Predictor Of Diastolic Blood Pressure Research Articles

Relationship between social determinants of health and clinical outcomes in adults with type 2 diabetes in Lebanon

BackgroundA growing number of ethnic minority populations in the United States are from the Middle East and North Africa (MENA) region, specifically Lebanon. This region is witnessing one of the highest expected increases in diabetes prevalence. However, limited data exists on how social determinants of health impact clinical care for diabetes in this population. The aim of this study was to assess the social determinants of health and their impact on clinical outcomes in Lebanese adults with type 2 diabetes (T2DM). MethodsA convenience sample of Lebanese patients with T2DM was recruited from primary health care centers in Lebanon. Data on demographics and social determinants of health, including socioeconomic status, neighborhood and built environment, as well as psychosocial variables were collected. Clinical outcomes including Hemoglobin A1c (A1C), systolic (SBP) and diastolic blood pressure (DBP) were measured. Unadjusted and adjusted linear regression models were used to test for associations between the independent variables and each of the outcomes. ResultsOut of the 300 adults with T2DM, 52% were men, 73% were married and 64% had an education level below high school. Results from multivariate analyses showed that food insecurity (β = 0.16, p = 0.01), owning an air conditioner (β = -0.64, p = 0.01), and commuting by walking (β = -0.93, p = 0.01) were independently associated with A1C. Predictors of DBP were male gender (β = 3.59, p = 0.03), age (β = -0.19, p = 0.005) and lack of confidence in filling medical forms (β = -4.89, p = 0.007), while male gender was the only predictor of SBP (β = 7.41, p = 0.008). ConclusionsThis is the first study to examine the relationship between social determinants of health and clinical outcomes for diabetes in the MENA region. Our findings suggest that living in an underprivileged neighborhood and built environment was significantly and independently associated with poor clinical outcomes among adults with T2DM in Lebanon. Findings from this study will inform care for immigrant populations with diabetes from the MENA region.

Do the Same Central Anthropometric Variables that Best Predict Blood Pressure in European Americans also Best Predict Blood Pressure in African Americans?

The purpose of this study was to determine if central anthropometric variables that best estimate blood pressure risks in European Americans also best estimate blood pressure risks in African Americans. The participants were 357 normotensive African and European American volunteers with a mean age of 32.6 ± 12.4 years. Participants were evaluated for central adiposity with dual energy X-ray absorptiometry, abdomen and thigh skinfolds, waist and hip circumferences, waist/hip ratio, waist/height ratio, body mass index, and systolic and diastolic blood pressures. Descriptive statistics, partial correlations, ANOVA and stepwise regressions were used to analyze the data. Central adiposity anthropometric indices made different contributions to blood pressure in African and European American men and women. When weight was held constant, waist circumference shared stronger partial relationships with blood pressure in African Americans (r = .30 to .47) than in European Americans (r = .11 to .32). Waist circumference in combination with other indices was a predictor of systolic and diastolic blood pressures in European American men (P<.05) but only a predictor for diastolic blood pressure in African American men and women (P<.01). Hip circumference was the only predictor for systolic blood pressure (P<.01) in African American men and women. Further research on the relative contributions of central anthropometric indices to blood pressure in African and European Americans is warranted. A better understanding of this relationship may help reduce hypertensive morbidity and mortality disparities between African and European Americans.

Inflammation and Muscle Oxygen Saturation are Associated with Exercise Pressor Response in Peripheral Artery Disease

PURPOSE: To determine whether calf muscle oxygen saturation (StO2) and vascular biomarkers of inflammation and oxidative stress were associated with an exercise pressor response during treadmill walking in patients with symptomatic peripheral artery disease (PAD). METHODS: A total of 179 patients were characterized on demographic variables, comorbid conditions, cardiovascular risk factors, ankle/brachial index, peak walking time (PWT), claudication onset time (COT), and calf muscle oxygen saturation (StO2) during a graded maximal treadmill test. The exercise pressor response was measured as the change in blood pressure from rest to the end of the first 2-minute treadmill exercise work stage (2 mph, 0% grade). Patients were further characterized on endothelial effects of circulating factors present in the sera using a cell culture-based bioassay on primary human arterial endothelial cells, and on circulating inflammatory and vascular biomarkers. RESULTS: During the maximal treadmill test, patients experienced COT at 197±164 seconds (mean±SD) and PWT at 395±254 seconds. There was a wide range in the change in systolic blood pressure (-46 to 50 mm Hg) and in diastolic blood pressure (-23 to 38 mm Hg), with mean increases of 4.3 mm Hg and 1.4 mm Hg, respectively. In multiple regression analyses, significant predictors of systolic blood pressure included glucose (p<0.001) and insulin (p=0.039). The significant predictors of diastolic blood pressure included cultured endothelial cell apoptosis (p=0.019), the percentage drop in exercise calf muscle StO2 (p=0.023), high sensitivity C-reactive protein (p=0.032), and glucose (p=0.033). CONCLUSION: Higher levels in pro-inflammatory vascular biomarkers, impaired calf muscle StO2 during exercise, and elevated blood glucose were independently associated with greater exercise pressor response in patients with symptomatic PAD. The clinical implication is that exercise and nutritional interventions designed to improve inflammation, microcirculation, and glucose metabolism may ameliorate the exercise pressor response in patients with symptomatic PAD.

Cardiometabolic Risk in Overweight and Obese Children in Bangladesh

Introduction: Childhood obesity is increasing dramatically and represents an important public health issue due to associated metabolic and cardiovascular comorbidities. Very limited data are available regarding cardiometabolic risk factors among this group in Bangladesh. Objective: To observe the cardiometabolic risk factors in overweight and obese children. Methods: This cross-sectional study was carried out in 88 overweight and obese children recruited consecutively by using CDC percentile chart for body mass index (BMI) in children between January 2017 and March 2018 in the Department of Endocrinology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh. After completing a questionnaire and relevant clinical examination, blood was collected for fasting plasma glucose (FPG), insulin, HbA1c, lipid profile and C-reactive protein (CRP). Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) was used to determine insulin resistance. Results: Central obesity (100%), dyslipidaemia (88.6%), raised CRP (81.8%) and metabolic syndrome (69.3%) were the most common cardiometabolic risk factors. Children with grade 3 obesity had significantly higher systolic blood pressure (115.57 ± 11.60 vs 105.71 ± 8.84 mmHg, p = 0.043) and insulin resistance (7.15 ± 4.97 vs 3.53 ± 2.04, p = 0.017) than grade 1 obesity. Blood pressure, insulin resistance and CRP increased while high density lipoprotein (HDL) decreased with increasing severity of obesity. BMI z score was a significant predictor of systolic blood pressure; waist circumference was an independent predictor of diastolic blood pressure and HDL; waist height ratio best predicted insulin resistance, CRP and total cholesterol in overweight/obese children. Conclusions: We have observed a high frequency of cardiometabolic risk factors in overweight and obese children and they increased worsened with increasing grade of obesity.

Facial Distances and Possible Risk of High Blood Pressure: The Analyses of Young and Middle‐ Aged Adult Populations of Northern Nigeria

The objectives of the study were to determine the relationship between the facial distances and blood pressure across different age groups of young adults and middle‐aged population in males and females of northern Nigeria. Secondly, to determine the best facial predictors and discriminators of the blood pressure in the study population. Participants included 397 males and 159 females of northern of Nigeria with mean age of 25.37± 7.78 years. The facial distances were measured using direct anthropometry and blood pressure was determined using standard protocols. Pearson's correlation, step–wise multiple linear regression and receiver operating characteristic curve were employed to analyze the data. Measurements of blood pressure were in mmHg, age in years, bmi in kg/m2 and the remaining facial distances in mm. It was observed that no significant correlation between the facial distances and blood pressure (BP) in younger adult males and females except for lower facial height (LFH) and diastolic BP in males. Above the age of 30 years, significant correlation was noticed between the right ear width (EW), left EW, head length (HL) with both systolic and diastolic BP. The nasal length (NL) and nasal width (NW) correlated significantly with systolic and diastolic BP respectively in males only. For females, bizygomatic distance (BD) correlated only with systolic BP. The best predictors of systolic BP were left EW and HL in males and females respectively, while the best predictors of diastolic BP were left EW and right EW in males and females respectively. LFH was found to predict only the systolic blood pressure component in younger male adults. The best discriminating potential of facial distances with regard to abnormal blood pressure was only observed in the middle‐aged population. In both sexes right EW and left EW had more than 80% discriminating ability of abnormal BP (area under curve &gt; 0.80). However, head width (HW) and HL had more than 80% discriminating ability of abnormal BP in males and females respectively. In conclusion, a significant correlation was observed between the facial distances and BP in middle‐ aged adult population. The facial soft tissue gave best predictors and discriminator in both sexes.Support or Funding InformationNoneThis abstract is from the Experimental Biology 2018 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.

Abstract 28: Increased Blood Pressure Response to Salt Intake in Hypertensive G Carriers of The NEDD4L SNP rs4149601

Introduction: Individual blood pressure (BP) response to high salt intake varies from minimal to substantial and is largely genetically determined. More than 50% of hypertensive patients are salt sensitive (SS) and respond to high salt intake by increasing their BP compared to only 10% in the normotensive population. ENaC is involved in sodium transport in the distal nephrons of the kidney as well as in the CNS in the choroid plexus and hypothalamic neurons. In turn, ENaC is controlled by the E3 ubiquitin ligase protein - NEDD4L. The functional NEDD4L SNP rs4149601 (G/A) influences the ability of NEDD4L to regulate ENaC expression and is associated with high blood pressure and salt sensitivity. We hypothesize that NEDD4L rs4149601 genotype is an independent predictor of BP response to salt intake in hypertensives. Methods: Daytime BP was measured using 24hr ABPM in 191 young (&lt;60 years old) Caucasian hypertensives (BP ≥130/85 mmHg). 24hr urine Na and K + , blood Na + and K + , and BMI were collected. Patient genotyping for the rs4149601 (G/A) SNP was done using TaqMan MGB probe based RT PCR. Linear regression analyzed (SAS Software) the influence of urine Na + , urine K + , blood K + ,blood Na + , age, gender, and BMI on blood pressure traits. Results: In hypertensive rs4149601 G carriers (n=169), systolic BP (SBP) varied significantly with salt intake (p=0.0088) while diastolic BP did not (p=0.7198). An SBP increase of 2.34 mmHg per 50 mmol Na was observed when urine Na alone is considered. Age (p=0.0002) and blood K + (p=0.0466) were also significant determinants of SBP in patients with the G allele. Only blood K + was a significant predictor of diastolic BP (DBP) in hypertensive G allele carriers. None of the factors tested influenced either SBP or DBP in hypertensive patients who are carriers of the A allele. Conclusion: The functional NEDD4L rs4149601 SNP influences individual daytime BP response to salt intake. This result supports the hypothesis that NEDD4L rs4149601 G carriers with intact C2 domain express higher levels of ENaC and therefore are more sensitive to salt intake. Thus, NEDD4L rs4149601 polymorphism genotyping may allow for identification of hypertensive individuals who will benefit to a greater extent from reducing the amount of salt in their diet.

Association of blood pressure and metabolic syndrome components with magnesium levels in drinking water in some Serbian municipalities

Chronic exposure to insufficient levels of magnesium (Mg) in drinking water increases the risk of magnesium deficiency and its association with hypertension, dyslipidemia and type 2 diabetes mellitus. The aim of the study was to assess the potential association of mineral contents in drinking water with blood pressure and other components of metabolic syndrome (MetS) (BMI as measure of obesity, triglycerides, glucose, and insulin resistance, index-HOMA IR), in a healthy population. This study was conducted in three randomly selected municipalities (Pozarevac, Grocka and Banovci), and recruited 90 healthy blood donors, aged 20-50 years. The Pozarevac area had a four times higher mean Mg level in drinking water (42 mg L(-1)) than Grocka (11 mg L(-1)). Diastolic blood pressure was lowest in subjects from Pozarevac. Serum Mg (sMg) was highest, and serum Ca(2+)/Mg (sCa/Mg) lowest in subjects from Pozarevac, and after adjustment for confounders (age, gender, BMI), only total cholesterol and sMg levels were independent predictors of diastolic blood pressure, sMg levels were independent predictors of triglycerides, and sCa/Mg predicted glucose levels. These results suggest that Mg supplementation in areas of lower magnesium levels in drinking water may be an important measure in the prevention of hypertension and MetS in general.

AnthropometricIndicesAssociated with Variation in Cardiovascular Parameters among Primary School Pupils in Ile-Ife

Purpose. This study investigated the anthropometric indices associated with variations in cardiovascular parameters among primary school pupils in Ile-Ife. Method. One thousand and twenty-six pupils (age range 6–14 years, mean age 10.12 years) from ten schools were recruited with parents' informed consent. Anthropometric (Height (Ht), Weight (Wt), Abdominal Circumference (AC)) and cardiovascular (Systolic Blood Pressure (SBP), Diastolic Blood Pressure (DBP), Heart Rate (HR)) parameters were measured using standard instruments and procedures. Blood pressure (BP) was measured after ten minutes of quiet sitting. Body Mass Index (BMI), Rate Pressure Product (RPP) and Pulse Pressure (PP) were estimated. Results. Age, Ht, Wt, BMI, and AC correlated significantly (P < .01) with BP and PP. AC and BMI were predictors of BP, HR, RPP, and PP. Conclusion. Significant correlations exist between age, Ht, Wt, BMI, AC, and BP with weight being a more viable predictor of SBP and age a more viable predictor of DBP.

Early predictors of hypertension in prematurely born adolescents

To assess the blood pressure of former preterm and term matched adolescent controls and to identify risk factors associated with blood pressure at 16 years. Observational cohort study. Secondary analysis of a randomized clinical trial. Three academic centres participating in the Multicenter Indomethacin IVH Prevention Trial. A total of 296 children born in 1989-1992 with birth weights 600 to <1250 g who participated in the Multicenter Indomethacin IVH Prevention Trial and 95 term controls were evaluated at 16 years. Blood pressure and predictors of blood pressure. The adjusted mean difference in blood pressure for preterm adolescents was 5.1 mm Hg; p=0.002 for systolic and 2.1 mm Hg; p=0.027 for diastolic blood pressure. Among preterms, the primary predictors of increased systolic blood pressure were weight gain velocity between birth and 36 months (b=8.54, p<0.001), pre-eclampsia (b=5.67, p=0.020), non-white race (b=3.77, p=0.04) and male gender (b=5.09). Predictors of diastolic blood pressure were weight gain velocity between birth and 36 months (b=4.69, p=0.001), brain injury (b=6.51, p=0.002) and male gender (b=-2.4, p=0.02). Early programming secondary to increased early weight gain velocity, intrauterine stress and neonatal brain injury may all contribute to risk of increased blood pressure among former preterm adolescents.

The relationship between basal blood pressure and body mass index in apparently healthy Nigerian adolescent students

Background: In contrast to the situation in developed countries, very few studies have been done on blood pressure (BP) determinants among Nigerian adolescents. Aim: To evaluate the relationship between basal BP and body mass index (BMI) in a group of healthy Nigerian secondary school students. Methods: This was a cross-sectional study of 1080 adolescent students selected by a two-stage multi-phase cluster sampling technique. The height, weight and BP of each student were taken using standard methods. Pearson correlation was used to describe the strength of association between variables. Multiple stepwise regressions were conducted to determine the individual or combined contribution(s) of some variables to the variation in BP levels. Results: Mean BMI for males and females were 17.63 ± 2.54 kg/m2 and 18.87 ± 1.81 kg/m2 respectively. Forty six students (4.3%) were overweight. Mean systolic and diastolic BPs were 113.13 + 11.44 mm Hg and 68.29 + 8.07 mm Hg respectively. Thirty-five subjects (3.2%) had systolic or diastolic BP above the 95th percentile for age and sex. Twenty-four (68.6%) of these subjects were also found to be overweight. A moderate positive correlation was observed between both systolic and diastolic BP and BMI. Regression analysis showed that weight, height and BMI were predictors of systolic BP. Height and BMI were the only predictors of diastolic BP. Conclusion: These findings suggest that there is a moderate association between basal BP and BMI. Recommendation: Control/prevention of the accumulation of excess body fat in adolescence is recommended. Keywords: Body mass index, Blood pressure, Adolescent, Nigerians

Genotype × nutrient association of common polymorphisms in obesity-related genes with food preferences and time structure of energy intake

Personal food preferences can either enhance or suppress the development of obesity and the selection and proportion of macronutrients in the diet seem to have a heritable component. In the present study, we therefore focused on dietary composition as a specific trait related to obesity and we determined whether genetic variations in leptin (LEP), LEP receptor (LEPR), adiponectin (ADIPOQ), IL-6 and pro-opiomelanocortin (POMC) underlie specific native food preferences and obesity-related anthropometric parameters. The total of 409 individuals of Czech Caucasian origin were enrolled into the present study and 7 d food records were obtained from the study subjects along with selected anthropometric measurements. In a subset of study subjects, plasma levels of ADIPOQ, LEP and soluble LEPR were measured. Independently of the BMI of the individuals, common variations in LEP and LEPR genes were associated with specific eating patterns, mainly with respect to timing of eating. The LEP + 19A/G polymorphism served as an independent predictor for BMI, percentage of body fat and skinfold thickness and significantly affected the time structure of the daily energy intake. The POMC RsaI polymorphism was associated with percentage of body fat. The ADIPOQ 45 T/G polymorphism was associated with the thickness of the subscapular skinfold. The LEPR Gln223Arg polymorphism was associated with multiple parameters, including diastolic blood pressure, meal sizes during the day and plasma ADIPOQ levels. In a separate analysis, soluble leptin receptor (sObR) plasma levels and LEP:sObR ratio were significantly correlated with systolic blood pressure (beta = - 0.66, P = 0.002; beta = - 1.23, P = 0.02) and sObR plasma levels also served as an independent predictor for diastolic blood pressure (beta = - 0.50; P = 0.04). To conclude, we report common allelic variants associated with specific feeding behaviour and obesity-related anthropometric traits. Moreover, we identified allelic variants that significantly influence the time structure of food intake during the day.

Association between time spent in sedentary, moderate to vigorous physical activity, body mass index, cardiorespiratory fitness and blood pressure

Background: Elevated blood pressure (BP) has been reported in young people and seems to be associated with body mass index (BMI) and reduced physical activity (PA).Aim: This study sought to analyse the association of BP with BMI, PA intensity patterns and cardiorespiratory fitness (CRF) in youth.Subjects and methods: A cross-sectional study was carried out including 66 boys (13.91±1.76) and 97 girls (14.02±1.71). Anthropometric characteristics, CRF and BP were assessed during school time and accelerometers were utilized to determine intensity of PA.Results: The linear regression model, adjusted for age, sex and height, showed that higher values of BMI were associated (p≤0.05) with higher values of systolic blood pressure (SBP) (1.39; 95% CI: 0.56; 2.23) and diastolic blood pressure (DBP) (1.52; 95% CI: 0.68; 2.37). Additionally, SBP, but not DBP, was inversely associated (p≤0.05) with moderate PA (−0.25; 95% CI: −0.47; −0.02) and positively correlated with sedentary activities (0.04; 95% CI: 0.00; 0.08).Conclusion: The present study showed that BMI and time spent in sedentary activities were inversely associated with SBP. However, time spent in moderate PA was positively associated with SBP. BMI was the single predictor of DBP.

Comparison of blood pressure measurements in children with and without habitual snoring

Higher or similar systolic and/or diastolic blood pressure has been recorded in children with sleep apnea compared to subjects with primary snoring or in those with primary snoring compared to controls. To investigate the association between blood pressure and habitual snoring, we studied children in four randomly selected schools in central Greece. A symptom questionnaire was answered by parents, and children's weight, height, and blood pressure were measured. Seven hundred and sixty children (4-14 years old; 352 female) were recruited. Fifty of 760 (6.6%) participants were snoring more than 3 nights/week (habitual snorers). Mean (+/- SD) systolic blood pressure was 106.9 (+/-10.6) mmHg in habitual snorers vs. 107 (+/- 12) in nonhabitual snorers (P > 0.05). Mean diastolic blood pressure was 61.9 (+/- 7.6) in the former vs. 61.8 (+/- 6.8) in the latter (P > 0.05). While age, gender, and body mass index were significant predictors of systolic blood pressure in a general linear model, snoring was not. Similarly, that gender and body mass index but not snoring were significant predictors of diastolic blood pressure. In a community sample of children, habitual snorers do not have higher morning systolic or diastolic blood pressure than nonhabitual snorers.

Is chronic inflammation a determinant of blood pressure in the elderly?

Background Previous studies have shown that a rise in blood pressure (BP) causes chronic inflammation of the endothelium which, in turn, may be responsible for further damage of endothelium and worsening of BP control. On the other hand, several metabolic abnormalities such as dyslipidemia, hyperinsulinemia/insulin-resistance, diabetes, and obesity causes inflammation followed by a later rise in arterial BP. We investigated the role of chronic inflammation in the modulation of BP independently of other traditional cardiovascular risk factors and atherosclerotic lesions. Methods A total of 537 aged subjects, selected from the whole population of the INCHIANTI cohort, were enrolled. All subjects underwent plasma insulin, glucose, interleukin-6 (IL-6), interleukin-10 (IL-10), interleukin-1β (IL-1β), interleukin-1 receptor antagonist (IL-1ra), C-reactive protein, and tumor necrosis factor-α (TNF-α) levels determination. The IL-6-174 C/G promoter polymorphism was also evaluated. Results After adjusting for age, sex, insulin resistance syndrome score, and severity of carotid atherosclerosis, serum IL-1β ( P < .001), IL-1ra ( P < .005) concentration and the insulin resistance syndrome score ( P < .001) were the only predictors of diastolic BP. Indeed, age ( P < .001), insulin resistance syndrome score ( P = .05), IL-1β ( P < .05), and severity of carotid atherosclerosis ( P < .05) were the only significant predictor of systolic BP. Conclusion These results suggest that chronic inflammation may play a role in the modulation of arterial BP.

Obesity in African women in the North West Province, South Africa is associated with an increased risk of non-communicable diseases: the THUSA study. Transition and Health during Urbanisation of South Africans.

The objective of the present study was to assess the relationship between anthropometric measurements and risk factors for non-communicable diseases (NCD) in South African black women. A cross-sectional sample of 1040 apparently healthy black female volunteers, 15-70 years old, was recruited from thirty-seven randomly selected sites in the North West Province, stratified according to level of urbanisation. We analysed the association between BMI, waist:hip (WHR), waist circumference (WC) and skinfold measurements and the following risk factors for NCD: blood pressure, serum lipids, fasting serum glucose and insulin and plasma fibrinogen, by using age-adjusted correlation analyses and stepwise regression analysis. Of the subjects, 28.6 % were obese (BMI>30). After adjustment for age and smoking status, BMI correlated significantly with diastolic blood pressure (r 0.21, P=0.037), serum triacylglycerols (TG) (r 0.30, P=0.003), fasting glucose (r 0.29, P=0.005) and log fasting insulin (r 0.24, P=0.02). There was a significant negative correlation between BMI and HDL-cholesterol (r -0.38, P<0.001). Similar but stronger correlations were found between both WC and WHR and these risk factors. Together with age, WC was a significant predictor of TG, HDL-cholesterol and fasting glucose in regression analysis, while subscapular skinfold was a significant predictor of diastolic blood pressure and fasting glucose concentration. Triceps skinfold was a significant predictor of total serum cholesterol, LDL-cholesterol, plasma fibrinogen and the insulin sensitivity index. Measures of obesity, particularly WC, are associated with the risk for NCD in black South African women, in which a high rate of obesity has been found.

Is the somatotropic axis related to sympathetic nerve activity in healthy ageing men?

The mechanisms underlying the age-related increase in blood pressure and sympathetic nerve activity remain largely unknown. The decline in growth hormone (GH) secretion and insulin-like growth factor-I (IGF-I) with age has been related to several cardiovascular risk factors. Low serum IGF-I levels in severe adult GH deficiency is associated with markedly increased sympathetic nerve activity. This study evaluates whether a relationship between serum IGF-I and sympathetic nerve traffic exists in healthy aging men. Sympathetic nerve activity to the muscle vascular bed (MSA) was recorded in 56 healthy normotensive males, and related to age (range 21-71 years), body mass index (BMI, range 18.4-32.2), serum IGF-I and plasma nitrate levels. Blood pressure, BMI and MSA increased with age, whereas IGF-I and plasma nitrate decreased. In a forward stepwise multiple regression analysis, age explained 40% of the variability in MSA and excluded other variables. Omitting age, IGF-I became the strongest independent predictor, explaining 23% of the variability in MSA. MSA was an independent predictor of diastolic blood pressure, but its influence (10%) was less than that of BMI (28%). BMI was not related to MSA or IGF-I. Decreased serum IGF-I levels are coupled to increased MSA during ageing, an effect independent from the impact of increased body weight. Although MSA is a weak predictor of rising blood pressure with age, it constitutes one possible pathway for the somatotropic axis to affect cardiovascular function in ageing.

Anthropometric Predictors of Blood Pressure : National Health and Nutrition Examination Survey III

Anthrppometric measurements, which’can be sensitive indicators of health, are valuable in assessing nutritional status. Data from the United States National Health And Nutrition Examination Survey (NHANES III, 1988–1994) were used to test relationships of percentage body fat and body fat distribution to blood pressure (BP) levels. The sample included 770 adults, (males = 355, females = 415), who were subdivided into three age categories: 19-44,45-64 and 65-90 years. The participants were not taking hypertension medication. Data were analyzed by S AS and SUDAAN and statistical procedures included factor and regression analyses. All analyses incorporated sampling weights. Results showed that abdominal/gluteal ratio (AGR) was the most important predictor ( p ≤.001) of systolic blood pressure levels for both males and females, followed by multiple skinfold measurements (MSFM) (p ≤.01) and body mass index (BMI) (p≤.05 ). AGR was the better predictor (p<.00l) of diastolic blood pressure levels for both males and females, followed by MSFM (p ≤.05). BMI foiled to be a significant predictor of diastolic blood pressure. There was a stronger predictability with the younger age groups. In summary, body fat distribution was a better predictor of blood pressure levels than percentage body fat. It is suggested that body fat distribution may be a more important risk factor for morbidity and mortality than obesity per se. These findings suggest that the relationship of percentage body fat and body fat distribution to blood pressure levels merit further research.

Evidence for a Dose-Response Relationship between Occupational Noise and Blood Pressure

In this study, we investigated the role of occupational noise exposure and blood pressure among workers at 2 plants. A noise-exposed plant (plant 1, > or = 89 dBA) and a less-noise-exposed plant (plant 2, < or = 83 dBA) were chosen. Exposure was based on department-wide average noise measures; on the basis of job location and adjusting for layoffs during their employment at the plant, a cumulative time-weighted average noise level was calculated for each worker. The study population comprised 329 males in plant 1 and 314 males in plant 2. Their ages ranged from 40 to 63 y (mean ages = 49.6 and 48.7, respectively), and they had worked at least 15 y at the plant. The clinical examination was administered prior to the workday and measured height, weight, pulse, and blood pressure. In addition, we noted medical and personal-habits histories, including alcohol intake and cigarette smoking patterns. We used a questionnaire to determine in-depth occupation, military history, noisy hobbies, and family history of hypertension. When individuals who took blood-pressure medication were removed from the analysis, t tests for differences in average blood pressure between plants showed a mean systolic blood pressure of 123.3 mm Hg in plant 1 versus 120.8 mm Hg in plant 2 (p = .06) and a mean diastolic blood pressure of 80.3 mm Hg versus 77.8 mm Hg in Plant 1 and 2, respectively (p = .014). On the basis of data from the combined plants, multivariate analysis revealed that age, body mass index, cumulative noise exposure, current use of blood pressure medications, and alcohol intake were significant predictors for systolic blood pressure. Cumulative noise exposure was a significant predictor of diastolic blood pressure in plant 1 but not in plant 2, possibly reflecting a threshold effect.

Blood pressures of Sherpa men in modernizing Nepal.

The relationship among potential risk factors (diet, adiposity, physical activity levels (PALs), and age) for elevated blood pressures (BP) was examined in 253 Sherpa men living in Kathmandu (low altitude sample: LAS) and in the Khumbu (high altitude sample: HAS) regions of Nepal. The study is based on data collected to assess nutritional status. Elevated BPs were highly prevalent among both samples of men (LAS: 21.7% and HAS: 24.8%). The highest percentage of elevated BP was found among the urban HAS (32.4%), while rural HAS had the lowest percentage (16.1%). Stepwise regression analyses showed that the BMI, age, and alcohol consumption were strong predictors of systolic blood pressure (SBP), and the BMI and age were strong predictors of diastolic blood pressure (DBP). No correlations were found among BP and intakes of sodium, calcium, potassium, or fat when all men (normotensive and elevated BP) were examined. Bivariate association between the BMI and BP showed that obese men were 8.6-9.1 times more likely to have elevated BP, and that alcohol consumers were 2.6 times more likely to have elevated BP. The results suggest that elevated BP is a problem for a large portion of male Sherpas and appears to be associated with an elevated BMI. A survey of the region only 30 years ago showed no cases of hypertension. Increasing adiposity, due primarily to decreasing PALS, places this population at risk of chronic illness in the future. Am. J. Hum. Biol. 11:469-479, 1999. Copyright 1999 Wiley-Liss, Inc.

Alcohol Consumption and Blood Pressure in Recently Hospitalised Patients

Howes JB, Ryan J, Fairbrother G, O'Neill K, Howes LG. Alcohol consumpton and blood pressure in recently hospitalized patients.One-thousand-four-hundred-and-fifty-three patients admitted to a teaching hospital, haemodynamically stable and not severely ill nor in significant pain, were interviewed within 48 h of admission and demographic data and a detailed drinking history were obtained. Supine blood pressures (BP) were recorded on the day following admission. The mean age of the population was 60.5 ± 19.9 years (range 16-99 years) and the mean reported alcohol consumption was 67.8 ± 273 g/week (range 0-6125 g/week). Thirty-six percent of patients were currently receiving antihypertensive drug therapy. On multivariant analysis, reported alcohol intake was not significantly related to systolic BP (β = 0,000, p = 0.902) or diastolic BP (β = 0.028, p = 0.281). Age (β = 0.331, p= 0.0001) and body weight (β = 0.121, p = 0.0002) were significant independent predictors of systolic BP, and body weight was a significant independent predictor of diastolic blood pressure (β = 0.207, p < 0.0001). A relationship between alcohol consumption and blood pressure was not apparent in this population of patients following admission to hospital. A positive association between alcohol consumption and blood pressure may not be a universal finding and may be contributed to by a “white coat” effect.