Prevalence of self-reported hypertension and its relation to dietary habits, in adults; a nutrition & health survey in Greece

Dietary factors in relation to hypertension: a mendelian randomization study

BACKGROUND

Observational studies have elucidated the associations between dietary factors and hypertension. Nevertheless, the exploration of these relationships using Mendelian randomization remains scarce currently.

METHODS

The Mendelian randomization approach investigated the potential causal relationships between 16 dietary factors and hypertension. To achieve this, we identified genetic variants associated with these dietary factors by utilizing data from European-descent genome-wide association studies with a stringent significance threshold (P < 5 × 10 - 8). Subsequently, we obtained genetic associations with hypertension from the extensive FinnGen Study, encompassing 92,462 cases and 265,626 controls. Our primary analytical method was the inverse variance weighted method, and we also conducted assessments for heterogeneity and pleiotropy to ensure the robustness and reliability of our findings.

RESULTS

The study revealed significant associations with hypertension risk for various dietary factors. Specifically, higher weekly alcohol consumption (OR: 1.53, 95% CI: 1.19-1.96) and more frequent alcohol intake (OR: 1.20, 95% CI: 1.08-1.33) were positively correlated with an increased risk of hypertension. Likewise, increased poultry intake (OR: 3.25, 95% CI: 1.83-5.78) and beef intake (OR: 1.80, 95% CI: 1.09-2.97) were also linked to a higher risk of hypertension. Conversely, there were protective factors associated with a decreased risk of hypertension. These included consuming salad and raw vegetables, dried fruits, cheese, and cereals. It is important to note that no evidence of pleiotropy was detected, underscoring the robustness of these findings.

CONCLUSIONS

This study uncovered causal relationships between various dietary factors and hypertension risk. Specifically, alcohol consumption in terms of drinks per week and intake frequency, as well as poultry and beef intake, were causally associated with an elevated risk of hypertension. In contrast, consuming salad/raw vegetables, dried fruits, cheese, and cereals demonstrated an inverse causal association with hypertension, suggesting a potential protective effect.

Knowledge Regarding Hypertension and Amount of Diet Consumption Among Adults From Uttarakhand: A Comparative Survey

BACKGROUND

Hypertension is becoming more common worldwide, and by 2025, its incidence is predicted to rise by 32.4%. The present study aims to assess the knowledge related to hypertension and the amount of diet consumption among adults at risk of developing hypertension in both rural and urban areas of Uttarakhand.

METHODS

A cross-sectional survey was conducted on 667 adults at risk of hypertension. The study sample included adults selected from the rural and urban communities of Uttarakhand. A semi-structured questionnaire on knowledge regarding hypertension and self-reported amount of diet consumption was used as a tool for data collection.

RESULTS

The mean age of participants in this study was 51.46 ± 1.44 years, and the majority of the participants had poor knowledge regarding hypertension as a disease and its consequences as well as preventive measures. The mean days for consumption of fruits were three days, four days for green vegetables, two days for eggs, and two days for a well-balanced diet, and the mean ± SD of a non-vegetarian diet consumption was 128 ± 182 gm. Another highlighted significant mean difference was found between knowledge of raised blood pressure with the amount of consumption of fruits, green leafy vegetables, a non-vegetarian diet, and a well-balanced diet.

CONCLUSION

In the present study, knowledge of blood pressure and raised blood pressure with its related factors was poor among all participants. The average consumption of all types of diet was two to three days a week, which was borderline, based on recommended dietary allowances. The knowledge related to raised blood pressure and its associated factors had significant mean differences for the mean consumption of fruits, non-vegetarian diet, and well-balanced diet.

Increased Body Mass Index and Hypertension: An Unbreakable Bond

BACKGROUND

Adherence with lifestyle recommendations is low among hypertensive patients. The main objective of this study was to assess the prevalence of diagnosed hypertension among the Greek urban population and to examine how lifestyle and sociodemographic characteristics differ between already known hypertensive and the rest of the population.

METHODS

In this cross-sectional survey, data were collected from 1,060 participants (mean age 47.1 ± 16.9 (mean ± 1standard deviation), 52.7% females). Sociodemographic characteristics, health risk factors, and medical history were involved. Body mass index (BMI) (kg/m2) was calculated, according to reported height and weight. Parametric tests and multiple logistic regression analysis were applied to identify whether socio-demographic characteristics and health risk factors differed between known hypertensive and the rest of the population.

RESULTS

Already known hypertensives were 179 (101 females-78 males). The prevalence of known hypertension was 16.9% (18.1% in females and 15.6% in males). In multivariate analysis, known hypertensives were more likely to have advanced age (P < 0,001, OR = 1.101, 95%CI 1.081-1.121) and increased BMI (P < 0,001, OR = 1.138, 95%CI 1.085-1.194). Moreover, they had a higher probability of suffering from other cardiovascular diseases or sharing other risk factors for cardiovascular diseases.

CONCLUSIONS

Among Greek urban population, almost one to six adults knows to suffer from hypertension. In spite the recommendations, patients who were aware of their illness have increased BMI compared with the rest of the population.

Prevalence and associated factors of undiagnosed hypertension among women aged 15-49 years in India: an analysis of National Family Health Survey-4 data

Hypertension is a major risk factor for cardiovascular disease globally. Although Indian studies have addressed the prevalence of hypertension and its associated factors, this study focuses upon women in the reproductive age group, 15-49 years, who have undiagnosed hypertension. We use NFHS-4 data for secondary analyses of prevalence and factors associated with undiagnosed hypertension among women aged 15-49 years in India. Multiple logistic regression was undertaken to identify associated factors. Our analyses showed that overall prevalence of undiagnosed hypertension was 18.69% among women aged 15-49 years in India. In rural areas, it was 17.09% compared  and 21.73% in urban areas. By comparison, only 8.86% self-reported a diagnosis of hypertension. Factors associated with undiagnosed hypertension were age, less than or more than normal BMI, higher wealth quintiles, no education, religion, caste, and geographical zones. Almost one in five women aged 15-49 years in India has undiagnosed hypertension with implications for personal and reproductive health.

Presence of Hypertension Is Reduced by Mediterranean Diet Adherence in All Individuals with a More Pronounced Effect in the Obese: The Hellenic National Nutrition and Health Survey (HNNHS)

Hypertension is a major risk of cardiovascular diseases. This study’s aim was to examine associations between hypertension and a priori known lifestyle risk factors, including weight status and Mediterranean diet adherence. The study included a representative sample of the adult population (N = 3775 (40.8% males)), from the Hellenic National Nutrition and Health Survey (HNNHS), which took place from September 2013 to May 2015. Demographic and anthropometric data were collected using validated questionnaires, and blood pressure (BP) measurements were performed for the two main metropolitan areas (N = 1040; 41.1%). Hypertension diagnosis was according to the International Classification of Diseases (ICD-10) guidelines. Weighted proportions, extended Mantel–Haenszel (M–H) analyses, and multiple logistic regressions (for the survey data) were performed. Mean systolic BP (SBP) and diastolic BP (DBP) were 118.6 mmHg and 72.2 mmHg respectively, with both values being higher in males compared to females in all age groups (p < 0.001). Study participants with hyperlipidemia or diabetes, and those overweight, were almost twice as likely to be hypertensives, with the odds increasing to 4 for those obese (p for all, < 0.05). Stricter Mediterranean diet adherence significantly decreased the likelihood of hypertension by 36% (OR: 0.64; 95% CI: 0.439, 0.943), and a significant interaction was found between Mediterranean diet adherence and weight status on hypertension. The presence of hypertension is clustered with comorbidities, but is significantly associated with modifiable risk factors, including Mediterranean diet and weight status, underlining the need for personalized medical nutritional treatment.

Aims, design and preliminary findings of the Hellenic National Nutrition and Health Survey (HNNHS)

Background

The aim of the Hellenic National Nutrition and Health Survey was to assess nutritional intake, health status and various behaviors in a representative sample of the Greek population.

Methods

Data collection took place from 01.09.2013 to 31.05.2015. Random stratified sampling was performed by (a) geographical density criteria of Greece (7 regions), (b) age group of the reference population (< 19, 20–64 and > 65 years) and (c) gender distribution. The final population enrolled included (throughout Greece), 4574 individuals (42.5% men; 57.5% women of who 47.2% were from Athens metropolitan area, 18.5% from Central Macedonia, and the remaining 34% almost equally scattered throughout the country (p for the comparisons with official statistics by region, age group and sex > 0.7). Questionnaires developed were based on extensive review of the literature, following a validation procedure when necessary.

Results

Preliminary analyses revealed that 32% of the adult population were overweight and 15.5% were obese, with significant gender differences in total and per age group (p < 0.001, for all). The majority of the adult population reported being active smokers (50.4%) or regular alcohol consumers (72.4%); with significant gender differences (p < 0.001, for all). Prevalence of hyperlipidemia was 16.7%, cardiovascular disease 13.9%, hypertension 13.3%, thyroid disease 13.8%, and Diabetes Mellitus 3.6%. Significant gender and age group differences were found in various diseases.

Conclusions

Study’s preliminary results provide valuable information about the Hellenic population’s health. Findings from this survey could be used to detect disease risk factors for public health prevention policies and programs.

Electronic supplementary material

The online version of this article (10.1186/s12874-018-0655-y) contains supplementary material, which is available to authorized users.

Cardiovascular disease in Greece; the latest evidence on risk factors

Cardiovascular disease (CVD) is a significant and ever-growing problem in Europe, accounting for nearly 45% of all deaths and leading to significant morbidity. Greece is one of the European Union member states that top the list of deaths due to ischemic heart disease and stroke, a fact that is mainly attributed to unfavorable changes in modifiable risk factors. The aim of this review is to examine the latest evidence on the most important CVD risk factors. According to studies conducted during the last two decades, the prevalence of arterial hypertension, hypercholesterolemia, diabetes mellitus, and obesity remained relatively stable or increased. The decrease in the prevalence of active smokers and the increase in physical activity, during the last few years, are the main favorable risk modifications in the Greek population. Nevertheless, citizens of Greece seem to gradually adopt unhealthy dietary habits by moving away from Mediterranean diet, as issue that is intensified after the outbreak of the Greek debt crisis. Furthermore, the inability of some patients to afford their medications and the possible health care deficiencies as well as the increasing prevalence of depression may make the situation even worse. During the financial crisis, CVD mortality seems to have remained unaffected, but there is evidence that the incidence of cardiovascular events is increasing. More effort is needed to control established and emerging CVD risk factors among the Greek population.

Ovo-vegetarian diet is associated with lower systemic blood pressure in Taiwanese women

OBJECTIVE

This study was designed to investigate blood pressure (BP) profiles among Taiwanese women with different dietary patterns.

STUDY DESIGN

Cross-sectional study.

METHODS

A total of 269 non-hypertensive Taiwanese women, 40 years of age or older, were surveyed using structured questionnaires, and measurements of BP and physiological parameters were made. To assess differences among vegans, ovo-vegetarians, and meat eaters in terms of BP, demographic, and health behavior data, the chi-squared and Fisher's exact tests were employed for categorical variables, and analysis of variance and independent t-tests were performed for continuous variables. Multiple regression analysis was used to examine the relationship between BP and dietary patterns while controlling for potential confounding factors.

RESULTS

A significant difference was found among the three test groups in terms of age, education, employment, stress, and waist-hip ratio. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) significantly differed among the three groups. After controlling for age, body weight, waist circumference, and hip circumference, the three groups were observed to be a significant risk factor of the SBP and DBP. The SBP and DBP of the ovo-vegetarian group were significantly lower than those of the meat-eater group. No significant differences were found between the vegan and meat-eater groups in terms of SBP and DBP.

CONCLUSION

Dietary pattern is a likely risk factor for SBP and DBP outcomes in Taiwanese women. In particular, the SBP and DBP of ovo-vegetarians are the lowest among the values observed for all dietary patterns. This finding suggests that an ovo-vegetarian diet is beneficial for long-term BP control and prevention of hypertension in females.

Prevalence and Correlates of Prehypertension and Hypertension among Adults in Northeastern China: A Cross-Sectional Study

Background: Prehypertension is a category between normotension and hypertension that is becoming increasingly common in China. However, limited data are available on the prevalence and correlates of prehypertension in northeastern China. Methods: A cross-sectional study using stratified, clustered multistage, and random sampling methods was performed on 17,584 participants. Results: The prevalence of prehypertension and hypertension was 36.0% and 30.8% in northeastern China, respectively. As age increased, the prevalence of prehypertension in males declined (p-trend < 0.001), in parallel to an increase in the prevalence of hypertension (p-trend < 0.001). The prevalence of hypertension for females increased as age increased (p-trend < 0.001). Logistic regression analysis showed that age, gender, location, drinking, Body Mass Index (BMI), abdominal obesity, hypertriglyceridemia, and hypercholesterolemia correlated with prehypertension and hypertension (p-trend < 0.05). Conclusions: This study revealed a high prevalence of prehypertension and hypertension in an adult population of northeastern China and some correlates of prehypertension and hypertension.

Prevalence and associated factors of self-reported hypertension among Tehran adults in 2011: a population-based study (Urban HEART-2)

BACKGROUND

Hypertension is an important public-health challenge worldwide. The prevalence of hypertension greatly varies across countries. The aim of this study was to estimate the prevalence of self-reported hypertension and to determine related factors in a large random sample of Tehran population in 2011.

METHODS

In this cross sectional study, 69173 individuals aged 25-64 years were selected using multistage cluster random sampling method. All participants were interviewed by trained personnel using standard questionnaires. Weighted prevalence and incidence rates were calculated and principle component analysis (PCA) was used to construct wealth index. Chi-square and odds ratio were used to assess associations in univariate analysis. Logistic Regression model was used in multivariate analysis.

RESULTS

The prevalence of self-reported hypertension was 5.27% in total, 3.83% in men and 6.64% in women (p< 0.001). The annual incidence rate of self-reported hypertension was 6.87 per 1000; 5.26 in men and 8.43 in women (p< 0.001), obviously varied across various districts. In multivariate analysis, age, sex (woman), marital status (single), obesity and smoking were positively associated with prevalence of self-reported hypertension. Education level was negatively associated to hypertension. On the other hand, wealth status was not associated to self-reported hypertension.

CONCLUSION

Our study findings highlighted low awareness rates of hypertension among Tehran adults especially in men and younger people. Hence, we recommend public health strategies to improve health education programs. Moreover, programs to develop the surveillance system and screening programs to early detection of undiagnosed cases are urgently needed particularly in high risk population subgroups.

Economic evaluation of statins in high-risk patients treated for primary and secondary prevention of cardiovascular disease in Greece

BACKGROUND

An economic evaluation was undertaken in order to assess several therapeutic alternatives (rosuvastatin, atorvastatin, simvastatin, and pravastatin) for the prevention of primary and secondary cardiovascular events in high-risk patients in Greece.

METHODS

A probabilistic Markov model with five distinct states provided estimates over a 20-year time span. The relative effectiveness of comparators was based on the literature. The HellenicSCORE risk equation was used to forecast survival. The transition probabilities from acute myocardial infarction or stroke to death were estimated with reference to the Framingham study. In addition, Framingham scores were used to calculate the probability of nonfatal acute myocardial infarction or nonfatal stroke. Costs were estimated from the perspective of sickness funds and included direct medical costs valued in the year 2012. The total treatment cost accounted for the cost of drugs, routine examinations, and resources expended in the management of acute myocardial infarction, stroke, and death. The utility decrements used are those for the Greek population. A supplementary budget impact analysis was also conducted.

RESULTS

The mean discounted quality-adjusted life years in the case of males for the rosuvastatin arm were 10.18 versus 10.04, 9.94, and 9.88 for atorvastatin, simvastatin, and pravastatin, respectively. The mean total cost was €15,392, €16,438, €17,009, and €17,356 for rosuvastatin, atorvastatin, simvastatin, and pravastatin, respectively. Similar results were obtained in the case of females, while all analyses demonstrated a statistically significant difference at the 95% level of significance. The total burden of 100% (single) use of rosuvastatin in a hypothetical cohort of 100 male patients for one year was €1.47 million versus €1.53 million for atorvastatin, €1.57 million for simvastatin, and €1.59 million for pravastatin.

CONCLUSION

Rosuvastatin may represent an attractive choice compared with likely alternative existing therapies used in the primary and secondary prevention of cardiovascular events by the National Health Service of Greece.

Self-reported prevalence of atherothrombosis in a general population sample of adults in Greece; a telephone survey

BACKGROUND

The aim of this study was to estimate the prevalence of selected atherothrombotic risk factors and several clinical manifestations of atherothrombosis, as well as the utilization rates of selected vascular interventions in Greece.

METHODS

During December 2009, 3,007 adults (aged 47 ± 16 years, 48.3% men and 51.7% women) recruited in a random-digit dialed telephone survey (response rate: 16%). The sample size was selected following a multistage and stratified by gender, age group, and Greek region procedure in order to be more representative. Data regarding medical history and socio-demographic characteristics of the participants were collected.

RESULTS

Overall, 6.5%, 17.7% and 14.0% of participants reported that they had been diagnosed with diabetes mellitus, hypertension and hypercholesterolemia, respectively. In the overall sample, 2.5% of participants reported that they had been diagnosed with angina, 2.0% with myocardial infarction, 1.6% with stroke and 2.5% with peripheral artery disease. Overall, 1.5% of participants reported that they had undergone percutaneous coronary intervention, 1.4% coronary artery bypass grafting, 0.6% angioplasty of a peripheral vessel, and 0.7% surgery of a peripheral vessel.

CONCLUSION

Despite the limitations may occur due to the sampling procedure, the findings of the present study indicate that atherothrombosis affects a large portion of the population in Greece and it is expected to impose a significant economic burden. The data of the current study could contribute in obtaining an accurate estimation of the economic burden of atherothrombosis in Greece because people who are aware of their condition/disease are those who use health care resources.

Body composition in severe refractory asthma: comparison with COPD patients and healthy smokers

Background

Body composition is an important parameter for patients with chronic obstructive pulmonary disease (COPD) whereas the association between asthma and obesity is not fully understood. The impact of severe refractory asthma (SRA) on fat free mass (FFM) has not been investigated.

Methodology and Principal Findings

213 subjects (70 healthy smokers, 71 COPD patients and 72 asthma patients) without significant comorbidities were included in the study. In all patients, body composition assessment (using bioelectrical impendance analysis, skinfold and anthropometric measurements) and spirometry were performed. Differences in fat free mass index (FFMI) between groups were assessed and determinants of FFMI in asthma were evaluated. Patients with SRA had lower values of FFMI compared to patients with mild-to-moderate asthma [18.0(17.3–18.3)–19.5(18.4–21.5), p<0.001], despite the fact that they were more obese. The levels of FFMI in SRA were lower than those of GOLD stage I–III COPD and comparable to those of stage IV COPD patients [18.0(17.3–18.3)–18.8(17.8–20.1), p = ns]. These differences were present even after proper adjustments for sex, age, smoking status, daily dose of inhaled corticosteroids (ICS) and daily use of oral corticosteroids (OCS). In multivariate analysis, independent predictors of FFMI in asthmatic patients were age, use of OCS and the presence of SRA, but not smoking, sex or cumulative dose of ICS used.

Conclusions and Significance

SRA is related to the presence of low FFMI that is comparable to that of GOLD stage IV COPD. The impact of this observation on asthma mechanisms and outcomes should be further investigated in large prospective studies.

Prevalence of chronic diseases and morbidity in primary health care in central Greece: an epidemiological study

Background

In Greece there is lack of large epidemiological studies regarding morbidity and mortality in primary health care. The aim of the present study was to estimate the prevalence and morbidity of the most common diseases in a large population sample from primary health care.

Methods

Four primary health centres were randomly selected. During one year period, 12 visits were performed in each centre, one per month, in random order and all visitors willing to participate in the study were included. Data on morbidity of each subject were recorded after performing an interview with the participant and checking his medical records, medical history and current medication. Diseases were coded using the international classification of primary care (ICPC) system.

Results

In total 20,299 subjects were recorded. The results revealed significant variations in morbidity between genders and age groups. However, in all age groups, diseases of the circulatory system were most prevalent, followed by endocrine, metabolic, musculoskeletal and respiratory diseases. Osteoporosis was significantly more prevalent in females compared to males, whereas skin and eye disorders were more prevalent in subjects below 65 years old. COPD prevalence was very low compared to worldwide data.

Conclusions

The present study revealed great variations in the prevalence of the diseases between genders and age groups. Our data justify the urgent need for the development of electronic health records that may help in the design of new prevention strategies in primary health care.

Awareness of hypertension: will it bring about a healthy lifestyle?

Guidelines for cardiovascular disease prevention recommend a non-pharmacological approach to reduce cardiovascular risk in those with elevated blood pressure. We assessed guideline adherence in hypertensives. This study was performed in the European Investigation into Cancer and Nutrition-NL cohort, consisting of 40,011 subjects. From 1993 to 1997, participants completed questionnaires (disease history, lifestyle and diet), a physical examination was performed and blood samples were drawn. Differences in proportions of guideline targets met between aware and unaware hypertensives were studied. Of 8779 hypertensive subjects, 90% was aware of their hypertension. They more often adhered to guidelines than unaware hypertensive subjects with respect to intake of polyunsaturated fat:saturated fat (38.6% vs 33.2%), fibres (40.6% vs 34.2%), body mass index <27 kg m(-2) (53.8% vs 46.5%) and alcohol (79.7% vs 72.6%). Despite statistical significance, the magnitude of these differences was small. Our study suggests that prevalence of a healthy lifestyle according to the recommendations in guidelines is slightly better in subjects aware of hypertension. There seems to be ample room for improvement in implementing the guidelines. Probably, patient tailored interventions and a multisiciplinary and multimodality approach can support this improvement.

Hipertensão arterial sistêmica auto-referida: validação diagnóstica em estudo de base populacional

Com o objetivo de investigar a validade do auto-relato de hipertensão arterial, realizou-se estudo transversal, de base populacional, com indivíduos de 20 anos ou mais de idade, residentes em Pelotas, Rio Grande do Sul, Brasil, selecionados por amostragem probabilística em dois estágios. A pressão arterial foi medida duas vezes (cinco minutos de intervalo) em 2.949 participantes visitados em casa. Aqueles com pressão sistólica 140mmHg e/ou diastólica 90mmHg foram revisitados, e a pressão medida mais duas vezes. Conforme padrão-ouro, hipertensão foi definida pela média das pressões na segunda visita ou uso de medicação anti-hipertensiva. O auto-relato foi obtido por meio da pergunta: "Algum médico disse que o(a) Sr.(a) tem pressão alta?". A prevalência auto-referida foi 33,6%, e a medida, 29,5%. A sensibilidade foi 84,3% (IC95%: 81,7-86,7), especificidade 87,5% (IC95%: 86,0-88,9), valor preditivo positivo 73,9% (IC95%: 71,0-76,6) e negativo de 93,0% (IC95%: 91,8-94,1). O auto-relato mostrou-se válido para monitoração da prevalência de hipertensão, um dos mais importantes fatores de risco para as doenças crônicas não transmissíveis.

Period prevalence and sociodemographic factors of hypertension in rural maharashtra: a cross-sectional study

BACKGROUND

Hypertension is most common cardiovascular disease and it account for large proportion of all cardiovascular deaths and disability worldwide.

RESEARCH QUESTIONS

What is the level of prevalence of hypertension in rural area? What are the soociodemographic factors associated with hypertension?

OBJECTIVES

To find out prevalence of hypertension in rural area.

STUDY DESIGN

A community-based cross-sectional study setting: Rural Health Training Centre Paithan, field practice area of govt. medical college Aurangabad, Maharashtra.

PARTICIPANTS

1297 persons aged 19 years and above.

STUDY PERIOD

June 2005 to December 2006.

MATERIALS AND METHODS

A house-to-house survey was conducted by the author himself, interviewed the participants by systematic random sampling method, using pretested structured standard questionnaire. Two independent blood pressure (BP) readings were taken in sitting position by visiting each participant at their home. Hypertension was defined as systolic BP more than or equal to 140 mm of Hg or diastolic BP more than or equal to 90 mm of Hg or those individuals currently taking antihypertensive treatment.

STATISTICAL TESTS

Percentiles, Chi Square test, Chi-Square for linear trend, multiple logistic regression analysis on SPSS software Version 10.

RESULTS

Overall prevalence of hypertension in the study subjects was 7.24%. Multiple logistic regression analysis identified various factors significantly associated with hypertension were age, sex, BMI, additional salt intake, smoking, DM, alcohol consumption, and higher socioeconomic status.

CONCLUSIONS

The overall prevalence of hypertension in study subjects was 7.24%.

Health behaviour patterns in relation to hypertension: the English Longitudinal Study of Ageing

OBJECTIVE

Clinical guidelines emphasize that hypertensive individuals should be encouraged to maintain healthy lifestyles with respect to smoking, physical activity, alcohol consumption and diet. We assessed health behaviours in a large sample of older hypertensive individuals, and tested whether medication for hypertension leads to compensatory increases in cardiovascular risk behaviours.

METHODS

Analysis of wave 1 of the English Longitudinal Study of Ageing, involving 5231 men and 6292 women aged at least 50 years. We analysed the prevalence of smoking, heavy drinking, sedentary behaviour and vigorous physical activity in relation to self-reported hypertension, controlling for age, sex, socioeconomic status, comorbidity (coronary heart disease, diabetes, arthritis), impairments of mobility, activities of daily living and depression.

RESULTS

The prevalence of self-reported hypertension was 37.8%, and 77% of hypertensive participants were prescribed medication. Hypertensive participants were less likely to smoke than normotensive ones (14.8 vs. 19.7%), with reduced odds of smoking [odds ratio (OR) 0.72, 95% confidence intervals (CI) 0.56-0.83] after adjusting for covariates. Hypertensive individuals were more likely to be heavy drinkers (OR 1.34, CI 1.10-1.62), to be sedentary (OR 1.14, CI 1.02-1.27), and not engage in vigorous physical activity (OR 0.84, CI 0.75-0.94). There was no evidence for risk compensation in medicated hypertensive individuals compared with unmedicated ones.

CONCLUSION

Smoking rates are low among hypertensive individuals, but the patterns of alcohol consumption and physical activity are suboptimal. Compensatory increases in risky behaviours appear not to be present in medicated individuals. There is considerable scope for advice and counselling to older hypertensive individuals to improve patterns of health behaviour.

Adherence to a Mediterranean-type diet and reduced prevalence of clustered cardiovascular risk factors in a cohort of 3204 high-risk patients

Background

The Mediterranean food pattern (MeDiet) has been suggested to have beneficial effects on cardiovascular risk factors. Scarcity of assessment of this effect on large samples of patients at high risk is, however, observed. Our objective was to estimate the association between adherence to MeDiet and the prevalence of risk factors in 3204 asymptomatic high-risk patients.

Design

Cross-sectional assessment of baseline characteristics of participants in a primary prevention trial.

Methods

Participants were assessed by their usual primary-care physicians to ascertain the prevalence of diet-related cardiovascular risk factors (diabetes, hypertension, dyslipidemia, or obesity) using standard diagnostic criteria. A dietitian interviewed each participant to obtain a 14-point score measuring the degree of adherence to MeDiet.

Results

Adherence to MeDiet was inversely associated with individual risk factors and, above all, with the clustering of them. The multivariate adjusted odds ratio to present simultaneously the four risk factors for those above the median value of the MeDiet score was 0.67 (95% confidence interval: 0.53–0.85). The multivariate odds ratios for successive categories of adherence to MeDiet were 1 (ref.), 1.03, 0.85, 0.70 and 0.54 ( P for trend ≤0.001).

Conclusion

Following a MeDiet was inversely associated with the clustering of hypertension, diabetes, obesity, and hypercholesterolemia among high-risk patients.

Prevalence, awareness, treatment, and risk factors associated with hypertension in the Iranian population: the national survey of risk factors for noncommunicable diseases of Iran

BACKGROUND

The prevalence of hypertension in the Middle East is not well defined. We examined the prevalence, awareness, treatment, and control of hypertension in Iran.

METHODS

The Survey of Risk Factors of Noncommunicable Diseases was conducted in 2005 and contains a representative sample of the Iranian adult population. Of 70,981 participants, the data of 68,250 adults aged 25-64 years who had two valid blood pressure (BP) readings were analyzed to estimate the total prevalence of hypertension (systolic BP >or= 140 mm Hg, diastolic BP >or= 90 mm Hg, or the concurrent use of antihypertensive agents) in the Iranian adult population.

RESULTS

Approximately 25% or 6.6 million Iranians aged 25-64 years had hypertension; additionally 46% or 12 million Iranians aged 25-64 years had prehypertension. Among hypertensive patients, 34% were aware of their elevated BP; 25% were taking antihypertensive medications; and of these treated subjects, only 24% had BP values <140/90 mm Hg. Hypertension and prehypertension were associated with age, male gender, obesity, central obesity, hypercholesterolemia, and diabetes.

CONCLUSIONS

The prevalence of hypertension and prehypertension is high, and the rates of awareness, treatment, and control are unacceptably low. These results underscore the urgent need to develop national strategies to improve prevention, detection, and treatment of hypertension in Iran.

Low RLS prevalence and awareness in central Greece: an epidemiological survey

Restless legs syndrome (RLS) is a sensorimotor disorder with a general population prevalence of 3-10%. A single, previous epidemiological study performed in south-east Europe reported the lowest prevalence rate amongst European countries. We conducted a population-based survey of RLS in central Greece. A total of 4200 subjects were randomly recruited. We used the international RLS study group criteria for diagnosis and the severity scale for severity assessment in subjects with RLS. We also included questions to assess the level of awareness of RLS in our region. A total of 3033 subjects were screened. The overall lifetime prevalence was 3.9% with a female-to-male ratio of 2.6:1. Nearly half of RLS patients reported moderate to severe intensity of symptoms. After adjustment for multiple comparisons we found no association of RLS with education level, smoking, alcohol intake, caffeine consumption, shift work, professional pesticide use or comorbid illness. Our study revealed a low level of awareness amongst the population and physicians in our region and sub-optimal management. We provide further evidence for low prevalence of RLS in south-east Europe and a low level of awareness of RLS in our region.

Dietary patterns and their correlates among middle-aged and elderly Chinese men: a report from the Shanghai Men's Health Study

Dietary patterns, which reflect the complexity of food preference, lifestyle and socio-economic status, may play a major role in health and longevity. Understanding dietary patterns and their correlates is important to the research of diet and health relationships. In the Shanghai Men's Health Study (SMHS) a total of 61,582 men aged 40-74 were recruited between 2002 and 2006. Their food intake over the previous year was collected using a validated FFQ. Study participants (75.6%) reported little or no change in meat and vegetable intake in the 5 years prior to recruitment. Using the baseline data of the SMHS, we assessed dietary patterns, as well as their relationship with socio-demographic and lifestyle factors and with prevalence of some chronic diseases. Three major dietary patterns, fruit-, vegetable- and meat-based diets, were identified in our population. Consumption of the fruit diet appeared to be more common among men who were older and more physically active, had higher income, and lower waist-to-hip ratio (WHR), while this diet was less common among manual labourers. The meat- or vegetable-based diets were less common among elderly men and more common among men with higher WHR. Dietary patterns appeared to be associated with the presence of health conditions. In general, subjects with a chronic disease were more likely to have the vegetable-based diet and less likely to have the fruit- or meat-based diets. Future studies of diet and health in this population will need to carefully take into account these potential confounders.