Prehypertension and its optimal indicator among adults in Hubei Province, Central China, 2013-2015

Effect of lipid accumulation product on the development of hypertension among nondiabetic individuals in eastern China: A cross-sectional study

This study was aimed at assessing the risk factors for hypertension (HTN) and prehypertension (PHT) in order to clarify the role of lipid accumulation product (LAP) in the development of HTN among nondiabetic individuals. A large cross-sectional study was conducted in community health service centers in urban Bengbu, Anhui Province, China. All participants completed an interview questionnaire and procedures to obtain physical measurements and biochemical indicators. Multivariate logistic regression was used to test for the prevalence of HTN and PHT in relation to each quartile increase in LAP level and family history of HTN. The resulting interaction effects were evaluated by relative excess risk of interaction (RERI), attributable proportion due to interaction (AP), and synergy index (SI). A total of 7733 subjects were enrolled in the study. The overall prevalence rates of PHT and HTN were 37.1% and 24.8%, respectively. After adjusting for confounding factors, multinomial logistic regression analysis showed that compared with subjects in LAP quartile 1, those in quartile 3 (OR, 1.257; 95% CI, 1.062-1.494) and quartile 4 (OR, 1.323; 95% CI, 1.101-1.592) had a significantly higher risk for HTN (p for trend < .001). A significant interaction was observed between LAP and family history of HTN in men (AP, 0.1661; 95% CI, 0.0024-0.3296; SI, 1.4037; 95% CI, 1.0599-1.8593) and in women (RERI, 1.4111; 95% CI, 0.1458-2.9678; AP, 0.1662; 95% CI, 0.0085-0.3237; SI, 1.3886; 95% CI, 1.0568-1.8247). The results demonstrated that the interactive effects of LAP with family history of HTN may influence the development of HTN synergistically.

Association of adiposity indices with prehypertension among Chinese adults: A cross-sectional study

The association of adiposity indices with prehypertension remains unclear in the Chinese non-hypertensive population. This study aimed to compare the association of adiposity indices, including waist circumference (WC), waist-to-height ratio, body roundness index (BRI), a body shape index (ABSI), and conicity index (CI), and prehypertension in the Chinese population. We recruited 61 475 participants from a population-based screening project in Guangdong province, China. Multiple logistic regression analyses were performed to detect the association between the six adiposity indices and prehypertension. Receiver operator characteristic curve (ROC) analysis was used to evaluate the predictive values of adiposity indices to prehypertension. The individuals were divided into two categories by blood pressure (BP) levels: normotension (<120/80 mmHg) and prehypertension (120-139/80-89 mmHg). A total of 33 233 people had prehypertension, with a prevalence of 54.04% and 42% males. Both logistics regression models presented a positive association between each adiposity index and prehypertension (p < .05), except for ABSI. The body mass index (BMI) was slightly more correlated with prehypertension than any other index. The standardized ORs for the six indices were 1.392, 1.361, 1.406, 1.039, 1.372, and 1.151, respectively. Compared to other adiposity indices, the WC had a significantly higher area under the curve (AUC) for predicting prehypertension (AUC: .619, sensitivity: 57%, specificity: 60.6%). In conclusion, WC and BMI might be the best indicators for prehypertension. Increasing evidence supports avoiding obesity as a preferred primary prevention strategy for prehypertension while controlling other major hypertension risk factors.

Emergent Anthropometric Indices in Differential Prediction of Prehypertension and Hypertension in Mexican Population: Results according to Age and Sex

Background

Hypertension (HTN) is recognized as a significant public health problem in the world. The objective of this study is to evaluate emergent anthropometric indices as predictors of preHTN and HTN according to age and sex in a sample of Mexican adults.

Methods

A cross-sectional study was conducted in 1,150 participants aged 18-80 years old. Anthropometric data and blood pressure measurements were analyzed. Comparisons between men and women were carried out by independent analysis. Cutoff points for each emergent anthropometric index were obtained using the values' upper second and third tertiles. Logistic regression models and receiver operating characteristics curve analyses were used to assess the association and the predictive value of several emergent anthropometric indices with the presence of preHTN and HTN.

Results

The prevalence of preHTN and HTN was 29.74% and 14.35%, respectively. In a logistic regression analysis adjusted by age and sex, the body roundness index (BRI) (OR = 2.08, p < 0.001) and conicity index (CI) (OR = 1.37, p=0.044) were associated with preHTN, while CI (OR = 2.47, p < 0.001) and waist to height squared (W/Ht2) (OR = 2.19, p < 0.001) were associated with HTN. Furthermore, in both sexes, BRI was the main predictor of preHTN (AUC: 0.634 and 0.656, respectively). Particularly, according to sex and age range, the predictive emergent anthropometric indices in men were the body shape index (ABSI) and waist to height cubic (W/Ht3) (AUC = 0.777 and 0.771, respectively), whereas in women, the predictors were CI and ABSI (AUC = 0.737 and 0.729, respectively). In men ≤40 years old, central body fat indices were predictors of preHTN and HTN, but in men >40 years old, the predictor indices were W/Ht3 and W/Ht2. In women ≤40 years, the pulse mass index (PMI) was the best main predictor (AUC = 0.909) of HTN.

Conclusion

CI, PMI, W/Ht3, W/Ht2, and ABSI could represent differential predictors of preHTN and HTN between men and women according to age range.

Development and Validation of a Risk Score Screening Tool to Identify People at Risk for Hypertension in Shanghai, China

Purpose

This study aimed to develop a screening tool based on a risk scoring approach that could identify individuals at high risk for hypertension in Shanghai, China.

Methods

A total of 3147 respondents from the 2013 Shanghai Chronic Disease and Risk Factor Surveillance were randomly divided into the derivation group and validation group. The coefficients obtained from multivariable logistic regression were used to assign a score to each variable category. The receiver operating characteristic (ROC) curve was used to find the optimal cut-off point and to evaluate the screening performance.

Results

Age, family history of hypertension, having diabetes, having dyslipidemia, body mass index, and having abdominal obesity contributed to the risk score. The area under the ROC curve was 0.817 (95% CI: 0.797–0.836). The optimal cut-off value of 20 had a sensitivity of 83.4%, and a specificity of 64.3%, demonstrating good performance.

Conclusion

We developed a simple and valid screening tool to identify individuals at risk for hypertension. Early detection could be beneficial for high-risk groups to better manage their conditions and delay the progression of hypertension and related complications.

Independent and combined effects of triglyceride-glucose index on prehypertension risk: a cross-sectional survey in China

Triglyceride-glucose (TyG) index is considered a simple and feasible indicator of insulin resistance (IR). This study aims to delve into the association and interaction of TyG index on the risk of prehypertension in Chinese adults. A community based cross-sectional survey conducted in Chinese population. Eligible participants were recruited, and questionnaire survey, anthropometric tests, and blood samples collection were performed. TyG index was obtained as ln [fasting TG(mg/dl) × FPG(mg/dl)/2]. Logistic regression model and the area under the receiver-operating characteristics (ROC) curves (AUC) were analyzed. Interaction analysis was conducted by calculating relative excess risk for interaction (RERI), attributable proportion for interaction (AP) as well as synergy index (SI). A total of 3115 recruited participants (1307 males and 1808 females) were aged 60.82 years on average. The prevalence of prehypertension reached 36.4% on the whole, 37.6% in male and 35.5% in female, respectively. The results of multivariable logistic regression model suggested that the adjusted OR for prehypertension was upregulated across TyG index quartiles, up to 2.06 (95% CI:1.53-2.77) for quartiles 4 versus quartiles 1. Furthermore, TyG index outperformed FPG (Z = 2.15, p = 0.032) and TG (Z = 6.10, p < 0.001) in discriminating prehypertension risk. Besides, TyG index with abdominal obesity (RERI:1.53, 95% CI:0.39-2.67; AP: 0.37, 95% CI: 0.16-0.59; SI:1.96, 95% CI:1.15-3.34) displayed a noticeable interaction on risk of prehypertension. Our study indicated that a higher TyG index rose the risk of prehypertension independently and synergistically with abdominal obesity in Chinese adults. Furthermore, it exhibited a higher predictability compared with conventional indices.

The management of prehypertension in young adults

The incidence of prehypertension (blood pressure 120-139 and/or 80-89 mm Hg) in young adults worldwide ranges from ~37.5% to 77.1%. Identifying high-risk groups of prehypertension in young adults is helpful for early and effective interventions and treatments to reduce the occurrence of future hypertension and organ damage. This review summarized the epidemiological characteristics, disease intervention measures, and disease progression characteristics of prehypertension to provide a basis for the development of targeted intervention measures for young adults with prehypertension.

Reference values for resting and post exercise hemodynamic parameters in a 6-18 year old population

This database is the first large dataset of haemodynamic changes of normal-weight pupils during a field exercise test. Here, we present a dataset for anthropometric and hemodynamic parameters measured both during relaxation and after exercise containing 1,173,342 data segments from 65,345 acquisition points of 10,894 normal weight subjects, covering an age range of 6–18 years collected in a course of 12 years. Data acquisition was carried out under standardised measuring conditions and specifications. Hemodynamic parameters were measured in the normal-weight population with a new and simple Fit-Test which could facilitate new projects worldwide to study and compare cardiovascular fitness.

Measurement(s)	anthropometric measurement • heart rate • blood pressure
Technology Type(s)	anthropometric analysis • Cardiac Monitoring
Factor Type(s)	age
Sample Characteristic - Organism	Homo sapiens

Machine-accessible metadata file describing the reported data: 10.6084/m9.figshare.11417481

The Quality of Spontaneous Adverse Drug Reaction Reports in China: A Descriptive Study

Pharmacovigilance is important to monitor the safety of drugs. There are, however, problems with the quality of adverse drug reaction reports in China. This study aimed to analyze the quality of adverse drug reaction reports in China, identify the factors affecting it, and propose measures to improve it. In our study, the western province of Shaanxi, the central province of Hubei and the eastern province of Jiangsu were chosen as typical, and adverse drug reaction reports from these three provinces from 2015 to 2017 were systematically sampled. The sampling reports were scored and graded to assess their quality. The results showed that only 10.18% were considered high quality in a total of 3429 reports. There were statistically significant differences in quality by year, province, report type, report source, and occupation of the reporter (p < 0.001). Reports from Shaanxi were slightly poorer quality, and "new" and "serious" reports and those from pharmacists were higher quality. Five indicators were particularly poor quality: patient information, adverse drug reaction, reporter information, drug information and vigilance. In conclusion, the quality of adverse drug reaction reports in China still needs improvement. Factors affecting quality included timing, location, report type, report source, and reporter's occupation. It may be helpful to publicize the importance of monitoring adverse drug reactions and improve the knowledge of reporters.

Prediction of Prehypertenison and Hypertension Based on Anthropometry, Blood Parameters, and Spirometry

Hypertension and prehypertension are risk factors for cardiovascular diseases. However, the associations of both prehypertension and hypertension with anthropometry, blood parameters, and spirometry have not been investigated. The purpose of this study was to identify the risk factors for prehypertension and hypertension in middle-aged Korean adults and to study prediction models of prehypertension and hypertension combined with anthropometry, blood parameters, and spirometry. Binary logistic regression analysis was performed to assess the statistical significance of prehypertension and hypertension, and prediction models were developed using logistic regression, naïve Bayes, and decision trees. Among all risk factors for prehypertension, body mass index (BMI) was identified as the best indicator in both men [odds ratio (OR) = 1.429, 95% confidence interval (CI) = 1.304⁻1.462)] and women (OR = 1.428, 95% CI = 1.204⁻1.453). In contrast, among all risk factors for hypertension, BMI (OR = 1.993, 95% CI = 1.818⁻2.186) was found to be the best indicator in men, whereas the waist-to-height ratio (OR = 2.071, 95% CI = 1.884⁻2.276) was the best indicator in women. In the prehypertension prediction model, men exhibited an area under the receiver operating characteristic curve (AUC) of 0.635, and women exhibited a predictive power with an AUC of 0.777. In the hypertension prediction model, men exhibited an AUC of 0.700, and women exhibited an AUC of 0.845. This study proposes various risk factors for prehypertension and hypertension, and our findings can be used as a large-scale screening tool for controlling and managing hypertension.

Comparison of adiposity indices in relation to prehypertension by age and gender: A community-based survey in Henan, China

BACKGROUND

To compare the efficiency of bioelectrical indices (visceral fat index [VFI], percentage body fat [PBF]) and anthropometric indices (body mass index, waist circumference, waist-to-height ratio, a body shape index ) in the relation to prehypertension (120-139/80-89 mm Hg) among the Chinese population.

METHODS

Using stratified multistage random sampling method, a general population-based sample of 11 175 adults in Henan province were selected from 2013 to 2015. The individuals were divided into three categories by blood pressure levels: normotension (<120 and 80 mm Hg), stage 1 prehypertension (120-129/80-84 mm Hg) and stage 2 prehypertension (130-139/85-89 mm Hg).

RESULTS

VFI and PBF tended to increase with age in men and women. However, for each age-specific group, men tended to have higher VFI than women (all P < 0.01) and women tended to have greater PBF (all P < 0.0001). The odds ratios (OR) and area under the receiver operating characteristic curves for prehypertension associated with adiposity indices declined with age. VFI and PBF showed higher standardized adjusted ORs for prehypertension in young (~40 years) men (VFI: 2.02-3.05; PBF: 1.82-2.80) and young women (VFI: 1.90-2.58; PBF:1.70-2.29). Moreover, based on Youden's index, VFI and PBF exhibited the superiority for identifying prehypertension in men (0.20-0.32) and women (0.31-0.39), respectively.

CONCLUSION

In summary, there was stronger association of VFI and PBF with prehypertension in men than in women, respectively, especially for young adults.

Risk factors for prehypertension and their interactive effect: a cross- sectional survey in China

BACKGROUND

Individuals with prehypertension are at higher risk of developing hypertension and cardiovascular diseases, while the interaction between factors may aggravate prehypertension risk. Therefore, this study aimed to evaluate the risk factors for prehypertension in Chinese middle-aged and elderly adults, and explore the potentially interactive effect of evaluated factors.

METHODS

All the participants that came from a community based cross-sectional survey were investigated in Bengbu, China, by being interviewed with a questionnaire. Body mass index (BMI), Waist circumference (WC) and lipid accumulation product (LAP) that reflect participants' obesity were also calculated. In addition, logistic regression model was applied to explore the risk factors of prehypertension, followed by the assessment of the interactive effects between risk factors on prehypertension by the relative excess risk due to interaction (RERI), attributable proportion due to interaction (AP) and synergy index (SI).

RESULTS

A total of 1777 participants were enrolled in this study, among which the prevalence of normtension, prehypertension and hypertension were 41.70%, 33.93% and 24.37% respectively. According to the multivariate logistic regression analysis, age (OR: 1.01, 95%CI: 1.00-1.02), smoking (OR: 1.67, 95%CI: 1.22-2.29), family history of cardiovascular diseases (OR: 1.52, 95%CI: 1.14-2.02), general obesity (OR: 1.51, 95%CI: 1.15-1.97) and LAP (OR: 2.58, 95%CI: 1.76-3.80) were all defined as the major factors that significantly related with the risk of prehypertension. When identifying prehypertension risk, the receiver-operating characteristics (ROC) curves (AUC) analysis indicated that LAP performed better than BMI in males (Z = 2.05, P = 0.03) and females (Z = 2.12, P = 0.03), but was superior to WC only in females (Z = 2.43, P = 0.01). What is more, there were significant interactive effects of LAP with family history of cardiovascular diseases (RERI: 1.88, 95%CI: 0.25-3.51; AP: 0.44, 95%CI: 0.20-0.69; SI: 2.37, 95%CI: 1.22-4.60) and smoking (RERI: 1.99, 95%CI: 0.04-3.93; AP: 0.42, 95%CI: 0.17-0.67; SI: 2.16, 95%CI: 1.68-4.00) on prehypertension risk. The value of AP (0.40, 95%CI: 0.03-0.77) also indicated a significant interaction between family history of cardiovascular diseases and smoking on prehypertension.

CONCLUSION

Prehypertension is currently prevalent in Chinese adults. This study indicated that age, family history of cardiovascular diseases, smoking, general obesity and LAP were significantly related with prehypertension risk. Furthermore, interactive effects on risk of prehypertension had been demonstrated in this study as well, which would help researchers to build strategy against prehypertension more comprehensively and scientifically.

Indicators of accumulated fat are stronger associated with prehypertension compared with indicators of circulating fat: A cross-sectional study

Recently, prehypertension has been considered as a risk factor for cardiovascular disease because it can progress to hypertension. The association between obesity and dyslipidemia with raised blood pressure has been reported in some studies; however, the ability of indicators of such conditions to predict prehypertension has been scarcely explored. In this cross-sectional study, we compared the ability of indicators of accumulated and circulating fat to discriminate between prehypertensive and normotensive Mexico City residents (n = 1377). The indicators were classified based on the parameters needed for their calculation: including only circulating fat (IOCFi) (e.g., Castelli risk indexes), including only accumulated fat (IOAFi) (e.g., waist circumference [WC]), and mixed (e.g., lipid accumulation product [LAP]). We compared the areas under the receiving operating characteristic curves (AURCs) and estimated the cutoff points for each indicator and their associated risk of prehypertension. The IOAFi had the greatest AURCs, followed by mixed and IOCFi; the AURCs for WC were the highest (AURC = 0.688 and 0.666 for women and men, respectively). The highest odds ratios for prehypertension were those associated with the cutoff points for IOAFi and LAP (e.g., OR = 2.8 for women with WC > 83.5 cm and OR = 2.6 for men with WC > 87.5 cm). Early detecting people at risk of cardiovascular disease is a necessity and given that WC had a better performance than the other indexes and it is relatively easy to measure, it has the potential of being used as a complementary measure in routine clinical examinations and by the general population as an auto-screening measurement to detect prehypertension.