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Choudhary N, Gopal K, Naqvi W, Kandakurti PK, Hazari A. Relationship between the level of physical activity and body mass index to blood pressure among overweight and obese young adults in the Northern Emirates city: A cross-sectional study. PLoS One 2024; 19:e0304360. [PMID: 38900755 PMCID: PMC11189183 DOI: 10.1371/journal.pone.0304360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Accepted: 05/11/2024] [Indexed: 06/22/2024] Open
Abstract
BACKGROUND Obesity affects both adults and children all over the world and it is a major causative factor for diabetes, cardiovascular disease, different types of cancer, and even death. Therefore, this study aimed to assess the level of PA and BMI to the risk of developing high BP among overweight and obese young adults. METHODOLOGY A cross-sectional study was carried out in the Thumbay Medi-city Northern Emirates, Ajman, UAE. Participants enrolled in the study under the convenient sampling method and inclusion criteria: young overweight and obese individuals, male and female, aged between 18 to 30 years. Approval was obtained from the Institutional Review Board (CoHS, GMU (IRB-COHS-STD-110-JUNE-2023). The blood pressure and body mass index were clinically measured using standard tools whereas the GPAQ questionnaire was used to determine the level of physical activity of all participants. RESULTS Out of 206 participants, 139 were overweight and 67 were obese. Further, 89 were found to have high normal BP, 93 normal BP, and 24 were found to have optimal blood pressure. The mean GPA scores were 322.8±62.28 in overweight individuals and 301.17±49.05 in obese individuals. Furthermore, among overweight and obese participants there is a weak correlation between PA & BMI (r = 0.06, p = 0.88) and (r = 0.15, p = 0.44) and the BP and BMI (r = 0.18, p = 1.02) and (r = 0.16, p = 0.90) were found. CONCLUSION Although PA, BMI, and BP are assumed to be related variables leading to various non-communicable diseases the present study showed a weak correlation between the level of PA and BMI to the risk of developing BP among overweight and obese young adults in the Northern Emirates.
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Affiliation(s)
- Naina Choudhary
- Department of Physiotherapy, College of Health Sciences, Gulf Medical University, Ajman, UAE
| | - Kumaraguruparan Gopal
- Department of Physiotherapy, College of Health Sciences, Gulf Medical University, Ajman, UAE
| | - Waqar Naqvi
- Department of Physiotherapy, College of Health Sciences, Gulf Medical University, Ajman, UAE
| | | | - Animesh Hazari
- Department of Physiotherapy, College of Health Sciences, Gulf Medical University, Ajman, UAE
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Masum M, Mamani DA, Howard JT. Alcohol and Binge Drinking Frequency and Hypertension: A National Cross-Sectional Study in the U.S. Am J Prev Med 2024:S0749-3797(24)00165-X. [PMID: 38762207 DOI: 10.1016/j.amepre.2024.05.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Revised: 05/10/2024] [Accepted: 05/13/2024] [Indexed: 05/20/2024]
Abstract
INTRODUCTION The relationship between alcohol consumption and hypertension is multifaceted and a major public health concern. The association becomes even more complicated when hypertension is undiagnosed. This study investigates how alcohol consumption patterns are linked to measured, diagnosed, undiagnosed, and composite hypertension (any indications of hypertension from blood pressure readings, professional diagnosis, or reported medication use) in the United States. METHODS Data from the National Health and Nutrition Examination Survey 2015-2020, a nationally representative cross-sectional study, were analyzed in 2023-2024. The final analytic sample was 12,950 participants. Complex-survey weighted multivariable linear and logistic regression models estimated the effect of different alcohol consumption levels on hypertension. RESULTS Descriptive findings show that those who consumed alcohol more than 3 times weekly exhibited the highest prevalence of measured (52.5%), undiagnosed (27.0%), and composite hypertension (69.4%) compared to other levels of alcohol drinking. Multivariable linear regression analysis indicated a notable elevation in systolic (4.8 unit) and diastolic (2.46 unit) blood pressure among individuals with frequent binge drinking episodes compared to individuals with infrequent drinking. Logistic regression models estimated that drinking over 3 times weekly increases the odds of measured, undiagnosed, and composite hypertension by 64%, 70%, and 54%, respectively, while frequent binge drinking episodes raise these odds by 82%, 65%, and 47%. CONCLUSIONS Contrary to some studies suggesting moderate alcohol intake has protective cardiovascular effects, the findings did not corroborate a "J-shaped" curve. This underscores the importance of regular blood pressure monitoring among individuals with binge drinking episodes and emphasizes the need for public health interventions to mitigate alcohol consumption and its associated hypertension risks.
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Affiliation(s)
- Muntasir Masum
- Department of Epidemiology & Biostatistics, University at Albany, Rensselaer, New York.
| | - Daniel A Mamani
- Department of Demography, University of Texas at San Antonio, San Antonio, Texas
| | - Jeffrey T Howard
- Department of Public Health, University of Texas at San Antonio, San Antonio, Texas
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Jensen GB, Grønbæk M, Jensen MT, Schnohr P, Nordestgaard BG, Lavie CJ, O'Keefe JH, Marott JL. Type of Alcohol and Blood Pressure: The Copenhagen General Population Study. Am J Med 2024:S0002-9343(24)00280-8. [PMID: 38750714 DOI: 10.1016/j.amjmed.2024.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Revised: 04/24/2024] [Accepted: 05/06/2024] [Indexed: 06/10/2024]
Abstract
BACKGROUND Most adults ingest alcoholic beverages. Alcohol shows strong and positive associations with blood pressure (BP). We hypothesized that intake of red wine, white wine, beer, and spirits and dessert wine show similar associations with BP in the general population. METHODS We included 104,467 males and females aged 20-100 years in the analysis of the Danish general population. Alcohol use and type of alcohol were assessed by questionnaire. Blood pressure was measured by automated digital BP manometer. Multivariable linear regression models were used when analyzing the association between number of drinks per week and BP, stratified by sex and adjusted for relevant confounders. Each alcohol type (red wine, white wine, beer, and spirits and dessert wine) was analyzed in similar models including adjustment for other alcohol types. RESULTS Most of the subjects (76,943 [73.7%]) drank more than 1 type of alcohol. However, 12,093 (12.6%) consumed red wine only, 4288 (4.5%) beer only, 1815 (1.9%) white wine only, and 926 (1.0%) spirits and dessert wine only. There was a dose-response association between total drinks per week and systolic and diastolic BP (SBP, DBP) (P < .001). The crude difference was 11 mmHg SBP and 7 mmHg DBP between high (>35 drinks per week) and low (1-2 drinks per week) alcohol intake. Overall, SBP was increased by 0.15-0.17 mmHG, and DBP was increased by 0.08-0.15 mmHg per weekly drink. After stratification for age and sex, effects were slightly higher among females and among individuals aged less than 60 years. CONCLUSION Alcohol intake is associated with highly significant increased SPB and DBP. The effect is similar for red wine, white wine, beer, and spirits.
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Affiliation(s)
- Gorm Boje Jensen
- The Copenhagen City Heart Study, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Denmark; National Institute of Public Health, University of Southern Denmark, Copenhagen.
| | - Morten Grønbæk
- The Copenhagen City Heart Study, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Denmark; National Institute of Public Health, University of Southern Denmark, Copenhagen
| | - Magnus T Jensen
- The Copenhagen City Heart Study, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Denmark; Steno Diabetes Center Copenhagen, Denmark
| | - Peter Schnohr
- The Copenhagen City Heart Study, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Denmark
| | - Børge Grønne Nordestgaard
- The Copenhagen City Heart Study, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Denmark; The Copenhagen General Population Study, Copenhagen University Hospital - Herlev and Gentofte, Herlev, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark; Department of Clinical Biochemistry, Copenhagen University Hospital - Herlev and Gentofte, Denmark
| | - Carl J Lavie
- Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinical School-the UQ School of Medicine, New Orleans, Louisiana
| | - James H O'Keefe
- Saint Luke's Mid America Heart Institute, University of Missouri-Kansas City
| | - Jacob Louis Marott
- The Copenhagen City Heart Study, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Denmark; The Copenhagen General Population Study, Copenhagen University Hospital - Herlev and Gentofte, Herlev, Denmark
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Woloshchuk CJ, Portillo C, Rodriguez-Crespo A, De Alba J, Amador NC, Cooper TV. Protective and risk factors for increased alcohol use in Latinx college students on the U.S./Mexico border. J Ethn Subst Abuse 2024; 23:287-304. [PMID: 35758062 DOI: 10.1080/15332640.2022.2089939] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Alcohol use is prevalent among undergraduates, however, limited research on drinking among Latinx college students exists. This study examined potential risk and protective factors of alcohol use and consequences. Participants (n = 382) completed multiple measures including alcohol use frequency and the Rutgers Alcohol Problem Index (RAPI). Linear regression models identified predictors of monthly and yearly drinking days and RAPI. Findings indicated that alcohol use frequency was associated with increasing age, parental alcohol use disorder, greater anger, and lower self-efficacy. Alcohol-related consequences were positively associated with anxiety and adverse childhood experiences. Early alcohol prevention and intervention efforts appear warranted.
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Pashek RE, Nkambule BB, Chan MV, Thibord F, Lachapelle AR, Cunha J, Chen MH, Johnson AD. Alcohol intake including wine drinking is associated with decreased platelet reactivity in a large population sample. Int J Epidemiol 2023; 52:1939-1950. [PMID: 37431613 PMCID: PMC10749750 DOI: 10.1093/ije/dyad099] [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] [Received: 11/10/2022] [Accepted: 06/22/2023] [Indexed: 07/12/2023] Open
Abstract
BACKGROUND Alcohol consumption is linked to decreased platelet function. Whether this link is dependent on sex or type of beverage remains unclear. METHODS Cross-sectional data were obtained from the Framingham Heart Study (N = 3427). Alcohol consumption was assessed by using standardized medical history and Harvard semi-quantitative food frequency questionnaires. Five bioassays measured 120 platelet reactivity traits across agonists in whole-blood and platelet-rich plasma samples. Linear mixed-effects models adjusted for age, sex and aspirin use, hypertension, body mass index, cholesterol, high-density lipoprotein, triglycerides, smoking and diabetes evaluated associations between platelet reactivity and alcohol consumption. Beta effects, the regression coefficients that estimate the amount of change in each unit of the predictor variable whereas all other predictor variables remain fixed, for heavy alcohol consumption were compared with effects of aspirin use. RESULTS Alcohol consumption was associated with decreased platelet reactivity, with more associations among wine and liquor compared with beer. Many platelet-alcohol associations in the full sample (86%, P < 0.01) had larger effect sizes in females. Lower light transmission aggregometry adenosine diphosphate (1.82 µM) maximum aggregation (P = 2.6E-3, 95% CI = -0.07, -0.02, β = -0.042) and area under the curve (P = 7.7E-3, 95% CI = -0.07, -0.01, β = -0.039) were associated with white wine consumption; however, red wine had no associations with platelet reactivity. The effect of aspirin use was on average 11.3 (±4.0) times greater than that of heavy drinking in our full sample. CONCLUSIONS We confirm associations between alcohol consumption and decreased platelet reactivity. Effects appeared larger for liquor and wine intake and in our female cohort. Red wine consumption is not associated with lower platelet function, contrasting with prior population studies. Although we report an inhibitory relationship between alcohol intake and platelet function, these effects appear much smaller than that of aspirin use.
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Affiliation(s)
- Robin E Pashek
- National Heart, Lung and Blood Institute’s, The Framingham Heart Study, Framingham, Framingham, MA, USA
- National Heart, Lung and Blood Institute, Population Sciences Branch, Framingham, MA, USA
| | - Bongani B Nkambule
- National Heart, Lung and Blood Institute’s, The Framingham Heart Study, Framingham, Framingham, MA, USA
- National Heart, Lung and Blood Institute, Population Sciences Branch, Framingham, MA, USA
| | - Melissa V Chan
- National Heart, Lung and Blood Institute’s, The Framingham Heart Study, Framingham, Framingham, MA, USA
- National Heart, Lung and Blood Institute, Population Sciences Branch, Framingham, MA, USA
| | - Florian Thibord
- National Heart, Lung and Blood Institute’s, The Framingham Heart Study, Framingham, Framingham, MA, USA
- National Heart, Lung and Blood Institute, Population Sciences Branch, Framingham, MA, USA
| | - Amber R Lachapelle
- National Heart, Lung and Blood Institute’s, The Framingham Heart Study, Framingham, Framingham, MA, USA
- National Heart, Lung and Blood Institute, Population Sciences Branch, Framingham, MA, USA
| | - Jason Cunha
- National Heart, Lung and Blood Institute’s, The Framingham Heart Study, Framingham, Framingham, MA, USA
- National Heart, Lung and Blood Institute, Population Sciences Branch, Framingham, MA, USA
| | - Ming-Huei Chen
- National Heart, Lung and Blood Institute’s, The Framingham Heart Study, Framingham, Framingham, MA, USA
- National Heart, Lung and Blood Institute, Population Sciences Branch, Framingham, MA, USA
| | - Andrew D Johnson
- National Heart, Lung and Blood Institute’s, The Framingham Heart Study, Framingham, Framingham, MA, USA
- National Heart, Lung and Blood Institute, Population Sciences Branch, Framingham, MA, USA
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Musich M, Costa AN, Salathe V, Miller MB, Curtis AF. Sex-Specific Contributions of Alcohol and Hypertension on Everyday Cognition in Middle-Aged and Older Adults. J Womens Health (Larchmt) 2023; 32:1086-1095. [PMID: 37023399 DOI: 10.1089/jwh.2022.0462] [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] [Indexed: 04/08/2023] Open
Abstract
Background: Separate lines of research have linked hypertension and alcohol use disorder to cognition among adults. Despite known sex differences in both of these conditions, studies examining associations on cognition are limited. We aimed to determine whether hypertension impacts the relationship between alcohol use and everyday subjective cognition and whether sex moderates this relationship in middle-aged and older adults. Materials and Methods: Participants (N = 275) 50+ years of age, who reported drinking, completed surveys measuring alcohol use (Alcohol Use Disorder Identification Test consumption items), self-reported history of hypertension, and everyday subjective cognition (Cognitive Failures Questionnaire [CFQ]). Regression was used to test a moderated moderation model examining independent and interactive roles of alcohol use, hypertension, and sex on cognition (CFQ scores: total, memory, distractibility, blunders, and names). Analyses controlled for age, years of education, race, body mass index, smoking status, depressive symptoms, global subjective sleep quality, number of prescription medication used, and number of comorbid medical conditions. Results: Sex moderated the interactive associations of hypertension and alcohol use frequency on CFQ-distractibility. Specifically, in women with hypertension, more alcohol use was associated with greater CFQ-distractibility (B = 0.96, SE = 0.34, p = 0.005). Discussion: Sex moderates the interactive association of hypertension and alcohol use on some aspects of subjective cognition in mid-to-late life. In women with hypertension, alcohol use may exacerbate problems with attentional control. Further exploration of sex- and or gender-specific mechanisms underlying these is warranted.
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Affiliation(s)
- Madison Musich
- Department of Psychological Sciences, University of Missouri-Columbia, Columbia, Missouri, USA
| | - Amy N Costa
- Department of Psychological Sciences, University of Missouri-Columbia, Columbia, Missouri, USA
| | - Victoria Salathe
- Department of Biological Sciences, University of Missouri-Columbia, Columbia, Missouri, USA
| | - Mary Beth Miller
- Department of Psychiatry, University of Missouri-Columbia, Columbia, Missouri, USA
| | - Ashley F Curtis
- Department of Psychological Sciences, University of Missouri-Columbia, Columbia, Missouri, USA
- Department of Psychiatry, University of Missouri-Columbia, Columbia, Missouri, USA
- College of Nursing, University of South Florida, Tampa, Florida, USA
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Wojtowicz JS. Long-Term Health Outcomes of Regular, Moderate Red Wine Consumption. Cureus 2023; 15:e46786. [PMID: 37954791 PMCID: PMC10634232 DOI: 10.7759/cureus.46786] [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] [Accepted: 10/09/2023] [Indexed: 11/14/2023] Open
Abstract
Studies that are conducted to assess alcohol's long-term health outcomes generally report the results as a pooled analysis across all types of alcohol. Questions have been raised regarding potential health differences between types of alcohol, such as beer, wine, or spirits. While these three share the same alcohol in the form of ethanol, they differ in the other compounds they contain that are particular to each type of alcohol, specifically the polyphenols in red wine. The generalizability of pooled results may be limited due to the differences in health outcomes that may exist between different types of alcohol and lead to overall conclusions that differ from the subset analysis by type of alcohol that is often reported in the data tables of an article. The objective of this systematic review was to specifically address the assessment of the long-term health outcomes of regular, moderate, red wine consumption. PubMed was searched from 1987 through June 2023. Studies were included if they met all the following criteria: adult participants, red wine consumption and its frequency (close to daily), volume in moderation (1 glass/day for women, 2 glasses/day for men), and measurement of long-term (> 2 years) health outcomes. Nonclinical animal studies, or studies with an endpoint as a marker or biomarker, without a health outcome, of short duration (< 2 years), small size (< 25 subjects), a focus on binge drinking, no wine analysis performed, review articles, meta-analysis, or editorial/commentary were excluded. A total of 74 studies met the inclusion/exclusion criteria. Of these, 27 (36%) evaluated cancer outcomes, 14 (19%) evaluated cardiovascular outcomes, 10 (14%) evaluated mortality, 7 (9%) evaluated weight gain, 5 (7%) evaluated dementia, and the remaining 11 evaluated a variety of health outcomes. There were no studies that demonstrated an association between red wine consumption and negative health outcomes. Forty-seven studies demonstrated an association between red wine consumption and positive health outcomes, whereas 26 studies were neutral, and one had mixed results where women had a positive health outcome and men were neutral. All studies on mortality and dementia showed positive health outcomes. From this systematic review of the literature, there is no evidence of an association between moderate red wine consumption and negative health outcomes. Across the various outcomes assessed, a beneficial effect of moderate red wine consumption was consistently seen for mortality and dementia, along with certain cancers (e.g., non-Hodgkin lymphoma) and cardiovascular conditions (e.g., metabolic syndrome). For other health outcomes, the association was neutral, i.e., neither harmful nor beneficial. This review is not intended to encourage red wine consumption for health outcomes but rather to avoid discouraging moderate red wine consumption based on misunderstanding or misinterpretation of the red wine data due to the reporting of pooled data across all types of alcohol.
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Lee H, Park MS, Kang MK, Song TJ. Association between Proteinuria Status and Risk of Hypertension: A Nationwide Population-Based Cohort Study. J Pers Med 2023; 13:1414. [PMID: 37763181 PMCID: PMC10533010 DOI: 10.3390/jpm13091414] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 09/07/2023] [Accepted: 09/18/2023] [Indexed: 09/29/2023] Open
Abstract
Proteinuria is associated with cardiovascular disease. However, the relationship between changes in proteinuria status and hypertension remains unclear. This study aimed to explore the association between changes in proteinuria status and the risk of developing hypertension with the data from the Korean National Health Insurance Database. We included participants without prior hypertension history who underwent their first health examination in 2003-2004 and a second examination in 2005-2006. Based on their proteinuria status during these two examinations, participants were classified into four groups: the proteinuria-free, proteinuria-resolved, proteinuria-developed, and chronic proteinuria groups. The study outcome was the incidence of hypertension. The study included 935,723 participants followed for a median of 14.2 years (mean age: 40.96 ± 11.01, 62.5% male participants). During this period, 346,686 (37.1%) cases of hypertension were reported. The chronic proteinuria group had the highest hypertension risk, followed by the proteinuria-developed, proteinuria-resolved, and proteinuria-free groups (p < 0.001). Those who recovered from proteinuria had a lower risk of developing hypertension than those with chronic proteinuria (hazard ratio: 0.58; 95% confidence interval: 0.53-0.63, p < 0.001). In contrast, individuals who developed proteinuria had a higher risk of hypertension than proteinuria-free individuals (hazard ratio: 1.31; 95% confidence interval: 1.26-1.35, p < 0.001). Our findings suggest a significant association between proteinuria status changes and hypertension. Effective management of proteinuria may potentially decrease the risk of developing hypertension.
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Affiliation(s)
| | | | | | - Tae-Jin Song
- Department of Neurology, Seoul Hospital, Ewha Womans University College of Medicine, Seoul 07804, Republic of Korea
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Qiu T, Jiang Z, Chen X, Dai Y, Zhao H. Comorbidity of Anxiety and Hypertension: Common Risk Factors and Potential Mechanisms. Int J Hypertens 2023; 2023:9619388. [PMID: 37273529 PMCID: PMC10234733 DOI: 10.1155/2023/9619388] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 05/09/2023] [Accepted: 05/15/2023] [Indexed: 06/06/2023] Open
Abstract
Anxiety is more common in patients with hypertension, and these two conditions frequently coexist. Recently, more emphasis has been placed on determining etiology in patients with comorbid hypertension and anxiety. This review focuses on the common risk factors and potential mechanisms of comorbid hypertension and anxiety. Firstly, we analyze the common risk factors of comorbid hypertension and anxiety including age, smoking, alcohol abuse, obesity, lead, and traffic noise. The specific mechanisms underlying hypertension and anxiety were subsequently discussed, including interleukin (IL)-6 (IL-6), IL-17, reactive oxygen species (ROS), and gut dysbiosis. Increased IL-6, IL-17, and ROS accelerate the development of hypertension and anxiety. Gut dysbiosis leads to hypertension and anxiety by reducing short-chain fatty acids, vitamin D, and 5-hydroxytryptamine (5-HT), and increasing trimethylamine N-oxide (TAMO) and MYC. These shared risk factors and potential mechanisms may provide an effective strategy for treating and preventing hypertension and comorbid anxiety.
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Affiliation(s)
- Tingting Qiu
- School of Nursing, Hengyang Medical School, University of South China, Hengyang, Hunan 421001, China
- The Central Hospital of Changsha City, Hengyang Medical School, University of South China, Changsha, Hunan 410000, China
| | - Zhiming Jiang
- Department of Cardiology, The Fourth Hospital of Changsha, Changsha, Hunan 410006, China
| | - Xuancai Chen
- Urinary Surgery, Affiliated Nanhua Hospital, University of South China, Hengyang 421002, China
| | - Yehua Dai
- Nursing College, University of Xiangnan, Chenzhou, Hunan 423000, China
| | - Hong Zhao
- School of Nursing, Hengyang Medical School, University of South China, Hengyang, Hunan 421001, China
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Hou J, Zhu L, Jin S, Li J, Xing Z, Wang Y, Wan X, Guo X, Wang A, Wang X, Liu J, Ma J, Zhou S, Zhang X, Zheng H, Wang J, Feng H, Sun S, Wang T. Prevalence of hypertension in endemic and non-endemic areas of Keshan disease: A cross-sectional study in rural areas of China. Front Nutr 2023; 10:1086507. [PMID: 36860691 PMCID: PMC9969988 DOI: 10.3389/fnut.2023.1086507] [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: 11/01/2022] [Accepted: 01/30/2023] [Indexed: 02/16/2023] Open
Abstract
Background Hypertension is a major public health concern that strongly influences the quality of life of people worldwide. Keshan disease (KD) is an endemic cardiomyopathy related to low selenium, threatening residents in rural areas of 16 provinces in China. Furthermore, the prevalence of hypertension in the KD-endemic areas has been increasing annually. However, hypertension research associated with KD has only focused on endemic regions, and no studies have compared hypertension prevalence between endemic and non-endemic areas. Therefore, this study investigated the prevalence of hypertension to provide a basis for preventing and controlling hypertension in the KD-endemic areas, even in rural areas. Methods We extracted blood pressure information from cardiomyopathy investigation data from a cross-sectional study of the KD-endemic and non-endemic areas. The hypertension prevalence between the two groups was compared using the Chi-square test or Fisher s exact test. Additionally, Pearson's correlation coefficient was employed to evaluate the relationship between the per capita gross domestic product (GDP) and hypertension prevalence. Results There was a statistically significant increase of hypertension prevalence in the KD-endemic areas (22.79%, 95% confidence interval [CI]: 22.30-23.27%) over the non-endemic areas (21.55%, 95% CI: 21.09-22.02%). In the KD-endemic areas, more men had hypertension than women (23.90% vs. 21.65%, P < 0.001). Furthermore, the hypertension prevalence was higher in the north than in the south in the KD-endemic areas (27.52% vs. 18.76%, P < 0.001), non-endemic areas (24.86% vs. 18.66%, P < 0.001), and overall (26.17% vs. 18.68%, P < 0.001). Finally, the prevalence of hypertension positively correlated with per capita GDP at province level. Conclusions The increasing hypertension prevalence is a public health problem in the KD-endemic areas. Healthy diets, such as high consumption of vegetables and seafoods, and foods that are rich in selenium, might help prevent and control hypertension in the KD-endemic areas and other rural areas in China.
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Affiliation(s)
- Jie Hou
- Institute of Keshan Disease, Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin, China,National Health Commission and Education Bureau of Heilongjiang Province, Key Laboratory of Etiology and Epidemiology, Harbin Medical University, Harbin, China,*Correspondence: Jie Hou,
| | - Lifang Zhu
- Institute of Keshan Disease, Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin, China
| | - Shuran Jin
- Institute of Keshan Disease, Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin, China
| | - Jinshu Li
- Sichuan Center for Disease Control and Prevention, Chengdu, China
| | - Zhifeng Xing
- Heilongjiang Provincial Center for Disease Control and Prevention, Harbin, China
| | - Yanling Wang
- Gansu Provincial Center for Disease Control and Prevention, Lanzhou, China
| | - Xiaoyan Wan
- The Second Research Institute for Endemic Disease Control and Prevention of Jilin Province, Jilin City, China
| | - Xianni Guo
- Shaanxi Institute for Endemic Disease Control and Prevention, Xi’an, China
| | - Anwei Wang
- Yunnan Institute of Endemic Disease Control and Prevention, Dali, China
| | - Xiuhong Wang
- Shandong Provincial Institute for Endemic Disease Control, Jinan, China
| | - Jinming Liu
- The Inner Mongolia Autonomous Region Comprehensive Center for Disease Control and Prevention, Hohhot, China
| | - Jing Ma
- Hebei Provincial Center for Disease Control and Prevention, Shijiazhuang, China
| | - Shuang Zhou
- Chongqing Center for Disease Control and Prevention, Chongqing, China
| | - Xiangdong Zhang
- Shanxi Institute of Endemic Disease Control and Prevention, Linfen, China
| | - Heming Zheng
- Henan Provincial Center for Disease Control and Prevention, Zhengzhou, China
| | - Jianhui Wang
- Liaoning Center for Disease Control and Prevention, Shenyang, China
| | - Hongqi Feng
- Institute of Keshan Disease, Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin, China,National Health Commission and Education Bureau of Heilongjiang Province, Key Laboratory of Etiology and Epidemiology, Harbin Medical University, Harbin, China
| | - Shuqiu Sun
- Institute of Keshan Disease, Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin, China,National Health Commission and Education Bureau of Heilongjiang Province, Key Laboratory of Etiology and Epidemiology, Harbin Medical University, Harbin, China
| | - Tong Wang
- Institute of Keshan Disease, Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin, China,National Health Commission and Education Bureau of Heilongjiang Province, Key Laboratory of Etiology and Epidemiology, Harbin Medical University, Harbin, China,Tong Wang,
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DNA Hypomethylation as a Potential Link between Excessive Alcohol Intake and Cardiometabolic Dysfunction in Morbidly Obese Adults. Biomedicines 2022; 10:biomedicines10081954. [PMID: 36009501 PMCID: PMC9406007 DOI: 10.3390/biomedicines10081954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 08/09/2022] [Accepted: 08/10/2022] [Indexed: 11/24/2022] Open
Abstract
A large percentage of obese patients in the United States suffer a comorbid substance use disorder, mainly alcohol use. Alcohol consumption interferes with the absorption of dietary methyl donors such as folate required for the one-carbon metabolism pathway and subsequently for DNA methylation. In this study, we assessed the association between alcohol consumption and DNA methylation in obese subjects. We obtained visceral adipose tissue (VAT) biopsies from bariatric patients. DNA methylation of 94 genes implicated in inflammation and immunity were analyzed in VAT in relation to alcohol consumption data obtained via questionnaires. Vasoreactivity was measured in the brachial artery and the VAT-isolated arterioles. Pro-inflammatory genes were significantly hypomethylated in the heavy drinking category correlating with higher levels of circulating inflammatory cytokines. Alcohol consumption correlated positively with body mass index (BMI), fat percentage, insulin resistance, impaired lipid profile, and systemic inflammation and negatively with plasma folate and vitamin B12, inflammatory gene DNA methylation, and vasoreactivity. In conclusion, these data suggest that alcohol intake is associated with lower DNA methylation and higher inflammation and cardiometabolic risk in obese individuals.
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The relationship between tooth loss and hypertension: a systematic review and meta-analysis. Sci Rep 2022; 12:13311. [PMID: 35922537 PMCID: PMC9349209 DOI: 10.1038/s41598-022-17363-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 07/25/2022] [Indexed: 11/16/2022] Open
Abstract
As tooth loss is the high end of periodontal problems and edentulous individuals are at higher risk of nutritional problems like obesity, understanding the association between tooth loss and hypertension is important for improving cardiovascular health. We searched for publications from the last two decades using three electronic databases (PubMed, Web of Science and Scopus) and conducted a systematic review and meta-analysis on the association between tooth loss and hypertension according to PRISMA-P guidelines. Quality assessments were performed using the Newcastle–Ottawa Scale and the GRADE approach. Twenty-four studies (20 cross-sectional, and 4 cohort) met the inclusion criteria for this review. Most cross-sectional studies showed that subjects with more tooth loss exhibited a greater proportion of hypertension and higher systolic blood pressure than those with less tooth loss. Meta-analyses revealed a statistically significant association between tooth loss and hypertension. The pooled odds ratios of hypertension for having tooth loss with no tooth loss and for edentulous with dentate were 2.22 (95% CI 2.00–2.45) and 4.94 (95% CI 4.04–6.05), respectively. In cohort studies, subjects with more tooth loss had a greater incidence of hypertension than those with less tooth loss during the follow-up period. The present systematic review and meta-analysis suggests that tooth loss is associated with an increased risk of hypertension and higher systolic blood pressure.
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What Is or What Is Not a Risk Factor for Arterial Hypertension? Not Hamlet, but Medical Students Answer That Question. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19138206. [PMID: 35805864 PMCID: PMC9266816 DOI: 10.3390/ijerph19138206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 06/08/2022] [Accepted: 07/04/2022] [Indexed: 11/30/2022]
Abstract
Hypertension is a leading cause of cardiovascular disease and premature death worldwide. The most important method of preventing hypertension is social awareness of its causes. An important role in educating society about hypertension is played by medical personnel. The study involved 327 students of medicine representing all years of study. The study used a proprietary questionnaire containing test questions about knowledge of the causes of hypertension (classical and non-classical factors), as well as questionable and false risk factors for the disease. The students’ knowledge of the complications of hypertension was also assessed. Most of the students rated their knowledge about hypertension as good. Classical risk factors for hypertension were identified by students in all years of study: I–III and IV–VI. Non-classical risk factors for hypertension were less often identified by the students. The students almost unanimously indicated that the complications of hypertension include heart failure, heart attack, stroke, aortic aneurysm, kidney failure, atherosclerosis, eye diseases and worse prognosis in COVID-19. Students’ knowledge of the causes of hypertension increased during medical studies. The knowledge of the respondents about classical risk factors for hypertension was extensive, whereas knowledge of non-classical risk factors it was insufficient. Most of the respondents were well aware of the complications of hypertension. Some students identified some factors incorrectly as increasing the risk of hypertension. Emphasis should be placed on the dissemination of knowledge about non-classical hypertension risk factors to medical students.
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The Association of Dietary Pattern with the Risk of Prehypertension and Hypertension in Jiangsu Province: A Longitudinal Study from 2007 to 2014. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19137620. [PMID: 35805279 PMCID: PMC9265600 DOI: 10.3390/ijerph19137620] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 06/20/2022] [Accepted: 06/20/2022] [Indexed: 02/06/2023]
Abstract
Hypertension is the most common chronic disease and the primary risk factor for cardiovascular diseases. Prehypertension is closely related to a variety of cardiovascular disease risk factors during the development of hypertension. The objective of this study was to explore the relationship between dietary patterns and hypertension in Jiangsu Province. Specifically, we included the participants from 2007 and then followed up in 2014 in the Jiangsu Province of China and collected information from food frequency questionnaires, anthropometric measurements, and disease self-reports. A total of 1762 women and men were included in the final analysis. We extracted four dietary patterns using factor analysis, calculated the pattern-specific factor scores, and divided the scores into quartiles, which increased from Q1 to Q4. Compared with participants in Q1, an increased risk of high diastolic blood pressure was found in Q4 of the snack dietary pattern. Additionally, participants in Q2–Q4 of the frugal dietary pattern were found to have a positive association with abnormal blood pressure. However, the results found in the frugal dietary pattern vanished after adjusting more confounders in Q4 of high systolic blood pressure. We found that some food items were associated with hypertension and prehypertension. The overconsumption of salt and alcohol are risk factors for both prehypertension and hypertension. Added sugar and saturated fatty acids are risk factors for hypertension, which may provide suggestions for the residents in China to change dietary habits to prevent prehypertension and hypertension.
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Oliveira IM, Araujo TAD, Roediger MDA, Zanetta DMT, Andrade FBD. [Factors associated with undiagnosed hypertension among elderly adults in Brazil - ELSI-Brazil]. CIENCIA & SAUDE COLETIVA 2022; 27:2001-2010. [PMID: 35544826 DOI: 10.1590/1413-81232022275.12512021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Accepted: 07/27/2021] [Indexed: 11/21/2022] Open
Abstract
This article aims to identify factors associated with undiagnosed systemic arterial hypertension (SAH) among elderly adults in Brazil. A total of 5,416 hypertensive participants in the Longitudinal Study of the Health of Elderly Brazilians (ELSI-BRAZIL) were evaluated. Undiagnosed SAH was identified by mean blood pressure (BP) ≥140/90 mmHg without previous SAH diagnosis. Logistic regression was used to verify factors associated with undiagnosed SAH. In this study, 19.8% of the hypertensive patients evaluated did not report a previous diagnosis of SAH. Age between 60 to 69 (OR: 0.68, 95%CI 0.55-0.85) and 70 to79 (OR: 0.67, 95%CI 0.51-0.89), being black (OR: 0.67, 95%CI 0.49-0.91), obese (OR: 0.51, 95%CI 0.40-0.65), having one chronic disease (OR: 0.54, 95%CI 0.44-0.66) or more (OR: 0.32, 95%CI 0.25-0.42) and medical consultations in the last year (OR: 0.47, 95%CI 0.38-0.58) were factors associated with lower chances of undiagnosed SAH, while being male (OR: 1.27, 95%CI 1,05-1,54), presenting low body weight (OR: 1.33, 95%CI 1,00-1,78) and alcohol consumption (OR: 1.36, 95%CI 1,09-1,68) increased the chances of having the undiagnosed condition. The characteristics identified in this study needs to be observed in health services, expanding early diagnosis and preventing the progression of BP and its future consequences.
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Affiliation(s)
- Isabela Martins Oliveira
- Faculdade de Saúde Pública, Universidade de São Paulo. Av. Dr. Arnaldo 715, Cerqueira César. 01246-904 São Paulo SP Brasil.
| | | | - Manuela de Almeida Roediger
- Faculdade de Saúde Pública, Universidade de São Paulo. Av. Dr. Arnaldo 715, Cerqueira César. 01246-904 São Paulo SP Brasil.
| | - Dirce Maria Trevisan Zanetta
- Faculdade de Saúde Pública, Universidade de São Paulo. Av. Dr. Arnaldo 715, Cerqueira César. 01246-904 São Paulo SP Brasil.
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Zewudie BT, Geze Tenaw S, Solomon M, Mesfin Y, Abebe H, Mekonnen Z, Tesfa S, Chekole Temere B, Aynalem Mewahegn A, lankrew T, Sewale Y. The magnitude of undiagnosed hypertension and associated factors among HIV-positive patients attending antiretroviral therapy clinics of Butajira General Hospital, Gurage Zone, Southern Ethiopia. SAGE Open Med 2022; 10:20503121221094454. [PMID: 35509957 PMCID: PMC9058352 DOI: 10.1177/20503121221094454] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 03/29/2022] [Indexed: 11/16/2022] Open
Abstract
Objectives: The study aimed to assess the magnitude of undiagnosed hypertension, and its associated factors among adult HIV-positive patients receiving antiretroviral therapy at Butajira General Hospital, southern Ethiopia. Methods: We applied an institutional-based cross-sectional study design at Butajira General Hospital from 1 May to 1 July 2021. We used a systematic random sampling technique to select the total number of participants. A structured interviewer-administered questionnaire was applied to collect the data (sociodemographic characteristics, clinical-related factors, and lifestyle-related factors from the study participants. Data were entered using Epi-data version 3.1 and analyzed by statistical package for social science version 25. We applied a multivariable logistic regression analysis model to identify variables significantly associated with hypertension. Results: The study comprised 388 participants with 39 years (10.6 SD) as the mean age of the participants. Of the total participants, 235 (60.6%) were female. In this study the magnitude of undiagnosed hypertension among HIV-positive patients was 18.8% (95% CI: 14.7%–23.2%). Having comorbidity of diabetes mellitus (adjusted odds ratio = 5.29, 95% CI: 2.154, 12.99), habit of alcohol drinking (adjusted odds ratio = 2.909, 95% CI: 1.306, 6.481), duration of antiretroviral therapy ⩾ 5 years (adjusted odds ratio = 3.087, 95% CI: 1.558, 6.115), and age ⩾ 40 years (adjusted odds ratio = 2.642, 95% CI: 1.450, 4.813) were factors significantly associated with undiagnosed hypertension. Conclusions and recommendations: The magnitude of undiagnosed hypertension among HIV-positive patients attending the antiretroviral therapy clinic of Butajira General Hospital is high. The findings of this study implied that HIV-positive patients attending antiretroviral therapy clinics should be monitored routinely for hypertension; especially participants aged ⩾40 years, highly active antiretroviral therapy duration ⩾5 years, having diabetes mellitus comorbidity need more attention. Primary healthcare integration is also vital to enhance the health of HIV-positive patients on antiretroviral therapy.
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Affiliation(s)
- Bitew Tefera Zewudie
- Department of Nursing, College of Medicine and Health Science, Wolkite University, Wolkite, Ethiopia
| | - Shegaw Geze Tenaw
- Department of Midwifery, College of Medicine and Health Science, Wolkite University, Wolkite, Ethiopia
| | - Mamo Solomon
- Department of Nursing, College of Medicine and Health Science, Wolkite University, Wolkite, Ethiopia
| | - Yibeltal Mesfin
- Department of Midwifery, College of Medicine and Health Science, Wolkite University, Wolkite, Ethiopia
| | - Haimanot Abebe
- Department of Nursing, College of Medicine and Health Science, Wolkite University, Wolkite, Ethiopia
| | - Zebene Mekonnen
- Department of Nursing, College of Medicine and Health Science, Wolkite University, Wolkite, Ethiopia
| | - Shegaw Tesfa
- Department of Nursing, College of Medicine and Health Science, Wolkite University, Wolkite, Ethiopia
| | - Bogale Chekole Temere
- Department of Nursing, College of Medicine and Health Science, Wolkite University, Wolkite, Ethiopia
| | - Agerie Aynalem Mewahegn
- Department of Nursing, College of Medicine and Health Science, Wolkite University, Wolkite, Ethiopia
| | - Tadele lankrew
- Department of Nursing, College of Medicine and Health Science, Wolaita Sodo University, Wolaita, Ethiopia
| | - Yihenew Sewale
- Department of Nursing, College of Medicine and Health Science, Debre Birhan University, Debre Birhan, Ethiopia
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Trends in the association between body mass index and blood pressure among 19-year-old men in Korea from 2003 to 2017. Sci Rep 2022; 12:6767. [PMID: 35473938 PMCID: PMC9043188 DOI: 10.1038/s41598-022-10570-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 04/11/2022] [Indexed: 11/08/2022] Open
Abstract
The strength of association between the body mass index (BMI) and blood pressure (BP) varies with population and time. Therefore, identifying the trends in BMI-BP association in adolescents can help predict the upcoming metabolic and cardiovascular disease burden. For this reason, from physical examination data collected from 2003 to 2017, a total of 5,133,246 Korean men aged 19 years were assessed for the annual trends and changes in the BMI-BP association. During the 15-year period, the mean BMI increased from 22.5 to 23.5 kg/m2, and the prevalence of obesity increased from 16.7 to 21.4%. Meanwhile, the mean systolic BP (SBP) decreased from 122.8 to 122.3 mmHg in the first year and gradually increased to 125.9 mmHg afterward. The diastolic BP (DBP) decreased from 71.5 to 70.0 mmHg in the first 4 years and then rose to 74.8 mmHg in the following years. The association analysis between BMI and SBP resulted in an annual increase in the correlation coefficient (SBP: 0.257-0.495, DBP: 0.164-0.413). The regression coefficient similarly increased between 2003 and 2015 but slightly decreased between 2015 and 2017 (SBP: 0.896-1.569, DBP: 0.405-0.861). The BMI-BP association increased over time (coefficient of the interaction term > 0, P < 0.001). Moreover, as the BMI increased, the annual increase in BP and BP per unit BMI also increased. In conclusion, this study emphasized a continuous shift towards obesity in BMI distribution and intensifying BMI-BP association over time in young men. Further research on factors affecting this BMI-BP association is needed to fully validate the potential applications of this hypothesis.
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Women and Alcohol: Limitations in the Cardiovascular Guidelines. Curr Probl Cardiol 2022:101200. [DOI: 10.1016/j.cpcardiol.2022.101200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 04/02/2022] [Indexed: 11/24/2022]
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Wang Y, Yao Y, Chen Y, Zhou J, Wu Y, Fu C, Wang N, Liu T, Xu K. Association between Drinking Patterns and Incident Hypertension in Southwest China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19073801. [PMID: 35409487 PMCID: PMC8997936 DOI: 10.3390/ijerph19073801] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Revised: 03/08/2022] [Accepted: 03/21/2022] [Indexed: 12/11/2022]
Abstract
Based on a prospective cohort study of adults from southwest China with heterogeneity in their demographical characteristics and lifestyles, we aimed to explore the association between drinking patterns and incident hypertension under the interaction of these confounding factors. The Cox proportional hazard model was used to estimate the hazard ratios (HR) and 95% confidence intervals (95% CI). Subgroup analysis was performed according to sex, ethnicity, area, occupation, smoking, and exercise to compare the differences in the association between drinking patterns and the incidence of hypertension. Blood pressure was higher in participants with a high drinking frequency than those with a low drinking frequency (p < 0.001). We found that total drinking frequency, liquor drinking frequency, rice wine drinking frequency, and alcohol consumption were significantly associated with an increased risk of hypertension. Compared with the non-drinking group, a heavy drinking pattern was positively correlated with hypertension. Drinking can increase the risk of hypertension, especially heavy drinking patterns, with a high frequency of alcohol intake and high alcohol consumption. From the analysis results of the longitudinal data, drinking alcohol is still an important risk factor for hypertension among Chinese subjects, especially for men, the rural population, the employed, the Han nationality, smokers, and certain exercise populations.
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Affiliation(s)
- Yawen Wang
- Key Laboratory of Public Health Safety, NHC Key Laboratory of Health Technology Assessment, Department of Biostatistics, School of Public Health, Fudan University, Shanghai 200032, China;
| | - Yuntong Yao
- Guizhou Province Centre for Disease Control and Prevention, 101 Bageyan Road, Yunyan District, Guiyang 550004, China; (Y.Y.); (J.Z.); (Y.W.)
| | - Yun Chen
- Key Laboratory of Public Health Safety, NHC Key Laboratory of Health Technology Assessment, Department of Epidemiology, School of Public Health, Fudan University, Shanghai 200032, China; (Y.C.); (C.F.); (N.W.)
| | - Jie Zhou
- Guizhou Province Centre for Disease Control and Prevention, 101 Bageyan Road, Yunyan District, Guiyang 550004, China; (Y.Y.); (J.Z.); (Y.W.)
| | - Yanli Wu
- Guizhou Province Centre for Disease Control and Prevention, 101 Bageyan Road, Yunyan District, Guiyang 550004, China; (Y.Y.); (J.Z.); (Y.W.)
| | - Chaowei Fu
- Key Laboratory of Public Health Safety, NHC Key Laboratory of Health Technology Assessment, Department of Epidemiology, School of Public Health, Fudan University, Shanghai 200032, China; (Y.C.); (C.F.); (N.W.)
| | - Na Wang
- Key Laboratory of Public Health Safety, NHC Key Laboratory of Health Technology Assessment, Department of Epidemiology, School of Public Health, Fudan University, Shanghai 200032, China; (Y.C.); (C.F.); (N.W.)
| | - Tao Liu
- Guizhou Province Centre for Disease Control and Prevention, 101 Bageyan Road, Yunyan District, Guiyang 550004, China; (Y.Y.); (J.Z.); (Y.W.)
- Correspondence: (T.L.); (K.X.); Tel./Fax: +86-138-8504-9099 (T.L.); +86-177-1739-3652 (K.X.)
| | - Kelin Xu
- Key Laboratory of Public Health Safety, NHC Key Laboratory of Health Technology Assessment, Department of Biostatistics, School of Public Health, Fudan University, Shanghai 200032, China;
- Correspondence: (T.L.); (K.X.); Tel./Fax: +86-138-8504-9099 (T.L.); +86-177-1739-3652 (K.X.)
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20
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Kim SY, Freeland-Graves JH, Kim HJ. Alcohol consumption according to socioeconomic and hypertensive status among Korean adults. Alcohol 2022; 98:19-24. [PMID: 34508815 DOI: 10.1016/j.alcohol.2021.09.002] [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: 12/04/2019] [Revised: 09/01/2021] [Accepted: 09/01/2021] [Indexed: 11/18/2022]
Abstract
This research investigated variations in alcohol consumption by socioeconomic factors and hypertensive status in South Korean adults, aged ≥19 years. This is a secondary data analysis using the Korea National Health and Nutrition Examination Survey (KNHANES). Alcohol intake by socioeconomic and hypertensive status was examined using data from the 2013 to 2016 KNHANES. Total participants were 19,641 adults, with 8,123 men and 11,518 women. Consumption of alcohol in the Korean population was estimated from a single 24-hour dietary recall. Alcohol intake differed, according to socioeconomic status, and, particularly, by occupation among Korean adults. Women with lower education consumed more alcohol daily than those with a higher education (p = 0.018). Furthermore, adult men with hypertension consumed a greater amount of alcohol daily, 30.9 g, than those with pre-hypertension, 23.7 g, followed by those without hypertension, 15.9 g (p < 0.001). In women, adults with pre-hypertension and hypertension consumed more alcohol daily, 9.4 g and 9.0 g, respectively, than those without, 6.6 g (p < 0.001). In addition, men with hypertension who were unaware of their disease and those who were cognizant consumed a higher amount of alcohol daily, 32.4 g and 28.6 g, respectively, than individuals without hypertension, 19.7 g (p < 0.001). Moreover, men with hypertension who had not been treated for hypertension and those in treatment consumed a greater amount of alcohol daily, 32.6 g and 28.0 g, respectively, than those without hypertension, 19.7 g (p < 0.001). In conclusion, Korean adults consume alcohol differently by socioeconomic status, and alcohol intake was more prevalent among people with hypertension.
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Affiliation(s)
- Sang Young Kim
- University of Texas at Austin, Division of Nutritional Sciences, 103 W. 24th Street, Austin, TX, 78712, United States.
| | - Jeanne H Freeland-Graves
- University of Texas at Austin, Division of Nutritional Sciences, 103 W. 24th Street, Austin, TX, 78712, United States.
| | - Hyun Ja Kim
- Gangneung-Wonju National University, Division of Food and Nutrition, 7 Jukheon-gil, Gangneung, Gangwon-do, 25457, Republic of Korea.
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Payseur DK, Belhumeur JR, Curtin LA, Moody AM, Collier SR. The effect of acute alcohol ingestion on systemic hemodynamics and sleep architecture in young, healthy men. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2022; 70:509-516. [PMID: 32369424 DOI: 10.1080/07448481.2020.1756826] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Revised: 02/12/2020] [Accepted: 04/13/2020] [Indexed: 06/11/2023]
Abstract
Objective Heightened nocturnal blood pressure (BP) may be attributed to the disruption of sleep, a condition worsened by alcohol ingestion. This study investigated the effects of acute alcohol ingestion on hemodynamics and sleep architecture in a young, healthy cohort of male. METHODS: Subjects (n = 17) underwent acute alcohol ingestion reaching a breath alcohol content of 0.08. Each subject endured a battery of hemodynamic tests and had their sleep architecture and nocturnal blood pressure monitored pre- and post-ingestion. Results: Systolic blood pressure (SBP) increased both 30 minutes and 12 hours after alcohol. Ambulatory nocturnal SBP significantly increased after alcohol compared to baseline measures. Minutes of total, rapid eye movement, and light sleep all increased after alcohol ingestion, while a decrease was observed for sleep latency. Conclusions: An acute bout of heavy alcohol consumption may attenuate nocturnal BP dipping that, in turn, may hasten the progression of hypertension-related cardiovascular disease.
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Affiliation(s)
- Daniel K Payseur
- Vascular Biology & Autonomic Studies Lab, Appalachian State University, Boone, North Carolina, USA
| | | | - Lisa A Curtin
- Department of Psychology, Appalachian State University, Boone, North Carolina, USA
| | - Anne M Moody
- Vascular Biology & Autonomic Studies Lab, Appalachian State University, Boone, North Carolina, USA
| | - Scott R Collier
- Vascular Biology & Autonomic Studies Lab, Appalachian State University, Boone, North Carolina, USA
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22
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Lewis SA, Doratt B, Sureshchandra S, Pan T, Gonzales SW, Shen W, Grant KA, Messaoudi I. Profiling of extracellular vesicle-bound miRNA to identify candidate biomarkers of chronic alcohol drinking in nonhuman primates. Alcohol Clin Exp Res 2022; 46:221-231. [PMID: 34910314 PMCID: PMC8858875 DOI: 10.1111/acer.14760] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 11/04/2021] [Accepted: 12/10/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND Long-term alcohol drinking is associated with numerous health complications including susceptibility to infection, cancer, and organ damage. However, due to the complex nature of human drinking behavior, it has been challenging to identify reliable biomarkers of alcohol drinking behavior prior to signs of overt organ damage. Recently, extracellular vesicle-bound microRNAs (EV-miRNAs) have been found to be consistent biomarkers of conditions that include cancer and liver disease. METHODS In this study, we profiled the plasma EV-miRNA content by miRNA-Seq from 80 nonhuman primates after 12 months of voluntary alcohol drinking. RESULTS We identified a list of up- and downregulated EV-miRNA candidate biomarkers of heavy drinking and those positively correlated with ethanol dose. We overexpressed these candidate miRNAs in control primary peripheral immune cells to assess their potential functional mechanisms. We found that overexpression of miR-155, miR-154, miR-34c, miR-450a, and miR-204 led to increased production of the inflammatory cytokines TNFα or IL-6 in peripheral blood mononuclear cells after stimulation. CONCLUSION This exploratory study identified several EV-miRNAs that could serve as biomarkers of long-term alcohol drinking and provide a mechanism to explain alcohol-induced peripheral inflammation.
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Affiliation(s)
- Sloan A. Lewis
- Department of Molecular Biology and Biochemistry, University of California, Irvine CA, USA,Institute for Immunology, University of California, Irvine CA, USA
| | - Brianna Doratt
- Department of Molecular Biology and Biochemistry, University of California, Irvine CA, USA,Institute for Immunology, University of California, Irvine CA, USA
| | - Suhas Sureshchandra
- Department of Molecular Biology and Biochemistry, University of California, Irvine CA, USA,Institute for Immunology, University of California, Irvine CA, USA
| | - Tianyu Pan
- Department of Statistics, University of California, Irvine CA, USA
| | - Steven W. Gonzales
- Oregon National Primate Research Center, Oregon Health and Science University, Beaverton, OR, USA
| | - Weining Shen
- Department of Statistics, University of California, Irvine CA, USA
| | - Kathleen A. Grant
- Oregon National Primate Research Center, Oregon Health and Science University, Beaverton, OR, USA
| | - Ilhem Messaoudi
- Department of Molecular Biology and Biochemistry, University of California, Irvine CA, USA,Institute for Immunology, University of California, Irvine CA, USA,Center for Virus Research, University of California, Irvine CA, USA,Corresponding Author: Ilhem Messaoudi, Molecular Biology and Biochemistry, University of California Irvine, 2400 Biological Sciences III, Irvine, CA 92697, Phone: 949-824-3078,
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Aladin AI, Chevli PA, Ahmad MI, Rasool SH, Herrington DM. Alcohol Consumption and Systemic Hypertension (from the Third National Health and Nutrition Examination Survey). Am J Cardiol 2021; 160:60-66. [PMID: 34548145 DOI: 10.1016/j.amjcard.2021.08.033] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 08/14/2021] [Accepted: 08/17/2021] [Indexed: 12/28/2022]
Abstract
Epidemiological studies have established the association between excessive alcohol consumption and systemic hypertension (SH). However, there are conflicting reports of the association of low to moderate alcohol consumption with SH. The objective of the study was to examine the associations of alcohol consumption and blood pressure categories using the 2017 American College of Cardiology/American Heart Association high blood pressure guidelines. This analysis included 17,059 participants from the Third National Health and Nutrition Examination Survey. Alcohol consumption was ascertained by way of a questionnaire. Blood pressure (mm Hg) was measured during the in-home interview and the participant's visit to the mobile examination center. We used multivariable logistic regression models to examine cross-sectional associations of alcohol consumption and blood pressure categories based on new American College of Cardiology/American Heart Association High Blood Pressure guidelines. Models were adjusted for age, gender, income, and cardiovascular risk factors. Compared with never drinkers, moderate drinkers (7 to 13 drinks/week) had increased odds of prevalent stage 1 and stage 2 SH (odds ratio [95% confidence interval] 1.51 [1.22 to 1.87] and 1.55 [1.20 to 2.00]). Similarly, there were significantly higher odds of prevalent stage 1 and stage 2 SH among heavy drinkers (≥14 drinks/week) (odds ratio [95% confidence interval] 1.65 [1.33 to 2.05] and 2.46 [1.93 to 3.14]). We did not find any association between alcohol consumption and elevated blood pressure category. Response bias must be considered because alcohol consumption was self-reported. Our study indicates the need for further research to understand the potential mechanisms by which alcohol consumption increases the risk of SH. In conclusion, this analysis from a population-based survey showed an association between moderate and heavy alcohol consumption and a higher prevalence of SH.
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Affiliation(s)
- Amer I Aladin
- Section of Interventional Cardiology, MedStar Georgetown University/Washington Hospital Center, Washington, District of Columbia.
| | | | - Muhammad Imtiaz Ahmad
- Section on Hospital Medicine, Department of Internal Medicine, Trinitas Regional Medical Center, Elizabeth City, New Jersey
| | - Shereen H Rasool
- Department of Pediatrics, Saint Joseph University Medical Center, Paterson, New Jersey
| | - David M Herrington
- Section on Cardiovascular Medicine, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina
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Song Y, Li J, Liu L, Xu R, Zhou Z, Xu B, Lin T, Chen P, Li H, Li Y, Liu C, Huang X, Wang B, Zhang Y, Li J, Huo Y, Ren F, Xu X, Zhang H, Qin X. Plasma Vitamin E and the Risk of First Stroke in Hypertensive Patients: A Nested Case-Control Study. Front Nutr 2021; 8:734580. [PMID: 34805240 PMCID: PMC8595403 DOI: 10.3389/fnut.2021.734580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 10/11/2021] [Indexed: 11/13/2022] Open
Abstract
Background: The association between plasma vitamin E levels and first stroke risk in men and women remains unclear. Objective: We aimed to examine the prospective association between plasma vitamin E and first stroke, and evaluate the effect modifiers for the association, among hypertensive patients. Design: The study sample was drawn from the China Stroke Primary Prevention Trial (CSPPT), which randomized a total of 20,702 hypertensive patients to a double-blind, daily treatment with either 10 mg enalapril and 0.8 mg folic acid or 10 mg enalapril alone. This nested case-control study, including 618 first stroke cases and 618 controls matched for age, sex, treatment group, and study site, was conducted after the completion of the CSPPT. Results: The median follow-up duration was 4.5 years. Among men, a significantly higher risk of first stroke (adjusted OR, 1.67; 95%CI: 1.01, 2.77) was found for those with plasma vitamin E ≥7.1 μg/mL (≥quartile 1) compared with those with plasma vitamin E < 7.1 μg/mL. Subgroup analyses further showed that the association between vitamin E (≥7.1 vs. <7.1 μg/mL) and first stroke in men was significantly stronger in non-drinkers (adjusted OR, 2.64; 95%CI: 1.41, 4.96), compared to current drinkers (adjusted OR, 0.84; 95% CI: 0.43, 1.66, P-interaction = 0.008). However, there was no significant association between plasma vitamin E and first stroke in women (P-interaction between sex and plasma vitamin E = 0.048). Conclusions: Among Chinese hypertensive patients, there was a statistically significant positive association between baseline plasma vitamin E and the risk of first stroke in men, but not in women. Clinical Trial Registration: https://clinicaltrials.gov/ct2/show/NCT00794885, Identifier: NCT00794885.
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Affiliation(s)
- Yun Song
- Key Laboratory of Precision Nutrition and Food Quality, Department of Nutrition and Health, College of Food Sciences and Nutritional Engineering, China Agricultural University, Beijing, China.,Institute of Biomedicine, Anhui Medical University, Hefei, China
| | - Jingyi Li
- State Key Laboratory of Natural Medicines, Research Center of Biostatistics and Computational Pharmacy, China Pharmaceutical University, Nanjing, China
| | - Lishun Liu
- Tsinghua Shenzhen International Graduate School, Tsinghua University, Shenzhen, China
| | - Richard Xu
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Ziyi Zhou
- Tsinghua Shenzhen International Graduate School, Tsinghua University, Shenzhen, China
| | - Benjamin Xu
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, United States
| | - Tengfei Lin
- Key Laboratory of Precision Nutrition and Food Quality, Department of Nutrition and Health, College of Food Sciences and Nutritional Engineering, China Agricultural University, Beijing, China.,College of Pharmacy, Jinan University, Guangzhou, China
| | - Ping Chen
- College of Pharmacy, Jinan University, Guangzhou, China
| | - Huan Li
- National Clinical Research Study Center for Kidney Disease, Southern Medical University, Guangzhou, China.,The State Key Laboratory for Organ Failure Research, Southern Medical University, Guangzhou, China.,Renal Division, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Youbao Li
- National Clinical Research Study Center for Kidney Disease, Southern Medical University, Guangzhou, China.,The State Key Laboratory for Organ Failure Research, Southern Medical University, Guangzhou, China.,Renal Division, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Chengzhang Liu
- Institute of Biomedicine, Anhui Medical University, Hefei, China.,Department of Scientific Research, Shenzhen Evergreen Medical Institute, Shenzhen, China
| | - Xiao Huang
- Department of Cardiology, Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Binyan Wang
- Institute of Biomedicine, Anhui Medical University, Hefei, China.,Department of Scientific Research, Shenzhen Evergreen Medical Institute, Shenzhen, China
| | - Yan Zhang
- Department of Cardiology, Peking University First Hospital, Beijing, China
| | - Jianping Li
- Department of Cardiology, Peking University First Hospital, Beijing, China
| | - Yong Huo
- Department of Cardiology, Peking University First Hospital, Beijing, China
| | - Fazheng Ren
- Key Laboratory of Precision Nutrition and Food Quality, Department of Nutrition and Health, College of Food Sciences and Nutritional Engineering, China Agricultural University, Beijing, China
| | - Xiping Xu
- Key Laboratory of Precision Nutrition and Food Quality, Department of Nutrition and Health, College of Food Sciences and Nutritional Engineering, China Agricultural University, Beijing, China.,National Clinical Research Study Center for Kidney Disease, Southern Medical University, Guangzhou, China.,The State Key Laboratory for Organ Failure Research, Southern Medical University, Guangzhou, China.,Renal Division, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Hao Zhang
- Key Laboratory of Precision Nutrition and Food Quality, Department of Nutrition and Health, College of Food Sciences and Nutritional Engineering, China Agricultural University, Beijing, China
| | - Xianhui Qin
- National Clinical Research Study Center for Kidney Disease, Southern Medical University, Guangzhou, China.,The State Key Laboratory for Organ Failure Research, Southern Medical University, Guangzhou, China.,Renal Division, Nanfang Hospital, Southern Medical University, Guangzhou, China
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25
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Lüscher TF. Wine, chocolate, and coffee: forbidden joys? Eur Heart J 2021; 42:4520-4522. [PMID: 34689207 DOI: 10.1093/eurheartj/ehab654] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 05/18/2021] [Accepted: 09/09/2021] [Indexed: 12/30/2022] Open
Affiliation(s)
- Thomas F Lüscher
- National Heart and Lung Institute, Imperial College London, London, UK.,Royal Brompton and Harefield Hospitals, Sidney Street, London SW3 6NP, UK.,King's College London, London, UK.,Center for Molecular Cardiology, University of Zürich, Zürich, Switzerland
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26
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The longitudinal associations between trajectory of and quantity of alcohol consumption and subsequent changes in blood pressure levels among non-hypertensive adults. Br J Nutr 2021; 126:1380-1388. [PMID: 33441197 DOI: 10.1017/s0007114521000088] [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: 11/05/2022]
Abstract
Given the dynamic characteristic of an individual's drinking behaviours, comprehensive consideration of alcohol consumption variation using repeated measures may improve insight into the nature of its association with blood pressure (BP) change. We examined the association between longitudinal alcohol consumption (trajectory and quantity) and changes in BP and pulse pressure (PP) among Korean aged ≥ 40 years living in rural areas. Totally, 1682 hypertension-free participants who completed all three health examinations (median, 5·3 years) were included. All three visits were used to determine the cumulative trajectory of and quantity of alcohol consumption and the latest two visits and the last visit were used for the recent trajectory and the most recent quantity of alcohol consumption, respectively. Changes in BP and PP from the baseline to the third visit were used as outcome. In men, ≥30 ml/d cumulative average alcohol consumption was associated with the greatest increase in systolic BP (SBP) in both baseline outcome-unadjusted (2·9 mmHg, P = 0·032) and -adjusted models (3·6 mmHg, P = 0·001), and the given association for the most recent alcohol consumption was observed in the baseline outcome-adjusted model (3·9 mmHg, P = 0·003). For PP, similar associations were observed only in the baseline outcome-adjusted model. No meaningful associations in diastolic BP in men and any BP or PP in women existed. The quantity of alcohol consumption rather than the trajectory may be significantly related to raised SBP, and a possible short-term influence of the most recent alcohol consumption may exist when baseline SBP is adjusted in men.
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27
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O'Neil PJ, Stafford KA, Ryscavage PA. Assessing risk factors for hypertension in young adults with perinatally acquired HIV infection: A case-control study. HIV Med 2021; 23:457-464. [PMID: 34725913 DOI: 10.1111/hiv.13199] [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: 09/15/2020] [Revised: 04/28/2021] [Accepted: 10/10/2021] [Indexed: 12/01/2022]
Abstract
OBJECTIVES Although the risk of AIDS-associated diseases has declined dramatically with combination antiretroviral therapy (cART), the incidence rates of chronic non-AIDS-associated diseases in perinatally HIV-infected adults have risen and have not been well characterized. Both traditional and HIV-associated risk factors have been found to contribute to hypertension in non-perinatally HIV-infected adults; whether these same factors contribute to hypertension in perinatally infected adults is not known. The purpose of this study was to determine the socio-demographic, clinical, virological and immunological factors associated with systemic hypertension among a cohort of perinatally HIV-infected adolescents and young adults. METHODS We conducted a case-control study among a population of adults aged 18-35 years with perinatally acquired HIV infection receiving care at the University of Maryland Medical Center. Covariates assessed included traditional risk factors such as age, family history of hypertension, and smoking, as well as numerous HIV- and antiretroviral-associated covariates, including CD4 nadir. RESULTS Approximately 31% of the cohort met criteria for hypertension. There were no significant differences in the odds of most traditional or HIV-associated risk factors among perinatally HIV-infected adults with hypertension compared with those with no diagnosis of hypertension. Exposure to lopinavir/ritonavir was associated with greater odds of not having hypertension, while a concurrent diagnosis of chronic kidney disease (CKD) was associated with greater odds of having hypertension. CONCLUSIONS The results of this study suggest that most traditional and HIV-related risk factors do not appear to increase the odds of having hypertension in this cohort of individuals. The aetiology of hypertension in this population remains to be elucidated.
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Affiliation(s)
- Patrick J O'Neil
- Greater Lawrence Family Health Center, Lawrence, Massachusetts, USA
| | - Kristen A Stafford
- Institute of Human Virology, University of Maryland Medical School, Baltimore, Maryland, USA
| | - Patrick A Ryscavage
- Institute of Human Virology, University of Maryland Medical School, Baltimore, Maryland, USA
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28
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Munezero T, Tomita A. Hypertension and Its Associated Mental Health Challenges Among Female African Refugees in Durban, South Africa. J Nerv Ment Dis 2021; 209:802-808. [PMID: 34310523 DOI: 10.1097/nmd.0000000000001387] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
ABSTRACT Hypertension is a serious medical condition that leads to various adverse health complications when left untreated. In addition to psychological challenge that female migrant refugees are exposed to premigration, they encounter barriers to care postmigration from xenophobia that affects their hypertension. We investigated the extent and mental health drivers of hypertension in refugees in Durban, South Africa. We interviewed 178 adult female African help-seeking refugees/migrants for hypertension (blood pressure ≥130/90 mm Hg) and mental health challenges (e.g., adverse childhood experience [ACE] and depression using the Center for Epidemiologic Studies-Depression scale). Eighty-six percent (n = 153) of participants were hypertensive, and based on the adjusted regression models, exposure to at least one ACE (adjusted odds ratio [aOR], 2.83; 95% confidence interval [CI], 1.11-7.26) and depression (aOR, 3.54; 95% CI, 1.10-11.37) were associated with hypertension, independent of smoking, alcohol, obesity, and physical exercise status. Hypertension and its associated mental health challenges are overlooked conditions in this population, with further efforts for screening being needed.
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29
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Yu A, Cooke AB, Scheffler P, Doonan RJ, Daskalopoulou SS. Alcohol Exerts a Shifted U-Shaped Effect on Central Blood Pressure in Young Adults. J Gen Intern Med 2021; 36:2975-2981. [PMID: 33674917 PMCID: PMC8481396 DOI: 10.1007/s11606-021-06665-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 02/14/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND Consumption of 1-2 alcoholic beverages daily has been associated with a lower risk of cardiovascular disease and all-cause mortality in middle-aged and older adults. Central blood pressure has emerged as a better predictor of cardiovascular risk than peripheral blood pressure. However, the effects of habitual alcohol consumption on central blood pressure particularly in young adults, who are among the largest consumers of alcohol in North America, have yet to be investigated. OBJECTIVE We aimed to study the effect of alcohol consumption on central and peripheral blood pressure, and arterial stiffness in young adults. DESIGN Cross-sectional observational study. MAIN MEASURES Using a standardized questionnaire, alcohol consumption (drinks/week) was queried; participants were classified as non- (< 2), light (2-6), moderate (women 7-9, men 7-14), and heavy drinkers (women > 9, men > 14). Central blood pressure and arterial stiffness were measured using applanation tonometry. KEY RESULTS We recruited 153 healthy, non-smoking, non-obese individuals. We found a U-shaped effect of alcohol consumption on blood pressure. Light drinkers had significantly lower central systolic and mean arterial blood pressure, but not peripheral blood pressure when compared to non- and moderate/heavy drinkers (P < 0.05). No significant associations with arterial stiffness parameters were noted. CONCLUSIONS A U-shaped relationship was found between alcohol consumption and central and mean arterial blood pressure in young individuals, which importantly, was shifted towards lower levels of alcohol consumption than currently suggested. This is the first study, to our knowledge, that examines the effect of alcohol consumption on central blood pressure and arterial stiffness exclusively in young individuals. Prospective studies are needed to confirm the relationships observed herein.
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Affiliation(s)
- Alice Yu
- Department of Medicine, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| | - Alexandra B Cooke
- Department of Medicine, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| | - Patrick Scheffler
- Department of Medicine, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| | - Robert J Doonan
- Department of Medicine, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| | - Stella S Daskalopoulou
- Department of Medicine, Faculty of Medicine, McGill University, Montreal, Quebec, Canada.
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30
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Jiang J, Chen G, Li B, Li N, Liu F, Lu Y, Guo Y, Li S, Chen L, Xiang H. Associations of residential greenness with hypertension and blood pressure in a Chinese rural population: a cross-sectional study. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2021; 28:51693-51701. [PMID: 33988845 DOI: 10.1007/s11356-021-14201-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 04/27/2021] [Indexed: 06/12/2023]
Abstract
Limited epidemiological literature identified the associations between residential greenness and hypertension in low-/middle-income countries. A random sampling strategy was adopted to recruit 39,259 residents, ≥ 18 years, and from 5 counties in central China. Blood pressure was measured based on the protocol of the American Heart Association. Hypertension was defined according to the 2010 Chinese guidelines for the management of hypertension. The satellite-derived normalized difference vegetation index (NDVI) and enhanced vegetation index (EVI) were applied to estimate the residential greenness. Mixed logit model and mixed linear model were utilized to explore the relationships of residential greenness with hypertension and blood pressure. Higher residential greenness was associated with lower odds of hypertension and blood pressure levels. For instance, an interquartile range (IQR) increase in NDVI500m was linked with lower odds of hypertension (OR = 0.92, 95%CI 0.88 to 0.95), a decrease of -0.88 mm Hg (95% CI -1.17 to -0.58) and -0.64 mm Hg (95% CI -0.82 to -0.46) in SBP and DBP, respectively. The effect of residential greenness was more pronounced in males, smokers, and drinkers. Long-term exposure to residential greenness was linked with lower odds of hypertension. More prospective studies are needed to verify the hypothesis.
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Affiliation(s)
- Jie Jiang
- Department of Global Health, School of Health Sciences, Wuhan University, Wuhan, Hubei, China
- Global Health Institute, Wuhan University, Wuhan, Hubei, China
| | - Gongbo Chen
- Guangdong Provincial Engineering Technology Research Center of Environmental and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Baojing Li
- Department of Global Public Health, Karolinska Institute, Stockholm, Sweden
| | - Na Li
- Department of Global Health, School of Health Sciences, Wuhan University, Wuhan, Hubei, China
- Global Health Institute, Wuhan University, Wuhan, Hubei, China
| | - Feifei Liu
- Department of Global Health, School of Health Sciences, Wuhan University, Wuhan, Hubei, China
- Global Health Institute, Wuhan University, Wuhan, Hubei, China
| | - Yuanan Lu
- Global Health Institute, Wuhan University, Wuhan, Hubei, China
- Environmental Health Laboratory, Department of Public Health Sciences, University of Hawaii at Manoa, Honolulu, HI, USA
| | - Yuming Guo
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Shanshan Li
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Lifeng Chen
- Department of Laboratory Medicine, Wuhan Pulmonary Hospital, Wuhan, Hubei, China.
| | - Hao Xiang
- Department of Global Health, School of Health Sciences, Wuhan University, Wuhan, Hubei, China.
- Global Health Institute, Wuhan University, Wuhan, Hubei, China.
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Lankester J, Zanetti D, Ingelsson E, Assimes TL. Alcohol use and cardiometabolic risk in the UK Biobank: A Mendelian randomization study. PLoS One 2021; 16:e0255801. [PMID: 34379647 PMCID: PMC8357114 DOI: 10.1371/journal.pone.0255801] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 07/25/2021] [Indexed: 12/13/2022] Open
Abstract
Observational studies suggest alcohol use promotes the development of some adverse cardiometabolic traits but protects against others including outcomes related to coronary artery disease. We used Mendelian randomization (MR) to explore causal relationships between the degree of alcohol consumption and several cardiometabolic traits in the UK Biobank. Using the well-established ADH1B Arg47His variant (rs1229984) and up to 24 additional SNPs recently found to be associated with alcohol consumption in an independent dataset as instruments, we conducted two-stage least squares and inverse weighted variance MR analyses, both as one-sample analyses in the UK Biobank and as two-sample analyses in external consortia. In the UK Biobank inverse variance weighted analyses, we found that one additional drink of alcohol per day was positively associated with systolic blood pressure (beta = 2.65 mmHg [1.40, 3.89]), hemorrhagic stroke (OR = 2.25 [1.41, 3.60]), and atrial fibrillation (OR = 1.26 [1.07, 1.48]), which were replicated in multivariable analyses. Alcohol was also associated with all cardiovascular disease and all-cause death. A positive association with myocardial infarction did not replicate in multivariable analysis, with suggestive mediation through blood pressure; similarly, a positive association between alcohol use with type 2 diabetes was mitigated by BMI in multivariable analysis. Findings were generally null in replication with two-sample analyses. Alcohol was not protective for any disease outcome with any analysis method, dataset, or strata. Stratifications by sex and smoking in the UK Biobank revealed higher point estimates of risk for several outcomes for men and mixed results for smoking strata, but no statistically significant heterogeneity. Our results are consistent with an overall harmful and/or null effect of alcohol on cardiometabolic health at all levels of use and suggest that even moderate alcohol use should not be promoted as a part of a healthy diet and lifestyle.
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Affiliation(s)
- Joanna Lankester
- Department of Medicine (Division of Cardiovascular Medicine), Stanford University School of Medicine, Stanford, CA, United States of America
| | - Daniela Zanetti
- Department of Medicine (Division of Cardiovascular Medicine), Stanford University School of Medicine, Stanford, CA, United States of America
| | - Erik Ingelsson
- Department of Medicine (Division of Cardiovascular Medicine), Stanford University School of Medicine, Stanford, CA, United States of America
- GlaxoSmithKline, Inc., Brentford, England, United Kingdom
| | - Themistocles L. Assimes
- Department of Medicine (Division of Cardiovascular Medicine), Stanford University School of Medicine, Stanford, CA, United States of America
- VA Palo Alto Health Care System, Palo Alto, CA, United States of America
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Fragopoulou E, Argyrou C, Detopoulou M, Tsitsou S, Seremeti S, Yannakoulia M, Antonopoulou S, Kolovou G, Kalogeropoulos P. The effect of moderate wine consumption on cytokine secretion by peripheral blood mononuclear cells: A randomized clinical study in coronary heart disease patients. Cytokine 2021; 146:155629. [PMID: 34247040 DOI: 10.1016/j.cyto.2021.155629] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 06/25/2021] [Accepted: 06/26/2021] [Indexed: 12/14/2022]
Abstract
Many studies conclude that wine consumption is related to lower risk for cardiovascular diseases partially through the amelioration of inflammatory biomarkers. The aim of the present study was to examine the effects of wine consumption on the inflammatory response and to compare these effects with the consumption of similar amount of alcohol without the wine micro-constituents in cardiovascular disease patients. Therefore, a randomized, single-blind, controlled, three-arm parallel intervention study was designed. Cardiovascular disease patients were randomly assigned to one of the three groups. In Group A participants consumed no alcohol, in Group B (ethanol group) and Group C (wine group) participants consumed 27 g of alcohol per day. Biological samples were collected at the beginning, on the 4th and 8th week and several biomarkers were measured. Peripheral blood mononuclear cells that were isolated from patients were incubated under basal and inflammatory conditions for 4 and 24 h and the secretion of interleukin 1β (IL-1β) and tumor necrosis factor α (TNFα) was measured. No significant difference was observed among the three groups before the initiation or during the intervention in the most soluble biomarkers. Higher TNFα secretion by peripheral blood mononuclear cells was observed at basal conditions in the ethanol group both at 4 and 24 h of incubation versus baseline secretion. Furthermore, lower secretion of the ΤNFα was observed after 8 weeks of intake in the wine group versus the ethanol group, both at 4 and 24 h of incubation. In conclusion, the light to moderate wine consumption for 8 weeks revealed an attenuation of the ethanol consumption effect on cytokine secretion at basal conditions from the patients' peripheral blood mononuclear cells.
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Affiliation(s)
- Elizabeth Fragopoulou
- Department of Nutrition and Dietetics, Harokopio University, 70 Eleftheriou Venizelou Avenue Kallithea, 17671 Athens, Greece.
| | - Chrysa Argyrou
- Department of Nutrition and Dietetics, Harokopio University, 70 Eleftheriou Venizelou Avenue Kallithea, 17671 Athens, Greece
| | - Maria Detopoulou
- Department of Nutrition and Dietetics, Harokopio University, 70 Eleftheriou Venizelou Avenue Kallithea, 17671 Athens, Greece
| | - Sofia Tsitsou
- Department of Nutrition and Dietetics, Harokopio University, 70 Eleftheriou Venizelou Avenue Kallithea, 17671 Athens, Greece
| | - Sotiria Seremeti
- Department of Nutrition and Dietetics, Harokopio University, 70 Eleftheriou Venizelou Avenue Kallithea, 17671 Athens, Greece
| | - Mary Yannakoulia
- Department of Nutrition and Dietetics, Harokopio University, 70 Eleftheriou Venizelou Avenue Kallithea, 17671 Athens, Greece
| | - Smaragdi Antonopoulou
- Department of Nutrition and Dietetics, Harokopio University, 70 Eleftheriou Venizelou Avenue Kallithea, 17671 Athens, Greece
| | - Genovefa Kolovou
- Cardiology Department, Onassis Cardiac Surgery Center, Athens. Greece
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Shi X, Nikolic G, Van Pottelbergh G, van den Akker M, Vos R, De Moor B. Development of Multimorbidity Over Time: An Analysis of Belgium Primary Care Data Using Markov Chains and Weighted Association Rule Mining. J Gerontol A Biol Sci Med Sci 2021; 76:1234-1241. [PMID: 33159204 PMCID: PMC8202155 DOI: 10.1093/gerona/glaa278] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Indexed: 11/25/2022] Open
Abstract
Background The prevalence of multimorbidity is increasing in recent years, and patients with multimorbidity often have a decrease in quality of life and require more health care. The aim of this study was to explore the evolution of multimorbidity taking the sequence of diseases into consideration. Methods We used a Belgian database collected by extracting coded parameters and more than 100 chronic conditions from the Electronic Health Records of general practitioners to study patients older than 40 years with multiple diagnoses between 1991 and 2015 (N = 65 939). We applied Markov chains to estimate the probability of developing another condition in the next state after a diagnosis. The results of Weighted Association Rule Mining (WARM) allow us to show strong associations among multiple conditions. Results About 66.9% of the selected patients had multimorbidity. Conditions with high prevalence, such as hypertension and depressive disorder, were likely to occur after the diagnosis of most conditions. Patterns in several disease groups were apparent based on the results of both Markov chain and WARM, such as musculoskeletal diseases and psychological diseases. Psychological diseases were frequently followed by irritable bowel syndrome. Conclusions Our study used Markov chains and WARM for the first time to provide a comprehensive view of the relations among 103 chronic conditions, taking sequential chronology into consideration. Some strong associations among specific conditions were detected and the results were consistent with current knowledge in literature, meaning the approaches were valid to be used on larger data sets, such as National Health care Systems or private insurers.
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Affiliation(s)
- Xi Shi
- STADIUS Center for Dynamical Systems, Signal Processing and Data Analytics, Department of Electrical Engineering (ESAT), KU Leuven, Leuven, Belgium
| | - Gorana Nikolic
- STADIUS Center for Dynamical Systems, Signal Processing and Data Analytics, Department of Electrical Engineering (ESAT), KU Leuven, Leuven, Belgium
| | - Gijs Van Pottelbergh
- Academic Centre of General Practice, Department of Public Health and Primary Care, KU Leuven, Belgium
| | - Marjan van den Akker
- Academic Centre of General Practice, Department of Public Health and Primary Care, KU Leuven, Belgium.,Institute of General Practice, Goethe University, Frankfurt am Main, Germany
| | - Rein Vos
- Department of Medical Informatics, Erasmus MC, University Medical Center Rotterdam, The Netherlands.,Department of Methodology and Statistics, Maastricht University, The Netherlands
| | - Bart De Moor
- STADIUS Center for Dynamical Systems, Signal Processing and Data Analytics, Department of Electrical Engineering (ESAT), KU Leuven, Leuven, Belgium
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Bianchi PC, Gomes-de-Souza L, Costa-Ferreira W, Palombo P, Carneiro de Oliveira PE, Engi SA, Leão RM, Planeta CS, Crestani CC, Cruz FC. Chronic ethanol vapor exposure potentiates cardiovascular responses to acute stress in male but not in female rats. Biol Sex Differ 2021; 12:27. [PMID: 33726842 PMCID: PMC7962247 DOI: 10.1186/s13293-021-00371-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Accepted: 03/01/2021] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Ethanol use is related to a wide variety of negative health outcomes, including cardiovascular diseases. Stress is also involved in numerous pathologies, such as cardiovascular diseases and psychiatric disorders. Sexual dimorphism is an important factor affecting cardiovascular response and has been proposed as a potential risk factor for sex-specific health problems in humans. Here, we evaluated the effect of prolonged ethanol vapor inhalation on arterial pressure, heart rate, and tail skin temperature responses to acute restraint stress, investigating differences between male and female rats. METHODS We exposed male and female Long-Evans rats to ethanol vapor for 14 h, followed by ethanol withdrawal for 10 h, for 30 consecutive days, or to room air (control groups). The animals underwent surgical implantation of a cannula into the femoral artery for assessment of arterial pressure and heart rate values. The tail skin temperature was measured as an indirect measurement of sympathetic vasomotor response. RESULTS Chronic ethanol vapor inhalation reduced basal heart rate in both female and male rats. Sex-related difference was observed in the decrease of tail cutaneous temperature evoked by stress, but not in the pressor and tachycardiac responses. Furthermore, prolonged ethanol inhalation enhanced the blood pressure and heart rate increase caused by acute restraint stress in male, but not in female rats. However, no effect of chronic ethanol vapor was observed in the tail cutaneous temperature response to restraint in either sex. CONCLUSION Chronic ethanol vapor exposure increased the cardiovascular reactivity to stress in male, but not in female rats.
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Affiliation(s)
- Paula C. Bianchi
- Laboratory of Neuropsypharmacology, School of Pharmaceutical Sciences, São Paulo State University (UNESP), Rod. Araraquara-Jaú km 1, Araraquara, SP 14801-902 Brazil
- Joint Graduate Program in Physiological Sciences UFSCar/UNESP, Rod. Washington Luís km 235, São Carlos, SP 13565-905 Brazil
- Laboratory of Pharmacology, Paulista Medicine School, Universidade Federal de São Paulo – UNIFESP, Leal Prado Building, Botucatu 862 Street, 04024-002, Vila Clementino, São Paulo, SP Brazil
| | - Lucas Gomes-de-Souza
- Laboratory of Neuropsypharmacology, School of Pharmaceutical Sciences, São Paulo State University (UNESP), Rod. Araraquara-Jaú km 1, Araraquara, SP 14801-902 Brazil
- Joint Graduate Program in Physiological Sciences UFSCar/UNESP, Rod. Washington Luís km 235, São Carlos, SP 13565-905 Brazil
| | - Willian Costa-Ferreira
- Laboratory of Neuropsypharmacology, School of Pharmaceutical Sciences, São Paulo State University (UNESP), Rod. Araraquara-Jaú km 1, Araraquara, SP 14801-902 Brazil
- Joint Graduate Program in Physiological Sciences UFSCar/UNESP, Rod. Washington Luís km 235, São Carlos, SP 13565-905 Brazil
| | - Paola Palombo
- Laboratory of Neuropsypharmacology, School of Pharmaceutical Sciences, São Paulo State University (UNESP), Rod. Araraquara-Jaú km 1, Araraquara, SP 14801-902 Brazil
- Joint Graduate Program in Physiological Sciences UFSCar/UNESP, Rod. Washington Luís km 235, São Carlos, SP 13565-905 Brazil
| | - Paulo E. Carneiro de Oliveira
- Laboratory of Psychology, Psychology Department, Universidade Federal de São Carlos - UFSCar, Rod. Washington Luís km 235, São Carlos, SP 13565-905 Brazil
| | - Sheila A. Engi
- Laboratory of Pharmacology, Paulista Medicine School, Universidade Federal de São Paulo – UNIFESP, Leal Prado Building, Botucatu 862 Street, 04024-002, Vila Clementino, São Paulo, SP Brazil
- Joint Graduate Program in Pharmacology, Pharmacology and Molecular Biology Institute - INFAR, Três de Maio 100 Street, 04044-020, Vila Clementino, São Paulo, SP Brazil
| | - Rodrigo M. Leão
- Biomedical Sciences Institute, Universidade Federal de Uberlândia, Uberlândia, Minas Gerais Brazil
| | - Cleopatra S. Planeta
- Laboratory of Neuropsypharmacology, School of Pharmaceutical Sciences, São Paulo State University (UNESP), Rod. Araraquara-Jaú km 1, Araraquara, SP 14801-902 Brazil
- Joint Graduate Program in Physiological Sciences UFSCar/UNESP, Rod. Washington Luís km 235, São Carlos, SP 13565-905 Brazil
| | - Carlos C. Crestani
- Laboratory of Neuropsypharmacology, School of Pharmaceutical Sciences, São Paulo State University (UNESP), Rod. Araraquara-Jaú km 1, Araraquara, SP 14801-902 Brazil
- Joint Graduate Program in Physiological Sciences UFSCar/UNESP, Rod. Washington Luís km 235, São Carlos, SP 13565-905 Brazil
| | - Fabio C. Cruz
- Laboratory of Pharmacology, Paulista Medicine School, Universidade Federal de São Paulo – UNIFESP, Leal Prado Building, Botucatu 862 Street, 04024-002, Vila Clementino, São Paulo, SP Brazil
- Joint Graduate Program in Pharmacology, Pharmacology and Molecular Biology Institute - INFAR, Três de Maio 100 Street, 04044-020, Vila Clementino, São Paulo, SP Brazil
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Choi YH, Huh DA, Moon KW. Joint Effect of Alcohol Drinking and Environmental Cadmium Exposure on Hypertension in Korean Adults: Analysis of Data from the Korea National Health and Nutrition Examination Survey, 2008 to 2013. Alcohol Clin Exp Res 2021; 45:548-560. [PMID: 33635568 DOI: 10.1111/acer.14551] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Accepted: 01/06/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Hypertension is a common disease found in 1.13 billion adults worldwide. Several animal studies have provided evidence of the joint effect of alcohol drinking and cadmium exposure on hypertension. However, no epidemiologic study has examined the association between these 2 risk factors and hypertension. Therefore, we examined the individual effects of alcohol drinking and cadmium and the joint effect of their coexposure on hypertension in the general population. METHODS We analyzed data from 8,403 South Korean adults who had been randomly assigned to the Korea National Health and Nutrition Examination Survey from 2008 to 2013. Multiple linear and logistic regression analyses were conducted to estimate the association of alcohol drinking and blood cadmium concentration with blood pressure and the odds ratio (OR) for hypertension. RESULTS The weighted prevalence of hypertension and high-risk drinking was 25.7 and 13.6%, respectively. The weighted geometric mean of blood cadmium levels was 0.94 μg/L (95% confidence interval [CI]: 0.93 to 0.96). After adjusting for demographic characteristics, anthropometric measurements, health-related behaviors, and dietary and disease variables, the OR for hypertension in the group with the high-risk alcohol drinking was 1.67 (95% CI: 1.34 to 2.06) compared with the group without high-risk alcohol drinking. When the highest and the lowest blood cadmium quartiles were compared, the OR for hypertension was 1.46 (95% CI: 1.15 to 1.86). The positive joint effect of high-risk drinking and blood cadmium levels was statistically significant for systolic blood pressure (SBP; p = 0.037) and diastolic blood pressure (DBP; p < 0.001). CONCLUSIONS Our results show that heavy alcohol drinking had a joint effect with cadmium exposure to increase the risk of hypertension. Future efforts are needed to reduce alcohol drinking and environmental cadmium exposure to prevent hypertension in the general population.
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Affiliation(s)
- Yun-Hee Choi
- Department of Health and Safety Convergence Science, Korea University, Seoul, Korea.,BK21 FOUR R&E Center for Learning Health System, Korea University, Seoul, Korea
| | - Da-An Huh
- Department of Health Science, Korea University, Seoul, Korea
| | - Kyong Whan Moon
- BK21 FOUR R&E Center for Learning Health System, Korea University, Seoul, Korea.,Department of Health and Environmental Science, Korea University, Seoul, Korea
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Abstract
Introduction: Despite the improved treatment protocol of hypertension, the magnitude of the disease and its related burden remains raised. Hypertension makes up the leading cause of stroke, kidney disease, arterial disease, eye disease, and cardiovascular disease (CVD) growth. Areas covered: This review provides the overview of the role of dietary salt and alcohol use reduction in the management of hypertension, a brief history of alcohol, the vascular endothelium functions, the effects of alcohol use on blood pressure (BP), the mechanisms of alcohol, brief history of salt, the effects of dietary salt intake on BP, and the mechanisms of salt. Expert opinion: Studies found that high dietary salt intake and heavy alcohol consumption have a major and huge impact on BP while both of them have been identified to increase BP. Also, they raise the risk of hypertension-related morbidity and mortality in advance. On the other way, the dietary salt and alcohol use reduction in the management of hypertension are significant in the control of BP and its related morbidity and mortality. Further, studies suggested that the dietary salt and alcohol use reductions are the cornerstone in the management of hypertension due to their significance as part of comprehensive lifestyle modifications.
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Affiliation(s)
- Addisu Dabi Wake
- Nursing Department, College of Health Sciences, Arsi University , Asella, Ethiopia
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Chidumwa G, Maposa I, Kowal P, Micklesfield LK, Ware LJ. Bivariate Joint Spatial Modeling to Identify Shared Risk Patterns of Hypertension and Diabetes in South Africa: Evidence from WHO SAGE South Africa Wave 2. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:E359. [PMID: 33466566 PMCID: PMC7796507 DOI: 10.3390/ijerph18010359] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 11/27/2020] [Accepted: 12/03/2020] [Indexed: 11/24/2022]
Abstract
Recent studies have suggested the common co-occurrence of hypertension and diabetes in South Africa. Given that hypertension and diabetes are known to share common socio-demographic, anthropometric and lifestyle risk factors, the aim of this study was to jointly model the shared and disease-specific geographical variation of hypertension and diabetes. The current analysis used the Study on Global Ageing and Adult Health (SAGE) South Africa Wave 2 (2014/15) data collected from 2761 participants. Of the 2761 adults (median age = 56 years), 641 (23.2%) had high blood pressure on measurement and 338 (12.3%) reported being diagnosed with diabetes. The shared component has distinct spatial patterns with higher values of odds in the eastern districts of Kwa-Zulu Natal and central Gauteng province. The shared component may represent unmeasured health behavior characteristics or the social determinants of health in our population. Our study further showed how a shared component (latent and unmeasured health behavior characteristics or the social determinants of health) is distributed across South Africa among the older adult population. Further research using similar shared joint models may focus on extending these models for multiple diseases with ecological factors and also incorporating sampling weights in the spatial analyses.
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Affiliation(s)
- Glory Chidumwa
- Division of Epidemiology and Biostatistics, School of Public Health, University of the Witwatersrand, Johannesburg 2198, South Africa;
| | - Innocent Maposa
- Division of Epidemiology and Biostatistics, School of Public Health, University of the Witwatersrand, Johannesburg 2198, South Africa;
| | - Paul Kowal
- World Health Organization SAGE, CH-1211 Geneva, Switzerland;
- Research Institute for Health Sciences, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Lisa K. Micklesfield
- South African Medical Research Council/Wits Developmental Pathways for Health Research Unit, School of Clinical Medicine, University of the Witwatersrand, Johannesburg 2198, South Africa; (L.K.M.); (L.J.W.)
| | - Lisa J. Ware
- South African Medical Research Council/Wits Developmental Pathways for Health Research Unit, School of Clinical Medicine, University of the Witwatersrand, Johannesburg 2198, South Africa; (L.K.M.); (L.J.W.)
- DSI-NRF Centre of Excellence in Human Development, University of the Witwatersrand, Johannesburg 2198, South Africa
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Yang J, Liu F, Wang B, Chen C, Church T, Dukes L, Smith JO. Blood Pressure States Transition Inference Based on Multi-State Markov Model. IEEE J Biomed Health Inform 2021; 25:237-246. [PMID: 32749984 DOI: 10.1109/jbhi.2020.3006217] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The investigation of risk factors associated with hypertension patients has been extensively studied in the past decades. However, the pattern of natural progressive trajectories to hypertension from nonhypertensive states was rarely explored. In this study, we are interested in discovering the underlying transition patterns between different blood pressure states, namely normal state, elevated state, and hypertensive state among the working population in the United States. A multi-state Markov model was built based on 88,966 clinical records from 34,719 participants we collected during the worksite preventive screening from 2012 to 2018. We first investigated the various risk factors, and we found that body mass index (BMI) is the most critical factor for developing new-onset hypertension. The transition probabilities, survival probabilities, and sojourn time of each state were derived given different levels of BMI, age groups, and gender categories. We found the underweight participants are more likely to remain in the current nonhypertensive states within 3 years, while extremely obese participants have a higher probability of developing hypertension. We discovered the distinct transition patterns among male and female participants. On average, the sojourn time in the normal state for normal-weight participants is 4.33 years for females and 2.18 years for their male counterparts. For the extremely obese participants, the average sojourn time in the normal state is 1.38 years for females and 0.71 years for males. In the end, a web-based graphical user interface (GUI) application was developed for clinicians to visualize the impact of behavioral interventions on delaying the progression of hypertension. Our analysis can provide a unique insight into hypertension research and proactive interventions.
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Yoshimoto H, Nakamura I, Kojima Y. Clinical characteristics of patients with alcohol dependence comorbid with hypertension among regular drinkers: An internet-based, cross-sectional study in Japan. Alcohol 2020; 89:147-156. [PMID: 33035594 DOI: 10.1016/j.alcohol.2020.09.005] [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: 11/19/2019] [Revised: 09/17/2020] [Accepted: 09/23/2020] [Indexed: 11/19/2022]
Abstract
While evidence suggests a strong association between alcohol and hypertension, little is known about the profile of patients with alcohol dependence comorbid with hypertension. This study aimed to clarify the clinical characteristics and health problems of this population through a web-based questionnaire survey using a research company's panel of adults in Japan. Of 20 000 regular drinkers, 176 on treatment for hypertension and with alcohol dependence (confirmed and/or an Alcohol Use Disorders Identification Test score ≥15 points) were included. Participants were asked about their health-related quality of life, work productivity, blood pressure (BP) control, receipt of brief interventions, and awareness of their alcohol dependence. Results were compared between the BP-controlled and BP-uncontrolled groups. The mean EQ-5D utility score was 0.838 in the entire population, and 0.786 vs. 0.892 in the groups (p < 0.0001). When 133 'employed' participants were compared, productivity loss was more apparent in the BP-uncontrolled group (presenteeism, 27.3% vs. 6.1%, p < 0.0001; absenteeism, 10.7% vs. 1.0%, p = 0.0003). The rate of dissatisfaction with BP control was 55.1% in the entire population (most [76.3%] of those dissatisfied considered alcohol a cause of inadequate BP control), ~78% in the uncontrolled group, and ~34% in the controlled group. Of those previously advised to reduce drinking or abstain from alcohol (60.2% of all participants), 63% (BP-uncontrolled group) and 55% (BP-controlled group) decreased their drinking. Though more than twice as many participants thought themselves to be alcohol-dependent in the BP-uncontrolled group than in the controlled group (41% vs. 15%), most (59% vs. 85%) showed no self-awareness of alcohol dependence. Patients with alcohol dependence comorbid with hypertension had impaired health status and reduced work productivity. They thought alcohol was the most common cause of inadequate BP control. Treatment beyond brief interventions is needed to enhance their awareness of alcohol dependence and their motivation to reduce drinking.
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Affiliation(s)
- Hisashi Yoshimoto
- Department of Family Medicine, General Practice and Community Health, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai Tsukuba-city, Ibaraki, 305-8575, Japan.
| | - Izuru Nakamura
- Medical Affairs, Otsuka Pharmaceutical Co., Ltd., Shinagawa Grand Central Tower, 2-16-4 Konan, Minato-ku, Tokyo, 108-8241, Japan
| | - Yoshitsugu Kojima
- Medical Affairs, Otsuka Pharmaceutical Co., Ltd., Shinagawa Grand Central Tower, 2-16-4 Konan, Minato-ku, Tokyo, 108-8241, Japan
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Khambule L, Snyman T, Norris SA, Crowther NJ, George JA. Branched-chain and aromatic amino acids and cardiometabolic risk in Black African and Asian Indian populations. Metabolomics 2020; 16:108. [PMID: 33033875 DOI: 10.1007/s11306-020-01734-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Accepted: 09/30/2020] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Studies have shown that systemic levels of branched-chain amino acids (BCAAs) and aromatic amino acids (AAAs) are elevated in cardiometabolic diseases (CMDs) in populations resident in high income countries. However, little is known about the association of BCAAs and AAAs with metabolic syndrome and its components in Asian Indian (AI) and Black African (BA) populations. OBJECTIVE The aim of this study was to describe the association of BCAAs and AAAs with the metabolic syndrome, its individual components and insulin resistance in AI and BA populations. METHODS Serum samples collected from AI (n = 349) and BA (n = 369) subjects were used to measure levels of BCAAs and AAAs by ultra-pressure liquid chromatography tandem mass spectrometry (UPLC-MS/MS). Anthropometric, demographic and cardiometabolic variables were measured in all subjects. RESULTS The sum of BCAAs and AAAs was higher in AIs compared to BAs. The BCAAs and AAAs were positively associated with insulin resistance, metabolic syndrome and its individual components. This was particularly the case for AI subjects, in unadjusted regression models. However, these associations were non-significant after adjusting for co-variates, particularly visceral adipose tissue (VAT). Triglyceride levels were significantly associated with valine and leucine levels in BAs even after adjustment for co-variates. Lastly, we found that fasting circulatory BCAA and AAA levels are strongly correlated with VAT in both populations. CONCLUSION This study identified specific associations of serum valine and leucine levels with triglycerides in BAs. The association of amino acids with CMDs was observed in AIs, but was found to be the result of confounding by VAT. Further studies are required to determine whether BCAAs and AAAs are aetiological factors in CMDs and how VAT modulates their serum levels.
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Affiliation(s)
- Lungile Khambule
- Department of Chemical Pathology, National Health Laboratory Service and Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
| | - Tracy Snyman
- Department of Chemical Pathology, National Health Laboratory Service and Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Shane A Norris
- Medical Research Council/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Nigel J Crowther
- Department of Chemical Pathology, National Health Laboratory Service and Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Jaya A George
- Department of Chemical Pathology, National Health Laboratory Service and Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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Acin MT, Rueda JR, Saiz LC, Parent Mathias V, Alzueta N, Solà I, Garjón J, Erviti J. Alcohol intake reduction for controlling hypertension. Cochrane Database Syst Rev 2020; 9:CD010022. [PMID: 32960976 PMCID: PMC8094445 DOI: 10.1002/14651858.cd010022.pub2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND High blood pressure constitutes one of the leading causes of mortality and morbidity all over the world. At the same time, heavy drinking increases the risk for developing cardiovascular diseases, including cardiomyopathy, hypertension, atrial arrhythmias, or stroke. Several studies have already assessed specifically the relationship between alcohol intake and hypertension. However, the potential effect on blood pressure of alcohol intake reduction interventions is largely unknown. OBJECTIVES To assess the effect of any intervention to reduce alcohol intake in terms of blood pressure decrease in hypertensive people with alcohol consumption compared to a control intervention or no intervention at all. To determine additional effects related to mortality, major cardiovascular events, serious adverse events, or quality of life. SEARCH METHODS The Cochrane Hypertension Information Specialist searched the following databases for randomised controlled trials up to June 2020: the Cochrane Hypertension Specialised Register, the Cochrane Central Register of Controlled Trials (CENTRAL) (Issue 5, 2020), MEDLINE Ovid (from 1946), MEDLINE Ovid Epub Ahead of Print, and MEDLINE Ovid In-Process, Embase Ovid (from 1974), ClinicalTrials.gov and the World Health Organization International Clinical Trials Registry Platform. Trial authors were contacted when needed and no language restrictions were applied. SELECTION CRITERIA We included randomised controlled trials with minimum 12 weeks duration and including 50 or more subjects per group with quantitative measurement of alcohol consumption and/or biological measurement of the outcomes of interest. Participants were adults (16 years of age or older) with systolic blood pressure (SBP) greater than 140 mmHg and diastolic blood pressure (DBP) greater than 90 mmHg, and SBP ≥ 130 or DBP ≥ 80 mmHg in participants with diabetes. We included any intervention implemented to reduce their alcohol intake. DATA COLLECTION AND ANALYSIS Two review authors independently assessed search results and extracted data using standard methodological procedures adopted by Cochrane. MAIN RESULTS A total of 1210 studies were screened. We included one randomised controlled trial involving a total of 269 participants with a two-year follow-up. Individual patient data for all participants were provided and used in this review. No differences were found between the cognitive-behavioural intervention group and the control group for overall mortality (RR 0.72, 95% CI 0.16 to 3.17; low-certainty evidence), cardiovascular mortality (not estimable) and cardiovascular events (RR 0.80, 95% CI 0.36 to 1.79; very low-certainty evidence). There was no statistical difference in systolic blood pressure (SBP) reduction (Mean Difference (MD) -0.92 mmHg, 95% confidence interval (CI) -5.66 to 3.82 mmHg; very low-certainty evidence) or diastolic blood pressure (DBP) decrease (MD 0.98 mmHg, 95% CI -1.69 to 3.65 mmHg; low-certainty evidence) between the cognitive-behavioural intervention group and the control group. We also did not find any differences in the proportion of subjects with SBP < 140 mmHg and DBP < 90 mmHg (Risk Ratio (RR) 1.21, 95% CI 0.88 to 1.65; very low-certainty evidence). Concerning secondary outcomes, the alcohol intake was significantly reduced in the cognitive-behavioural intervention compared with the control group (MD 191.33 g, 95% CI 85.36 to 297.30 g). We found no differences between the active and control intervention in the proportion of subjects with lower-risk alcohol intake versus higher-risk and extreme drinkers at the end of the study (RR 1.04, 95% CI 0.68 to 1.60). There were no estimable results for the quality of life outcome. AUTHORS' CONCLUSIONS An intervention for decreasing alcohol intake consumption did not result in differences in systolic and diastolic blood pressure when compared with a control intervention, although there was a reduction in alcohol intake favouring the active intervention. No differences were found either for overall mortality, cardiovascular mortality or cardiovascular events. No data on serious adverse events or quality of life were available to assess. Adequate randomised controlled trials are needed to provide additional evidence on this specific question.
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Affiliation(s)
| | - José-Ramón Rueda
- Department of Preventive Medicine and Public Health, University of the Basque Country, Leioa, Spain
| | - Luis Carlos Saiz
- Unit of Innovation and Organization, Navarre Health Service, Pamplona, Spain
| | | | - Natalia Alzueta
- Drug Prescribing Service, Navarre Health Service, Pamplona, Spain
| | - Ivan Solà
- Iberoamerican Cochrane Centre, Biomedical Research Institute Sant Pau (IIB Sant Pau), CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - Javier Garjón
- Medicines Advice and Information Service, Navarre Health Service, Pamplona, Spain
| | - Juan Erviti
- Unit of Innovation and Organization, Navarre Health Service, Pamplona, Spain
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Liu F, Liu Y, Sun X, Yin Z, Li H, Deng K, Zhao Y, Wang B, Ren Y, Liu X, Zhang D, Chen X, Cheng C, Liu L, Liu D, Chen G, Hong S, Wang C, Zhang M, Hu D. Race- and sex-specific association between alcohol consumption and hypertension in 22 cohort studies: A systematic review and meta-analysis. Nutr Metab Cardiovasc Dis 2020; 30:1249-1259. [PMID: 32446870 DOI: 10.1016/j.numecd.2020.03.018] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Revised: 03/08/2020] [Accepted: 03/18/2020] [Indexed: 12/27/2022]
Abstract
BACKGROUND AND AIMS The alcohol-hypertension relation has been well documented, but whether women have protective effect or race and type of beverage consumed affect the association remain unclear. To quantify the relation between total or beverage-specific alcohol consumption and incident hypertension by considering the effect of sex and race. METHODS AND RESULTS Articles were identified in PubMed and Embase databases with no restriction on publication date. Pooled relative risks (RRs) and 95% confidence intervals (CIs) were calculated by random effects models. Restricted cubic splines were used to model the dose-response association. This study involved 22 articles (31 studies) and included 414,477 participants. The hypertension risk was different among liquor, wine, and beer at 5.1-10 g/d of ethanol consumption (P-across subgroups = 0.002). The hypertension risk differed between men (RR: 1.14, 95% CI: 1.07, 1.20) and women (RR: 0.98, 95% CI: 0.89, 1.06) at 10 g/d (P-across subgroups = 0.005). We found a linear alcohol-hypertension association among white (P-linearity = 0.017), black people (P-linearity = 0.035), and Asians (P-linearity<0.001). With 10 g/d increment of consumption, the RRs for hypertension were 1.06 (95% CI: 1.04, 1.08), 1.14 (95% CI: 1.01, 1.28), and 1.06 (95% CI: 1.01, 1.10) for Asians, black, and white people, respectively. CONCLUSION Sex modifies the alcohol-hypertension association at low level of alcohol consumption and we did not find evidence of a protective effect of alcohol consumption among women. Black people may have higher hypertension risk than Asians and white people at the same ethanol consumption.
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Affiliation(s)
- Feiyan Liu
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China; The Third Affiliated Hospital of Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China; Guangdong Key Laboratory for Genome Stability & Disease Prevention, Shenzhen University Health Science Center, Shenzhen, Guangdong, People's Republic of China
| | - Yu Liu
- The Third Affiliated Hospital of Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China
| | - Xizhuo Sun
- The Third Affiliated Hospital of Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China
| | - Zhaoxia Yin
- The Third Affiliated Hospital of Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China
| | - Honghui Li
- The Third Affiliated Hospital of Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China
| | - Kunpeng Deng
- Yantian Entry-exit Inspection and Quarantine Bureau, Shenzhen, Guangdong, People's Republic of China
| | - Yang Zhao
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China; The Third Affiliated Hospital of Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China
| | - Bingyuan Wang
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China; The Third Affiliated Hospital of Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China
| | - Yongcheng Ren
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China; The Third Affiliated Hospital of Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China
| | - Xuejiao Liu
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China; The Third Affiliated Hospital of Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China; Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Dongdong Zhang
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China; The Third Affiliated Hospital of Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China; Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Xu Chen
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China; The Third Affiliated Hospital of Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China; Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Cheng Cheng
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China; The Third Affiliated Hospital of Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China; Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Leilei Liu
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China; The Third Affiliated Hospital of Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China; Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Dechen Liu
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China; The Third Affiliated Hospital of Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China; Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Guozhen Chen
- Department of Clinical Medicine, Shenzhen University, Shenzhen, Guangdong, People's Republic of China
| | - Shihao Hong
- Department of Clinical Medicine, Shenzhen University, Shenzhen, Guangdong, People's Republic of China
| | - Chongjian Wang
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Ming Zhang
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China; The Third Affiliated Hospital of Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China; Guangdong Key Laboratory for Genome Stability & Disease Prevention, Shenzhen University Health Science Center, Shenzhen, Guangdong, People's Republic of China.
| | - Dongsheng Hu
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China; The Third Affiliated Hospital of Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China; Guangdong Key Laboratory for Genome Stability & Disease Prevention, Shenzhen University Health Science Center, Shenzhen, Guangdong, People's Republic of China.
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The Effects of Alcohol Consumption on Cardiometabolic Health Outcomes Following Weight Loss in Premenopausal Women with Obesity: A Pilot Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17155302. [PMID: 32717926 PMCID: PMC7432916 DOI: 10.3390/ijerph17155302] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 07/17/2020] [Accepted: 07/21/2020] [Indexed: 11/16/2022]
Abstract
Alcohol (i.e., ethanol) is consumed regularly by much of the adult population; yet, the health effects associated with its use are not well-characterized. Clinical interventions to investigate the effects of moderate alcohol consumption on metabolic outcomes, including adiposity and cardiovascular risk factors, are limited and have yielded conflicting data. In addition, no study has reported the effects of routine alcohol intake during weight loss in a controlled feeding trial. We present the first randomized controlled pilot trial to investigate the effects of moderate alcohol consumption on metabolic outcomes during weight loss in women with obesity. Both groups consumed 30% energy restricted diets and were randomized to either an ethanol-free control (CTL) group or a group (EtOH) that consumed 35 g ethanol daily for eight weeks. Our findings demonstrate that, despite similar weight loss, the decrease in mean arterial pressure was attenuated in the EtOH group, relative to the CTL group (p = 0.02). In addition, decreases in other outcomes, including visceral adipose tissue (p = 0.23), circulating lipids (triglycerides (p = 0.11) and cholesterol (p = 0.11)), and uric acid (p = 0.07) tended to be attenuated with alcohol consumption. These pilot data provide potential evidence that moderate alcohol consumption may mitigate the beneficial effects of weight loss and support the need for larger Randomized Controlled Trials (RCTs) to better investigate the metabolic effects of moderate alcohol intake in humans.
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Jung MH, Shin ES, Ihm SH, Jung JG, Lee HY, Kim CH. The effect of alcohol dose on the development of hypertension in Asian and Western men: systematic review and meta-analysis. Korean J Intern Med 2020; 35:906-916. [PMID: 31795024 PMCID: PMC7373951 DOI: 10.3904/kjim.2019.016] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Accepted: 02/08/2019] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND/AIMS There are inconsistencies in the effects of low to moderate dose alcohol consumption on the development of hypertension in adult men. We hypothesized that a region-specific effect might participate in this heterogeneity. METHODS We conducted a systematic review and meta-analysis to evaluate the effect of alcohol dose on hypertension incidence using contemporary data through December 2017. Subjects were categorized according to their level of alcohol consumption as non-drinkers (reference) and low- (0.01 to 20.0 g/day), moderate- (20.1 to 40.0 g/day), moderate- to high- (40.1 to 60.0 g/day), and high-dose (> 60.0 g/day) drinkers. We defined hypertension as a blood pressure ≥ 140/90 mmHg and/or the use of anti-hypertensive drugs. RESULTS In total, 11 articles (seven Asian and four Western) were selected for our analysis. Among Asian men, a significantly elevated risk was observed even in the low alcohol dose group in comparison with the group with no alcohol consumption, and the risk increased in a dose-dependent manner (pooled relative risks [95% confidence intervals (CI)]: 1.25 [1.13 to 1.38], 1.48 [1.27 to 1.72], 1.75 [1.43 to 2.15], and 1.78 [1.51 to 2.09]). Among Western men, a similar dose-response relationship was noted in general (p for subgroup difference > 0.1), but a significantly elevated risk was evident only in the high-dose group (pooled relative risks [95% CI]: 1.22 [0.85 to 1.74], 1.57 [0.90 to 2.75], 1.47 [0.44 to 4.91], and 1.49 [1.02 to 2.18]). CONCLUSION Even low doses of alcohol can lead to the development of hypertension, particularly in Asian men. Our findings could serve as additional evidence for developing an appropriate preventive strategy in each region.
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Affiliation(s)
- Mi-Hyang Jung
- Cardiovascular Center, Hallym University Chuncheon Sacred Heart Hospital, Chuncheon, Korea
| | - Ein-Soon Shin
- Research Agency for Clinical Practice Guidelines, KAMS Research Center, Korean Academy of Medical Sciences, Seoul, Korea
| | - Sang-Hyun Ihm
- Division of Cardiology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
- Correspondence to Sang-Hyun Ihm, M.D. Division of Cardiology, Department of Internal Medicine, College of Medicine, Bucheon St. Mary’s Hospital, The Catholic University of Korea, 327 Sosa-ro, Wonmi-gu, Bucheon 14647, Korea Tel: +82-32-340-7027, Fax: +82-32-340-2669, E-mail:
| | - Jin-Gyu Jung
- Department of Family Medicine, Research Institute for Medical Sciences, Chungnam National University College of Medicine, Daejeon, Korea
| | - Hae-Young Lee
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
| | - Cheol-Ho Kim
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
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Madavanakadu Devassy S, Benny AM, Scaria L, Nannatt A, Fendt-Newlin M, Joubert J, Joubert L, Webber M. Social factors associated with chronic non-communicable disease and comorbidity with mental health problems in India: a scoping review. BMJ Open 2020; 10:e035590. [PMID: 32595154 PMCID: PMC7322289 DOI: 10.1136/bmjopen-2019-035590] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVES The purpose of this study is to examine the existing literature of the major social risk factors which are associated with diabetes, hypertension and the comorbid conditions of depression and anxiety in India. DESIGN Scoping review. DATA SOURCES Scopus, Embase, CINAHL Plus, PsycINFO, Web of Science and MEDLINE were searched for through September 2019. ELIGIBILITY CRITERIA FOR SELECTING STUDIES Studies reporting data on social risk factors for diabetes or hypertension and depression or anxiety in community-based samples of adults from India, published in English in the 10 years to 2019, were included. Studies that did not disaggregate pooled data from other countries were excluded. DATA EXTRACTION AND SYNTHESIS Two independent reviewers extracted study aims; methods; sample size and description; demographic, social and behavioural risk factors and a summary of findings from each paper. Risk factors were synthesised into six emergent themes. RESULTS Ten studies were considered eligible and included in this review. Nine presented cross-sectional data and one was a qualitative case study. Six themes emerged, that is, demographic factors, economic aspects, social networks, life events, health barriers and health risk behaviours. CONCLUSIONS Literature relating to the major social risk factors associated with diabetes, hypertension and comorbid depression and anxiety in India is sparse. More research is required to better understand the interactions of social context and social risk factors with non-communicable diseases and comorbid mental health problems so as to better inform management of these in the Indian subcontinent.
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Affiliation(s)
- Saju Madavanakadu Devassy
- Department of Social Work, Rajagiri College of Social Sciences, Cochin, Kerala, India
- Rajagiri International Center for Consortium Research Social Care (ICRS), Rajagiri College of Social Sciences, Cochin, Kerala, India
| | - Anuja Maria Benny
- Rajagiri International Center for Consortium Research Social Care (ICRS), Rajagiri College of Social Sciences, Cochin, Kerala, India
| | - Lorane Scaria
- Rajagiri International Center for Consortium Research Social Care (ICRS), Rajagiri College of Social Sciences, Cochin, Kerala, India
| | - Anjana Nannatt
- Department of Social Work, Rajagiri College of Social Sciences, Cochin, Kerala, India
| | | | - Jacques Joubert
- Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Victoria, Australia
| | - Lynette Joubert
- Department of Social Work, University of Melbourne, Melbourne, Victoria, Australia
| | - Martin Webber
- Department of Social Policy and Social Work, University of York, York, UK
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Abstract
BACKGROUND Experimental studies suggest that omega-3 fatty acid have favorable effects on blood pressure (BP). However, data on the association of long-term dietary intake of omega-3 fatty acid or fish with risk of hypertension in healthy subjects are sparse. We examined whether fish or omega-3 fatty acid consumption was associated with incident hypertension in the Physicians' Health Study (PHS). METHODS In a prospective cohort study, we analyzed data on 12 279 PHS participants (mean age: 53.0 ± 8.7 years) free of hypertension at baseline. Fish and omega-3 fatty acid consumption were assessed from a baseline semiquantitative food-frequency questionnaire. Incident hypertension was ascertained via self-reports on annual follow-up questionnaires. RESULTS During a mean follow-up of 15.8 years, 6299 men (51.3%) developed hypertension. In a multivariable model controlling for established risk factors for hypertension, fish and omega-3 fatty acid consumption was not significantly associated with incident hypertension. The hazard ratio (95% CI) of hypertension was 1.10 (0.93-1.30) for men who consumed at least five servings per week of fish compared with those who did not consume any fish (P for trend = 0.29). For the highest versus lowest quintile of omega-3 fatty acid intake, the hazard ratio of hypertension was 1.02 (0.94-1.11) (P for trend = 0.34). The associations did not vary by type of fish. There was also no evidence of effect modification by baseline BP, BMI, or history of hypercholesterolemia. CONCLUSION Overall, long-term dietary intake of fish and omega-3 fatty acid was not associated with incident hypertension in a cohort of middle-aged and older US men.
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Marques AP, Szwarcwald CL, Pires DC, Rodrigues JM, Almeida WDSD, Romero D. [Factors associated with arterial hypertension: a systematic review]. CIENCIA & SAUDE COLETIVA 2020; 25:2271-2282. [PMID: 32520271 DOI: 10.1590/1413-81232020256.26972018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Accepted: 10/03/2018] [Indexed: 01/11/2023] Open
Abstract
A systematic review of demographic, socioeconomic, behavioral and anthropometric factors associated with hypertension. We included observational studies, of populations aged 18 or older, from the past ten years, published in English, Portuguese or Spanish from Pubmed, Web of Science, Scopus and Lilacs bases. The most found factors related to the greater chance of having hypertension were age and the Body Mass Index (BMI). Other factors associated with the disease were: gender (male), education (lower education), income (lower income) and waist circumference (high). Never having smoked, never having consumed alcohol and white skin color were characteristics related to a lower chance of having hypertension. As demonstrated, demographic, socioeconomic, behavioral and anthropometric characteristics are important factors associated with a greater chance of having hypertension in the adult population. However, while most of the factors associated with it are amenable to intervention, broader health promotion policies will be needed to reduce socioeconomic inequalities in the prevalence of the disease.
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Affiliation(s)
- Aline Pinto Marques
- Laboratório de Informação em Saúde, Instituto de Comunicação e Informação Científica e Tecnológica em Saúde, Fundação Oswaldo Cruz. Av. Brasil 4365, Manguinhos. 21040-900, Rio de Janeiro, RJ, Brasil.
| | - Célia Landmann Szwarcwald
- Laboratório de Informação em Saúde, Instituto de Comunicação e Informação Científica e Tecnológica em Saúde, Fundação Oswaldo Cruz. Av. Brasil 4365, Manguinhos. 21040-900, Rio de Janeiro, RJ, Brasil.
| | - Débora Castanheira Pires
- Laboratório de Informação em Saúde, Instituto de Comunicação e Informação Científica e Tecnológica em Saúde, Fundação Oswaldo Cruz. Av. Brasil 4365, Manguinhos. 21040-900, Rio de Janeiro, RJ, Brasil.
| | - Jéssica Muzy Rodrigues
- Laboratório de Informação em Saúde, Instituto de Comunicação e Informação Científica e Tecnológica em Saúde, Fundação Oswaldo Cruz. Av. Brasil 4365, Manguinhos. 21040-900, Rio de Janeiro, RJ, Brasil.
| | - Wanessa da Silva de Almeida
- Laboratório de Informação em Saúde, Instituto de Comunicação e Informação Científica e Tecnológica em Saúde, Fundação Oswaldo Cruz. Av. Brasil 4365, Manguinhos. 21040-900, Rio de Janeiro, RJ, Brasil.
| | - Dalia Romero
- Laboratório de Informação em Saúde, Instituto de Comunicação e Informação Científica e Tecnológica em Saúde, Fundação Oswaldo Cruz. Av. Brasil 4365, Manguinhos. 21040-900, Rio de Janeiro, RJ, Brasil.
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Yoshimura R, Yamamoto R, Shinzawa M, Tomi R, Ozaki S, Fujii Y, Ito T, Tanabe K, Moriguchi Y, Isaka Y, Moriyama T. Drinking frequency modifies an association between salt intake and blood pressure: A cohort study. J Clin Hypertens (Greenwich) 2020; 22:649-655. [PMID: 32175653 DOI: 10.1111/jch.13844] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2020] [Revised: 02/24/2020] [Accepted: 02/27/2020] [Indexed: 11/28/2022]
Abstract
Salt sensitivity is one of the crucial risk factors of hypertension. The aim of the present prospective cohort study was to assess the clinical impact of alcohol drinking on an association between salt intake and blood pressure. The present study included 451 employees at a pharmaceutical company in Japan who underwent annual health checkups in both 2017 and 2018. The main exposure of interest was self-reported drinking frequency at their first checkups: rarely, occasionally, and daily. To assess the association between the change of salt intake estimated from single-spot urine specimens and that of blood pressure, the differences in systolic/diastolic blood pressure and salt intake between 2017 and 2018 were calculated for each subject. Multivariable-adjusted linear regression models adjusting for clinically relevant factors clarified a drinking frequency-dependent association between Δsalt intake and Δsystolic blood pressure (per 1 g/d of Δsalt intake adjusted β [95% confidence interval] 0.19 [-0.73, 1.12], 0.84 [0.14, 1.53], and 1.78 [0.86, 2.69] in rare, occasional, and daily drinkers). A similar association between Δsalt intake and Δdiastolic blood pressure was also observed (-0.24 [-1.02, 0.54], 0.67 (0.18, 1.16), 0.95 [0.38, 1.51], in rare, occasional, and daily drinkers). The interactions between drinking frequency and Δsalt intake were found to be statistically significant (P for interaction = .028 and .006 for ∆systolic blood pressure and ∆diastolic blood pressure, respectively). The present study identified enhanced salt sensitivity in the subjects who drink at a higher frequency, suggesting that the reduction in alcohol consumption may improve salt sensitivity in higher frequency drinkers.
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Affiliation(s)
- Ryuichi Yoshimura
- Department of Nephrology, Osaka University Graduate School of Medicine, Suita, Japan.,Division of Nephrology, Shimane University Hospital, Izumo, Japan
| | - Ryohei Yamamoto
- Department of Nephrology, Osaka University Graduate School of Medicine, Suita, Japan.,Health and Counseling Center, Osaka University, Toyonaka, Japan.,Heatlth Promotion and Regulation, Department of Health Promotion Medicine, Osaka University Graduate School of Medicine, Toyonaka, Japan
| | - Maki Shinzawa
- Department of Nephrology, Osaka University Graduate School of Medicine, Suita, Japan
| | - Ryohei Tomi
- Department of Nephrology, Osaka University Graduate School of Medicine, Suita, Japan
| | - Shingo Ozaki
- Department of Nephrology, Osaka University Graduate School of Medicine, Suita, Japan
| | - Yoshiyuki Fujii
- Department of Nephrology, Osaka University Graduate School of Medicine, Suita, Japan
| | - Takafumi Ito
- Division of Nephrology, Shimane University Hospital, Izumo, Japan
| | - Kazuaki Tanabe
- Department of Internal Medicine IV, Shimane University Faculty of Medicine, Izumo, Japan
| | | | - Yoshitaka Isaka
- Department of Nephrology, Osaka University Graduate School of Medicine, Suita, Japan
| | - Toshiki Moriyama
- Department of Nephrology, Osaka University Graduate School of Medicine, Suita, Japan.,Health and Counseling Center, Osaka University, Toyonaka, Japan.,Heatlth Promotion and Regulation, Department of Health Promotion Medicine, Osaka University Graduate School of Medicine, Toyonaka, Japan
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Zhao F, Liu Q, Li Y, Feng X, Chang H, Lyu J. Association between alcohol consumption and hypertension in Chinese adults: Findings from the CHNS. Alcohol 2020; 83:83-88. [PMID: 31525410 DOI: 10.1016/j.alcohol.2019.09.004] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Revised: 09/06/2019] [Accepted: 09/09/2019] [Indexed: 11/13/2022]
Abstract
OBJECTIVES To obtain information about alcohol consumption (henceforth "drinking") among Chinese adults from 1991 to 2011, and to explore the association between drinking behavior and hypertension. METHODS According to the longitudinal data obtained in the China Health and Nutrition Survey (1991-2011), 50,013 records of 12,577 adults were selected by applying eligibility criteria. The chi-test was employed to explore the association between drinking and hypertension, by considering the frequency of drinking, daily alcohol intake, alcohol type, and the prevalence of hypertension. A multilevel logistic regression model was used to analyze the longitudinal association between drinking frequency and the prevalence of hypertension. RESULTS The prevalence of hypertension was higher in participants with a high drinking frequency than in those with a low drinking frequency among both males and females (p < 0.001). A step increase in daily alcohol intake was not associated with any obvious changes in the prevalence of hypertension in males, but the prevalence in each drinking group was higher than that in the nondrinking group, the prevalence of hypertension in females was lowest among those with a daily alcohol intake below 15 g. The types of alcohol consumed differed significantly between males and females (p < 0.001). Longitudinal analysis results showed that compared with the nondrinking group, drinking frequency ≤2 times/week was positively correlated with hypertension in both males (OR = 1.51, 95% CI = 1.26-1.82, p < 0.001) and females (OR = 1.67, 95% CI = 1.08-2.58, p < 0.05) after adjusting for covariates, meanwhile, the same positive correlation also occurred in males with drinking frequency >2 times/week (OR = 2.13, 95% CI = 1.77-2.56, p < 0.05), the risk of hypertension increased with the increase in drinking frequency. CONCLUSIONS Drinking can increase the prevalence of hypertension in Chinese males and females. From the analysis results of longitudinal data, drinking alcohol is still an important risk factor for hypertension among Chinese subjects, especially those who drink with high frequency.
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Affiliation(s)
- Fanfan Zhao
- Clinical Research Center, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China; School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China
| | - Qingqing Liu
- Clinical Research Center, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China; School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China
| | - Yuanjie Li
- Department of Human Anatomy, Histology and Embryology, School of Basic Medical Sciences, Xi'an Jiaotong University Science Center, Xi'an, Shaanxi, China
| | - Xiaojie Feng
- Clinical Research Center, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China; School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China
| | - Hong Chang
- Department of Teaching Office, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Jun Lyu
- Clinical Research Center, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China; School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China.
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Burroughs Peña MS, Mbassa RS, Slopen NB, Williams DR, Buring JE, Albert MA. Cumulative Psychosocial Stress and Ideal Cardiovascular Health in Older Women. Circulation 2020; 139:2012-2021. [PMID: 30813768 DOI: 10.1161/circulationaha.118.033915] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Research implicates acute and chronic stressors in racial/ethnic health disparities, but the joint impact of multiple stressors on racial/ethnic disparities in cardiovascular health is unknown. METHODS In 25 062 women (24 053 white; 256 Hispanic; 440 black; 313 Asian) articipating in the Women's Health Study follow-up cohort, we examined the relationship between cumulative psychosocial stress (CPS) and ideal cardiovascular health (ICH), as defined by the American Heart Association's 2020 strategic Impact Goals. This health metric includes smoking, body mass index, physical activity, diet, blood pressure, total cholesterol, and glucose, with higher levels indicating more ICH and less cardiovascular risk (score range, 0-7). We created a CPS score that summarized acute stressors (eg, negative life events) and chronic stressors (eg, work, work-family spillover, financial, discrimination, relationship, and neighborhood) and traumatic life event stress reported on a stress questionnaire administered in 2012 to 2013 (score range, 16-385, with higher scores indicating higher levels of stress). RESULTS White women had the lowest mean CPS scores (white: 161.7±50.4; Hispanic: 171.2±51.7; black: 172.5±54.9; Asian: 170.8±50.6; Poverall<0.01). Mean CPS scores remained higher in Hispanic, black, and Asian women than in white women after adjustment for age, socioeconomic status (income and education), and psychological status (depression and anxiety) ( P<0.01 for each). Mean ICH scores varied by race/ethnicity ( P<0.01) and were significantly lower in black women and higher in Asian women compared with white women (β-coefficient [95% CI]: Hispanics, -0.02 [-0.13 to -0.09]; blacks, -0.34 [-0.43 to -0.25]; Asians, 0.34 [0.24 to 0.45]); control for socioeconomic status and CPS did not change these results. Interactions between CPS and race/ethnicity in ICH models were not significant. CONCLUSIONS Both CPS and ICH varied by race/ethnicity. ICH remained worse in blacks and better in Asians compared with whites, despite taking into account socioeconomic factors and CPS.
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Affiliation(s)
- Melissa S Burroughs Peña
- Center for the Study of Adversity and Cardiovascular Disease (NURTURE Center), Division of Cardiology, Department of Medicine, University of California, San Francisco (M.S.B.P., R.S.M., M.A.A.)
| | - Rachel S Mbassa
- Center for the Study of Adversity and Cardiovascular Disease (NURTURE Center), Division of Cardiology, Department of Medicine, University of California, San Francisco (M.S.B.P., R.S.M., M.A.A.)
| | - Natalie B Slopen
- Department of Epidemiology and Biostatistics, University of Maryland School of Public Health, College Park (N.B.S.)
| | - David R Williams
- Department of Social and Behavioral Sciences (D.R.W.), Harvard T.H. Chan School of Public Health, Boston, MA
| | - Julie E Buring
- Department of Epidemiology (J.E.B.), Harvard T.H. Chan School of Public Health, Boston, MA.,Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital (J.E.B.), Boston, MA
| | - Michelle A Albert
- Center for the Study of Adversity and Cardiovascular Disease (NURTURE Center), Division of Cardiology, Department of Medicine, University of California, San Francisco (M.S.B.P., R.S.M., M.A.A.)
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