Hypertension Odds Ratio Research Articles

The efficacy of peripartum transthoracic echocardiography in women with preeclampsia.

To examine the features and efficacy of transthoracic echocardiography (TTE) in preeclampsia. We retrospectively reviewed the medical records of 145 pregnant women with preeclampsia, who underwent TTE at Seoul St. Mary's Hospital between July 2006 and June 2016. We analyzed echocardiographic features in preeclampsia and the relationship between the severity of preeclampsia and TTE findings. Additionally, we examined the predictive echocardiographic factors of persistent hypertension and calculated the adjusted odds ratio (OR) and 95% confidence interval (CI) for multiple regression models by considering systolic and diastolic blood pressure and pre-pregnancy body mass index (BMI). Hemodynamic findings assessed by TTE in women with preeclampsia included systolic and diastolic dysfunction, increased left ventricular mass, and enlarged left atrium. Diastolic dysfunction and left ventricular hypertrophy (LVH) were more common in preeclampsia with severe features (39.84% vs. 32.05%, p=0.010, and 21.79% vs. 8.96%, p=0.041, respectively). In the patients with systolic dysfunction, the adjusted OR for persistent hypertension was 17.41 (95% CI=2.83-107.20). The ORs for grade 1 and grade 2 diastolic dysfunction were 12.58 and 32.84, respectively (95% CI, 2.99-52.92 and 3.61-298.58, respectively). When LVH assessed by TTE was considered with diastolic dysfunction, the risk for persistent hypertension increased (OR 19.28; 95% CI-4.36-85.20). TTE not only can reveal the severity of preeclampsia, but also can be a useful tool for the follow-up of persistent hypertension.

Gender difference in the association between aminotransferase levels and hypertension in a Chinese elderly population.

Few epidemiological studies have examined the association between serum aminotransferase levels and hypertension, and have yielded inconsistent results.A cross-sectional study was performed in a Chinese rural elderly population. A total of 2174 participants with normal range of aminotransferase levels and without excessive drinking were included in the present study. Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels were measured on fasting morning serum samples using the Kinetic method. Hypertension was defined as systolic blood pressure ≥140 mm Hg and/or diastolic blood pressure ≥90 mm Hg and/or receiving treatment for hypertension. Multiple logistic regression was used to estimate the association between gender-specific aminotransferase levels and hypertension.Increased serum ALT but not AST level was positively associated with hypertension. After adjusting for potential confounding variables, the association of hypertension and ALT level was only significant in women: for each 1 IU/L elevation of ALT level, the adjusted odds ratio (OR), and corresponding 95% confidence interval (CI) of hypertension was 1.04 (1.01, 1.07); the ORs of hypertension increased across tertiles of ALT, and the ORs (95% CIs) were 1.00, 1.17 (0.85, 1.60), and 1.63 (1.15, 2.31 (P value for trend = .021). Furthermore, the association was only significant in central obesity women or nondrinking women.ALT level was significantly associated with hypertension only in women in a Chinese rural elderly population. Further studies are warranted to explore the possible gender-related association and to extend them to different populations.

Abstract P182: Risk for Hypertension Extends Across Generations in the Community: a Multi-generational Cohort Study

Background: Hypertension is a major risk factor for cardiovascular disease, and parental hypertension is known to predict high blood pressure (BP) in children. However, the extent to which risk for hypertension is conferred across multiple generations, notwithstanding the impact of environmental factors, is unclear. Our objective was therefore to evaluate the degree to which risk for hypertension extends across multiple generations. Methods: We studied three generations of Framingham Heart Study participants with objectively ascertained, uniform BP measurements performed at serial examinations spanning 5 decades: First Generation cohort (1948-2005), Second Generation cohort (1971-2008), and Third Generation cohort (2002-2005). We examined the simultaneous associations of early-onset hypertension (prior to age 55 years) in parents or grandparents with normotension (BP <120/80; reference), prehypertension (BP 120-139/80-89 mmHg), and hypertension (BP ≥140/90 mmHg, or use of antihypertensive medication) in the Third Generation cohort. We estimated odds ratios (OR) and 95% confidence intervals (CI) for prehypertension and hypertension per additional parent or grandparent with early-onset hypertension using multinomial logistic regression adjusting for standard environmental factors. Results: Our final dataset for analyses included BP measurements collected from 2280 First Generation participants (i.e., grandparents), 3122 Second Generation participants (i.e., parents), and 3608 Third Generation participants (mean age 39 years, 53% women). In Third Generation participants, risk for elevated BP was conferred simultaneously by both parental (OR for prehypertension 1.72 [CI, 1.42-2.08]; OR for hypertension 2.22 [CI, 1.72-2.86]) and grandparental (OR for prehypertension 1.24 [CI, 1.05-1.46]; OR for hypertension 1.38 [CI, 1.11-1.73]) early-onset hypertension. In a secondary analysis with a subset of 3319 Third Generation participants with all covariates available, results were also similar in models additionally adjusting for physical activity and daily dietary intake of sodium. Conclusions: A predisposition for developing hypertension is conferred from grandparents to grandchildren, even after adjusting for parental history of hypertension and lifestyle factors. Additional studies are warranted to elucidate how identifying transgenerational risk for early-onset hypertension can improve the care of individuals at risk. Our results also suggest that when assessing an individual’s risk for hypertension, more accurate risk stratification could be achieved by considering both parental and grandparental history of hypertension.

Maternal-foetal outcomes in pregnant women with glomerulonephritides. Are all glomerulonephritides alike in pregnancy?

In spite of the interest for chronic renal diseases (CKD) in pregnancy data on specific diseases is fragmentary; while recent studies analysed the most common glomerulonephritides (GN), none was addressed at GN as a group. The aim of our study was to analyse the main pregnancy-related outcomes in GN patients in a large multicentre cohort.Patients with a diagnosis of GN were selected from the TOCOS cohort (TOCOS: TOrino Cagliari Observational Study): out of 714 singleton deliveries GN was the diagnosis in 126; lupus GN and IgA nephropathy accounted for 37 and 33 cases; 1418 low-risk singleton deliveries followed-up in the same Centers served as controls (non diabetic, non nephropathic, non obese women, without any other known chronic illness; pregnancies after ovodonation or in vitro fertilisation were excluded, if declared). Multiple regression analysis considered: pre-term (<37 weeks), early preterm delivery (<34 weeks), small for gestational age baby (SGA) and the development of hypertension, proteinuria and preeclampsia (PE) limiting this outcome to the cases without hypertension and proteinuria at baseline.The population consisted mainly of early CKD stages (stage 1: 61.9%; hypertension 27.8%; proteinuria <0.5 g/day: 55.7%). Age and parity were not different in cases and low-risk controls (age: 31.20 ± 5.5 vs 31.24 ± 5.5 years, primiparous 56.3% vs 57.5%). The incidence of preterm and early preterm delivery was higher in GN versus controls and increased commensurately with CKD stage. In the multivariate analysis, CKD stage was significantly associated with early preterm delivery and development-doubling of proteinuria (odds ratio (OR) around 3 in both), while the OR for baseline hypertension did not reach statistical significance. While the risk pattern did not differ in lupus and non-lupus GN, a significantly higher OR of PE was observed in IgA nephropathy (OR 28.09 versus other GN); risk for pre-term delivery was not increased (OR 0.27 (0.06–1.11)), thereby suggesting “late-maternal” PE.In conclusion, within the limits of heterogeneity and small numbers, our analysis identifies proteinuria as the most reliable risk marker for adverse pregnancy outcomes and suggests a specific association between IgA nephropathy and late-maternal PE.

Higher skeletal muscle mass may protect against ischemic stroke in community-dwelling adults without stroke and dementia: The PRESENT project

BackgroundIt is well known that a low skeletal muscle mass (SMM) is associated with stroke. However, it is unknown whether increasing muscle mass can prevent stroke.MethodsThis community-based cross-sectional study was supported by the regional government. SMM measurements and brain computed tomography was performed in 722 stroke-free and dementia-free subjects (aged 50–75 years). Subjects were divided into quartiles (Q) by SMM, checked using the bioelectrical impedance analysis method (InBody 770, InBody, Seoul, Korea). Odds ratios (ORs) of brain white matter changes/silent infarction (WMC/SI) were calculated. The subjects were then divided into two groups by sex and evaluated.ResultsIn the analysis of the four groups, the unadjusted ORs of Q2–Q4 were 0.616 (95% confidence interval [CI], 0.372–1.022; P = 0.061), 0.290 (CI, 0.159–0.530; P < 0.001), and 0.209 (CI, 0.108–0.403; P < 0.001) for the risk of WMC/SI. Adjusted ORs for age, hypertension, diabetes mellitus, education, hypercholesterolemia, and smoking were 0.994 (CI, 0.513–1.740; P = 0.085), 0.669 (CI, 0.329–1.362; P = 0.268), and 0.464 (CI, 0.219–0.984; P = 0.045). In the two–group (dichotomized) analysis, the unadjusted OR for the higher muscle mass groups (Q3 + Q4) was 0.313 (CI, 0.200–0.491; P < 0.001). The adjusted OR was 0.577 (CI, 0.340–0.979; P = 0.042). Considering sex, the adjusted OR were 0.351 (CI, 0.141–0.869; P = 0.024) in men and 0.771 (CI, 0.391–1.519; P = 0.452) in women.ConclusionsOur findings suggest that increased SMM may protect against WMC/SI, especially in men.

Exploring Inpatient Hospitalizations and Morbidity in Patients With Adrenal Insufficiency.

Patients with adrenal insufficiency (AI) (primary AI [PAI], secondary AI due to a pituitary disorder [PIT] and congenital adrenal hyperplasia [CAH]) have reduced life expectancy; however, the underlying explanation remains unknown. To evaluate characteristics, comorbidities, and hospitalizations in AI patients. Retrospective observational. Using a United States-based national payer database comprising of more than 108 million members, strict inclusion criteria including diagnostic codes and steroid prescription records were used to identify 10 383 adults with AI; 1014 with PAI, 8818 with PIT, and 551 with CAH. Patients were matched 1:1 to controls, based on age (±5 y), gender, insurance, and region and followed for more than 12 months. None. Demographic variables, comorbidities (diabetes mellitus [DM] types 1 and 2, depression, anxiety, hyperlipidemia, hypertension) and hospitalization incidence. Compared with controls, patients with AI had higher odds of DM, hypertension, hyperlipidaemia, depression, and anxiety, ranging from an odds ratio (OR) of 1.51 for hyperlipidaemia in PAI to 3.85 for DM in CAH. Odds of having DM (OR, 3.85; 95% confidence interval, 2.52-5.90) or anxiety (OR, 2.99; 95% confidence interval, 2.02-4.42) compared with controls were highest in CAH, whereas depression was highest in PAI and PIT (OR, 2.40 and 2.55). ORs of hyperlipidaemia and hypertension (OR, 1.98 and 2.24) were highest in the PIT cohort. Inpatient admissions were more frequent in PAI (4.64:1; P < .0001) and PIT (4.00:1; P < .0001) than controls; infection was the most common cause for admission. Patients with AI carry a significant metabolic and psychiatric burden, with higher risk of comorbidities and hospital admissions than matched controls.

STK39 and WNK1 Are Potential Hypertension Susceptibility Genes in the BELHYPGEN Cohort.

The serine/threonine kinase With-No-Lysine (K) Kinase 1 (WNK1) activates the thiazide-sensitive Na+/Cl− cotransporter through phosphorylation of STE20/SPS1-related proline/alanine-rich kinase, another serine/threonine kinase encoded by STK39. The aim of this study was to look for association between WNK1 and STK39 gene variants, and blood pressure (BP) and hypertension.Seven hundred seventy-nine Caucasian hypertensive patients (HYP) recruited in 6 academic centers from Belgium, and 906 normotensive (NT) controls were genotyped for 5 single nucleotide polymorphisms—rs3754777, rs6749447, rs35929607 (STK39), rs1468326, and rs765250 (WNK1)—using the Snapshot method.The rare TT genotype at the rs3754777 locus (STK39) was overrepresented in HYP versus NT (7.3% vs 3.0%, P = 0.0002). In the whole study population, the multivariable-adjusted odds ratio (OR) for having hypertension associated with the TT genotype was 5.9 (95% confidence interval: 2.2–15.6), and systolic BP was 10 mm Hg higher in TT compared with wild-type subjects (140.1 vs 130.4 mm Hg, P = 0.002). Similarly, the AA genotype at the rs1468326 locus (WNK1) was twice as frequent in HYP versus NT (5.5% vs 2.3%, P < 0.0001), and associated with an increased adjusted OR of hypertension (4.1; 1.5–11.7) and a higher systolic BP (139.8 vs 130.1 mm Hg, P = 0.003). In the whole cohort, a dose-dependent increase in systolic BP was observed according to the number of at-risk genotypes (0: 129.8 mm Hg; 1: 133.0 mm Hg; 2: 149.3 mm Hg, P = 0.02).Single nucleotide polymorphisms rs3754777 (STK39) and rs1468326 (WNK1) were associated with hypertension and BP in our multicenter Belgian case-control study, which supports the role of STK39 and WNK1 as potential hypertension susceptibility genes. Replication in different clinical settings and study of other candidate loci belonging to the same molecular pathway is warranted.

Change in Body Mass Index and Its Impact on Incidence of Hypertension in 18-65-Year-Old Chinese Adults.

Aims: This study assessed change in body mass index (BMI) and its impact on the incidence of hypertension in 18- to 65-year-old Chinese adults. Methods: Two waves of data were collected in 2006 and 2011 by the China Health and Nutrition Survey (CHNS) with samples drawn from nine provinces in China. The logistic regression model was used to examine the association between change in BMI and the incidence of hypertension, and odds ratio (OR) and 95% confident interval (95% CI) were calculated. Results: The risk of incident hypertension increased as the quartile of the BMI difference value (D-value) increased in men (OR and 95% CI for the highest quartile vs. the lowest quartile: 2.303, 1.560–3.401, respectively, p for trend < 0.001) and women (OR and 95% CI for the highest quartile vs. the lowest quartile: 1.745, 1.199–2.540, respectively, p for trend = 0.004). Compared with non-overweight subjects in 2011, the ORs of incident hypertension were all significantly higher for overweight subjects, regardless of their overweight status at baseline (p < 0.05). Conclusions: In conclusion, the results from this study provide unequivocal evidence that prevention of weight gain is likely to have a great impact on the incidence of hypertension in Chinese adults.

Kidney Function Decline and Apparent Treatment-Resistant Hypertension in the Elderly.

BackgroundCross-sectional studies show a strong association between chronic kidney disease and apparent treatment-resistant hypertension, but the longitudinal association of the rate of kidney function decline with the risk of resistant hypertension is unknown.MethodsThe population-based Three-City included 8,695 participants older than 65 years, 4265 of them treated for hypertension. We estimated the odds ratios (OR) of new-onset apparent treatment-resistant hypertension, defined as blood pressure ≥ 140/90 mmHg despite use of 3 antihypertensive drug classes or ≥ 4 classes regardless of blood pressure, associated with the mean estimated glomerular filtration rate (eGFR) level and its rate of decline over 4 years, compared with both controlled hypertension and uncontrolled nonresistant hypertension with ≤ 2 drugs. GFR was estimated with three different equations.ResultsBaseline prevalence of apparent treatment-resistant hypertension and of controlled and uncontrolled nonresistant hypertension, were 6.5%, 62.3% and 31.2%, respectively. During follow-up, 162 participants developed apparent treatment-resistant hypertension. Mean eGFR decline with the MDRD equation was 1.5±2.9 mL/min/1.73 m² per year: 27.7% of the participants had an eGFR ≥3 and 10.1% ≥ 5 mL/min/1.73 m² per year. After adjusting for age, sex, obesity, diabetes, and cardiovascular history, the ORs for new-onset apparent treatment-resistant hypertension associated with a mean eGFR level, per 15 mL/min/1.73m² drop, were 1.23 [95% confidence interval 0.91–1.64] compared to controlled hypertension and 1.10 [0.83–1.45] compared to uncontrolled nonresistant hypertension; ORs associated with a decline rate ≥ 3 mL/min/1.73m² per year were 1.89 [1.09–3.29] and 1.99 [1.19–3.35], respectively. Similar results were obtained when we estimated GFR with the CKDEPI and the BIS1 equations. ORs tended to be higher for an eGFR decline rate ≥ 5 mL/min/1.73m² per year.ConclusionThe speed of kidney function decline is associated more strongly than kidney function itself with the risk of apparent treatment-resistant hypertension in the elderly.

Gender differences in the association of hypertension with gamma–glutamyltransferase and alanine aminotransferase levels in Chinese adults in Qingdao, China

The aim of the study was to study the associations of hypertension with gamma–glutamyltransferase (GGT) and alanine aminotransferase (ALT) levels. Data of 3575 men and 5504 women were analyzed. Multivariate logistic regression analysis was performed to estimate the odds ratio (OR) for hypertension with GGT and ALT. Compared with the lowest quartile, the multivariate adjusted ORs for hypertension were 0.97 (0.79, 1.19) in men and 0.88 (0.74, 1.04) in women for ALT and 2.29 (1.68, 3.14) and 1.52 (1.27, 1.83) for GGT in the highest quartile group. The ORs for hypertension in the low waist circumference category were 2.61 (1.56, 4.36) in men and 1.41 (0.94, 2.12) in women and in the high waist circumference category 4.01 (2.21, 7.29) and 2.26 (1.54, 3.32) for GGT. The elevated GGT, but not ALT, was associated with the presence of the hypertension in men and women. The association is stronger in obese men and women than in their lean counterparts.

Relationship between Duration of Sleep and Hypertension in Adults: A Meta-Analysis.

Epidemiologic studies have shown that chronic short sleep may be associated with the development of hypertension; however, the results are controversial. This meta-analysis was conducted to determine whether the duration of sleep is associated with hypertension. Reference databases (PubMed, EmBase, the Cochrane Library, Chinese Biological Medicine database) were searched for studies related to sleep duration and hypertension. Sleep duration categories (≤ 5 h, 6 h, 7 h, 8 h, ≥ 9 h) and prevalence or incidence of hypertension in each sleep category were extracted. A general analysis and subgroup analyses stratified by gender, age, study design, and different definitions of sleep duration were conducted to evaluate the relationship between sleep duration and hypertension. Thirteen articles out of a total of 1,628 articles involving 347,759 participants met the inclusion criteria. A U-shaped change in pooled odds ratios (ORs) for hypertension due to the change of sleep duration was observed. The unadjusted OR for hypertension of individuals who slept ≤ 5 h vs. 7 h was 1.61, 95% CI = 1.28-2.02; those who slept ≥ 9 h vs. 7 h was 1.29, 95% CI = 0.97-1.71. The pooled ORs were still significant after adjusted by age and gender. Women deprived of sleep (sleep time ≤ 5 h vs. 7 h, OR = 1.68, 95% CI = 1.39-2.03) had a higher risk of hypertension than men (OR = 1.30, 95% CI = 0.93-1.83). Excessively longer and shorter periods of sleep may both be risk factors for high blood pressure; these associations are stronger in women than men.

Ovarian infertility is associated with cardiovascular disease risk factors in later life: A Japanese cross-sectional study

ObjectivesThis study aimed to clarify the association between ovarian infertility and cardiovascular disease risk factors in later life in Japanese women. Study designThe Japan Nurses’ Health Study (JNHS) is a cohort study of Japanese women’s health. Data from the JNHS baseline survey (n=49,927) between 2001 and 2007 were used in a cross-sectional, retrospective analysis. A total of 44,601 women were classified into three categories: ovarian infertility group (n=1167), other infertility group (n=4619), and no infertility group (n=38,815). Logistic regression analysis compared with the no infertility group was performed. Main outcome measuresAge-adjusted odds ratios (ORs) and multivariable-adjusted ORs for hypertension, hypercholesterolemia, and diabetes mellitus (DM). ResultsThe prevalence of obese women (BMI ≥25) who were <45 years old in the ovarian infertility group was significantly higher compared with that in the other groups. Women in the ovarian infertility group were at risk for hypertension at ≥45 years old (age-adjusted OR: 1.65%, confidence interval [CI]: 1.23–2.21); for hypercholesterolemia at <45 and ≥45 years old (age-adjusted OR: 1.42, 95% CI: 1.06–1.88 at <45 years; age-adjusted OR: 1.39, 95% CI: 1.06–1.81 at ≥45 years); and for DM at <45 years old (age-adjusted OR: 2.92, 95% CI: 1.57–5.46). ConclusionsJapanese women with ovarian infertility (most women have polycystic ovary syndrome) are at high risk of hypertension from 45 years of age, hypercholesterolemia at all ages, and diabetes mellitus (DM) before 45 years old.

Incidence and risk of hypertension with bevacizumab in non-small-cell lung cancer patients: a meta-analysis of randomized controlled trials.

AimA study was conducted to determine the overall risk and incidence of hypertension with bevacizumab in non-small-cell lung cancer (NSCLC) patients.Materials and methodsElectronic databases such as the Embase, PubMed, and Cochrane Library were searched for related trials. Statistical analyses were conducted to calculate the overall incidence rates, odds ratios (ORs), and 95% confidence intervals (CIs) by using either random-effect or fixed-effect models depending on the heterogeneity.ResultsA total of 3,155 subjects from nine studies were included. The overall incidences of all-grade and high-grade hypertension in NSCLC patients were 19.55% (95% CI 10.17%–34.3%) and 6.95% (95% CI 5.81%–8.30%). Bevacizumab use was associated with a significantly increased risk in all-grade hypertension (OR 8.07, 95% CI 3.87–16.85; P=0.0002) and high-grade hypertension (OR 5.93, 95% CI 3.41–10.32; P<0.0001). No evidence of publication bias was determined for the ORs of hypertension in our meta-analysis.ConclusionBevacizumab is associated with a significantly increased risk of hypertension development in NSCLC patients. Early monitoring and effective management of hypertension might be important steps for the safe use of this drug.

Restless Legs Syndrome and Hypertension in Mexican Women.

RLS is a common chronic disorder characterized by an irresistible need to move the lower limbs that affects sleep. Poor sleep has been associated with increased blood pressure (BP). Thus, we evaluated the cross-sectional relationship between RLS and hypertension (HTN) in a large cohort study in Mexico. In 2011, 54,925 female participants from the Mexican Teachers' Cohort responded to a four-item questionnaire based on the International Restless Legs Syndrome Study Group's minimal diagnostic criteria. Women also reported diagnosis and treatment of HTN. We used multivariable logistic regression models to estimate prevalence odds ratios (ORs) for HTN, adjusting for lifestyle and dietary factors. We also estimated adjusted prevalence ORs for HTN by frequency of RLS symptoms. We identified 9,230 cases (17%) of RLS, and the prevalence of HTN was 13.1% among women with RLS and 9.4% among those without RLS. The multivariable-adjusted prevalence OR for HTN comparing women with to those without RLS was 1.18 (95% confidence interval [CI]: 1.10-1.26). Compared to those without RLS, the prevalence OR of HTN in women reporting a symptom frequency of once a month or less was 1.14 (95% CI: 1.00-1.30); among those with symptoms two to four times a month, the OR was 1.17 (95% CI: 1.05-1.30); and for those with symptoms at least two times a week, the OR was 1.22 (95% CI: 1.10-1.35). We observed an association between RLS and HTN. Future studies should evaluate the impact of treating RLS on BP.

Association of Serum 25-Hydroxyvitamin D and Parathyroid Hormone With Hypertension in Middle-Aged and Older Korean Adults.

Previous studies have suggested that serum 25-hydroxyvitamin D [25(OH)D] and parathyroid hormone (PTH) levels are associated with hypertension. However, the associations have yet to be studied in Koreans. This study explored the relationship among serum 25(OH)D, PTH concentrations, and the presence of hypertension in middle-aged and older Korean adults using the most recent nationally representative survey data. A population-based, cross-sectional study was conducted with data collected from 5,260 Korean adults (aged ≥50 years) who participated in the 2010 and 2011 Korean National Health and Nutrition Examination Surveys. Hypertension was defined as a systolic blood pressure ≥140 mm Hg, diastolic blood pressure ≥90 mm Hg, or current use of antihypertensive medication. The prevalence of hypertension significantly increased according to the quartiles of serum PTH levels (P < 0.0001), but not of serum 25(OH)D levels. In multivariable logistic analysis, the adjusted odds ratios (ORs) for hypertension were significantly higher among participants in the highest quartile than among those in the lowest quartile of serum PTH level, after adjusting for potential confounders (OR = 1.26, 95% confidence interval: 1.02-1.56, P = 0.03). The adjusted ORs for hypertension tended to decrease across the quartiles of serum 25(OH)D level, but the associations were not significant. Serum 25(OH)D was not associated with the presence of hypertension, whereas serum PTH was positively associated, suggesting that serum PTH may be an independent risk factor for hypertension in middle-aged and older Korean adults.

Association Between High Serum Soluble Corin and Hypertension: A Cross-Sectional Study in a General Population of China.

Corin has been suggested to be associated with hypertension by cell- and animal-based studies. However, the association still lacks population-based evidence which critically promotes translation from basic research to clinical and preventive practice. Here, we aimed to explore the association in a general population of China. From January to May 2010, we conducted a cross-sectional study in 2,498 participants aged above 30 years, residing in Gusu district of Suzhou. Serum soluble corin and blood pressure were measured. Hypertensive participants had a higher level of serum corin than nonhypertensive participants (median (interquartile range): 1,836.83 (1,497.85-2,327.87) pg/ml vs. 1,579.14 (1,322.18-1,956.82) pg/ml, P < 0.001). Higher serum corin was positively associated with prevalent hypertension (odds ratio (OR) = 2.01, P < 0.001). In the multiple analysis, participants in the third (OR = 1.43, P = 0.007) and fourth (OR = 1.96, P < 0.001) quartiles had significantly increased odds of hypertension compared to those in the lowest quartile of serum corin. ORs of hypertension positively and significantly increased with serum corin levels (P for trend <0.001). Further subgroup analysis showed that ORs of hypertension associated with high corin (over the median level of serum corin: 1,689.20 pg/ml) were still significant in subgroups by age, body mass index, total cholesterol, low-density lipoprotein cholesterol, and fasting plasma glucose (all P < 0.05). Our study showed that hypertensive participants had an increased serum corin level compared to those without hypertension. This finding suggests that corin may play a role in the pathology of hypertension.

Is there an association between aircraft noise exposure and the incidence of hypertension? A meta-analysis of 16784 participants.

To determine if aircraft noise exposure causes an increased incidence of hypertension among residents near airports. We conducted a meta-analysis of observational studies to evaluate the association between aircraft noise exposure and the incidence of hypertension. PubMed, Embase, Web of Science, the Cochrane Library, and the Chinese Biomedical Literature Database were searched without any restrictions. Odds ratios (ORs) with 95% confidence intervals (CIs) were extracted. The pooled ORs were calculated using both the fixed effects model and random effects model. All analyses were performed using STATA version 12.0 software (Stata Corporation, College Station, TX, USA). We examined five studies, comprising a total of 16,784 residents. The overall OR for hypertension in residents with aircraft noise exposure was 1.63 (95% CI, 1.14-2.33), and one of our included studies showed that there was no evidence that aircraft noise is a risk factor for hypertension in women. According to our subgroup analysis, the summary OR for the incidence was 1.31 (95% CI, 0.85-2.02) with I2 of 80.7% in women and 1.36 (95% CI, 1.15-1.60) with moderate heterogeneity in men. The pooled OR for the incidence of hypertension in residents aged over 55 years and under 55 years was 1.66 (95% CI, 1.21-2.27) with no heterogeneity and 1.78 (95% CI, 1.33-2.39) with I2 of 29.4%, respectively. The present meta-analysis suggests that aircraft noise could contribute to the prevalence of hypertension, but the evidence for a relationship between aircraft noise exposure and hypertension is still inconclusive because of limitations in study populations, exposure characterization, and adjustment for important confounders.

Relationship between Blood Mercury Level and Risk of Cardiovascular Diseases: Results from the Fourth Korea National Health and Nutrition Examination Survey (KNHANES IV) 2008-2009.

Limited epidemiologic data is available regarding the cardiovascular effects of mercury exposure. The purpose of this study was to determine the relationship between mercury exposure from fish consumption and cardiovascular disease in a nationally representative sample of Korean adults using the Fourth Korea National Health and Nutrition Examination Survey (KNHANES IV 2008~2009). Survey logistic regression models accounting for the complex sampling were used to estimate the odds ratios (OR) adjusted for fish consumption frequency, age, education, individual annual income, household annual income, body mass index (BMI), waist circumference (WC), alcohol consumption status, and smoking status. The mean blood mercury level in the population was 5.44 μg/L. Trends toward increased blood mercury levels were seen for increased education level (P=0.0011), BMI (P<0.0001), WC (P<0.0001), and fish (i.e., anchovy) consumption frequency (P=0.0007). The unadjusted OR for hypertension in the highest blood mercury quartile was 1.450 [95% confidential interval (CI): 1.106~1.901] times higher than that of the lowest quartile. The fish consumption-adjusted OR for hypertension in the highest blood mercury quartile was 1.550 (95% CI: 1.131~2.123) times higher than that of the lowest quartile, and the OR for myocardial infarction or angina in the highest blood mercury quartile was 3.334 (95% CI: 1.338~8.308) times higher than that of the lowest quartile. No associations were observed between blood mercury levels and stroke. These findings suggest that mercury in the blood may be associated with an increased risk of hypertension and myocardial infarction or angina in the general Korean population.

Impact of consanguinity on cardio-metabolic health and other diseases: findings from an Afro-Indian tribal community.

Numerous anthropological reports have indicated consanguineous marriage in populous Asian countries, but the overall impact of first cousin marriage on survival and health of specific communities has rarely been reported. The aim of the study was to estimate risks for various complex diseases in the progeny of consanguineous parents. A cross-sectional study was conducted among 222 women among Siddis, a particularly vulnerable tribal group in the state of Gujarat, India, who are Sunni Muslims by faith. The Siddis are not part of the original Negrito element of India. They are descendants of Africans from Northeast and East Africa who were brought to India as slaves, soldiers, or servants. The degree of consanguinity between each female and her spouse and the degree of consanguinity between their parents and proband's grandparents were recorded with the help of pedigrees. The results showed that the rate of consanguinity in the present generation was 49% (N = 109), higher than preceding generations. A significant association was observed between women's age, educational level, occupational status, consanguineous parents, and consanguinity. Socioeconomic status and consanguinity showed U-shaped associations. Nearly three times odds for cardio-metabolic risks (2.65 odds ratio (OR) for heart diseases, 2.44 OR for diabetes mellitus, and 2.62 OR for hypertension) have been contracted in the progeny of consanguineous marriage in the parental generation. The risk of cardio-metabolic diseases is higher in offspring of consanguineous couples, and there is a significant increase in the prevalence of common adult diseases.

Metabolic changes in immigrants from Africa to a Western country: time-lag effects of 20 years since immigration.

An increase in the prevalence of type 2 diabetes mellitus occurs in immigrants from developing regions to Western countries. However, the dynamics of these transitions in relation to the duration of residence in the new environment are not clearly defined. Data concerning cardiovascular risk factors were retrospectively extracted from medical charts of 736 Ethiopian immigrants and 575 randomly-chosen, age and sex matched non-Ethiopian subjects ("reference group"). Ethiopian immigrants were designated "established" (≥ 20 years of residence), "intermediate" (10-15 years of residence), or "recent" (<10 years of residence). Compared to non-Ethiopians, the age- and sex-adjusted odds ratio (OR) for diabetes was 1.00 (95%CI: 0.66-1.49) for established, 0.55 (95%CI: 0.29-1.03) for intermediate, and 0.15 (95%CI: 0.04-0.50) for recent immigrants (P < 0.001). The corresponding OR for hypertension was 0.94 (95%CI: 0.68-1.31), 0.42 (95%CI: 0.26-0.69), and 0.14 (95%CI: 0.06-0.30) for the established, intermediate, and recent immigrants respectively (P < 0.001). In contrast to the gradual increase in prevalence of diabetes and hypertension, the Ethiopian immigrants maintained their lower body mass index (BMI) (28.7 ± 5 vs 25.5 ± 5 kg/m(2) respectively, P < 0.001) and serum low-density-lipoprotein cholesterol (129 ± 36 vs 118 ± 34 mg/dL, P < 0.001) compared to the non-Ethiopians even after 20 years of residence in Israel. The prevalence of diabetes and hypertension among the immigrants increased to about half that of the local population within 15 years and became equal to that of the local population after a time-lag of 20 years. These metabolic derangements occurred despite maintaining desirable BMI levels, reinforcing the need for re-defining optimal BMI ranges in relation to the ethnic origin.