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Das M, Verma M, Shri N, Singh M, Singh RR. Relationship between height and hypertension among women in India: Evidence from the fourth round of National Family Health Survey. Diabetes Metab Syndr 2022; 16:102384. [PMID: 35016040 DOI: 10.1016/j.dsx.2021.102384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 12/27/2021] [Accepted: 12/29/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND AND AIMS Hypertension (HTN) is associated with significant morbidity and mortality, especially among women. Literature suggests an association between height and hypertension. We did this study to ascertain an association between hypertension and height and explore their determinants among Indian women of reproductive age group (15-49 years). METHODS We did a secondary data analysis of the National Family Health Survey-4 (2015-16) and included 5,36,093 women between 20 and 49 years. Blood pressure and height were measured using the standard procedures. Weighted analysis was done to depict the association between the two variables. RESULTS Overall prevalence of HTN was 13.49%. We observed an inverse association between height and mean blood pressure of the women, and shorter women had a higher prevalence of HTN. The height of women was found to be associated with lower systolic blood pressure but not with diastolic blood pressure. Women's height depicted significant associations with age and other socio-economic and geographical parameters. Prevalence of HTN depicted a significant association with height and across other subgroups stratified by these parameters. CONCLUSION We observed a positive association between the systolic BP and the height of the female. Height is one of the most convenient forms of identifying target groups that should not be missed during screening women for NCDs, especially during pregnancy to prevent premature morbidity and mortality. We recommend disseminating this concept to our primary health care workers, who are also the point of first contact for early screening and halt the burden of disease.
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Affiliation(s)
- Milan Das
- Department of Population and Development, International Institute for Population Sciences, Mumbai, India.
| | - Madhur Verma
- Department of Community & Family Medicine, All India Institute of Medical Sciences, Bathinda, Punjab, 151001, India.
| | - Neha Shri
- Department of Survey Research and Data Analytics, International Institute for Population Sciences (IIPS), Mumbai, India.
| | - Mayank Singh
- Department of Fertility and Social Demography, International Institute for Population Sciences (IIPS), Mumbai, India.
| | - Rajeev Ranjan Singh
- Department of Population and Development, International Institute for Population Sciences, Mumbai, India.
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Cochran JM, Siebert VR, Bates J, Butulija D, Kolpakchi A, Kadiyala H, Taylor A, Jneid H. The Relationship between Adult Height and Blood Pressure. Cardiology 2021; 146:345-350. [PMID: 33721862 DOI: 10.1159/000514205] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Accepted: 12/17/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND Identification and modification of cardiovascular risk factors is paramount to reducing cardiovascular disease morbidity and mortality. Hypertension is a major risk factor for cardiovascular disease, but its association with height remains largely underrecognized. OBJECTIVES The objective of this manuscript is to review the evidence examining the association between blood pressure and human stature and to summarize the plausible pathophysiological mechanisms behind such an association. METHODS A systematic review of adult human height and its association with hypertension and coronary artery disease was undertaken. The literature evidence is summarized and tabulated, and an overview of the pathophysiological basis for this association is presented. RESULTS Shorter arterial lengths found in shorter individuals may predispose to hypertension in a complex hemodynamic interplay, which is explained predominantly by summated arterial wave reflections and an elevated augmentation index. Our systemic review suggests that an inverse relationship between adult height and blood pressure exists. However, differences in the studied populations and heterogeneity in the methods applied across the various studies limit the generalizability of these findings and their clinical application. CONCLUSION Physiological studies and epidemiological data suggest a potential inverse association between adult height and blood pressure. Further research is required to define the relationship more clearly between adult height and blood pressure and to assess whether antihypertensive therapeutic approaches and goals should be modified according to patients' heights.
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Affiliation(s)
- John Michael Cochran
- Department of Internal Medicine, Baylor College of Medicine and the Michael E DeBakey VA Medical Center, Houston, Texas, USA.,Department of Cardiology, Baylor University Medical Center, Dallas, Texas, USA
| | - Vincent R Siebert
- Department of Internal Medicine, Baylor College of Medicine and the Michael E DeBakey VA Medical Center, Houston, Texas, USA.,Department of Cardiology, Loyola University Medical Center, Chicago, Illinois, USA
| | - Jeffrey Bates
- Department of Internal Medicine, Baylor College of Medicine and the Michael E DeBakey VA Medical Center, Houston, Texas, USA
| | - Djenita Butulija
- Department of Internal Medicine, Baylor College of Medicine and the Michael E DeBakey VA Medical Center, Houston, Texas, USA
| | - Anna Kolpakchi
- Department of Internal Medicine, Baylor College of Medicine and the Michael E DeBakey VA Medical Center, Houston, Texas, USA
| | - Himabindu Kadiyala
- Department of Internal Medicine, Baylor College of Medicine and the Michael E DeBakey VA Medical Center, Houston, Texas, USA
| | - Addison Taylor
- Department of Internal Medicine, Baylor College of Medicine and the Michael E DeBakey VA Medical Center, Houston, Texas, USA
| | - Hani Jneid
- Section of Cardiology, Baylor College of Medicine and the Michael E DeBakey VA Medical Center, Houston, Texas, USA,
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Association between height and hypertension among US adults: analyses of National Health and Nutrition Examination Survey 2007-18. Clin Hypertens 2021; 27:6. [PMID: 33637121 PMCID: PMC7908753 DOI: 10.1186/s40885-021-00164-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 02/08/2021] [Indexed: 11/30/2022] Open
Abstract
Background Previous studies that investigated association of height with prevalence and control of hypertension found mixed results. This cross-sectional study explored these associations among US adults (≥20 years). Methods The National Health and Nutrition Examination Survey (NHANES) 2007–18 data was analyzed. Height was measured in meters and was converted into centimeters (cm) and was further divided into quartiles: Q1 (135.3–159.2 cm), Q2 (159.3–166.2 cm), Q3 (166.3–173.6 cm), Q4 (173.7–204.5 cm). Hypertension definition of the ‘2017 American College of Cardiology/American Heart Association Guideline’ was used. Logistic regression analyses were conducted to find out the association between the dependent variable and the covariates. Linear regression analyses were conducted to find out the association of height with systolic blood pressure (SBP), diastolic blood pressure (DBP), pulse pressure (PP), and the covariates among the individuals who were not taking any antihypertensive drugs. Crude odds ratio, adjusted odds ratio (AOR), and adjusted beta-coefficient (for linear regression) with 95% confidence interval (CI) were reported. The following covariates were included: age, gender, race/ethnicity, family income, education level, cholesterol level, high-density lipoprotein level, chronic kidney disease status, diabetes status, smoker, aerobic leisure-time physical activity, and survey period. Sample weight of NHANES was adjusted. Results Among the 21,935 participants (47.1% males), the prevalence of hypertension was 46.1%. Among 6154 participants taking medication (43.0% males), 57.2% had uncontrolled hypertension. In the final logistic regression analyses, participants in Q2 height quartile had 20% lower odds of being hypertensive compared to those in Q4 height quartile (AOR: 0.8; 95% CI: 0.7,1.0). Other height categories did not reveal any significant association. Compared to Q4 height category, Q1 (AOR: 1.7; 95% CI: 1.2,2.3), Q2 (AOR: 1.4; 95% CI: 1.1,1.8), and Q3 (AOR: 1.3; 95% CI: 1.1,1.6) height categories had higher odds of uncontrolled hypertension. PP was inversely associated and DBP was positively associated with height. Conclusions Although height was not associated with prevalence of hypertension, it had inverse association with uncontrolled hypertension. It was also significantly associated with DBP and PP among the individuals with untreated hypertension. Supplementary Information The online version contains supplementary material available at 10.1186/s40885-021-00164-4.
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Islam MT, Siraj MS, Hassan MZ, Nayem M, Chandra Nag D, Islam MA, Islam R, Mazumder T, Choudhury SR, Siddiquee AT. Influence of height on blood pressure and hypertension among Bangladeshi adults. INTERNATIONAL JOURNAL CARDIOLOGY HYPERTENSION 2021; 5:100028. [PMID: 33447757 PMCID: PMC7803027 DOI: 10.1016/j.ijchy.2020.100028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Revised: 03/16/2020] [Accepted: 04/07/2020] [Indexed: 12/30/2022]
Abstract
Background Recent studies have reported that height is inversely associated with blood pressure and hypertension. However, there is lack of comprehensive findings from Bangladesh in this regard. Objective The purpose of this study was to explore the association between height and blood pressure in a Bangladeshi population. Setting Rural and urban sites from seven divisions of Bangladesh. Participants Participants were 7932 males and females (aged ≥35 years) evaluated in the 2011 Bangladesh Demographic Health Survey. Participants (n = 7647) who had complete height, weight, systolic and diastolic blood pressure (SBP and DBP) measurements and non-missing medication history, were included in the analysis. Methods Hypertension was defined as an SBP over 140 mmHg or/and a DBP over 90 mmHg, or current use of antihypertensive medication. Difference between SBP and DBP was calculated to get pulse pressure (PP). Multivariate linear and logistic regression models were used. Results PP decreased linearly with increasing height among males (−0.11, P < 0.05) and females (−0.19, P < 0.05) after adjusting for age, BMI, living region, type of occupation, wealth index, and highest level of education. SBP decreased linearly with increasing height among only females (−0.14, P < 0.05), after adjusting for age, BMI, living region, type of occupation, wealth index, and highest level of education. No association was found between quartiles of height and prevalence of hypertension. Conclusions Height was found to be inversely associated with pulse pressure in both sexes. Studies with longitudinal design are needed to investigate the association between shortness with blood pressure and hypertension.
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Affiliation(s)
| | | | | | | | | | | | | | - Tapas Mazumder
- International Centre for Diarrheal Disease Research, Bangladesh
| | | | - Ali Tanweer Siddiquee
- International Centre for Diarrheal Disease Research, Bangladesh.,Shiga University of Medical Science, Otsu, Japan
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Kumaran K, Joshi SM, Di Gravio C, Lubree H, Joglekar C, Bhat D, Kinare A, Bavdekar A, Bhave S, Pandit A, Osmond C, Yajnik C, Fall C. Do components of adult height predict body composition and cardiometabolic risk in a young adult South Asian Indian population? Findings from a hospital-based cohort study in Pune, India: Pune Children's Study. BMJ Open 2020; 10:e036897. [PMID: 33033015 PMCID: PMC7542941 DOI: 10.1136/bmjopen-2020-036897] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES We investigated whether the relationship between components of height and cardiovascular disease (CVD) risk may be explained by body composition. We also examined relationships between parental heights and offspring CVD risk. DESIGN A cohort study using cross-sectional data. SETTING A secondary care hospital setting in Pune, India. PARTICIPANTS We studied 357 young adults and their parents in the Pune Children's Study. Primary and secondary outcomes: we measured weight, total height, leg length, sitting height, plasma glucose, insulin and lipids, and blood pressure (BP). Total and regional lean and fat mass were measured by dual X-ray absorptiometry. RESULTS Leg length was inversely related, and sitting height was directly related to BMI. Total height and leg length were directly related to lean mass, while sitting height was directly related to both lean and fat mass. Leg length was inversely related to systolic BP and 120 min glucose, independent of lean and fat mass. Sitting height was directly related to systolic BP and triglycerides; these relationships were attenuated on adjustment for lean and fat mass. When examined simultaneously, greater leg length was protective and greater sitting height was associated with a more detrimental CVD risk profile. CONCLUSIONS Shorter adult leg length and greater sitting height are associated with a more adverse CVD risk factor profile. The mechanisms need further study, but our findings suggest a role for lean and fat mass.
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Affiliation(s)
- Kalyanaraman Kumaran
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, Hampshire, UK
- Epidemiology Research Unit, CSI Holdsworth Memorial Hospital, Mysore, Karnataka, India
| | - Suyog M Joshi
- Diabetes Unit, KEM Hospital Research Centre, Pune, Maharashtra, India
| | - Chiara Di Gravio
- Department of Biostatistics, Vanderbilt University, Nashville, Tennessee, USA
| | - Himangi Lubree
- Vadu Rural Health Centre, KEM Hospital Research Centre, Pune, Maharashtra, India
| | - Charudatta Joglekar
- Department of Statistics, BKL Walawalkar Hospital and Diagnostic Centre, Ratnagiri, Maharashtra, India
| | - Dattatray Bhat
- Diabetes Unit, KEM Hospital Research Centre, Pune, Maharashtra, India
| | - Arun Kinare
- Department of Radiodiagnosis, Bharati Medical College and Hospital, Bharati Vidyapeeth, Pune, Maharashtra, India
| | - Ashish Bavdekar
- Department of Paediatrics, KEM Hospital, Pune, Maharashtra, India
| | - Sheila Bhave
- Department of Paediatrics, KEM Hospital, Pune, Maharashtra, India
| | - Anand Pandit
- Department of Paediatrics, KEM Hospital, Pune, Maharashtra, India
| | - Clive Osmond
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, Hampshire, UK
| | | | - Caroline Fall
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, Hampshire, UK
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Das Gupta R, Haider SS, Hashan MR, Rahman MA, Sarker M. Association between height and hypertension in the adult Nepalese population: Findings from a nationally representative survey. Health Sci Rep 2019; 2:e141. [PMID: 31890899 PMCID: PMC6920697 DOI: 10.1002/hsr2.141] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Revised: 09/27/2019] [Accepted: 10/07/2019] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND AND AIMS The burden of hypertension is increasing in Nepal. Different studies have evaluated the relationship between height and blood pressure in different regions, with mixed results. The relationship between height and hypertension has not yet been explored in the Nepalese context. Given this knowledge gap, this study aims to determine the relationship between height and hypertension among Nepalese adults (aged ≥18 years). METHODS This study utilized the dataset from the Nepal Demographic and Health Survey (NDHS) 2016. Hypertension was defined as systolic blood pressure ≥ 140 mmHg and/or a diastolic blood pressure ≥ 90 mmHg. Height, measured in centimeters (cm), was analyzed as a continuous variable. Based on previous evidence, the following covariates were considered: age, sex, presence of overweight or obesity, educational status, household wealth status, and place, province, and ecological zone of residence. Multilevel multivariable logistic regression was done to evaluate the association between height and hypertension. Both crude odds ratio (COR) and adjusted odds ratio (AOR) are reported, along with a 95% confidence interval (CI). Sample weight of NDHS was adjusted during analysis. RESULTS Among 13 393 weighted individuals over the age of 18 years, the prevalence of hypertension in Nepal was found to be 21.1% (95% CI, 19.9%-22.4%). In the final multivariable model, after adjusting for relevant covariates, it was found that height was inversely associated with hypertension. For a Nepalese adult, the odds of hypertension decreased by 10% with each 10-cm increase in height (AOR 0.9; 95% CI 0.8-0.9; P = 0.003). CONCLUSION Awareness should be raised among people with low stature for prevention of hypertension. Longitudinal studies are recommended to include genetic and social/environmental determinants of stature in the analyses.
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Affiliation(s)
- Rajat Das Gupta
- Centre of Excellence for Non‐Communicable Diseases and Nutrition, BRAC James P Grant School of Public HealthBRAC UniversityDhakaBangladesh
- Centre of Excellence for Science of Implementation and Scale‐Up, BRAC James P Grant School of Public HealthBRAC UniversityDhakaBangladesh
- Department of Epidemiology and Biostatistics, Arnold School of Public HealthUniversity of South CarolinaColumbiaSouth CarolinaUnited States of America
| | - Shams Shabab Haider
- Centre of Excellence for Science of Implementation and Scale‐Up, BRAC James P Grant School of Public HealthBRAC UniversityDhakaBangladesh
| | - Mohammad Rashidul Hashan
- Infectious Diseases DivisionInternational Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b)DhakaBangladesh
| | - Muhammad Aziz Rahman
- School of Nursing and Healthcare ProfessionsFederation UniversityVictoriaAustralia
- School of Nursing and MidwiferyLa Trobe UniversityHeidelbergAustralia
| | - Malabika Sarker
- Centre of Excellence for Non‐Communicable Diseases and Nutrition, BRAC James P Grant School of Public HealthBRAC UniversityDhakaBangladesh
- Centre of Excellence for Science of Implementation and Scale‐Up, BRAC James P Grant School of Public HealthBRAC UniversityDhakaBangladesh
- Institute of Public HealthHeidelberg UniversityHeidelbergGermany
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Castro-Porras LV, Rojas-Russell ME, Aedo-Santos Á, Wynne-Bannister EG, López-Cervantes M. Stature in adults as an indicator of socioeconomic inequalities in Mexico. Rev Panam Salud Publica 2018; 42:e29. [PMID: 31093058 PMCID: PMC6386041 DOI: 10.26633/rpsp.2018.29] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2017] [Accepted: 09/08/2017] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVE To estimate the association between stature in Mexican adults and some sociodemographic factors. METHODS We studied a sample of 30 970 subjects, using anthropometric data from the 2012 National Health and Nutrition Survey (ENSANUT 2012). The first quartile was used as the cutoff to define short stature. We analyzed differences among stature strata for sociodemographic variables by using the Kruskal-Wallis test. We estimated odds ratios to measure the association between stature and sociodemographic variables, controlling for potential confounders. RESULTS Persons from the southern region of the country were some three times as likely to be of short stature than were subjects in the northern region. The stature difference between the Mexican states with the highest and the lowest average stature was larger than the average difference in stature between Mexico and the United States of America. Adults who had had less than six years of schooling presented the highest prevalence of short stature, regardless of sex, region of the country, place of residence (rural or urban), or the proportion of indigenous language speakers in a state. In addition, the stratum with the highest marginalization (percentage of the population lacking education and services, with a low income, and living in a small community) showed the highest prevalence of short stature. CONCLUSION In Mexico, adults who are of short stature have unequal living conditions when compared to those of average or high stature, and this could drive increases in health inequity.
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Affiliation(s)
| | - Mario E. Rojas-Russell
- Facultad de Estudios Superiores Zaragoza, Universidad Nacional Autónoma de México, Ciudad de México, México
| | - Ángeles Aedo-Santos
- Facultad de Medicina, Universidad Nacional Autónoma de México, Ciudad de México, México
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Lao TT, Hui ASY, Sahota DS, Leung TY. Maternal height and risk of hypertensive disorders in pregnancy. J Matern Fetal Neonatal Med 2017; 32:1420-1425. [PMID: 29179584 DOI: 10.1080/14767058.2017.1410786] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
PURPOSE The relationship between maternal height and gestational hypertensive disorders was examined in a cohort of Chinese gravidae managed in 1997-2013 to clarify the association between short stature with preeclampsia (PE) and gestational hypertension (GH). MATERIALS AND METHODS Retrospective study of 87 290 gravidae categorized by their height into four quartile groups. The impact of short stature, defined as height in the lowest quartile, on incidence of PE and GH was studied in relation to the presence of risk factors. The independent role of short stature was determined by regression analysis. RESULTS The 25th, 50th, and 75th percentile values of height were 154 cm, 158 cm, and 161 cm respectively. The incidence of PE, but not GH, was inversely correlated with height (p = .025). Short stature altered the impact of parity status, advanced age, high body mass index, infant gender, and medical history, on incidence of PE but not GH. On regression analysis, short stature increased risk of PE (adjusted RR 1.134, 95%CI 1.005-1.279) but reduced GH (adjusted RR 0.836, 95%CI 0.718-0.974). CONCLUSIONS Maternal short stature should be defined according to distribution in a specific ethnic group, and it exerts a significant but opposite effect on the incidence of PE versus GH.
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Affiliation(s)
- Terence T Lao
- a Department of Obstetrics & Gynecology , The Chinese University of Hong Kong , Hong Kong SAR , People's Republic of China.,b Prince of Wales Hospital , Hong Kong SAR , People's Republic of China
| | - Annie S Y Hui
- a Department of Obstetrics & Gynecology , The Chinese University of Hong Kong , Hong Kong SAR , People's Republic of China.,b Prince of Wales Hospital , Hong Kong SAR , People's Republic of China
| | - Daljit S Sahota
- a Department of Obstetrics & Gynecology , The Chinese University of Hong Kong , Hong Kong SAR , People's Republic of China.,b Prince of Wales Hospital , Hong Kong SAR , People's Republic of China
| | - Tak-Yeung Leung
- a Department of Obstetrics & Gynecology , The Chinese University of Hong Kong , Hong Kong SAR , People's Republic of China.,b Prince of Wales Hospital , Hong Kong SAR , People's Republic of China
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Sohn K. The Association between Height and Hypertension in Indonesia. ECONOMICS AND HUMAN BIOLOGY 2017; 27:74-83. [PMID: 28550808 DOI: 10.1016/j.ehb.2017.04.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2016] [Revised: 03/28/2017] [Accepted: 04/19/2017] [Indexed: 06/07/2023]
Abstract
There is growing interest in the influence of early-life conditions on the development of disease. Among diseases in adulthood, hypertension is particularly important for the developing world because considerably more people there are and will be afflicted with the disease than in the developed world and hypertensives there are often unaware of their disease status. We employed height as a proxy for the influence of early-life conditions and estimated the relation between height and hypertension status in Indonesia. We analysed 9,597 men and 10,143 women, aged 25-70. We employed a linear probability model to relate height to hypertension status by sex and age. When we controlled for an array of covariates, a 10cm increase in height was related to an approximately 7% point reduction in the likelihood of being hypertensive for both men and women. This is about a quarter of the prevalence of hypertension in Indonesia. This relation was linear and stronger among older individuals. In addition, the pre- and post-pubertal environments (measured by leg and trunk lengths, respectively) contributed similarly to hypertension. Further evidence suggests that women are more likely to be hypertensive at older ages because they are on average shorter than men.
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Affiliation(s)
- Kitae Sohn
- Department of Economics, Konkuk University. 120 Neungdong-ro. Gwangjin-gu, Seoul, 05029, South Korea; School of Economics and Finance, Curtin University, GPO Box U1987, Perth, WA, 6845, Australia.
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Kwiatkowska E, Domański L, Bober J, Safranow K, Pawlik A, Ciechanowski K, Wiśniewska M, Kędzierska K. Clinical and Biochemical Characteristics of Brain-Dead Donors as Predictors of Early- and Long-Term Renal Function After Transplant. EXP CLIN TRANSPLANT 2017. [PMID: 28621640 DOI: 10.6002/ect.2016.0145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVES Organs from brain-dead donors are the main source of allografts for transplant. Comparisons between living-donor and brain-dead donor kidneys show that the latter are more likely to demonstrate delayed graft function and lower long-term survival. This study aimed to assess the effects of various clinical and biochemical factors of donors on early- and long-term renal function after transplant. MATERIALS AND METHODS We analyzed data from kidney recipients treated between 2006 and 2008 who received organs from brain-dead donors. Data from 54 donors and 89 recipients were analyzed. RESULTS No relation was observed between donor sodium concentration and the presence of delayed graft function. Donor height was positively correlated with creatinine clearance in recipients in the 1 to 3 months after renal transplant. Donor diastolic blood pressure was negatively correlated with estimated glomerular filtration rate throughout the observation period. Donor age was negatively correlated with the allograft recipient's estimated glomerular filtration rate throughout 4 years of observation. Donor estimated glomerular filtration rate was positively correlated with that of the recipient throughout 3 years of observation. CONCLUSIONS The results of this study indicate that various factors associated with allograft donors may influence graft function.
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Affiliation(s)
- Ewa Kwiatkowska
- From the Clinical Department of Nephrology, Transplantology and Internal Medicine, Pomeranian Medical University, Szczecin, Poland
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Height and prevalence of hypertension in a middle-aged and older Chinese population. Sci Rep 2016; 6:39480. [PMID: 28000763 PMCID: PMC5175189 DOI: 10.1038/srep39480] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Accepted: 11/23/2016] [Indexed: 11/09/2022] Open
Abstract
Evidence from epidemiological studies reported that height was inversely associated with cardiovascular diseases, but the association between height and hypertension was unclear. The purpose of this study was to explore the association between height and blood pressure or prevalence of hypertension in a middle-aged and older Chinese population. A total of 33,197 participants aged 37 to 94 years were recruited from the Dongfeng-Tongji cohort study in Hubei province, China. All participants completed baseline questionnaires, medical examinations and provided blood samples. Hypertension was define as a systolic blood pressure (SBP) over 140 mmHg or/and a diastolic blood pressure (DBP) over 90 mmHg, or current use of antihypertensive medication, or participants with self-reported physician diagnosis of hypertension. Multivariate linear and logistic regression models were used. The prevalence of hypertension was 69.1% for men and 58.0% for women. Pulse pressure (PP) and SBP, but not DBP decreased linearly with increasing height among men and women. Comparing the highest with the shortest quartile of height, the multivariate-adjusted odds ratios were 0.80 (95% confidence interval, 0.71, 0.91) for men and 0.83 (0.74, 0.92) for women. In conclusion, height was associated with reduced SBP, PP and prevalence of hypertension in a middle-aged and older Chinese population.
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Rodríguez López S, Bensenor IM, Giatti L, Molina MDC, Lotufo PA. Association between maternal education and blood pressure: mediation evidence through height components in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Ann Hum Biol 2016; 44:243-251. [DOI: 10.1080/03014460.2016.1188983] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Santiago Rodríguez López
- Center for Clinical and Epidemiologic Research, University of São Paulo, São Paulo, Brazil
- Research and Study Centre on Culture and Society, National Scientific and Technical Research Council (CIECS-CONICET-UNC), Córdoba, Argentina
- Department of Biology, Autonomous University of Madrid, Madrid, Spain
| | - Isabela M. Bensenor
- Center for Clinical and Epidemiologic Research, University of São Paulo, São Paulo, Brazil
- School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Luana Giatti
- School of Nutrition, Federal University of Ouro Preto, Ouro Preto, Brazil
| | | | - Paulo A. Lotufo
- Center for Clinical and Epidemiologic Research, University of São Paulo, São Paulo, Brazil
- School of Medicine, University of São Paulo, São Paulo, Brazil
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Abstract
An adverse intrauterine environment is associated with an increased risk of elevated blood pressure and kidney disease in later life. Many studies have focused on low birth weight, prematurity and growth restriction as surrogate markers of an adverse intrauterine environment; however, high birth weight, exposure to maternal diabetes and rapid growth during early childhood are also emerging as developmental risk factors for chronic diseases. Altered programming of nephron number is an important link between exposure to developmental stressors and subsequent risk of hypertension and kidney disease. Maternal, fetal, and childhood nutrition are crucial contributors to these programming effects. Resource-poor countries experience the sequential burdens of fetal and childhood undernutrition and subsequent overnutrition, which synergistically act to augment the effects of developmental programming; this observation might explain in part the disproportionate burden of chronic disease in these regions. Numerous nutritional interventions have been effective in reducing the short-term risk of low birth weight and prematurity. Understanding the potential long-term benefits of such interventions is crucial to inform policy decisions to interrupt the developmental programming cycle and stem the growing epidemics of hypertension and kidney disease worldwide.
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Hoque ME, Khokan MR, Bari W. "Impact of stature on non-communicable diseases: evidence based on Bangladesh Demographic and Health Survey, 2011 data". BMC Public Health 2014; 14:1007. [PMID: 25261299 PMCID: PMC4195861 DOI: 10.1186/1471-2458-14-1007] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2014] [Accepted: 09/16/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In this paper, an attempt has been made to explore the relationship between height and occurrence of the non-communicable diseases such as diabetes and hypertension. METHODS For the purpose of analysis, Bangladesh Demographic and Health Survey (BDHS), 2011 data was used. Bivariate analysis along with a Chi-square test was performed to examine association between height and diseases. To measure the impact of stature on diabetes and hypertension, three different logistic regression models (Model I: considering only quartiles of height, Model II: covariates of model I along with demographic variables and Model III: covariates of model II along with clinical variable) were considered. RESULTS Occurrence of diabetes and hypertension was found to be inversely related with the height of participants. This inverse association was statistically significant for all three models. After controlling the demographic and clinical variables simultaneously, the odds ratio for highest quartile compared to the lowest quartile was 0.82 with 95% confidence interval (0.69, 0.98) for diabetes; whereas it was 0.72 with 95% confidence interval (0.55, 0.95) for hypertension. CONCLUSIONS Findings of this paper indicate that persons with shorter stature are substantially more likely to develop diabetes as well as hypertension. The occurrence of non-communicable diseases like diabetes and hypertension can be reduced by controlling genetic and non-genetic (early-life and childhood) factors that may influence the height.
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Affiliation(s)
- Md Erfanul Hoque
- Department of Statistics, Biostatistics & Informatics, University of Dhaka, Dhaka, 1000, Bangladesh.
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Han TS, Conway GS, Willis DS, Krone N, Rees DA, Stimson RH, Arlt W, Walker BR, Ross RJ. Relationship between final height and health outcomes in adults with congenital adrenal hyperplasia: United Kingdom congenital adrenal hyperplasia adult study executive (CaHASE). J Clin Endocrinol Metab 2014; 99:E1547-55. [PMID: 24878054 DOI: 10.1210/jc.2014-1486] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
CONTEXT Treatment of congenital adrenal hyperplasia (CAH) in childhood focuses on growth and development and adult final height (FH) is a measure of effective treatment. We hypothesized that shorter adults will have more severe underlying disease and worse health outcomes. METHODS This was a cross-sectional analysis of 199 adults with CAH. FH and quality of life were expressed as z-scores adjusted for midparental target height or UK population height. RESULTS FH correlated inversely with age (men, r = -0.38; women, r = -0.26, P < .01). Men and women had z-scores adjusted for midparental target height of -2 and -1, respectively, and both groups had UK population height z-scores of -1 below the UK population (P < .01). In women, FH was shorter in non-salt-wasting than salt-wasting classic CAH (P < .05) and in moderately affected genotype group B women than either more severely affected groups null and A (P < .01) or the mildest group C (P < .001). Short stature and a higher prevalence of hypertension were observed in classic CAH patients diagnosed late (after 1 y) compared with those diagnosed early and in women treated with glucocorticoid only compared with those treated with both glucocorticoids and mineralocorticoids (P < .05). FH did not associate with insulin sensitivity, lipid profile, adiposity, or quality of life. CONCLUSIONS Adult CAH patients remain short, although height prognosis has improved over time. The shortest adults are those diagnosed late with moderate severity CAH and are at increased risk of adult hypertension; we hypothesize that these patients are exposed in childhood to high androgens and/or excessive glucocorticoids with potential programming of hypertension. Another possibility is inadequate mineralocorticoid treatment early in life in the late-diagnosed patient group. Prospective studies are now required to examine these hypotheses.
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Affiliation(s)
- T S Han
- Department of Endocrinology (T.S.H.), St Peter's National Health Service Foundation Trust, Surrey KT16 0PZ, United Kingdom; Department of Endocrinology (G.S.C.), University College London Hospitals, London W1T 3AA, United Kingdom; Society for Endocrinology (D.S.W.), Bristol BS32 4JT, United Kingdom; Centre for Endocrinology, Diabetes, and Metabolism (N.K., W.A.), School of Clinical and Experimental Medicine, University of Birmingham, Birmingham B15 2TT, United Kingdom; Centre for Endocrine and Diabetes Sciences (D.A.R.), Institute for Molecular and Experimental Medicine, Cardiff University, Cardiff CF10 3US, United Kingdom; Endocrinology Unit (R.H.S., B.R.W.), Centre for Cardiovascular Science, Queen's Medical Research Institute, University of Edinburgh, Edinburgh EH16 4SB, United Kingdom; and Academic Unit of Diabetes, Endocrinology, and Metabolism (R.J.R.), University of Sheffield, Sheffield S10 2HF, United Kingdom
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Tsuboi N, Kanzaki G, Koike K, Kawamura T, Ogura M, Yokoo T. Clinicopathological assessment of the nephron number. Clin Kidney J 2014; 7:107-14. [PMID: 25852857 PMCID: PMC4377791 DOI: 10.1093/ckj/sfu018] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2014] [Accepted: 02/14/2014] [Indexed: 02/06/2023] Open
Abstract
Recent studies have demonstrated much larger variability in the total number of nephrons in normal populations than previously suspected. In addition, it has been suggested that individuals with a low nephron number may have an increased lifetime risk of hypertension or renal insufficiency, emphasizing the importance of evaluating the nephron number in each individual. In view of the fact that all previous reports of the nephron number were based on analyses of autopsy kidneys, the identification of surrogate markers detectable in living subjects is needed in order to enhance understanding of the clinical significance of this parameter. In this review, we summarize the clinicopathological factors and findings indicating a reduction in the nephron number, focusing particularly on those found at the time of a preserved renal function.
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Affiliation(s)
- Nobuo Tsuboi
- Division of Nephrology and Hypertension, Department of Internal Medicine , The Jikei University School of Medicine , Tokyo , Japan
| | - Go Kanzaki
- Division of Nephrology and Hypertension, Department of Internal Medicine , The Jikei University School of Medicine , Tokyo , Japan
| | - Kentaro Koike
- Division of Nephrology and Hypertension, Department of Internal Medicine , The Jikei University School of Medicine , Tokyo , Japan
| | - Tetsuya Kawamura
- Division of Nephrology and Hypertension, Department of Internal Medicine , The Jikei University School of Medicine , Tokyo , Japan
| | - Makoto Ogura
- Division of Nephrology and Hypertension, Department of Internal Medicine , The Jikei University School of Medicine , Tokyo , Japan
| | - Takashi Yokoo
- Division of Nephrology and Hypertension, Department of Internal Medicine , The Jikei University School of Medicine , Tokyo , Japan
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Silva EC, Martins IS, de Araújo EAC. [Metabolic syndrome and short stature in adults from the metropolitan area of São Paulo city (SP, Brazil)]. CIENCIA & SAUDE COLETIVA 2011; 16:663-8. [PMID: 21340342 DOI: 10.1590/s1413-81232011000200030] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2007] [Accepted: 06/04/2008] [Indexed: 11/21/2022] Open
Abstract
The undernutrition has been appointed as a risk factor to cause chronic diseases in later life. The objective of this study was to investigate the prevalence of metabolic syndrome and its relationship to short stature, as evidence of stunting in early life in adults. It is a cross-sectional study of adult population (age 20 to 64 years old) living in the metropolitan area of São Paulo city (SP, Brazil). The sample comprehended a total of 287 individuals, 214 (74.6%) were women and 73 (25.4%) were men. The anthropometric, clinical and biochemical data were collected through the physical exam and the fast blood after 8 hours. The standard prevalence for sex and age to metabolic syndrome was 34.0% and the short stature was 29.0%. In multiple logistic regression analyses the metabolic syndrome showed to be associated to short stature adjusted by sex, age, education, income, smoking, alcohol consumption, family history of coronary disease, hypertension, diabetes and body mass index. In this study was demonstrated association between metabolic syndrome and short stature in adults.
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Affiliation(s)
- Elaine Cristina Silva
- Departamento de Nutrição, Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo SP.
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Ranasinghe P, Jayawardana MANAAD, Constantine GR, Sheriff MHR, Matthews DR, Katulanda P. Patterns and correlates of adult height in Sri Lanka. ECONOMICS AND HUMAN BIOLOGY 2011; 9:23-29. [PMID: 21126931 DOI: 10.1016/j.ehb.2010.09.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/01/2010] [Revised: 09/15/2010] [Accepted: 09/27/2010] [Indexed: 05/30/2023]
Abstract
The present study examines patterns and socioeconomic and demographic correlates of adult height among Sri Lankan adults. Data were available for height and socio-demographic factors from a nationally representative cross-sectional sample of 4477 subjects above 18 years. Recruitment was between 2005 and 2006. Mean age of all subjects was 46.1±15.1 years. Mean height of males and females were 163.6±6.9cm and 151.4±6.4cm respectively. Mean height showed a significant negative correlation with age (p<0.001, r=-0.207). Highest mean height in females 154.0±5.9cm and males 165.6±6.9cm were observed in those born after 1977. Rural females (151.4±6.2cm) were significantly taller than the urban (151.3±7.2cm). However, this was not observed in males. In multivariate analysis, year of birth, level of education and household income were significantly associated with height. Height demonstrated a significant negative correlation with systolic blood pressure (r=-0.032), presence of diabetes (r=-0.069), total cholesterol (r=-0.106), HDL cholesterol (r=-0.142) and LDL cholesterol (r=-0.104). Height was associated with household income and level of education in Sri Lanka and demonstrated a distinct increasing trend over successive generations.
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Affiliation(s)
- Priyanga Ranasinghe
- Diabetes Research Unit, Department of Clinical Medicine, Faculty of Medicine, University of Colombo, Sri Lanka
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Abstract
Abundant evidence supports the association between low birth weight (LBW) and renal dysfunction in humans. Anatomic measurements of infants, children, and adults show significant inverse correlation between LBW and nephron number. Nephron numbers are also lower in individuals with hypertension compared with normotension among white and Australian Aboriginal populations. The relationship between nephron number and hypertension among black individuals is still unclear, although the high incidence of LBW predicts low nephron number in this population as well. LBW, a surrogate for low nephron number, also associates with increasing BP from childhood to adulthood and increasing risk for chronic kidney disease in later life. Because nephron numbers can be counted only postmortem, surrogate markers such as birth weight, prematurity, adult height, reduced renal size, and glomerulomegaly are potentially useful for risk stratification, for example, during living-donor assessment. Because early postnatal growth also affects subsequent risk for higher BP or reduced renal function, postnatal nutrition, a potentially modifiable factor, in addition to intrauterine effects, has significant influence on long-term cardiovascular and renal health.
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Affiliation(s)
- Valerie A Luyckx
- Department of Medicine, HMRC 260, University of Alberta, Edmonton, Canada, T6G 2S2.
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20
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Santos CDDL, Clemente APG, Martins PA, Sawaya AL. Influência do déficit de estatura nos desvios nutricionais em adolescentes e pré-adolescentes. REV NUTR 2009. [DOI: 10.1590/s1415-52732009000200001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJETIVO: Avaliar a influência do déficit estatural nos desvios nutricionais em pré-adolescentes e adolescentes de baixa renda. MÉTODOS: Calculou-se o Índice de Massa Corporal a partir do peso e da estatura de alunos da rede pública entre 4 e 8ª séries. Foram utilizadas as tabelas do National Center for Health Statistics de 2000 para crianças e adolescentes e foi considerado excesso de peso Índice de Massa Corporal/Idade>P85 e déficit de peso Índice de Massa Corporal/Idade <P5. Déficit estatural foi classificado quando estatura/idade foi menor que -1 desvio-padrão. Foram comparadas as proporções de baixo peso e excesso de peso nos grupos com e sem déficit estatural, de acordo com sexo e faixa etária. RESULTADOS: Foram avaliados 3 766 jovens sendo 50,4% do sexo feminino. A média de idade foi de 12,8, desvio-padrão de 2,0 anos, sem diferença significante entre os grupos. No grupo com déficit de estatura, observou-se que o excesso de peso é mais prevalente entre os mais velhos. Naqueles sem déficit de estatura a distribuição por idades foi semelhante para as três classificações de Índice de Massa Corporal/Idade. A distribuição por sexo mostra que o excesso de peso no grupo com déficit de estatura foi mais acentuada entre as meninas (76,1%) enquanto que no grupo com estatura normal a diferença foi mínima entre os sexos (4,4%). CONCLUSÃO: Na presença do déficit de estatura, o excesso de peso foi mais prevalente nos maiores de 12 anos e entre o sexo feminino. Os meninos sem déficit de estatura mostraram uma proporção maior de excesso de peso em relação aos com déficit de estatura.
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Martins IS, Oliveira DCD, Marinho SP, Araújo EACD. Hipertensão em segmentos sociais pauperizados da região do Vale do Paraíba São Paulo. CIENCIA & SAUDE COLETIVA 2008; 13:477-86. [DOI: 10.1590/s1413-81232008000200023] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2006] [Accepted: 04/13/2007] [Indexed: 11/22/2022] Open
Abstract
O objetivo deste trabalho foi verificar as relações entre fatores socioeconômicos, ambientais e biológicos com a hipertensão, segundo gênero. A população estudada foi formada por adultos residentes em dois municípios do Vale do Paraíba (SP), uma das regiões mais pobres do estado de São Paulo. Foi composta por 274 (39,8%) homens e 415 (60,2 %) mulheres. O estudo foi realizado por meio de um modelo de regressão logística hierarquizada, aplicado separadamente para homens e mulheres. Foram estimados os odds ratios ajustados (ORaj), com intervalo de confiança de 95% e a = 0,05. Para os homens, os seguintes fatores de risco estiveram associados à hipertensão: viver na zona rural (ORaj=2,00; p=0,01); etilismo (ORaj= 1,90; p=0,03) e idade acima de 40 anos (ORaj=3,10; p<0,0001). Famílias numerosas, com mais de seis pessoas exerceram efeito protetor (ORaj=0,46; p=0,02). Para mulheres, os fatores de risco associados foram: ausência de escolaridade (ORaj= 2,37; p=0,0003); sedentarismo (ORaj=1,71; p=0,04); obesidade acompanhada de baixa estatura (ORaj= 4,66; p <0,0001) e idade acima de 40 anos ( ORaj=5,29; p=0,01). A obesidade isolada não se associou à hipertensão, nos níveis pressóricos iguais ou maiores do que os correspondentes ao estágio II do padrão de referência.
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Schooling CM, Jiang C, Lam TH, Thomas GN, Heys M, Lao X, Zhang W, Adab P, Cheng KK, Leung GM. Height, its components, and cardiovascular risk among older Chinese: a cross-sectional analysis of the Guangzhou Biobank Cohort Study. Am J Public Health 2007; 97:1834-41. [PMID: 17761579 PMCID: PMC1994197 DOI: 10.2105/ajph.2006.088096] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVES Better childhood conditions, inferred from height and specifically leg length, are usually protective against ischemic heart disease and its risk factors in Western countries. In other geoethnic populations, height is less clearly protective, casting doubt on there being a biological etiology. To clarify the role of childhood conditions, we examined the associations of height and its components with cardiovascular risk among older Chinese people. METHODS We used multivariable regression to examine the associations of height and its components with blood pressure, lipid profile, and diabetes in 10413 older Chinese adults (mean age=64.6 years). RESULTS After we adjusted for age, gender, socioeconomic status, and lifestyle habits, greater sitting height was associated with diabetes and dyslipidemia. Longer legs were associated with lower pulse pressure and lower low-density lipoprotein cholesterol. CONCLUSIONS We provide indirect anthropometric evidence for the role of pre-pubertal and pubertal exposures on cardiovascular risk. Pubertal exposures are stronger than are prepubertal exposures but may be influenced by osteoporotic decline in old age. Further research should establish whether the observed relations are ethnically specific or relate to the stage or trajectory of socioeconomic development.
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Affiliation(s)
- C Mary Schooling
- Department of Community Medicine, School of Public Health, University of Hong Kong, Hong Kong, People's Republic of China
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Schooling CM, Thomas GN, Leung GM, Ho SY, Janus ED, Lam TH. Is height associated with cardiovascular risk in Chinese adults? Epidemiology 2007; 18:274-8. [PMID: 17259904 DOI: 10.1097/01.ede.0000254656.02400.27] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Better childhood conditions, proxied by greater height, are usually protective against ischemic heart disease in western countries. These relations are less evident in other settings. METHODS We used multivariable logistic regression to examine the relation of height to the metabolic syndrome and its components in a rapidly developed Asian population using a representative, cross-sectional Hong Kong Chinese sample of 2860 adults from 1994 to 1996. RESULTS Height was inversely associated with increased blood pressure (odds ratio = 0.74; 95% confidence interval = 0.58-0.94) and raised fasting plasma glucose (0.71; 0.55-0.91), but only after adjustment for central obesity. Central obesity was also positively associated with height (2.09; 1.67-2.62) for tallest compared with shortest tertile, confounding these relationships. The association between height and central obesity was much stronger in men than in women. CONCLUSION The relation of height to cardiovascular risk may relate to a society's history and stage of socioeconomic development.
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Affiliation(s)
- C Mary Schooling
- Department of Community Medicine, School of Public Health, The University of Hong Kong, Hong Kong
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Martins PA, Hoffman DJ, Fernandes MTB, Nascimento CR, Roberts SB, Sesso R, Sawaya AL. Stunted children gain less lean body mass and more fat mass than their non-stunted counterparts: a prospective study. Br J Nutr 2007; 92:819-25. [PMID: 15533271 DOI: 10.1079/bjn20041274] [Citation(s) in RCA: 89] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The aim of the present study was to analyse the changes in body composition of stunted children during a follow-up period and to test the hypothesis of a tendency to accumulate body fat as a consequence of undernutrition early in life. We selected fifty boys and girls aged 11 to 15, who were residents of slums in São Paulo, Brazil. Twenty were stunted (S) and thirty had normal stature (NS). The children's nutritional status and body composition were assessed through anthropometry and dual-energy X-ray absorptiometry, at the beginning of the present study and after 3 years, and changes in lean mass (LM and LM%) and fat mass (FM and FM%) were calculated. Stunted boys accumulated more body fat (FM%: S=1·62%, NS=−3·40%;P=0·003) and gained less lean mass (LM%: S=−1·46, NS=3·21%;P=0·004). Stunted girls gained less lean mass (S=7·87 kg, NS=11·96 kg;P=0·032) and had significantly higher values of FM% at follow-up when compared with their baseline values (P=0·008), whereas non-stunted girls had a non-significant difference in FM% over time (P=0·386). These findings are important to understand the factors involved in the increased prevalence of overweight and obesity among poor populations, which appear to be associated with hunger during infancy and/or childhood.
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Affiliation(s)
- P A Martins
- Department of Physiology, Federal University of São Paulo, CEP 04023-060, Brazil
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Barrenäs ML, Bratthall A, Dahlgren J. The association between short stature and sensorineural hearing loss. Hear Res 2006; 205:123-30. [PMID: 15953522 DOI: 10.1016/j.heares.2005.03.019] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2004] [Accepted: 03/10/2005] [Indexed: 11/24/2022]
Abstract
In order to test the Thrifty Phenotype Hypothesis on hearing, data from two cross-sectional studies on hearing were re-evaluated. The data sets comprised 500 18-year-old conscripts, and 483 noise-exposed male employees. Sensorineural hearing loss (SNHL) was over-represented among conscripts with a short stature (odds ratio=2.2) or hearing loss in the family (odds ration=4.2), but not among noise-exposed conscripts (odds ratio=0.9-1.3). Among noise-exposed short employees, hypertension and age exhibited a negative impact on high frequency hearing thresholds, while among tall employees hypertension had no effect on hearing and the influence of age was less pronounced (p<0.01 for body height; p<0.02 for age, hypertension and the interaction between body height and hypertension; p<0.05 for the interaction between body height and age). This suggests that mechanisms linked to fetal programming and growth retardation and/or insulin-like growth factor 1 levels during fetal life, such as a delayed cell cycle during the time window when the cochlea develops, may cause SNHL in adulthood.
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Affiliation(s)
- Marie-Louise Barrenäs
- Göteborg Pediatric Growth Research Centre, Department of Pediatrics, Institute for the Health of Women and Children, University of Göteborg, S416 85 Göteborg, Sweden.
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Abstract
More and more evidence is emerging that highlights the far-reaching consequences of prenatal (intrauterine) programming on organ function and adult disease. In humans, low birth weight (LBW) occurs more frequently in disadvantaged communities among whom there is often a disproportionately high incidence of adult cardiovascular disease, hypertension, diabetes mellitus, and kidney disease. Indeed, many epidemiologic studies have found an inverse association between LBW and higher blood pressures in infancy and childhood, and overt hypertension in adulthood. Multiple animal models have demonstrated the association of LBW with later hypertension, mediated, at least in part, by an associated congenital nephron deficit. Although no direct correlation has been shown between nephron number and birth weight in humans with hypertension, nephron numbers were found to be lower in adults with essential hypertension, and glomeruli tend to be larger in humans of lower birth weight. An increase in glomerular size is consistent with hyperfiltration necessitated by a reduction in total filtration surface area, which suggests a congenital nephron deficit. Hyperfiltration manifests clinically as microalbuminuria and accelerated loss of renal function, the prevalence of which are higher among adults who had been of LBW. A kidney with a reduced nephron number has less renal reserve to adapt to dietary excesses or to compensate for renal injury, as is highlighted in the setting of renal transplantation, where smaller kidney to recipient body-weight ratios are associated with poorer outcomes, independent of immunologic factors. Both hypertension and diabetes are leading causes of end-stage renal disease worldwide, and their incidences are increasing, especially in underdeveloped communities. Perinatal programming of these 2 diseases, as well as of nephron number, may therefore have a synergistic impact on the development of hypertension and kidney disease in later life. Existing evidence suggests that birth weight should be used as a surrogate marker for future risk of adult disease. Although the ideal solution to minimize morbidity would be to eradicate LBW, until this panacea is realized, it is imperative to raise awareness of its prognostic implications and to focus special attention toward early modification of risk factors for cardiovascular and renal disease in individuals of LBW.
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Affiliation(s)
- Valerie A Luyckx
- Renal Division, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115, USA.
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Grillol LP, Siqueira AFA, Silva AC, Martins PA, Verreschi ITN, Sawaya AL. Lower resting metabolic rate and higher velocity of weight gain in a prospective study of stunted vs nonstunted girls living in the shantytowns of São Paulo, Brazil. Eur J Clin Nutr 2005; 59:835-42. [PMID: 15900308 DOI: 10.1038/sj.ejcn.1602150] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Previous studies have shown that stunting increases the risk of obesity in developing countries, particularly among girls and women, but the underlying reasons are not known. This study aimed to investigate the relationship between stunting, weight gain, and resting metabolic rate. DESIGN AND SUBJECTS A prospective study was conducted over 36 months with girls from shantytowns in São Paulo, Brazil. A total of 15 stunted girls (S) were compared with 15 nonstunted (N) ones of similar weight for height ratio. INTERVENTIONS Resting metabolic rate was measured using indirect calorimetry, and the socioeconomic status was determined by interviews in the household. In addition, body composition was measured by skinfold thickness, while the growth rate was calculated dividing the change in weight and the change in height by the follow-up period. RESULTS The results of the present study, when combined, revealed that the S group had a lower resting metabolic rate throughout the follow-up period with the differences being significant at 24 and 36 months of follow-up, associated with an increase in the rate of weight gain and a decrease in lean mass, when compared to the N group. CONCLUSIONS These changes are known to be risk factors for obesity and may help to explain the particularly higher prevalence of obesity in women in urban areas of developing countries.
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Affiliation(s)
- L P Grillol
- Universidade do Vale do Itajaí, Balneário Camboriú, Santa Catarina, Brazil.
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Ferreira HDS, Florêncio TMTDM, Fragoso MDAC, Melo FP, Silva TGD. Hipertensão, obesidade abdominal e baixa estatura: aspectos da transição nutricional em uma população favelada. REV NUTR 2005. [DOI: 10.1590/s1415-52732005000200005] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJETIVO: Investigar, em mulheres de muito baixa renda, a prevalência e a associação entre a baixa estatura, o sobrepeso, a obesidade abdominal e a hipertensão arterial, discutindo os achados, segundo o processo de transição nutricional e a hipótese da programação fetal (hipótese Barker). MÉTODOS: Foram estudadas 223 mulheres de 18 a 65 anos, por meio dos seguintes indicadores: índice de massa corporal (kg/m²) >25 para sobrepeso + obesidade ou <18,5 para magreza; razão cintura-quadril > 0,8 para obesidade abdominal; pressão arterial sistólica e/ou diastólica >140/90mmHg para hipertensão; percentil 25 (1º quartil) para baixa estatura. RESULTADOS: A prevalência de sobrepeso + obesidade (35,9%) foi superior à de magreza (9,4%). A pressão diastólica associou-se com o índice de massa corporal (r=0,37; IC 95%: 0,01 <r² <0,26) e com a razão cintura-quadril (r=0,35; IC 95%: 0,01 <r² <0,25). Comparando-se os 1º e 4º quartis de estatura, encontraram-se os seguintes resultados, respectivamente, para a prevalência de hipertensão: 23,3% e 8,9% (odds ratio=3,08; p=0,03); para sobrepeso + obesidade: 41,7% e 35,7% (p=0,51); para o índice de massa corporal médio: 24,6 e 23,7 (p=0,27); para a média da razão cintura-quadril: 0,87 e 0,85 (p=0,04). CONCLUSÃO: A prevalência de sobrepeso/obesidade foi menor do que a de desnutrição. A baixa estatura, um indicador de desnutrição no início da vida, foi um importante fator de risco para a hipertensão arterial e para a obesidade abdominal. Apesar da miséria, a população parece estar passando pelo processo de transição nutricional. Os mecanismos resultantes da adaptação metabólica à desnutrição imposta no início da vida, parecem desempenhar importante papel na determinação desses achados.
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Ala L, Gill G, Gurgel R, Cuevas L. Evidence for affluence-related hypertension in urban Brazil. J Hum Hypertens 2004; 18:775-9. [PMID: 15215877 DOI: 10.1038/sj.jhh.1001750] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Cardiovascular diseases are a leading cause of mortality, and systemic hypertension is a major risk factor. There is an increasing prevalence of hypertension in urban areas of developing countries, due to lifestyle changes associated with economic transition and urbanisation. This study aimed to describe the prevalence and identify risk factors for hypertension in an urban area of South America (Coroa do Meio district in Aracaju, Sergipe State, north-east Brazil) and to examine intraurban hypertension prevalence differences. A cross-sectional survey of 400 adults aged 25 years and over was carried out. Information about health and lifestyle was obtained from a structured interview, followed by assessment of blood pressure (BP) and anthropometry. There were 31.8% (95% confidence interval 27.3-36.6%) participants with hypertension (defined as a systolic BP >140, diastolic BP >90 mmHg, or on antihypertensive medication). Hypertension was independently associated with older age, central obesity (greater waist-to-hip ratio), shorter height and residing in a high socio-economic residential area. Of the four neighbouring areas, hypertension prevalence was 52% in the area of highest income and education, compared with 19, 24 and 34% in the other three areas. The high prevalence of hypertension in this population, and the strong independent association with relative affluence, demonstrates the need for effective primary prevention of hypertension, targeted at modifiable risk factors.
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Affiliation(s)
- L Ala
- Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, UK
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Florêncio TT, Ferreira HS, Cavalcante JC, Sawaya AL. Short stature, obesity and arterial hypertension in a very low income population in North-eastern Brazil. Nutr Metab Cardiovasc Dis 2004; 14:26-33. [PMID: 15053161 DOI: 10.1016/s0939-4753(04)80044-9] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND AND AIM This cross-sectional study involved the adult population (age >18 and <60 years) of a 315-shack slum on the outskirts of the city of Maceió in North-eastern Brazil. The purpose was to investigate whether short stature in adults (an indicator of undernutrition in early life) is associated with arterial hypertension and obesity. METHODS AND RESULTS We collected the subjects socio-economic data, and arterial hypertension (AH), weight, height, waist circumference and waist/hip (W/H) circumference ratio measurements. Hypertension was diagnosed as diastolic AH f 90 mmHg and/or systolic AH f 140 mmHg. The body mass index (BMI) was used to determine nutritional status, with overweight/obesity being defined on the basis of a cut-off point of 25 kg/m2. A W/H ratio of f 0.80 for women or f 0.95 for men was considered indicative of abdominal obesity. Short stature was defined as falling into the 1st quartile (Q) of height distribution. Hypertension was prevalent in 28.5% of the population (women=38.5%; men=18.4%). The systolic and diastolic AH readings were significantly higher in women in the 1st Q than in those in the 4th Q, and the same was true of W/H. The prevalence of hypertension was statistically significant for the first two Q's in comparison with the last two: 22.1% vs 14.6% (men), and 42.4% vs 34.6% (women). Hypertension was more prevalent in women who were obese and short (50%) than in those who were obese but not short (OR=1.98; CI=1.22-2.96). CONCLUSIONS Living conditions were extremely precarious and the prevalence of hypertension was quite high. Stature negatively correlated with hypertension and overweight in women but not in men.
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Affiliation(s)
- T T Florêncio
- Department of Physiology, Federal University of São Paulo, São Paulo, Brazil.
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Stefanec T. How the endothelium and its bone marrow-derived progenitors influence development of disease. Med Hypotheses 2004; 62:247-51. [PMID: 14962635 DOI: 10.1016/s0306-9877(03)00327-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2003] [Accepted: 10/31/2003] [Indexed: 10/26/2022]
Abstract
The association between diseases accompanied by abnormal endothelial/vascular function (atherosclerosis, hypertension, diabetes mellitus, preeclampsia), and conditions characterized by increased tissue growth and normal endothelial/vascular function (cancer, placental size, birth length, adult height) could be caused by inherited characteristics of endothelial cells and their bone marrow-derived precursors. The genotype responsible for normal endothelial/precursor function could be modified by intrauterine and postnatal endothelial injury; telomere shortening caused by increased endothelial precursor proliferation in response to injury can result in premature endothelial senescence and a decreased precursor proliferative potential, thereby leading to an abnormal endothelial/precursor phenotype and the associated diseases. The individual endothelial/precursor phenotype could be established early in life and its changes in response to risk factors for diseases followed over time, thus providing a unique opportunity for identification and early institution of prophylactic and therapeutic interventions in diseases that cause most of the morbidity and mortality in advanced industrialized societies.
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van Hoorn J, Dekker G, Jeffries B. Gestational diabetes versus obesity as risk factors for pregnancy-induced hypertensive disorders and fetal macrosomia. Aust N Z J Obstet Gynaecol 2002; 42:29-34. [PMID: 11926638 DOI: 10.1111/j.0004-8666.2002.00035.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To assess whether obesity and/or gestational diabetes mellitus (GDM) are independent risk factors for fetal macrosomia and/or pregnancy-induced hypertensive disorders. DESIGN Retrospective computerised database review. SETTING Lyell McEwin Health Service, South Australia. SAMPLE All nulliparous women delivering singleton babies in the years 1999 and 2000 MAIN OUTCOME MEASURES Birth weights, the occurrence of fetal macrosomia, gestational hypertension and preeclampsia were compared between 258 normoglycaemic women (control group), 76 women with only an abnormal glucose challenge test, and 51 women with GDM. RESULTS Only GDM with fasting hyperglycaemia is a risk factor for macrosomia (risk ratio: 3.3 95% confidence limits 1.229-8.736). Smoking is associated with a decrease in the incidence of pregnancy-induced hypertensive disorders. CONCLUSIONS Our data strongly suggest that GDM and obesity are not independent risk factors for pregnancy-induced hypertensive disorders.
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Affiliation(s)
- Jessika van Hoorn
- Department of Obstetrics and Gynaecology, Adelaide University, South Australia, Australia
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