Systolic Blood Pressure In Men Research Articles

Sex differences and determinants of coronary microvascular function in asymptomatic adults with type 2 diabetes.

Coronary microvascular dysfunction (CMD) is a significant complication in type 2 diabetes (T2D) and may be more common in women. We aimed to evaluate the sex differences and sex-specific clinical determinants of CMD in adults with T2D without prevalent cardiovascular disease. Single center pooled analysis of four prospective studies comparing asymptomatic people with T2D and controls. All subjects underwent comprehensive cardiovascular phenotyping with myocardial perfusion reserve (MPR) quantified with perfusion MRI. Participants with silent coronary disease were excluded. Multivariable linear regression was performed to identify determinants of MPR with an interaction term for sex. Four-hundred and seventy-nine T2D (age 57 ± 11y, 42% women) were compared with 116 controls (age 53 ± 11y, 41% women). Men with T2D, but not women, demonstrated worse systolic function and higher extra-cellular volume fraction than controls. MPR was significantly lower in T2D than controls (women, 2.6 ± 0.9 vs. 3.3 ± 1.0, p <0.001; men, 3.1 ± 0.9 vs. 3.5 ± 1.0, p = 0.004), and lower in women than men with T2D (p <0.001). More women than men with T2D had MPR <2.5 (46% vs. 26%, p <0.001). There was a significant interaction between sex and body mass index (BMI) for MPR (p-interaction <0.001). Following adjustment for clinical risk factors, inverse association with MPR were body mass index (BMI) in women (β = -0.17, p = 0.045) and systolic blood pressure in men (β = -0.14, p = 0.049). Among asymptomatic adults with T2D, women had a greater prevalence of CMD than men. Risk factors modestly but significantly associated with coronary microvascular dysfunction in asymptomatic people with T2D were BMI among women and systolic blood pressure among men.

Examining the causal association between moderate alcohol consumption and cardiovascular risk factors in the Taiwan Biobank: a Mendelian randomization analysis.

The Mendelian randomization approach uses genetic variants as instrumental variables to study the causal association between the risk factors and health outcomes of interest. We aimed to examine the relation between alcohol consumption and cardiovascular risk factors using two genetic variants as instrumental variables: alcohol dehydrogenase 1B (ADH1B) rs1229984 and aldehyde dehydrogenase 2 (ALDH2) rs671. Using data collected in the Taiwan Biobank-an ongoing, prospective, population-based cohort study-our analysis included 129,032 individuals (46,547 men and 82,485 women) with complete data on ADH1B rs1229984 and ALDH2 rs671 genotypes and alcohol drinking status. We conducted instrumental variables regression analysis to examine the relationship between alcohol drinking and body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting glucose, glycated hemoglobin (HbA1c), triglycerides, high-density lipoprotein cholesterol (HDLc), and low-density lipoprotein cholesterol (LDLc). In the rs1229984-instrumented analysis, alcohol drinking was only associated with higher levels of SBP in men and lower levels of DBP in women. In the rs671-instrumented analysis, alcohol drinking was associated with higher levels of BMI, SBP, DBP, fasting glucose, triglycerides, HDLc and lower levels of LDLc in men; alcohol drinking was associated with higher levels of HDLc and lower levels of SBP, HbA1c, and triglycerides in women. Using Mendelian randomization analysis, some of our study results among men echoed findings from the previous systematic review, suggesting that alcohol drinking may be causally associated with higher levels of BMI, SBP, DBP, fasting glucose, triglycerides, HDLc, and lower levels of LDLc. Although alcohol drinking is beneficial to a few cardiovascular risk factors, it is detrimental to many others. The assumptions that underlie the Mendelian randomization approach should also be carefully examined when interpreting findings from such studies.

ARTERIAL HYPERTENSION AS A COMPONENT OF METABOLIC SYNDROME IN MEN IN AN OPEN URBAN POPULATION

Purpose. To determine blood pressure (BP) levels and the prevalence of arterial hypertension (AH), as a component of metabolic syndrome, in men of an open urban population aged 25–64 years. Materials and methods. A one-time epidemiological study was conducted on a representative sample of men 25–64 years old, formed from the electoral lists of citizens of the city of Tyumen in the amount of 1000 people, the response was 85.0%. To analyze the prevalence of AH as a component of the metabolic syndrome, the NCEP ATP III (2004), IDF (2005), All-Russian Scientific Society of Cardiology (2009) assessment criteria were used. Results. The levels of systolic BP in men of the Tyumen population were high due to the average age groups of 35–44 and 45–54 years; in the same groups there was a significant increase in the average values and percentile distribution of the trait. According to the levels of diastolic BP in men of the Tyumen population, a directional age trend of the indicator was formed with a significant increase in its levels in each subsequent age group. In terms of the prevalence of AH, the standardized indicator in the male population of Tyumen 25–64 years old was 59.8%; a positive relationship was established with age in the younger and older age categories. Conclusion. Thus, the study results obtained in an open urban population, which identified the most vulnerable age categories of men with regard to the development of metabolic syndrome, represent a scientific basis for the formation of a preventive program in the region.

Sex Differences in the Relationship between Personal, Psychological and Biochemical Factors with Blood Pressure in a Healthy Adult Mexican Population: A Cross-Sectional Study.

Hypertension is one of the main risk factors related to cardiovascular mortality, being the levels of blood pressure (BP) related to a variety of personal, anthropometric, biochemical and psychological variables; however, the study evaluating the association of all these factors in systolic blood pressure (SBP) and diastolic blood pressure (DBP) in a sample of relatively healthy subjects has not been performed. The aim of the study was to determine the main variables associated with SBP and DPB in a sample of relatively healthy subjects. A total of 171 participants were included, in which personal, anthropometric, positive and negative psychological variables and biochemical variables were measured. We observed that men showed higher levels of SBP and DBP than women, with more differences for SBP. Among the biochemical factors and SBP, we found that albumin and monocytes were positively correlated with it, while potassium, phosphorus and eosinophils were negatively correlated with it. Additionally, schooling was a constant variable negatively correlated with SBP in all samples (global, men and women). Among psychological variables, we observed that emotional perception was negatively correlated with SBP in men's and women's samples, while autonomy was positively correlated with SBP in the men's sample; however, their association was less when compared with the personal and biochemical variables included in the multivariate model. With regard to DBP, we observed that the biochemical variables, hemoglobin, sodium, uric acid and glucose, were positively correlated with DBP in the global sample, while chloride and BUN were negatively correlated with it. In addition, many personal and behavioral variables, including BMI, age and smoking consumption frequency, also correlated with DBP in the global sample. In conclusion, BP is affected by different factors, and these affect each sex differently.

Abstract 15558: Blood Pressure Responses During Exercise Were Associated With Average Home Blood Pressure and Home Blood Pressure Variability: The Electronic Framingham Heart Study

Introduction: Abnormal blood pressure (BP) responses during exercise are associated with incident hypertension and cardiovascular disease, but how exercise BP responses relate to average home BP and home BP variability (BPV) over one-year follow-up is unknown. Objective: We investigated whether exercise BP was associated with average home BP and home BPV, after accounting for resting BP, in the electronic Framingham Heart Study (eFHS). We hypothesized that higher exercise BP predicts higher average home BP and home BPV over one-year follow-up. Methods: At a FHS research exam (2016-2019), participants underwent maximum incremental ramp cycle ergometry cardiopulmonary exercise testing (CPET) with BP measured every two minutes. Participants enrolled in the eFHS were provided with a digital BP cuff to measure home BP weekly for up to one year. Linear regression models were used to examine associations of exercise BP with average home systolic BP (SBP) and week-to-week average real variability (ARV) of home SBP over one-year follow-up, adjusting for covariates. ARV, which considers both the dispersion and order of BP readings, was quantified as the average of the absolute differences between consecutive BP readings. We used p&lt;0.05 for significance. Results: The study sample included 806 participants (mean age 53 years, 58% women, 46% hypertension, median number of home BP returns 22, average home SBP 122 mmHg). Adjusting for resting SBP and other covariates, higher exercise SBP (as measured by peak SBP, SBP at 75 Watts, and SBP/workload slope) was associated with higher average home SBP ( Figure 1A ). Higher SBP/workload slope was associated with elevated ARV of home SBP in men ( Figure 1B ). Conclusion: Higher exercise SBP responses are associated with higher average digital home-based SBP and home-based SBP variability over one-year follow-up after accounting for resting SBP.

Blood Pressure Values in Apparently Healthy Sudanese Population

Introduction: Blood pressure is one of the most often measured clinical parameters, and assessment of blood pressure has a considerable impact on diagnostic decisions.&#x0D; Objectives: To establish blood pressure normal reference values in Sudanese.&#x0D; Methods: A cross-sectional study was conducted from September 2016 to November 2018. Eight hundred eighty-eight healthy adult Sudanese between the ages of 18 and 60 (203 men and 685 women) were randomly selected from the states of Khartoum, Northern, Gezira, Red Sea, and North Darfur. Clinical, anthropometric, and blood pressure measurement data were collected.&#x0D; Results: The mean for all volunteers was 113.93 ± 9.917 mmHg, systolic blood pressure (SBP) and 75.29 ± 6.79 mmHg, diastolic blood pressure (DBP). SBP in men was 118.6 + 7.642 mmHg compared to 112.53 + 9.121 mmHg in women, while DBP in men was 77.51 + 5.984 mmHg compared to 74.63 + 6.844 mmHg in women. Beside the gender variations, blood pressure values also showed geographical variability. There was a positive connection between blood pressures (SBP and DBP), BMI, and age. (P &lt; 0.05) was used for significance.&#x0D; Conclusion: Blood pressure of Sudanese was found to be within the normal international range with gender and geographical variability. It showed positive correlation with age and BMI.

Effects of sumac supplementation on metabolic markers in adults with metabolic syndrome: a triple-blinded randomized placebo-controlled cross-over clinical trial

BackgroundDespite the prior evidence of the impacts of sumac on glycemic indices, lipid profile and visceral fat, there is a lack of evidence regarding the efficacy of sumac in cases with metabolic syndrome (MetS). Therefore, we aimed to assess the effect of sumac supplementation on MetS markers among adults with this syndrome.MethodsIn this triple-blinded randomized placebo-controlled cross-over clinical trial 47 adults with MetS were randomly assigned to receive 500 mg sumac or placebo (lactose) capsule, twice a day. Each phase took 6 weeks and there was a 2-week washout between phases. All clinical evaluations and laboratory tests were conducted before and after each phase.ResultsAt the baseline of the study, mean (± SD) age, weight, and waist circumference of participants were respectively 58.7 (± 5.8) yr, 79.9 (± 14.3) kg, and 107.6 (± 10.8) cm. Intention to treat analysis (ITT) analyses revealed that sumac supplementation decreased systolic blood pressure by 5 mmHg (128.8 ± 21.4 at the baseline vs. 123.2 ± 17.6 after 6 weeks intervention, P = 0.001). The comparison of changes in two trial arms showed that sumac supplementation significantly reduced systolic blood pressure (sumac group -5.59 ± 10.6 vs. control group 0.76 ± 10.5, P = 0.004), but did not change anthropometric indices or diastolic blood pressure. Similar results were also found in the per-protocol analyses.ConclusionsThis cross-over trial revealed that sumac supplementation could reduce systolic blood pressure in men and women with MetS. Daily intake of 1000 mg sumac, as an adjuvant therapy, may be beneficial in management of MetS in adults.

Abstract P389: Sex-Specific Genetic Interrogation of Cardiovascular Disease Drug Targets

Investigating sex-specific effects of genetically-proxied drug target inhibition on cardiovascular disease (CVD) liability may improve the understanding of CVD pathophysiology and therapeutic intervention, to enhance the formulation of sex-specific treatment in clinical practice. We aimed to investigate sex-specific associations between genetic variation at CVD drug targets and CVD risk factors in the UK Biobank for anti-hypertensive, lipid-lowering and anti-inflammatory drug targets. Firstly, we conducted genome-wide association studies (GWAS) for systolic blood pressure (SBP), C-reactive protein (CRP), low density lipoprotein (LDL)-cholesterol for 488,226 women and men in the UK Biobank. We then performed genetic colocalization analyses to identify shared or differential genetic loci for CVD risk factors in males and females. Our findings highlight that females and males share potentially causal variants for SBP at the ADRB1, CACNA1D, CACNB2, CACNB3 and SLC12A3 drug targets, for LDL-cholesterol at PCSK9, HMGCR, and for CRP at IL6R . Notably, we highlight heterogeneous effects of SBP in men and women at ACE, CACNA1S, CACNA1C . This is the first comprehensive genetic interrogation of sex-specific effects on drug targets, suggesting physiological differences in hypertension-mediated CVD between men and women and potential differential response to anti-hypertensive medication. Whether this has viable clinical implications is yet to be formally tested in further sex-specific analyses in genetic association studies and clinical trials.

Science, Medicine, and the Anesthesiologist

Science, Medicine, and the Anesthesiologist

The Dash Diet Pattern and Blood Pressure Changes in US Veterans With Type 2 Diabetes – a Post-hoc Analysis of the Blueberry Consumption and Type 2 Diabetes Study

ObjectivesThe goals of nutrition therapy for adults with type 2 diabetes include promoting healthful eating patterns and supporting improvements in cardiometabolic risk factors. Hypertension, which is a risk factor for stroke, myocardial infarction and heart failure, is common in persons with diabetes. There is limited data on the relationship between the Dietary Approaches to Stop Hypertension (DASH) diet and blood pressure in US veterans with type 2 diabetes. The primary objective of the study is to determine the effect of the DASH diet pattern on blood pressure in US veterans. MethodsA secondary analysis from the Blueberry Consumption and Type 2 Diabetes study (NCT02972996, clinicaltrials.gov) was conducted in fifty-two men (mean ± SD baseline characteristics: 67 ± 6 years; weight, 102 ± 14 kg; body mass index, 34 ± 4 kg/m2; systolic blood pressure, 129 ± 17 mmHg; diastolic blood pressure, 76 ± 8 mmHg; hemoglobin A1c, 7.3 ± 0.8%) with type 2 diabetes. DASH diet patterns for six nutrients (protein, total fat, calcium, potassium, sodium and fiber) were collected by three-day food records. DASH diet scores were created by summing the scores for the six nutrients. Baseline blood pressure was collected according to standard protocol and used for the analysis. Multiple linear regression was used to determine the association between the DASH diet score and blood pressure. ResultsIn multiple linear regression analysis, adjusted for age, body mass index and comorbid conditions, a higher DASH score was associated with a decrease in systolic blood pressure (β = –5.96; P = 0.026) but not diastolic blood pressure (β = –1.65; P = 0.169). For every one unit increase in the DASH score, the estimated mean systolic blood pressure decreased by approximately 6.0 mmHg. ConclusionsThese findings suggest that adherence to the DASH diet pattern is associated with a decrease in systolic blood pressure in men who are US veterans with type 2 diabetes. The results should be verified by randomized clinical trials evaluating the effects of the DASH diet on blood pressure in adults with type 2 diabetes. Funding SourcesThe U.S. Highbush Blueberry Council; the study is the result of work supported with resources and the use of facilities at the Stratton VA Medical Center, Albany, NY, USA.

Influence of Coronary Artery Disease over Exercise Systolic Blood Pressure in Men with Hypertension

Abstract Aim: Disclosing coronary artery disease by analyzing the rates of systolic blood pressure response to workload during exercise stress test. Methods: 53 males with hypertension underwent exercise stress test on bicycle ergometer and coronary angiography within one month. rates of systolic blood pressure to workloads in the first stage peak exercise, second, fourth and sixth minute of recovery were analyzed and compared. Also basic characteristics of patients involved in the study were also analyzed. Results: All systolic blood pressure to workload rates during exercise and recovery resulted higher in males with coronary artery disease and hypertension compared with hypertension but no coronary artery disease. Conclusion: High levels of systolic blood pressure to workloads rates in males with hypertension reveal the diagnosis of coronary artery disease despite the ECG variations during exercise stress test and this are not influenced by other basic characteristics of the patients.

Intrasession Reliability Analysis for Oscillometric Blood Pressure Method Using a Digital Blood Pressure Monitor in Peruvian Population.

Blood Pressure (BP) is one of the most used measured clinical parameters in health promotion and intervention. BP measures can vary due to different parameters, so we aim to study the intrasession test–retest reliability for an oscillometric method using a digital tensiometer in the Peruvian population aged over 15 with and without a diagnosis of hypertension (HT). Data were taken from the Demographic and Family Health Survey conducted in Peru in 2019. Technicians had to follow a standardized protocol on the conditions to carry out a valid and reliable measurement. Relative reliability was excellent in most cases (intraclass correlation coefficient > 0.9); absolute reliability was excellent (standard error of measurement < 5%) and smallest real difference < 10% in most cases. The Bland–Altman plot showed a systematic error of 2.36 for systolic BP in men and 2.16 in women, and 0.823 for diastolic BP in men and 0.71 for diastolic BP in women. Results suggest that the oscillometric method with a digital blood pressure monitor was reliable in absolute and relative terms in this population, so it could be used as a reliable control test to measure changes after an intervention.

Effects of isometric leg training on ambulatory blood pressure and morning blood pressure surge in young normotensive men and women

Despite the reported association between diurnal variations in ambulatory blood pressure (BP) and elevated cardiovascular disease risk, little is known regarding the effects of isometric resistance training (IRT), a practical BP-lowering intervention, on ambulatory BP and morning BP surge (MBPS). Thus, we investigated whether (i) IRT causes reductions in ambulatory BP and MBPS, in young normotensives, and (ii) if there are any sex differences in these changes. Twenty normotensive individuals (mean 24-h SBP = 121 ± 7, DBP = 67 ± 6 mmHg) undertook 10-weeks of bilateral-leg IRT (4 × 2-min/2-min rest, at 20% maximum voluntary contraction (MVC) 3 days/week). Ambulatory BP and MBPS (mean systolic BP (SBP) 2 h after waking minus the lowest sleeping 1 h mean SBP) was measures pre- and post-training. There were significant reductions in 24-h ambulatory SBP in men (− 4 ± 2 mmHg, P = 0.0001) and women (− 4 ± 2 mmHg, P = 0.0001) following IRT. Significant reductions were also observed in MBPS (− 6 ± 8 mmHg, p = 0.044; − 6 ± 7 mmHg, P = 0.019), yet there were no significant differences between men and women in these changes, and 24-h ambulatory diastolic BP remained unchanged. Furthermore, a significant correlation was identified between the magnitude of the change in MBPS and the magnitude of changes in the mean 2-h SBP after waking for both men and women (men, r = 0.89, P = 0.001; women, r = 0.74, P = 0.014). These findings add further support to the idea that IRT, as practical lifestyle intervention, is effective in significantly lowering ambulatory SBP and MBPS and might reduce the incidence of adverse cardiovascular events that often occur in the morning.

Sanatorium-and-spa treatment of patients who have had a new coronavirus infection (COVID-19)

Evaluation of the effectiveness of sanatorium-and-spa treatment of patients who have undergone a new coronavirus infection (COVID-19), taking into account the polymorphism of symptom complexes. The study included 56 patients (22 men, 34 women; mean age 64.9±8.21 and 64.76±9.12 years, respectively) who had COVID-19 and were treated at a spa. The mandatory program of rehabilitation and rehabilitation sanatorium treatment included: exercise therapy with elements of breathing exercises, general massage with an emphasis on the chest, halo and speleotherapy, hydrotherapy, inhalations, as well as psychotherapeutic methods. The length of stay in the sanatorium was at least 2 weeks. We assessed the dynamics of indicators characterizing the activity of the cardiovascular and respiratory systems (BP, heart rate, Stange test), exercise tolerance (6-minute walk test), as well as psycho-emotional state (test «Health, Activity, Mood», SAN) up to and after treatment. Against the background of sanatorium-and-spa treatment in patients who underwent COVID-19, the number of complaints significantly decreased: in men from 6.2±2.4 to 3.4±1.3, in women from 7.7±1.5 to 4.12±1.5 (p≤0.05). A similar dynamics of indicators characterizing the activity of the cardiovascular system was noted: the level of systolic blood pressure in men decreased by 7.3%, in women - by 10.3%; the level of diastolic blood pressure - by 4.1 and 1.4%, respectively. Heart rate in men decreased from 83.69±15.2 to 75.54±12.24 beats/min; in women - from 92.16±14.16 to 76.4±11.68 beats/min. The distance traveled for men (6-minute walk test) increased from 384.15±108.78 to 408.92±97.30 m; in women - from 371.84±75.9 to 397.12±76.2 m (p≤0.05). The breath holding time on inspiration (Stange test) in men increased from 38.00±10.64 to 45.69±9.51 s; in women - from 39.96±9.31 to 43.60±6.93 s. The values of the «Well-being» indicator (SAN test) in men significantly increased - from 4.5±1.8 to 5.1±0.9 points (p≤0.05); «Activity» - from 4.8±0.8 to 5.4±0.5 points (p≤0.05); «Mood» - from 4.7±1.4 to 5.4±0.6 points. Similar dynamics were observed in women. Against the background of the sanatorium stage of treatment, a stable positive dynamics of the indicators of the functional state of the body was noted in both men and women. The analysis carried out confirms the need to develop and implement rehabilitation programs in sanatorium-resort conditions for patients who have had a new coronavirus infection.

Blood pressure in dementia, mild cognitive impairment, and subjective cognitive decline related to time of death.

ObjectiveIt is unknown whether systolic blood pressure (SBP) drop is part of the normal aging process or due to the onset of dementia for some people. SBP drop is referring to the decrease in blood pressure often seen before death. Thus, the aim of this study was to examine whether SBP at time of diagnosis of dementia, mild cognitive impairment, or subjective cognitive decline was associated with years prior to death, and whether these associations were modified by diagnoses, age, and sex.MethodsParticipants were 2,236 patients from the Norwegian Registry of Persons Assessed for Cognitive Symptoms (NorCog), who died during follow‐up (2009–2017) for whom we had valid blood pressure measurements. Mean age at diagnosis was 77.5 years (SD 8.3), and patients were followed for an average of 3.9 years (SD 2.2, maximum 10.5 years). The patients had subjective cognitive decline (95), mild cognitive impairment (573), dementia (1,401), or no diagnoses related to cognitive deficits (167). SBP as dependent variable was regressed against years prior to death.ResultsIn men, SBP was 1.8 mmHg lower per year closer to death (p < .01), and this trend was linear without any acceleration. This association between years prior to death and SBP in men was not modified by age, year of diagnosis, or diagnosis. There was no such association in women.ConclusionSBP was significantly lower for those diagnosed close to death in men, but not in women. This association was not modified by either age or onset of diagnosis. Thus, the lowering of SBP is more related to closeness to death and sex than to dementia or age. The downward trend was linear all 10 years prior to death, with no acceleration closer to death.

Age and sex specific effects of APOE genotypes on ischemic heart disease and its risk factors in the UK Biobank

APOE genotypes are associated with ischemic heart disease (IHD), several other cardiovascular diseases and dementia. Previous studies have not comprehensively considered all genotypes, especially ε2ε2, nor associations by age and sex, although IHD incidence differs by sex. In the UK Biobank, including 391,992 white British participants, we compared effects of APOE genotypes on IHD and its risk factors. Compared to the ε3ε3 genotype, ε2ε2 was not clearly associated with IHD but was associated with lower plasma apolipoprotein B (apoB). The ε2ε3 genotype conferred lower IHD risk, systolic blood pressure (SBP), pulse pressure and plasma apoB than ε3ε3. ε3ε4 and ε4ε4 conferred higher IHD risk, higher pulse pressure and plasma apoB, but lower glycated haemoglobin (HbA1c) than ε3ε3. The associations by age and sex were fairly similar, except ε2ε2 compared to ε3ε3 was marginally positively associated with IHD in the younger age group and nominally inversely associated with SBP in men. ε3ε4 compared to ε3ε3 was nominally positively associated with SBP in women. APOE genotypes affect IHD risk increasingly from ε2ε3, ε3ε3, ε3ε4 to ε4ε4, with similar patterns for pulse pressure and plasma apoB, but not for diabetes. Associations with blood pressure differed by sex. Greater understanding of products of APOE and their effects might generate targets of intervention.

SEX DIFFERENCES IN LIFESTYLE FACTORS AND BLOOD PRESSURE: A CROSS-SECTIONAL ANALYSIS FROM THE GUBBIO STUDY, AN ITALIAN RESIDENTIAL STUDY

Objective: Hypertension is a well-established major risk factor for cardiovascular disease. Lifestyle behaviors for its prevention and control are recommended within worldwide guidelines. Their relationship with blood pressure (BP), and particularly sex differences, need more investigations. The aim was to investigate impact of lifestyle factors on BP and sex differences in the Gubbio residential study. Design and method: Cross-sectional analyses were performed using data from Gubbio study. Information's concerning lifestyle factors were collected using self-reported questionnaire and were further completed with a baseline clinical examination and blood exams. Three BP measurements were performed following a standard protocol. Age-adjusted and multiple linear regressions were used to examine the relationships between lifestyle parameters and BP. We used heterogeneity test to observe sex differences. Results: In Gubbio residential study, 3,183 persons were included (48% men, 43 ± 17 years old). Mean systolic BP (SBP) was 119 ± 16 mmHg and 10.6% were hypertensives. In multivariable analysis, age, BMI, uric acid and fast blood glucose (FBG) were positively associated with SBP in both sexes. Alcohol was positively associated in women while coffee in women and education level in men were negatively associated with SBP. We observed sex differences concerning education level (high versus low education, p = 0.03), BMI (overweight versus normal, p = 0.04), age (p &lt; 10-4) and coffee consumption (p = 0.04) associated to SBP. Conclusions: Many different factors influence differently SBP in men and women (age, education level, BMI, coffee and alcohol consumptions).

Perfluoroalkyl substances and blood pressure in exposed young population in the Veneto Region, Italy

Abstract Background Residents in a large area of the Veneto Region (North-Eastern Italy) were exposed to perfluoroalkyl substances (PFASs) via drinking water. Studies on the association between PFASs and blood pressure (BP) levels are limited and results are inconsistent. Using cross-sectional data from the Regional health surveillance program, we aimed to quantify the associations between PFAS serum concentrations and blood pressure and hypertension prevalence. Methods The study included 16,224 individuals aged 20-39 years. Pregnant women (n = 327), participants with self-reported diagnosis or under treatment (n = 296) or with missing information on the selected covariates (n = 114) were excluded, leaving 15,487 subjects. Hypertension (HYP) was defined as any self-reported diagnosis, use of antihypertensive drugs, or raised systolic/diastolic blood pressure (SBP)≥140, DBP ≥90 mmHg). Serum PFASs were measured by HPLC-MS. Generalized additive models were used to investigate the relation between each PFAS (perfluorooctanoic acid (PFOA), perfluorooctane sulfonic acid (PFOS), perfluorohexane sulfonic acid (PFHxS), and perfluorononanoic acid (PFNA)) ln transformed and by decile, and SBP, DBP, HYP, adjusted for potential confounders. Results Both SBP and DBP increased significantly with an increase in the ln-transformed serum PFASs concentration in a monotonic way. The predicted increase in SBP and DBP were 1.62 (95% CI = 0.69, 2.55), 1.64 mmHg (95% CI = 0.96, 2.31) from lowest to highest decile of PFOA. The associations were stronger for SBP in men and DBP in women. One unit increase in each ln-PFAS was positively associated with an increased odds of HYP in men: PFOA OR = 1.07 (1.01-1.14), PFOS OR = 1.18 (1.05-1.32), PFHxS OR = 1.11 (1.03-1.19), PFNA OR = 1.19 (1.01-1.41). Conclusions Our findings suggest that exposure to PFAS is associated with increased blood pressure and thus may contribute as a risk factor for the development of cardiovascular diseases. Key messages Serum PFASs were associated with raised systolic blood pressure in men and diastolic blood pressure in women in a large highly exposed young adult population. Serum PFASs were associated with raised prevalence of hypertension in men.

Depressive symptoms and metabolic syndrome components among older Chinese adults

BackgroundFew studies examined associations between depressive symptoms and metabolic syndrome (MetS) among older Chinese adults. Considering that the prevalence of depressive symptoms is high in older Chinese adults, we aimed to examine associations of depressive symptoms with MetS and its components in older Chinese adults.MethodsData from a community-based cross-sectional study of 4579 Chinese adults aged 60 years or older were analyzed. Depressive symptoms were assessed using the nine-item Patient Health Questionnaire. The presence of MetS was defined based on the Adult Treatment Panel III criteria, which include obesity, reduced blood high-density lipoprotein, high blood pressure (BP), elevated fasting plasma glucose and hypertriglyceridemia. A participant was considered as having MetS if he or she met at least three of the above-mentioned criteria.ResultsIn all participants, depressive symptoms were related to elevated fasting plasma glucose (≥ 7.0 mmol/L) (adjusted odds ratio [OR] = 1.50, 95% confidence interval [CI] [1.00–2.20]) and diabetes (adjusted OR = 1.50, 95% CI [1.01–2.20]). The associations of depressive symptoms with MetS and its components were not significant among women. However, there was a negative association between depressive symptoms and elevated systolic BP (≥ 130 mm Hg) (OR = 0.59, 95% CI [0.4–0.9]), and similar findings were observed after adjusting for lifestyle-related variables in men.ConclusionsIn older Chinese adults, depressive symptoms were negatively associated with elevated systolic BP in men while these findings were not found in women.

Effect of lifestyle on blood pressure in Portuguese population under antihypertensive drugs

Abstract Background Hypertension is one of the main risk factors for disability and death from cardiovascular diseases. Current guidelines include initiatives to control blood pressure values in hypertensive patients that focus on lifestyle changes. The main objective of this study was to estimate the association between lifestyle and blood pressure in patients under antihypertensive drugs. Methods An analysis of the data of Portuguese Health Examination Survey (INSEF) was performed. Individuals who met INSEF inclusion criteria and who referred to be under antihypertensive drugs in the two weeks prior to the questionnaire were studied. Lifestyle variables (alcohol consumption, smoking, additional salt intake, fruit and vegetables consumption, practice of physical activity) were measured by questionnaire, and blood pressure values were obtained by physical examination. Associations between lifestyle factors and blood pressure, stratified by sex and adjusted to sociodemographic variables and to obesity, were estimated through a multiple linear regression model. Results Alcohol consumption (ß=6.31, p = 0.007) and smoking (ß=4.72, p = 0.018) were associated with systolic blood pressure in men. Additional salt intake, fruit and vegetable consumption, and practice of physical activity were not associated with blood pressure in men. In women, no association was observed for any behavioural variable. Conclusions These conclusions reinforce the need, also in the population under antihypertensive drugs, particularly in the male sex, to focus the fight against high systolic blood pressure in these two modifiable and preventable behaviours: smoking and alcoholic consumption. Key messages Alcohol consumption and smoking are the behavioral determinants associated with high systolic blood pressure values in men under antihypertensive drugs. These conclusions reinforce the need to focus the fight against high systolic blood pressure in the preventable and modifiable behavioural determinants.