Modifiable Risk Factors Hypertension Research Articles

Association between socioeconomic factors and urinary sodium-to-potassium ratio: the Nagahama Study.

High sodium intake is a simple modifiable risk factor for hypertension. Although not confirmed, lower socioeconomic status may be a factor that increases sodium intake. We aimed to clarify the association between socioeconomic status and urinary sodium-to-potassium ratio by cross-sectional and longitudinal analyses. The study included 9410 community residents. Spot urine sodium-to-potassium ratios were measured twice with a 5-year interval. Socioeconomic status was investigated using a self-administered questionnaire. Cross-sectional analysis revealed that educational attainment was inversely associated with urinary sodium-to-potassium ratio (years of education ≤ 9: 3.0 ± 1.8, ≤ 12: 2.9 ± 1.6, ≥ 13: 2.8 ± 1.6; P < 0.001), whereas no significant association was observed with household income. Men, particularly individuals living alone, exhibited markedly high sodium-to-potassium ratios (3.6 ± 2.3). Although frequent intake of vegetables, fruits, and dairy products was also inversely associated with the ratio, the associations with educational attainment ( ≤ 9: reference, ≤ 12: β = -0.032, P = 0.026, ≥ 13: β = -0.059, P < 0.001), marital status (β = -0.040, P < 0.001), and sex*marital status interaction (β = 0.054, P = 0.001) were independent of these covariates. Educational attainment was also inversely associated with differences in the urinary sodium-to-potassium ratio during the follow-up period (odds ratio, 0.70; P < 0.001). Lower educational attainment was an independent determinant for urinary sodium-to-potassium ratio. Health literacy education, particularly in men living alone, may be a factor for reducing salt intake even in high-income countries where equal educational opportunity is assured.

The Burden of Modifiable Risk Factors in Newly Defined Categories of Blood Pressure

BackgroundThe 2017 American College of Cardiology/American Heart Association Guideline introduced new categories of high blood pressure. The vast majority of individuals in these newly defined categories are recommended for nonpharmacological intervention rather than antihypertensive therapy. This study sought to determine the burden of potentially modifiable risk factors of hypertension among untreated adults in the newly defined categories of blood pressure. MethodsWe analyzed data from the 1999-2014 National Health and Nutrition Examination Survey (N = 37,448). Potentially modifiable risk factors included abdominal obesity, high non-high-density lipoprotein (HDL) cholesterol, secondhand smoking, binge drinking, suboptimal physical activity, and low-fiber diet. ResultsAlthough the prevalence of certain modifiable risk factors decreased during the study period, the prevalence of low fiber intake, suboptimal physical activity, abdominal obesity, and binge drinking remained high during the last combined survey cycle (2011-2014). Modifiable risk factors generally demonstrated dose–response relationships with high blood pressure categories. The most common type of risk factor clustering included low fiber intake, suboptimal physical activity, high non-HDL cholesterol, and abdominal obesity, with its prevalence increasing gradually from 9.5% (95% confidence interval, 8.8%-10.3%) in the normal blood pressure group to 16.5% (95% confidence interval, 14.8%-18.3%) in the stage 2 hypertension group (Ptrend < .001). The prevalence of 4 or more modifiable risk factors per participant increased stepwise, ranging from 28.5% in the normal blood pressure group to 48.0% in the stage 2 hypertension group (Ptrend < .001). ConclusionsThe burden of potentially modifiable risk factors for hypertension shows progressive increase along the blood pressure categories and represents an important target for nonpharmacologic intervention.

Relationship between Coping Mechanisms to Psychosocial Stress with Blood Pressure in Young Adults: A Pilot Study

Background: Hypertension is a major risk factor for cardiovascular diseases, one of the leading causes of death worldwide. Prehypertension is a precursor of hypertension, with high prevalence in young adults. Psychosocial stress can be one of the modifiable risk factors for hypertension. The objective of the study is to assess the relationship between coping mechanism to psychosocial stress and the blood pressure of young adults.Methods: A comparative crosssectional pilot study was conducted in 36 young adults aged less than 45 years. The pulse rate, blood pressure and body mass index of the respondents were recorded. Psychosocial stress was measured by plasma cortisol following an acute mental stress test; and the level of stress and the coping strategies to stress were assessed using validated Malay Version questionnaires: DASS- 21 and Brief R-COPE questionnaires.Results: Forty four percent of subjects had normotension and fifty six percent had above-normal blood pressure (prehypertension and mild hypertension). Subjects with above-normal blood pressure were associated with high plasma cortisol levels (p = 0.032), and high body mass indexes (BMI) (p = 0.004). Maladaptive coping strategy was found to be associated with high stress scores (p = 0.019). The relationship between stress and cortisol was not significant, though a higher cortisol level was noted in the high blood pressure group.Conclusion: In conclusion, higher cortisol levels and greater BMIs were associated with above-normal blood pressure in young adults. These findings are useful for future research in this area, and the continuation of this study will hopefully yield a more significant relationship.Bangladesh Journal of Medical Science Vol.17(3) 2018 p.439-445

Prevalence of modifiable risk factors for hypertension among secondary school adolescents, Abuja, Nigeria, 2016

Introduction: globally, hypertension is one of the prominent non-communicable diseases and its increased prevalence had been noted in adolescents. Modifiable risk factors such as obesity, unhealthy diet, and physical inactivity have consistently been implicated in adolescents hypertension. This study assessed the prevalence of modifiable risk factors of hypertension among secondary school adolescents, Abuja, Nigeria.

Study on Associated Risk Factors of Hypertension at Sipaghat of Sindhupalchowk District, Nepal

Background: Hypertension is a progressive cardiovascular syndrome arising from complex and interrelated etiologies. Males have slightly higher prevalence than female in most of countries of Southeast-Asian region.Objective: The objective of study is to find out prevalence and the risk factors of hypertension at Sipaghat, Sindhulchowk, Nepal.Materials and Methods: A cross-sectional study was conducted at Sipaghat of Sindhupalchowk district in May 2016 and 260 persons were selected randomly. Results: The prevalence of hypertension was higher in male (25.4%) than female (17.4%). Mean age of study population was 42.08 years with standard deviation, 15.95 years. Variables namely age group, smoking, alcohol consumption and family history of hypertension were found to be significant at 5 percent level of significance. Alcohol consumption and smokers have more than two times higher chance of getting hypertension compared to alcohol non-consumer and nonsmoker with 95% confidence intervals were 1.08-4.80 and 1.21-6.10, respectively. Persons with family history of hypertension have 3.8 times more chance of getting hypertension compared to no family history of hypertension with 1.89-7.61 of 95% confidence interval.Conclusion: Lifestyle modification reduces blood pressure which prevents or delays the incidence of hypertension. Hypertension can be controlled and prevented by modifying the lifestyle. People should be advised to avoid modifiable risk factors of hypertension like smoking, consumption of alcohol and physical inactivity through health education programs.Nepalese Journal of Statistics, 2017, Vol. 1, 73-82

The modifiable risk factors of hypertension in youths

Objective: To verify the modifiable cause(s) of hypertension in youths.Method: It is a prospective observational study, it was done in out patient private clinic in Kerbala city during the period between May 2004 and October 2006 .three hundred and fifty persons were included, the ages of all persons ranged between 20 and 35years, but 236 were hypertensive and 114 were normotensive.The main parameters that were studied included; body mass index (BMI) ,total serum cholesterol and smoking.&#x0D; Results: All the hypertensive patients belong to families with history of hypertension, 80.5% of them were hypercholestremic,64.4% were obese and 53.8% were smoker. On the other side, only 21% of the persons of the normotensive group belonged to families with hypertension , none of them were obese, but 7.9% were hypercholestremic and 13.1% were smoker.Conclusion: hypercholestremia,obesity and smoking are a modifiable causes of hypertension in youth. Early recognition, education and treatment of hypercholestremia plus weight reduction and cessation of smoking may prevent or reduce the severity of hypertension and hence its hazardous complication later on.

Role of plasma adiponectin /C-reactive protein ratio in obesity and type 2 diabetes among African Americans.

Obesity is a modifiable risk factor for hypertension and T2D. Objective(s): We examined relations between fasting plasma adiponectin (ADIP), C-reactive protein (CRP) concentrations and markers of T2D in African Americans (AA). Fasting plasma ADIP, CRP, Insulin (IN), HOMA-IR, lipid profiles, body fat percent (%BF), waist circumference (WC), body mass index (BMI) and blood pressure measures were determined in AA women (W: n=77) and men (M: n=34). Participants were classified into: 1) Normal fasting glucose (FG) and Normal %BF; 2) Normal FG and High %BF; and 3) High FG. Compared to men, women had significantly higher mean ADIP (W: 31.4±2.9 vs. M: 18.0±4.4 ng/L), CRP (W: 3.2±0.3 vs. M: 2.0±0.5 mg/L), %BF (W: 41.2±0.9 vs. M: 27.2±1.3), and BMI (W: 32.3±0.7 vs. M: 29.2±1.1 kg/m2). Women with normal FG and %BF had significantly higher ADIP (64.0±6.0) and lower CRP (1.3±0.6) concentrations than normal FG/ high %BF (ADIP: 37.0±5.0 and CRP: 3.1 ±0.5) and high FG (ADIP: 15.1±4.1 and CRP: 4.0 ± 0.5) groups. Women with high ADIP to CRP ratio had favorable metabolic and anthropometric profiles. Low ADIP and high CRP are associated with excessive %BF and FG in AA women. ADIP/CRP, may be useful for detecting metabolic dysregulation.

Long-term exposure to residential ambient fine and coarse particulate matter and incident hypertension in post-menopausal women

BackgroundLong-term exposure to ambient particulate matter (PM) has been previously linked with higher risk of cardiovascular events. This association may be mediated, at least partly, by increasing the risk of incident hypertension, a key determinant of cardiovascular risk. However, whether long-term exposure to PM is associated with incident hypertension remains unclear. MethodsUsing national geostatistical models incorporating geographic covariates and spatial smoothing, we estimated annual average concentrations of residential fine (PM2.5), respirable (PM10), and course (PM10–2.5) fractions of particulate matter among 44,255 post-menopausal women free of hypertension enrolled in the Women's Health Initiative (WHI) clinical trials. We used time-varying Cox proportional hazards models to evaluate the association between long-term average residential pollutant concentrations and incident hypertension, adjusting for potential confounding by sociodemographic factors, medical history, neighborhood socioeconomic measures, WHI study clinical site, clinical trial, and randomization arm. ResultsDuring 298,383 person-years of follow-up, 14,511 participants developed incident hypertension. The adjusted hazard ratios per interquartile range (IQR) increase in PM2.5, PM10, and PM10–2.5 were 1.13 (95% CI: 1.08, 1.17), 1.06 (1.03, 1.10), and 1.01 (95% CI: 0.97, 1.04), respectively. Statistically significant concentration-response relationships were identified for PM2.5 and PM10 fractions. The association between PM2.5 and hypertension was more pronounced among non-white participants and those residing in the Northeastern United States. ConclusionsIn this cohort of post-menopausal women, ambient fine and respirable particulate matter exposures were associated with higher incidence rates of hypertension. These results suggest that particulate matter may be an important modifiable risk factor for hypertension.

The Prevalence of Hypertension Accompanied by High Homocysteine and its Risk Factors in a Rural Population: A Cross-Sectional Study from Northeast China

Previous studies found that hypertension and high homocysteine (HHcy) exhibited a synergistic effect on the risk of cardiovascular diseases. This study aimed to investigate the prevalence of hypertension accompanied by HHcy and its risk factors in the rural areas of northeast China. This study was conducted using a stratified cluster random sampling method, and included 6529 subjects with complete data. Demographic characteristics were obtained from a questionnaire. Blood pressure and anthropometric indices were measured, and serum indices were analyzed. Hypertension accompanied by HHcy was defined as hypertension plus HHcy [homocysteine (Hcy) > 10 µmol/L]. The mean concentration of Hcy was 17.29 μmol/L in the general population. The prevalence of hypertension accompanied by HHcy was so high that it reached 45.1% of our study population and accounted for 86.8% of the total participants with hypertension. Multiple logistic regression analysis indicated that the modifiable risk factors of hypertension accompanied by HHcy included obesity, diabetes, dyslipidemia, and inactive physical activities. We found that the mean level of Hcy, and the prevalences of HHcy and hypertension accompanied by HHcy were very high among the rural population of northeast China. Obesity, diabetes, dyslipidemia, and inactive physical activities were modifiable risk factors of hypertension accompanied by HHcy.

Association Between Multiple Modifiable Risk Factors of Cardiovascular Disease and Hypertension among Asymptomatic Patients in Central Appalachia

The central Appalachian region of the United States is disproportionately burdened with cardiovascular diseases (CVD) and associated risk factors; however, research to inform clinical practice and policies and programs is sparse. This study aimed to examine the association between multiple modifiable risk factors for CVD and hypertension in asymptomatic patients in central Appalachia. Between January 2011 and December 2012, 1629 asymptomatic individuals from central Appalachia participated in screening for subclinical atherosclerosis. Participants were asked to report their hypertension status (yes/no). In addition, data on two nonmodifiable risk factors (sex, age) and five modifiable risk factors (obesity, diabetes mellitus, hypercholesterolemia, smoking, and sedentary lifestyle) were collected. Multivariable logistic regression analyses were conducted to assess association between hypertension and risk factors. Of the 1629 participants, approximately half (49.8%) had hypertension. Among people with hypertension, 31.4% were obese and 62.3% had hypercholesterolemia. After adjusting for sex and age, obesity and diabetes mellitus were associated with a more than twofold increased odds of having hypertension (odds ratio [OR] 2.02, confidence interval [CI] 1.57-2.60 and OR 2.30, CI 1.66-3.18, respectively). Hypercholesterolemia and sedentary lifestyle were associated with higher odds for hypertension (OR 1.26, CI 1.02-1.56 and OR 1.38, CI 1.12-1.70, respectively), compared with referent groups. Having two, three, and four to five modifiable risk factors was associated with increased odds of having hypertension by about twofold (OR 1.72, CI 1.21-2.44), 2.5-fold (OR 2.55, CI 1.74-3.74), and sixfold (OR 5.96, CI 3.42-10.41), respectively. This study suggests that the odds of having hypertension increases with a higher number of modifiable risk factors for CVD. As such, implementing an integrated CVD program for treating and controlling modifiable risk factors for hypertension would likely decrease the future risk of CVD.

Dietary Approach to Stop Hypertension with Sodium Reduction for Chinese Canadians (DASHNa-CC): A Pilot Randomized Controlled Trial.

There is a lack of culturally sensitive dietary interventions targeting Chinese Canadians despite unhealthy dietary behaviours being identified as the most important modifiable risk factor for hypertension in the Chinese population. To determine the feasibility of a culturally sensitive dietary intervention for hypertension control; to examine the potential effects of the intervention on blood pressure and health-related quality of life among Chinese Canadians in community. This study was a two-group pilot randomized controlled trial with 8 weeks follow up. Sixty self-identified Chinese Canadians, older than 45 years old and with grade one hypertension but not on antihypertensive medications were recruited in community. The control group received usual care and the intervention group received usual care plus newly developed DASHNa-CC intervention. The DASHNa-CC intervention consisted of a written manual, two classroom sessions, and one telephone booster call to provide healthy dietary and sodium reduction advice, integrated with Traditional Chinese Medicine food therapy recommendations for hypertension control. 618 Chinese Canadians participated in blood pressure screening, and 60 eligible participants recruited. Participants were highly satisfied with the intervention and adhered to the trial protocol. The lost to follow-up rate was 5%. At 8 weeks post-randomization, those in the intervention group had greater reductions in systolic blood pressure [3.8mmHg, t (55) = -1.58, p = 0.12] and higher physical health scores [t (55) = 2.13, p = 0.04] compared to those of the control group. There were no group differences in health care utilization. It is feasible to deliver the DASHNa-CC intervention in a Chinese Canadian community. The DASHNa-CC intervention may decrease blood pressure and improve health-related quality of life for Chinese Canadians.

Diet and Blood Pressure Control in Chinese Canadians: Cultural Considerations.

Hypertension is highly prevalent in Chinese Canadians and diet has been identified as an important modifiable risk factor for hypertension. The current anti-hypertensive dietary recommendations in hypertension care guidelines lack examination of cultural factors, are not culturally sensitive to ethnic populations, and cannot be translated to Chinese Canadian populations without cultural considerations. Guided by Leininger's Sunrise Model of culture care theory, this paper investigates how cultural factors impact Chinese Canadians' dietary practice. It is proposed that English language proficiency, health literacy, traditional Chinese diet, migration and acculturation, and Traditional Chinese Medicine influence Chinese Canadians' dietary practices. A culturally congruent nursing intervention should be established and tailored according to related cultural factors to facilitate Chinese Canadians' blood pressure control. In addition, further study is needed to test the model adapted from Sunrise Model and understand its mechanism.

Abstract 615: Association Between Multiple Modifiable Risk Factors of Cardiovascular Disease and Hypertension in a Rural Population of the United States

Background: Hypertension (HTN) is one of the major risk factors for cardiovascular diseases (CVD) that afflicts one-third of the population in United States (US). This study examined the association between multiple modifiable risk factors for HTN in a rural hard-to-reach population. Methods: During January 2011 and December 2012, 1629 community-dwelling asymptomatic individuals from central Appalachia participated in screening for subclinical atherosclerosis, during which the participants were asked to report whether a physician or health worker has informed them that they had HTN (yes/no). Additionally, baseline data consisting of two non-modifiable risk factors (sex, age) and 5 modifiable risk factors (obesity, diabetes, hypercholesterolemia, smoking, and sedentary lifestyle) were collected. Descriptive statistics involving prevalence of risk factors and multivariate logistic regression analyses to determine the strength of association between hypertension and the number of risk factors were conducted. Results: Of the 1629 study participants, about half (49.8%) had hypertension. Among hypertensive patients, 31.4% were obese and 62.3% having hypercholesterolemia. Overall, having 2 risk factors consisted the largest group of participants with HTN. After adjusting for the non-modifiable risk factors (sex, age), obesity and diabetes increased the odds of having HTN by more than two folds ([OR=2.02, CI=1.57-2.60] and [OR=2.30, CI=1.66-3.18], respectively) and hypercholesterolemia and sedentary lifestyle increased the odds for HTN by more than one fold ([OR=1.26, CI=1.02-1.56) and [OR=1.38, CI=1.12-1.70], respectively). Compared to those without HTN, having 2, 3, and 4 or 5 modifiable risk factors were significantly associated with increased odds of having HTN by about two-folds [OR=1.72, CI=1.21-2.44], two and half folds [OR=2.55, 1.74-3.74], and six folds [OR=5.96, 3.42-10.41], respectively. Conclusion: The study suggests that odds of having HTN increases with the number of modifiable risk factors for CVD. Hence, by implementing an integrated CVD program for treating and controlling modifiable risk factors of HTN would decrease the future risk of CVD and help to achieve the 2020 Impact Goal of the American Health Association.

Modifiable risk factors of hypertension: A hospital-based case-control study from Kerala, India

Introduction:Hypertension is a major cause of cardiovascular morbidity and mortality in Kerala. Excess dietary salt, low dietary potassium, overweight and obesity, physical inactivity, excess alcohol, smoking, socioeconomic status, psychosocial stressors, and diabetes are considered as modifiable risk factors for hypertension.Objectives:To estimate and compare the distribution of modifiable risk factors among hypertensive (cases) and nonhypertensive (controls) patients and to estimate the effect relationship of risk factors.Materials and Methods:Age- and sex-matched case–control study was conducted in a tertiary care hospital in Kerala using a pretested interviewer-administered structured questionnaire based on the WHO STEPS instrument for chronic disease risk factor surveillance. Bivariate and multiple logistic regression analyses were done.Results:A total of 296 subjects were included in the study. The mean age of study sample was 50.13 years. All modifiable risk factors studied vis-ΰ-vis obesity, lack of physical activity, inadequate fruits and vegetable intake, diabetes, smoking, and alcohol use were significantly different in proportion among cases and controls. Obesity, lack of physical activity, smoking, and diabetes were found to be significant risk factors for hypertension after adjusting for other risk factors.Conclusion:Hypertension is strongly driven by a set of modifiable risk factors. Massive public awareness campaign targeting risk factors is essential in controlling hypertension in Kerala, especially focusing on physical exercise and control of diabetes, obesity, and on quitting smoking.

Contribution of modifiable risk factors for hypertension and type-2 diabetes in Peruvian resource-limited settings

BackgroundIt is important to understand the local burden of non-communicable diseases including within-country heterogeneity. The aim of this study was to characterise hypertension and type-2 diabetes profiles across different Peruvian...

Health Professional Advice and Adult Action to Reduce Sodium Intake.

Excessive sodium intake is a key modifiable risk factor for hypertension and cardiovascular disease. Although 95% of U.S. adults exceed intake recommendations, knowledge is limited regarding whether doctor or health professional advice motivates patients to reduce intake. Our objectives were to describe the prevalence and determinants of taking action to reduce sodium, and to test whether receiving advice was associated with action. Analyses, conducted in 2014, used data from the 2013 Behavioral Risk Factor Surveillance System, a state-based telephone survey representative of non-institutionalized adults. Respondents (n=173,778) from 26 states, the District of Columbia, and Puerto Rico used the new optional sodium module. We estimated prevalence ratios (PRs) based on average marginal predictions, accounting for the complex survey design. Fifty-three percent of adults reported taking action to reduce sodium intake. Prevalence of action was highest among adults who received advice (83%), followed by adults taking antihypertensive medications, adults with diabetes, adults with kidney disease, or adults with a history of cardiovascular disease (range, 73%-75%), and lowest among adults aged 18-24 years (29%). Overall, 23% of adults reported receiving advice to reduce sodium intake. Receiving advice was associated with taking action (prevalence ratio=1.59; 95% CI=1.56, 1.61), independent of sociodemographic and health characteristics, although some disparities were observed across race/ethnicity and BMI categories. Our results suggest that more than half of U.S. adults in 26 states and two territories are taking action to reduce sodium intake, and doctor or health professional advice is strongly associated with action.

Effects of leisure time physical activity on blood pressure in healthy adults over 3 years: The PEP family heart study

Background: Physical inactivity and obesity are modifiable risk factors for hypertension. We evaluated effects of leisure time physical activity (LTPA) on blood pressure (BP) and overweight/obesity in apparently healthy adults in a 3-years observational study.

Modifiable Risk factors of Hypertension and Socio-demographic Profile in Oghara, Delta State; Prevalence and Correlates.

Background:Factors associated with the development of hypertension can be categorized into modifiable and non-modifiable risk factors. The modifiable risk factors include obesity, physical inactivity, high salt diet, smoking alcohol consumption and others.Aim:This study was aimed to determine the prevalence of modifiable risk factors of hypertension in a rural community; Oghara and to ascertain if any association exists with these risk factors and socio-demographic variables.Subjects and Methods:Descriptive cross-sectional study design was utilized for the study and it was carried out over a period of 6 months (Feburary 2012 to August 2012). Cluster sampling was utilized to select a total of 272 respondents for the study. An interviewer administered questionnaire was used to collect data and data analysis was performed by SPSS version 16.0 (Chicago II, USA).Results:The prevalence of hypertension is 21.0% (57/272), while the prevalence of modifiable risk factors of hypertension such as smoking, alcohol consumption and obesity are 15.8% (43/272), 43.4% (118/272) and 18.8% (51/272) respectively. There is a statistical significant association between hypertension and smoking (P < 0.001), as well as hypertension and alcohol. (P < 0.001), on the other hand socio-demographic variables were significantly associated with smoking (P < 0.001).Conclusion:The study showed high prevalence of modifiable risk factors of hypertension. This underscores the need for preventive efforts to encourage changes in life style pattern in order to reverse the impending epidemic of hypertension and other non-communicable diseases.

Socio-demographic determinants and awareness regarding hypertension among adult population in an urban slum of Mumbai, India

Background: Hypertension is a well-established risk factor for major cardiovascular diseases, thus a great challenge in modern public health. It is common, asymptomatic, readily detectable, having preventable risk factors and often lead to lethal complications if left untreated. Methods: A cross-sectional study was carried out among 133 people in the field practice area of the T. N. Medical College, Mumbai during the period of August to October 2005. A pre-designed questionnaire was used to collect necessary information such as socio-demographic profile and level of awareness regards to risk factors, and complications of hypertension as the tool of data collection. Results were analysed using Statistical Package of Social Sciences (SPSS) version -17.0. Results: In the present study, out of total 133 respondents, 60.9% were females and 39.1% were males. Awareness of modifiable risk factors for hypertension is significantly more in males than in females. As age increases awareness of non-modifiable risk factors for hypertension also increases. Socio-economic status of respondents shows significant association with awareness of complications of hypertension. Conclusions: In this study, the level of awareness regarding hypertension among study population was poor indicating a need to target the hypertension screening and awareness campaigns. Hypertension awareness can also be improved by increasing public knowledge and health education targeting general public.

Factors associated with components of arterial pressure among older individuals (the multinational MEDIS study): the role of the Mediterranean diet and alcohol consumption.

The aim of this work was to evaluate factors associated with arterial blood pressure in a sample of older Mediterranean people without known cardiovascular disease. During 2005 to 2011, 2813 older (aged 65-100 years) individuals from 22 Mediterranean islands and the rural Mani region (Peloponnesus) voluntarily enrolled. Standard procedures were used to determine arterial BP and pulse pressure and for the evaluation of dietary habits (including tea and alcoholic beverages consumption), lifestyle, and anthropometric and clinical characteristics of the participants. Participants who reported low alcohol consumption (ie, 0-1 glasses per day) were less likely to have hypertension (odds ratio, 0.34; 95% confidence interval, 0.14-0.84) as compared with those who reported high alcohol consumption (ie, 5+ glasses per day). Adherence to the Mediterranean diet was inversely associated with mean arterial pressure (β coefficient, -0.18; 95% confidence interval, -0.33 to -0.16). Alcohol drinking remains an important modifiable risk factor for hypertension. Adherence to the Mediterranean diet was associated with decreased arterial peripheral resistance.