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Kandasamy G, Subramani T, Sam G, Almanasef M, Almeleebia T, Shorog E, Alshahrani AM, Hmlan A, Al Suhaym AY, Prabahar K, Veeramani VP, Amirthalingam P. Biosocial predictors and blood pressure goal attainment among postmenopausal women with hypertension. Front Cardiovasc Med 2024; 11:1268791. [PMID: 38433758 PMCID: PMC10906718 DOI: 10.3389/fcvm.2024.1268791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Accepted: 01/18/2024] [Indexed: 03/05/2024] Open
Abstract
Objectives In postmenopausal states, women may not maintain blood pressure (BP) in the same way as men, even though most women follow their treatment plans and prescriptions more consistently than men. Biological and lifestyle factors influence the progression of hypertension in postmenopausal women (PMW). This study aimed to determine biosocial predictors associated with achieving the target BP in PMW with hypertension. Methods A prospective observational study was conducted in the General Medicine Department at Karuna Medical College Hospital, Kerala, India. The definition of BP goal attainment was established based on the guidelines outlined by the VIII Joint National Committee 2014 (JNC VIII). Multivariate logistic regression analysis was used to analyse biosocial predictors, such as educational status, employment status, body mass index (BMI), number of children, age at menarche, age at menopause, and number of co-morbidities, associated with BP goal achievement. Results Of the patients, 56.4% achieved their BP goals on monotherapy and 59.7% achieved it on combination therapy. Level of education [odds ratio (OR) = 1.275, 95% confidence interval (CI): 0.234-7.172], employment status (OR = 0.853, 95% CI: 0.400-1.819), age at menopause (OR = 1.106, 95% CI: 0.881-1.149), number of children (OR = 1.152, 95% CI: 0.771-1.720), BMI (OR = 0.998, 95% CI: 0.929-1.071), and number of co-morbidities (OR = 0.068, 95% CI: 0.088-1.093) did not show a significant relationship, and age at menarche (OR = 1.577, 95% CI: 1.031-2.412) showed a significant association with BP goal attainment among hypertensive postmenopausal women. Conclusion Half of the hypertensive postmenopausal women did not achieve their BP goals. Interventions are required to expand screening coverage and, under the direction of medical professionals, there should be plans to improve hypertension control and increase awareness of the condition.
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Affiliation(s)
- Geetha Kandasamy
- Department of Clinical Pharmacy, College of Pharmacy, King Khalid University, Abha, Saudi Arabia
| | | | - Gigi Sam
- Department of Pharmaceutical Sciences, College of Pharmacy, Shaqra University, Dawadmi, Saudi Arabia
| | - Mona Almanasef
- Department of Clinical Pharmacy, College of Pharmacy, King Khalid University, Abha, Saudi Arabia
| | - Tahani Almeleebia
- Department of Clinical Pharmacy, College of Pharmacy, King Khalid University, Abha, Saudi Arabia
| | - Eman Shorog
- Department of Clinical Pharmacy, College of Pharmacy, King Khalid University, Abha, Saudi Arabia
| | - Asma M. Alshahrani
- Department of Clinical Pharmacy, College of Pharmacy, King Khalid University, Abha, Saudi Arabia
| | - Amjad Hmlan
- Department of Clinical Pharmacy, College of Pharmacy, King Khalid University, Abha, Saudi Arabia
| | - Atheer Y. Al Suhaym
- Eradah Hospital and Mental Health in Jazan, Ministry of Health, Jazan, Saudi Arabia
| | - Kousalya Prabahar
- Department of Pharmacy Practice, Faculty of Pharmacy, University of Tabuk, Tabuk, Saudi Arabia
| | - Vinoth Prabhu Veeramani
- Department of Pharmacy Practice, Faculty of Pharmacy, University of Tabuk, Tabuk, Saudi Arabia
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Musa IR, Osman OE, Adam I. The association between parity and hypertension: a cross-sectional, community-based study. Front Cardiovasc Med 2023; 10:1247244. [PMID: 37937292 PMCID: PMC10626486 DOI: 10.3389/fcvm.2023.1247244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Accepted: 10/13/2023] [Indexed: 11/09/2023] Open
Abstract
Background The available data on the association between parity and hypertension are inconclusive. This study was conducted to investigate the prevalence of hypertension and its association with parity among adult Sudanese women. Methods A multi-stage sampling survey was conducted in four villages in the River Nile State in Sudan between July and September 2022. The World Health Organization's three-level stepwise questionnaire was used to gather the participants' sociodemographic characteristics (age, sex, marital status, parity, educational level, occupation, obstetric history, family history of hypertension, weight and height). Regression analyses were performed. Results A total of 408 women were recruited. The median [measured in terms of interquartile range (IQR)] age was 45.0 years (33.0-55.7 years). A linear regression analysis revealed a significant association between parity and diastolic blood pressure (coefficient, 0.60; P = 0.011). The prevalence of hypertension (55.9%) increased with parity and ranged from 43.7% to 74.9%. In the multivariate analyses, increasing age (adjusted odds ratio [AOR], 1.03; 95% confidence interval [CI], 1.02-1.05), increasing parity (AOR, 1.09; 95% CI, 1.01-1.19), family history of hypertension (AOR, 1.79; 95% CI, 1.15-2.77), and increasing body mass index (AOR, 1.09; 95% CI, 1.05-1.13) were associated with hypertension. In women of ages ≥ 50 years, increasing parity was significantly associated with hypertension (AOR, 1.15; 95% CI, 1.2-1.29). Para > 5 (AOR, 2.73; 95% CI, 1.11-6.73) was associated with hypertension. Conclusion A high prevalence of hypertension was found among Sudanese women, and that parity at 5 or more is linked to hypertension.
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Affiliation(s)
- Imad R. Musa
- Department of Medicine, Royal Commission Hospital at AL Jubail Industrial City, Al Jubail, Saudi Arabia
| | - Osman E. Osman
- Faculty of Medicine, Alneelain University, Khartoum, Sudan
| | - Ishag Adam
- Department of Obstetrics and Gynecology, Unaizah College of Medicine and Medical Sciences, Qassim University, Unaizah, Saudi Arabia
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Rahmati M, Saei Ghare Naz M, Azizi F, Ramezani Tehrani F. Parity and hypertension risk in couples: does number of parity matter: findings from Tehran Lipid and Glucose Study. BMC Public Health 2023; 23:474. [PMID: 36907869 PMCID: PMC10010040 DOI: 10.1186/s12889-023-15397-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 03/07/2023] [Indexed: 03/14/2023] Open
Abstract
BACKGROUND AND AIMS As reported, hypertension (HTN) plays a leading role in explaining mortality worldwide, but it still has many confounding factors. This study explored whether the number of parity and age matters for HTN among couples from the Tehran Lipid and Glucose Study (TLGS). METHODS This study was conducted on 2851 couples from TLGS. All the variables were collected based on the standard protocol. The participants were categorized into four and five categories according to the number of parity (childless, one, two, three, or more parities) and age (18-30y, 30-40y, 40-50y, 50-60y, and 60-70y), respectively. Spline regression models via log link function for the binary outcome and linear link function for continuous outcomes were applied to evaluate the effect of interaction term age and parity categories on the desired outcome. RESULTS Among the total of 2851 pairs, 2.3% had no child, 9.5% had 1 child, 38.4% had 2 children, and 49.8% had ≥ 3 children. The adjusted risk (95% CI) of HTN in females aged 40-50y with 1 child, 2 and ≥ 3 children compared to no child were 1.14(1.04, 1.26), 1.05(1.01, 1.10), 1.12(1.07, 1.17), respectively (p < 0.05). Moreover, in those aged 50-60y with 2 and ≥ 3 children, the risk of HTN significantly increased by 4%. In females aged 60-70y with ≥ 3 children compared to those without children, the risk of HTN increased by 2%. For males aged 30-40y with 2 children compared to the no child group, the adjusted risk of HTN increased by 17%, while for those with ≥ 3 children in the same age group, this risk significantly decreased by 13%. Moreover, in males aged 30-40y with 2 children, risk ratio of HTN increased by 17%, but in males with ≥ 3 children, it decreased by 13% and in those in the same groups but aged 40-50y the risk increased by 6% and 11%, respectively. CONCLUSION Our findings suggest that gender, childlessness, having one child, and multi-parity had different impacts on HTN. Further research is needed to confirm our findings.
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Affiliation(s)
- Maryam Rahmati
- Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Marzieh Saei Ghare Naz
- Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fahimeh Ramezani Tehrani
- Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Abuawad AK, Bozack AK, Navas-Acien A, Goldsmith J, Liu X, Hall MN, Ilievski V, Lomax-Luu AM, Parvez F, Shahriar H, Uddin MN, Islam T, Graziano JH, Gamble MV. The Folic Acid and Creatine Trial: Treatment Effects of Supplementation on Arsenic Methylation Indices and Metabolite Concentrations in Blood in a Bangladeshi Population. ENVIRONMENTAL HEALTH PERSPECTIVES 2023; 131:37015. [PMID: 36976258 PMCID: PMC10045040 DOI: 10.1289/ehp11270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Revised: 02/19/2023] [Accepted: 02/24/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Chronic arsenic (As) exposure is a global environmental health issue. Inorganic As (InAs) undergoes methylation to monomethyl (MMAs) and dimethyl-arsenical species (DMAs); full methylation to DMAs facilitates urinary excretion and is associated with reduced risk for As-related health outcomes. Nutritional factors, including folate and creatine, influence one-carbon metabolism, the biochemical pathway that provides methyl groups for As methylation. OBJECTIVE Our aim was to investigate the effects of supplementation with folic acid (FA), creatine, or the two combined on the concentrations of As metabolites and the primary methylation index (PMI: MMAs/InAs) and secondary methylation index (SMI: DMAs/MMAs) in blood in Bangladeshi adults having a wide range of folate status. METHODS In a randomized, double-blinded, placebo (PBO)-controlled trial, 622 participants were recruited independent of folate status and assigned to one of five treatment arms: a) PBO (n = 102 ), b) 400 μ g FA/d (400FA; n = 153 ), c) 800 μ g FA/d (800FA; n = 151 ), d) 3 g creatine/d (creatine; n = 101 ), or e) 3 g creatine + 400 μ g of FA / d (creatine + 400 FA ; n = 103 ) for 12 wk. For the following 12 wk, half of the FA participants were randomly switched to the PBO while the other half continued FA supplementation. All participants received As-removal water filters at baseline. Blood As (bAs) metabolites were measured at weeks 0, 1, 12, and 24. RESULTS At baseline, 80.3% (n = 489 ) of participants were folate sufficient (≥ 9 nmol / L in plasma). In all groups, bAs metabolite concentrations decreased, likely due to filter use; for example, in the PBO group, blood concentrations of MMAs (bMMAs) (geometric mean ± geometric standard deviation ) decreased from 3.55 ± 1.89 μ g / L at baseline to 2.73 ± 1.74 at week 1. After 1 wk, the mean within-person increase in SMI for the creatine + 400 FA group was greater than that of the PBO group (p = 0.05 ). The mean percentage decrease in bMMAs between baseline and week 12 was greater for all treatment groups compared with the PBO group [400FA: - 10.4 (95% CI: - 11.9 , - 8.75 ), 800FA: - 9.54 (95% CI: - 11.1 , - 7.97 ), creatine: - 5.85 (95% CI: - 8.59 , - 3.03 ), creatine + 400 FA : - 8.44 (95% CI: - 9.95 , - 6.90 ), PBO: - 2.02 (95% CI: - 4.03 , 0.04)], and the percentage increase in blood DMAs (bDMAs) concentrations for the FA-treated groups significantly exceeded that of PBO [400FA: 12.8 (95% CI: 10.5, 15.2), 800FA: 11.3 (95% CI: 8.95, 13.8), creatine + 400 FA : 7.45 (95% CI: 5.23, 9.71), PBO: - 0.15 (95% CI: - 2.85 , 2.63)]. The mean decrease in PMI and increase in SMI in all FA groups significantly exceeded PBO (p < 0.05 ). Data from week 24 showed evidence of a reversal of treatment effects on As metabolites from week 12 in those who switched from 800FA to PBO, with significant decreases in SMI [- 9.0 % (95% CI: - 3.5 , - 14.8 )] and bDMAs [- 5.9 % (95% CI: - 1.8 , - 10.2 )], whereas PMI and bMMAs concentrations continued to decline [- 7.16 % (95% CI: - 0.48 , - 14.3 ) and - 3.1 % (95% CI: - 0.1 , - 6.2 ), respectively] for those who remained on 800FA supplementation. CONCLUSIONS FA supplementation lowered bMMAs and increased bDMAs in a sample of primarily folate-replete adults, whereas creatine supplementation lowered bMMAs. Evidence of the reversal of treatment effects on As metabolites following FA cessation suggests short-term benefits of supplementation and underscores the importance of long-term interventions, such as FA fortification. https://doi.org/10.1289/EHP11270.
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Affiliation(s)
- Ahlam K. Abuawad
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, New York, USA
| | - Anne K. Bozack
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, New York, USA
- Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, Berkeley, California, USA
| | - Ana Navas-Acien
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, New York, USA
| | - Jeff Goldsmith
- Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, New York, USA
| | - Xinhua Liu
- Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, New York, USA
| | - Megan N. Hall
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, USA
| | - Vesna Ilievski
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, New York, USA
| | - Angela M. Lomax-Luu
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, New York, USA
| | - Faruque Parvez
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, New York, USA
| | - Hasan Shahriar
- Columbia University Arsenic Project in Bangladesh, Dhaka, Bangladesh
| | - Mohammad N. Uddin
- Columbia University Arsenic Project in Bangladesh, Dhaka, Bangladesh
| | - Tariqul Islam
- Columbia University Arsenic Project in Bangladesh, Dhaka, Bangladesh
| | - Joseph H. Graziano
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, New York, USA
| | - Mary V. Gamble
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, New York, USA
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Rahaman MS, Mise N, Ikegami A, Zong C, Ichihara G, Ichihara S. The mechanism of low-level arsenic exposure-induced hypertension: Inhibition of the activity of the angiotensin-converting enzyme 2. CHEMOSPHERE 2023; 318:137911. [PMID: 36669534 DOI: 10.1016/j.chemosphere.2023.137911] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 01/14/2023] [Accepted: 01/17/2023] [Indexed: 06/17/2023]
Abstract
It is now well-established that arsenic exposure induces hypertension in humans. Although arsenic-induced hypertension is reported in many epidemiological studies, the underlying molecular mechanism of arsenic-induced hypertension is not fully characterized. In the human body, blood pressure is primarily regulated by a well-known physiological system known as the renin-angiotensin system (RAS). Hence, we explored the potential molecular mechanisms of arsenic-induced hypertension by investigating the regulatory roles of the RAS. Adult C57BL/6JJcl male mice were divided into four groups according to the concentration of arsenic in drinking water (0, 8, 80, and 800 ppb) provided for 8 weeks. Arsenic significantly raised blood pressure in arsenic-exposed mice compared to the control group, and significantly raised plasma MDA and Ang II and reduced Ang (1-7) levels. RT-PCR results showed that arsenic significantly downregulated ACE2 and MasR in mice aortas. In vitro studies of endothelial HUVEC cells treated with arsenic showed increased level of MDA and Ang II and lower levels of Ang (1-7), compared with the control. Arsenic significantly downregulated ACE2 and MasR expression, as well as those of Sp1 and SIRT1; transcriptional activators of ACE2, in HUVECs. Arsenic also upregulated markers of endothelial dysfunction (MCP-1, ICAM-1) and inflammatory cytokines (IL-6, TNF-α) in HUVECs. Our findings suggest that arsenic-induced hypertension is mediated, at least in part, by oxidative stress-mediated inhibition of ACE2 as well as by suppressing the vasoprotective axes of RAS, in addition to the activation of the classical axis.
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Affiliation(s)
- Md Shiblur Rahaman
- Department of Environmental and Preventive Medicine, Jichi Medical University School of Medicine, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan; Department of Environmental Science and Disaster Management, Noakhali Science and Technology University, Noakhali, 3814, Bangladesh; Graduate School of Environmental Science, Hokkaido University, Sapporo, 060-0810, Japan
| | - Nathan Mise
- Department of Environmental and Preventive Medicine, Jichi Medical University School of Medicine, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan
| | - Akihiko Ikegami
- Department of Environmental and Preventive Medicine, Jichi Medical University School of Medicine, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan
| | - Cai Zong
- Department of Occupational and Environmental Health, Faculty of Pharmaceutical Sciences, Tokyo University of Science, 2641 Yamazaki, Noda, 278-8510, Japan
| | - Gaku Ichihara
- Department of Occupational and Environmental Health, Faculty of Pharmaceutical Sciences, Tokyo University of Science, 2641 Yamazaki, Noda, 278-8510, Japan
| | - Sahoko Ichihara
- Department of Environmental and Preventive Medicine, Jichi Medical University School of Medicine, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan.
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Rahaman MS, Rahman MM, Mise N, Sikder MT, Ichihara G, Uddin MK, Kurasaki M, Ichihara S. Environmental arsenic exposure and its contribution to human diseases, toxicity mechanism and management. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2021; 289:117940. [PMID: 34426183 DOI: 10.1016/j.envpol.2021.117940] [Citation(s) in RCA: 166] [Impact Index Per Article: 55.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 08/03/2021] [Accepted: 08/06/2021] [Indexed: 05/27/2023]
Abstract
Arsenic is a well-recognized environmental contaminant that occurs naturally through geogenic processes in the aquifer. More than 200 million people around the world are potentially exposed to the elevated level of arsenic mostly from Asia and Latin America. Many adverse health effects including skin diseases (i.e., arsenicosis, hyperkeratosis, pigmentation changes), carcinogenesis, and neurological diseases have been reported due to arsenic exposure. In addition, arsenic has recently been shown to contribute to the onset of non-communicable diseases, such as diabetes mellitus and cardiovascular diseases. The mechanisms involved in arsenic-induced diabetes are pancreatic β-cell dysfunction and death, impaired insulin secretion, insulin resistance and reduced cellular glucose transport. Whereas, the most proposed mechanisms of arsenic-induced hypertension are oxidative stress, disruption of nitric oxide signaling, altered vascular response to neurotransmitters and impaired vascular muscle calcium (Ca2+) signaling, damage of renal, and interference with the renin-angiotensin system (RAS). However, the contributions of arsenic exposure to non-communicable diseases are complex and multifaceted, and little information is available about the molecular mechanisms involved in arsenic-induced non-communicable diseases and also no suitable therapeutic target identified yet. Therefore, in the future, more basic research is necessary to identify the appropriate therapeutic target for the treatment and management of arsenic-induced non-communicable diseases. Several reports demonstrated that a daily balanced diet with proper nutrient supplements (vitamins, micronutrients, natural antioxidants) has shown effective to reduce the damages caused by arsenic exposure. Arsenic detoxication through natural compounds or nutraceuticals is considered a cost-effective treatment/management and researchers should focus on these alternative options. This review paper explores the scenarios of arsenic contamination in groundwater with an emphasis on public health concerns. It also demonstrated arsenic sources, biogeochemistry, toxicity mechanisms with therapeutic targets, arsenic exposure-related human diseases, and onsets of cardiovascular diseases as well as feasible management options for arsenic toxicity.
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Affiliation(s)
- Md Shiblur Rahaman
- Department of Environmental and Preventive Medicine, Jichi Medical University School of Medicine, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan; Department of Environmental Science and Disaster Management, Noakhali Science and Technology University, Noakhali, 3814, Bangladesh
| | - Md Mostafizur Rahman
- Department of Environmental Sciences, Jahangirnagar University, Dhaka, 1342, Bangladesh
| | - Nathan Mise
- Department of Environmental and Preventive Medicine, Jichi Medical University School of Medicine, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan
| | - Md Tajuddin Sikder
- Department of Public Health and Informatics, Jahangirnagar University, Dhaka, 1342, Bangladesh
| | - Gaku Ichihara
- Department of Occupational and Environmental Health, Faculty of Pharmaceutical Sciences, Tokyo University of Science, 2641 Yamazaki, Noda, 278-8510, Japan
| | - Md Khabir Uddin
- Department of Environmental Sciences, Jahangirnagar University, Dhaka, 1342, Bangladesh
| | - Masaaki Kurasaki
- Faculty of Environmental Earth Science, Hokkaido University, Sapporo, 060-0810, Japan
| | - Sahoko Ichihara
- Department of Environmental and Preventive Medicine, Jichi Medical University School of Medicine, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan.
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Moazzeni SS, Asgari S, Azizi F, Hadaegh F. Live birth/parity number and the risk of incident hypertension among parous women during over 13 years of follow-up. J Clin Hypertens (Greenwich) 2021; 23:2000-2008. [PMID: 34657376 PMCID: PMC8630610 DOI: 10.1111/jch.14369] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Revised: 08/30/2021] [Accepted: 09/15/2021] [Indexed: 12/14/2022]
Abstract
The effect of live birth/parity number on incident hypertension was investigated among Iranian parous women aged 30–70 years. The study population included 2188 normotensive women who were enrolled in 1999–2001. They were followed for incident hypertension (based on JNC 7 report) by 3‐year intervals up to April 2018. Multivariable Cox proportional hazard models, adjusted for a wide set of potential hypertension risk factors, reproductive factors, and pregnancy complications, were applied to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) of the number of parity/live birth(s) for incident hypertension. Additionally, as a sensitivity analysis, age‐scale Cox regression was also done. During a median follow‐up of 13.5 years, 935 incident hypertension have occurred. Compared to those with two live births, the participants who had 3 and ≥4 live births were at higher risk of hypertension development by the HRs of 1.25 [95% CI: 1.02–1.55] and 1.39 [1.12–1.72], respectively, in the full‐adjusted model. Moreover, each additional live birth increased the risk of hypertension by a HR of 1.06 [95%CI: 1.02–1.11]. Results of parity number were also similar. Considering age as time scale also did not change the results generally. The authors found a significant interaction between live birth/parity number and age groups; the adverse effect of higher live birth/parity numbers on hypertension development was mainly found among those aged < 50 years. To sum up, compared to the live birth/parity number of two, Iranian women with ≥3 live birth/parity had a higher risk of incident hypertension; the issue was more prominent among younger mothers.
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Affiliation(s)
- Seyyed Saeed Moazzeni
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Samaneh Asgari
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farzad Hadaegh
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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