention measures should be designed on the modification of lifestyle, nutrition and physical activities, and early screening for early identification of cardiometabolic risks factors should be practised to reduce the risk of developing cardiovascular diseases.

Prevalence of and risk factors for hypertension in Ethiopia: A systematic review and meta-analysis

BACKGROUND

A number of epidemiological studies were performed to know the prevalence of and the risk factors for hypertension. However, these studies reported inconsistent results. As a result, this systematic review and meta-analysis were planned to generate representative data on the prevalence of and risk factors for hypertension among the Ethiopian adult population.

METHODS

Five electronic databases, namely, PubMed, Science Direct, Google Scholar, Hinari, and African Journals Online, were searched for studies published in English from 1 January 2010 to 31 August 2020. Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument and Newcastle-Ottawa scale were used for data extraction and quality assessment for this review. Stata version 14 statistical software was used for the analysis, and due to high heterogeneity a random effects model was used for meta-analysis at 95% confidence interval (CI).

RESULTS

In this review, 35 observational studies were included. The pooled prevalence of hypertension in Ethiopia was 20.63% (95% CI [18.70, 22.55]) with the I 2 value of 96.1%. Older age (≥40 years) (adjusted odds ratio [AOR]: 3.46 [95% CI: 2.67, 4.49]), urban residence (AOR: 1.47 [95% CI: 1.28, 1.70]), educational status less than grade 12 (AOR: 1.67 [95% CI: 1.38, 2.01]), family history of hypertension (AOR: 4.33 [95% CI: 2.95, 6.34]), diabetes mellitus (DM) (AOR: 5.18 [95% CI: 3.01, 8.88]), body mass index (BMI) ≥25 (AOR: 3.79 [95% CI: 2.61, 5.50]), central obesity (AOR: 1.91 [95% CI: 1.09, 3.36]), and alcohol consumption (AOR: 1.72 [95% CI: 1.26, 2.34]) were the identified risk factors for hypertension.

CONCLUSION

The pooled prevalence of hypertension is relatively higher as compared to the previous reports in Ethiopia. Older age, urban residence, lower educational coverage, family history of hypertension, DM, BMI ≥25, alcohol consumption, and central obesity were the risk factors for hypertension. The governments and stakeholders should design an appropriate strategy to prevent and control the disease in the Ethiopian population.

Interaction between ALDH2 rs671 and life habits affects the risk of hypertension in Koreans: A STROBE observational study

Aldehyde dehydrogenase-2 (ALDH2) is associated with the risk of hypertension, and the effects of lifestyle factors on blood pressure vary according to genotype. Among the Han Chinese, the risk of hypertension is lower in the group with the rs671 A allele than in the group with the G allele, and there is a significant association between the frequency of fried food consumption and hypertension. However, the A allele significantly increases the risk of hypertension with increased fried food intake. This study aimed to investigate the effect of the relationship between ALDH2 polymorphism and complex lifestyle habits (fried food consumption and exercise) on hypertension.rs671 polymorphisms of ALDH2 were examined using Korean genome and epidemiology data from 8157 hypertensive cases and 9550 controls. Further, we investigated whether the A allele is protective against hypertension in Koreans and explored the effect of the combination of fried food intake and exercise habits on hypertension by genotype.The genotype frequencies of rs671, which is specific to East Asia, were 2.51% AA, 26.66% GA, and 70.83% GG in the Korean population. The group with inactive aldehyde dehydrogenase-2 had a low odds ratio [OR = 0.75 (95% CI:0.69-0.80), P = 4.35 × 10-14] of hypertension, and low metabolism of acetaldehyde. Subjects carrying the A allele exhibited an increased risk of hypertension with increased fried food intake without exercise [OR = 2.256 (95% CI:1.094-4.654), P = .028].ALDH2 polymorphism and complex lifestyle habits (fried food consumption and exercise) are associated with the risk of hypertension. Further, the A allele is associated with a low risk of hypertension, but it increases the risk of hypertension as fried food intake without exercise increases.

Consensus and Controversy in the Debate over the Biphasic Impact of Alcohol Consumption on the Cardiovascular System

In the past few decades, research has focused on the importance of addressing modifiable risk factors as a means of lowering the risk of cardiovascular disease (CVD), which represents the worldwide leading cause of death. For quite a long time, it has been considered that ethanol intake has a biphasic impact on the cardiovascular system, mainly depending on the drinking pattern, amount of consumption, and type of alcoholic beverage. Multiple case-control studies and meta-analyses reported the existence of a "U-type" or "J-shaped" relationship between alcohol and CVD, as well as mortality, indicating that low to moderate alcohol consumption decreases the number of adverse cardiovascular events and deaths compared to abstinence, while excessive alcohol use has unquestionably deleterious effects on the circulatory system. However, beginning in the early 2000s, the cardioprotective effects of low doses of alcohol were abnegated by the results of large epidemiological studies. Therefore, this narrative review aims to reiterate the association of alcohol use with cardiac arrhythmias, dilated cardiomyopathy, arterial hypertension, atherosclerotic vascular disease, and type 2 diabetes mellitus, highlighting literature disagreements over the risk and benefits of low to moderate drinking on the cardiovascular system.

Association between the proportions of carbohydrate and fat intake and hypertension risk: findings from the China Health and Nutrition Survey

OBJECTIVE

The aim of this study was to expound the dietary effects of different proportions of carbohydrate and fat on hypertension in the Chinese population.

METHODS

We used data derived from the China Health and Nutrition Survey (CHNS) from 1991 to 2011. In total, 10 459 Chinese participants aged over 12 years were included in the final analysis. A multivariable Cox regression was used to calculate the hazard ratio and 95% confidence interval (95% CI) of hypertension in each group, and the medium proportion of carbohydrate and fat (MPCF) diet intake group was used as the reference.

RESULTS

Compared with the participants who consumed an MPCF diet, the individuals who consumed a high-carbohydrate and low-fat (HCLF) diet had a higher risk of developing hypertension (hazard ratio: 1.295, 95% CI: 1.167-1.436), especially the individuals who were young (hazard ratio: 1.422, 95% CI: 1.106-1.828), were living in rural areas (hazard ratio: 1.373, 95% CI: 1.206-1.565) and consumed alcohol (hazard ratio: 1.363, 95% CI: 1.153-1.611). In addition, a low-carbohydrate and high-fat (LCHF) diet was not associated with hypertension (hazard ratio: 0.861, 95% CI: 0.694-1.068). Moreover, these associations were observed at the majority energy intake level.

CONCLUSION

An HCLF diet was significantly associated with an increased risk of hypertension.

Gender-Specific Longitudinal Association of Sleep Duration with Blood Pressure among Children: Evidence from CHNS 2004-2015

Purpose

We conducted this study to add the evidence regarding the gender-specific association between sleep duration and blood pressure (BP) in children.

Methods

A secondary analysis was performed among 1000 children aged 7–13 years, who had at least two rounds of survey records in China Health and Nutrition Survey through 2004–2015. Generalized estimating equation was used to explore the gender-specific association of sleep duration with BP. The subgroup analysis was applied in those participants with normal weight.

Results

The time trend of decreasing sleep duration, along with increasing BP level, was observed in each age group during the survey period. Short sleepers (<9 hours per day) have higher level of both systolic BP (SBP) and diastolic BP (DBP) than long sleepers in girls (all p < 0.05). By contrast, only SBP was higher in short sleepers among boys (p < 0.05). There was gender difference in the association between sleep duration and DBP (p for interaction <0.05). The stratification analysis showed that short sleep duration could consistently predict a higher level of diastolic BP (DBP) in both crude (β = 2.968, 95% CI: 1.629, 4.306) and adjusted models (β = 1.844, 95% CI: 0.273, 3.416) only in girls. Sleep duration was also analyzed as continuous variable, and the very similar associations were observed. Moreover, the established associations can be verified among children with normal weight.

Conclusions

There was a time trend of decreasing sleep duration alongside increasing BP among children from 2004 to 2015. Short sleep duration was independently associated with increased DBP; however, only girls were susceptible to the association.