Incidence Of Elevated Blood Pressure Research Articles

Elevated blood pressure among children born to women with obstructed labour in Eastern Uganda: a cohort study

BackgroundGlobally, high systolic blood pressure accounts for 10.8 million deaths annually. The deaths are disproportionately higher among black people. The reasons for this disparity are poorly understood, but could include a high burden of perinatal insults such as birth asphyxia. Therefore, we aimed to assess the incidence of elevated blood pressure and to explore associated factors among children born to women with obstructed labour.MethodsWe followed up children born to women with obstructed labour aged 25 to 44 months at Mbale regional referral hospital that had participated in the sodium bicarbonate trial ( Trial registration number PACTR201805003364421) between October 2021 and April 2022. Our primary outcome was elevated blood pressure defined as blood pressure (either systolic or diastolic or both) ≥ the 90th percentile for age, height, and sex in the reference population based on the clinical practice guideline for screening and management of high blood pressure in children and adolescents. We used logistic regression to estimate odds ratios between selected exposures and elevated blood pressure.ResultsThe incidence of elevated blood pressure was (39/140, 27.9%: 95% (CI: 20.6–36.1)). Participants aged three years and above had twice the odds of elevated blood pressure as those aged less than three years (Adjusted odds ratio (AOR) 2.46: 95% CI (1.01–5.97). Female participants had 2.81 times the odds of elevated blood pressure as their male counterparts (AOR 2.81 95% CI (1.16–6.82). Participants with reduced estimated glomerular filtration rate had 2.85 times the odds of having elevated blood pressure as those with normal estimated glomerular filtration rate (AOR 2.85 95% CI (1.00–8.13). We found no association between arterial cord lactate, stunting, wealth index, exclusive breastfeeding, food diversity and elevated blood pressure.ConclusionOur findings show a high incidence of elevated blood pressure among children. We encourage routine checking for elevated blood pressure in the pediatric population particularly those with known risk factors.

Six-month incidence of hypertension and diabetes among adults with HIV in Tanzania: A prospective cohort study.

Data describing the incidence of hypertension and diabetes among people with HIV in sub-Saharan Africa remain sparse. In this study, adults with HIV were enrolled from a public clinic in Moshi, Tanzania (September 2020-March 2021). At enrollment, a survey was administered to collect information on comorbidities and medication use. Each participant's blood pressure and point-of-care glucose were measured. Baseline hypertension was defined by blood pressure ≥140/90 mmHg or self-reported hypertension at enrollment. Baseline diabetes was defined by self-reported diabetes or hyperglycemia (fasting glucose ≥126 mg/dl or random glucose ≥200 mg/dl) at enrollment. At 6-month follow-up, participants' blood pressure and point-of-care glucose were again measured. Incident hypertension was defined by self-report of new hypertension diagnosis or blood pressure ≥140/90 mmHg at follow-up in a participant without baseline hypertension. Incident diabetes was defined as self-report of new diabetes diagnosis or measured hyperglycemia at follow-up in a participant without baseline diabetes. During the study period, 477 participants were enrolled, of whom 310 did not have baseline hypertension and 457 did not have baseline diabetes. At six-month follow-up, 51 participants (95% CI: 38, 67) had new-onset hypertension, corresponding to an incidence of 33 new cases of hypertension per 100 person-years. Participants with incident hypertension at 6-month follow-up were more likely to have a history of alcohol use (90.2% vs. 73.7%, OR = 3.18, 95% CI:1.32-9.62, p = 0.008) and were older (mean age = 46.5 vs. 42.3, p = 0.027). At six-month follow-up, 8 participants (95% CI: 3, 16) had new-onset diabetes, corresponding to an incidence of 3 new cases of diabetes per 100 person-years. In conclusion, the incidence of elevated blood pressure and diabetes among Tanzanians with HIV is higher than what has been reported in high-income settings.

Combined effect of height growth and overweight/obesity on blood pressure in children

Objective To investigate the association between the combined effect of height growth and overweight/obesity with elevated blood pressure in Chinese children. Methods Based on a cohort study of puberty development in Xiamen, a cluster sampling method was used to select 1 313 children whose complete height, weight and blood pressure levels at baseline were obtained in 2017 and during a follow-up in 2019. The incidence of elevated blood pressure was compared between four different subgroups, and multivariate Logistic regression was performed to analyze the combined effect in boys and girls. Results Among 1 313 children, the prevalence of elevated blood pressure at baseline was 25.2%. After 2 years of follow-up, the incidence of elevated blood pressure was 19.7% and 23.4% in boys, and 16.6% in girls. After adjusting for factors including age, sex, family history of hypertension, sleep time, intake of fruits, vegetables, sugar-sweetened beverages, and meat products, multivariate Logistic regression analyses showed that children in the high height growth and overweight/obesity group were more likely to exhibit a higher incidence of elevated blood pressure (overall: RR = 2.41, 95% CI = 1.44–4.04; boys: RR = 2.69, 95% CI = 1.45–5.02). Among girls, the risk of elevated blood pressure in the low height growth and overweight/obesity group also increased significantly ( RR = 4.47, 95% CI = 1.45–13.75). Conclusion A large magnitude of height growth and being overweight/obesity were associated with elevated blood pressure in children, especially boys. Therefore, interventions that are targeted toward obesity prevention in children before pubertal growth spurts in height may be beneficial to reduce childhood high blood pressure. 【摘要】 目的 分析不同身高增长幅度与超重肥胖联合作用对儿童新发血压偏高的影响, 为探索防控儿童血压偏高的策 略提供科学依据。 方法 基于厦门市青春期发育队列研究, 采用整群抽样方法, 选取 2017 年基线和 2019 年随访时身高、 体重和血压数据完整的 1 313 名小学生作为研究对象。采用多因素 Logistic 回归模型分析不同身高增长幅度与超重肥胖 的联合作用对儿童血压偏高的影响。 结果 1 313 名小学生基线时 (2017 年) 血压偏高检出率为 25.2%; 随访 2 年后, 未发 生血压偏高的人群中有 19.7% 的儿童新发了血压偏高, 男生血压偏高新发率为 23.4%, 女生为 16.6%。多因素 Logistic 回归 模型分析显示, 在调整年龄、性别、高血压家族史J垂眠时间、水果、蔬菜、含糖饮料及肉制品摄人情况后, 总体及男生身高增 长高水平超重肥胖组血压偏高新发的风险高于身高增长低水平非超重肥胖组 (总体: RR = 2.41, 95% CI =1.44~4.04; 男生: RR = 2.69, 95% CI = 1.45~5.02); 女生身高增长低水平联合超重肥胖组血压偏高检出率也显著增加 ( RR = 4.47, 95% CI = 1.45~13.75)。 结论 身高增长幅度较高和超重肥胖是儿童血压偏高发病的影响因素, 尤其是在男生中。在青春期身高突增 前对儿童进行肥胖的预防和干预可能有益于降低儿童期高血压的发生。

Study of Correlation of Hypertension and Anthropometric Measurements in Obese Vs Non – Obese Individuals

Background: Obesity exists worldwide at a large incidence rate. All systolic and diastolic blood pressure show a strong association with the height and weight of both sexes. This research was intended to establish the incidence of hypertension in obese patients relative to findings reported in non-obese persons. The objective is to research Hypertension in accordance with the Body Mass Index and to equate it between the two classes of Obese and Non-Obese persons. Subjects and Methods: The following anthropometric tests were carried out of both such patients Height 2. Weight 3. Circumference of dimension 4. The hip circumference. The Body Mass Index and the Waist Hip Ratio is determined from these measures. Blood pressure monitoring of BP was taken three times to validate systemic hypertension. Careful history was first taken of these cases involving pre-existing chronic hypertension and disease diagnosis. Results: The pre-hypertension level saw more people from both Obese and non-obese classes. Prevalence of stages 1 and 2 of hypertension was mostly seen in obese people. The mean systolic and diastolic blood pressure was higher in obese males than females but barely any noticeable variation in the waist circumference of > 100 and in the waist circumference of 90-100 cm, males were greater than females. Conclusion: The incidence of elevated blood pressure and mean systolic and diastolic blood pressure in increased BMI classes, i.e. obese people, was far higher. High BMI demonstrated a strong hypertension association.

Prevalence and risk factors for pre-hypertension and hypertension amongst school going adolescents in a rural area: an observational study

Background: Hypertension seen in childhood can progress into adulthood thereby increasing morbidity and mortality due to cardiovascular diseases in adulthood. Younger the age of onset of hypertension, the greater is the reduction of life expectancy if left untreated. With increase in incidence of elevated blood pressure and hypertension in children; it is important to measure and record blood pressure along with weight and height at least once a year as recommended by National Institute of Health (NIH) task force of USA. Aims and objectives was to determine the prevalence of pre-hypertension and hypertension and to identify the associated risk factors for them in school going adolescents.Methods: An observational/cross-sectional study conducted among adolescents studying between Std 5th to Std 9th. A total 507 students belonging to the age group of 10-17 years were examined. Anthropometric measurements were taken to calculate Body Mass Index (BMI) and Blood pressure was measured by using mercury sphygmomanometer. Gender, age and height were considered for determining hypertension.Results: Amongst the 507 children, prevalence of pre-hypertension was 15.4% and that of hypertension was 10.85%. The study also revealed statistically significant higher prevalence of hypertension in males than in females. Family history of hypertension and dietary habits, obesity were positively correlated with higher prevalence of hypertension. A higher prevalence of pre-hypertension and hypertension was seen in the present study group compared to the similar studies in the state.Conclusions: The prevalence of pre-hypertension and hypertension among adolescent school children was 15.38% and 10.8% respectively. Possible risk factors for this current trend may be the increasing sedentary life style, faulty eating habits, and increased fat/salt contents of diet. The results suggest the need for more public awareness and prevention programs for childhood obesity and hypertension.

Fish, Long-Chain n-3 PUFA and Incidence of Elevated Blood Pressure: A Meta-Analysis of Prospective Cohort Studies.

Results from prospective cohort studies on fish or long-chain (LC) n-3 polyunsaturated fatty acid (PUFA) intake and elevated blood pressure (EBP) are inconsistent. We aimed to investigate the summary effects. Pertinent studies were identified from PubMed and EMBASE database through October 2015. Multivariate-adjusted risk ratios (RRs) for incidence of EBP in the highest verses the bottom category of baseline intake of fish or LC n-3 PUFA were pooled using a random-effects meta-analysis. Over the follow-up ranging from 3 to 20 years, 20,497 EBP events occurred among 56,204 adults from eight prospective cohort studies. The summary RR (SRR) was 0.96 (95% CI: 0.81, 1.14; I2 = 44.70%) for fish in four studies, and 0.73 (95% CI: 0.60, 0.89; I2 = 75.00%) for LC n-3 PUFA in six studies (three studies for biomarker vs. three studies for diet). Circulating LC n-3 PUFA as biomarker was inversely associated with incidence of EBP (SRR: 0.67; 95% CI: 0.55, 0.83), especially docosahexaenoic acid (SRR: 0.64; 95% CI: 0.45, 0.88), whereas no significant association was found for dietary intake (SRR: 0.80; 95% CI: 0.58, 1.10). The present finding suggests that increased intake of docosahexaenoic acid to improve its circulating levels may benefit primary prevention of EBP.

New Insights into Blood Pressure Control for Intracerebral Haemorrhage.

Although blood pressure (BP) levels may rise in the weeks preceding intracerebral haemorrhage (ICH), in contrast to findings in the ischaemic stroke population, the initial post-ICH BP is often much higher than the last pre-morbid level. Elevated BP is therefore common in acute ICH, often with markedly elevated levels, and is associated with poor outcomes, though the exact pathophysiological mechanisms remain unclear. The Antihypertensive Treatment of Acute Cerebral Haemorrhage (ATACH) trial and the INTEnsive blood pressure Reduction in Acute Cerebral haemorrhage Trial (INTERACT) demonstrated that early and intensive lowering of elevated BP in the acute ICH period is feasible and safe. Importantly, recent CT perfusion studies have shown that early, intense BP reduction does not reduce cerebral blood flow or promote cerebral ischaemia. The recent, large INTERACT2 trial confirmed the safety of early BP lowering in ICH and suggested that intensive target-driven BP reduction may improve outcomes, with a non-significant trend towards reduced death and major disability and a significant favourable shift of scores on the modified Rankin scale compared with guideline-based treatment. BP lowering in acute ICH may reduce haematoma growth, particularly when target levels are achieved early and are sustained, though the evidence is partly conflicting. Other aspects of BP may also be important following acute ICH, with maximum systolic BP and systolic BP variability being independent predictors of poor outcomes in a recent study. This chapter gives an overview of the current evidence regarding BP in ICH and covers the following topics: the incidence of elevated BP in acute ICH and the patterns of BP observed before and after the event; the effect of elevated BP on outcomes in ICH and the potential underlying pathophysiological mechanisms; the safety and feasibility of BP lowering; the effects of BP lowering on clinical and radiological outcomes; other important aspects of BP in ICH; and the choice of antihypertensive agent.

The prevalence of high blood pressure as one of cardiovascular risk factors among women with polycystic ovary syndrome

Background Polycystic ovary syndrome (PCOS) is one of the commonest endocrinopathy diagnosed among women mainly at reproductive age. For the first time it was described by Stein and Leventhal in 1935 and defined by two of the three findings: irregular menses (oligo-/amenorrhoea), hyperandrogenism or polycystic ovaries appearance on ultrasound, provided that other causes of androgen excess and dysovulation are excluded. PCOS is very often associated with infertility, endometrium cancer, obesity, insulin resistance, impaired glucose metabolism, higher risk for type 2 diabetes, high blood pressure, impaired lipid profile, mental illnesses and non-alcoholic liver steatosis. The presence of some of mentioned conditions may exacerbate the risk of cardiovascular events in women with PCOS [1, 2]. The main goal of our study was to assess the frequency of hypertension among women with PCOS. Material and methods Retrospective analysis of medical records of 213 women, age 17–42 (mean 25 ± 6 years). Results Twenty-two women (10%) in examined group suffered from hypertension. The incidence of elevated blood pressure was higher among women with insulin resistance (p = 0.006). Prevalence odds ratio (OR) of arterial hypertension in the group with hyperprolactinaemia was 0.15 (confidence interval [CI] 0.06–0.37) and in the group with insulin resistance (OR) 1.05 (CI 0.61–1.83). Conclusion The prevalence of hypertension among women with PCOS is higher when compared with healthy women at the same age. Thus, due to the young age of enrolled patients, it seems reasonable to recommend extension of the diagnostics of PCOS with blood pressure assessment.

A systematic review on the effects of maternal calcium supplementation on offspring's blood pressure.

Background:Evidence proposes that maternal calcium (Ca) supplement during pregnancy may be inversely associated with the off spring's blood pressure (BP) level. It is suggested that increased maternal Ca intake during pregnancy may result in lower BP in the off spring. The reduction in the incidence of hypertension in mothers is documented but the effects on the off spring are uncertain.Materials and Methods:We conducted a systematic review of the literature to summarize the evidence supporting an association between maternal dietary Ca intake during pregnancy and the BP in the off spring. In this systematic review, relevant papers were selected in three phases. After quality assessment, a reviewer extracted the data while the other one checked the extracted data. We summarized the information regarding the association of maternal Ca intake either by food or supplements with BP in the off spring.Results:Four randomized trials and three observational studies were included in this review. The results were more consistent among the studies including older children (1-9 years) where a higher maternal Ca intake was associated with a reduction in the off spring's systolic BP. One large randomized trial found a clinically and statistically significant reduction in the incidence of elevated BP in 7-year-old children [relative risk (RR) = 0.59, 95% confidence interval (CI) 0.39-0.90].Conclusion:Overall, our findings confirm the beneficial effects of maternal Ca intake during pregnancy for the off spring's BP level.

Eat your fruit and vegetables

Your parents were smart when they told you to eat all of your vegetables, and encouraged you to eat your fruit, but they probably did not know that eating more fruit and vegetables would lower the risk of stroke. 1 He FJ Nowson CA MacGregor GA Fruit and vegetable consumption and stroke: a meta-analysis of cohort studies. Lancet. 2006; 367: 320-326 Summary Full Text Full Text PDF PubMed Scopus (792) Google Scholar , 2 Ness AR Maynard M Frankel S et al. Diet in childhood and adult cardiovascular and all cause mortality: the Boyd Orr cohort. Heart. 2005; 91: 894-898 Crossref PubMed Scopus (135) Google Scholar Results of epidemiological studies of the relation between intakes of nutrients in fruit and vegetables, such as vitamin C or beta-carotene, and risk of stroke have been inconsistent. 3 Ness AR Powles JW Fruit and vegetables, and cardiovascular disease: a review. Int J Epidemiol. 1997; 26: 1-13 Crossref PubMed Scopus (1083) Google Scholar , 4 Leppala JM Virtamo J Fogelholm R et al. Controlled trial of alpha-tocopherol and beta-carotene supplements on stroke incidence and mortality in male smokers. Arterioscler Thromb Vasc Biol. 2000; 20: 230-235 Crossref PubMed Scopus (158) Google Scholar However, disease prevention might not be attributable to single nutrients, but to the interaction of nutrient and non-nutritive components in whole foods. Fruit and vegetables are rich in many health-promoting nutrients and food compounds, including antioxidants such as vitamin C and folate, potassium, phytochemicals, dietary fibre, and plant proteins that have been inversely related to high blood pressure and stroke. 3 Ness AR Powles JW Fruit and vegetables, and cardiovascular disease: a review. Int J Epidemiol. 1997; 26: 1-13 Crossref PubMed Scopus (1083) Google Scholar , 4 Leppala JM Virtamo J Fogelholm R et al. Controlled trial of alpha-tocopherol and beta-carotene supplements on stroke incidence and mortality in male smokers. Arterioscler Thromb Vasc Biol. 2000; 20: 230-235 Crossref PubMed Scopus (158) Google Scholar , 5 Appel LJ Moore TJ Obarzanek E et al. A clinical trial of the effects of dietary patterns on blood pressure. DASH Collaborative Research Group. N Engl J Med. 1997; 336: 1117-1124 Crossref PubMed Scopus (4242) Google Scholar , 6 Steffen LM Kroenke CH Yu X et al. Associations of plant foods, dairy products, and meat consumption with fifteen-year incidence of elevated blood pressure in young black and white adults: The CARDIA Study. Am J Clin Nutr. 2005; 82: 1169-1177 PubMed Google Scholar , 7 John JH Ziebland S Yudkin P Roe LS Neil HA for the Oxford Fruit and Vegetable Study GroupEffects of fruit and vegetable consumption on plasma antioxidant concentrations and blood pressure: a randomised controlled trial. Lancet. 2002; 359: 1969-1974 Summary Full Text Full Text PDF PubMed Scopus (405) Google Scholar , 8 Bazzano LA He J Ogden LG et al. Dietary intake of folate and risk of stroke in US men and women: NHANES I epidemiologic follow-up study. National health and nutrition examination survey. Stroke. 2002; 33: 1183-1188 Crossref PubMed Scopus (133) Google Scholar It is likely that the combination of nutrients and compounds in foods has greater health benefits than the individual nutrient alone. 9 Jacobs DR Steffen LM Nutrients, foods, and dietary patterns as exposures in research: a framework for food synergy. Am J Clin Nutr. 2003; 78: 508S-513S PubMed Google Scholar In this week's Lancet, a meta-analysis by Feng He and colleagues provides strong evidence of an inverse relation between fruit and vegetable intake and risk of stroke. 1 He FJ Nowson CA MacGregor GA Fruit and vegetable consumption and stroke: a meta-analysis of cohort studies. Lancet. 2006; 367: 320-326 Summary Full Text Full Text PDF PubMed Scopus (792) Google Scholar Compared with individuals who consumed less than 3 servings of fruit and vegetables per day, those who ate more than 5 daily servings of fruit and vegetables had a 26% lower risk of stroke, while 3–5 servings per day conferred a 9% lower risk. Less than a quarter of adults in the USA eat 5 or more servings of fruit and vegetables per day, and there is therefore a serious need to develop and implement public-health strategies to achieve this dietary goal. Fruit and vegetable consumption and stroke: meta-analysis of cohort studiesIncreased fruit and vegetable intake in the range commonly consumed is associated with a reduced risk of stroke. Our results provide strong support for the recommendations to consume more than five servings of fruit and vegetables per day, which is likely to cause a major reduction in strokes. Full-Text PDF

Associations of plant food, dairy product, and meat intakes with 15-y incidence of elevated blood pressure in young black and white adults: the Coronary Artery Risk Development in Young Adults (CARDIA) Study

Consumption of plant foods and dairy and meat products may moderate increases in blood pressure. The objective was to evaluate associations of dietary intake with the 15-y incidence of elevated blood pressure (EBP; ie, incident systolic BP >or= 130 mm Hg, diastolic BP >or= 85 mm Hg, or use of antihypertensive medication). Proportional hazards regression was used to evaluate relations of dietary intake at years 0 and 7 with the 15-y incidence of EBP in the Coronary Artery Risk Development in Young Adults (CARDIA) Study of 4304 participants aged 18-30 y at baseline. EBP incidence varied from 12% in white women to 33% in black men. Plant food intake (whole grains, refined grains, fruit, vegetables, nuts, or legumes) was inversely related to EBP after adjustment for age, sex, race, center, energy intake, cardiovascular disease risk factors, and other potential confounding factors. Compared with quintile 1, the relative hazards of EBP for quintiles 2-5 of plant food intake were 0.83 (95% CI: 0.68, 1.01), 0.83 (0.67, 1.02), 0.82 (0.65, 1.03), and 0.64 (0.53, 0.90), respectively; P for trend = 0.01. Dairy intake was not related to EBP (P for trend = 0.06), and positive dose-response relations for EBP were observed across increasing quintiles of meat intake (P for trend = 0.004). In subgroup analyses, risk of EBP was positively associated with red and processed meat intake, whereas it was inversely associated with intakes of whole grain, fruit, nuts, and milk. Adjustment for intermediary factors in the causal pathway attenuated these relations. These findings are consistent with a beneficial effect of plant food intake and an adverse effect of meat intake on blood pressure.

Ten-year incidence of elevated blood pressure and its predictors: the CARDIA study. Coronary Artery Risk Development in (Young) Adults.

Few prospective studies have examined associations of lifestyle factors or variables in the insulin resistance syndrome (syndrome X) with incidence of elevated blood pressure (BP) in black subjects and women. This report estimates the 10-year incidence of high blood pressure (HBP) and high normal blood pressure (HNBP) in the biracial cohort of the Coronary Artery Risk Development in (Young) Adults Study (CARDIA), and examines lifestyle factors and four syndrome X variables, measured at baseline, as predictors. CARDIA examined 5115 black and white men and women aged 18-30 years in 1985-1986, and re-examined them at 2, 5, 7, and 10 years. The 10-year incidence of HBP was 16.4% in black men, 7.8% in white men, 13.1% in black women, and 3.2% in white women, while the 10-year incidence of HBP or HNBP was 29.5%, 16.2%, 19.2%, and 6.3%, respectively, in the four sex-race subgroups. Predictors included body mass index, waist circumference, physical activity, alcohol intake, pulse rate, cigarette smoking, education, fasting insulin, triglycerides, uric acid, and high-density lipoprotein cholesterol, as well as age and systolic BP. In univariate analyses, each of these variables was significantly related to incidence in at least one of the four sex-race groups. In multivariate analyses that included control for age and systolic pressure, independent predictors included fasting insulin in white men and women, triglycerides in white men, uric acid and pulse rate in black men, waist circumference in white men and black women, and education (inverse) in white men and black and white women. These results suggest that lower socioeconomic status, as assessed by education level, and one or more syndrome X variables, ie, fasting insulin, triglycerides, uric acid, may be associated with development of elevated BP in young adults.

Regional disparities in the incidence of elevated blood pressure among young adults: the CARDIA study.

Within the United States, little is known about regional disparities in blood pressure (BP), their changes over time, or explanations for their existence. A population-based cohort of 5115 black and white men and women, 18 to 30 years old in 1985-1986 (balanced on age, race, sex, and education), was followed up for 7 years in four centers: Birmingham, Ala; Chicago, Ill; Minneapolis, Minn; and Oakland, Calif. Differences in elevated BP (EBP) prevalence among centers at years 0, 2, 5, and 7 and in 7-year incidence of EBP were assessed. Sociodemographic and dietary variables, physical activity, weight, smoking, and alcohol were considered. At year 0, no regional differences were seen. Seven years later, there was marked variability in prevalence of EBP overall and for both black and white men, from a low in Chicago (9% for black men and 5% for white men) to a high in Birmingham (25% for black men and 14% for white men). Birmingham also had the highest 7-year incidence (11%) and overall prevalence at year 7 (14%). The adjusted odds ratios, with Birmingham as referent (95% CIs), for 7-year incidence of EBP overall were 0.38 (0.24, 0.60) for Chicago, 0.37 (0.24, 0.57) for Minneapolis, and 0.74 (0.52, 1.07) for Oakland. Regional disparities are absent at baseline but become apparent as the cohort ages. These differences are not fully explained by the available behavioral and sociodemographic characteristics.

Adolescent blood pressure survey: Tulsa, Oklahoma, 1987 to 1989.

The study goals were to document the incidence of elevated blood pressure (BP) values in public high school students in Tulsa, Oklahoma; to determine whether age and sex are risk factors; and to encourage adolescents with abnormal screening BP values to seek medical care. Over a 2-year period, 5537 adolescents aged 14 to 19 years were evaluated by a mass screening method. Blood pressure was measured once between 8:30 and 9:30 AM, with the students seated. Korotkoff phases 1 and 5 were recorded as systolic and diastolic BP. According to the criteria of the Second Task Force on Hypertension in Children and Adolescents, 334 students had elevated BP values (either systolic, diastolic, or both) (an incidence of 6%). Boys had an incidence of elevated systolic BP of 5.8%, while girls had a 2.8% incidence, a difference that might have been expected because of the generally higher incidence among men in the adult population. The incidence of elevated diastolic BP was 2.8% in boys and 2.1% in girls. Statistically significant differences between boys and girls mean systolic and diastolic elevations were found, but were not considered clinically significant. An instructional mailing was done in an effort to stimulate follow-up medical care for those with abnormal findings, but its effect was not measured.

Clinical profile of indian non-insulin-dependent diabetics with nephropathy and renal failure

We studied the clinical profile of 296 non-insulin-dependent diabetic (NIDDM) patients with nephropathy and renal failure. Male preponderance was striking in this group and the age of onset of diabetes was between 30 and 50 years in 75%. Retinopathy was present in 86% with proliferative changes in 20% and coronary artery disease was evident in 40% of the patients. The incidence of retinopathy and coronary artery disease was significantly higher in this group than in a group of non-insulin-dependent diabetics without nephropathy (86% vs. 18.5%; 40% vs. 30% respectively, P < 0.01). It is our observation that patients with NIDDM developing nephropathy and renal failure have had an early onset of disease and are significantly more often male. There is also a greater incidence of elevated blood pressure, coronary artery disease and retinopathy in this group.

Relative weight, smoking and contraceptive pills: interrelations to blood pressure in students.

Hypertension is 1 of the most important risk factors of cardiovascular disease. Kannel et al have shown in a prospective study that relative body weight, weight change under observation, and skinfold thickness were distinctly related to existing blood pressure levels and to the subsequent rate of development of hypertension. Recent evidence has suggested that the patient with essential hypertension may be identified early in life, even before gross hypertension occurs. Stamler et al found in a prospective study of middle aged men that the baseline blood pressure was the measurement most powerfully related to follow-up blood pressure. The risk of developing hypertension in from 1-4 years for males originally normotensive was best correlated with baseline blood pressure. Multivariate analyses indicated that relative weight and cigarette smoking also added low-order independent contributors to blood pressure in predicting the risk of hypertension development. The use of variables made it possible to identify that portion of the population with a very high incidence of elevated blood pressure 4-5 years later. A relation between oral contraceptives and hypertension has been suggested. Some characteristics related to blood pressure measured at a health examination of 1st and 3rd year university students are reported here.

Relative Weight, Smoking and Contraceptive Pills: Interrelations to Blood Pressure in Students

Abstract Hypertension is one of the most important risk factors of cardiovascular diseases. Kannel et al1 have shown in a prospective study that relative body weight, weight change under observation, and skinfold thickness were distinctly related to existing blood pressure levels and to the subsequent rate of development of hypertension. Recent evidence has suggested that the patient with essential hypertension may be identified early in life, even before gross hypertension occurs. Stamler et al2 found in a prospective study of middle-aged males that the baseline blood pressure was the measurement most powerfully related to follow-up blood pressure. The risk of developing hypertension in from one to four years for males originally normotensive was best correlated with baseline blood pressure. Multivariate analyses indicated that relative weight and cigarette smoking also added low-order independent contributors to blood pressure in predicting the risk of development of hypertension. The use of variables made it possible to identify that portion of the population with a very high incidence of elevated blood pressure four to five years later. A relation between oral contraceptives and hypertension has been suggested.3 Some characteristics related to blood pressure measured at a health examination of first- and third-year university students are reported here.

Sustained hypertension after poliomyelitis.

Several reports have dealt with the vasomotor instability that is sometimes part of acute poliomyelitis.1-8Hypertension and shock, the former numerically predominant, have been described. In a study based on thousands of blood pressure measurements in poliomyelitis patients, Kemp noted a transient rise in blood pressure in over half the fatal cases and in more than a third of those who developed the bulbar or bulbospinal form of the disease.1In other series, the incidence of elevated blood pressure in acutely ill poliomyelitis patients varied from 7%4to 47%.2The hypertension has been attributed either to damage of the bulbar vasomotor centers by the virus or to the anoxia and carbon dioxide retention secondary to respiratory paralysis. In general, the hypertension of the acute phase has been more common in those groups with bulbar involvement1-3,8and with respiratory paralysis.2,4Renal dysfunction during the acute

HEREDITY IN ARTERIOLAR (ESSENTIAL) HYPERTENSION

Heredity is the most important known factor in the development of arteriolar (essential) hypertension. Valuable evidence for this opinion can be secured by studying the blood pressure in a large number of hypertensive and nonhypertensive families, with an effort to obtain the blood pressure readings of all of the available relatives in two or more generations. This has been the purpose and method of the present study. A definite relationship between heredity and arteriolar (essential) hypertension and its complications was noted long ago by Dieulafoy, Raymond, Broadbent, Gowers, Allbutt 1 and others. More recently, this relationship was further demonstrated by the results of systematic studies of family histories. In the studies, O'Hare, Walker and Vickers 2 and Weitz 3 showed that a history of cardiovascular disease is frequent among the relatives of hypertensive patients. Weitz 3 showed in addition that there was an abnormally high incidence of elevated blood pressure