Hg Higher Diastolic Blood Pressure Research Articles

Association analysis between an epigenetic alcohol risk score and blood pressure

BackgroundEpigenome‐wide association studies have identified multiple DNA methylation sites (CpGs) associated with alcohol consumption, an important lifestyle risk factor for cardiovascular diseases. This study aimed to test the hypothesis that an alcohol consumption epigenetic risk score (ERS) is associated with blood pressure (BP) traits.ResultsWe implemented an ERS based on a previously reported epigenetic signature of 144 alcohol-associated CpGs in meta-analysis of participants of European ancestry. We found a one-unit increment of ERS was associated with eleven drinks of alcohol consumed per day, on average, across several cohorts (p < 0.0001). We examined the association of the ERS with systolic blood pressure (SBP), diastolic blood pressure (DBP), and hypertension (HTN) in 3,898 Framingham Heart Study (FHS) participants. Cross-sectional analyses in FHS revealed that a one-unit increment of the ERS was associated with 1.93 mm Hg higher SBP (p = 4.64E−07), 0.68 mm Hg higher DBP (p = 0.006), and an odds ratio of 1.78 for HTN (p < 2E−16). Meta-analysis of the cross-sectional association of the ERS with BP traits in eight independent external cohorts (n = 11,544) showed similar relationships with BP levels, i.e., a one-unit increase in ERS was associated with 0.74 mm Hg (p = 0.002) higher SBP and 0.50 mm Hg (p = 0.0006) higher DBP, but not with HTN. Longitudinal analyses in FHS (n = 3260) and five independent external cohorts (n = 4021) showed that the baseline ERS was not associated with a change in BP over time or with incident HTN.ConclusionsOur findings demonstrate that the ERS has potential clinical utility in assessing lifestyle factors related to cardiovascular risk, especially when self-reported behavioral data (e.g., alcohol consumption) are unreliable or unavailable.Graphic

Independent Effects of Blood Pressure on Intraocular Pressure and Retinal Ganglion Cell Degeneration: A Mendelian Randomization Study.

To investigate the causal effect of elevated blood pressure on primary open-angle glaucoma (POAG) and POAG endophenotypes. Two-sample Mendelian randomization (MR) was performed to investigate the causal effect of elevated systolic blood pressure (SBP) (N = 757,601) and diastolic blood pressure (DBP) (N = 757,601) on intraocular pressure (IOP) (N = 139,555), macular retinal nerve fiber layer (mRNFL) thickness (N = 33,129), ganglion cell complex (GCC) thickness (N = 33,129), vertical cup-to-disc ratio (VCDR) (N = 111,724), and POAG liability (Ncases = 16,677, Ncontrols = 199,580). The primary analysis was conducted using the inverse-variance weighted approach. Sensitivity analyses were performed to investigate robustness to horizontal pleiotropy, winner's curse, and collider bias. Multivariable MR was performed to investigate whether any effect of blood pressure on retinal ganglion cell degeneration was mediated through increased IOP. Increased genetically predicted SBP and DBP associated with an increase in IOP (0.17 mm Hg [95% CI = 0.11 to 0.24] per 10 mm Hg higher SBP, P = 5.18 × 10-7, and 0.17 mm Hg [95% CI = 0.05 to 0.28 mm Hg] per 10 mm Hg higher DBP, P = 0.004). Increased genetically predicted SBP associated with a thinner GCC (0.04µm [95% CI = -0.07 to -0.01µm], P = 0.018) and a thinner mRNFL (0.04µm [95% CI = -0.07 to -0.01µm], P = 0.004), an effect that arises independently of IOP according to our mediation analysis. Neither SBP nor DBP associated with VCDR or POAG liability. These findings support a causal effect of elevated blood pressure on retinal ganglion cell degeneration that does not require intermediary changes in IOP. Targeted blood pressure control may help preserve vision by lowering IOP and, independently, by preventing retinal ganglion cell degeneration, including in individuals with a normal IOP.

Association between Tea Consumption and Hypertension Risk among Middle-Aged and Older Chinese Adults

BackgroundCurrent evidence on tea consumption and hypertension is inconclusive, and prospective studies among habitual tea drinkers remain limited. ObjectiveWe investigated the associations of habitual tea consumption with hypertension risk and longitudinal blood pressure changes in 2 large cohorts. MethodsThis study included participants aged 40–75 y from the Shanghai Women's Health Study (n = 31,351) and the Shanghai Men's Health Study (n = 28,342), without hypertension, diabetes, cardiovascular disease, or cancer at baseline. Information on tea consumption was assessed during in-person interviews at enrollment and follow-up visits. Incident hypertension was identified by self-reported diagnosis, medication use, or blood pressure measurements. ResultsCurrent tea drinkers had a 7% higher risk than the non–current tea drinker group [HRs (95% CIs): women, 1.07 (1.01, 1.14); men, 1.07 (1.02, 1.12)]. The amount of tea drinking showed significant dose–response associations with hypertension: compared with the non-current group, HRs (95% CIs) for women and men were 1.01 (0.90, 1.14) and 1.02 (0.96, 1.08) for low (women/men: <100/200 g/mo), 1.07 (1.01, 1.15) and 1.05 (0.99, 1.12) for medium (women/men: 100–250/200–250 g/mo), and 1.18 (1.01, 1.39) and 1.10 (1.03, 1.17) for the high-amount group (women/men: >250 g/mo). Among participants without hypertension, compared with non–current tea drinkers, least-squares means of 3-y changes in blood pressure were 0.3–0.4 mm Hg higher for women and men as current drinkers and 0.7–0.9 mm Hg higher for men in the high-consumption group. Compared with those who never drank tea, women who drank tea consistently had 0.5 (0.2, 0.7) mm Hg higher diastolic blood pressure (DBP), whereas men had 0.5 (0.04, 0.9) mm Hg higher systolic blood pressure and 0.3 (0.04, 0.6) mm Hg higher DBP, respectively. ConclusionsOur findings suggest that habitual tea drinking is associated with a slightly higher risk of hypertension and a minor increase in blood pressure among middle-aged and older Chinese adults, which warrants confirmation by long-term intervention studies.

Cardiovascular symptoms affect the patterns of habitual coffee consumption

Excessive coffee consumption can lead to unpleasant sensations such as tachycardia and heart palpitations. Our aim was to investigate if cardiovascular symptoms can lead to alterations in habitual patterns of coffee consumption. We used information from up to 390,435 European ancestry participants in the UK Biobank, aged 39-73 y. Habitual coffee consumption was self-reported, and systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate were measured at baseline. Cardiovascular symptoms at baseline were based on hospital diagnoses, primary care records, and/or self-report. Mendelian randomization (MR) was used to examine genetic evidence for a causal association between SBP, DBP, and heart rate with habitual coffee consumption. Participants with essential hypertension, angina, or heart arrhythmia were all more likely to drink less caffeinated coffee and to be non-habitual or decaffeinated coffee drinkers compared with those who did not report related symptoms (P≤3.5×10-8 for all comparisons). Higher SBP and DBP were associated with lower caffeinated coffee consumption at baseline, with consistent genetic evidence to support a causal explanation across all methods [MR-Egger regression (MREggr) β: -0.21 cups/d (95% CI: -0.34, -0.07) per 10 mm Hg higher SBP and -0.33 (-0.61, -0.07) per 10 mm Hg higher DBP)]. In genetic analyses, higher resting heart rate was associated with a greater odds of being a decaffeinated coffee drinker (MREggr OR: 1.71; 95% CI: 1.31, 2.21) per 10 beats/min). We provide causal genetic evidence for cardiovascular system-driven influences on habitual coffee intakes, suggesting that people tend to naturally regulate their coffee consumption based on blood pressure levels and heart rate. These findings suggest that observational studies of habitual coffee intakes are prone to influences by reverse causation, and caution is required when inferred health benefits result from comparisons with coffee abstainers or decaffeinated coffee drinkers.

Associations of drinking rainwater with macro-mineral intake and cardiometabolic health: a pooled cohort analysis in Bangladesh, 2016\u20132019

This study explores the associations of drinking rainwater with mineral intake and cardiometabolic health in the Bangladeshi population. We pooled 10030 person-visit data on drinking water sources, blood pressure (BP) and 24-h urine minerals. Fasting blood glucose (FBG) was measured in 3724 person-visits, and lipids in 1118 person-visits. We measured concentrations of sodium (Na), potassium (K), calcium (Ca) and magnesium (Mg) in 253 rainwater, 935 groundwater and 130 pond water samples. We used multilevel linear or gamma regression models with participant-, household- and community-level random intercepts to estimate the associations of rainwater consumption with urine minerals and cardiometabolic biomarkers. Rainwater samples had the lowest concentrations of Na, K, Ca and Mg. Rainwater drinkers had lower urine minerals than coastal groundwater drinkers: −13.42 (95% CI: −18.27, −8.57) mmol Na/24 h, −2.00 (95% CI: −3.16, −0.85) mmol K/24 h and −0.57 (95% CI: −1.02, −0.16) mmol Mg/24 h. The ratio of median 24-hour urinary Ca for rainwater versus coastal groundwater drinkers was 0.72 (95% CI: 0.64, 0.80). Rainwater drinkers had 2.15 (95% CI: 1.02, 3.27) mm Hg higher systolic BP, 1.82 (95% CI: 1.19, 2.54) mm Hg higher diastolic BP, 0.59 (95% CI: 0.17, 1.01) mmol/L higher FBG and −2.02 (95% CI: −5.85, 0.81) mg/dl change in high-density lipoprotein cholesterol compared with the coastal groundwater drinkers. Drinking rainwater was associated with worse cardiometabolic health measures, which may be due to the lower intake of salubrious Ca, Mg and K.

Influence of Dietary Approaches to Stop Hypertension-Type Diet, Known Genetic Variants and Their Interplay on Blood Pressure in Early Childhood: ABCD Study.

There is limited evidence on association between adherence to the Dietary Approaches to Stop Hypertension (DASH diet) and a lower blood pressure (BP) in children. In a population-based cohort study, among 1068 Dutch children aged 5 to 7, we evaluated the association between a DASH-type diet, 29 known genetic variants incorporated in a genetic risk score, and their interaction on BP. We calculated DASH score based on the food intake data measured through a validated 71-item food frequency questionnaire. In our sample, DASH score ranged from 9 (low adherence to the DASH diet) to 33 (median=21), and genetic score ranged from 18 (low genetic risk on high BP) to 41 (median=29). After adjustment for covariates, each 10 unit increase in DASH score was associated with a lower systolic BP of 0.7 mm Hg (P=0.033). DASH score was negatively associated with hypertension (odds ratio=0.96 [0.92-0.99], P=0.044). Similarly, each SD increment in genetic score was associated with 0.5 mm Hg higher diastolic BP (P=0.002). We found a positive interaction between low DASH score and high genetic score on diastolic BP adjusted for BP risk factors (β=1.52, Pinteraction=0.019 in additive scale and β=0.03, Pinteraction=0.021 in multiplicative scale). Our findings show that adherence to the DASH-type diet, as well as a low (adult-derived) genetic risk profile for BP, is associated with lower BP in children and that the genetic basis of BP phenotypes at least partly overlaps between adults and children. In addition, we found evidence of a gene-diet interaction on BP in children.

Blood Pressure and Risk of Subarachnoid Hemorrhage in China.

Background and Purpose—Subarachnoid hemorrhage (SAH) has a high case fatality rate and young mean age at onset compared with other types of stroke, but the pathogenesis of SAH is not fully understood. We examined associations of systolic and diastolic blood pressure with incident nontraumatic SAH in a large prospective study in China.Methods—In 2004 to 2008, 512 891 adults (59% women) from the general population were recruited into the CKB study (China Kadoorie Biobank). Participants were interviewed, measured, and followed up for fatal and nonfatal events. After excluding those with prior vascular disease, Cox regression analysis was used to relate blood pressure to incident SAH events. Analyses were adjusted for major confounders and corrected for regression dilution to give associations with long-term average blood pressure.Results—At baseline, mean age was 51 (SD, 11) years, and mean systolic blood pressure/diastolic blood pressure was 130.6/77.6 (SD, 21.0/11.1) mm Hg. During 3.5 million person-years of follow-up, there were 553 incident SAH cases (mean age at event, 61 [SD, 11] years), yielding an overall annual incidence rate of 12.9 per 100 000. Higher average levels of blood pressure were linearly and positively associated with higher risks of incident SAH: a 10 mm Hg higher systolic blood pressure and a 5 mm Hg higher diastolic blood pressure were associated with hazard ratios for SAH of 1.21 (95% CI, 1.13–1.29) and 1.20 (95% CI, 1.12–1.28), respectively. There was no evidence that the hazard ratios varied by age or sex or by levels of other vascular risk factors. Elevated blood pressure (systolic blood pressure, >120 mm Hg) accounted for 23% of all SAH cases.Conclusions—The incidence of SAH in China was comparable with estimates from Western populations. Higher levels of blood pressure were positively associated with higher risks of SAH, and elevated blood pressure accounted for about a quarter of all SAH cases.

2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines.

2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines.

Association of Antibodies to Citrullinated Protein Antigens with Blood Pressure in First-Degree Relatives of Rheumatoid Arthritis Patients: The Studies of the Etiology of Rheumatoid Arthritis

Background: Hypertension is more common in patients with rheumatoid arthritis (RA) than in the general population. It is unknown whether hypertension is due to RA-related medications or the disease itself. Therefore, we sought to investigate associations between RA-related autoantibodies, specifically antibodies to citrullinated protein antigens (ACPA) and systolic blood pressure (SBP) and diastolic blood pressure (DBP) in first-degree relatives of RA patients, who were free of RA and RA-related medications. We hypothesized that a greater number of detectable ACPA would be associated with high SBP and DBP, independent of other risk factors in these first-degree relatives. Methods: We evaluated associations between ACPA and SBP and DBP in a cross-sectional study of 72 first-degree relatives (defined as parent, child, or sibling) of RA patients. Fifteen ACPA were measured using a Bio-Plex bead-based assay; each was dichotomized as positive/negative based on pre-specified cut-points. Analysis of covariance was used to evaluate associations between ACPA positivity and SBP and DBP, adjusting for age, sex, race, body mass index (BMI), pack-years of smoking, high sensitivity C-reactive protein (hsCRP), and current use of anti-hypertensive medications. Results: Average age was 51 and 69% were women. Mean SBP was 119 ± 18 and DBP was 74 ± 9 mm Hg. Thirty-three (46%) first-degree relatives were positive for ≥1 ACPA; and were younger, had lower BMI, more pack-years of smoking, and higher hsCRP concentrations compared to ACPA negative first-degree relatives. For each additional positive ACPA, SBP was 0.98 ± 0.5 mm Hg (p = 0.05) higher, and DBP was 0.66 ± 0.3 mm Hg (p = 0.04) higher. Anti-cit-fibrinogen A (211–230) positive and anti-cit-filaggrin positive first-degree relatives had 11.5 and 13.9 mm Hg higher SBP (p = 0.02) respectively. Anti-cit-clusterin, cit-filaggrin, and cit-vimentin positive first-degree relatives had 7–8 mm Hg higher DBP (p = 0.03, 0.05, 0.05 respectively), compared to being negative for these individual ACPA. Consistent with associations between ACPA, SBP, and DBP, anti-cyclic citrullinated peptides (anti-CCP2) positive first-degree relatives had 16.4± (p = 0.03) higher SBP and 12.1± mm Hg (p = 0.01) higher DBP than anti-CCP2 negative first-degree relatives. Conclusion: In first-degree relatives without RA, ACPA positivity is associated with higher SBP and DBP. Subclinical autoimmune processes and ACPA may play a role in the vascular changes potentially leading to hypertension prior to RA onset.

Vitamin D, Hypertension, and Ischemic Stroke in 116 655 Individuals From the General Population: A Genetic Study.

Observational studies indicate that low concentrations of plasma 25-hydroxyvitamin D (25(OH)D) are associated with high blood pressure, hypertension, and ischemic stroke. However, whether these associations are causal remain unknown. A total of 116 655 white individuals of Danish descent from the general population were genotyped for genetic variants in DHCR7 and CYP2R1 affecting plasma 25(OH)D concentrations; 35 517 had plasma 25(OH)D measurements. Primary outcomes were blood pressure, hypertension, and ischemic stroke. Median follow-up for incident ischemic stroke was 9.3 years (range, 1 day-33.6 years). DHCR7/CYP2R1 allele score was as expected associated with lower 25(OH)D concentration (F=328 and R2=1.0%). A genetically determined 10 nmol/L lower 25(OH)D concentration was associated with a 0.68 (95% confidence interval [CI], 0.20-1.17) mm Hg higher systolic blood pressure and a 0.36 (95% CI, 0.08-0.63) mm Hg higher diastolic blood pressure with corresponding observational estimates of 0.58 (95% CI, 0.50-0.68) and 0.40 (95% CI, 0.35-0.45) mm Hg. The odds ratio for hypertension was 1.02 (95% CI, 0.97-1.08) for a genetically determined 10 nmol/L lower 25(OH)D with a corresponding observational odds ratio of 1.06 (95% CI, 1.05-1.07). The odds ratio for ischemic stroke was 0.98 (95% CI, 0.86-1.13) for a genetically determined 10 nmol/L decrease in 25(OH)D with a corresponding observational odds ratio of 1.03 (95% CI, 1.01-1.05). Genetic and observational low 25(OH)D concentrations were associated with higher blood pressure, as well as with hypertension consistent with causal relationships. Because observational but not genetic low 25(OH)D concentration was associated with ischemic stroke, and as the CIs overlapped, we can neither support nor exclude a causal relationship.

Hypertension in Pregnancy and Offspring Cardiovascular Risk in Young Adulthood: Prospective and Sibling Studies in the HUNT Study (Nord-Trøndelag Health Study) in Norway.

Women with hypertensive disorders in pregnancy are at increased lifetime risk for cardiovascular disease. We examined the offspring's cardiovascular risk profile in young adulthood and their siblings' cardiovascular risk profile. From the HUNT study (Nord-Trøndelag Health Study) in Norway, 15 778 participants (mean age: 29 years), including 210 sibling groups, were linked to information from the Medical Birth Registry of Norway. Blood pressure, anthropometry, serum lipids, and C-reactive protein were assessed. Seven hundred and six participants were born after exposure to maternal hypertension in pregnancy: 336 mothers had gestational hypertension, 343 had term preeclampsia, and 27 had preterm preeclampsia. Offspring whose mothers had hypertension in pregnancy had 2.7 (95% confidence interval, 1.8-3.5) mm Hg higher systolic blood pressure, 1.5 (0.9-2.1) mm Hg higher diastolic blood pressure, 0.66 (0.31-1.01) kg/m2 higher body mass index, and 1.49 (0.65-2.33) cm wider waist circumference, compared with offspring of normotensive pregnancies. Similar differences were observed for gestational hypertension and term preeclampsia. Term preeclampsia was also associated with higher concentrations of non-high-density lipoprotein cholesterol (0.14 mmol/L, 0.03-0.25) and triglycerides (0.13 mmol/L, 0.06-0.21). Siblings born after a normotensive pregnancy had nearly identical risk factor levels as siblings born after maternal hypertension. Offspring born after maternal hypertension in pregnancy have a more adverse cardiovascular risk profile in young adulthood than offspring of normotensive pregnancies. Their siblings, born after a normotensive pregnancy, have a similar risk profile, suggesting that shared genes or lifestyle may account for the association, rather than an intrauterine effect. All children of mothers who have experienced hypertension in pregnancy may be at increased lifetime risk of cardiovascular disease.

Adiposity and Blood Pressure in 110 000 Mexican Adults.

Previous studies have reached differing conclusions about the importance of general versus central markers of adiposity to blood pressure, leading to suggestions that population-specific adiposity thresholds may be needed. We examined the relevance of adiposity to blood pressure among 111 911 men and women who, when recruited into the Mexico City Prospective Study, were aged 35 to 89 years, had no chronic disease, and were not taking antihypertensives. Linear regression was used to estimate the effects on systolic and diastolic blood pressure of 2 markers of general adiposity (body mass index and height-adjusted weight) and 4 markers of central adiposity (waist circumference, hip circumference, waist:hip ratio, and waist:height ratio), adjusted for relevant confounders. Mean (SD) adiposity levels were: body mass index (28.7±4.5 kg/m2), height-adjusted weight (70.2±11.2 kg), waist circumference (93.3±10.6 cm), hip circumference (104.0±9.0 cm), waist:hip ratio (0.90±0.06), and waist:height ratio (0.60±0.07). Associations with blood pressure were linear with no threshold levels below which lower general or central adiposity was not associated with lower blood pressure. On average, each 1 SD higher measured adiposity marker was associated with a 3 mm Hg higher systolic blood pressure and 2 mm Hg higher diastolic blood pressure (SEs <0.1 mm Hg), but for the waist:hip ratio, associations were only approximately half as strong. General adiposity associations were independent of central adiposity, but central adiposity associations were substantially reduced by adjustment for general adiposity. Findings were similar for men and women. In Mexican adults, often overweight or obese, markers of general adiposity were stronger independent predictors of blood pressure than measured markers of central adiposity, with no threshold effects.

Abstract 113: Adherence to Antihypertensive Medication in the Jackson Heart Study (JHS)

Objectives: Adherence to antihypertensive medications is associated with increased blood pressure (BP) control and reduced cardiovascular disease and mortality. The Jackson Heart Study (JHS) is a longitudinal study of 5,301 adults recruited from the general population of the Jackson, Mississippi area designed to evaluate cardiovascular disease in African Americans. The goal of the current analysis was to develop a measure of adherence to antihypertensive medication from available JHS data to facilitate future research in this sample. Methods: JHS participants were asked to bring in all medications taken in the prior two weeks to the baseline interview and were asked if they had taken each medication in the past 24 hours. Non-adherence was defined as not taking all antihypertensive medications in the past 24 hours. The mean of two clinic BP measurements taken one minute apart with a Hawksley random zero sphygmomanometer was used for this analysis. The associations between non-adherence and systolic/diastolic BP and uncontrolled BP (systolic/diastolic BP ≥ 140/90 mm Hg) were examined using linear and Poisson regression. Analyses were adjusted for age, sex, smoking, years of education, income, cohabitation, diabetes, depressive symptoms, and weekly stress symptoms. Results: Of the 5,301 JHS participants, 2,415 who reported current use of antihypertensive medication and had valid clinic BP and 24-hour adherence data were included. The mean age was 54.9 (SD 12.9) years and 68.7% (n=1,660) were female. Overall, 25.3% of participants (n=612) were non-adherent to their antihypertensive medication. For adherent and non-adherent participants, the mean systolic BP was 130.0 (SD 17.2) and 135.2 (SD 19.8) mm Hg, respectively ( P &lt;0.001), and the mean diastolic BP was 78.7 (SD 10.6) and 79.4 (SD 10.9) mm Hg, respectively ( P =0.15). After multivariable adjustment and compared to their adherent counterparts, non-adherent participants had 4.6 (SD 0.8) mm Hg higher systolic BP ( P &lt;.001) and 1.1 (SD 0.4) mm Hg higher diastolic BP ( P =.01). The prevalence of uncontrolled BP was 31.3% among adherent participants and 41.7% among non-adherent participants. After multivariable adjustment, non-adherent participants were 1.28 times more likely to have uncontrolled BP (95% CI:1.14-1.43; P &lt;.001). Conclusions: These findings suggest that 24-hour adherence to antihypertensive medications is a viable measure of medication adherence in the JHS. Implications: Evaluatingmedication adherence in patients with hypertension is important butchallenging. Valid and reliable self-report measures are needed when objectivemeasures are unavailable. If validated in future research, 24-hour adherence to antihypertensive medications may provide a parsimonious way of assessing medication adherence in epidemiological studies.

The association of renal artery calcification with hypertension in community-living individuals: the multiethnic study of atherosclerosis

Hypertension (HTN) is a modifiable risk factor for cardiovascular disease (CVD). Renal artery calcium (RAC) may signal the presence of flow-limiting atherosclerotic disease that may contribute to changes in the kidney's regulation of blood pressure. We hypothesized that RAC is independently associated with HTN. We examined a multiethnic cohort of 1285 participants who underwent abdominal computed tomography scans in five US communities. After adjustment for age, gender, race/ethnicity, CVD risk factors, abdominal aortic calcium score, and kidney function, the presence of RAC was associated with a 50% higher odds of HTN (odds ratio: 1.54; 95% confidence interval 1.11–2.13). Similarly, the presence of RAC was associated with a 8.5 mm Hg higher systolic blood pressure, a 2.1 mm Hg higher diastolic blood pressure, and a 7.4-mm Hg higher pulse pressure. In conclusion, independent of CVD risk factors, abdominal aortic calcium, and kidney function, the presence of RAC is associated with HTN prevalence.

Endotoxin and β-1,3-d-Glucan in Concentrated Ambient Particles Induce Rapid Increase in Blood Pressure in Controlled Human Exposures.

Short-term exposure to particulate matter (PM) is associated with increased blood pressure (BP) in epidemiological studies. Understanding the impact of specific PM components on BP is essential in developing effective risk-reduction strategies. We investigated the association between endotoxin and β-1,3-d-Glucan-two major biological PM components-and BP. We also examined whether vascular endothelial growth factor, a vasodilatory inflammatory marker, modified these associations. We conducted a single-blind, randomized, crossover trial of controlled human exposure to concentrated ambient particles with 50 healthy adults. Particle-associated-endotoxin and β-1,3-d-Glucan were sampled using polycarbonate-membrane-filters. Supine resting systolic BP and diastolic BP were measured pre-, 0.5-hour post-, and 20-hour postexposure. Urine vascular endothelial growth factor concentration was determined using enzyme-linked immunosorbant assay and creatinine-corrected. Exposures to endotoxin and β-1,3-d-Glucan for 130 minutes were associated with increases in BPs: at 0.5-hour postexposure, every doubling in endotoxin concentration was associated with 1.73 mm Hg higher systolic BP (95% confidence interval, 0.28, 3.18; P=0.02) and 2.07 mm Hg higher diastolic BP (95% confidence interval, 0.74, 3.39; P=0.003); every doubling in β-1,3-d-Glucan concentration was associated with 0.80 mm Hg higher systolic BP (95% confidence interval, -0.07, 1.67; P=0.07) and 0.88 mm Hg higher diastolic BP (95% confidence interval, 0.09, 1.66; P=0.03). Vascular endothelial growth factor rose after concentrated ambient particle endotoxin exposure and attenuated the association between endotoxin and 0.5-hour postexposure diastolic BP (Pinteraction=0.02). In healthy adults, short-term endotoxin and β-1,3-d-Glucan exposures were associated with increased BP. Our findings suggest that the biological PM components contribute to PM-related cardiovascular outcomes, and postexposure vascular endothelial growth factor elevation might be an adaptive response that attenuates these effects.

Creatine kinase as predictor of blood pressure and hypertension. Is it all about body mass index? A follow-up study of 250 patients.

The correlation between creatine kinase (CK) and blood pressure (BP) was examined prospectively in 120 patients with persistent high CK and 130 individuals with normal CK. Hypertension was defined as systolic BP (SBP) ≥ 140 mm Hg or diastolic BP (DBP) ≥ 90 mm Hg or current use of antihypertensive medication. Baseline CK was weakly correlated with SBP (r = 0.11, P = .07) and DBP (r = 0.16, P = .01) at follow-up. Persons with persistent high CK had higher SBP (140.8 mm Hg vs 138.2 mm Hg) and DBP (83.2 mm Hg vs 81.0 mm Hg, P = .06) values and were more likely to have hypertension (66.7% vs 55.5%, P = .05) than individuals with normal CK. In age- and sex-adjusted analysis, a 1-unit change in logCK was associated with a 4.9-mm Hg higher SBP, a 3.3-mm Hg higher DBP, and a 2.2-higher odds for having hypertension at follow-up (P = .1, .07, and .06, respectively). When including body mass index (BMI) to the model, BMI was a strong and independent predictor for SBP, DBP, and hypertension at follow-up and the CK effect on blood pressure was substantially attenuated. This study showed that the CK effect on blood pressure is clearly modified by BMI.

Indoor Air Pollution and Blood Pressure in Adult Women Living in Rural China

Background: Almost half of the world’s population uses coal and biomass fuels for domestic energy. Limited evidence suggests that exposure to air pollutants from indoor biomass combustion may be associated with elevated blood pressure (BP).Objective: Our aim was to assess the relationship between air pollution exposure from indoor biomass combustion and BP in women in rural China.Methods: We measured 24-hr personal integrated gravimetric exposure to fine particles < 2.5 µm in aerodynamic diameter (PM2.5) and systolic BP (SBP) and diastolic BP (DBP) in the winter and summer among 280 women ≥ 25 years of age living in rural households using biomass fuels in Yunnan, China. We investigated the association between PM2.5 exposure and SBP and DBP using mixed-effects models with random intercepts to account for correlation among repeated measures.Results: Personal average 24-hr exposure to PM2.5 ranged from 22 to 634 µg/m3 in winter and from 9 to 492 µg/m3 in summer. A 1-log-µg/m3 increase in PM2.5 exposure was associated with 2.2 mm Hg higher SBP [95% confidence interval (CI), 0.8 to 3.7; p = 0.003] and 0.5 mm Hg higher DBP (95% CI, –0.4 to 1.3; p = 0.31) among all women; estimated effects varied by age group. Among women > 50 years of age, a 1-log-µg/m3 increase in PM2.5 exposure was associated with 4.1 mm Hg higher SBP (95% CI, 1.5 to 6.6; p = 0.002) and 1.8 mm Hg higher DBP (95% CI, 0.4 to 3.2; p = 0.01). PM2.5 exposure was positively associated with SBP among younger women, but the association was not statistically significant.Conclusion: PM2.5 exposure from biomass combustion may be a risk factor for elevated BP and hence for cardiovascular events. Our findings should be corroborated in longitudinal studies.

Blood Pressure Responses to Psychosocial Stress in Young Adults With Very Low Birth Weight: Helsinki Study of Very Low Birth Weight Adults

Young adults born prematurely with very low birth weight (</=1500 g) have higher blood pressure than do their counterparts born at term. We tested whether they also have higher blood pressure reactivity to psychosocial stress, which may be a more-specific predictor of long-term cardiovascular morbidity. Systolic and diastolic blood pressure levels for 44 very low birth weight adults (mean age: 23.1 years; SD: 2.3 years) and 37 control subjects (mean age: 23.6 years; SD: 2.0 years) were measured through noninvasive finger photoplethysmography during a standardized psychosocial stress challenge (Trier Social Stress Test). Baseline and task values and their difference (ie, reactivity) served as outcome variables. In comparison with the control group, the very low birth weight group had 7.9 mm Hg higher diastolic blood pressure during the task and 4.8 mm Hg higher diastolic reactivity, with adjustment for gender and age, height, and BMI at testing. A similar trend was seen for systolic blood pressure during the baseline period and the task, but the group differences were not statistically significant. Our results indicate that very low birth weight is associated with elevated blood pressure reactivity to psychosocial stress and, therefore, may increase the risk of cardiovascular morbidity.

Association Between a Dopamine-4 Receptor Polymorphism and Blood Pressure

Dopamine receptor genes are candidates for hypertension susceptibility. Locally released dopamine increases renal sodium excretion, and defective renal dopamine receptor signaling has been shown to play a role in hypertension. Dopamine-4 receptors are expressed in juxtaglomerular and cortical collecting cells, where dopamine activation could alter sodium and water metabolism and affect blood pressure (BP). The dopamine-4 receptor (DRD4) gene has a 16 amino acid (48 base pairs [bp]) repeat polymorphism located in exon 3 where a G-protein binding area is encoded. The long allele (defined as at least one 7 to 10 repeat) has been associated with the personality trait Novelty Seeking and with substance abuse, but associations between dopamine-4 receptor polymorphisms and BP have not been reported. We genotyped 479 female and 385 male subjects of white ethnicity at the DRD4 repeat polymorphism site and classified each subject as having either the long or short genotype. We found associations between the DRD4 long allele and increased systolic BP (P = .031), diastolic BP (P = .034), and a history of regular alcohol use (P = .008). Furthermore, for systolic BP (P = .009) and pulse pressure (P = .002), we found evidence for an interaction between dopamine-4 receptor alleles and age, indicating that the effects of dopamine-4 receptor variants on BP increase with age. In this white population, the long variant of the DRD4 gene is associated with a 3-mm Hg higher systolic and 2-mm Hg higher diastolic BP.

Poster presentations

Poster presentations