Risk of hypertension amongst Swedish male snuff users: a prospective study

To explore the association between different types of obesity and blood pressure in adolescents aged 12-17 years in eastern China. Using multi-stage stratified random sampling, a total of 8279 adolescents aged between 12 and 17 years in eastern China were selected as the research objects from the "Nutrition and Health Surveillance for Chinese Children and Nursing Mothers" project from 2016 to 2017. According to BMI and WHtR, the subjects were divided into four types: non-obesity, general obesity, simple abdominal obesity and combined obesity. The normal high blood pressure and high blood pressure of people with different types of obesity were determined according to Blood Pressure Standards for Children at 3-17 Years Old Per Year and Height in China. The relationship between different types of obesity and the prevalence of high blood pressure was analyzed by χ~2 test, analysis of variance, multi-level linear model and multi-level Logistic regression model. The prevalence of high normal blood pressure was 13. 66%(1069), and the prevalence of high blood pressure was 18. 79%(1782) in adolescents aged 12 to 17 years in eastern China. In the non-obese group, the prevalence of high normal blood pressure was 12. 85%(732), and the prevalence of high blood pressure was 13. 79%(999). In the general obesity group, the prevalence of high normal blood pressure was 20. 45%(99), and the prevalence of high blood pressure was 23. 62%(160). In the central obesity group, the prevalence of high normal blood pressure was 6. 95%(32), and the prevalence of high blood pressure was 14. 64%(87). The prevalence of high normal blood pressure was 16. 68%(206), and the prevalence of high blood pressure was 42. 42%(536) in the complex obesity group. The prevalence of high blood pressure(χ~2=8. 05, P<0. 01) the difference was statistically significant. Results of the multi-level model showed that the risk of high blood pressure in central obesity group was significantly higher in girls than in non-obese group(OR=1. 50, 95%CI 1. 12-2. 02). The risk of high normal blood pressure(OR=2. 05, 95%CI 1. 62-2. 58; OR=1. 83, 95%CI 1. 38-2. 42) and high blood pressure(OR=2. 06, 95%CI 1. 59-2. 67; OR=1. 57, 95%CI 1. 15-2. 14) in obese boys and girls were significantly higher than those in non-obese group. The risk of high normal blood pressure(OR=3. 80, 95%CI 3. 19-4. 51; OR=2. 79, 95%CI 2. 30-3. 37), high blood pressure(OR=4. 07, 95%CI 3. 39-4. 88; OR=2. 84, 95%CI 2. 32-3. 46) in both boys and girls with compound obesity was significantly higher than that in the non-obese group. Different types of obesity have varying degrees of correction with different blood pressure levels in adolescents aged 12-17 years, combined obesity has the highest risk of elevated blood pressure.

Hypertension Editors' Picks: Air Pollution.

Hypertension Editors' Picks.

Hypertension curriculum review: epidemiology and the prevention of hypertension.

Undetected Hypertension and Prehypertension in Children with Diabetes Need Attention

<i>Circulation</i> Editors’ Picks

This clinical advisory statement from the Coordinating Committee of the National High Blood Pressure Education Program is intended to advance and clarify the recommendations of the Sixth Report of the Joint National Committee on the Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC VI, 1997).1 The advisory addresses several interrelated issues about blood pressure (BP) that affect people approaching the later decades of life. On the basis of the wealth of currently available evidence, the committee now recommends a major paradigm shift in urging that systolic BP become the major criterion for diagnosis, staging, and therapeutic management of hypertension, particularly in middle-aged and older Americans. Several lines of strong evidence support the initiative to emphasize systolic BP. Pathophysiologically, there are strong associations among aging, increased stiffness of large arteries, increased systolic BP, increased pulse pressure, and the prevalence of cardiac and vascular disease. Epidemiologically, isolated systolic hypertension is the most common form of hypertension and is present in approximately two thirds of hypertensive individuals >60 years of age. Diagnostically, classification and staging of hypertension are more precise when systolic rather than diastolic BP is used as the principal criterion. Risk stratification for major complications of hypertension (stroke, myocardial infarction, heart failure, and kidney failure) is actually confounded by the use of diastolic BP; in older people with systolic hypertension, diastolic BP is inversely related to cardiovascular risk. Clinical benefits of treatment of isolated systolic hypertension include reductions in stroke, myocardial infarction, heart failure, kidney failure, and overall cardiovascular disease morbidity and mortality. Currently, only 1 in 4 Americans with hypertension falls below JNC VI–recommended values of 140/90 mm Hg in uncomplicated hypertension or 130/85 mm Hg in individuals with kidney disease or diabetes. Hypertension control rates are poorest in older people, primarily as a result of inadequate …

The objective of the study was to examine the risks for high blood pressure associated with under nutrition and over nutrition among adolescents, as both forms of malnutrition coexist in India owing to nutritional transition. Adolescents (9-16 yrs) from schools catering to Lower Socio Economic class (LSE; 943 boys, 1000 girls) and High Socio Economic class (HSE; 867 boys, 1042 girls) were measured for weight, height, sitting height, body fat, skin folds and blood pressure. Results revealed that high prevalence of overweight in adolescents from HSE class compared to that in LSE (24.1% vs 2.2% in boys and 20.8% vs 3.9% in girls; p<0.01 for both) indicated risk for High Systolic Blood Pressure (HSBP) while high prevalence of stunting in LSE class (20.8% in boys and 11.8% in girls) indicated risk for High Diastolic Blood Pressure (HDBP). Leg height to height ratio showed significant inverse association with blood pressure levels. In LSE class, prevalence of HDBP was significantly higher than prevalence of HSBP in each quartile of BMI, body fat and skin folds. Increase in systolic blood pressure per unit increase of BMI, was higher in adolescents from LSE class (1.99 mmHg in boys and 1.03 mmHg in girls) compared to those in HSE class (0.91 mmHg in boys and 0.52 mmHg in girls) and this was also true for diastolic blood pressure. Implications of increase in BMI are serious for undernourished children than better nourished children. The observation therefore, underscores the need for planning strategies for preventing adiposity in adolescents from urban as well as rural and poor sections of Indian population.

To observe the association between the leukocyte count and blood pressure value and hypertension risk in a Chinese community-based population. A total of 4 188 participants who took part in the baseline examination in 1992 and the follow-up survey in 2007 from the Chinese Multi-Provincial Cohort Study were included in this study. The relationship of leukocyte and blood pressure value and hypertension risk were evaluated by cross-sectional analyses.The prospective association between baseline leukocyte count and blood pressure changes and risk of hypertension were analyzed in 2 954 normotensive individuals at baseline examination.The associations between leukocyte count and blood pressure was evaluated with Spearman's rank correlation analyses and linear regression models,and the associations between leukocyte count and risk of hypertension was evaluated with logistic regression models. (1) The cross-sectional study results showed that the correlation coefficient of leukocyte count and systolic blood pressure and diastolic blood pressure was 0.208 and 0.154 (both P < 0.001), respectively.Multiple linear regression analyses showed that every 1×10(9)/L increment in leukocyte count was associated with 1.41 mmHg (1 mmHg = 0.133 kPa) systolic blood pressure increase (95% CI: 1.20-1.63 mmHg, P < 0.001) and 0.63 mmHg diastolic blood pressure increase (95% CI: 0.51-0.76 mmHg, P < 0.001). Multivariable logistic regression analyses showed that every 1×10(9)/L increment in leukocyte count was associated with a 15% increased risk of hypertension (OR: 1.15, 95% CI: 1.12-1.19, P < 0.001). (2) During 15 years of follow-up, 47.2% (1 394/2 954) normotensive individuals progressed to hypertension. Spearman's rank correlation analyses showed that, the correlation coefficient of leukocyte count and systolic blood pressure change and diastolic blood pressure change was 0.062 (P = 0.003) and 0.102 (P < 0.001), respectively.Multiple linear regression analyses showed that every 1×10(9)/L increment in baseline leukocyte count was associated with 1.03 mmHg systolic blood pressure increase (95% CI: 0.74-1.32 mmHg, P < 0.001) and 0.64 mmHg diastolic blood pressure increase (95% CI: 0.48-0.80 mmHg, P < 0.001). Multivariable logistic regression analyses showed that every 1×10(9)/L increment in leukocyte count was associated with a 9% increased risk of incident hypertension (OR: 1.09, 95% CI: 1.06-1.13, P < 0.001). Elevated leukocyte count is associated with increased blood pressure value and hypertension among Chinese community-based population, suggesting that inflammation may participate in the pathogenesis of hypertension.

Association Between Anthropometry and High Blood Pressure in a Representative Sample of Preschoolers in Madrid

<i>Hypertension</i> Editors’ Picks

Hypertension is highly prevalent in the United States and worldwide. In the United States, 1 in 3 adults (≈73 million people) have hypertension. The financial and human costs of hypertension are substantial. The estimated costs attributable to hypertension in the United States alone in 2010 were $70 billion direct costs for medical treatments and $24 billion indirect costs because of lost productivity.1 Awareness and treatment of hypertension have improved considerably during the past several decades: >80% of all people with hypertension are aware of the condition and 75% are using antihypertensive medications.2,3 However, despite enormous effort and treatment-related expenditures, only 53% of those with documented hypertension have their blood pressure controlled.3 Older age (Figure 1), left ventricular hypertrophy, and obesity are important risk factors for uncontrolled or drug-resistant hypertension.4 Importantly, the foregoing are also risk factors for increased aortic stiffness.5 Figure 1. Hypertension prevalence and control rates as a function of age in the National Health and Nutrition Examination Survey 2003 to 2004. Data derived from Wong et al.44 During the past 2 decades, measures of aortic stiffness have emerged as important risk factors for progression of blood pressure and incident cardiovascular disease. Carotid femoral pulse wave velocity (CFPWV), a measure of aortic wall stiffness, increases markedly with age, particularly after midlife. For example, Framingham Heart Study investigators have shown that the prevalence of CFPWV ≥12 m/s increases from a few percentage before 50 years of age to ≥60% after 70 years of age (Figure 2A). Importantly, elevated CFPWV is associated with high risk for incident hypertension (Figure 2B) and cardiovascular disease (Figure 2C). Figure 2C should be interpreted within the context that a normal value (<95th percentile) for CFPWV in a healthy Framingham Heart Study reference sample <50 years of age was 8.1 …

Asociación entre antropometría y presión arterial alta en una muestra representativa de preescolares de Madrid

To describe the consumption of snuff in a rural male population and to explore associations between snuff use and obesity. Tobacco use was explored in 834 men aged 30-75 years old who participated in a cross-sectional population survey in the municipality of Vara (participation rate was 81%). Self-reported questionnaires assessed the habits of smoking and snuff use. Anthropometric measures were obtained during a health examination. Of these men 21% (n = 179) were snuff users, 13% (n = 109) current smokers, and 65% (n = 546) were non-users. Of all snuff users 65% (n = 116) were former smokers, and 35% (n = 63) were exclusive snuff users (current users who never smoked). Among non-users 65% (n = 357) were never users and 35% (n = 189) had quit smoking without nicotine substitution. These men were characterized by abdominal obesity; OR 1.84 (1.08-3.12) (p = 0.002) (WHR 41.0) and OR 1.71 (1.08-2.72) (p = 0.022) (waist circumference 4102 cm). One can/week use of snuff among ex-smokers was associated with a 1.21 cm wider (0.05-2.36) (p = 0.041) waist circumference and 0.01 (0.00-0.02) units higher (p = 0.021) WHR. There were statistically significant associations between former smoking without current nicotine substitute and both general and abdominal obesity. No similar association with abdominal obesity was seen among exclusive snuff users. Abdominal obesity in current snuff users is limited to former smokers. The remaining effect of previous smoking has to be considered in future studies on obesity and related disorders in snuff users. Counselling among people who substitute snuff for smoking should include measures to prevent weight gain.

Ambulatory Blood Pressure and Increased Left Ventricular Mass in Children at Risk for Hypertension