Odds Ratios For High Blood Pressure Research Articles

Exploratory analysis of the association between organophosphate ester mixtures with high blood pressure of children and adolescents aged 8-17years: cross-sectional findings from the National Health and Nutrition Examination Survey.

Epidemiological studies on the effect of organophosphate esters (OPEs) on high blood pressure (BP) among children and adolescents are scant. Therefore, the main objective of the present study was to explore the effect of exposure to OPEs on high BP among children and adolescents. A total of 1340 participants were included in the current analyses. Multivariable logistic regression models were implemented to calculate odds ratios (ORs) and corresponding 95% confidence intervals (CIs) to examine the association between OPE metabolites and high BP. We also assessed the modified effect of sex, age, and overweight/obesity on this association. Furthermore, quantile g-computation (Qgcomp) and Bayesian kernel machine regression (BKMR) were exhibited to analyze the association between multiple OPE metabolite mixtures and high BP. After adjusting for covariates, the highest (vs. lowest) tertiles of bis (1-choloro-2-propyl) phosphate (BCPP), bis-2-chloroethyl phosphate (BCEP), and di-n-butyl phosphate (DBUP) were associated with 1.23 (95% CI: 0.83, 1.83), 1.27 (95% CI: 0.85, 1.92), and 1.01 (95% CI: 0.67, 1.53) odds ratios for high BP, respectively. In the Qgcomp, a quartile increase in OPE metabolite mixtures was weakly associated with an elevated risk of high BP (adjusted OR: 1.06, 95CI%: 0.81, 1.37). The results from BKMR showed a positive trend of association between OPE metabolite mixture on the risk of high BP. In conclusion, our study demonstrated that higher levels of BCPP, BCEP, and DBUP were weakly associated with high BP among US children and adolescents. Moderate evidence suggested OPE metabolite mixtures had positive joint effects on high BP. Consequently, longitudinal studies with repeated measurements are warranted to examine the relationships between multiple OPE metabolites and high blood pressure among children and adolescents.

RELATIONSHIP BETWEEN SERUM OSTEOCALCIN AND BLOOD PRESSURE IN CHINESE ADOLESCENTS AGED 12–18 YEARS

Objective: The relationship between serum osteocalcin level and blood pressure remains unclear. The aim of this study was to determine whether osteocalcin would be associated with blood pressure in Chinese adolescents. Design and method: A total of 1686 subjects (1022 boys,60.6%) aged 12–18 years from Ningxia were randomly selected through a stratified cluster sampling. Serum osteocalcin levels were measured by ELISA. Blood pressure (BP) by using a calibrated electronic sphygmomanometer according to the standard method by the American Hypertension Education Project Working Group. Results: The proportions of Hypertension was highest in the< = 33th percentile subgroup (39.8%) and lowest in the > 66th percentile subgroup (26.3%) in boys, with statistically significant differences between groups (2 = 10.988, P = 0.027). Compared with the subgroup of the< = 33th percentile, the odds ratios (ORs) for abnormal blood pressure were 0.73(95% confidence interval (CI), 0.55—0.96) in the 34th–66th percentile subgroup, 0.64(95% CI, 0.48—0.84) in the > 66th percentile subgroup, respectively. Additionally, the corresponding ORs for high BP were 0.63(95%CI,0.45–0.89) in the 34th–66th percentile subgroup,0.59(95%CI,0.42–0.84) in the > 66th percentile subgroup, respectively. Similar results were found in boys (P all < 0.05). After Adjusting age, fasting blood glucose and BMI, the ORs for high BP were 0.60(95%CI,0.36–0.99) in the > 66th percentile subgroup compared with the reference subgroup. Conclusions: Serum osteocalcin is a protective factor for hypertension in Chinese adolescents, especially in boys.

The association between fluoride in water and blood pressure in children and adolescents.

The objective of this study was to determine the association between water and plasma fluoride and blood pressure (BP) among children and adolescents. Our study population was individuals of 8-18 years in the 2013-2016 National Health and Nutrition Examination Survey. We performed a multivariable linear and logistic regression analysis to examine the relationship between fluoride and BP. In a linear regression analysis for systolic BP (SBP) (mmHg) adjusting for age, sex, race, and poverty, fluoride in water (mg/L) was significant with a coefficient of -0.44 (p = 0.046) among adolescents (12-18 years). Additional adjustments for race, poverty, serum levels of cotinine, and BMI remained significant. While an inverse relationship was found in children (8-11 years), none were significant. Fluoride in plasma was not significant across all ages. The odds ratio of high BP for an increase in water fluoride also was not significant. Higher concentrations of fluoride in water were associated with low SBP only among adolescents. Fluoride alone cannot be responsible for BP as several biological metabolic processes may influence its physiological effects. Fluoride consumption should be considered in conjunction with these processes. The high fluoride in drinking water was statistically significantly associated with low systolic BP in children and adolescents. The odds ratio of high BP for an increase in fluoride in drinking water was not significant. Our study contributes to the existing literature by providing individualized data and results on an individual level.

Association of Serum High-Density Lipoprotein Cholesterol with High Blood Pressures at Checkup: Results of Kanagawa Investigation of Total Checkup Data from the National Database-9 (KITCHEN-9).

Background: although high-density lipoprotein has cardioprotective effects, the association between serum high-density lipoprotein cholesterol (HDL-C) and hypertension is poorly understood. Therefore, we investigated whether high and low concentrations of HDL-C are associated with high blood pressure (HBP) using a large healthcare dataset. Methods: in a community-based cross-sectional study of 1,493,152 Japanese people (830,669 men and 662,483 women) aged 40–74 years who underwent a health checkup, blood pressures automatically measured at healthcare center were investigated in nine HDL-C groups (20–110 mg/dL or over). Results: crude U-shaped relationship were observed between the nine HDL-C and blood pressures in both men and women. Logistic regression analysis showed left-to-right inverted J-shaped relationships between HDL-C and odds ratios for HBP (≥140/90 mmHg and/or pharmacotherapy), with lower limits of 90–99 mg/dL in both sexes, which were unchanged after adjusting for confounding factors. However, further adjustment for body mass index and serum triglyceride concentration revealed positive linear associations between HDL-C and HBP, although blunt U-shaped associations remained in nonalcohol drinkers. Conclusion: both low and extremely high HDL-C concentrations are associated with HBP. The former association might be dependent on excess fat mass concomitant with low HDL-C, whereas the latter association may be largely dependent on frequent alcohol consumption.

Association between alcohol intake pattern and metabolic syndrome components and simulated change by alcohol intake reduction: A cross-sectional study from the Japan Multi-Institutional Collaborative Cohort Study.

To investigate the association between alcohol intake pattern in amount and frequency and metabolic syndrome (Mets) components, we simulated the change in the prevalence of Mets components by intake reduction. In order to manage Mets, alcohol intake reduction with moderation of intake pattern is required. However, evidence investigating the comparative impact of alcohol intake reduction in amount and frequency for Mets components is limited. We conducted a large-scale cross-sectional study in the general Japanese population. The study subjects included 37,371 non-drinkers and current drinkers recruited in the Japan Multi-Institutional Collaborative Cohort Study. Odds ratios (ORs) for Mets components according to alcohol intake amount and frequency were estimated using a multiple logistic regression model. The prevalence of Mets components was estimated after assumed alcohol intake reduction of a) none, b) 10g/day (men) or 5g/day (women), c) 20g/day (men) or 10g/day (women), d) less than 20g/day (men) or 10g/day (women) for moderate-to-heavy drinkers, e) 1-2 times/week, and f) 3-4 times/week. The ORs with alcohol intake amount and frequency increased with high blood pressure while decreasing with dyslipidemia. A J-shaped association was observed between intake amount and Mets. The estimated prevalence (%) of high blood pressure and dyslipidemia in men were a) 45.2, b) 43.0, c) 41.4, d) 40.4, e) 42.9, and f) 42.0; and a) 50.3, b) 51.8, c) 52.9, d) 50.2, e) 52.7, and f) 53.4 in women. The estimated prevalence of high blood pressure in women did not evidently decrease. Simulated alcohol intake reduction showed decreased prevalence for high blood pressure and increased prevalence for dyslipidemia in men after reduced intake amount and frequency. The largest decreased prevalence for high blood pressure was observed in men when all moderate-to-heavy drinkers reduced their alcohol intake amount to less than 20g/day.

Association of the combined estimated 24-h urinary Na/K ratio and body mass index with blood pressure: Cross-sectional data from the KOBE study

Objective Several studies have suggested that high dietary Na/K ratio and body mass index (BMI) increase the prevalence of hypertension. However, there have been a few reports on the combination of these two factors and their relationship with hypertension. This study aimed to examine the association of the combined estimated 24-h urinary Na/K ratio (24h-u-Na/K) (high or low) and BMI (high or low) with the risk of high blood pressure.Method We performed a cross-sectional study involving 1,112 participants (340 men and 772 women) of the Kobe Orthopedic and Biomedical Epidemiological study (KOBE study) who had no cardiovascular diseases or current anti-hypertensive medications. Sex-specific analyses were performed. The 24h-u-Na/K ratio was calculated from an estimation formula using collected spot urine. Participants were divided into four groups based on their 24h-u-Na/K ratio (low or high) and BMI (low or high), with the cutoff points being the median and 25 kg/m2, respectively. Participants with systolic blood pressure (SBP) ≥130 mmHg or diastolic blood pressure (DBP) ≥80 mmHg were diagnosed with high blood pressure. Odds ratios (ORs) for high blood pressure according to the combined risks of high 24h-u-Na/K and BMI were examined with a logistic regression analysis.Results The average SBP/DBP for men and women was 122.7/77.9 and 113.3/69.1 mmHg, respectively, and prevalence of high blood pressure among men and women was 47.4% and 21.3%, respectively. The mean BMI was 22.8 kg/m2 for men and 20.9 kg/m2 for women. The median 24h-u-Na/K was 3.2 for men and 3.1 for women. The prevalence of high blood pressure (men, women) was the highest in the group in which both 24h-u-Na/K and BMI were high (60.0%, 62.9%; men: P=0.273; women: P<0.001). In the same group, the multivariate-adjusted ORs for high blood pressure were significantly higher for both men (2.59; 95% confidence interval [CI]: 1.15-5.86) and women (10.78; 95% CI: 4.87-23.88) compared to the reference group with both factors classified as low. Women with low BMI but high 24h-u-Na/K also demonstrated a higher risk for high blood pressure (OR: 1.62; 95% CI: 1.10-2.40).Conclusion The risk of high blood pressure was the highest when both BMI and 24h-u-Na/K were high. The current specific healthcare guidance in Japan is focused on obese individuals. However, in order to prevent hypertension more effectively, additional focus should be placed on the Na/K diet. Increased intake of vegetables and fruits and reduced intake of salt should be strongly recommended.

Association of School Residential PM2.5 with Childhood High Blood Pressure: Results from an Observational Study in 6 Cities in China.

Objective: To investigate the association of long-term PM2.5 exposure with blood pressure (BP) outcomes in children aged 6–18 years, and to examine the population attributable risk (PAR) of PM2.5 exposure. Methods: A total of 53,289 participants aged 6–18 years with full record of age, sex, BP, height, and local PM2.5 exposure from a cross-sectional survey conducted in 6 cities of China in 2013 were involved in the present study. PM2.5 data from 18 January 2013 to 31 December 2013 were obtained from the nearest environmental monitoring station for each selected school. Two-level linear and logistic regression models were used to evaluate the influence of PM2.5 on children’s BP, and PAR was calculated in each sex and age group. Results: Participants had a mean age of 10.8 (standard deviation: 3.4) years at enrollment, 51.7% of them were boys. U-shaped trends along with increased PM2.5 concentration were found for both systolic blood pressure (SBP) and diastolic blood pressure (DBP), with the thresholds of 57.8 and 65.0 μg/m3, respectively. Both increased annual mean of PM2.5 concentration and ratio of polluted days were associated with increased BP levels and high blood pressure (HBP), with effect estimates for BP ranging from 2.80 (95% CI: −0.51, 6.11) mmHg to 5.78 (95% CI: 2.32, 9.25) mmHg for SBP and from 0.77 (95% CI: −1.98, 3.52) mmHg to 2.66 (−0.35, 5.66) mmHg for DBP, and the odds ratios for HBP from 1.21 (0.43, 3.38) to 1.92 (0.65, 5.67) in the highest vs. the lowest quartiles. Overall, 1.16% of HBP in our participants could be attributed to increased annual mean of PM2.5 concentration, while 2.82% could be attributed to increased ratio of polluted days. These proportions increased with age. Conclusions: The association between long-term PM2.5 exposure and BP values appeared to be U-shaped in Chinese children aged 6–18 years, and increased PM2.5 exposure was associated with higher risk of HBP.

Obesity mediated the association of exposure to polycyclic aromatic hydrocarbon with risk of cardiovascular events

Exposure to polycyclic aromatic hydrocarbons (PAHs) could cause high blood pressure (BP) and increased risk for atherosclerotic cardiovascular disease (ASCVD). However, the mechanisms underlying the relationship between them were unclear. We investigated potential mediation effect of obesity on the association of exposure to PAHs with high BP and increased risk for ASCVD. In the repeated measures study, 106 community-dwelling residents in Wuhan, China finished the physical examination in the winter and summer seasons, eight urinary PAHs metabolites were measured. Associations of urinary PAHs with high BP and increased risk for ASCVD were assessed using either linear mixed effect models or generalized estimating equations models. Mediation analysis was performed to evaluate the mediating effect of obesity on the association of urinary PAHs metabolites with high BP or increased risk of ASCVD. We observed the positive association between urinary PAHs metabolites and BP or the odds ratios for high BP (all P<0.05). Additionally, each one-unit increase in ln-transformed urinary levels of 4-hydroxyphenanthrene or the total of PAH metabolites was associated with a 12.63% or 11.91% increase in the estimated 10-year ASCVD risk (both P<0.05). The waist-to-height ratio mediated 29.0% of the association of urinary 4-hydroxyphenanthrene with increased risk of ASCVD (P<0.05). The findings suggest that PAHs exposure may be associated with elevated BP and an increased risk of ASCVD. Obesity may partially mediate the association between PAHs exposure and higher BP or increased risk of ASCVD.

Shift work and the relationship with metabolic syndrome in Chinese aged workers.

BackgroundShift work is indicated to be associated with adverse metabolic disorders. However, potential effects of shift work on metabolic syndrome (MetS) and its components have not been well established.MethodsIn total, 26,382 workers from Dongfeng-Tongji Cohort were included in this study. Information on shift work history was gathered through questionnaires and metabolic traits were measured. Logistic regression models were used to calculate the odds ratio (OR) and 95% confidence interval (CI) for long-term shift work related with MetS and each component, respectively. Further stratification analysis was performed to detect the differences on MetS between female and male shift workers.ResultsLong-term shift work was associated with MetS without adjusting for any confounders. Compared with the group of non-shift work, the multivariate-adjusted ORs (95%CI) of MetS associated with 1–10, 11−20, and ≥20y of shift work were 1.05 (0.95−1.16), 1.14 (1.03−1.26), 1.16 (1.01−1.31), respectively. In female workers, we found a dose-response relationship that every 10 years increase in shift work was associated with a 10% (95% CI: 1%−20%) elevated OR of MetS, while no significant dose-response trend was found among male workers. Furthermore, shift work duration was significantly associated with ORs of high blood pressure (1.07, 1.01−1.13), long waist circumference (1.10, 1.01−1.20) and high glucose levels (1.09, 1.04−1.15). No significant association was observed between shift work and low HDL cholesterol) and raised triglyceride levels.ConclusionsLong-term shift work was associated with metabolic syndrome and the association might differ by gender in retired workers. Applicable intervention strategies are needed for prevention of metabolic disorders for shift workers.

Evidence of underdiagnosis and markers of high blood pressure risk in children aged 6 to 13 years

ObjectiveTo estimate the prevalence of high blood pressure (BP) in school children, as well as the reported frequency of previous measurements of BP in these children, and to identify high BP risk markers in the sample. MethodsThis was a cross-sectional study involving 794 children aged 6 to 13 years, enrolled in public elementary schools. A questionnaire was given to parents/guardians, consisting of perinatal, socioeconomic data, and information on previous measurements of BP in these children. Anthropometric measurements included weight, height, waist, hip, and arm and neck circumference, in addition to the three BP measurements. Classification of BP levels was carried out according to current international recommendations, established in 2004. ResultsThe prevalence of high BP (hypertension or prehypertension) was 7%. Only 21.7% of children had previously undergone BP measurements. The odds ratio of high BP among children with and without overweight was 2.9 (95% CI = 1.7 to 5.0, p < 0.001). None of the anthropometric measurements was superior to the Z-score of BMI as a predictor of high BP. History of hypertension during pregnancy (p < 0.001), prematurity (p = 0.006), maternal hypertension (p = 0.01), and paternal hypertension (p = 0.008) were also correlated with the presence of high BP in children. ConclusionsOverweight and family history constitute the main risk markers of high BP in children. The low frequency of BP measurement in children observed in this municipality contributes to the underdiagnosis of the disease, with irreversible consequences for these individuals.

Evidence of underdiagnosis and markers of high blood pressure risk in children aged 6 to 13 years

Objectiveto estimate the prevalence of high blood pressure (BP) in schoolchildren, as well as the reported frequency of previous measurements of BP in these children, and to identify high BP risk markers in the sample. Methodsthis was a cross-sectional study involving 794 children aged 6 to 13 years, enrolled in public elementary schools. A questionnaire was given to parents/guardians, consisting of perinatal, socioeconomic data, and information on previous measurements of BP in these children. Anthropometric measurements included weight, height, waist, hip, and arm and neck circumference, in addition to the three BP measurements. Classification of BP levels was carried out according to current international recommendations, established in 2004. Resultsthe prevalence of high BP (hypertension or prehypertension) was 7%. Only 21.7% of children had previously undergone BP measurements. The odds ratio of high BP among children with and without overweight was 2.9 (95% CI=1.7 to 5.0, p<0.001). None of the anthropometric measurements was superior to the Z-score of BMI as a predictor of high BP. History of hypertension during pregnancy (p<0.001), prematurity (p=0.006), maternal hypertension (p=0.01), and paternal hypertension (p=0.008) were also correlated with the presence of high BP in children. Conclusionsoverweight and family history constitute the main risk markers of high BP in children. The low frequency of BP measurement in children observed in this municipality contributes to the underdiagnosis of the disease, with irreversible consequences for these individuals.

Abstract MP49: Socioeconomic Status and Metabolic Syndrome Components in Prepubescent Colombian Children

The association between socioeconomic status (SES) and cardiometabolic risk has been extensively described in developed societies. However, this topic has received little attention in children from developing populations undergoing nutritional transition. Using data from a population-based cross-sectional study of 1,260 children, aged 6-10 y, in Bucaramanga (Colombia), we examined the association between SES and prevalence of metabolic syndrome components (MetS) components. SES was defined according to classification of neighborhood public service fees. High mean blood pressure (≥ 90 th %ile) was determined using sex-, age-, and height-adjusted cut points. For the remaining MetS components we defined internal age- and sex-specific cut points as follows: fasting triglycerides ≥ 90 th %ile; HDL ≤ 10 th %ile; insulin resistance (HOMA-IR) ≥ 90 th %ile; and waist circumference ≥ 90 th %ile. Odds ratios (ORs) and 95% confidence intervals (CIs) for each MetS component were calculated across SES before ( Model 1 ) and after adjustment for measures of early-life nutrition ( Model 2 ) and lifestyle factors ( Model 3 )( Table ). Colombian children from households in high-SES neighborhoods had higher odds of central obesity and insulin resistance, but lower odds of high triglycerides and low HDL cholesterol than their low-SES counterparts ( Table ). ORs for high blood pressure were null. These results suggest that, in low-SES children from nutritionally transitioning populations, blood lipids may emerge as early cardiometabolic risk factors in the absence of central obesity and insulin resistance. These findings highlight the importance of evaluating MetS components individually in prepubescent children. Research is needed to confirm these associations and to understand the cultural and lifestyle factors that may differentiate cardiometabolic risk across SES in children of developing countries.

Regular exercise and a healthy dietary pattern are associated with lower resting blood pressure in non-obese adolescents: a population-based study

The study aims to assess the association of diet and frequency of extracurricular physical activity (PA) on blood pressure (BP) in non-obese adolescents. A total of 7185 non-obese adolescents aged 12-18 years were analysed to elucidate the relationship between BP and exercise/eating habit. Totally, 10.3% of the boys and 4.6% of the girls who responded to the questionnaire reported undertaking regular extracurricular physical exercise > or =3 times/week and were classified as being physically active. An unhealthy eating habit (UEH) score was constructed by counting the number of 'yes' responses to 11 dietary behavioural items considered to be unhealthy. In logistic regression analysis, age, body mass index, exercise frequency and UEH were significantly associated with BP (P<0.001). The odds ratios (ORs) for high BP in physically more active adolescents vs those who were less active was 0.48 (95% confidence interval (CI) 0.30-0.77). The OR for high BP in those with UEH scores in the highest quartile vs those with UEH scores in the lowest quartile was 1.63 (95% CI 1.24-2.15). In conclusion, regular exercise and a healthy diet are positively associated with lower BP even in non-obese adolescents.

Effects of overweight on blood pressure and incidence of hypertension: Results of an 18-year follow-up study in China

Objectives: To investigate the effects of overweight and obesity on blood pressure (BP) tracking from adolescence to adulthood and the incidence of hypertension in young adults in a cohort from 1987 to 2005. Methods: The baseline survey was conducted in 4623 school students aged six to fifteen in 1987. According to body mass index (BMI), 260 children were enrolled and divided into the overweight group (n=42) and the control group (n=218). Overweight was defined as BMI ≥90th percentile (P90) of the same age and the same gender, with BMI <50th percentile (P50) as the control group. They were followed up 18 years later. Results: The total follow-up rate was 75.8%. In the overweight group, both baseline and follow-up BP levels were significantly higher than the control group (P<0.01), and the incidence of hypertension (≥140/90 mm Hg) was also higher after 18 years (30.0% vs 13.8%), but there was no significant difference (P>0.05). When the increments in BMI (ΔBMI) were used to replace BMI, we divided the students into ΔBMI≥P75 group (HΔBMI) and ΔBMI<P50 group (NΔBMI). We found that the development of high BP directly correlated with increments in BMI during the follow-up period. The prevalence and odds ratio of high BP were higher by 4.5-fold in individuals in HΔBMI group when compared with the NΔBMI group (37.9% vs 8.8%, P<0.01). Conclusions: Overweight during adolescence predicts higher incidence of hypertension, which is a major risk factor of youth hypertension.

Influence of Age on the Relationship between Alcohol Consumption and Metabolic Syndrome

Background: Relationships between alcohol consumption and risks for metabolic syndrome in general populations are very controversial. It is unknown whether age influences the relationship between alcohol intake and the prevalence of metabolic syndrome. Objective: The purpose of this study was to determine whether age influences the relationship between alcohol consumption and metabolic syndrome. Methods: Men aged ≧35 and <45 years (younger group) and those aged ≧65 years (older group), matched for alcohol intake and smoking history, were divided into four subgroups by alcohol intake [non-, light (<22 g ethanol/day), heavy (≧22 and <44 g ethanol/day) and very heavy (≧44 g ethanol/day) drinkers]. Odds ratios (ORs) versus nondrinkers for each risk factor and metabolic syndrome were compared between the younger and older groups. Results: Both in the younger and older groups, ORs for high blood pressure and low HDL cholesterol were significantly high and low, respectively, in all drinker groups. In younger subjects, the OR for large waist circumference was significantly low in light drinkers, and the OR for high hemoglobin A_1c was significantly low in light and heavy drinkers, while these associations were not found in older subjects. The OR for metabolic syndrome was significantly low in light and heavy drinkers in the younger subjects but was not significant in any drinker groups in older subjects. Conclusion: Age influences the relationships between alcohol consumption and atherosclerotic risk factors, and there is a significant association between alcohol intake and a lower risk for metabolic syndrome in young men but not in elderly men.