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Cui Y, Zhang F, Wang H, Wu J, Zhang D, Xing Y, Shen X. Children who appeared or remained overweight or obese predict a higher follow-up blood pressure and higher risk of hypertension: a 6-year longitudinal study in Yantai, China. Hypertens Res 2023; 46:1840-1849. [PMID: 37095339 DOI: 10.1038/s41440-023-01286-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 03/28/2023] [Accepted: 04/04/2023] [Indexed: 04/26/2023]
Abstract
Few longitudinal studies have examined the effect of weight status change on blood pressure change over time and incidence of hypertension among Chinese children. The longitudinal study enrolled 17,702 Chinese children aged 7 years in Yantai in 2014 as baseline, with a continuous 5 years of follow-up to 2019. Generalized estimating equation model was fitted to examine the main and interaction effects of weight status change and time with blood pressure and the incidence of hypertension. Compared with the participants who remained normal weight, the participants who remained overweight or obese had higher systolic blood pressure (SBP) (β = 2.89, p < 0.001) and diastolic blood pressure (DBP) (β = 1.79, p < 0.001). Significant interactions were identified between weight status change and time with SBP (χ2interaction = 697.77, p < 0.001) and DBP (χ2interaction = 270.49, p < 0.001). The odds ratio (OR) and 95% confidence interval (CI) of hypertension were 1.70 (1.59-1.82) for participants who appeared overweight or obese, 2.26 (2.14-2.40) for participants who remained overweight or obese, compared with the participants who remained normal weight. Those who switched from overweight or obesity to normal weight had almost the same risk of developing hypertension (OR = 1.13, 95% CI: 1.02 to 1.26) as children who remained normal weight. Children who appeared or remained overweight or obese predict a higher follow-up blood pressure and higher risk of hypertension, whereas losing weight could reduce blood pressure and the risk of hypertension. Children who appeared or remained overweight or obese predict a higher follow-up blood pressure and higher risk of hypertension, whereas losing weight could reduce blood pressure and the risk of hypertension.
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Affiliation(s)
- Yixin Cui
- Department of Epidemiology and Health Statistics, Medical College of Qingdao University, Qingdao, 266071, China
| | - Fan Zhang
- Department of Epidemiology and Health Statistics, Medical College of Qingdao University, Qingdao, 266071, China
| | - Hao Wang
- Department of Epidemiology and Health Statistics, Medical College of Qingdao University, Qingdao, 266071, China
| | - Jianyan Wu
- Department of Anesthetized One, Jiaozhou People's Hospital of Qingdao, Qingdao, Shandong Province, China
| | - Dongfeng Zhang
- Department of Epidemiology and Health Statistics, Medical College of Qingdao University, Qingdao, 266071, China
| | - Yufang Xing
- Institute of Infectious Disease Control and Prevention, Shandong Center for Disease Control and Prevention, Jinan, Shandong Province, China.
| | - Xiaoli Shen
- Department of Epidemiology and Health Statistics, Medical College of Qingdao University, Qingdao, 266071, China.
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Welser L, Pfeiffer KA, Silveira JFDC, Valim ARDM, Renner JDP, Reuter CP. Incidence of Arterial Hypertension is Associated with Adiposity in Children and Adolescents. Arq Bras Cardiol 2023; 120:e20220070. [PMID: 36888776 DOI: 10.36660/abc.20220070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 10/05/2022] [Indexed: 02/19/2023] Open
Abstract
BACKGROUND The increase of hypertension in children and adolescents has attracted the attention of the scientific community largely due to its association with the obesity epidemic. OBJECTIVES To describe the incidence of hypertension and its relationship with the cardiometabolic and genetic profile in children and adolescents from a city in southern Brazil in a three-year period. METHODS This longitudinal study followed 469 children and adolescents, aged 7-17 years old (43.1% boys), assessed at two-time points. We evaluated systolic and diastolic blood pressures (SBP and DBP), waist circumference (WC), body mass index (BMI), body fat percentage (%BF), lipid profile, glucose, cardiorespiratory fitness (CRF), and rs9939609 Polymorphism ( FTO ). Cumulative incidence of hypertension was calculated, and multinomial logistic regression was conducted. The statistical significance was established as p < 0.05. RESULTS After three years, the incidence of hypertension was 11.5%. Overweight or obese individuals were more likely to become borderline hypertensive (overweight OR: 3.22, 95% CI: 1.08-9.55; obesity OR: 4.05, 95% CI: 1.68-9.75), and obese individuals were more likely to become hypertensive (obesity OR: 4.84, 95% CI: 1.57-14.95). High-risk WC and %BF values were associated with hypertension development (OR: 3.41, 95% CI: 1.26-9.19; OR: 2.49, 95% CI: 1.08-5.75, respectively). CONCLUSIONS We found a higher incidence of hypertension in children and adolescents as compared with previous studies. Individuals with higher values of BMI, WC and %BF at baseline were more likely to develop hypertension, suggesting the importance of adiposity in the development of hypertension even in such a young population.
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Affiliation(s)
- Letícia Welser
- Universidade de Santa Cruz do Sul, Santa Cruz do Sul, RS - Brasil
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Gong QH, Li SX, Qian LJ, Wang SJ, Zhang Y, Zou ZQ. Effect of changes in body mass index and waist-to-height ratio on blood pressure in 11- to 13-year-old children: a prospective population study. Ann Hum Biol 2022; 49:280-290. [PMID: 36382866 DOI: 10.1080/03014460.2022.2148739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Existing evidence about associations between change in body mass index (BMI) and waist-to-height ratio (WHtR) change and high blood pressure are relatively limited. AIMS We aimed to investigate the associations of general overweight (based on BMI) and abdominal obesity (based on WHtR) change with high blood pressure in Chinese children. SUBJECTS AND METHODS A school-based cohort study in Ningbo region (China) was conducted among children with baseline evaluations in October 2016 with follow-up two years later. A total of 1432 children aged 11-13 years participated in this study. RESULTS Our results showed that a change from normal BMI or WHtR to overweight or abdominal obesity in children was associated with high blood pressure (adjusted odds ratio (AOR), 2.62; p<0.05 or AOR, 2.79; p<0.05, respectively). In addition, an increased risk of high blood pressure was observed in children who maintained overweight or abdominal obesity (AOR, 1.67; p<0.05 or AOR, 1.69; p<0.05, respectively), but not in children who experienced remission to non-excess weight. Interestingly, children who increased BMI or WHtR had greater impact on SBP than on DBP. CONCLUSION The 2-year longitudinal study indicated that general overweight or abdominal obesity can predict the risk factor of high blood pressure in children. However, children who remitted to non-excess weight did not exhibit an increased risk of high blood pressure.
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Affiliation(s)
- Qing-Hai Gong
- Ningbo Municipal Center for Disease Control and Prevention, Ningbo, China
| | - Si-Xuan Li
- Ningbo Municipal Center for Disease Control and Prevention, Ningbo, China
| | - Li-Jia Qian
- Ningbo Municipal Center for Disease Control and Prevention, Ningbo, China
| | - Si-Jia Wang
- Ningbo Municipal Center for Disease Control and Prevention, Ningbo, China
| | - Yan Zhang
- Ningbo Municipal Center for Disease Control and Prevention, Ningbo, China
| | - Zu-Quan Zou
- Beilun District Center for Disease Control and Prevention, Ningbo, China
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Nguyen TT, Nguyen MH, Nguyen YH, Nguyen TTP, Giap MH, Tran TDX, Pham TTM, Pham KM, Nguyen KT, Le VTT, Su CT, Duong TV. Body mass index, body fat percentage, and visceral fat as mediators in the association between health literacy and hypertension among residents living in rural and suburban areas. Front Med (Lausanne) 2022; 9:877013. [PMID: 36148456 PMCID: PMC9485490 DOI: 10.3389/fmed.2022.877013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 07/11/2022] [Indexed: 11/16/2022] Open
Abstract
Background Hypertension is a major cause of death and disability worldwide. Enhancing health literacy (HL) may help to alleviate the risk of hypertension and its burden. However, evidence on the association between HL and hypertension and potential mechanisms remain to be explored. Objectives This study examined the association between HL and hypertension; and explored whether body mass index (BMI), body fat percentage (PBF), and visceral fat (VF) were mediators of this association in people who resided in rural and suburban areas in Vietnam. Methods A cross-sectional survey was conducted from 1st July to 31st December 2019, involving 1655 residents and exploring participants' sociodemographic characteristics, HL, health-related behaviors, comorbidities, body composition, and blood pressure (BP). People with systolic BP ≥ 140 mmHg or diastolic BP ≥ 90 mmHg or using antihypertensive medication were classified as having hypertension. Multiple logistic regression and mediation analyses were used to explore associations. Results The hypertension prevalence was 41.9% (694/1,655). In adjusted models, a higher HL score was associated with a lower hypertension likelihood (OR = 0.96; 95%CI = 0.95–0.97; p < 0.001). Factors associated with a higher odd of hypertension were overweight/obese (OR = 1.69; 95%CI = 1.24–2.29; p = 0.001), high PBF (OR = 2.35; 95%CI = 1.85–2.99; p < 0.001), and high VF (OR = 2.27; 95%CI = 1.63–3.16; p < 0.001). Notably, PBF significantly mediated the association between HL and hypertension (indirect effect, OR = 0.99; 95%CI = 0.98–0.99; p = 0.009; percent mediated = 8.56%). The mediating roles of BMI and VF were not found. Conclusion The prevalence of hypertension was relatively high. People with better HL were less likely to have hypertension. The association between HL and hypertension was partially explained by PBF. Strategic approaches are required to improve people's HL and body fat which further help to manage hypertension in rural and suburban areas.
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Affiliation(s)
- Tham T. Nguyen
- Faculty of Public Health, Hai Phong University of Medicine and Pharmacy, Hai Phong, Vietnam
| | - Minh H. Nguyen
- International Ph.D. Program in Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Yen H. Nguyen
- Department of Pharmacology and Clinical Pharmacy, Can Tho University of Medicine and Pharmacy, Can Tho, Vietnam
- Department of Pharmacy, Can Tho University of Medicine and Pharmacy Hospital, Can Tho, Vietnam
- Ph.D. Program in School of Pharmacy, College of Pharmacy, Taipei Medical University, Taipei, Taiwan
| | - Thao T. P. Nguyen
- Health Personnel Training Institute, University of Medicine and Pharmacy, Hue University, Hue, Vietnam
| | - Manh H. Giap
- Emergency Department, Bai Chay Hospital, Hạ Long, Vietnam
| | - Tung D. X. Tran
- Stem Cell Unit, Van Hanh Hospital, Ho Chi Minh, Vietnam
- Hi-Tech Institute, Nguyen Tat Thanh University, Ho Chi Minh, Vietnam
| | - Thu T. M. Pham
- Faculty of Public Health, Hai Phong University of Medicine and Pharmacy, Hai Phong, Vietnam
- School of Public Health, College of Public Health, Taipei Medical University, Taipei, Taiwan
| | - Khue M. Pham
- Faculty of Public Health, Hai Phong University of Medicine and Pharmacy, Hai Phong, Vietnam
| | - Kien T. Nguyen
- Department of Health Promotion, Faculty of Social and Behavioral Sciences, Hanoi University of Public Health, Hanoi, Vietnam
| | - Vinh-Tuyen T. Le
- Department of Pharmacognosy - Traditional Pharmacy - Pharmaceutical Botanic, Can Tho University of Medicine and Pharmacy, Can Tho, Vietnam
- Ph.D. Program in Clinical Drug Development of Herbal Medicine, College of Pharmacy, Taipei Medical University, Taipei, Taiwan
| | - Chien-Tien Su
- School of Public Health, Taipei Medical University, Taipei, Taiwan
- Department of Family Medicine, Taipei Medical University Hospital, Taipei, Taiwan
| | - Tuyen Van Duong
- International Ph.D. Program in Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- School of Nutrition and Health Sciences, Taipei Medical University, Taipei, Taiwan
- *Correspondence: Tuyen Van Duong
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Bai L, Zhou J, Tong L, Ding W. Association between body composition and blood pressure in normal-weight Chinese children and adolescents. BMC Pediatr 2022; 22:240. [PMID: 35501836 PMCID: PMC9063238 DOI: 10.1186/s12887-022-03289-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Accepted: 04/14/2022] [Indexed: 11/30/2022] Open
Abstract
Background The aim of this study was to assess the associations of body fat distribution and lean body mass (LBM) with blood pressure (BP) in normal-weight Chinese children and adolescents. Methods A total of 898 normal-weight Chinese children and adolescents, aged 10–18 years, were included this cross-sectional study via a cluster sampling method. The bioelectrical impedance analysis (BIA) was used to measure body composition. The participants were measured for blood pressure (BP) using a calibrated electronic sphygmomanometer according to the standard method by the "American Hypertension Education Project Working Group". Results Body composition was related to abnormal BP in normal-weight children and adolescents. After the model adjusted for age, smoking, and drinking, regression analysis showed that fat mass percentage (FMP) was negatively associated with abnormal BP, while LBM was positively associated with abnormal BP in boys(P < 0.05). Whereas FMP and visceral fat level (VFL) were positively associated with abnormal BP in girls (P < 0.05). Conclusions There are sex differences in the relationships between total body fat, visceral fat and lean body mass with abnormal BP in normal-weight youths. Therefore, it is of great significance to pay attention to the relative influence of the body composition of the boys and girls in the prevention and treatment of hypertension in youths.
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Affiliation(s)
- Ling Bai
- School of Public Health and Management, Ningxia Medical University, Shengli Street, Xingqing District, Yinchuan, 750004, Ningxia, China.,Key Laboratory of Environmental Factors and Chronic Disease Control, No.1160, Shengli Street, Xingqing District, Yinchuan, 750004, Ningxia, China
| | - Jinyu Zhou
- School of Public Health and Management, Ningxia Medical University, Shengli Street, Xingqing District, Yinchuan, 750004, Ningxia, China.,Key Laboratory of Environmental Factors and Chronic Disease Control, No.1160, Shengli Street, Xingqing District, Yinchuan, 750004, Ningxia, China
| | - Lingling Tong
- School of Public Health and Management, Ningxia Medical University, Shengli Street, Xingqing District, Yinchuan, 750004, Ningxia, China.,Key Laboratory of Environmental Factors and Chronic Disease Control, No.1160, Shengli Street, Xingqing District, Yinchuan, 750004, Ningxia, China
| | - Wenqing Ding
- School of Public Health and Management, Ningxia Medical University, Shengli Street, Xingqing District, Yinchuan, 750004, Ningxia, China. .,Key Laboratory of Environmental Factors and Chronic Disease Control, No.1160, Shengli Street, Xingqing District, Yinchuan, 750004, Ningxia, China.
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Tang X, Liu Y, Hu J, Zhai L, Jia L, Ding N, Ma Y, Wen D. Association of waist circumference with blood pressure and familial dietary habits in preschool children: a cross-sectional study in northeastern China. Ital J Pediatr 2022; 48:53. [PMID: 35365196 PMCID: PMC8973802 DOI: 10.1186/s13052-022-01236-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 01/28/2022] [Indexed: 11/15/2022] Open
Abstract
Background Childhood obesity increases the risk of elevated blood pressure (BP) in children. Body mass index (BMI), waist circumference (WC) and waist-to-height ratio (WHtR) are traditional obesity indices, but the extent to which these indices are associated with elevated BP in childhood remains debatable. Moreover, the familial dietary environment plays an important role in obesity, so it is necessary to determine the most relevant dietary factors for childhood obesity to prevent elevated BP. Our study aimed to identify the obesity indices that are most closely associated with elevated BP and then to determine the independent familial dietary factors for those obesity indices. Method A total of 605 children aged 2 to 6 years, as well as their parents, were involved in this study. The weight, height, WC and BP of the children were measured. Information on familial environments was obtained by questionnaires completed by the parents. BMI, WC and WHtR were standardized into z scores, and categorical variables of these three obesity indices were defined as BMI Category, WC Category and WHtR Category. Logistic regression was used to analyse the associations between all obesity indices and elevated BP. Multivariate linear regression and logistic regression were used to determine the independent factors for obesity indices. Results The obesity indices that were most closely associated with elevated BP were WC and WC Category. Parental BMI, birth weight, eating wheat as a staple food, appetite, eating speed, snacking while watching TV, parental encouragement to eat a diverse assortment of foods and drinking milk were independently associated with WC in both males and females. The risk of abdominal obesity increased 1.375 times in males and 1.631 times in females if appetite increased one level. If eating speed increased one level, the risk of abdominal obesity increased 1.165 times in males and 0.905 times in females. Females who drank milk more than 6 times per week had a 0.546 times lower risk of abdominal obesity. Conclusion WC was an anthropometric parameter more closely associated with elevated BP. In addition to genetics, some familial dietary factors involving eating preference, eating habits and parental feeding practice were independently associated with WC and abdominal obesity in preschool children. Supplementary Information The online version contains supplementary material available at 10.1186/s13052-022-01236-3.
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Affiliation(s)
- Xiao Tang
- Health Sciences Institute, China Medical University, Shenyang, Liaoning Province, 110122, P.R. China.,School of Public Health, Dalian Medical University, Dalian, Liaoning Province, 116044, P.R. China
| | - Yang Liu
- Health Sciences Institute, China Medical University, Shenyang, Liaoning Province, 110122, P.R. China.,Liaoning Key Laboratory of Obesity and Glucose/Lipid Associated Metabolic Diseases, China Medical University, Shenyang, Liaoning Province, 110122, P.R. China
| | - Jiajin Hu
- Health Sciences Institute, China Medical University, Shenyang, Liaoning Province, 110122, P.R. China.,Liaoning Key Laboratory of Obesity and Glucose/Lipid Associated Metabolic Diseases, China Medical University, Shenyang, Liaoning Province, 110122, P.R. China
| | - Lingling Zhai
- School of Public Health, China Medical University, Shenyang, Liaoning Province, 110122, P.R. China
| | - Lihong Jia
- Health Sciences Institute, China Medical University, Shenyang, Liaoning Province, 110122, P.R. China.,School of Public Health, China Medical University, Shenyang, Liaoning Province, 110122, P.R. China
| | - Ning Ding
- Institute of International Medical Education, China Medical University, Shenyang, Liaoning Province, 110122, P.R. China
| | - Yanan Ma
- School of Public Health, China Medical University, Shenyang, Liaoning Province, 110122, P.R. China
| | - Deliang Wen
- Health Sciences Institute, China Medical University, Shenyang, Liaoning Province, 110122, P.R. China. .,Liaoning Key Laboratory of Obesity and Glucose/Lipid Associated Metabolic Diseases, China Medical University, Shenyang, Liaoning Province, 110122, P.R. China.
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Wang C, Fu W, Cao S, Xu H, Tian Q, Gan Y, Guo Y, Yan S, Yan F, Yue W, Lv C, Lu Z. Association of adiposity indicators with hypertension among Chinese adults. Nutr Metab Cardiovasc Dis 2021; 31:1391-1400. [PMID: 33812733 DOI: 10.1016/j.numecd.2021.01.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 01/01/2021] [Accepted: 01/05/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND AND AIMS Obesity has been linked to the development of hypertension, but the comparison of relationships between different obesity parameters with hypertension are scarcely studied with nationally representative Chinese adults samples. We sought to compare the predictive strengths of different obesity indicators to hypertension. METHODS AND RESULTS Data in this study were obtained from the Chinese National Stroke Prevention Project with a nationally representative sample of Chinese aged 40 years and older. A total of 162,880 individuals were included. Multi-level analyses and Receiver Operating Characteristic (ROC) curves were used to examine the risk of hypertension in relation to different obesity parameters, including body mass index (BMI), waist circumference (WC), lipid accumulation product index (LAP), visceral adiposity index (VAI), and body adiposity index (BAI). As results, the BMI, WC, LAP, VAI, and BAI were positively associated with the risk of hypertension (P < 0.001). In total, BMI had the strongest association with hypertension when compared with other obesity indicators, and one SD up of BMI would increase the risk of hypertension by 53.9% (95% CI: 1.514-1.566). For men, WC was most associated with hypertension, and one SD up of WC would increase the risk of hypertension by 73.3% (95% CI: 1.685-1.782). For women, BMI showed the strongest predictive power, one SD up of BMI would increase the risk of hypertension by 51.0% (95% CI: 1.479-1.543). CONCLUSIONS BMI, WC, LAP, VAI, and BAI are all positively corrected to hypertension, but gender disparities should be considered in predicting hypertension by obesity indicators.
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Affiliation(s)
- Chao Wang
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Wenning Fu
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Shiyi Cao
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Hongbin Xu
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Qingfeng Tian
- College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Yong Gan
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yingying Guo
- Children's Healthcare Department, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Shijiao Yan
- School of International Education, Hainan Medical University, Haikou, China
| | - Feng Yan
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Wei Yue
- Neurology Department, Tianjin Huanhu Hospital, Tianjin, China
| | - Chuanzhu Lv
- Emergency and Trauma College, Hainan Medical University, Haikou, China; Department of Emergency, The Second Affiliated Hospital of Hainan Medical University, Haikou, China.
| | - Zuxun Lu
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
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Zhang W, He K, Zhao H, Hu X, Yin C, Zhao X, Shi S. Association of body mass index and waist circumference with high blood pressure in older adults. BMC Geriatr 2021; 21:260. [PMID: 33874889 PMCID: PMC8056549 DOI: 10.1186/s12877-021-02154-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Accepted: 03/15/2021] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND The relationship between obesity and prevalent high blood pressure in older adults has predominantly been estimated using categorical measures of body mass index (BMI) and waist circumference (WC), masking the shape of the dose-response relationship. We aimed to examine the precise relationship of BMI, WC with high blood pressure and to assess the appropriate level of BMI and WC for high blood pressure. METHODS We examined data for 126,123 individuals in Xinzheng city aged ≥60 years from a population based study from January to December 2019. Logistic regression and restricted cubic spline models were applied to assess the relationship and the appropriate level of BMI and WC for high blood pressure. An additive interaction analysis was used to test synergistic effects between a higher BMI and WC for high blood pressure. RESULTS The full-adjusted odds ratios (ORs) with 95% confidence intervals (CIs) of an increase of 1 kg/m2 in BMI and 1 cm in WC for high blood pressure were 1.084 (1.080-1.087) and 1.026(1.024-1.027), respectively. Multivariable adjusted restricted cubic spline analyses showed the nonlinear relationships of BMI and WC with high blood pressure in both men and women (all P < 0.001). The risk of high blood pressure increased steeply with increasing BMI from ≥25 kg/m2 and WC ≥ 88 cm or 86 cm for males and females, respectively. And we observed a significant additive interaction between a higher BMI and WC such that the prevalence of high blood pressure was significantly enhanced. CONCLUSION These findings suggest increased high blood pressure prevalence in the older adults with increased BMI and WC. BMI ≤ 25 kg/m2 and WC ≤ 88 cm or 86 cm for males and females may be the best suggestion with regard to primary prevention of high blood pressure in older adults.
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Affiliation(s)
- Wenli Zhang
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Songhe Shi, 100 Kexue Avenue, Zhengzhou, Henan, 450001, People's Republic of China
| | - Kun He
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Songhe Shi, 100 Kexue Avenue, Zhengzhou, Henan, 450001, People's Republic of China
| | - Hao Zhao
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Songhe Shi, 100 Kexue Avenue, Zhengzhou, Henan, 450001, People's Republic of China
| | - Xueqi Hu
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Songhe Shi, 100 Kexue Avenue, Zhengzhou, Henan, 450001, People's Republic of China
| | - Chunyu Yin
- Department of Neurology, Chinese People's Liberation Army General Hospital, Beijing, People's Republic of China
| | - Xiaoyan Zhao
- Department of Neurology, Chinese People's Liberation Army General Hospital, Beijing, People's Republic of China
| | - Songhe Shi
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Songhe Shi, 100 Kexue Avenue, Zhengzhou, Henan, 450001, People's Republic of China.
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Blood pressure and resting heart rate in 3-17-year-olds in Germany in 2003-2006 and 2014-2017. J Hum Hypertens 2021; 36:544-553. [PMID: 33854175 PMCID: PMC9225953 DOI: 10.1038/s41371-021-00535-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 03/12/2021] [Accepted: 03/29/2021] [Indexed: 11/22/2022]
Abstract
To track blood pressure (BP) and resting heart rate (RHR) in children and adolescents is important due to its associations with cardiovascular outcomes in the adulthood. Therefore, the aim of this study was to examine BP and RHR over a decade among children and adolescents living in Germany using national examination data. Cross-sectional data from 3- to 17-year-old national survey participants (KiGGS 2003–06, n = 14,701; KiGGS 2014–17, n = 3509) including standardized oscillometric BP and RHR were used for age- and sex-standardized analysis. Measurement protocols were identical with the exception of the cuff selection rule, which was accounted for in the analyses. Different BP and RHR trends were observed according to age-groups. In 3- to 6-year-olds adjusted mean SBP and DBP were significantly higher in 2014–2017 compared to 2003–2006 (+2.4 and +1.9 mm Hg, respectively), while RHR was statistically significantly lower by −3.8 bpm. No significant changes in BP or in RHR were observed in 7- to 10-year-olds over time. In 11- to 13-year-olds as well as in 14- to 17-year-olds lower BP has been observed (SBP −2.4 and −3.2 mm Hg, respectively, and DBP −1.8 and −1.7 mm Hg), while RHR was significantly higher (+2.7 and +3.7 bpm). BP trends did not parallel RHR trends. The downward BP trend in adolescents seemed to follow decreasing adult BP trends in middle and high-income countries. The increase in BP in younger children needs confirmation from other studies as well as further investigation. In school-aged children and adolescents, the increased RHR trend may indicate decreased physical fitness.
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Yuan Y, Mu JJ, Chu C, Zheng WL, Wang Y, Hu JW, Ma Q, Wang KK, Yan Y, Liao YY, Chen C. Predictive Role of Child-To-Adult Blood Pressure Trajectories for Incident Metabolic Syndrome: 30-Year Hanzhong Adolescent Hypertension Study. Endocr Pract 2020; 27:433-442. [PMID: 33840450 DOI: 10.1016/j.eprac.2020.09.010] [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: 02/26/2020] [Revised: 08/06/2020] [Accepted: 09/04/2020] [Indexed: 11/17/2022]
Abstract
OBJECTIVE The relationship between child-to-adult blood pressure (BP) trajectories and metabolic syndrome (MetS) is unknown. We aimed to determine the predictive role of BP trajectories for incident MetS and its components. METHODS The prospective Hanzhong Adolescent Hypertension study began in 1987 and included 2692 participants free of MetS at baseline with at least 3 BP measurements available from 1987 to 2017. RESULTS The systolic BP (SBP) trajectory patterns were grouped as normal (class 1, 18.7%), high normal (class 2, 60.3%), prehypertensive (class 3, 13.1%), stage 1 hypertensive (class 4, 5.7%), and stage 2 hypertensive (class 5, 2.2%). Compared with those in the normal group, individuals in classes 2 to 5 had significantly higher risks of MetS (all Ps < .05), and those with hypertension had more than an 8-fold higher risk of MetS (both P < .05). The fully adjusted risk ratios (RRs) of central obesity increased significantly in a stepwise manner as the SBP trajectory group increased from class 1 to class 5 (P < .05). Compared with those with a normal SBP trajectory, participants in the prehypertensive group and stage 1 and stage 2 hypertensive groups had significantly higher RRs for high-risk triglycerides after full adjustment (RR = 1.89 [1.22-2.94]; RR = 3.61 [2.16-6.02]; and RR = 3.22 [1.52-6.84], respectively). CONCLUSION Our study suggests that BP trajectories are predictive of incident MetS outcomes. Early detection of hypertension or modest elevations in BP is crucial. The stage of hypertension based on SBP level showed a greater association with central obesity.
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Affiliation(s)
- Yue Yuan
- Department of Cardiovascular Medicine, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China; Key Laboratory of Molecular Cardiology of Shaanxi Province, Xi'an, China
| | - Jian-Jun Mu
- Department of Cardiovascular Medicine, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China; Key Laboratory of Molecular Cardiology of Shaanxi Province, Xi'an, China.
| | - Chao Chu
- Department of Cardiovascular Medicine, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China; Key Laboratory of Molecular Cardiology of Shaanxi Province, Xi'an, China
| | - Wen-Ling Zheng
- Department of Cardiovascular Medicine, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China; Key Laboratory of Molecular Cardiology of Shaanxi Province, Xi'an, China
| | - Yang Wang
- Department of Cardiovascular Medicine, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China; Key Laboratory of Molecular Cardiology of Shaanxi Province, Xi'an, China
| | - Jia-Wen Hu
- Department of Cardiovascular Medicine, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China; Key Laboratory of Molecular Cardiology of Shaanxi Province, Xi'an, China
| | - Qiong Ma
- Department of Cardiovascular Medicine, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China; Key Laboratory of Molecular Cardiology of Shaanxi Province, Xi'an, China
| | - Ke-Ke Wang
- Department of Cardiovascular Medicine, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China; Key Laboratory of Molecular Cardiology of Shaanxi Province, Xi'an, China
| | - Yu Yan
- Department of Cardiovascular Medicine, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China; Key Laboratory of Molecular Cardiology of Shaanxi Province, Xi'an, China
| | - Yue-Yuan Liao
- Department of Cardiovascular Medicine, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China; Key Laboratory of Molecular Cardiology of Shaanxi Province, Xi'an, China
| | - Chen Chen
- Department of Cardiovascular Medicine, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China; Key Laboratory of Molecular Cardiology of Shaanxi Province, Xi'an, China
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Oliveras A. Prognostic value of adiposity indices for hypertension. J Clin Hypertens (Greenwich) 2019; 21:1505-1506. [PMID: 31498538 DOI: 10.1111/jch.13668] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Accepted: 08/03/2019] [Indexed: 11/29/2022]
Affiliation(s)
- Anna Oliveras
- Hypertension Unit, Nephrology Department, Hospital Universitari del Mar, Barcelona, Spain.,IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.,Universitat Autònoma de Barcelona, Barcelona, Spain
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12
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Xu R, Zhang X, Zhou Y, Wan Y, Gao X. Parental overweight and hypertension are associated with their children's blood pressure. Nutr Metab (Lond) 2019; 16:35. [PMID: 31149019 PMCID: PMC6537379 DOI: 10.1186/s12986-019-0357-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Accepted: 05/01/2019] [Indexed: 01/01/2023] Open
Abstract
Background We evaluated the association between parental factors (overweight, history of hypertension, and education level) and children’s blood pressure status. Further, we evaluated to what extent the potential association could be interpreted by children’s adiposity indices. Methods The current study included 3316 Chinese school students (1579 girls and 1737 boys, aged 6–14 years) and their parents. Parents reported information on their height, body weight, history of hypertension, and the highest education level. Trained medical staff measured children’s blood pressure, height, body weight, waist circumference (WC), and percentage of body fat (PBF, assessed by bio-impedance method). Z-score of all three indices were calculated and used in the analysis. We used generalized linear model to evaluate the association between parental information and z-score of children’s blood pressure. Meditation analysis was used to evaluate the proportion contributed by z-score of children’s adiposity indices (BMI, WC, and PBF). Results We found that parental overweight and hypertension, but not parental education level, were significantly associated with children’s systolic and diastolic blood pressure (P < 0.05 for all). Approximately 30.4–92.2% of the association between these two parental factors and children’s systolic blood pressure were mediated by children’s adiposity indices, and 22.3–55.6% for children’s diastolic blood pressure. The strongest meditative factor, among the three obesity indices, was children’s BMI z-score. Conclusions The association between parental factors and children’s blood pressure was mainly mediated by children’s adiposity indices. Electronic supplementary material The online version of this article (10.1186/s12986-019-0357-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Renying Xu
- 1Department of Clinical Nutrition, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Xiaomin Zhang
- 1Department of Clinical Nutrition, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yiquan Zhou
- 1Department of Clinical Nutrition, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yanping Wan
- 1Department of Clinical Nutrition, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Xiang Gao
- 2Department of Nutritional Science, The Pennsylvania State University, University Park, PA 16802 USA
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Xu RY, Zhou YQ, Zhang XM, Wan YP, Gao X. A two-year study of parental obesity status and childhood obesity in China. Nutr Metab Cardiovasc Dis 2019; 29:260-267. [PMID: 30642789 DOI: 10.1016/j.numecd.2018.11.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Revised: 11/13/2018] [Accepted: 11/14/2018] [Indexed: 11/15/2022]
Abstract
BACKGROUND AND AIMS We evaluated the association between parental obesity and their children's obesity parameters [e.g., percentage of body fat (PBF)] over time. METHODS AND RESULTS The study included 2066 Chinese parents-children trios (n = 1001 girls and 1065 boys, aged 6-14 years). Children's height, weight, waist circumference (WC) and PBF (bioelectrical impedance analysis) were annually assessed from 2014 (baseline) to 2016. Information on parental height and body weight, and children's diet and physical activity was collected in 2014. The association between parental obesity and changes in their children's PBF during follow-up was analyzed using a mixed effects model. We also examined changes in children's BMI and WC in secondary analyses. Baseline mean BMI, WC, and PBF for children were 17.6 ± 3.5 kg/m2, 60.5 ± 9.6 cm, and 16.6 ± 6.5%, respectively. We observed that maternal, but not paternal, obesity was associated with a greater increase in children's PBF during the follow-up. An adjusted mean difference in annual increase of PBF was 0.41% [95% confidence interval (CI): 0.01%, 0.84%] for children with obese mothers, compared with those with normal-weight mothers. Both maternal and paternal obesity was associated with a greater increase in their children's BMI and WC (p trend<0.01 for both); however, the associations were stronger in mother-children pairs than those in father-children pairs. CONCLUSIONS Maternal obesity was associated with a greater increase in PBF in Chinese school-aged children.
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Affiliation(s)
- R Y Xu
- Department of Clinical Nutrition, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China; Shanghai Key Laboratory of Pediatric Gastroenterology and Nutrition, China
| | - Y Q Zhou
- Department of Clinical Nutrition, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - X M Zhang
- Department of Clinical Nutrition, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Y P Wan
- Department of Clinical Nutrition, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China; Shanghai Key Laboratory of Pediatric Gastroenterology and Nutrition, China.
| | - X Gao
- Department of Nutritional Sciences, The Pennsylvania State University, University Park, PA, USA.
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Manios Y, Karatzi K, Moschonis G, Ioannou G, Androutsos O, Lionis C, Chrousos G. Lifestyle, anthropometric, socio-demographic and perinatal correlates of early adolescence hypertension: The Healthy Growth Study. Nutr Metab Cardiovasc Dis 2019; 29:159-169. [PMID: 30660688 DOI: 10.1016/j.numecd.2018.10.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Revised: 10/12/2018] [Accepted: 10/15/2018] [Indexed: 12/24/2022]
Abstract
BACKGROUND AND AIMS Various lifestyle, anthropometric, socio-demographic and perinatal characteristics have been separately associated with elevated blood pressure in children and adolescents. The aim of this study was to simultaneously evaluate all potential risk factors and to identify the most dominant correlates of early adolescence hypertension in a large group of school children 9-13 years old. METHODS AND RESULTS A cross-sectional study with 1444 schoolchildren 9-13 years old, having full data on lifestyle, anthropometric, socio-demographic and perinatal indices, as well as blood pressure measurements. Early adolescents born large for their gestational age (LGA) (OR, 95% C.I. 0.49 (0.25-0.97)), those with higher levels of moderate to vigorous physical activity (MVPA) (OR, 95% C.I. 0.71 (0.53-0.96)) and those of a higher socioeconomic status (SES) (OR, 95% C.I. 0.51 (0.33-0.79)), had lower risk of hypertension, compared with their counterparts with appropriate birth weight, low levels of PA and with low SES respectively, independently of the variables used in the multivariate model. On the other hand, overweight and obese early adolescents (OR, 95% C.I. 2.61 (1.88-3.62)), those with central obesity (OR, 95% C.I. 1.75 (1.12-2.73)) and those having a hypertensive father (OR, 95% C.I. 1.93 (1.20-3.12)) had higher risk of hypertension compared with normal weight early adolescents and those without a family history of hypertension. CONCLUSIONS Among the parameters examined, early adolescence abnormal body weight and central obesity, low PA, non LGA, low SES family and family history of hypertension were found to be independently associated with higher risk of hypertension. The identified correlates of early adolescence hypertension can be used by public health initiatives for early detection and management of this major public health problem, prioritizing early adolescents and families at the highest possible risk for hypertension.
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Affiliation(s)
- Y Manios
- Department of Nutrition and Dietetics, School of Health Science & Education, Harokopio University of Athens, Greece.
| | - K Karatzi
- Department of Nutrition and Dietetics, School of Health Science & Education, Harokopio University of Athens, Greece
| | - G Moschonis
- Department of Rehabilitation, Nutrition and Sport, College of Science, Health and Engineering, La Trobe University, Bundoora, VIC 3086, Melbourne, Australia
| | - G Ioannou
- Department of Nutrition and Dietetics, School of Health Science & Education, Harokopio University of Athens, Greece
| | - O Androutsos
- Department of Nutrition and Dietetics, School of Health Science & Education, Harokopio University of Athens, Greece
| | - C Lionis
- Clinic of Social and Family Medicine, School of Medicine, University of Crete, Heraklion, Crete, Greece
| | - G Chrousos
- First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, "Aghia Sophia" Children's Hospital, Athens, Greece
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