Adiposity and blood pressure among 55 000 relatively lean rural adults in southwest of China

Does Sex Matter in Obesity-Induced Periodontal Inflammation in the SSLepR Mutant Rats?

Introduction: The incidence of obesity has dramatically increased worldwide. Obesity has been shown to exacerbate the progression of periodontal disease. Studies suggest a sex difference in periodontitis, whereby males are more sensitive to periodontal inflammation compared to females. Aim: In the current study, it was hypothesized that obesity drives periodontal inflammation and bone loss in both sexes. Methodology: Utilizing leptin receptor mutant (SSLepR mutant) rats as a genetic model of obesity, 11-12-week-old male and female lean Dahl salt-sensitive (SS) rats and obese SSLepR mutant rats were used to investigate sex differences in obesity-induced periodontal inflammation. Results: Body weight, insulin, hemoglobin A1c and cholesterol levels were significantly elevated in the obese SSLepR mutant strain vs. the lean SS strain within the same sex. Sex differences in body weight and plasma hemoglobin A1c were only observed in obese SSLepR mutant rats, with males having significantly greater body weight and hemoglobin A1c vs. females. Plasma thiobarbituric acid reactive substances (TBARs) and monocyte chemoattractant protein-1 (MCP-1), markers of systemic oxidative stress and inflammation, respectively, were significantly elevated in obese SSLepR mutant rats vs. lean SS rats, with no sex differences in these parameters in either rat strains. Although micro-CT analyses of the maxillary first molar alveolar bone from obese SSLepR mutant rats revealed no evidence of bone loss and/or sex differences, immuno-histochemical analysis revealed significant elevations in periodontal IL-6 and decreases in IL-10 in obese SSLepR mutant rats vs. lean SS rats, with no apparent sex differences in these parameters. Conclusions: Obesity increases systemic and periodontal inflammation, without evidence of bone loss or apparent sex differences in SSLepR mutant rats.

Association between sleep behaviors and stroke in Southwest China: a prospective cohort study

BACKGROUND

Sleep can function as a potential modifiable risk factor in the control and prevention of stroke. Geography significantly influences sleep patterns. The association of sleep with stroke in population of Southwest China has not so far been investigated.

METHODS

A total of 55,001 residents aged from 30 to 79 years in Southwest China were included in this study, obtaining their complete information of baseline survey and follow-up in China Kadoorie Biobank (CKB). Sleep-evaluating score was constructed on the basis of short/long sleep duration, insomnia, and snoring. The multivariate Cox proportional hazards regression was used to analyze the association between sleep behaviors and stroke.

RESULTS

During 11.15 years of follow-up, 3410 stroke cases (572.78 cases/100,000 person-years) were documented. There exists no association of sleep-evaluating score with the risk of stroke in the total population. Male-predisposing association between sleep-evaluating score and risk of stroke was observed (for total stroke, HR = 1.52, 95% CI: 1.03-2.23; for hemorrhagic stroke, HR = 2.31, 95% CI: 1.22-4.34), with anisotropism in male residents with overweight and obesity (HR = 1.93, 95% CI: 1.03-3.63), and those without hypertension (HR = 1.76, 95% CI: 1.01-3.07) in the baseline survey.

CONCLUSIONS

There exists the male-predisposing association between sleep-evaluating score and the risk of stroke in Southwest China. Improving sleep is required for reducing the risk of stroke.

Exploring the association of dietary patterns with the risk of hypertension using principal balances analysis and principal component analysis

OBJECTIVE

In the field of nutritional epidemiology, principal component analysis (PCA) has been used extensively in identifying dietary patterns. Recently, compositional data analysis (CoDA) has emerged as an alternative approach for obtaining dietary patterns. We aimed to directly compare and evaluate the ability of PCA and principal balances analysis (PBA), a data-driven method in CoDA, in identifying dietary patterns and their associations with the risk of hypertension.

DESIGN

Cohort study. A 24-h dietary recall questionnaire was used to collect dietary data. Multivariate logistic regression analysis was used to analyse the association between dietary patterns and hypertension.

SETTING

2004 and 2009 China Health and Nutrition Survey.

PARTICIPANTS

A total of 3892 study participants aged 18-60 years were included as the subjects.

RESULTS

PCA and PBA identified five patterns each. PCA patterns comprised a linear combination of all food groups, whereas PBA patterns included several food groups with zero loadings. The coarse cereals pattern identified by PBA was inversely associated with hypertension risk (highest quintile: OR = 0·74 (95 % CI 0·57, 0·95); Pfor trend = 0·037). None of the five PCA patterns was associated with hypertension. Compared with the PCA patterns, the PBA patterns were clearly interpretable and accounted for a higher percentage of variance in food intake.

CONCLUSIONS

Findings showed that PBA might be an appropriate and promising approach in dietary pattern analysis. Higher adherence to the coarse cereals dietary pattern was associated with a lower risk of hypertension. Nevertheless, the advantages of PBA over PCA should be confirmed in future studies.

Association between sleep duration and hypertension in southwest China: a population-based cross-sectional study

OBJECTIVE

Hypertension is a major risk factor and cause of many non-communicable diseases in China. While there have been studies on various diet and lifestyle risk factors, we do not know whether sleep duration has an association to blood pressure in southwest China. This predictor is useful in low-resource rural settings. We examined the association between sleep duration and hypertension in southwest China.

DESIGN

Population-based cross-sectional study.

SETTING

This study was part of the baseline survey of a large ongoing prospective cohort study, the China Kadoorie Biobank. Participants were enrolled in 15 townships of Pengzhou city in Sichuan province during 2004-2008.

PARTICIPANTS

55 687 participants aged 30-79 years were included. Sleep duration was assessed by a self-reported questionnaire.

MAIN OUTCOME MEASURES

Hypertension was defined as systolic blood pressure ≥140 mm Hg and/or diastolic blood pressure ≥90 mm Hg, or prior physician-diagnosed hypertension in hospitals at the township (community) level or above.

RESULTS

The prevalence of hypertension was 25.17%. The percentages of subjects with sleep durations of <6, 6, 7, 8 and ≥9 hours were 17.20%, 16.14%, 20.04%, 31.95% and 14.67%, respectively. In multivariable-adjusted analyses, the increased ORs of having hypertension were across those who reported ≥9 hours of sleep (men: 1.16, 95% CI 1.04 to 1.30; women: 1.19, 95% CI 1.08 to 1.32; general population: 1.17, 95% CI 1.08 to 1.26). The odds of hypertension was relatively flat until around 6.81 hours of sleep duration and then started to increase rapidly afterwards in subjects and a J-shaped pattern was observed. There was a U-shaped relationship between sleep duration and hypertension in females.

CONCLUSION

Long sleep duration was significantly associated with hypertension and a J-shaped pattern was observed among rural adults in southwest China, independent of potential confounders. However, this association was not obvious between short sleep duration and hypertension.

Relative Telomere Length in Peripheral Blood Cells and Hypertension Risk among Mine Workers: A Case-Control Study in Chinese Coal Miners

Hypertension is a common chronic disease in middle-aged and elderly people and is an important risk factor for many cardiovascular diseases. Its pathogenesis remains unclear. Epidemiological studies have found that the loss of telomere length in peripheral blood cells can increase the risk of coronary heart disease, myocardial infarction, and other diseases. However, a correlation between loss of telomere length and hypertension has not been established. In this study, we aimed to explore the association between telomere length and the risk of essential hypertension (EH) in Chinese coal miners. A case-control study was performed with 215 EH patients and 222 healthy controls in a large coal mining group located in North China. Face-to-face interviews were conducted by trained staff with the necessary medical knowledge. Relative telomere length (RTL) was measured by a quantitative real-time PCR assay using DNA extracted from peripheral blood. In the control group, the age-adjusted RTL was statistically significantly lower in miners performing hard physical labour compared with nonphysical labour (P = 0.043). A significantly shorter age-adjusted RTL was found in the control group of participants who consumed alcohol regularly compared with those who do not consume alcohol (P = 0.024). Age-adjusted RTL was negatively correlated with body mass index (BMI) and alcohol consumption. Hypertension was also found to be significantly correlated with factors such as age, BMI, alcohol consumption, smoking, and tea consumption. Our results suggest that RTL is associated with hypertension in coal miners.

Early menarche and blood pressure in adulthood: systematic review and meta-analysis

Background

It has been reported that early menarche is associated with high blood pressure and hypertension. However, some studies have failed to observe such association. We carried out a systematic review and meta-analysis on the association of early menarche with hypertension and high blood pressure in adulthood.

Methods

PUBMED, SciELO, Scopus and LILACS databases were searched. Studies that evaluated the association of early menarche with hypertension or high blood pressure, among women aged 20 years or more were included. Random effects models were used to pool the estimates. Meta-regression was used to evaluate the contribution of different co-variables to heterogeneity.

Results

We identified 17 studies with 18 estimates on the association of early menarche with hypertension and high blood pressure. The odds of hypertension/high blood pressure was higher among women with early menarche [pooled (OR):1.25; 95% confidence interval (CI): 1.17-1.34; P < 0.001]. In the meta-regression analysis, studies evaluating 1500 subjects or more had a higher pooled OR [1.27; 95%CI (1.19;1.36)] than those with less participants. Although funnel plots showed some asymmetry, Egger tests were not statistically significant. Therefore, it is unlikely that the observed association was to publication bias.

Conclusions

Early menarche is associated with hypertension among adult woman.

Association of Age-Related Trends in Blood Pressure and Body Composition Indices in Healthy Adults

Purpose: Adiposity is one of the important determinants of blood pressure. The aim of this study is to evaluate the association between blood pressure and body composition indices throughout the whole lifespan of healthy adults.

Patients and Methods: This study was from an ongoing cross-sectional survey of the Chinese health wherein data included basic physiological parameters. Partial Pearson correlation analysis was used to assess the correlation between blood pressure and body composition indices. Multiple linear regression analysis was used to assess the association of body mass index, lean mass percent, and visceral fat rating against blood pressure in each age group.

Results: In the whole population stratified by gender, while body mass index had the highest r-value of correlation with systolic blood pressure in both males (r = 0.296, p < 0.001) and females(r = 0.237, p < 0.001), and fat mass percent had the highest r-value of correlation with diastolic blood pressure in males (r = 0.351, p < 0.001) and females(r = 0.277, p < 0.001), the strength of association with blood pressure were similar across most of the body composition indices. In multiple linear regression analysis, both body mass index and visceral fat rating were positively while lean mass percent was negatively associated with blood pressure in all age groups in both genders, whereas all the association was weaker in the elderly compared to the younger.

Conclusion: Maintain the total body fat in a favorable range and appropriately increase the body muscle mass is a strategy to reduce the occurrence of cardiovascular event by decreasing the risk of hypertension through the whole adult life.

Validity of cardiometabolic index, lipid accumulation product, and body adiposity index in predicting the risk of hypertension in Chinese population

OBJECTIVES

Adiposity, defined by higher cardiometabolic index (CMI), lipid accumulation product (LAP), and body adiposity index (BAI), has conferred increased metabolic risk. However, the incremental utility of CMI, LAP, and BAI in association with prevalent hypertension has not been well described in a population-based setting. We hypothesized that CMI, LAP, and BAI would provide important insight into hypertension risk.

METHODS

Blood pressure (BP), fasting lipid profiles, and anthropometric parameters were recorded in a cross-sectional study of 11,400 participants (mean age, 54 years; 53% women) from China. Logistic regression models were used to assess associations of CMI, LAP, and BAI with prevalent hypertension. BAI was evaluated according to hip (cm)/[height (m)^1.5]-18; LAP was calculated separately for men [(WC-65) × TG] and women [(WC-58) × TG]; and CMI was defined by TG/HDL-C × waist-to-height ratio.

RESULTS

CMI, LAP, and BAI were independently correlated with higher SBP and DBP, with nonstandardized (B) coefficients ranging from 1.827 to 4.590 mmHg and 1.475 to 2.210 mmHg (all P < 0.001). After adjustment for hypertension risk factors and potential confounders, CMI, LAP, and BAI, modeled as continuous measures, carried hypertension odds (95% CI) of 1.356 (1.259-1.459), 1.631 (1.501-1.771), and 1.555 (1.454-1.662) in women, respectively, per SD increment. In men, each SD increase in CMI, LAP, and BAI experienced a 31%, 65%, and 53% higher hypertension risk, respectively. Moreover, among women, the odds ratio (95% CI) for hypertension were 2.318 (1.956-2.745), 3.548 (2.985-4.217), and 3.004 (2.537-3.557) in the 4th quartile vs the first quartile of CMI, LAP, and BAI, respectively. For men, the corresponding figures were 2.200 (1.838-2.635), 3.892 (3.238-4.677), and 3.288 (2.754-3.927), respectively.

CONCLUSION

Measurements of CMI, LAP, and BAI provide a more complete understanding of hypertension risk related to variation in body fat distribution and pinpoint hypertensive participants in great risk of cardiovascular disease in the future.

Cross-sectional, school-based study of 14-19 year olds showed that raised blood pressure was associated with obesity and abdominal obesity

AIM

Gaining weight has been directly associated with an increased probability of developing high blood pressure (HBP) and metabolic abnormalities. We examined the independent and combined effects of overweight, obesity and abdominal obesity on blood pressure in adolescents.

METHODS

This cross-sectional school-based study evaluated 869 adolescents (53.4% girls) from 14 to 19 years of age, and the data were collected in 2013 in the city of Imperatriz, Maranhão, Brazil. The outcome was HBP. The independent variables were overweight and obesity classified by body mass index, abdominal obesity classified by the waist-to-height ratio and the combination of obesity and overweight and abdominal obesity. The potential confounding variables were age, the socio-economic status of the family, parental education, type of school and physical activity levels.

RESULTS

The prevalence ratios of HBP were higher when male and female adolescents were overweight (1.61-3.11), generally obese (3.20-4.70), had abdominal obesity (2.18-3.02) and were both generally obese and had abdominal obesity (3.28-5.16) compared with normal weight adolescents.

CONCLUSION

Obesity or abdominal obesity increased the risk of HBP in adolescents aged 14-19. However, adolescents who were both generally obese and had abdominal obesity showed an even higher risk of having HBP.

Prevalence and determinants of hypertension in Myanmar - a nationwide cross-sectional study

BACKGROUND

Non-communicable diseases (NCDs), malaria and tuberculosis dominate the disease pattern in Myanmar. Due to urbanization, westernized lifestyle and economic development, it is likely that NCDs such as cerebrovascular disease and ischemic heart disease are on a rise. The leading behavioral- and metabolic NCDs risk factors are tobacco smoke, dietary risks and alcohol use, and high blood pressure and body mass index, respectively. The study aimed at estimating the prevalence and determinants of hypertension, including metabolic-, behavioral- and socio-demographic risk factors.

METHODS

A nationwide, cross-sectional study of 7429 citizens of Myanmar aged 15-64 years were examined in 2009, using the WHO STEPS methodology. In separate analyses by gender, odds radios (ORs) and 95 % confidence intervals (CIs) for determinants of hypertension were estimated using logistic regression analyses. Confounders included in analyses were chosen based on Directed acyclic graphs (DAGs).

RESULTS

The prevalence of hypertension was 30.1 % (95 % CI: 28.4-31.8) in males and 29.8 % (28.5-31.1) in females. The mean BMI was 21.7 (SD 4.3) kg/m(2) for males and 23.0 (5.1) kg/m(2) for females. In fully adjusted analyses, we found in both genders increased OR for hypertension if the participants had high BMI (males: OR = 2.6; 95 % CI 2.1-3.3, females: OR = 2.3; 2.0-2.7) and high waist circumference (males: OR = 3.4; 1.8-6.8, females: OR = 2.7; 2.2-3.3). In both sexes, associations were also found between hypertension and low physical activity at work, or living in urban areas or the delta region. Being underweight and use of sesame oil in cooking was associated with lower odds for hypertension.

CONCLUSIONS

The prevalence of hypertension was high and associated with metabolic-, behavioral- and socio-demographic factors. Due to expected rapid economic growth in Myanmar we recommend similar studies in the future to follow up and describe trends in the risk factors, especially modifiable factors, which will most likely be on rise. Studies on effectiveness on interventions are needed, and policies to reduce the burden of NCD risk factors should be implemented if proven effective in similar settings.