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Wang X, Zeng Q, Ma N, Peng L, Liu L, Hong F, Xu Y. Sex-specific differences in the association between metabolically healthy overweight/obesity and the risk of hypertension in Chinese ethnic minorities. Endocrine 2023; 80:317-327. [PMID: 36708464 DOI: 10.1007/s12020-023-03308-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 01/10/2023] [Indexed: 01/29/2023]
Abstract
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.
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Affiliation(s)
- Xin Wang
- School of Public Health & key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang 550025, China
| | - Qibing Zeng
- School of Public Health & key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang 550025, China
| | - Nana Ma
- School of Public Health & key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang 550025, China
| | - Lian Peng
- School of Public Health & key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang 550025, China
| | - Leilei Liu
- School of Public Health & key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang 550025, China
| | - Feng Hong
- School of Public Health & key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang 550025, China.
| | - Yuyan Xu
- School of Public Health & key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang 550025, China.
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Ramezankhani A, Azizi F, Momenan AA, Hadaegh F. Sex Differences in Cumulative Exposure to Metabolic Risk Factors Before Hypertension Onset: The Cohort of the Tehran Lipid and Glucose Study. J Am Heart Assoc 2021; 10:e021922. [PMID: 34779244 PMCID: PMC9075390 DOI: 10.1161/jaha.121.021922] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Background Previous studies have shown a sex difference in the association between hypertension and cardiovascular disease; however, the precise mechanism remains unclear. Because there are strong associations between metabolic risk factors (MRFs) and hypertension, a sex‐specific analysis of MRFs before hypertension onset could offer new insights and expand our understanding of sex differences in cardiovascular disease. We evaluated cumulative exposure to major MRFs and rate of change of those factors, including body mass index, waist circumference, systolic blood pressure, diastolic blood pressure, fasting plasma glucose, total cholesterol, triglycerides, and high‐density lipoprotein cholesterol among individuals who did and did not develop hypertension at follow‐up. Methods and Results We included 5374 participants (2191 men) initially without hypertension with age range of 20–50 years at baseline who participated in the Tehran Lipid and Glucose Study, and had been examined at least 3 times during the study period (1999–2018). In both sexes, the cumulative exposure to all MRFs (except for fasting plasma glucose and high‐density lipoprotein cholesterol in men) were higher in those who developed hypertension, compared with those who did not develop hypertension. However, women experienced greater cumulative exposure to major MRFs, compared with their male counterparts. Also, they experienced a faster increase in waist circumference, systolic blood pressure, diastolic blood pressure, and high‐density lipoprotein cholesterol than men. Furthermore, rapid increase in systolic blood pressure began earlier in women than men, at the age of 30 years. We also found that those men who developed hypertension experienced unfavorable change in major MRFs during young adulthood (<50 years of age). Conclusions Women exhibited more metabolic disturbances than men before onset of hypertension, which may explain the stronger impact of hypertension for major types of cardiovascular disease in women, compared with men.
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Affiliation(s)
- Azra Ramezankhani
- Prevention of Metabolic Disorders Research Center Research Institute for Endocrine Sciences Shahid Beheshti University of Medical Sciences Tehran Iran
| | - Fereidoun Azizi
- Endocrine Research Center Research Institute for Endocrine Sciences Shahid Beheshti University of Medical Sciences Tehran Iran
| | - Amir Abbas Momenan
- Prevention of Metabolic Disorders Research Center Research Institute for Endocrine Sciences Shahid Beheshti University of Medical Sciences Tehran Iran
| | - Farzad Hadaegh
- Prevention of Metabolic Disorders Research Center Research Institute for Endocrine Sciences Shahid Beheshti University of Medical Sciences Tehran Iran
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Cooper AJ, Gupta SR, Moustafa AF, Chao AM. Sex/Gender Differences in Obesity Prevalence, Comorbidities, and Treatment. Curr Obes Rep 2021; 10:458-466. [PMID: 34599745 DOI: 10.1007/s13679-021-00453-x] [Citation(s) in RCA: 140] [Impact Index Per Article: 46.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/19/2021] [Indexed: 12/16/2022]
Abstract
PURPOSE OF REVIEW Obesity is a heterogeneous condition, yet sex/gender is rarely considered in the prevention or clinical care of this disease. This review examined and evaluated recent literature regarding the influence of sex and gender on obesity prevalence, comorbidities, and treatment in adults. RECENT FINDINGS Obesity is more prevalent in women than men in most countries, but in some countries and population subgroups, this gap is more pronounced. Several obesity-related comorbidities, including type 2 diabetes and hypertension, demonstrate sex-specific pathways. Women, compared to men, are more likely to be diagnosed with obesity and seek and obtain all types of obesity treatment including behavioral, pharmacological, and bariatric surgery. Men tend to have greater absolute weight loss, but this difference is attenuated once accounting for baseline weight. Obesity is a multifactorial condition with complex interactions among sex/gender, sociocultural, environmental, and physiological factors. More sex/gender research is needed to investigate mechanisms underlying sex/gender differences in prevalence, comorbidities, and treatment, identify ways to increase men's interest and participation in obesity treatment, and examine differences in obesity prevalence and treatments for transgender and gender non-conforming individuals.
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Affiliation(s)
- Ashley J Cooper
- Department of Biobehavioral Health Sciences, University of Pennsylvania School of Nursing, 418 Curie Blvd, Philadelphia, PA, 19104, USA
| | - Sapana R Gupta
- Drexel University College of Medicine, Philadelphia, PA, USA
| | | | - Ariana M Chao
- Department of Biobehavioral Health Sciences, University of Pennsylvania School of Nursing, 418 Curie Blvd, Philadelphia, PA, 19104, USA.
- Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA.
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Zhang Z, Zhang T, Zhao E, Ding S, Kang X, Zhang W, Liu B, Liu H, Cheng A, Li G, Wang Q. Interaction of sex, age, body mass index and race on hypertension risk in the American population: a cross-sectional study. Eur J Public Health 2021; 31:1042-1047. [PMID: 34410370 DOI: 10.1093/eurpub/ckab107] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND The joint effects of sex, age, body mass index (BMI) and race on hypertension have not been fully addressed. Herein, we carried out this study aiming to investigate the possible effects of the interaction of sex, age, BMI and race on risk of hypertension. METHODS By using the data of a sample-adjusted 2656 women and 2515 men in American National Health and Nutrition Examination Survey 2015-16, we analyzed the interaction of sex, age, BMI and race by logistic regression models, followed by strata-specific analyses. Hypertension was defined as a systolic blood pressure ≥130 mmHg/diastolic blood pressure ≥80 mmHg or taking anti-hypertensive medication. RESULTS A total of 5171 participants were included in analysis, and the prevalence of hypertension was 53.68%. The interactive effect of sex and age, BMI and age, race and age were statistically significant on hypertension. Strata-specific analyses showed that female at 40 years and above were positively associated with hypertension than those at 20-39 years. The associations also persistence in male. The risk estimates for age ≥40 on hypertension were consistently positive across all overweight/obesity and race groups. The effect was most prominent among overweight populations aged 60-80 years and Other Hispanic aged 40 years and above. CONCLUSION There exists interactive effect of sex and age, BMI and age, race and age on hypertension in American population. The effect of age on hypertension was more prominent in female, overweight populations and Other Hispanic populations. Differences in age, BMI and race should be considered when providing corresponding antihypertensive measures.
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Affiliation(s)
- Zhenhong Zhang
- Public Health School, Medical College of Qingdao University, Qingdao, China
| | - Tao Zhang
- Qingdao Fuwai Cardiovascular Hospital, Qingdao, China
| | - Enhui Zhao
- Public Health School, Medical College of Qingdao University, Qingdao, China
| | - Shihan Ding
- Public Health School, Medical College of Qingdao University, Qingdao, China
| | - Xiao Kang
- Public Health School, Medical College of Qingdao University, Qingdao, China
| | - Wenwen Zhang
- Public Health School, Medical College of Qingdao University, Qingdao, China
| | - Bingkun Liu
- Public Health School, Medical College of Qingdao University, Qingdao, China
| | - Haoran Liu
- Public Health School, Medical College of Qingdao University, Qingdao, China
| | - Anlan Cheng
- Public Health School, Medical College of Qingdao University, Qingdao, China
| | - Guoju Li
- Qingdao Women and Children's Hospital, Qingdao University, Qingdao, China
| | - Qiuzhen Wang
- Public Health School, Medical College of Qingdao University, Qingdao, China
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Chiriacò M, Tricò D, Leonetti S, Petrie JR, Balkau B, Højlund K, Pataky Z, Nilsson PM, Natali A. Female Sex and Angiotensin-Converting Enzyme (ACE) Insertion/Deletion Polymorphism Amplify the Effects of Adiposity on Blood Pressure. Hypertension 2021; 79:36-46. [PMID: 34689596 DOI: 10.1161/hypertensionaha.121.18048] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The pathophysiological link between adiposity and blood pressure is not completely understood, and evidence suggests an influence of sex and genetic determinants. We aimed to identify the relationship between adiposity and blood pressure, independent of a robust set of lifestyle and metabolic factors, and to examine the modulating role of sex and Angiotensin-Converting Enzyme (ACE) insertion/deletion (I/D) polymorphisms. In the Relationship Between Insulin Sensitivity and Cardiovascular Disease (RISC) study cohort, 1211 normotensive individuals, aged 30 to 60 years and followed-up after 3.3 years, were characterized for lifestyle and metabolic factors, body composition, and ACE genotype. Body mass index (BMI) and waist circumference (WC) were independently associated with mean arterial pressure, with a stronger relationship in women than men (BMI: r=0.40 versus 0.30; WC: r=0.40 versus 0.30, both P<0.01) and in individuals with the ID and II ACE genotypes in both sexes (P<0.01). The associations of BMI and WC with mean arterial pressure were independent of age, sex, lifestyle, and metabolic variables (standardized regression coefficient=0.17 and 0.18 for BMI and WC, respectively) and showed a significant interaction with the ACE genotype only in women (P=0.03). A 5 cm larger WC at baseline increased the risk of developing hypertension at follow-up only in women (odds ratio, 1.56 [95% CI, 1.15-2.10], P=0.004) and in II genotype carriers (odds ratio, 1.87 [95% CI, 1.09-3.20], P=0.023). The hypertensive effect of adiposity is more pronounced in women and in people carrying the II variant of the ACE genotype, a marker of salt sensitivity.
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Affiliation(s)
- Martina Chiriacò
- Metabolism, Nutrition, and Atherosclerosis Laboratory, Department of Clinical and Experimental Medicine, University of Pisa, Italy. (M.C., D.T., S.L., A.N.)
| | - Domenico Tricò
- Metabolism, Nutrition, and Atherosclerosis Laboratory, Department of Clinical and Experimental Medicine, University of Pisa, Italy. (M.C., D.T., S.L., A.N.).,Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Italy. (D.T.)
| | - Simone Leonetti
- Metabolism, Nutrition, and Atherosclerosis Laboratory, Department of Clinical and Experimental Medicine, University of Pisa, Italy. (M.C., D.T., S.L., A.N.)
| | - John R Petrie
- BHF Glasgow Cardiovascular Research Centre, University of Glasgow, United Kingdom (J.R.P.)
| | - Beverley Balkau
- Clinical Epidemiology, CESP, University Paris-Saclay, UVSQ, University Paris-Sud, Inserm U1018, Villejuif, France (B.B.)
| | - Kurt Højlund
- Steno Diabetes Center Odense, Odense University Hospital, Denmark (K.H.)
| | - Zoltan Pataky
- Division of Endocrinology, Diabetes, Nutrition and Therapeutic Patient Education, WHO Collaborating Centre, University Hospitals of Geneva, University of Geneva, Switzerland (Z.P.)
| | - Peter M Nilsson
- Department of Clinical Sciences, Lund University, Skane University Hospital, Malmö, Sweden (P.M.N.)
| | - Andrea Natali
- Metabolism, Nutrition, and Atherosclerosis Laboratory, Department of Clinical and Experimental Medicine, University of Pisa, Italy. (M.C., D.T., S.L., A.N.)
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Liu N, Birstler J, Venkatesh M, Hanrahan L, Chen G, Funk L. Obesity and BMI Cut Points for Associated Comorbidities: Electronic Health Record Study. J Med Internet Res 2021; 23:e24017. [PMID: 34383661 PMCID: PMC8386370 DOI: 10.2196/24017] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 11/01/2020] [Accepted: 06/21/2021] [Indexed: 01/30/2023] Open
Abstract
Background Studies have found associations between increasing BMIs and the development of various chronic health conditions. The BMI cut points, or thresholds beyond which comorbidity incidence can be accurately detected, are unknown. Objective The aim of this study is to identify whether BMI cut points exist for 11 obesity-related comorbidities. Methods US adults aged 18-75 years who had ≥3 health care visits at an academic medical center from 2008 to 2016 were identified from eHealth records. Pregnant patients, patients with cancer, and patients who had undergone bariatric surgery were excluded. Quantile regression, with BMI as the outcome, was used to evaluate the associations between BMI and disease incidence. A comorbidity was determined to have a cut point if the area under the receiver operating curve was >0.6. The cut point was defined as the BMI value that maximized the Youden index. Results We included 243,332 patients in the study cohort. The mean age and BMI were 46.8 (SD 15.3) years and 29.1 kg/m2, respectively. We found statistically significant associations between increasing BMIs and the incidence of all comorbidities except anxiety and cerebrovascular disease. Cut points were identified for hyperlipidemia (27.1 kg/m2), coronary artery disease (27.7 kg/m2), hypertension (28.4 kg/m2), osteoarthritis (28.7 kg/m2), obstructive sleep apnea (30.1 kg/m2), and type 2 diabetes (30.9 kg/m2). Conclusions The BMI cut points that accurately predicted the risks of developing 6 obesity-related comorbidities occurred when patients were overweight or barely met the criteria for class 1 obesity. Further studies using national, longitudinal data are needed to determine whether screening guidelines for appropriate comorbidities may need to be revised.
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Affiliation(s)
- Natalie Liu
- Department of Surgery, University of Wisconsin-Madison, Madison, WI, United States
| | - Jen Birstler
- Department of Biostatistics and Medical Informatics, University of Wisconsin-Madison, Madison, WI, United States
| | - Manasa Venkatesh
- Department of Surgery, University of Wisconsin-Madison, Madison, WI, United States
| | - Lawrence Hanrahan
- Department of Family Medicine and Community Health, University of Wisconsin-Madison, Madison, WI, United States
| | - Guanhua Chen
- Department of Biostatistics and Medical Informatics, University of Wisconsin-Madison, Madison, WI, United States
| | - Luke Funk
- Department of Surgery, University of Wisconsin-Madison, Madison, WI, United States.,Department of Surgery, William S. Middleton Memorial VA, Madison, WI, United States
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Zuo J, Chao H, Tang B, Avolio AP, Schlaich MP, Nolde JM, Adji A, Carnagarin R. Female Gender Is Associated with Higher Susceptibility of Weight Induced Arterial Stiffening and Rise in Blood Pressure. J Clin Med 2021; 10:jcm10163479. [PMID: 34441775 PMCID: PMC8396951 DOI: 10.3390/jcm10163479] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 07/29/2021] [Accepted: 08/02/2021] [Indexed: 01/13/2023] Open
Abstract
Arterial stiffness is an important predictor of cardiovascular events, independent of traditional risk factors. Stiffening of arteries, though an adaptive process to hemodynamic load, results in substantial increase in the pulsatile hemodynamic forces that detrimentally affects the microcirculation perfusing the vital organs such as the brain, heart and kidneys. Studies have proposed that arterial stiffness precedes and may contribute to the development of hypertension in individuals with obesity. Our study sought to determine the gender-based effects on arterial stiffening in obesity which may predispose to the development of hypertension. We found female sex is associated with higher susceptibility of weight-related arterial stiffening and rise in blood pressure in obesity. Women had significantly higher carotid-femoral pulse wave velocity (CF-PWV) with higher body mass index (BMI) status (normal: 7.9 ± 2 m/s; overweight: 9.1 ± 2 m/s; obese: 9 ± 2 m/s, p < 0.001), whereas it was similar in males across all BMI categories. The linear association between arterial stiffness and BMI following adjustment for age and brachial systolic and diastolic blood pressure (BP), remained significant in females (β = 0.06; 95% CI 0.01 to 0.1; p < 0.05) but not in males (β = 0.04; 95% CI -0.01 to 0.1; p > 0.05). The mean CF-PWV values increased by 0.1 m/s for every 1 kg/m2 increase in BMI in the female subjects in the age adjusted linear model, while such effect was not seen in the male subjects. In line with arterial stiffening, the overweight and obese females demonstrated significantly higher systolic brachial BP. (BP difference: ΔBP 9-11 mmHg, p < 0.01) and central systolic pressure (ΔBP 8-10 mmHg, p < 0.05) compared to their lean counterparts, unlike the male subjects. Our results suggest that female gender is associated with higher susceptibility of weight-related arterial stiffening and rise in blood pressure.
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Affiliation(s)
- Junli Zuo
- Department of Geriatrics and Geriatrics Centre, Ruijin Hospital/Jiaotong University School of Medicine, Shanghai 200240, China; (J.Z.); (H.C.); (B.T.)
- Department of Biomedical Sciences, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW 2109, Australia;
| | - Huijuan Chao
- Department of Geriatrics and Geriatrics Centre, Ruijin Hospital/Jiaotong University School of Medicine, Shanghai 200240, China; (J.Z.); (H.C.); (B.T.)
| | - Biwen Tang
- Department of Geriatrics and Geriatrics Centre, Ruijin Hospital/Jiaotong University School of Medicine, Shanghai 200240, China; (J.Z.); (H.C.); (B.T.)
| | - Alberto P. Avolio
- Department of Biomedical Sciences, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW 2109, Australia;
| | - Markus P. Schlaich
- Dobney Hypertension Centre, School of Medicine—Royal Perth Hospital Research Foundation, University of Western Australia, Perth, WA 6000, Australia; (M.P.S.); (J.M.N.)
- Departments of Cardiology and Nephrology, Royal Perth Hospital, Perth, WA 6000, Australia
- Neurovascular Hypertension & Kidney Disease Laboratory, Baker Heart and Diabetes Institute, Melbourne, VIC 3004, Australia
| | - Janis Marc Nolde
- Dobney Hypertension Centre, School of Medicine—Royal Perth Hospital Research Foundation, University of Western Australia, Perth, WA 6000, Australia; (M.P.S.); (J.M.N.)
| | - Audrey Adji
- Department of Biomedical Sciences, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW 2109, Australia;
- St Vincent’s Hospital and Clinical School UNSW, Sydney, NSW 2000, Australia
- Victor Chang Cardiac Research Institute, Sydney, NSW 2010, Australia
- Correspondence: (A.A.); (R.C.); Tel.: +61-2-8382-1111 (A.A.); +61-8-9224-0316 (R.C.)
| | - Revathy Carnagarin
- Dobney Hypertension Centre, School of Medicine—Royal Perth Hospital Research Foundation, University of Western Australia, Perth, WA 6000, Australia; (M.P.S.); (J.M.N.)
- Correspondence: (A.A.); (R.C.); Tel.: +61-2-8382-1111 (A.A.); +61-8-9224-0316 (R.C.)
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Bunsawat K, Lefferts EC, Grigoriadis G, Wee SO, Kilianek MM, Fadel PJ, Clifford PS, Fernhall BO, Baynard T. Central and Peripheral Postexercise Blood Pressure and Vascular Responses in Young Adults with Obesity. Med Sci Sports Exerc 2021; 53:994-1002. [PMID: 33060547 DOI: 10.1249/mss.0000000000002540] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Adults with obesity are at an increased risk of incident hypertension. Regular aerobic exercise is recommended for the prevention and treatment of hypertension, but whether young adults with obesity exhibit impaired postexercise blood pressure (BP) and vascular responses remains unclear. PURPOSE We tested the hypothesis that young adults with obesity exhibit attenuated postexercise hypotension (PEH) and postexercise peripheral vasodilation compared with young adults without obesity. METHODS Thirty-six normotensive adults without and with obesity (11 men and 7 women per group) underwent measurements of brachial and central BP, and leg blood flow (Doppler ultrasound) at baseline and at 30, 60, and 90 min after acute 1-h moderate-intensity cycling. Leg vascular conductance (LVC) was calculated as flow/mean arterial pressure. RESULTS Both groups exhibited similar brachial and central PEH (peak change from baseline, -2 and -4 mm Hg for brachial and central systolic BPs, respectively, for both groups; time effect, P < 0.05). Both groups also exhibited postexercise peripheral vasodilation, assessed via LVC (time effect, P < 0.05), but its overall magnitude was smaller in young adults with obesity (LVC change from baseline, +47% ± 37%, +29% ± 36%, and +20% ± 29%) compared with young adults without obesity (LVC change from baseline, +88% ± 58%, +59% ± 54%, and +42% ± 51%; group effect, P < 0.05). CONCLUSIONS Although obesity did not impair PEH after acute moderate-intensity exercise, young adults with obesity exhibited smaller postexercise peripheral vasodilation compared with young adults without obesity. Collectively, these findings have identified evidence for obesity-induced alterations in the peripheral vasculature after exercise.
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Affiliation(s)
| | - Elizabeth C Lefferts
- Integrative Physiology Laboratory, Department of Kinesiology and Nutrition, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL
| | - Georgios Grigoriadis
- Integrative Physiology Laboratory, Department of Kinesiology and Nutrition, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL
| | | | - Melissa M Kilianek
- Integrative Physiology Laboratory, Department of Kinesiology and Nutrition, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL
| | - Paul J Fadel
- Department of Kinesiology, College of Nursing and Health Innovation, University of Texas at Arlington, Arlington, TX
| | - Philip S Clifford
- Integrative Physiology Laboratory, Department of Kinesiology and Nutrition, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL
| | - B O Fernhall
- Integrative Physiology Laboratory, Department of Kinesiology and Nutrition, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL
| | - Tracy Baynard
- Integrative Physiology Laboratory, Department of Kinesiology and Nutrition, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL
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Kim S, Cho S, Nah EH. The patterns of lifestyle, metabolic status, and obesity among hypertensive Korean patients: a latent class analysis. Epidemiol Health 2020; 42:e2020061. [PMID: 32882119 PMCID: PMC7871153 DOI: 10.4178/epih.e2020061] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 08/31/2020] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVES This study aimed to identify latent classes in hypertensive patients based on the clustering of factors including lifestyle risk factors, metabolic risk factors, and obesity in each sex. METHODS This cross-sectional study included 102,780 male and 103,710 female hypertensive patients who underwent health check-ups at 16 centers in Korea, in 2018. A latent class analysis approach was used to identify subgroups of hypertensive patients. Multinomial logistic regression was performed to examine the association between latent classes and comorbidities of hypertension. RESULTS A four-class model provided the best fit for each sex. The following latent classes were identified: Class I (male: 16.9%, female: 1.7%; high risk of lifestyle behaviors [HB] with metabolic disorders and obesity [MO]), Class II (male: 32.4%, female: 47.1%; low risk of lifestyle behaviors [LB] with MO), Class III (male: 15.3%, female: 1.8%; HB with metabolic disorders and normal weight [MNW]), Class IV (male: 35.5%, female: 49.4%; LB with MNW). Lifestyle patterns in the latent classes were classified as high-risk or low-risk according to smoking and high-risk drinking among male, and presented complex patterns including physical inactivity alone or in combination with other factors, among female. Stage 2 hypertensive or diabetic individuals were likely to belong to classes including obesity (HB-MO, LB-MO) in both sexes, and additionally belonged to the HB-MNW class in male. CONCLUSIONS Metabolic disorders were included in all latent classes, with or without lifestyle risk factors and obesity. Hypertensive females need to manage obesity, and hypertensive males need to manage lifestyle risk factors and obesity. Sex-specific lifestyle behaviors are important for controlling hypertension.
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Affiliation(s)
- Suyoung Kim
- Health Promotion Research Institute, Korea Association of Health Promotion, Seoul, Korea
| | - Seon Cho
- Health Promotion Research Institute, Korea Association of Health Promotion, Seoul, Korea
| | - Eun-Hee Nah
- Health Promotion Research Institute, Korea Association of Health Promotion, Seoul, Korea
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Chen Y, Zhang Z, Wang J, Sun H, Zhao X, Cheng X, Zhao Q. Sex differences in the association of abdominal adipose tissue and anthropometric data with untreated hypertension in a Chinese population. Biol Sex Differ 2020; 11:38. [PMID: 32680562 PMCID: PMC7367233 DOI: 10.1186/s13293-020-00317-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Accepted: 07/07/2020] [Indexed: 01/15/2023] Open
Abstract
Background There are inconsistent interpretations of the interrelationship of adiposity, anthropometric indices, and blood pressure (BP) in hypertensive patients. Additionally, whether these relationships differ between sexes is unknown. We aimed to elucidate the associations of adiposity indices measured using quantitative computed tomography (QCT) with BP and hypertension and to determine the effect of sex on the interrelationship of these parameters in a Chinese population. Methods Abdominal adipose fat, including the visceral adipose tissue (VAT) area and subcutaneous adipose tissue (SAT) area, was measured by QCT in 1488 patients (514 men, 974 women). Body mass index (BMI), waist circumference (WC), hip circumference (HC), and systolic (SBP) and diastolic BP (DBP) were measured. Pearson correlation coefficients, multivariate analyses, and receiver operating characteristic (ROC) curves were used to assess the relationship and potential of adiposity indices to BP and risk of hypertension within sex groups. Results Men had significantly greater VAT area but less SAT area than women in hypertensive group. VAT, SAT, and WC were more highly correlated with SBP in men than in women. After controlling for body weight, height, and age, VAT area and WC were positively associated with SBP (VAT: β = 0.309, p < 0.001; WC: β = 0.148, p = 0.001) and DBP (VAT: β = 0.099, p = 0.034; WC: β = 0.198, p = 0.001) in women. VAT area was positively associated with SBP (β = 0.444, p < 0.001) and DBP (β = 0.146, p = 0.021) in men. WC had a significant correlation with an increased risk of hypertension in women but a borderline association in men (p = 0.059) when adjusted for VAT area and SAT area. Conclusions The association of abdominal adiposity with hypertension differs qualitatively by sex. WC may be an important determinant of hypertension and may be used for risk stratification for hypertension among Chinese individuals.
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Affiliation(s)
- Youzhou Chen
- Department of Cardiology, Beijing Jishuitan Hospital, No. 31 East Street, Xinjiekou, XiCheng District, Beijing, 100035, China
| | - Zhuoli Zhang
- Department of Radiology, Robert H. Lurie Comprehensive Cancer Center, Feinberg School of Medicine, Northwestern University, 737 N. Michigan Ave, 16th Floor, Chicago, USA
| | - Jihong Wang
- Department of Cardiology, Beijing Jishuitan Hospital, No. 31 East Street, Xinjiekou, XiCheng District, Beijing, 100035, China
| | - Huayi Sun
- Department of Cardiology, Beijing Jishuitan Hospital, No. 31 East Street, Xinjiekou, XiCheng District, Beijing, 100035, China
| | - Xingshan Zhao
- Department of Cardiology, Beijing Jishuitan Hospital, No. 31 East Street, Xinjiekou, XiCheng District, Beijing, 100035, China
| | - Xiaoguang Cheng
- Department of Radiology, Beijing Jishuitan Hospital, No. 31 East Street, Xinjiekou, XiCheng District, Beijing, 100035, China.
| | - Qiong Zhao
- Inova Heart and Vascular Institute, Inova Fairfax Hospital, 3300 Gallows Road, Falls, Church, VA, 22042, USA.
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11
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Marques AP, Szwarcwald CL, Pires DC, Rodrigues JM, Almeida WDSD, Romero D. [Factors associated with arterial hypertension: a systematic review]. CIENCIA & SAUDE COLETIVA 2020; 25:2271-2282. [PMID: 32520271 DOI: 10.1590/1413-81232020256.26972018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Accepted: 10/03/2018] [Indexed: 01/11/2023] Open
Abstract
A systematic review of demographic, socioeconomic, behavioral and anthropometric factors associated with hypertension. We included observational studies, of populations aged 18 or older, from the past ten years, published in English, Portuguese or Spanish from Pubmed, Web of Science, Scopus and Lilacs bases. The most found factors related to the greater chance of having hypertension were age and the Body Mass Index (BMI). Other factors associated with the disease were: gender (male), education (lower education), income (lower income) and waist circumference (high). Never having smoked, never having consumed alcohol and white skin color were characteristics related to a lower chance of having hypertension. As demonstrated, demographic, socioeconomic, behavioral and anthropometric characteristics are important factors associated with a greater chance of having hypertension in the adult population. However, while most of the factors associated with it are amenable to intervention, broader health promotion policies will be needed to reduce socioeconomic inequalities in the prevalence of the disease.
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Affiliation(s)
- Aline Pinto Marques
- Laboratório de Informação em Saúde, Instituto de Comunicação e Informação Científica e Tecnológica em Saúde, Fundação Oswaldo Cruz. Av. Brasil 4365, Manguinhos. 21040-900, Rio de Janeiro, RJ, Brasil.
| | - Célia Landmann Szwarcwald
- Laboratório de Informação em Saúde, Instituto de Comunicação e Informação Científica e Tecnológica em Saúde, Fundação Oswaldo Cruz. Av. Brasil 4365, Manguinhos. 21040-900, Rio de Janeiro, RJ, Brasil.
| | - Débora Castanheira Pires
- Laboratório de Informação em Saúde, Instituto de Comunicação e Informação Científica e Tecnológica em Saúde, Fundação Oswaldo Cruz. Av. Brasil 4365, Manguinhos. 21040-900, Rio de Janeiro, RJ, Brasil.
| | - Jéssica Muzy Rodrigues
- Laboratório de Informação em Saúde, Instituto de Comunicação e Informação Científica e Tecnológica em Saúde, Fundação Oswaldo Cruz. Av. Brasil 4365, Manguinhos. 21040-900, Rio de Janeiro, RJ, Brasil.
| | - Wanessa da Silva de Almeida
- Laboratório de Informação em Saúde, Instituto de Comunicação e Informação Científica e Tecnológica em Saúde, Fundação Oswaldo Cruz. Av. Brasil 4365, Manguinhos. 21040-900, Rio de Janeiro, RJ, Brasil.
| | - Dalia Romero
- Laboratório de Informação em Saúde, Instituto de Comunicação e Informação Científica e Tecnológica em Saúde, Fundação Oswaldo Cruz. Av. Brasil 4365, Manguinhos. 21040-900, Rio de Janeiro, RJ, Brasil.
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12
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Factors associated with increase in blood pressure and incident hypertension in early midlife: the Hordaland Health Study. Blood Press 2020; 29:267-275. [DOI: 10.1080/08037051.2020.1762070] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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13
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Wagata M, Kogure M, Nakaya N, Tsuchiya N, Nakamura T, Hirata T, Narita A, Metoki H, Ishikuro M, Kikuya M, Tanno K, Fukushima A, Yaegashi N, Kure S, Yamamoto M, Kuriyama S, Hozawa A, Sugawara J. Hypertensive disorders of pregnancy, obesity, and hypertension in later life by age group: a cross-sectional analysis. Hypertens Res 2020; 43:1277-1283. [PMID: 32404963 DOI: 10.1038/s41440-020-0463-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Revised: 03/24/2020] [Accepted: 04/14/2020] [Indexed: 12/16/2022]
Abstract
We investigated whether the association between a history of hypertensive disorders of pregnancy (HDP) and hypertension in later life varies by age group and the effect of obesity on the association between a history of HDP and hypertension in later life. This cross-sectional population-based study was conducted at the Tohoku Medical Megabank Project in Miyagi and Iwate, Japan. The study subjects were 33,412 parous women of 20 years of age and older. We used multivariate logistic regression analysis to assess the association between a history of HDP and hypertension. We constructed a composite variable that combined a history of HDP (±) and overweight/obesity (BMI ≥ 25 kg/m2) (±), resulting in four categories, and analyzed the risks of each category by multivariate logistic regression analysis. In total, 1585 (4.7%) women had a history of HDP. The prevalence of hypertension was higher in women with HDP (51.4%) than in those without HDP (36.8%; p < 0.01). The adjusted odds ratios (ORs) for hypertension in women with HDP in their 30s, 40s, 50s, 60s, and 70s or older were 3.63, 1.84, 2.15, 1.48, and 1.86, respectively. In the interaction analysis, the association between a history of HDP and hypertension was stronger in women in their 30s-50s than in women who were 60 or older (p = 0.057). The adjusted ORs for hypertension were higher in overweight/obese women with HDP than in their nonoverweight/obese counterparts in all age groups (30s: 27.17 vs. 2.22; 70s: 4.75 vs. 1.90). In conclusion, the association between HDP and later hypertension was stronger in younger women and in obese women in the 30-70 age group.
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Affiliation(s)
- Maiko Wagata
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan.,Graduate School of Medicine, Tohoku University, Sendai, Japan.,Tohoku University Hospital, Tohoku University, Sendai, Japan
| | - Mana Kogure
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan.,Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Naoki Nakaya
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan.,Graduate School of Medicine, Tohoku University, Sendai, Japan.,Saitama Prefectural University, Koshigaya, Japan
| | - Naho Tsuchiya
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan.,Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Tomohiro Nakamura
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan.,Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Takumi Hirata
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan.,Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Akira Narita
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan.,Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Hirohito Metoki
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan.,Tohoku Medical Pharmaceutical University, Sendai, Japan
| | - Mami Ishikuro
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan.,Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Masahiro Kikuya
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan.,Graduate School of Medicine, Tohoku University, Sendai, Japan.,Teikyo University School of Medicine, Tokyo, Japan
| | - Kozo Tanno
- Iwate Tohoku Medical Megabank Organization, Iwate Medical University, Yahaba, Japan.,School of Medicine, Iwate Medical University, Morioka, Japan
| | - Akimune Fukushima
- Iwate Tohoku Medical Megabank Organization, Iwate Medical University, Yahaba, Japan.,School of Medicine, Iwate Medical University, Morioka, Japan
| | - Nobuo Yaegashi
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan.,Graduate School of Medicine, Tohoku University, Sendai, Japan.,Tohoku University Hospital, Tohoku University, Sendai, Japan
| | - Shigeo Kure
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan.,Graduate School of Medicine, Tohoku University, Sendai, Japan.,Tohoku University Hospital, Tohoku University, Sendai, Japan
| | - Masayuki Yamamoto
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan.,Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Shinichi Kuriyama
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan.,Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Atsushi Hozawa
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan.,Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Junichi Sugawara
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan. .,Graduate School of Medicine, Tohoku University, Sendai, Japan.
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14
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Liu YL, Mi YJ, Zhang B, Wang HJ, Yu J, Pan XB, Wang C, Tian QB. The Impact of Hypertension Definition Based on Two-visit Strategy on Estimate of Hypertension Burden: Results From the China Health and Nutrition Survey 1989-2011. J Epidemiol 2020; 31:180-186. [PMID: 32224596 PMCID: PMC7878710 DOI: 10.2188/jea.je20190163] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Background The diagnosis of hypertension should be based on the mean of two or more properly measured BP readings on each of two visits for clinical practice, but a one-visit strategy was applied in most epidemiological surveys. The impact of hypertension definition based on two visits on estimates of hypertension burden is unknown. This study aims to assess the impact of hypertension diagnosis based on a two-visit strategy for estimating hypertension burden in China. Methods The one-visit and two-visit strategies were applied to investigate the incidence of hypertension in a cohort study based on the China Health and Nutrition Survey (CHNS) 1989–2011. Additionally the prevalence of hypertension was investigated in a cross-sectional study based on the CHNS 2006–2009/2011 and the hypertension burden in China was estimated with data from the 2012–2015 China hypertension survey. Results Overall, the age-adjusted incidence of hypertension based on the two-visit strategy (1.82%; 95% confidence interval [CI], 1.74–1.90%) was 62.1% lower than estimation based on the one-visit strategy (4.80%; 95% CI, 4.68–4.93%). Similar results were found in the prevalence of hypertension (one-visit: 18.13% [95% CI, 17.34–18.92%]; two-visit: 9.47% [95% CI, 8.87–10.07%]). When the two-visit strategy was applied to the 2012–2015 China hypertension survey, the hypertension burden was predicted to be overestimated by 25.5–47.8% (based on JNC 7) and 23.5–48.2% (based on the 2017 ACC/AHA). Conclusion The hypertension burden would decrease from 244.5 million persons to 127.5–182.3 million persons in China if the two-visit strategy was applied.
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Affiliation(s)
- Ying-Li Liu
- Department of Epidemiology and Statistics, School of Public Health, Hebei Medical University.,Hebei Province Key Laboratory of Environment and Human Health
| | - Ying-Jun Mi
- Hebei Province Key Laboratory of Environment and Human Health.,Department of Social Medicine and Health Care Management, School of Public Health, Hebei Medical University
| | - Bing Zhang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention
| | - Hui-Jun Wang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention
| | - Jie Yu
- Department of Epidemiology and Statistics, School of Public Health, Hebei Medical University.,Hebei Province Key Laboratory of Environment and Human Health
| | - Xing-Bing Pan
- Department of Epidemiology and Statistics, School of Public Health, Hebei Medical University.,Hebei Province Key Laboratory of Environment and Human Health
| | - Chao Wang
- Department of Epidemiology and Statistics, School of Public Health, Hebei Medical University.,Hebei Province Key Laboratory of Environment and Human Health
| | - Qing-Bao Tian
- Department of Epidemiology and Statistics, School of Public Health, Hebei Medical University.,Hebei Province Key Laboratory of Environment and Human Health
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15
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Liens entre les paramètres anthropométriques et l’hypertension artérielle chez les diabétiques tunisiens de type 2. NUTR CLIN METAB 2019. [DOI: 10.1016/j.nupar.2018.10.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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16
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Clemmer JS, Faulkner JL, Mullen AJ, Butler KR, Hester RL. Sex-specific responses to mineralocorticoid receptor antagonism in hypertensive African American males and females. Biol Sex Differ 2019; 10:24. [PMID: 31072402 PMCID: PMC6507140 DOI: 10.1186/s13293-019-0238-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Accepted: 04/16/2019] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND African Americans (AA) develop hypertension (HTN) at an earlier age, have a greater frequency and severity of HTN, and greater prevalence of uncontrolled HTN as compared to the white population. Mineralocorticoid antagonists have been shown to be very effective in treating uncontrolled HTN in both AA and white patients, but sex-specific responses are unclear. METHODS We evaluated the sex-specific impact of mineralocorticoid antagonism in an AA population. An AA cohort (n = 1483) from the Genetic Epidemiology Network of Arteriopathy study was stratified based on sex and whether they were taking spironolactone, a mineralocorticoid antagonist, in their antihypertensive regimen. RESULTS As compared to AA women not prescribed a mineralocorticoid antagonist, AA women taking spironolactone (n = 9) had lower systolic and diastolic blood pressure despite having a similar number of antihypertensive medications. The proportion of AA women with uncontrolled HTN was significantly less for patients taking spironolactone than for patients not prescribed spironolactone. Interestingly, none of these associations were found in the AA males or in white females. CONCLUSIONS Our data suggests that spironolactone is particularly effective in reducing blood pressure and controlling HTN in AA women. Further research into the impact of this therapy in this underserved and understudied minority is warranted.
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Affiliation(s)
- John S Clemmer
- Department of Physiology and Biophysics, Center for Computational Medicine, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS, 39216-4505, USA.
| | - Jessica L Faulkner
- Vascular Biology Center, Medical College of Georgia, Augusta University, Augusta, GA, 30912-5563, USA
| | - Alex J Mullen
- Department of Physiology and Biophysics, Center for Computational Medicine, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS, 39216-4505, USA
| | - Kenneth R Butler
- Department of Medicine, University of Mississippi Medical Center, Jackson, MS, 39216-4505, USA
| | - Robert L Hester
- Department of Physiology and Biophysics, Center for Computational Medicine, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS, 39216-4505, USA.,Department of Data Sciences, John D. Bower School of Population Health, University of Mississippi Medical Center, Jackson, MS, 39216-4505, USA
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17
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18
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Bianchi M, Cusumano A, Torres C, Rojas N, Velasco G. Prevalencia de obesidad e hipertensión arterial y su asociación con edad y sexo en la ciudad de Resistencia (Argentina), años 2008-2014. HIPERTENSION Y RIESGO VASCULAR 2019; 36:14-20. [DOI: 10.1016/j.hipert.2018.04.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2018] [Revised: 04/11/2018] [Accepted: 04/13/2018] [Indexed: 11/25/2022]
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19
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Chu DT, Minh Nguyet NT, Dinh TC, Thai Lien NV, Nguyen KH, Nhu Ngoc VT, Tao Y, Son LH, Le DH, Nga VB, Jurgoński A, Tran QH, Van Tu P, Pham VH. An update on physical health and economic consequences of overweight and obesity. Diabetes Metab Syndr 2018; 12:1095-1100. [PMID: 29799416 DOI: 10.1016/j.dsx.2018.05.004] [Citation(s) in RCA: 107] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Accepted: 05/04/2018] [Indexed: 12/21/2022]
Abstract
Overweight and obesity (OW and OB) have been on the increase globally and posed health risks to the world's population of all ages, including pre-born babies, children, adolescents, adults and elderly people, via their comorbid conditions. Excellent examples of comorbidities associated with obesity include cancer, cardiovascular diseases (CVD) and type 2 diabetes mellitus (T2DM). In this article, we aimed to review and update scientific evidence regarding the relationships between obesity and its common physical health consequences, including CVD, T2DM, hypertension, ischemic stroke, cancer, dyslipidemia and reproductive disorders. In addition, the economic burden of OW and OB will be discussed. Abundant evidence is found to support the associations between obesity and other diseases. In general, the odd ratios, risk ratios or hazard ratios are often higher in OW and OB people than in the normal-weight ones. However, the molecular mechanism of how OW and OB induce the development of other diseases has not been fully understood. Figures also showed that obesity and its-related disorders exert enormous pressure on the economy which is projected to increase. This review highlights the fact that obesity can lead to numerous lethal health problems; therefore, it requires a lot of economic resources to fight against this epidemic.
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Affiliation(s)
- Dinh-Toi Chu
- Faculty of Biology, Hanoi National University of Education, Hanoi, Vietnam; Institute for Research and Development, Duy Tan University, 03 Quang Trung, Danang, Vietnam.
| | - Nguyen Thi Minh Nguyet
- Center for Environment and Health Studies, Thai Binh Medical University, Thai Binh, Vietnam
| | - Thien Chu Dinh
- Institute for Research and Development, Duy Tan University, 03 Quang Trung, Danang, Vietnam
| | | | - Khanh-Hoang Nguyen
- School of Geography, Earth and Environmental Sciences, University of Birmingham, Birmingham, B15 2TT, United Kingdom
| | | | - Yang Tao
- College of Food Science and Technology, Nanjing Agricultural University, Nanjing, 8 210095, China
| | - Le Hoang Son
- VNU University of Science, Vietnam National University, Hanoi, Vietnam
| | - Duc-Hau Le
- VINMEC Research Institute of Stem Cell and Gene Technology, Hanoi, Vietnam
| | - Vu Bich Nga
- National Institute of Diabetes and Metabolic Disorders, Hanoi, Vietnam
| | - Adam Jurgoński
- Department of Biological Function of Food, Institute of Animal Reproduction and Food Research, Polish Academy of Sciences, Tuwima 10 Str., 10-748, Olsztyn, Poland
| | - Quoc-Hung Tran
- University of Economics and Business, Vietnam National University, Hanoi, Vietnam
| | - Pham Van Tu
- Faculty of Social Work, Hanoi National University of Education, Hanoi, Vietnam
| | - Van-Huy Pham
- AI Lab, Faculty of Information Technology, Ton Duc Thang University, Ho Chi Minh City, Vietnam.
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Matei Ș, Cutler SJ, Preda M, Dorobanțu M, Ilinca C, Gheorghe-Fronea O, Rădulescu L, Oprescu N, Deaconu A, Zorilă C, Dorobanțu B. The Relationship Between Psychosocial Status and Hypertensive Condition. Curr Hypertens Rep 2018; 20:102. [DOI: 10.1007/s11906-018-0902-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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21
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Wang S, Peng R, Liang S, Dong K, Nie W, Yang Q, Ma N, Zhang J, Wang K, Song C. Comparison of adiposity indices in relation to prehypertension by age and gender: A community-based survey in Henan, China. Clin Cardiol 2018; 41:1583-1592. [PMID: 30284305 DOI: 10.1002/clc.23086] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2018] [Revised: 09/25/2018] [Accepted: 10/01/2018] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND To compare the efficiency of bioelectrical indices (visceral fat index [VFI], percentage body fat [PBF]) and anthropometric indices (body mass index, waist circumference, waist-to-height ratio, a body shape index ) in the relation to prehypertension (120-139/80-89 mm Hg) among the Chinese population. METHODS Using stratified multistage random sampling method, a general population-based sample of 11 175 adults in Henan province were selected from 2013 to 2015. The individuals were divided into three categories by blood pressure levels: normotension (<120 and 80 mm Hg), stage 1 prehypertension (120-129/80-84 mm Hg) and stage 2 prehypertension (130-139/85-89 mm Hg). RESULTS VFI and PBF tended to increase with age in men and women. However, for each age-specific group, men tended to have higher VFI than women (all P < 0.01) and women tended to have greater PBF (all P < 0.0001). The odds ratios (OR) and area under the receiver operating characteristic curves for prehypertension associated with adiposity indices declined with age. VFI and PBF showed higher standardized adjusted ORs for prehypertension in young (~40 years) men (VFI: 2.02-3.05; PBF: 1.82-2.80) and young women (VFI: 1.90-2.58; PBF:1.70-2.29). Moreover, based on Youden's index, VFI and PBF exhibited the superiority for identifying prehypertension in men (0.20-0.32) and women (0.31-0.39), respectively. CONCLUSION In summary, there was stronger association of VFI and PBF with prehypertension in men than in women, respectively, especially for young adults.
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Affiliation(s)
- Shuaibing Wang
- The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China.,Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, China.,Henan Key Laboratory of Tumor Epidemiology, Zhengzhou, China
| | - Rui Peng
- The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China.,Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, China.,Henan Key Laboratory of Tumor Epidemiology, Zhengzhou, China
| | | | - Kaiyan Dong
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, China.,Henan Key Laboratory of Tumor Epidemiology, Zhengzhou, China.,Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou, China
| | - Wei Nie
- Henan Academy of Medical Sciences, Zhengzhou, China
| | - Qian Yang
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, China.,Henan Key Laboratory of Tumor Epidemiology, Zhengzhou, China
| | - Nan Ma
- Henan Academy of Medical Sciences, Zhengzhou, China
| | - Jianying Zhang
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, China.,Henan Key Laboratory of Tumor Epidemiology, Zhengzhou, China.,Henan Academy of Medical and Pharmaceutical Sciences, Zhengzhou University, Zhengzhou, China
| | - Kaijuan Wang
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, China.,Henan Key Laboratory of Tumor Epidemiology, Zhengzhou, China
| | - Chunhua Song
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, China.,Henan Key Laboratory of Tumor Epidemiology, Zhengzhou, China
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22
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Body mass index, abdominal fatness, and hypertension incidence: a dose-response meta-analysis of prospective studies. J Hum Hypertens 2018; 32:321-333. [DOI: 10.1038/s41371-018-0046-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Revised: 01/19/2018] [Accepted: 01/29/2018] [Indexed: 11/09/2022]
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23
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Effect of dietary energy and polymorphisms in BRAP and GHRL on obesity and metabolic traits. Obes Res Clin Pract 2018; 12:39-48. [DOI: 10.1016/j.orcp.2016.05.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Revised: 05/02/2016] [Accepted: 05/09/2016] [Indexed: 12/29/2022]
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Faulkner JL, Belin de Chantemèle EJ. Sex Differences in Mechanisms of Hypertension Associated With Obesity. Hypertension 2017; 71:15-21. [PMID: 29133358 DOI: 10.1161/hypertensionaha.117.09980] [Citation(s) in RCA: 71] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- Jessica L Faulkner
- From the Vascular Biology Center, Medical College of Georgia at Augusta University, GA
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Wang F, Han L, Hu D. Fasting insulin, insulin resistance and risk of hypertension in the general population: A meta-analysis. Clin Chim Acta 2016; 464:57-63. [PMID: 27836689 DOI: 10.1016/j.cca.2016.11.009] [Citation(s) in RCA: 136] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Revised: 11/06/2016] [Accepted: 11/06/2016] [Indexed: 01/12/2023]
Abstract
BACKGROUND Studies on the association of fasting insulin concentrations or insulin resistance with subsequent risk of hypertension have yielded conflicting results. OBJECTIVE To quantitatively assess the association of fasting insulin concentrations or homeostasis model assessment insulin resistance (HOMA-IR) with incident hypertension in a general population by performing a meta-analysis. METHODS We searched the PubMed and Embase databases until August 31, 2016 for prospective observational studies investigating the elevated fasting insulin concentrations or HOMA-IR with subsequent risk of hypertension in the general population. Pooled risk ratio (RR) and 95% confidence interval (CI) of hypertension was calculated for the highest versus the lowest category of fasting insulin or HOMA-IR. RESULTS Eleven studies involving 10,230 hypertension cases were identified from 55,059 participants. Meta-analysis showed that the pooled adjusted RR of hypertension was 1.54 (95% CI 1.34-1.76) for fasting insulin concentrations and 1.43 (95% CI 1.27-1.62) for HOMA-IR comparing the highest to the lowest category. Subgroup analysis results showed that the association of fasting insulin concentrations with subsequent risk of hypertension seemed more pronounced in women (RR 2.07; 95% CI 1.19-3.60) than in men (RR 1.48; 95% CI 1.17-1.88). CONCLUSIONS This meta-analysis suggests that elevated fasting insulin concentrations or insulin resistance as estimated by homeostasis model assessment is independently associated with an exacerbated risk of hypertension in the general population. Early intervention of hyperinsulinemia or insulin resistance may help clinicians to identify the high risk of hypertensive population.
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Affiliation(s)
- Feng Wang
- Department of Cardiology, The Frist Affiliated Hospital of Chongqing Medical University, Chongqing, China, 400016
| | - Lili Han
- Department of Emergency, Zoucheng People's Hospital, Zoucheng, Shandong Province, China, 273500
| | - Dayi Hu
- Department of Cardiology, The Frist Affiliated Hospital of Chongqing Medical University, Chongqing, China, 400016.
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Qi SF, Zhang B, Wang HJ, Yan J, Du P, Zhang W, Mi YJ, Zhao JJ, Liu DW, Tian QB. Joint effects of age and body mass index on the incidence of hypertension subtypes in the China Health and Nutrition Survey: A cohort study over 22years. Prev Med 2016; 89:23-30. [PMID: 27155441 PMCID: PMC6443580 DOI: 10.1016/j.ypmed.2016.05.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2015] [Revised: 03/28/2016] [Accepted: 05/01/2016] [Indexed: 01/15/2023]
Abstract
OBJECTIVES We seek to investigate the joint effects of age and body mass index (BMI) on the incident hypertension subtypes among Chinese adults during 1989-2011. METHODS We investigated the Incidence rates (IRs, per 100person-years) of hypertension subtypes, adjusted relative risks (RRs) and population attributable risk percent (PAR%) of BMI for hypertension, and clarified the age-specific effect of BMI on incident hypertension utilizing a dynamic cohort study from the China Health and Nutrition Survey (CHNS) 1989-2011. RESULTS Normotensive participants (n=53,028) at baseline were included, with mean age was 41.7 (95% CI, 41.6-41.7)years old. During a total of 118,694person years (average was 6.38years) of follow-up, a total of 5208 incident cases of hypertension were documented. The IRs of hypertension were 4.4 (95% CI, 4.3-4.5), which increased gradually by age and BMI (Ptrend<0.001). Compared with those with BMI<22kg/m(2), the RR of hypertension was 3.13 (95% CI, 2.84-3.45) in the group with BMI≥28kg/m(2). The PAR% (BMI>22 vs. BMI<22) for hypertension in Chinese population was 32% (95% CI, 29-34%). Similar trends were observed in all age and BMI groups for both isolated systolic hypertension and systolic-diastolic hypertension, which were mainly affected by age. In contrast, the peak IR of isolated diastolic hypertension was observed in participants aged 30-49years with higher BMIs. CONCLUSIONS The PAR% (IR of BP≥140/90 or treatment for BMI>22 vs. IR for BMI<22) of elevated body weight for hypertension was 32% in Chinese population.
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Affiliation(s)
- Su-Fen Qi
- Department of Epidemiology and Statistics, School of Public Health, Hebei Medical University, 361 East Zhongshan Road, Shijiazhuang 050017, China
| | - Bing Zhang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, 27 Nanwei Road, Xicheng District, Beijing 100050, China
| | - Hui-Jun Wang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, 27 Nanwei Road, Xicheng District, Beijing 100050, China
| | - Jing Yan
- Research Center of Electron Microscope, Hebei Medical University, 361 East Zhongshan Road, Shijiazhuang 050017, China
| | - Pei Du
- Department of Epidemiology and Statistics, School of Public Health, Hebei Medical University, 361 East Zhongshan Road, Shijiazhuang 050017, China
| | - Wei Zhang
- Department of Pathology, Hebei Medical University, 361 East Zhongshan Road, Shijiazhuang 050017, China
| | - Ying-Jun Mi
- Department of Epidemiology and Statistics, School of Public Health, Hebei Medical University, 361 East Zhongshan Road, Shijiazhuang 050017, China
| | - Jing-Jing Zhao
- Department of Epidemiology and Statistics, School of Public Health, Hebei Medical University, 361 East Zhongshan Road, Shijiazhuang 050017, China
| | - Dian-Wu Liu
- Department of Epidemiology and Statistics, School of Public Health, Hebei Medical University, 361 East Zhongshan Road, Shijiazhuang 050017, China
| | - Qing-Bao Tian
- Department of Epidemiology and Statistics, School of Public Health, Hebei Medical University, 361 East Zhongshan Road, Shijiazhuang 050017, China.
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de Simone G, Mancusi C, Izzo R, Losi MA, Aldo Ferrara L. Obesity and hypertensive heart disease: focus on body composition and sex differences. Diabetol Metab Syndr 2016; 8:79. [PMID: 27956942 PMCID: PMC5129668 DOI: 10.1186/s13098-016-0193-x] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2016] [Accepted: 11/22/2016] [Indexed: 12/15/2022] Open
Abstract
There is evidence that hypertension is frequently associated with overweight/obesity even in kids and adolescents. Either conditions influence development of left ventricular (LV) hypertrophy (LVH), through different biological and hemodynamic mechanisms: obesity is conventionally thought to elicit a coherent growth of LV chamber dimensions and myocardial wall thickness (eccentric LV geometry), whereas a more accentuated increase in wall-thickness (concentric LV geometry) is attributed to hypertension. While during youth these differences are visible, proportion of LV concentric geometry, the most harmful LV geometric pattern, sharply raises in obese individuals during middle age, and becomes the most frequent geometric patterns among obese-hypertensive individuals. Two conditions with elevated hemodynamic impact, severe obstructive sleep apnea and masked hypertension contribute to the development of such a geometric pattern, but non-hemodynamic factors, and specifically body composition, also influence prevalence of concentric LV geometry. Contrasting a general belief, it has been observed that adipose mass strongly influences LV mass, particularly in women, especially when fat-free mass is relatively deficient. Thus, though blood pressure control is mandatory for prevention and reduction of LVH in obese hypertensive patients, without reduction of visceral adiposity regression of LVH is difficult. Future researches should be addressed on (1) assessing whether LVH resulting from alteration of body composition carries the same prognosis as pressure overload LVH; (2) defining tissue characterization of the hypertrophic heart in obese-hypertensive patients; (3) evaluating whether assessment of hemodynamic loading conditions and biological markers can help defining management of the association of obesity with hypertension.
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Affiliation(s)
- Giovanni de Simone
- Hypertension Research Center, Federico II University Hospital, Via S. Pansini 5, Building 1, 80131 Naples, Italy
- Department of Translational Medical Sciences, Federico II University Hospital, Naples, Italy
| | - Costantino Mancusi
- Hypertension Research Center, Federico II University Hospital, Via S. Pansini 5, Building 1, 80131 Naples, Italy
- Department of Translational Medical Sciences, Federico II University Hospital, Naples, Italy
| | - Raffaele Izzo
- Hypertension Research Center, Federico II University Hospital, Via S. Pansini 5, Building 1, 80131 Naples, Italy
- Department of Translational Medical Sciences, Federico II University Hospital, Naples, Italy
| | - Maria Angela Losi
- Hypertension Research Center, Federico II University Hospital, Via S. Pansini 5, Building 1, 80131 Naples, Italy
- Department of Advanced Medical Bioscience, Federico II University Hospital, Naples, Italy
| | - L. Aldo Ferrara
- Hypertension Research Center, Federico II University Hospital, Via S. Pansini 5, Building 1, 80131 Naples, Italy
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Peeters GMEEG, Herber-Gast GCM, Dobson AJ, Brown WJ. Changes in the Relationships Between Body Mass Index and Health Outcomes Across Middle Age and Older Adulthood. Mayo Clin Proc 2015; 90:903-10. [PMID: 26141330 DOI: 10.1016/j.mayocp.2015.04.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2015] [Revised: 03/30/2015] [Accepted: 04/03/2015] [Indexed: 12/30/2022]
Abstract
OBJECTIVE To examine patterns of the incidence of diabetes, hypertension, and mortality by single units of body mass index (BMI) and 5-year age groups using longitudinal data from middle-aged and older women. PATIENTS AND METHODS Middle-aged (born between 1946 and 1951; N = 13,715) and older (born between 1921 and 1926; N = 12,432) participants in the Australian Longitudinal Study on Women's Health completed surveys in 1996 and at approximately 3-year intervals thereafter until 2011. Proportions of women with diabetes, hypertension, and mortality over 3-year intervals were estimated for each unit of BMI and 5-year age group (45 to < 50, 50 to < 55, 55 to < 60, 70 to < 75, 75 to < 80, and 80 to < 85 years) using generalized additive modeling with adjustment for time-varying covariates. RESULTS Three-year incidence of diabetes (1.2%-3.6%), hypertension (5.2%-17.8%), and death (0.4%-9.5%) increased with age. For both diabetes and hypertension, the associations with BMI were curvilinear in middle-aged women and became almost linear in older women. With increasing age, the slope became steeper, and the increase started at lower BMI values. For hypertension, there was a marked increase in intercept from 75 years onward. In contrast, mortality risks were highest for low BMI (≤ 20) in all age groups. A clear U-shaped curve was observed only in the oldest age group. CONCLUSION The shapes of the relationships between BMI and incidence of diabetes, hypertension, and mortality change with age, suggesting that weight management interventions should be tailored for different age groups.
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Affiliation(s)
- G M E E Geeske Peeters
- School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, Australia; School of Public Health, University of Queensland, Brisbane, Australia.
| | | | - Annette J Dobson
- School of Public Health, University of Queensland, Brisbane, Australia
| | - Wendy J Brown
- School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, Australia
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Zatu MC, van Rooyen JM, Loots DT, Greeff M, Schutte AE. A comparison of the cardiometabolic profile of black South Africans with suspected non-alcoholic fatty liver disease (NAFLD) and excessive alcohol use. Alcohol 2015; 49:165-72. [PMID: 25543202 DOI: 10.1016/j.alcohol.2014.11.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2013] [Accepted: 11/11/2014] [Indexed: 01/01/2023]
Abstract
Excessive alcohol use and non-alcoholic fatty liver disease (NAFLD) are putative cardiovascular disease risk factors. In order to ease the identification of these conditions on primary health care level, we aimed to determine and compare the demographic and cardiometabolic characteristics of excessive alcohol users and those with suspected NAFLD in black South Africans. In the Prospective Urban Rural Epidemiology study (North West Province, South Africa, N = 2021, collected in 2005) we selected 338 participants, namely: 1) alcohol users (N = 143) reporting 'yes' to alcohol intake, with high gamma-glutamyl transferase (GGT) ≥80 U/L and a percentage carbohydrate deficient transferrin (%CDT) ≥2%; 2) non-alcohol users (N = 127) self-reporting 'no' to alcohol intake with GGT ≤30 U/L and %CDT ≤2%; and 3) NAFLD group (N = 68) who were non-drinkers with GGT levels ≥60 U/L and %CDT ≤ 2%. The demographics indicated that the alcohol users were mostly men (73%) with a body mass index (BMI) of 19.8 (15.2-27.3) kg/m(2), 90% of which were smokers. Systolic blood pressure (SBP) of alcohol users significantly correlated with high-density lipoprotein cholesterol (HDL-C) (β = 0.24; p = 0.003) and waist circumference (WC) (β = 0.22; p = 0.006). Non-alcohol users were mostly women (84%) with a BMI of 26.0 (18.0-39.2) kg/m(2) and blood pressure in this group related positively with triglycerides. The NAFLD group were also mostly women (72%) with a comparatively larger WC (p < 0.001) and an adverse metabolic profile (total cholesterol: 5.55 ± 1.69 mmol/L; glycosylated hemoglobin: 6.03 (4.70-9.40) %). Diastolic blood pressure in the NAFLD group associated positively with WC (β = 0.27; p = 0.018). We therefore found disparate gender and cardiometabolic profiles of black South Africans with suspected NAFLD and excessive alcohol use. The described profiles may aid health care practitioners in low resource settings when using these crude screening measures of gender, obesity indices (and self-reported alcohol use) to identify individuals at risk.
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Affiliation(s)
- Mandlenkosi Caswell Zatu
- Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, North West Province 2520, South Africa; Department of Physiology, University of Limpopo (Medunsa), Pretoria, Gauteng 0001, South Africa; Medical Research Council: Research Unit for Hypertension and Cardiovascular Disease, Faculty of Health Sciences, North West University, South Africa
| | - Johannes Marthinus van Rooyen
- Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, North West Province 2520, South Africa; Medical Research Council: Research Unit for Hypertension and Cardiovascular Disease, Faculty of Health Sciences, North West University, South Africa
| | - Du Toit Loots
- Centre for Human Metabonomics, North-West University, Potchefstroom, North West Province 2520, South Africa
| | - Minrie Greeff
- Africa Unit for Transdisciplinary Health Research (AUTHeR), North-West University, Potchefstroom, North West Province 2520, South Africa
| | - Aletta Elisabeth Schutte
- Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, North West Province 2520, South Africa; Medical Research Council: Research Unit for Hypertension and Cardiovascular Disease, Faculty of Health Sciences, North West University, South Africa.
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30
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Brooks VL, Shi Z, Holwerda SW, Fadel PJ. Obesity-induced increases in sympathetic nerve activity: sex matters. Auton Neurosci 2014; 187:18-26. [PMID: 25435000 DOI: 10.1016/j.autneu.2014.11.006] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2014] [Revised: 11/02/2014] [Accepted: 11/08/2014] [Indexed: 01/18/2023]
Abstract
Abundant evidence obtained largely from male human and animal subjects indicates that obesity increases sympathetic nerve activity (SNA), which contributes to hypertension development. However, recent studies that included women reported that the strong relationships between muscle SNA and waist circumference or body mass index (BMI) found in men are not present in overweight and obese women. A similar sex difference in the association between adiposity and hypertension development has been identified in animal models of obesity. In this brief review, we consider two possible mechanisms for this sex difference. First, visceral adiposity, leptin, insulin, and angiotensin II have been identified as potential culprits in obesity-induced sympathoexcitation in males. We explore if these factors wield the same impact in females. Second, we consider if sex differences in vascular reactivity to sympathetic activation contribute. Our survey of the literature suggests that premenopausal females may be able to resist obesity-induced sympathoexcitation and hypertension in part due to differences in adipose disposition as well as its muted inflammatory response and reduced production of pressor versus depressor components of the renin-angiotensin system. In addition, vascular responsiveness to increased SNA may be reduced. However, more importantly, we identify the urgent need for further study, not only of sex differences per se, but also of the mechanisms that may mediate these differences. This information is required not only to refine treatment options for obese premenopausal women but also to potentially reveal new therapeutic avenues in obese men and women.
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Affiliation(s)
- Virginia L Brooks
- Department of Physiology and Pharmacology, Oregon Health & Science University, Portland, OR 97239, United States.
| | - Zhigang Shi
- Department of Physiology and Pharmacology, Oregon Health & Science University, Portland, OR 97239, United States
| | - Seth W Holwerda
- Department of Medical Pharmacology and Physiology, Dalton Cardiovascular Research Center, University of Missouri, Columbia, MO 65212, United States
| | - Paul J Fadel
- Department of Medical Pharmacology and Physiology, Dalton Cardiovascular Research Center, University of Missouri, Columbia, MO 65212, United States
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31
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Arshi B, Tohidi M, Derakhshan A, Asgari S, Azizi F, Hadaegh F. Sex-specific relations between fasting insulin, insulin resistance and incident hypertension: 8.9 years follow-up in a Middle-Eastern population. J Hum Hypertens 2014; 29:260-7. [DOI: 10.1038/jhh.2014.70] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2013] [Revised: 06/30/2014] [Accepted: 07/02/2014] [Indexed: 01/06/2023]
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