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Graff TC, Birmingham WC, Wadsworth LL, Hung M. Doing it all: Effects of Family Responsibilities and Marital Relationship Quality on Mothers' Ambulatory Blood Pressure. Ann Behav Med 2024; 58:67-78. [PMID: 37824850 PMCID: PMC10729791 DOI: 10.1093/abm/kaad058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2023] Open
Abstract
BACKGROUND The shared provider responsibility between married couples does not translate to equally shared division of childcare (CC) and household labor. While some marriages contain highly positive aspects, marriages may also simultaneously contain both positive and negative aspects. The negativity in these relationships can negate the positivity and could potentially lead to the detriment of mothers' health. PURPOSE We examined mothers' ambulatory blood pressure (ABP) associated with their marital relationship quality and perceived equity with her spouse on CC and household tasks. METHODS We investigate these associations using a mixed multilevel model analysis on a sample of 224 mothers in heterosexual marriages, all of whom had children under the age of 18 years currently living in the home. RESULTS Mothers' perception of equity in the division of CC responsibilities contributed to lower ABP. Additionally, mothers in supportive marital relationships (low negativity and high positivity) had lower ABP than those in ambivalent relationships (both high negativity and positivity). There was a crossover interaction such that the effect of relationship quality on ABP was moderated by the perception of equity in the division of CC. For mothers who report doing all the CC, they had lower ABP if they had a supportive marital relationship compared with mothers in ambivalent relationships. Whereas mothers who report more equity in CC and have a supportive relationship have higher ABP compared with mothers in ambivalent relationships. CONCLUSIONS This study has implications related to dynamics within marital relationships. These results demonstrate important relational influences on mothers' ABP.
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Affiliation(s)
- Tyler C Graff
- Department of Psychology, Brigham Young University, Provo, UT, USA
| | | | - Lori L Wadsworth
- Romney Institute of Public Service and Ethics, Brigham Young University, Provo, UT, USA
| | - Man Hung
- Division of Public Health, University of Utah, Salt Lake City, UT, USA
- College of Dental Medicine, Roseman University of Health Sciences, South Jordan, UT, USA
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Holmbäck U, Grudén S, Litorp H, Willhems D, Kuusk S, Alderborn G, Söderhäll A, Forslund A. Effects of a novel weight-loss combination product containing orlistat and acarbose on obesity: A randomized, placebo-controlled trial. Obesity (Silver Spring) 2022; 30:2222-2232. [PMID: 36123783 PMCID: PMC9826204 DOI: 10.1002/oby.23557] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 07/18/2022] [Indexed: 01/11/2023]
Abstract
OBJECTIVE The aim of this study was to evaluate the effect of a novel, oral, modified-release formulation of the lipase inhibitor orlistat and the glucosidase/amylase inhibitor acarbose (denoted EMP16) on relative body weight after 26 weeks compared with placebo. METHODS The randomized, double-blind, placebo-controlled trial had a 26-week treatment period, with dose escalation up to 6 weeks. Participants, adults between ages 18 and 75 years, with BMI ≥30 kg/m2 or ≥28 kg/m2 with risk factors, were randomly assigned to EMP16 120-mg orlistat/40-mg acarbose (EMP16-120/40), EMP16-150/50, or placebo. The primary end point was relative weight loss from baseline to week 26 assessed in participants with at least one post-baseline weight measurement. RESULTS Of 156 randomized participants, 149 constituted the intention-to-treat population. The mean (95% CI) estimated treatment difference to placebo in relative weight loss after 26 weeks in the intention-to-treat population was -4.70% (-6.16% to -3.24%; p < 0.0001) with EMP16-120/40 and -5.42% (-6.60% to -4.24%; p < 0.0001) with EMP16-150/50. CONCLUSIONS This trial indicates that orlistat and acarbose can be successfully combined in a modified-release formulation to provide efficacious weight loss with no unexpected safety issues. EMP16 may be a promising candidate among other medications for improved weight management.
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Affiliation(s)
- Ulf Holmbäck
- Department of Public Health and Caring SciencesUppsala UniversityUppsalaSweden
- Empros Pharma ABSolnaSweden
| | | | - Helena Litorp
- Department of Global Public HealthKarolinska InstitutetStockholmSweden
- Clinical Trial Consultants ABUppsalaSweden
- Department of Women's and Children's HealthUppsala UniversityUppsalaSweden
| | - Daniel Willhems
- Clinical Trial Consultants ABUppsalaSweden
- Department of Biomedical and Clinical SciencesLinköping UniversityLinköpingSweden
| | | | - Göran Alderborn
- Department of Pharmaceutical BiosciencesUppsala UniversityUppsalaSweden
| | | | - Anders Forslund
- Department of Women's and Children's HealthUppsala UniversityUppsalaSweden
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Humbert X, Licaj I, Fedrizzi S, Alexandre J, Menotti A, Manrique A, Allouche S, Touzé E, Terradura-Vagnarelli O, Puddu PE. Relationship between lifestyle factors and hypertension: a cross-sectional analysis from the Gubbio study. Acta Cardiol 2022:1-9. [PMID: 35727257 DOI: 10.1080/00015385.2022.2088170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
BACKGROUND Hypertension (HTN) is a well-established and a major risk factor for cardiovascular disease. Lifestyle behaviours for its prevention and control are recommended within worldwide guidelines. Their relationship with HTN need more investigations. AIM We aimed to investigate the associations between lifestyle, anthropometric and biological measurements and BP in the Gubbio residential study. METHODS Cross-sectional analyses were performed using data from Gubbio study. Information concerning lifestyle factors were collected using self-reported questionnaire and were further completed with a baseline clinical examination and blood exams. Three BP measurements were performed following a standard protocol. Age-adjusted and multivariable logistic regressions were used to examine the relationships between lifestyle parameters and HTN separately for each sex. We used heterogeneity test to observe sex differences. RESULTS There were 3,183 persons included (48% men, 43 ± 17 years old). Mean systolic BP (SBP) was 119 ± 16 mmHg and 10.6% were hypertensives. Age [OR: 129.70 (95%CI: 18.57-905.79) in women and OR: 8.37 (95%CI: 4.01-17.48) (p < 0.0001) in men] and BMI [OR: 2.14 (95%CI: 1.32-3.46) (p = 0.006) in women and OR: 1.81 (95%CI: 1.05-3.12), p = 0.03 in men], were positively associated with SBP in both sexes. Serum uric acid [OR: 3.86 (95%CI: 2.03-7.26), p = 0.04] was positively associated with HTN in women while fasting blood glucose [OR: 3.04 (95%CI: 1.55-5.97), p < 0.001] were associated to HTN only in men. DISCUSSION In addition to age, BMI is associated with HTN in both sexes while sex differences were observed in the associations between serum uric acid, fasting blood glucose and HTN.
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Affiliation(s)
- Xavier Humbert
- Department of General Medicine, Medical School, UNICAEN, Normandie Université, Caen, France
| | - Idlir Licaj
- Department of Community Medicine, Faculty of Health Sciences, The UiT Arctic University of Norway, Tromsø, Norway
| | - Sophie Fedrizzi
- Department of Pharmacology, UNICAEN, Normandie Université, Caen, France
| | - Joachim Alexandre
- Department of Pharmacology, UNICAEN, Normandie Université, Caen, France
| | | | - Alain Manrique
- Department of Nuclear Medicine, CHU Caen, EA 4650UNICAEN, Normandie Université, Caen, France
| | - Stéphane Allouche
- Department of Biochemistry, CHU Caen, EA 4650, UNICAEN, Normandie Université, Caen, France
| | - Emmanuel Touzé
- Department of Neurology, CHU Caen, INSERM U 1237. UNICAEN, Normandie Université, Caen, France
| | | | - Paolo E Puddu
- EA 4650, UNICAEN, Normandie Université, Caen, France
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Statin therapy is associated with better ambulatory blood pressure control: a propensity score analysis. J Hypertens 2021; 38:546-552. [PMID: 31584522 DOI: 10.1097/hjh.0000000000002276] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Statin therapy was associated with lower blood pressure (BP) in some but not all studies. We evaluated the association between statin therapy and ambulatory BP in a large hypertensive population using 'propensity score matching'. METHODS Retrospective observational study on 1827 consecutive essential hypertensive patients evaluated with 24-h ambulatory BP monitoring. Antihypertensive treatment intensity (ATI) was calculated to compare different drug associations. We used a propensity score matching to compare two equally-sized cohorts of patients with similar characteristics according to statin therapy. Matching was performed on log-transformed propensity score in a 1 : 1 fashion with a caliper of 0.1, in order to account for the different baseline characteristics between statin and no-statin group. RESULTS Mean age: 58.1 ± 13.8 years; male sex: 55%. Patients on statin therapy: 402 (22%). These patients showed lower 24-h BP (-2.8/-7.1 mmHg), daytime (-3.3/-7.6 mmHg) and night-time BP (-2.5/-6.0 mmHg, all P < 0.001). They also showed better ambulatory BP control, even after adjustment for confounding factors. The analyses on the groups derived from the 'propensity score matching' (369 patients in each group) confirmed these results (OR 1.8 for 24-h BP control; OR = 1.6 for daytime BP control; OR = 1.7 for night-time BP control, all P < 0.001). CONCLUSION Statin therapy is associated with better ambulatory BP control in essential hypertensive patients. This result is not affected by the intensity of the antihypertensive treatment or by the several cofactors analyzed.
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Lelong H, Blacher J, Baudry J, Adriouch S, Galan P, Fezeu L, Hercberg S, Kesse-Guyot E. Combination of Healthy Lifestyle Factors on the Risk of Hypertension in a Large Cohort of French Adults. Nutrients 2019; 11:nu11071687. [PMID: 31340445 PMCID: PMC6683281 DOI: 10.3390/nu11071687] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 07/18/2019] [Accepted: 07/19/2019] [Indexed: 02/07/2023] Open
Abstract
Background: Healthy lifestyle factors are widely recommended for hypertension prevention and control. Nevertheless, little is known about their combined impact on hypertension, in the general population. Our aim was to compute a Healthy Lifestyle Index (HLI) comprising the main non-pharmacological measures usually recommended to improve hypertension prevention: normal weight, regular physical activity, limited alcohol consumption, adoption of a healthy diet; to evaluate their combined impact on hypertension incidence. Methods: We prospectively followed the incidence of hypertension among 80,426 French adults participating in the NutriNet-Santé cohort study. Self-reported dietary, socio-demographic, lifestyle and health data were assessed at baseline and yearly using a dedicated website; the association between HLI and hypertension risk was assessed by multivariable Cox proportional hazards models adjusted for age, sex, family history of hypertension, socio-demographic and lifestyle factors. Hypothetical Population Attributable Risks associated to each factor were estimated. Results: During a median follow-up of 3.5 years (IQR: 1.5–5.3), 2413 incident cases of hypertension were identified. Compared with no or one healthy lifestyle factor, the hazard ratios (HR) for hypertension were 0.76 (95% CI, 0.67–0.85) for two factors, 0.47 (95% CI, 0.42–0.53) for three factors and 0.35 (95% CI, 0.30–0.41) for all healthy lifestyle factors (p-trend <0.0001). Compared with adhering to 0, 1, 2 or 3 healthy lifestyles, adhering to all of them was found associated with a reduction of the hypertension risk of half (HR = 0.55 (95% CI, 0.46–0.65)). Conclusion: Active promotion of healthy lifestyle factors at population level is a key leverage to fight the hypertension epidemic.
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Affiliation(s)
- Helene Lelong
- AP-HP, Diagnosis and Therapeutic Center, Faculty of Medicine, Hôtel-Dieu Hospital, Paris-Descartes University, 75004 Paris, France.
- UREN (Nutritional Epidemiology Research Unit)-U557 INSERM, U1125 INRA, CNAM, CRNH IdF, Paris 13, Sorbonne Paris Cité University, 93000 Bobigny, France.
| | - Jacques Blacher
- AP-HP, Diagnosis and Therapeutic Center, Faculty of Medicine, Hôtel-Dieu Hospital, Paris-Descartes University, 75004 Paris, France
- UREN (Nutritional Epidemiology Research Unit)-U557 INSERM, U1125 INRA, CNAM, CRNH IdF, Paris 13, Sorbonne Paris Cité University, 93000 Bobigny, France
| | - Julia Baudry
- UREN (Nutritional Epidemiology Research Unit)-U557 INSERM, U1125 INRA, CNAM, CRNH IdF, Paris 13, Sorbonne Paris Cité University, 93000 Bobigny, France
| | - Solia Adriouch
- UREN (Nutritional Epidemiology Research Unit)-U557 INSERM, U1125 INRA, CNAM, CRNH IdF, Paris 13, Sorbonne Paris Cité University, 93000 Bobigny, France
| | - Pilar Galan
- UREN (Nutritional Epidemiology Research Unit)-U557 INSERM, U1125 INRA, CNAM, CRNH IdF, Paris 13, Sorbonne Paris Cité University, 93000 Bobigny, France
| | - Leopold Fezeu
- UREN (Nutritional Epidemiology Research Unit)-U557 INSERM, U1125 INRA, CNAM, CRNH IdF, Paris 13, Sorbonne Paris Cité University, 93000 Bobigny, France
| | - Serge Hercberg
- UREN (Nutritional Epidemiology Research Unit)-U557 INSERM, U1125 INRA, CNAM, CRNH IdF, Paris 13, Sorbonne Paris Cité University, 93000 Bobigny, France
- Department of Public Health, Avicenne Hospital, 93000 Bobigny, France
| | - Emmanuelle Kesse-Guyot
- UREN (Nutritional Epidemiology Research Unit)-U557 INSERM, U1125 INRA, CNAM, CRNH IdF, Paris 13, Sorbonne Paris Cité University, 93000 Bobigny, France
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Graff TC, Luke SG, Birmingham WC. Supportive hand-holding attenuates pupillary responses to stress in adult couples. PLoS One 2019; 14:e0212703. [PMID: 30794665 PMCID: PMC6386442 DOI: 10.1371/journal.pone.0212703] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Accepted: 02/07/2019] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Social relationships, particularly marriage, have been shown to ameliorate the potentially pathogenic impact of stressful events but prior research has been mostly aimed at downstream effects, with less research on real-time reactivity. Pupillometry is an innovative procedure that allows us to see the effects of acute stress in real time. The muscles that control pupil size are linked to the autonomic nervous system, so that when stressed, the pupils dilate; this occurs within 200ms. This quick response allows us to see the immediate effects of acute stress on the autonomic nervous system (ANS), and the real-time effects of social support in buffering stress. PURPOSE The purpose of this study is to examine the dampening effects of received social support on the ANS's pupillary response. METHODS Eighty individuals (40 couples) were randomly assigned to either a spousal support (i.e., spouse hand-holding) or non-support condition (i.e., alone) and administered a Stroop task while pupil dilation was measured. RESULTS The Stroop task elicited a stress reaction in terms of pupil dilation in response to the incongruent task trials. Participants in the support condition showed accelerated habituation to the stress task (p < .001), and less pupil reactivity (p < .001) providing evidence for buffering effects of social support via spousal presence and hand-holding. CONCLUSIONS These results reveal the speed at which stress-buffering occurs, suggesting that pupillometry could be a good method to address the immediate dampening effects of social support.
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Affiliation(s)
- Tyler C. Graff
- Department of Psychology, Brigham Young University, Provo, Utah, United States of America
| | - Steven G. Luke
- Department of Psychology, Brigham Young University, Provo, Utah, United States of America
| | - Wendy C. Birmingham
- Department of Psychology, Brigham Young University, Provo, Utah, United States of America
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Thereaux J, Lesuffleur T, Czernichow S, Basdevant A, Msika S, Nocca D, Millat B, Fagot-Campagna A. Multicentre cohort study of antihypertensive and lipid-lowering therapy cessation after bariatric surgery. Br J Surg 2018; 106:286-295. [PMID: 30325504 DOI: 10.1002/bjs.10999] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Revised: 07/05/2018] [Accepted: 08/17/2018] [Indexed: 12/13/2022]
Abstract
Abstract
Background
Few studies have assessed changes in antihypertensive and lipid-lowering therapy after bariatric surgery. The aim of this study was to assess the 6-year rates of continuation, discontinuation or initiation of antihypertensive and lipid-lowering therapy after bariatric surgery compared with those in a matched control group of obese patients.
Methods
This nationwide observational population-based cohort study used data extracted from the French national health insurance database. All patients undergoing gastric bypass or sleeve gastrectomy in France in 2009 were matched with control patients. Mixed-effect logistic regression models were used to analyse factors that influenced discontinuation or initiation of treatment over a 6-year interval.
Results
In 2009, 8199 patients underwent primary gastric bypass (55·2 per cent) or sleeve gastrectomy (44·8 per cent). After 6 years, the proportion of patients receiving antihypertensive and lipid-lowering therapy had decreased more in the bariatric group than in the control group (antihypertensives: –40·7 versus –11·7 per cent respectively; lipid-lowering therapy: –53·6 versus –20·2 per cent; both P < 0·001). Gastric bypass was the main predictive factor for discontinuation of therapy for hypertension (odds ratio (OR) 9·07, 95 per cent c.i. 7·72 to 10·65) and hyperlipidaemia (OR 11·91, 9·65 to 14·71). The proportion of patients not receiving treatment at baseline who were subsequently started on medication was lower after bariatric surgery than in controls for hypertension (5·6 versus 15·8 per cent respectively; P < 0·001) and hyperlipidaemia (2·2 versus 9·1 per cent; P < 0·001). Gastric bypass was the main protective factor for antihypertensives (OR 0·22, 0·18 to 0·26) and lipid-lowering medication (OR 0·12, 0·09 to 0·15).
Conclusion
Bariatric surgery is associated with a good discontinuation of antihypertensive and lipid-lowering therapy, with gastric bypass being more effective than sleeve gastrectomy.
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Affiliation(s)
- J Thereaux
- Department of Statistics, Caisse Nationale d'Assurance Maladie des Travailleurs Salariés, Paris, France
- Department of General, Digestive and Metabolic Surgery, La Cavale Blanche University Hospital, and Groupe d'Étude de la Thrombose de Bretagne Occidentale, EA 3878, University of Bretagne Occidentale, Brest, France
| | - T Lesuffleur
- Department of Statistics, Caisse Nationale d'Assurance Maladie des Travailleurs Salariés, Paris, France
| | - S Czernichow
- Department of Nutrition, Hôpital Européen Georges Pompidou, Centre Spécialisé Obésité Ile de France Sud, Assistance Publique–Hôpitaux de Paris (AP-HP) and University Paris Descartes, Paris, France
| | - A Basdevant
- Department of Heart and Nutrition, Institute of Cardiometabolism and Nutrition, ICAN, AP-HP, Pitié-Salpêtrière Hospital, and France Sorbonne Universities, University Pierre et Marie Curie-Paris 6, Paris, France
| | - S Msika
- Department of General, Digestive and Metabolic Surgery, Louis Mourier Hospital, AP-HP, Diderot Paris 7 University, Colombes, France
| | - D Nocca
- Department of Surgery, Faculty of Medicine of Montpellier, Centre Hospitalier Universitaire Montpellier, Montpellier, France
| | - B Millat
- Department of Statistics, Caisse Nationale d'Assurance Maladie des Travailleurs Salariés, Paris, France
| | - A Fagot-Campagna
- Department of Statistics, Caisse Nationale d'Assurance Maladie des Travailleurs Salariés, Paris, France
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Tian Z, Li Y, Li L, Liu X, Shi Y, Yang K, Liu R, Zhang H, Qian X, Yin L, Zhao J, Wang C. Dose-response relationship between visceral fat index and untreated hypertension in Chinese rural population: the RuralDiab study. ACTA ACUST UNITED AC 2018; 12:448-456.e1. [PMID: 29678423 DOI: 10.1016/j.jash.2018.03.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Accepted: 03/14/2018] [Indexed: 01/10/2023]
Abstract
The study aimed to explore the association of visceral fat index (VFI) with untreated hypertension in different genders and evaluate the practicability of VFI as a marker for discriminating untreated hypertension in Chinese rural population. A total of 12,536 eligible participants aged 35 years and older were derived from the RuralDiab study in China. VFI was assessed with bioelectrical impendence methods and divided into sex-specific quartiles. Logistic regression and restricted cubic spline regression were performed. Receiver operating characteristic curve was applied to analyze the discriminating performance of VFI. Meanwhile, a meta-analysis was conducted to validate the result of this study. Compared with the lowest VFI quartile, the adjusted odds ratios (ORs) and 95% confidence interval (95% CI) in the highest VFI quartile were 3.68 (2.91-4.66) in male and 2.63 (2.12-3.25) in female (Ptrend < .01). Nonlinear increasing trends about the risk of untreated hypertension were observed with the continuously increasing VFI in both genders (Plinearity < .01). The sensitivity and specificity in the optimal cutoff values for VFI were 58.37% and 62.26% in male, and 49.09% and 66.67% in female. The area under the curves (95% CI) were 0.64 (0.63-0.66) in male and 0.61 (0.60-0.62) in female. Meta-analysis results displayed the pooled odds ratios (95% CI) of 2.65 (1.79-3.93) in male and 2.27 (1.74-2.95) in female. VFI was significantly positively correlated with the risk of untreated hypertension, and dose-response relationships were observed in both genders in Chinese rural population. However, VFI as a marker had limited potential for discriminating untreated hypertension.
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Affiliation(s)
- Zhongyan Tian
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Yuqian Li
- Department of Clinical Pharmacology, School of Pharmaceutical Science, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Linlin Li
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Xiaotian Liu
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Yuanyuan Shi
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Kaili Yang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Ruihua Liu
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Honglei Zhang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Xinling Qian
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Lei Yin
- Department of Prevention and Health care, Military Hospital of Henan Province, Zhengzhou, Henan, PR China
| | - Jingzhi Zhao
- Department of Prevention and Health care, Military Hospital of Henan Province, Zhengzhou, Henan, PR China
| | - Chongjian Wang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China.
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Ye J, Li Z, Lv Y, An L, Yu J, Guo X, Yao Y, Yu Y, Jin L. Associations of Blood Pressure with the Factors among Adults in Jilin Province: A Cross-Sectional Study Using Quantile Regression Analysis. Sci Rep 2017; 7:13613. [PMID: 29051578 PMCID: PMC5648827 DOI: 10.1038/s41598-017-14045-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Accepted: 10/05/2017] [Indexed: 01/17/2023] Open
Abstract
Hypertension has become a major public health challenge. However, numerous research results reported in the literature focus primarily on risk factors of hypertension, little is known about how the whole continuum of blood pressure (BP) is associated with risk factors of hypertension. This study aims to reveal quantile-specific associations of BP with its risk factors. A cross-sectional survey based on a sample of 23,050 adults aged 18 to 79 years was conducted in Jilin Province in 2012, and some subjects were excluded due to missing values in BP or having BP control according to the purpose of this study. Quantile regression (QR) was employed to investigate the associations between systolic/diastolic blood pressure (SBP/DBP) and the risk factors. The SBP and DBP in males presented statistically higher than females (P < 0.001). High-salt diet for males manifested a slightly increasing positive association with higher SBP only for high quantiles (≥70), but with a higher DBP for middle part of the quantiles (30~75), compared with bland diet. High-salt diet, drinking and high-density lipoprotein cholesterol (HDL-C) were positively associated with BP measures in males. And the coefficient of total cholesterol (TC) in QR increased with BP in females who used to live in town.
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Affiliation(s)
- Junsen Ye
- Epidemiology and Biostatistics, School of Public Health, NO. 1163 Xinmin Street, Jilin University, Changchun, Jilin, China, 130021
| | - Zhongmin Li
- Epidemiology and Biostatistics, School of Public Health, NO. 1163 Xinmin Street, Jilin University, Changchun, Jilin, China, 130021
| | - Yaogai Lv
- Epidemiology and Biostatistics, School of Public Health, NO. 1163 Xinmin Street, Jilin University, Changchun, Jilin, China, 130021
| | - Lan An
- Epidemiology and Biostatistics, School of Public Health, NO. 1163 Xinmin Street, Jilin University, Changchun, Jilin, China, 130021
| | - Jianxing Yu
- Epidemiology and Biostatistics, School of Public Health, NO. 1163 Xinmin Street, Jilin University, Changchun, Jilin, China, 130021
| | - Xin Guo
- Epidemiology and Biostatistics, School of Public Health, NO. 1163 Xinmin Street, Jilin University, Changchun, Jilin, China, 130021
| | - Yan Yao
- Epidemiology and Biostatistics, School of Public Health, NO. 1163 Xinmin Street, Jilin University, Changchun, Jilin, China, 130021
| | - Yaqin Yu
- Epidemiology and Biostatistics, School of Public Health, NO. 1163 Xinmin Street, Jilin University, Changchun, Jilin, China, 130021
| | - Lina Jin
- Epidemiology and Biostatistics, School of Public Health, NO. 1163 Xinmin Street, Jilin University, Changchun, Jilin, China, 130021.
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10
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Shimada YJ, Tsugawa Y, Iso H, Brown DFM, Hasegawa K. Association of bariatric surgery with risk of acute care use for hypertension-related disease in obese adults: population-based self-controlled case series study. BMC Med 2017; 15:161. [PMID: 28830535 PMCID: PMC5568280 DOI: 10.1186/s12916-017-0914-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2017] [Accepted: 07/11/2017] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Hypertension carries a large societal burden. Obesity is known as a risk factor for hypertension. However, little is known as to whether weight loss interventions reduce the risk of hypertension-related adverse events, such as acute care use (emergency department [ED] visit and/or unplanned hospitalization). We used bariatric surgery as an instrument for investigating the effect of large weight reduction on the risk of acute care use for hypertension-related disease in obese adults with hypertension. METHODS We performed a self-controlled case series study of obese patients with hypertension who underwent bariatric surgery using population-based ED and inpatient databases that recorded every bariatric surgery, ED visit, and hospitalization in three states (California, Florida, and Nebraska) from 2005 to 2011. The primary outcome was acute care use for hypertension-related disease. We used conditional logistic regression to compare each patient's risk of the outcome event during sequential 12-month periods, using pre-surgery months 13-24 as the reference period. RESULTS We identified 980 obese patients with hypertension who underwent bariatric surgery. The median age was 48 years (interquartile range, 40-56 years), 74% were female, and 55% were non-Hispanic white. During the reference period, 17.8% (95% confidence interval [CI], 15.4-20.2%) had a primary outcome event. The risk remained unchanged in the subsequent 12-month pre-surgery period (18.2% [95% CI, 15.7-20.6%]; adjusted odds ratio [aOR] 1.02 [95% CI, 0.83-1.27]; P = 0.83). In the first 12-month period after bariatric surgery, the risk significantly decreased (10.5% [8.6-12.4%]; aOR 0.58 [95% CI, 0.45-0.74]; P < 0.0001). Similarly, the risk remained significantly reduced in the 13-24 months after bariatric surgery (12.9% [95% CI, 10.8-15.0%]; aOR 0.71 [95% CI, 0.57-0.90]; P = 0.005). By contrast, there was no significant reduction in the risk among obese patients who underwent non-bariatric surgery (i.e., cholecystectomy, hysterectomy, spinal fusion, or mastectomy). CONCLUSIONS In this population-based study of obese adults with hypertension, we found that the risk of acute care use for hypertension-related disease decreased by 40% after bariatric surgery. The data provide the best evidence on the effectiveness of substantial weight loss on hypertension-related morbidities, underscoring the importance of discussing options for weight reduction when treating obese patients with hypertension.
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Affiliation(s)
- Yuichi J Shimada
- Cardiology Division, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Gray/Bigelow 800, Boston, MA, 02114, USA.
| | - Yusuke Tsugawa
- Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA, 02115, USA
| | - Hiroyasu Iso
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, 1-1 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - David F M Brown
- Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, MA, 02114, USA
| | - Kohei Hasegawa
- Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, MA, 02114, USA
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Hu Y, Wang Z, Wang Y, Wang L, Han W, Tang Y, Xue F, Hou L, Liang S, Zhang B, Wang W, Asaiti K, Pang H, Zhang M, Jiang J. Prevalence, Awareness, Treatment, and Control of Hypertension among Kazakhs with high Salt Intake in Xinjiang, China: A Community-based Cross-sectional Study. Sci Rep 2017; 7:45547. [PMID: 28358015 PMCID: PMC5371982 DOI: 10.1038/srep45547] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2016] [Accepted: 03/01/2017] [Indexed: 12/21/2022] Open
Abstract
Hypertension is a leading cause of death worldwide; data on hypertension among ethnic minorities in China are sparse. This study aimed to estimate hypertension prevalence, awareness, treatment, and control in a Kazakh population, and to assess the association between salt intake and the above measures. A cross-sectional survey was conducted among Kazakh adults (≥30 years old) in the town of Hongdun, Altay, Xinjiang. Survey procedures included a questionnaire, physical measurement, and laboratory tests. Of 1805 eligible individuals, 1668 (92.4%) were included in the analysis. After adjustment for gender, age, and occupation, prevalence of hypertension was 45.5%. The proportions with awareness, treatment, control, or medication-control were 61.0%, 28.8%, 2.9% and 10.1%, respectively. Higher prevalence was seen among nomads and farmers (50.7% and 44.6%, respectively). However, the proportions with treatment or control were lower than seen among urban citizens. Hypertension prevalence was higher in those with higher salt intake (p = 0.0008). In contrast, the proportions with awareness (p = 0.0389), treatment (p = 0.0010), control (p = 0.0503), and medication-control (p = 0.2012) reduced as salt intake increased. In conclusion, hypertension prevalence is high in this population, but the proportions with awareness, treatment, or control are sub-optimal. Public health interventions that improve hypertension prevention and control, particularly among nomads, is needed.
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Affiliation(s)
- Yaoda Hu
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences/School of Basic Medicine Peking Union Medical College, Beijing, China
| | - Zixing Wang
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences/School of Basic Medicine Peking Union Medical College, Beijing, China
| | - Yuyan Wang
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences/School of Basic Medicine Peking Union Medical College, Beijing, China
| | - Lei Wang
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences/School of Basic Medicine Peking Union Medical College, Beijing, China
| | - Wei Han
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences/School of Basic Medicine Peking Union Medical College, Beijing, China
| | - Yong Tang
- The People’s Hospital of Altay Prefecture, Xinjiang, China
| | - Fang Xue
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences/School of Basic Medicine Peking Union Medical College, Beijing, China
| | - Lei Hou
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences/School of Basic Medicine Peking Union Medical College, Beijing, China
| | - Shaohua Liang
- The People’s Hospital of Altay Prefecture, Xinjiang, China
| | - Biao Zhang
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences/School of Basic Medicine Peking Union Medical College, Beijing, China
| | - Weizhi Wang
- The People’s Hospital of Altay Prefecture, Xinjiang, China
| | | | - Haiyu Pang
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences/School of Basic Medicine Peking Union Medical College, Beijing, China
| | - Mingtao Zhang
- The People’s Hospital of Altay Prefecture, Xinjiang, China
| | - Jingmei Jiang
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences/School of Basic Medicine Peking Union Medical College, Beijing, China
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12
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Matta J, Carette C, Levy Marchal C, Bertrand J, Pétéra M, Zins M, Pujos-Guillot E, Comte B, Czernichow S. Weight for gestational age and metabolically healthy obesity in adults from the Haguenau cohort. BMJ Open 2016; 6:e011367. [PMID: 27580829 PMCID: PMC5013421 DOI: 10.1136/bmjopen-2016-011367] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND An obesity subphenotype, named 'metabolically healthy obese' (MHO) has been recently defined to characterise a subgroup of obese individuals with less risk for cardiometabolic abnormalities. To date no data are available on participants born with small weight for gestational age (SGA) and the risk of metabolically unhealthy obesity (MUHO). OBJECTIVE Assess the risk of MUHO in SGA versus appropriate for gestational age (AGA) adult participants. METHODS 129 young obese individuals (body mass index ≥30 kg/m²) from data of an 8-year follow-up Haguenau cohort (France), were identified out of 1308 participants and were divided into 2 groups: SGA (n=72) and AGA (n=57). Metabolic characteristics were analysed and compared using unpaired t-test. The HOMA-IR index was determined for the population and divided into quartiles. Obese participants within the first 3 quartiles were considered as MHO and those in the fourth quartile as MUHO. Relative risks (RRs) and 95% CI for being MUHO in SGA versus AGA participants were computed. RESULTS The SGA-obese group had a higher risk of MUHO versus the AGA-obese group: RR=1.27 (95% CI 1.10 to 1.6) independently of age and sex. CONCLUSIONS In case of obesity, SGA might confer a higher risk of MUHO compared with AGA.
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Affiliation(s)
| | - Claire Carette
- Nutrition Department, Hôpital Européen Georges-Pompidou, Paris, France
| | - Claire Levy Marchal
- INSERM CIE 05 - Unité d'épidémiologie clinique, Hôpital Robert Debré, Paris, France
| | - Julien Bertrand
- INRA, UMR 1019, UNH, CRNH Auvergne, F-63000 CLERMONT-FERRAND, France
- Clermont Université, Université d'Auvergne, Unité de Nutrition Humaine, BP 10448, F-63000 CLERMONT-FERRAND, France
| | - Mélanie Pétéra
- INRA, UMR 1019, UNH, CRNH Auvergne, F-63000 CLERMONT-FERRAND, France
- Clermont Université, Université d'Auvergne, Unité de Nutrition Humaine, BP 10448, F-63000 CLERMONT-FERRAND, France
| | - Marie Zins
- INSERM, UMS 011, Villejuif, France
- Paris Descartes University, Paris, France
| | - Estelle Pujos-Guillot
- INRA, UMR 1019, UNH, CRNH Auvergne, F-63000 CLERMONT-FERRAND, France
- Clermont Université, Université d'Auvergne, Unité de Nutrition Humaine, BP 10448, F-63000 CLERMONT-FERRAND, France
| | - Blandine Comte
- INRA, UMR 1019, UNH, CRNH Auvergne, F-63000 CLERMONT-FERRAND, France
- Clermont Université, Université d'Auvergne, Unité de Nutrition Humaine, BP 10448, F-63000 CLERMONT-FERRAND, France
| | - Sébastien Czernichow
- INSERM, UMS 011, Villejuif, France
- Nutrition Department, Hôpital Européen Georges-Pompidou, Paris, France
- Paris Descartes University, Paris, France
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13
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Metabolically Healthy Overweight and Obesity Is Associated with Higher Adherence to a Traditional Dietary Pattern: A Cross-Sectional Study among Adults in Lebanon. Nutrients 2016; 8:nu8070432. [PMID: 27447668 PMCID: PMC4963908 DOI: 10.3390/nu8070432] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2016] [Revised: 07/11/2016] [Accepted: 07/13/2016] [Indexed: 02/07/2023] Open
Abstract
This study aimed to examine the proportion and socio-demographic correlates of Metabolically Healthy Overweight and Obesity (MHOv/O) among Lebanese adults and to investigate the independent effect of previously identified dietary patterns on odds of MHOv/O. Data were drawn from the National Nutrition and Non-Communicable Disease Risk Factor Survey (Lebanon 2008-2009). Out of the 337 adult participants who had complete socio-demographic, lifestyle, dietary as well as anthropometric and biochemical data, 196 had a BMI ≥ 25 kg/m² and their data were included in this study. MHOv/O was identified using the Adult Treatment Panel criteria. Dietary patterns previously derived in this study population were: Fast Food/Dessert, Traditional-Lebanese and High-Protein. The proportion of MHOv/O in the study sample was 37.2%. Females, higher education and high level of physical activity were positively associated with odds of MHOv/O. Subjects with higher adherence to the Traditional-Lebanese pattern had higher odds of MHOv/O (OR: 1.83, 95% CI: 1.09-3.91). No significant associations were observed between the Fast Food/Dessert and the high-protein patterns with MHOv/O. Follow-up studies are needed to confirm those findings and understand the mechanisms by which the Traditional-Lebanese pattern may exert a protective effect in this subgroup of overweight and obese adults.
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Jesky MD, Hayer MK, Thomas M, Dasgupta I. Do Obese Individuals With Hypertension Have More Difficult-to-Control Blood Pressure and End Organ Damage Than Their Nonobese Counterparts? J Clin Hypertens (Greenwich) 2015; 17:466-72. [PMID: 25807883 PMCID: PMC8031993 DOI: 10.1111/jch.12532] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2014] [Revised: 01/21/2015] [Accepted: 01/23/2015] [Indexed: 11/29/2022]
Abstract
The authors assessed whether individuals with elevated body mass index (BMI) and hypertension had more difficult-to-control blood pressure (BP) and more evidence of end organ damage using data collected prospectively over 11 years from a secondary care hypertension clinic. A total of 1114 individuals were divided by BMI criteria into normal (n=207), overweight (n=440), and obese (n=467). Mean daytime, nighttime, and 24-hour systolic BP and diastolic BP were similar in all groups. There was less nocturnal dip in obese compared with overweight groups (P=.025). Individuals with a normal BMI were taking fewer antihypertensive medications than those in the obese group (P=.01). Individuals classified as obese had a higher left ventricular mass index than those with a normal BMI (female, P=.028; male, P<.001); this relationship remained after multivariate linear regression. Obese individuals with hypertension required more medication to achieve similar mean ambulatory BP values, had less nocturnal dip in BP, and had a higher prevalence of left ventricular hypertrophy. As such, obese patients are at potentially increased risk of cardiovascular events.
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Affiliation(s)
| | | | - Mark Thomas
- Renal UnitBirmingham Heartlands HospitalBirminghamUK
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15
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Ying A, Arima H, Czernichow S, Woodward M, Huxley R, Turnbull F, Perkovic V, Neal B. Effects of blood pressure lowering on cardiovascular risk according to baseline body-mass index: a meta-analysis of randomised trials. Lancet 2015; 385:867-74. [PMID: 25468168 DOI: 10.1016/s0140-6736(14)61171-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND The cardiovascular benefits of blood pressure lowering in obese people compared with people of normal weight might depend on choice of drug. We compared the effects of blood pressure-lowering regimens on cardiovascular risk in groups of patients categorised by baseline body-mass index (BMI). METHODS We used individual patient data from trials included in the Blood Pressure Lowering Treatment Trialists' Collaboration to compare the effects of different classes of blood pressure-lowering regimens for the primary outcome of total major cardiovascular events (stroke, coronary heart disease, heart failure, and cardiovascular death). We used meta-analyses and meta-regressions to assess interactions between treatment and BMI when fitted as either a categorical variable (<25 kg/m(2), 25 to <30 kg/m(2), and ≥30 kg/m(2)) or a continuous variable. FINDINGS Analyses were based on 135,715 individuals from 22 trials who had 14,353 major cardiovascular events. None of the six primary comparisons showed evidence that protection varied by drug class across the three BMI groups (all p for trend >0·20). When analysed as a continuous variable, angiotensin-converting-enzyme inhibitors gave slightly greater protection for each 5 kg/m(2) higher BMI than did calcium antagonists (hazard ratio 0·93, 95% CI 0·89-0·98; p=0·004) or diuretics (0·93, 0·89-0·98; p=0·002). The meta-regressions showed no relation between BMI category and the risk reduction for a given fall in systolic blood pressure. By contrast with a previous report, we noted no relation between BMI and the efficacy of calcium antagonists compared with diuretics. INTERPRETATION We found little evidence that selection of a particular class of blood pressure-lowering drug will lead to substantially different outcomes for individuals who are obese compared with those who are lean. FUNDING None.
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16
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Lelong H, Galan P, Kesse-Guyot E, Fezeu L, Hercberg S, Blacher J. Relationship between nutrition and blood pressure: a cross-sectional analysis from the NutriNet-Santé Study, a French web-based cohort study. Am J Hypertens 2015; 28:362-71. [PMID: 25189870 DOI: 10.1093/ajh/hpu164] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Hypertension is the most prevalent chronic disease worldwide. Lifestyle behaviors for its prevention and control are recommended within worldwide guidelines. Nevertheless, their combined relationship with blood pressure (BP) level, particularly in the general population, would need more investigations. Our aim in this study was to evaluate the relative impact of lifestyle and nutritional factors on BP level. METHODS Cross-sectional analyses were performed using data from 8,670 volunteers from the NutriNet-Santé Study, an ongoing French web-based cohort study. Dietary intakes were assessed using three 24-hour records. Information on lifestyle factors was collected using questionnaires and 3 BP measurements following a standardized protocol. Age-adjusted associations and then multivariate associations between systolic BP (SBP) and lifestyle behaviors were estimated using multiple linear regressions. RESULTS SBP was higher in participants with elevated body mass indices (BMIs). Salt intake was positively associated with SBP in men but not in women. The negative relationship between consumption of fruits and vegetables and SBP was significant in both sexes. Alcohol intake was positively associated with SBP in both sexes; physical activity was not. The 5 parameters representing the well-accepted modifiable factors for hypertension reduction plus age and education level, accounted for 19.7% of the SBP variance in women and 12.8% in men. Considering their squared partial correlation coefficient, age and BMI were the most important parameters relating to SBP level. Salt intake was not associated with SBP in either sex after multiple adjustments. CONCLUSIONS BMI was the main contributory modifiable factor of BP level after multiple adjustments.
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Affiliation(s)
- Helene Lelong
- Paris-Descartes University, Faculty of Medicine; Hôtel-Dieu Hospital; Assistance Publique-Hopitaux de Paris; Diagnosis and Therapeutic Center, Paris, France; Paris 13, Sorbonne Paris Cité University; Nutritional Epidemiology Research Unit-UMR U1153 INSERM, U1125 INRA, CNAM, Paris 13, Centre de Recherche en Epidémiologies et Biostatistiques Sorbonne Paris Cité, UFR SMBH, Bobigny, France
| | - Pilar Galan
- Paris 13, Sorbonne Paris Cité University; Nutritional Epidemiology Research Unit-UMR U1153 INSERM, U1125 INRA, CNAM, Paris 13, Centre de Recherche en Epidémiologies et Biostatistiques Sorbonne Paris Cité, UFR SMBH, Bobigny, France
| | - Emmanuelle Kesse-Guyot
- Paris 13, Sorbonne Paris Cité University; Nutritional Epidemiology Research Unit-UMR U1153 INSERM, U1125 INRA, CNAM, Paris 13, Centre de Recherche en Epidémiologies et Biostatistiques Sorbonne Paris Cité, UFR SMBH, Bobigny, France
| | - Leopold Fezeu
- Paris 13, Sorbonne Paris Cité University; Nutritional Epidemiology Research Unit-UMR U1153 INSERM, U1125 INRA, CNAM, Paris 13, Centre de Recherche en Epidémiologies et Biostatistiques Sorbonne Paris Cité, UFR SMBH, Bobigny, France
| | - Serge Hercberg
- Paris 13, Sorbonne Paris Cité University; Nutritional Epidemiology Research Unit-UMR U1153 INSERM, U1125 INRA, CNAM, Paris 13, Centre de Recherche en Epidémiologies et Biostatistiques Sorbonne Paris Cité, UFR SMBH, Bobigny, France; Department of Public Health, Avicenne Hospital, Bobigny, France
| | - Jacques Blacher
- Paris-Descartes University, Faculty of Medicine; Hôtel-Dieu Hospital; Assistance Publique-Hopitaux de Paris; Diagnosis and Therapeutic Center, Paris, France; Paris 13, Sorbonne Paris Cité University; Nutritional Epidemiology Research Unit-UMR U1153 INSERM, U1125 INRA, CNAM, Paris 13, Centre de Recherche en Epidémiologies et Biostatistiques Sorbonne Paris Cité, UFR SMBH, Bobigny, France;
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17
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JIANG B, LIU H, RU X, ZHANG H, WU S, WANG W. Hypertension detection, management, control and associated factors among residents accessing community health services in Beijing. Sci Rep 2014; 4:4845. [PMID: 24784167 PMCID: PMC4007080 DOI: 10.1038/srep04845] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2014] [Accepted: 04/11/2014] [Indexed: 01/13/2023] Open
Abstract
The aim of this study was to analyse high blood pressure detection, management, control and associated factors among residents accessing community health services (CHSs) in Beijing. We screened for HBP in 9524 individuals aged 50 years or older who accessed care in four Beijing CHSs. Among the 9397 residents with questionnaire responses that qualified them for inclusion in the study, 5029 patients with HBP were identified, 1510 (i.e., 30% of the HBP patient group) of whom were newly identified cases. The rate of hypertension detection was 53.5%. Among the 5029 HBP patients, the rates of awareness, treatment and control of hypertension were 70.0%, 62.1% and 29.6%, respectively. In general, the rate of hypertension control was higher when the rates of hypertension awareness and treatment were higher in subgroups stratified by different sociodemographic and risk factors, except for the overweight and obesity subgroups. In conclusion, suboptimal HBP awareness, treatment, and control are still major problems confronting CHSs in Beijing. Control of hypertension in the population may be improved by increasing awareness and improving the treatment of hypertension in CHSs.
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Affiliation(s)
- Bin JIANG
- Department of Neuroepidemiology, Beijing Neurosurgical Institute, Capital Medical University, Beijing 100050, China
- Beijing Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China
| | - Hongmei LIU
- Department of Neuroepidemiology, Beijing Neurosurgical Institute, Capital Medical University, Beijing 100050, China
- Beijing Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China
| | - Xiaojuan RU
- Department of Neuroepidemiology, Beijing Neurosurgical Institute, Capital Medical University, Beijing 100050, China
- Beijing Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China
| | - Hui ZHANG
- Department of Neuroepidemiology, Beijing Neurosurgical Institute, Capital Medical University, Beijing 100050, China
- Beijing Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China
| | - Shengping WU
- Department of Neuroepidemiology, Beijing Neurosurgical Institute, Capital Medical University, Beijing 100050, China
- Beijing Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China
| | - Wenzhi WANG
- Department of Neuroepidemiology, Beijing Neurosurgical Institute, Capital Medical University, Beijing 100050, China
- Beijing Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China
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18
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Sutamtewagul G, Dumrongmoncolgul N, Kijsirichareanchai K, Gadwala S, Arvandi A, Suarez J, Meyerrose G. Effect of Alcohol Intake in Patients with Hypertension Currently on Medication Treatment. ALCOHOLISM TREATMENT QUARTERLY 2014. [DOI: 10.1080/07347324.2013.833785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Blacher J, Halimi JM, Hanon O, Mourad JJ, Pathak A, Schnebert B, Girerd X. Management of hypertension in adults: the 2013 French Society of Hypertension guidelines. Fundam Clin Pharmacol 2013; 28:1-9. [PMID: 23952903 DOI: 10.1111/fcp.12044] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2013] [Accepted: 06/05/2013] [Indexed: 12/11/2022]
Abstract
To improve the management of hypertension in the French population, the French Society of Hypertension has decided to issue a new set of guidelines that include the following practical characteristics: usefulness for clinical practice, short, easy-to-read format, comprehensive writing for non-physicians, wide dissemination among healthcare professionals and the hypertensive population, assessment of their impact among healthcare professionals and with regard to public health goals. These guidelines, so-called the appointments of the hypertensive patient, include 15 recommendations, divided into three chapters, according to the timing of the medical management: prior to treatment initiation, the initial treatment plan (first 6 months) and the long-term care plan (beyond 6 months). We hope that a vast dissemination of these simple guidelines will help to improve hypertension control in the French population from 50% to 70%, an objective expected to be achieved in 2015 in France.
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Affiliation(s)
- Jacques Blacher
- Société Française d'Hypertension Artérielle, Maison du Cœur, 5 rue des Colonnes-du-Trône, 75012, Paris, France
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20
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de Simone G, Devereux RB, Izzo R, Girfoglio D, Lee ET, Howard BV, Roman MJ. Lack of reduction of left ventricular mass in treated hypertension: the strong heart study. J Am Heart Assoc 2013; 2:e000144. [PMID: 23744404 PMCID: PMC3698775 DOI: 10.1161/jaha.113.000144] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Background Hypertensive left ventricular mass (LVM) is expected to decrease during antihypertensive therapy, based on results of clinical trials. Methods and Results We assessed 4‐year change of echocardiographic LVM in 851 hypertensive free‐living participants of the Strong Heart Study (57% women, 81% treated). Variations of 5% or more of the initial systolic blood pressure (SBP) and LVM were categorized for analysis. At baseline, 23% of men and 36% of women exhibited LV hypertrophy (LVH, P<0.0001). At the follow‐up, 3% of men and 10% of women had regression of LVH (P<0.0001 between genders); 14% of men and 15% of women, free of baseline LVH, developed LVH. There was an increase in LVM over time, more in men than in women (P<0.001). Participants whose LVM did not decrease had similar baseline SBP and diastolic BP, but higher body mass index (BMI), waist/hip ratio, heart rate (all P<0.008), and urinary albumin/creatinine excretion (P<0.001) than those whose LVM decreased. After adjusting for field center, initial LVM index, target BP, and kinship degree, lack of decrease in LVM was predicted by higher baseline BMI and urinary albumin/creatinine excretion, independently of classes of antihypertensive medications, and significant effects of older age, male gender, and percentage increase in BP over time. Similar findings were obtained in the subpopulation (n=526) with normal BP at follow‐up. Conclusions In a free‐living population, higher BMI is associated with less reduction of hypertensive LVH; lack of reduction of LVM is independent of BP control and of types of antihypertensive treatment, but is associated with renal damage.
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Affiliation(s)
- Giovanni de Simone
- Department of Translational Medical Sciences, Federico II University, Napoli, Italy.
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