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Brosolo G, Da Porto A, Bulfone L, Vacca A, Bertin N, Catena C, Sechi LA. Cortisol secretion and abnormalities of glucose metabolism in nondiabetic patients with hypertension. J Hypertens 2024; 42:227-235. [PMID: 37796203 DOI: 10.1097/hjh.0000000000003590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/06/2023]
Abstract
OBJECTIVE Glycometabolic changes are associated with hypercortisolism in Cushing's syndrome. Because impaired glucose tolerance (IGT) and insulin resistance are frequently detected in patients with essential hypertension, we hypothesized that in these patients, early glycometabolic abnormalities might be related to differences in regulation of cortisol secretion. METHODS In a cross-sectional study, we included 155 nondiabetic, essential hypertensive patients who were free of organ complications. The homeostasis model assessment (HOMA) index and the area under the curve of plasma glucose (AUC-glucose) and insulin (AUC-insulin) concentration following an oral glucose tolerance test were measured, together with daily plasma cortisol (8 a.m., 3 p.m. and 12 a.m.; AUC-cortisol) and 8 a.m. cortisol after 1 mg overnight dexamethasone suppression test (DST). RESULTS IGT was present in 27% of patients who were older and had higher BMI, plasma triglycerides and uric acid, AUC-cortisol and DST-cortisol, and lower HDL-cholesterol. Frequency of IGT increased progressively across tertiles of DST-cortisol, together with levels of glycated hemoglobin, fasting insulin and C-peptide, HOMA-index, AUC-glucose, and AUC-insulin. AUC-cortisol and DST-cortisol were directly correlated with insulin, C-peptide, HOMA-index, AUC-glucose, and AUC-insulin. Multivariate regression analysis showed that DST-cortisol was directly and independently correlated with HOMA index, AUC-glucose, and AUC-insulin. In a logistic regression model, both AUC-cortisol and DST-cortisol independently predicted IGT. CONCLUSION Daily cortisol and cortisol response to DST are independent determinants of IGT and insulin resistance in nondiabetic patients with hypertension, suggesting that even subtle differences in regulation of cortisol secretion might increase the risk of these patients to develop diabetes.
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Affiliation(s)
| | | | - Luca Bulfone
- Internal Medicine and European Hypertension Excellence Center
| | - Antonio Vacca
- Internal Medicine and European Hypertension Excellence Center
| | - Nicole Bertin
- Thrombosis and Hemostasis Unit, Department of Medicine, University of Udine, Udine, Italy
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GÜNEŞLİ A, ACIBUCA A, ALTIN C, GEZMİŞ E, TEKİNDAL MA, YALÇIN Ç, ALKAN O. Karotis Arter Hasarını Etkileyen Kan Basıncı Sınırları. Kesitsel Bir Çalışma. CUKUROVA MEDICAL JOURNAL 2020. [DOI: 10.17826/cumj.702344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Liu L, Chen CL, Lo K, Huang JY, Yu YL, Huang YQ, Feng YQ. Trends of Status of Hypertension in Southern China, 2012-2019. Int J Gen Med 2020; 13:599-608. [PMID: 32982377 PMCID: PMC7500839 DOI: 10.2147/ijgm.s267346] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 08/12/2020] [Indexed: 12/12/2022] Open
Abstract
Purpose Little is known about the recent trends of hypertension in southern China. The aim of the study was to investigate the trends of hypertension in Guangdong Province between 2012 and 2019. Methods We conducted two cross-sectional surveys in 2012 and 2019 in southern China, which included 10,970 and 27,483 participants, respectively, aged 35 to 75 years old using a method of stratified, multistage, and cluster sampling. Hypertension was defined as a mean systolic/diastolic blood pressure (SBP/DBP) ≥140/90mmHg, or a self-reported condition, or any pharmacological treatment in the last 2 weeks. In addition, according to the 2017 ACC/AHA guideline for high blood pressure, we estimated the prevalence and control rate of hypertension. Results According to the 2010 Chinese guideline, the age-standardized rate of hypertension prevalence was 34.7% in 2012 and 36.9% in 2019 with a slight increase, while the prevalence of prehypertension was stable (14.5% vs 14.3%). Over the period of our study, 45.6% and 60.7% of hypertensive patients knew their diagnosis in 2012 and 2019, and 40.8% and 51.5% were using antihypertensive medications, respectively. The control rates increased from 15.1% to 23.6%. Hypertension prevalence was 64.5% in 2012 and 63.2% in 2019, and the control rate increased from 3.0% to 4.8% during the study period under the 2017 ACC/AHA guideline. Conclusion Although the past 7 years have seen some progress in hypertension management, the rates of hypertension awareness, treatment, and control in southern Chinese remained regrettably low, and the prevalence rate was still high.
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Affiliation(s)
- Lin Liu
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, People's Republic of China
| | - Chao-Lei Chen
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, People's Republic of China
| | - Kenneth Lo
- Centre for Global Cardiometabolic Health, Department of Epidemiology, Brown University, Providence, RI, USA
| | - Jia-Yi Huang
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, People's Republic of China
| | - Yu-Ling Yu
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, People's Republic of China
| | - Yu-Qing Huang
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, People's Republic of China
| | - Ying-Qing Feng
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, People's Republic of China
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Trends in status of hypertension in rural northeast China: results from two representative cross-sectional surveys, 2013-2018. J Hypertens 2020; 37:1596-1605. [PMID: 30882603 DOI: 10.1097/hjh.0000000000002076] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
OBJECTIVE To investigate the long-term natural trends in the status of hypertension in rural northeast China from 2013 to 2018. METHODS Two successive cross-sectional surveys were conducted in Liaoning rural areas in 2013 and 2018, which included 10 753 and 10 926 participants aged at least 40 years from different villages, respectively. A multistage, stratified, and cluster random sampling method was used to ensure that the samples of the two studies were representative. Hypertension was defined as a mean SBP at least 140 mmHg or a mean DBP at least 90 mmHg, and/or self-reported use of antihypertensive medication within the past 2 weeks. The prevalence and control rate of hypertension were also estimated according to the 2017 American College of Cardiology/American Heart Association high blood pressure guideline. RESULTS Overall, the age-standardized prevalence of hypertension increased from 52.3 to 53.6%, while the age-specified DBP level increased by 5.2% (82.4 vs. 86.7 mmHg) during the study period. However, the control rate unfortunately remained low (4.1 vs. 3.6%), despite unsatisfied awareness and treatment rates of hypertension in rural northeast China. Under the 2017 American College of Cardiology/American Heart Association guideline, the prevalence of hypertension increased from 73.9 to 79.1%; however, the control rate decreased sharply from 1.8 to 0.5% between 2013 and 2018. CONCLUSION Despite the high prevalence of hypertension during the past 5 years, blood pressure levels increased significantly, especially the DBP level. Awareness, treatment, and control of hypertension remained unacceptably low. Therefore, strategies targeting the management of hypertension should be emphasized in rural northeast China.
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Cuspidi C, Sala C, Tadic M, Gherbesi E, Grassi G, Mancia G. Pre-hypertension and subclinical carotid damage: a meta-analysis. J Hum Hypertens 2018; 33:34-40. [DOI: 10.1038/s41371-018-0114-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Revised: 07/07/2018] [Accepted: 08/03/2018] [Indexed: 11/09/2022]
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Liu B, Dong X, Xiao Y, Mao X, Pan W, UN D, Qin G. Variability of metabolic risk factors associated with prehypertension in males and females: a cross-sectional study in China. Arch Med Sci 2018; 14:766-772. [PMID: 30002693 PMCID: PMC6040139 DOI: 10.5114/aoms.2018.76066] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Accepted: 05/29/2017] [Indexed: 12/21/2022] Open
Abstract
INTRODUCTION Prehypertension is highly prevalent. However, very few studies have evaluated the association of various metabolic risk factors in those with prehypertension and, more importantly, possible differences based on gender. MATERIAL AND METHODS Data of clinical characteristics were collected from 3891 subjects. Risk factors were analyzed by multiple logistic regression analysis. The areas under receiver operating characteristic curves were compared to assess the discriminatory value of metabolic parameters for predicting prehypertension. RESULTS The incidence of prehypertension was 55.9% (66.9% of men, 41.1% of women). Prehypertensives showed clusters of metabolic associations including changes in the levels of plasma high-density lipoprotein cholesterol (OR = 1.550), triglycerides (OR = 1.141) and fasting blood glucose (OR = 1.320) after adjusting for age, sex, body mass index and smoking. The metabolic associations also showed differences based on gender. For instance, higher total cholesterol (OR = 1.602) was the most evident risk factor in men with prehypertension, while higher triglycerides (OR = 1.314) and lower high-density lipoprotein cholesterol (OR = 1.729) were the main risk factors in women. CONCLUSIONS Our study suggests that risk associations of prehypertension show gender differences. These results emphasize the importance of health education, active management of blood pressure and timely and effective treatment of abnormal lipid profile in subjects with prehypertension.
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Affiliation(s)
- Bo Liu
- Department of Laboratory, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Xiaoqi Dong
- Oral Maxillofacial Surgery, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Yufei Xiao
- Department of Laboratory, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Xianya Mao
- Department of Laboratory, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Wensheng Pan
- Department of Gastroenterology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Das UN
- BioScience Research Centre, Department of Medicine, Gayatri Vidya Parishad Hospital, GVP College of Engineering Campus, Visakhapatnam, India
- UND Life Sciences, USA
| | - Guangming Qin
- Department of Laboratory, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
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Guo X, Zheng L, Zhang X, Zou L, Li J, Sun Z, Hu J, Sun Y. The prevalence and heterogeneity of prehypertension: a meta-analysis and meta-regression of published literature worldwide. Cardiovasc J Afr 2016; 23:44-50. [PMID: 22331252 PMCID: PMC3721861 DOI: 10.5830/cvja-2011-058] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2011] [Accepted: 09/15/2011] [Indexed: 01/15/2023] Open
Abstract
Objective Prehypertension appears to be a precursor of hypertension and has been recognised as a major risk factor for cardiovascular disease (CVD). Recognition of prehypertension provides important opportunities for preventing hypertension and CVD. We aimed to investigate the world-wide prevalence and heterogeneity of prehypertension. Methods We performed a meta-analysis of cross-sectional studies worldwide that reported the prevalence of prehypertension. We searched for publications between January 1966 and November 2010, using PubMed, Ovid and the Cochrane Library, with the keyword ‘prehypertension’, supplemented by a manual search of references from recent reviews and relevant published original studies. Pooled prevalence of prehypertension was calculated using random-effects models. Heterogeneity was investigated by subgroup analysis and meta-regression. Twenty-two articles met our inclusion criteria, with a total sample of 242 322 individuals. Results The overall pooled prevalence of prehypertension was 38%. Significant heterogeneity across estimates of prevalence was observed (p = 0.000, I2 = 99.9%). The prevalence rose as the sample size increased, and was higher among men than women (41 vs 34%). The non-Asian population was more likely to be prehypertensive than Asian individuals (42 vs 36%). A high prevalence of 47% was observed among the black African population in the non-Asian subgroup. The inception year of the surveys was the only source of heterogeneity we found by meta-regressional analysis (p = 0.06). Conclusion These results indicate that the prevalence of prehypertension was relatively high, particularly among males. Although more attention has been paid to this segment of the population since 2003, additional practical and reasonable steps should be taken to prevent and treat prehypertension.
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Affiliation(s)
- X Guo
- Department of Cardiology, First Affiliated Hospital of China Medical University, Shenyang, People's Republic of China
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Yao W, Sun Y, Wang X, Niu K. Elevated Serum Level of Interleukin 17 in a Population With Prehypertension. J Clin Hypertens (Greenwich) 2015; 17:770-4. [PMID: 26140526 PMCID: PMC8032147 DOI: 10.1111/jch.12612] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2015] [Revised: 04/16/2015] [Accepted: 04/19/2015] [Indexed: 01/24/2023]
Abstract
Cytokines play an important role in the pathogenesis of hypertension. The authors hypothesized that interleukin 17 (IL-17) might contribute to the prehypertensive state. This study evaluated the relationship between serum levels of IL-17 and prehypertension. A total of 394 participants were enrolled, after excluding for hypertension or treated hypertension, and divided into two groups (optimal blood pressure [BP] and prehypertension) based on the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure classification of BP. Optimal BP was defined as systolic BP <120 mm Hg and diastolic BP <80 mm Hg. Prehypertension was defined as systolic BP of 120 to 139 mm Hg or diastolic BP of 80 to 89 mm Hg. IL-17A levels were determined by enzyme-linked immunosorbent assay. The mean serum IL-17 concentration in the prehypertension group was significantly higher than in the optimal BP group. The cohort was divided into quartiles Q1 (≤3.5 ng/L), Q2 (3.60 to 6.10 ng/L), Q3 (6.20 to 10.00 ng/L), and Q4 (≥10.10 ng/L) based on IL-17 levels. The Q2 to Q4 groups had increasing odds ratios for having prehypertension compared with the Q1 group. Elevated serum IL-17 was accompanied by a rise in systolic BP. Thus, increased serum IL-17 levels are associated with prehypertension.
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Affiliation(s)
- Wei Yao
- Department of CardiologyTianjin Medical University General HospitalTianjin Medial UniversityTianjinChina
| | - Yuemin Sun
- Department of CardiologyTianjin Medical University General HospitalTianjin Medial UniversityTianjinChina
| | - Xuechun Wang
- Department of CardiologyTianjin Medical University General HospitalTianjin Medial UniversityTianjinChina
| | - Kaijun Niu
- Nutritional Epidemiology Institute and School of Public HealthTianjin Medical UniversityTianjinChina
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Rodríguez-Ramírez M, Simental-Mendía LE, González-Ortiz M, Martínez-Abundis E, Madero A, Brito-Zurita O, Pérez-Fuentes R, Revilla-Monsalve C, Islas-Andrade S, Rodríguez-Morán M, Guerrero-Romero F. Prevalence of Prehypertension in Mexico and Its Association With Hypomagnesemia. Am J Hypertens 2015; 28:1024-30. [PMID: 25618517 DOI: 10.1093/ajh/hpu293] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2014] [Accepted: 12/15/2014] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Prehypertension (preHTN) increases the risk of developing hypertension. The objectives of this study were to estimate the prevalence of preHTN in the Mexican adult population and evaluate the association between hypomagnesemia and preHTN. METHODS This study was a 2-phase, population-based study. In the first phase, 4,272 Mexican adults (aged 20-65 years) were enrolled to determine the prevalence of preHTN. In the second phase, a cross-sectional analysis was performed to evaluate the association between hypomagnesemia and preHTN. The exclusion criteria were chronic diarrhea, malignancy, hepatic and renal diseases, chronic inflammatory disease, and the intake of magnesium supplements. PreHTN was defined as a systolic blood pressure (BP) of 120-139 mm Hg and/or diastolic BP of 80-89 mm Hg, and hypomagnesemia was defined as a serum magnesium concentration <1.8 mg/dl. RESULTS The prevalence of preHTN was 37.5% (95% confidence interval (CI): 36.0-39.0): 46.7% were men (95% CI: 44.1-49.4) and 33.2% (95% CI: 31.5-5.0) were women. The serum magnesium data were available for 921 participants. Hypomagnesemia was identified in 276 (30.0%; 95% CI: 27.1-33.0) subjects; of them, 176 (63.8%; 95% CI: 58.3-69.6) had preHTN. Individuals with preHTN exhibited lower magnesium levels than individuals without preHTN (1.78±0.36 vs. 1.95±0.37, P < 0.0005). A multiple logistic regression analysis (adjusted for age, sex, smoking, body mass index, waist circumference, fasting glucose, total cholesterol, high-density lipoprotein cholesterol, and triglycerides levels) indicated a significant association between hypomagnesemia and preHTN (odds ratio = 1.78; 95% CI: 1.5-4.0, P < 0.0005). CONCLUSIONS The prevalence of preHTN in the Mexican population is 37.5%, and hypomagnesemia is strongly associated with preHTN.
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Affiliation(s)
- Mariana Rodríguez-Ramírez
- The Multidisciplinary Research Group on Diabetes of the Mexican Social Security Institute, Durango, Dgo, México
| | - Luis E Simental-Mendía
- The Multidisciplinary Research Group on Diabetes of the Mexican Social Security Institute, Durango, Dgo, México
| | - Manuel González-Ortiz
- The Multidisciplinary Research Group on Diabetes of the Mexican Social Security Institute, Durango, Dgo, México; Institute of Experimental and Clinical Therapeutics, Department of Physiology, Health Science University Center, University of Guadalajara, Guadalajara, Mexico
| | - Esperanza Martínez-Abundis
- The Multidisciplinary Research Group on Diabetes of the Mexican Social Security Institute, Durango, Dgo, México; Institute of Experimental and Clinical Therapeutics, Department of Physiology, Health Science University Center, University of Guadalajara, Guadalajara, Mexico
| | - Agustín Madero
- The Multidisciplinary Research Group on Diabetes of the Mexican Social Security Institute, Durango, Dgo, México
| | - Olga Brito-Zurita
- The Multidisciplinary Research Group on Diabetes of the Mexican Social Security Institute, Durango, Dgo, México
| | - Ricardo Pérez-Fuentes
- The Multidisciplinary Research Group on Diabetes of the Mexican Social Security Institute, Durango, Dgo, México
| | - Cristina Revilla-Monsalve
- The Multidisciplinary Research Group on Diabetes of the Mexican Social Security Institute, Durango, Dgo, México
| | - Sergio Islas-Andrade
- The Multidisciplinary Research Group on Diabetes of the Mexican Social Security Institute, Durango, Dgo, México
| | - Martha Rodríguez-Morán
- The Multidisciplinary Research Group on Diabetes of the Mexican Social Security Institute, Durango, Dgo, México
| | - Fernando Guerrero-Romero
- The Multidisciplinary Research Group on Diabetes of the Mexican Social Security Institute, Durango, Dgo, México;
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Sosner P, Ott J, Steichen O, Bally S, Krummel T, Brucker M, Lequeux B, Dourmap C, Llaty P, Le Coz S, Baguet S, Miranne A, Labrunée M, Gremeaux V, Lopez-Sublet M. [Physical activity level and home blood pressure measurement: Pilot study "Acti-HTA"]. Ann Cardiol Angeiol (Paris) 2015; 64:205-209. [PMID: 26047874 DOI: 10.1016/j.ancard.2015.04.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2015] [Accepted: 04/28/2015] [Indexed: 06/04/2023]
Abstract
While physical activity (PA) is recommended for high blood pressure management, the level of PA practice of hypertensive patients remains unclear. We aimed to assess the association between the level of both PA and blood pressure of individuals consulting in 9 hypertension specialist centres. Eighty-five hypertensive patients were included (59 ± 14 years, 61% men, 12% smokers, 29% with diabetes). Following their consultation, they performed home blood pressure measurement (HBPM) over 7 days (2 in the morning+2 in the evening), they wrote in a dedicated form their daily activities to estimate the additional caloric expenditure using Acti-MET device (built from International physical Activity Questionnaire [IPAQ]). Thus, patients completed a self-administered questionnaire "score of Dijon" (distinguishing active subjects with a score>20/30, from sedentary<10/30). Subjects with normal HBPM value (<135/85 mm Hg) (55% of them) compared to those with high HBPM were older, had a non-significant trend towards higher weekly caloric expenditure (4959 ± 5045 kcal/week vs. 4048 ± 4199 kcal/week, P=0.3755) and score of Dijon (19.44 ± 5.81 vs. 18.00 ± 4.32, P=0.2094) with a higher proportion of "active" subjects (48.9% vs. 34.2%, P=0.1773). In conclusion, our results demonstrate a "tendency" to a higher level of reported PA for subjects whose hypertension was controlled. This encourages us to continue with a study that would include more subjects, which would assess PA level using an objective method such as wearing an accelerometer sensor.
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Affiliation(s)
- P Sosner
- Centre médico-sportif Mon Stade, 5, rue Elsa-Morante, 75013 Paris, France; Laboratoire MOVE (EA6314), université de Poitiers, 8, allée Jean-Monnet, 86000 Poitiers, France; Centre de diagnostic, Hôtel-Dieu, AP-HP, 1, parvis Notre-Dame, 75004 Paris, France.
| | - J Ott
- Service de néphrologie, centre hospitalier d'Haguenau, 64, avenue Pr-Leriche, 67500 Haguenau, France
| | - O Steichen
- Service de médecine interne, hôpital Tenon, AP-HP, 4, rue Chine, 75020 Paris, France
| | - S Bally
- Service de néphrologie-dialyse, centre hospitalier Métropole Savoie, place Lucien-Biset, 73011 Chambéry, France
| | - T Krummel
- Service de néphrologie, CHU de Strasbourg, 1, place Hôpital, 67000 Strasbourg, France
| | - M Brucker
- Service de néphrologie, centre hospitalier de Valence, 179, avenue Maréchal-Juin, 26000 Valence, France
| | - B Lequeux
- Service de cardiologie, CHU de Poitiers, 2, rue Milétrie, 86021 Poitiers, France
| | - C Dourmap
- Service de cardiologie, CHU de Rennes, 2, rue Henri-Le-Guilloux, 35000 Rennes, France
| | - P Llaty
- Service de cardiologie, CHU de Poitiers, 2, rue Milétrie, 86021 Poitiers, France
| | - S Le Coz
- Service de néphrologie, centre hospitalier de Saint-Nazaire, 11, boulevard Georges-Charpak, 44606 Saint-Nazaire, France
| | - S Baguet
- Service de cardiologie, groupe hospitalier Mutualiste, 8, rue Dr-Calmette, 38000 Grenoble, France
| | - A Miranne
- Faculté de médecine et de pharmacie, université de Poitiers, 6, rue Milétrie, 86000 Poitiers, France
| | - M Labrunée
- Médecine physique et réadaptation, hôpital Rangueil, CHU de Toulouse, 1, avenue Pr-Jean-Poulhès, 31059 Toulouse, France
| | - V Gremeaux
- Pôle rééducation-réadaptation, CHU de Dijon, 23, rue Gaffarel, 21000 Dijon, France; Inserm U1093 « cognition, action, et plasticité sensorimotrice », 21078 Dijon, France
| | - M Lopez-Sublet
- Service de médecine interne, CHU Avicenne, AP-HP, 125, rue Stalingrad, 93000 Bobigny, France
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Yao W, Sun Y, Wang X, Si Q, Chen H, Wan Z. High prevalence of metabolic syndrome in a middle-aged and elderly population with prehypertension in Tianjin. Clin Exp Hypertens 2014; 37:369-74. [PMID: 25496289 DOI: 10.3109/10641963.2014.977487] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Prehypertension has been reported as being correlated with future cardiovascular risk and end-organ damage in middle-aged and elderly persons, and also playing an important role in metabolic syndrome (MetS). The association between prehypertension and MetS has rarely been reported among urban adults in Tianjin, China. METHODS In this cross-sectional study, a total of 1176 participants aged 40-70 years (524 males and 652 females) were enrolled after excluding participants with hypertension or treated hypertension. Participants were divided into two groups [optimal blood pressure (BP) and prehypertension] based on the classification of BP from the JNC-7. The definition of MetS was as per the International Diabetes Federation standard. An adjusted logistic regression model was used to assess relationships between prehypertension and MetS. RESULTS The prehypertension group had a significantly higher odds ratio (OR) than the optimal BP group for abnormal waist circumference (WC), fasting plasma glucose (FPG) and triglycerides (TG). In addition, the prehypertension group had a higher OR (3.12; 95% confidence interval 2.34-4.18) for having MetS after adjusting for potential confounders. CONCLUSIONS The risk of having MetS was significantly associated with prehypertension in middle-aged and elderly persons in Tianjin. Stricter control of BP in this age group is warranted.
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Affiliation(s)
- Wei Yao
- Department of Cardiology, Tianjin Medical University General Hospital, Tianjin Medial University , Tianjin , China
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Ethnic differences in the incidence of hypertension among rural Chinese adults: results from Liaoning Province. PLoS One 2014; 9:e86867. [PMID: 24489797 PMCID: PMC3906098 DOI: 10.1371/journal.pone.0086867] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2013] [Accepted: 12/16/2013] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND This study was conducted to examine the differences in the incidence of hypertension and associated risk factors between Mongolian and Han populations in northeast China. METHODS A population-based sample of 4753 Mongolian subjects and 20,247 Han subjects aged ≥ 35 years and free from hypertension at baseline were followed from 2004-2006 to 2010. Incident hypertension was defined as systolic blood pressure ≥ 140 mmHg, diastolic blood pressure ≥ 90 mmHg, or current use of antihypertensive medication. RESULTS During mean 4.3 years follow-up, a total of 8779 individuals developed hypertension. The age-adjusted incidence of hypertension for Mongolian subjects was 12.64 per 100 person-years, for Han subjects was 9.77 per 100 person-years (P<0.05). The incidence of hypertension was positively correlated with age, physical activity, drinking, body mass index (BMI), family of hypertension and prehypertension in the Han population. In the Mongolian population, hypertension was positively correlated with age, physical activity, education level, drinking, BMI, prehypertension and family history of hypertension. The rates of awareness, treatment and control of hypertension for newly developed cases among both Han and Mongolian populations were low. (36.5% vs. 42.3%, 13.1% vs. 18.2%, 0.7% vs. 1.3%, P<0.05, respectively). CONCLUSIONS The incidence rate of hypertension is higher in the Mongolian populations than that in the Han populations, and hypertension in both ethnic populations was associated with similar risk factors. Our results suggest that most newly-diagnosed cases of hypertension are not adequately treated. Improvements in hypertension prevention and control programs in rural China are urgently needed.
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Petrie JR, Malik MO, Balkau B, Perry CG, Højlund K, Pataky Z, Nolan J, Ferrannini E, Natali A. Euglycemic Clamp Insulin Sensitivity and Longitudinal Systolic Blood Pressure. Hypertension 2013; 62:404-9. [DOI: 10.1161/hypertensionaha.111.00439] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Insulin resistance may be an independent risk factor for the development of hypertension, but change in blood pressure (BP) over time has not been adequately studied in healthy individuals fully characterized for insulin sensitivity. In the Relationship between Insulin Sensitivity and Cardiovascular disease (RISC) study, we measured insulin sensitivity (M/I) using the euglycemic clamp technique in 1073 healthy European adults (587 women, 486 men) aged 30 to 60 years followed up 3 years later. Systolic BP (SBP) at baseline was higher in insulin-resistant women (ie, those in the low sex-specific M/I tertile) compared with those in the intermediate (
P
<0.001) or high tertiles (
P
=0.06; mean±SD: 117±13, 111±12, 114±12 mm Hg, respectively). It did not differ across M/I tertiles in men. After adjustment for age, body mass index, baseline SBP, and other covariates, low insulin sensitivity (M/I) predicted a longitudinal rise in SBP in women but not in men; M/I was not associated with change in diastolic BP. SBP rose over time in both sexes and within all M/I tertiles (
P
<0.05), except in women with high insulin sensitivity. Therefore, in women (but not in men), low insulin sensitivity was associated with higher SBP at 3 years, and high insulin sensitivity was associated with a lower rise in SBP over time.
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Affiliation(s)
- John R. Petrie
- From the University of Glasgow, Glasgow, United Kingdom (J.R.P., M.O.M., C.P.); Khyber Medical University Peshawar, Peshawar, Pakistan (M.O.M); INSERM U1018, Villejuif, France (B.B.); University Paris Sud 11, UMRS 1018, Villejuif, France (B.B.); Odense University Hospital, Odense, Denmark (K.H.); University Hospital of Geneva, Switzerland (Z.P.); Steno Diabetes Center, Copenhagen, Denmark (J.N.); and the Department of Internal Medicine, University of Pisa, Pisa, Italy (E.F., A.N.)
| | - Muhammad Omar Malik
- From the University of Glasgow, Glasgow, United Kingdom (J.R.P., M.O.M., C.P.); Khyber Medical University Peshawar, Peshawar, Pakistan (M.O.M); INSERM U1018, Villejuif, France (B.B.); University Paris Sud 11, UMRS 1018, Villejuif, France (B.B.); Odense University Hospital, Odense, Denmark (K.H.); University Hospital of Geneva, Switzerland (Z.P.); Steno Diabetes Center, Copenhagen, Denmark (J.N.); and the Department of Internal Medicine, University of Pisa, Pisa, Italy (E.F., A.N.)
| | - Beverley Balkau
- From the University of Glasgow, Glasgow, United Kingdom (J.R.P., M.O.M., C.P.); Khyber Medical University Peshawar, Peshawar, Pakistan (M.O.M); INSERM U1018, Villejuif, France (B.B.); University Paris Sud 11, UMRS 1018, Villejuif, France (B.B.); Odense University Hospital, Odense, Denmark (K.H.); University Hospital of Geneva, Switzerland (Z.P.); Steno Diabetes Center, Copenhagen, Denmark (J.N.); and the Department of Internal Medicine, University of Pisa, Pisa, Italy (E.F., A.N.)
| | - Colin G. Perry
- From the University of Glasgow, Glasgow, United Kingdom (J.R.P., M.O.M., C.P.); Khyber Medical University Peshawar, Peshawar, Pakistan (M.O.M); INSERM U1018, Villejuif, France (B.B.); University Paris Sud 11, UMRS 1018, Villejuif, France (B.B.); Odense University Hospital, Odense, Denmark (K.H.); University Hospital of Geneva, Switzerland (Z.P.); Steno Diabetes Center, Copenhagen, Denmark (J.N.); and the Department of Internal Medicine, University of Pisa, Pisa, Italy (E.F., A.N.)
| | - Kurt Højlund
- From the University of Glasgow, Glasgow, United Kingdom (J.R.P., M.O.M., C.P.); Khyber Medical University Peshawar, Peshawar, Pakistan (M.O.M); INSERM U1018, Villejuif, France (B.B.); University Paris Sud 11, UMRS 1018, Villejuif, France (B.B.); Odense University Hospital, Odense, Denmark (K.H.); University Hospital of Geneva, Switzerland (Z.P.); Steno Diabetes Center, Copenhagen, Denmark (J.N.); and the Department of Internal Medicine, University of Pisa, Pisa, Italy (E.F., A.N.)
| | - Zoltan Pataky
- From the University of Glasgow, Glasgow, United Kingdom (J.R.P., M.O.M., C.P.); Khyber Medical University Peshawar, Peshawar, Pakistan (M.O.M); INSERM U1018, Villejuif, France (B.B.); University Paris Sud 11, UMRS 1018, Villejuif, France (B.B.); Odense University Hospital, Odense, Denmark (K.H.); University Hospital of Geneva, Switzerland (Z.P.); Steno Diabetes Center, Copenhagen, Denmark (J.N.); and the Department of Internal Medicine, University of Pisa, Pisa, Italy (E.F., A.N.)
| | - John Nolan
- From the University of Glasgow, Glasgow, United Kingdom (J.R.P., M.O.M., C.P.); Khyber Medical University Peshawar, Peshawar, Pakistan (M.O.M); INSERM U1018, Villejuif, France (B.B.); University Paris Sud 11, UMRS 1018, Villejuif, France (B.B.); Odense University Hospital, Odense, Denmark (K.H.); University Hospital of Geneva, Switzerland (Z.P.); Steno Diabetes Center, Copenhagen, Denmark (J.N.); and the Department of Internal Medicine, University of Pisa, Pisa, Italy (E.F., A.N.)
| | - Ele Ferrannini
- From the University of Glasgow, Glasgow, United Kingdom (J.R.P., M.O.M., C.P.); Khyber Medical University Peshawar, Peshawar, Pakistan (M.O.M); INSERM U1018, Villejuif, France (B.B.); University Paris Sud 11, UMRS 1018, Villejuif, France (B.B.); Odense University Hospital, Odense, Denmark (K.H.); University Hospital of Geneva, Switzerland (Z.P.); Steno Diabetes Center, Copenhagen, Denmark (J.N.); and the Department of Internal Medicine, University of Pisa, Pisa, Italy (E.F., A.N.)
| | - Andrea Natali
- From the University of Glasgow, Glasgow, United Kingdom (J.R.P., M.O.M., C.P.); Khyber Medical University Peshawar, Peshawar, Pakistan (M.O.M); INSERM U1018, Villejuif, France (B.B.); University Paris Sud 11, UMRS 1018, Villejuif, France (B.B.); Odense University Hospital, Odense, Denmark (K.H.); University Hospital of Geneva, Switzerland (Z.P.); Steno Diabetes Center, Copenhagen, Denmark (J.N.); and the Department of Internal Medicine, University of Pisa, Pisa, Italy (E.F., A.N.)
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14
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Hong H, Wang H, Liao H. Prehypertension is associated with increased carotid atherosclerotic plaque in the community population of Southern China. BMC Cardiovasc Disord 2013; 13:20. [PMID: 23510396 PMCID: PMC3618079 DOI: 10.1186/1471-2261-13-20] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2012] [Accepted: 02/19/2013] [Indexed: 11/10/2022] Open
Abstract
Background The proceeding of blood pressure (BP) from normal level to the hypertension has been found to be associated with increased cardiovascular events and multiple vascular risk factors. However, whether the process is associated with increased carotid atherosclerotic plaque per se or not is still unclear. Methods Nine hundred and forty-two participants aged from 46 to 75 were enrolled from community population in Southern China. Their metabolic risk factors, carotid intima-media thickness (cIMT) and atherosclerotic plaque formation were analyzed and stratified by different blood pressure levels according to JNC-7 or ESH/ESC-2007 classification. Results From low BP level to higher BP level, multiple metabolic risk factors increased linearly. Prehypertension in JNC-7 classification (or normal BP and high normal BP in ESH/ESC-2007 classification) was correlated with thicker cIMT and more plaque formation than normotension (or optimal BP) (p < 0.001). After adjusting multiple metabolic factors, the differences were still significant (p < 0.05). Furthermore, prehypertensive participants had a trend to be thicker carotid IMT (OR and its 95% CI: 1.65, 0.97-2.82, p = 0.067) and significantly higher carotid plaque occurrence (OR and its 95% CI: 2.36, 1.43-3.88, p = 0.001) than normotensive ones. However, there was no significant difference of cIMT and plaque formation between normal BP and high normal BP (p > 0.05). Plaque formation in prehypertension was as significant as that in hypertension. Conclusion Prehypertension is associated with significantly increased carotid atherosclerotic plaque and is a primary stratify risk factor for carotid atherosclerosis which could cause ischemic stroke in middle-aged and elderly population in Southern China.
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Affiliation(s)
- Hua Hong
- Department of Neurology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, P. R. China.
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15
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Xu B, Xu Z, Xu X, Cai Q, Xu Y. Prevalence, awareness, treatment, and control of hypertension among residents in Guangdong Province, China, 2004 to 2007. Circ Cardiovasc Qual Outcomes 2013; 6:217-22. [PMID: 23481521 DOI: 10.1161/circoutcomes.111.000062] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
BACKGROUND As a result of the large variation in geographic, demographic, and socioeconomic characteristics in different regions of China, the prevalence and treatment of hypertension in different regions differ widely. However, little is known about the recent trends of hypertension in Guangdong Province in southern China. We assessed the trends in prevalence, awareness, treatment, and control of hypertension in Guangdong Province between 2004 and 2007. METHODS AND RESULTS The Guangdong Provincial Chronic Disease Risk Factor Surveillance, modeled on the national Chronic Disease Risk Factor Surveillance, was conducted every 3 years beginning in 2004 with a representative sample of Guangdong Province residents ≥18 years of age. Data from the Guangdong Provincial Chronic Disease Risk Factor Surveillance I (2004; n=7633) and II (2007; n=6447) were used to describe the trends in the prevalence of hypertension among Guangdong Province adults. Hypertension outcomes were examined with interview and examination data. From 2004 to 2007, the age-standardized prevalence rate of hypertension in Guangdong Province residents increased from 12.2% to 15.4% (P<0.001), with the largest increases among rural women (from 9.3% to 19.1%; P<0.001). Among hypertensive people, there was no improvement in awareness and treatment between 2004 and 2007; the control rates decreased from 7.1% in 2004 to 4.5% in 2007 (P<0.01). CONCLUSIONS One in 7 Guangdong Province adults is hypertensive, but only one quarter are aware of the condition. About 22% of hypertensive patients receive treatment, and few have their hypertension effectively controlled. Hypertension has become a major public health problem in southern China. Comprehensive public health measures need to be taken to decrease the incidence of hypertension and to prevent the progression of hypertension to cardiovascular disease.
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Affiliation(s)
- Bayi Xu
- Department of Noncommunicable Disease Control and Prevention, Center for Disease Control and Prevention of Shantou Municipal, Guangdong Province, China
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16
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Sympathovagal Imbalance in Young Prehypertensives: Importance of Male-Female Difference. Am J Med Sci 2013; 345:10-7. [DOI: 10.1097/maj.0b013e31824ba080] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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17
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Pal GK, Pal P, Nanda N, Amudharaj D, Adithan C. Cardiovascular dysfunctions and sympathovagal imbalance in hypertension and prehypertension: physiological perspectives. Future Cardiol 2013; 9:53-69. [DOI: 10.2217/fca.12.80] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Hypertension (HTN) and prehypertension (pre-HTN) have been identified as independent risk factors for adverse cardiovascular events. Recently, increased psychosocial stress and work stress have contributed to the increased prevalence of HTN and pre-HTN, in addition to the contribution of obesity, diabetes, poor food habits and physical inactivity. Irrespective of the etiology, sympathetic overactivity has been recognized as the main pathophysiologic mechanism in the genesis of HTN and pre-HTN. Sympathovagal imbalance owing to sympathetic overactivity and vagal withdrawal is reported to be the basis of many clinical disorders. However, the role played by vagal withdrawal has been under-reported. In this review, we have analyzed the pathophysiologic involvement of sympathovagal imbalance in the development of HTN and pre-HTN, and the link of sympathovagal imbalance to cardiovascular dysfunctions. We have emphasized that adaptation to a healthier lifestyle will help improve sympathovagal homeostasis and prevent the occurrence of HTN and pre-HTN.
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Affiliation(s)
- Gopal Krushna Pal
- Department of Physiology, Jawaharlal Institute of Post-graduate Medical Education & Research (JIPMER), Puducherry – 605 006, India
| | - Pravati Pal
- Department of Physiology, Jawaharlal Institute of Post-graduate Medical Education & Research (JIPMER), Puducherry – 605 006, India
| | - Nivedita Nanda
- Department of Biochemistry, Pondicherry Institute of Medical Sciences (PIMS), Puducherry – 605 014, India
| | - Dharmalingam Amudharaj
- Department of Physiology, Jawaharlal Institute of Post-graduate Medical Education & Research (JIPMER), Puducherry – 605 006, India
| | - Chandrasekaran Adithan
- Department of Pharmacology, Jawaharlal Institute of Post-graduate Medical Education & Research (JIPMER), Puducherry – 605 006, India
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18
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Abstract
High blood pressure is reported in over two-thirds of patients with type 2 diabetes, and its development coincides with the development of hyperglycaemia. Many pathophysiological mechanisms underlie this association. Of these mechanisms, insulin resistance in the nitric-oxide pathway; the stimulatory effect of hyperinsulinaemia on sympathetic drive, smooth muscle growth, and sodium-fluid retention; and the excitatory effect of hyperglycaemia on the renin-angiotensin-aldosterone system seem to be plausible. In patients with diabetes, hypertension confers an enhanced risk of cardiovascular disease. A blood pressure of lower than 140/85 mm Hg is a reasonable therapeutic goal in patients with type 2 diabetes according to clinical trial evidence. People with controlled diabetes have a similar cardiovascular risk to patients without diabetes but with hypertension. A renin-angiotensin system blocker combined with a thiazide-type diuretic might be the best initial antihypertensive regimen for most people with diabetes. In general, the positive effects of antihypertensive drugs on cardiovascular outcomes outweigh the negative effects of antihypertensive drugs on glucose metabolism.
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Affiliation(s)
- Ele Ferrannini
- Department of Internal Medicine, University of Pisa, Pisa, Italy.
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19
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Lee JH, Yang DH, Park HS, Cho Y, Jun JE, Park WH, Chun BY, Shin JY, Shin DH, Lee KS, Kim KS, Kim KB, Kim YJ, Chae SC. Incidence of hypertension in Korea: 5-year follow-up study. J Korean Med Sci 2011; 26:1286-92. [PMID: 22022179 PMCID: PMC3192338 DOI: 10.3346/jkms.2011.26.10.1286] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2011] [Accepted: 08/29/2011] [Indexed: 11/20/2022] Open
Abstract
Limited data are available about the incidence of hypertension over the 5-yr in non-hypertensive subjects. The study subjects were 1,806 subjects enrolled in a rural area of Daegu, Korea for a cohort study from August to November 2003. Of them, 1,287 (71.3%) individuals had another examination 5 yr later. To estimate the incidence of hypertension, 730 non-hypertensive individuals (265 males; mean age = 56.6 ± 11.1 yr-old) at baseline examination were analyzed in this study. Hypertension was defined as either a new diagnosis of hypertension or self-reports of newly initiated antihypertensive treatment; prehypertension was if the systolic blood pressure was 120-139 mmHg and/or diastolic blood pressure was 80-89 mmHg. During the 5-yr follow-up, 195 (26.7%) non-hypertensive individuals developed incident hypertension. The age-adjusted 5-yr incidence rates of hypertension were 22.9% (95% confidence interval [CI] = 19.9-29.0) in overall subjects, 22.2% (95% CI = 17.2-27.2) in men, and 24.3% (95% CI = 20.4-28.2) in women. The incidence rates of hypertension significantly increased with age. In the multivariate analysis, prehypertension (Odds ratio [OR] 2.25; P < 0.001) and older age (OR 2.26; P = 0.010) were independent predictors for incident hypertension. In this rapidly aging society, population-based preventive approach to decrease blood pressure, particularly in subjects with prehypertension, is needed to reduce hypertension.
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Affiliation(s)
- Jang Hoon Lee
- Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea
| | - Dong Heon Yang
- Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea
| | - Hun Sik Park
- Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea
| | - Yongkeun Cho
- Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea
| | - Jae Eun Jun
- Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea
| | - Wee Hyun Park
- Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea
| | - Byung Yeol Chun
- Department of Preventive Medicine, Kyungpook National University School of Medicine, Daegu, Korea
| | - Ji-Yeon Shin
- Department of Preventive Medicine, Kyungpook National University School of Medicine, Daegu, Korea
| | - Dong Hoon Shin
- Department of Preventive Medicine, Keimyung University School of Medicine, Daegu, Korea
| | - Kyeong Soo Lee
- Department of Preventive Medicine and Public Health, Yeungnam University College of Medicine, Daegu, Korea
| | - Kee-Sik Kim
- Department of Internal Medicine, Daegu Catholic University Hospital, Daegu, Korea
| | - Kwon-Bae Kim
- Department of Internal Medicine, Keimyung University Dongsan Medical Center, Daegu, Korea
| | - Young Jo Kim
- Department of Internal Medicine, Yeungnam University Hospital, Daegu, Korea
| | - Shung Chull Chae
- Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea
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20
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Zhang WH, Zhang L, An WF, Ma JL. Prehypertension and clustering of cardiovascular risk factors among adults in suburban Beijing, China. J Epidemiol 2011; 21:440-6. [PMID: 21946627 PMCID: PMC3899460 DOI: 10.2188/jea.je20110022] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Background Prehypertension is common in China and is associated with an increased risk of cardiovascular disease. The present study estimated the current prevalence of prehypertension and its association with clustering of other modifiable cardiovascular risk factors (CRFs) among adults in suburban Beijing. Methods A cross-sectional survey of a representative sample of 19 003 suburban adults aged 18 to 76 years was carried out in 2007. Questionnaire data and information on blood pressure, anthropometric characteristics, and laboratory measurements were collected. Results The age-standardized prevalence of prehypertension was 35.7% (38.2% in men and 31.8% in women) among adults in suburban Beijing. The prevalence of overweight/obesity, diabetes, dyslipidemia, and physical inactivity was higher in participants with prehypertension (26.7%, 4.8%, 34.3%, and 60.4%, respectively) as compared with normotensive participants (15.9%, 2.7%, 20.5%, and 29.1%, respectively), and in participants with hypertension as compared with those with prehypertension. Overall, 85.3%, 49.8%, and 17.8% of prehypertensive men had 1 or more, 2 or more, and 3 or more CRFs (overweight/obesity, diabetes, dyslipidemia, current smoking, and physical inactivity). These proportions were higher than those in normotensive men (81.5%, 45.1%, and 13.4%) and lower than those in men with hypertension (91.7%, 56.4%, 19.2%). Similar results were found when women with prehypertension were compared with women who were normotensive or hypertensive. Conclusions A high prevalence of prehypertension and clustering of other modifiable CRFs are common among prehypertensive adults in suburban Beijing. More-effective population-based lifestyle modifications are required to prevent progression to hypertension and reduce the increasing burden of cardiovascular disease in China.
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Affiliation(s)
- Wei-Hong Zhang
- Department of Basic Medical Sciences, Nursing College, Zhengzhou University, Zhengzhou, China
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21
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Huan Y, DeLoach S, Keith SW, Pequignot EC, Falkner B. High blood pressure and obesity increase the risk of abnormal glucose tolerance in young adult african americans. J Clin Hypertens (Greenwich) 2011; 13:397-403. [PMID: 21649838 DOI: 10.1111/j.1751-7176.2010.00421.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Higher prevalence of both hypertension and obesity in African Americans is associated with a disproportionately greater burden of cardiovascular diseases in this ethnic group. The purpose of this study was to examine whether there is an interaction between hypertension and obesity that significantly increases the expression of metabolic risk factors for cardiovascular disease. Four groups of young adult African Americans were recruited based on their weight and blood pressure (BP). The effects of weight and BP on metabolic risk factors were analyzed based on data obtained from 484 patients. Results demonstrated that high BP and obesity were independently associated with increased odds of abnormal glucose tolerance, 1.8- and 2.2-fold, respectively. The coexistence of both high BP and obesity further increased the odds of abnormal glucose tolerance 4-fold. In addition, the geometric mean of homeostasis model assessment, an estimate of insulin resistance, increased by 18% with high BP, 60% with obesity, and 90% with the presence of both high BP and obesity. Although no statistically significant interaction between high BP and obesity was detected, the relationships of both high BP and obesity with metabolic risk factors were clearly additive.
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Affiliation(s)
- Yonghong Huan
- Division of Nephrology, Department of Medicine, Thomas Jefferson University, Philadelphia, PA, USA
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