Risk Of Elevated Blood Pressure Research Articles

Prevalence of hypertension in women under 50 in the PICTURE cohort study

Abstract Background Epidemiological data indicate an upward trend in hypertension (HT) prevalence in the recent decades. The risk of elevated blood pressure (BP) significantly increases with age, but it has been observed also in the younger population. Currently it is estimated that nearly 10 million adults in Poland have HT. Despite some improvement in treatment and BP control, they are still below expectations in the Polish population. Common misconception assumes that HT rarely occurs in women in comparison to men, which can lead to lower awareness, lower participation in routine screening and delayed diagnosis, especially in younger women. Purpose To assess the prevalence of hypertension (HT) among women under 50 years of age in the PICTURE cohort study. Methods The analysis is based on 769 women (average age 41.6±4.2 years) participating in "Population Cohort Study of Wroclaw Citizens (PICTURE)" established between 2019 and 2021. HT was diagnosed based on (1) patient-reported HT previously diagnosed by a physician, and/or (2) patient-reported intake of hypotensive medication, and/or (3) the average of two blood pressure measurements of systolic ≥140 mmHg and/or diastolic ≥90 mmHg. Additional analysis included other parameters such as BMI, WHR, attitudes toward tobacco smoking and alcohol consumption. Results HT was diagnosed in 12.5% of women under 50 years of age. More than half (55.2%) of HT cases in this group were previously undiagnosed. Women with hypertension had significantly higher chance of excessive body mass and abdominal obesity in comparison to women with normal BP. Excessive body weight characterized 68.7% of women with HT vs 34.5% without HT (p<0.0001), whereas abdominal obesity characterized 71.9% of women with HT vs 44.8% without HT (p<0.0001). Tobacco smoking was more prevalent among women with HT. A total of 21.3% of women with HT were current tobacco smokers vs 11.8% without HT (p=0.01). Conclusions More than half of HT cases were previously undiagnosed. Majority of HT cases in women were associated with traditional modifiable risk factors including excessive body mass, abdominal obesity and tobacco smoking. Intensive screening programs to increase HT diagnosis should be introduced in younger age groups, also in younger women.

Greater Pulse Consumption in Adults Is Associated With Improved Diet Quality, Favorable Weight-Related Outcomes and Reduced Risk of Elevated Blood Pressure

Greater Pulse Consumption in Adults Is Associated With Improved Diet Quality, Favorable Weight-Related Outcomes and Reduced Risk of Elevated Blood Pressure

Importance of Multispecialty Coordination of Care in an Electroconvulsive Therapy Patient With Musculoskeletal, Neurological, and Vascular Injuries: A Case Report.

Electroconvulsive therapy (ECT) is considered an effective therapy for patients suffering from severe, life-threatening, intractable depression. This treatment modality delivers controlled electrical currents (typically no more than 100 J) under general anesthesia to induce seizure. Although generally considered to have a high safety profile, physiological changes induced during the ictal phase of ECT, such as elevation in blood pressure and intracranial pressure, impose additional risks to patients with concomitant cardiovascular or cerebrovascular conditions. We describe the successful use of ECT in a unique case complicated by a combination of acute vertebral artery dissection, traumatic intracerebral hemorrhage, and cervical spine injury sustained from a suicide attempt by intentional motor vehicle collision. Although ECT can be safely administered in the presence of recent vertebral artery dissection and traumatic intraparenchymal hemorrhage, an emphasis on multispecialty coordination is crucial to monitor and reduce the risk of elevated blood pressure and further cervical spine injury.

Effect of Interaction Between Vitamin D and Serum Uric Acid on Hypertension in Adults

Abstract OBJECTIVE To investigate whether the interaction between serum vitamin D and serum uric acid has an effect on blood pressure. METHODS A cross-sectional study was conducted with 7,951 subjects selected from the health management center of the Second Hospital of Dalian Medical University during 1 January 2020 and 30 September 2022. The dose–response relationship between serum vitamin D, blood uric acid, and blood pressure was analyzed using restricted cubic spline. The relationship between each variable and elevated blood pressure was analyzed using multifactorial analysis in a generalized additive model and combined with a multiplicative–additive hierarchical interaction model to explore the effects of the interaction of serum vitamin D and blood uric acid on elevated blood pressure. RESULTS The mean age of the study population was (42.61 ± 11.17) years and the detection rate of hypertension was 12.14% (965/7,951). The risk of elevated blood pressure (high-normal blood pressure + hypertension) decreased with increasing serum vitamin D concentration, but the risk of elevated blood pressure increased with increasing serum uric acid levels. Compared with those with adequate serum vitamin D and normal blood uric acid, the odds ratio (OR) for the risk of high-normal blood pressure was 1.54 [95% confidence interval, CI (1.22, 1.94), P < 0.001] and the OR for the risk of hypertension was 3.17 [95% CI (2.13, 4.72), P < 0.001] for those with inadequate serum vitamin D and high blood uric acid. The risk of elevated blood pressure was highest when serum 25-hydroxyvitamin D was less than 25 nmol/l and blood uric acid was higher than 600 µmol/l. CONCLUSIONS The interaction between serum vitamin D and blood uric acid has an effect on elevated blood pressure. The risk of hypertension was maximized when serum vitamin D was insufficient and blood uric acid was high.

#2961 Association of polygenic risk scores for blood pressure with incidence of hypertension and chronic kidney disease

Abstract Background and Aims Genetic risk for elevated blood pressure (BP) has been associated with a higher risk of hypertension and cardiovascular disease. However, the generalizability of previous findings has been limited due to a lack of studies among Asian populations. This study aimed to investigate whether genetic risk for BP predicts the incidence of hypertension and chronic kidney disease (CKD) in Asian populations. Method We performed genome-wide association studies for systolic and diastolic BP (SBP and DBP, respectively) using data from the Korean Genome and Epidemiology Study (KoGES). We then meta-analyzed these results with summary statistics from Biobank Japan to construct polygenic risk scores (PRSs) and examined the association between BP PRSs and incident hypertension or CKD. This study included participants without hypertension, cardiovascular disease, or CKD at baseline (n=4349, median age 48.5 years, 48.8% men). Participants were categorized into four groups based on their PRS percentile (<5, 5–50, 50–95, >95). Results As the PRS percentile increases, the median SBP and DBP at baseline also increase. Compared to the lowest SBP PRS percentile, higher PRS percentile was associated with increased risk of hypertension (hazard ratio [HR] 1.49, 95% confidence interval [CI] 1.22–1.83 for PRS percentile 5–50, HR 1.94, 95% CI 1.58–2.38 for PRS percentile 50–95, and HR 2.35, 95% CI 1.80–3.07 for PRS percentile >95). Elevated DBP PRS was also associated with higher risk of hypertension (HR 1.27, 95% CI 1.04–1.54 for PRS percentile 5–50, HR 1.72, 95% CI 1.41–2.09 for PRS percentile 50-95, and HR 2.09, 95% CI 1.60–2.72 for PRS percentile >95). The highest PRS percentile for SBP and DBP was associated with earlier onsets of hypertension by median 11 and 9 years, respectively, compared to the lowest PRS percentile for SBP and DBP. However, both SBP and DBP RPSs were not associated with incident CKD. Conclusion Genetic risk for elevated BP was associated with a higher risk of incident hypertension and earlier onset of hypertension in the Asian population. However, there was no association between PRS for elevated BP and the incidence of CKD.

Analysis of older adult blood pressure readings and hypertension treatment rates among the unsheltered population of Miami-Dade County.

To assess prevalence of elevated blood pressure readings, rates of established hypertension diagnosis, and blood pressure control medication prescription rates in a cohort of older people experiencing unsheltered homelessness presenting to a Street Medicine clinic in Miami-Dade County, Florida. In addition, we will compare outcomes found in the study cohort to that of the general population. Demographic information, clinical history, blood pressure control medication prescription, and blood pressure measurements were taken by a Street Medicine team of medical providers. The team routinely provides medical evaluations and care for people experiencing unsheltered homelessness who reside in rough sleeper tent encampments located on the street. Clinical information and vitals were recorded in REDCap. De-identified data from patients 65 years and above were downloaded and compared to a general population data set-the Centers for Disease Control National Health and Nutrition Examination Survey (CDC NHANES) 2017-2020 Pre-pandemic cohort. Data analysis was performed using R Studio version 4.3.2. Blood pressure was reported in 120 distinct interactions with older people experiencing homelessness. Compared to the age-matched NHANES data, older people experiencing unsheltered homelessness were at significantly increased relative risk for elevated blood pressure within the range of Stage 1 Hypertension (RR: 3.914, 95% CI: 2.560-5.892, P < 0.001), and within range of Stage 2 Hypertension (RR: 5.550, 95% CI: 4.272-7.210, P < 0.001). According to NHANES, 49.6% of adults over 60 with diagnosed hypertension receive treatment. Of study participants, 69% of those with elevated blood pressure had previously received a diagnosis of hypertension and 15.9% on medication to control blood pressure. Our cohort of older people experiencing unsheltered homelessness had higher rates of elevated blood pressure and reduced rates of hypertension diagnosis and treatment as compared to the general population. Older people experiencing unsheltered homelessness are a growing population, and future research should seek to evaluate and understand older adult care vulnerabilities, including chronic disease management, to improve health outcomes for those who are aging, hypertensive, and unhoused.

FRI098 Triglyceride Glucose Index Is Associated With Elevated Blood Pressure, Independent Of Body Mass Index: Analysis From NHANES Study

Abstract Disclosure: H. Ayesh: None. K.D. Niswender: None. Introduction: Triglyceride glucose index (TyG) is a novel marker of insulin resistance. Elevated blood pressure is associated with significant morbidity and mortality. Early identification of individuals at-risk for cardiovascular disease is essential for effective prevention. There are multiple reports in the literature that triglyceride glucose index (TyG), is associated with elevated blood pressure. In this study, we determined the association of TyG with elevated blood pressure, independent of body mass index (BMI), age, and diabetes status. Methods: A sample of 6799 individuals from the NHANES study population (2011-2020) consisting of all individuals who are above 18 years of age and have serum glucose and serum triglyceride levels available to calculate TyG. Elevated blood pressure status was assigned based on the question“Ever told you had high blood pressure” from NHANES survey.”. TyG was calculated using the formula “ln[fasting TG (mg/dL) × fasting plasma glucose (mg/dL)/2]”. TyG values were divided into 4 quartiles as follow: 1st(&amp;lt;4.36), 2nd (&amp;lt; 4.56), 3rd(&amp;lt; 4.77), 4th(&amp;gt; 4.77). Logistic regression analysis was performed to assess the association between TyG and elevated blood pressure. The analysis was adjusted for age, BMI, and diabetes status. Results: The analysis revealed a significant association between elevated blood pressure and TyG independent of age, BMI and diabetes status. The odds of elevated blood pressure were higher in the 4th quartile TyG compared to the 1st quartile with an odds ratio of 1.39 (95% CI 1.21-1.59), P value &amp;lt; 0.001. Discussion/Conclusion: These results indicate that TyG can serve as a screening tool to identify individuals at risk for elevated blood pressure. Serum triglyceride and glucose measurement are affordable and routine in clinical practice. Implementation of auto-calculation of TyG based on serum triglyceride and glucose values in electronic health records may provide helpful screening and monitoring tools to identify individuals at risk for elevated blood pressure, especially with normal BMI. Future high-quality prospective studies will be helpful to further understand the association. Presentation: Friday, June 16, 2023

Associations between depressive, anxiety, stress symptoms and elevated blood pressure: Findings from the CHCN-BTH cohort study and a two-sample Mendelian randomization analysis

BackgroundWe aimed to determine whether depressive, anxiety, stress symptoms were associated with the risk of elevated blood pressure by performing longitudinal cohort and Mendelian Randomization (MR) analyses. MethodsWe used data from the Cohort Study on Chronic Disease of Community Natural Population in the Beijing-Tianjin-Hebei region (CHCN-BTH) from 2017 to 2021. The Depression-Anxiety-Stress Scale was used to evaluate the depressive, anxiety, stress symptoms. The longitudinal associations between depressive, anxiety, stress symptoms and elevated blood pressure were estimated using Cox proportional regression models. Two-sample MR analysis was performed using the Inverse-variance weighted (IVW), weighted median, and MR–Egger to explore the causal relationships between depressive, anxiety, stress symptoms and elevated blood pressure. ResultsIn total, 5624 participants were included. The risk of SBP ≥ 140 mmHg or DBP ≥ 90 mmHg was significantly higher in participants with baseline anxiety symptoms (HR = 1.48, 95 % CI: 1.03 to 2.12, P = 0.033; HR = 1.56, 95 % CI: 1.05 to 2.32, P = 0.028), especially in men and individuals with higher educational levels, independent of baseline depression and anxiety at the two-year follow-up. The two-sample MR analysis showed positive associations between depressive, anxiety, stress symptoms and elevated blood pressure. LimitationSelf-reported mental health symptoms, relatively shorter follow-up duration and the European-derived genome-wide association study data for MR analysis. ConclusionsAnxiety symptoms were positively associated with elevated blood pressures in the longitudinal analysis independent of depression, stress, and other confounders. The results were verified in MR analysis, providing evidence for causal effects of anxiety symptoms on the risk of elevated blood pressure.

MEASUREMENT OF BLOOD PRESSURE AND BMI AMONG OVERWEIGHT, UNDERWEIGHT AND NORMAL WEIGHT MEDICAL STUDENTS OF AMU ALIGARH, U.P, INDIA: A CROSS SECTIONAL STUDY

Background: Hypertension is known as a silent killer. Early detection is the key to successful management and treatment of hypertension. In maximum studies, higher BMI has been associated with an increased risk of elevated blood pressure. Weight-related problems have been detected in various university students in earlier studies. Themedical students were found to be at a higher risk due to their sedentary lifestyle and other factors. The present study was undertaken to measure the blood pressure and BMI of undergraduate medical students and to detect the correlation between them.Methods: 230 undergraduate Unani medical students were enrolled in the current study, and their information was evaluated. The subsequent variables were measured: height (m), weight (kg), and BMI (kg/m2).Results: 68 males and 82 females had normal BMIs of 22.29 ± 2.03 and 21.50 ± 1.97 kg/m2, respectively (p = 0.001). 13.04% and 21.73% of participants were found to be overweight and underweight, respectively. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) of subjects in the normal weight category were determined to be 120.13 ± 7.53/ 79.71 ± 4.17 respectively in males and 112.80±5.76/75.54±5.34 females (p = 0.05). Students were found to be normotensive, pre- hypertensive, and hypertensive in males 66.66%, 27.77%, and 5.55% and 75.71%, 21.42% and 2.85% of female cases, respectively. Both in males and females, a significant positive correlation of BMI was discovered with SBP and DBP. In the current survey, a higher percentage of men (5.55%) were determined to be obese as compared to women (2.85%).Conclusion: There are weight-related concerns and associated complications like elevated blood pressure in medical students having elevated levels of BMI.

Associations of parental reproductive age and elevated blood pressure in offspring: An observational study.

Increased parental reproductive age has been a social trend around the world, and elevated blood pressure in children leads to an approximately two-fold increased risk of hypertension in adulthood. Aim of this study is to assess the associations of parental reproductive age with the risk of elevated blood pressure in offspring, and to explore the influence of offspring lifestyle on the associations. Data was obtained from a national school program conducted in 7 Chinese provinces, and the final sample was 39,190 students aged 7-18 years. Anthropometric measurements and questionnaires were designed to collect data of children blood pressure and information respectively. In this study, 26.7% of children were defined as elevated blood pressure. A U-shaped pattern was observed in the relationship between maternal age and risk of elevated blood pressure, while risk of elevated blood pressure decreased continuously with paternal age increased. After adjustment, offspring of paternal age ≤27 & maternal age ≤26 years and those of paternal age >30 & maternal age >32 years were related to great risk of elevated blood pressure (OR = 1.18, 95% CI: 1.08-1.29, P < 0.001; OR = 1.18, 95% CI: 1.01-1.38, P < 0.05). When stratified by lifestyle status, significant associations between maternal/paternal age and risk of elevated blood pressure were only observed in those with worse lifestyle behaviors, but not in offspring with healthier lifestyle. Our findings demonstrate that risk of elevated blood pressure in children is independently related to parental reproductive age, and children maintaining a healthy lifestyle may mitigate the adverse effect.

Long term renal outcome and risk of elevated blood pressure in children undergoing complete primary repair of bladder exstrophy (CPRE)

Since the initiation of staged reconstruction for bladder exstrophy (BE), hypertension has been a known complication of the procedure. Hypertension is a well-established risk factor for chronic kidney disease (CKD) progression and associated with cardiovascular/cerebrovascular morbidity and mortality. Few studies exist evaluating the risk of developing hypertension among patients with bladder exstrophy who underwent CPRE. We hypothesized that long-term blood pressure levels may be elevated in males vs females, and may be correlated with presence of hydronephrosis, bladder neck reconstruction, or continence status. We sought to revisit our long-term experience with CPRE and determine factors associated with incidence of elevated blood pressures. We reviewed all BE patients undergoing CPRE at our institution from 1999 to 2019. Patients were considered eligible for inclusion if last renal ultrasound was obtained at least 5 years after repair. Upper tract outcomes based on imaging, history of pyelonephritis and renal function tests measured by serum creatinine and estimated glomerular filtration rate (eGFR, Schwartz formula) were reviewed. Systolic/diastolic blood pressures (SBP/DBP) from all encounters were captured. All blood pressure values were age adjusted by percentile. A total of 36 patients were considered eligible for review. Median follow-up of this cohort was 10.01 (5.16-21.47) years. The mean creatinine for the patients available was 0.58mg/dL (SD=0.20), at mean age of 8.90 years Neither SBP or DBP were significantly elevated in males vs females, but had lower odds of elevation >90th percentile for those with higher eGFR, lower renal length, and reimplantation. Pyelonephritis incidence was 38% (n = 14) with first episode at mean age of 8.8 years, and mean of 3.7 episodes per patient. At long term follow up, blood pressures following CPRE were not significantly elevated, despite the relatively frequent occurrence of CKD, and hydronephrosis. Male gender does appear to suggest higher risk for long-term deterioration in this regard. Higher eGFR, higher renal length, and presence of ureteral reimplantation were associated with lower likelihood of systolic/diastolic blood pressure elevation. Continence status and bladder neck reconstruction were not associated with likelihood of blood pressure elevation. Blood pressure and upper-tract outcomes for patients undergoing CPRE at birth are positive for the majority of patients. To avoid complications from hypertension, patients should be closely evaluated as the risks associated with elevated blood pressure are significant. Ultimately, larger-scale prospective and multi-institutional studies are further needed to characterize risks of hypertension in this complex patient population.

Association of coffee consumption pattern and metabolic syndrome among middle-aged and older adults: A cross-sectional study.

The association between coffee consumption and the risk of metabolic syndrome (MetS) remains inconsistent. The aim of this study was to evaluate the association between coffee intake and components of MetS. A cross-sectional survey including 1,719 adults was conducted in Guangdong, China. Data on age, gender, education level, marriage status, body mass index (BMI), current smoking and drinking status and breakfast habit, coffee consumption type, and daily servings were derived based on 2-day, 24-h recall. MetS were assessed according to the International Diabetes Federation definition. Multivariable logistic regression was conducted to examine the association between the coffee consumption type, daily servings, and the components of MetS. Regardless of the coffee type, compared with non-coffee consumers, coffee consumers had higher odds ratios (ORs) of the elevated fasting blood glucose (FBG) in both men [OR: 3.590; 95% confidence intervals (CI): 2.891-4.457] and women (OR: 3.590; 95% CI: 2.891-4.457). In women, the risk of elevated blood pressure (BP) was 0.553 times (OR: 0.553; 95% CI: 0.372-0.821, P = 0.004) for people who drank total coffee > 1 serving/day than for non-coffee drinkers. In conclusion, regardless of type, coffee intake is associated with an increased prevalence of FBG in both men and women, but has a protective effect on hypertension only in women.

Follow-up study on the relationship between changes in waist circumference and body weight and changes in blood pressure levels among high cardiovascular risk population

Objective: To investigate the relationship between changes in waist circumference, body weight, and blood pressure change in a high cardiovascular risk population and to provide a theoretical basis and reference for the prevention and treatment of hypertension and cardiovascular disease. Methods: A total of 12 931 patients with a high risk of cardiovascular disease participating in the follow-up survey in 2016 were selected as the study subjects, and their long-term follow-up data from 2017 to 2019 were included in the analysis. Statistical analysis was performed using a t-test, χ2 test, and generalized estimation equation (GEE). Results: Increased waist circumference, body weight, and BMI were associated with a higher risk of elevated blood pressure in people at high risk of cardiovascular disease. Waist circumference, weight, and BMI were reduced when blood pressure levels were lower. SBP and DBP increased by 0.200 (95%CI: 0.164-0.236) mmHg and 0.085 (95%CI: 0.066-0.105) mmHg for each 1 cm increase of waist circumference. SBP increased by 0.355 (95%CI: 0.289-0.421) mmHg and DBP increased by 0.182 (95%CI: 0.144-0.220) mmHg for each 1 kg increase in body weight. For each 1 kg/m2 increase in BMI, SBP increased by 1.100 (95%CI: 1.194-1.258) mmHg, and DBP increased by 0.365 (95%CI: 0.273-0.456) mmHg. Compared with urban residents, SBP changes more with waist circumference and body weight, and DBP changes more with waist circumference in high-risk cardiovascular disease groups (all P for interaction <0.05). SBP with waist circumference and BMI and DBP with BMI was greater in participants without hypertension than in those with hypertension (all P for interaction <0.05). Conclusion: There is a positive linear correlation between the changes in waist circumference, body weight, and BMI and the changes in blood pressure in a high-risk cardiovascular disease population.

Abstract 10153: Cord Blood Metabolite Signatures for Elevated Blood Pressure in Childhood and Adolescence

Background: Risk factors for high blood pressure (BP) in children start in utero . Cord blood metabolites reflect exposures of the developing fetus to the in utero environment. No studies have examined whether cord blood metabolites are associated with BP in children. Objectives: To examine prospective associations of cord blood metabolites with systolic BP (SBP), diastolic BP (DBP), and risk of elevated BP in childhood and adolescence. Methods: We used data from the Boston Birth Cohort. Metabolites were measured in cord blood plasma samples collected at birth. SBP and DBP were measured at clinic visits between 3 to 18 years. We calculated BP percentiles per the 2017 American Academy of Pediatrics Clinical Practice Guideline. We examined associations of cord metabolites with SBP and DBP percentiles using linear mixed models and with elevated BP using mixed-effects Poisson regression. We used the False Discovery Rate (FDR) method to adjust for multiple comparisons. Results: Our study included 902 mother-child dyads (60% Black, 23% Hispanic, 45% female). Children were followed for a median of 9.2 (IQR: 6.7-11.7) years, and the median number of BP observations per child was 7 (IQR: 4-11). After FDR adjustment, 3, 94, and 22 metabolites were respectively associated with SBP, DBP, and risk of elevated BP; 2 metabolites (1-methylnicotinamide, dimethylguanidino valeric acid) were associated with all three outcomes, and 22 metabolites were associated with both DBP and risk of elevated BP. After multivariable adjustment, 48 metabolites remained significantly associated with DBP. Metabolites that showed the strongest associations with SBP, DBP, and risk of elevated BP included nucleotides (e.g., xanthosine, hypoxanthine, xanthine) and acylcarnitines (e.g., C6 and C7 carnitines), which represent fatty acid oxidation and purine metabolism pathways. Conclusions: In this predominantly urban, low-income, minority cohort, cord blood metabolites were prospectively associated with BP and risk of elevated BP from childhood to adolescence. Acylcarnitines and purine metabolism may be involved in the early life origins of hypertension. Cord metabolites may explain the intergenerational effects of in utero environments on BP in childhood and adolescence.

Abstract 14508: Association of Multi-Ethnic Genome-Wide Blood Pressure Polygenic Risk Score With Adverse Cardiovascular Events

Background: Traditional cardiovascular (CV) risk factors and the underlying genetic risk of elevated blood pressure (BP) determine an individual’s composite risk of developing adverse CV events. We evaluated the relative contributions of the traditional CV risk factors to the development of adverse CV events in the context of varying BP polygenic risk score (PRS) profiles among multiethnic population-based cohorts (ARIC, MESA, JHS, FHS, CARDIA, and CHS cohort). Methods: Multiethnic genome-wide BP PRS was constructed among participants with WGS data through TOPMed program and were stratified into high, intermediate, and low genetic risk (&gt;80 th , 20-80 th , &lt;20 th centile). Based on the ACC/AHA Pooled Cohorts Equation (PCE), participants were stratified into low and high (10y-ASCVD risk: &lt;10% or ≥10%) CV risk factor profile groups. Cox regression was used to assess the risk of adverse CV events (incident HF, CHD, and stroke) and its components. Results: Among 21,899 American adults (mean age: 56 years; 56% women; 36% non-White race), 1 SD increase in the BP PRS computed using 1.1 million variants was associated with systolic BP (β: 4.7, 95% CI: 4.5-5.0) and HTN (OR: 1.09, 95% CI: 1.09-1.10), respectively. This association was robustly seen across racial/ethnic groups. Each SD increase in BP PRS was associated with a higher risk of the primary outcome (HR: 1.08 [1.05-1.11]) after controlling for ACC/AHA PCE risk score. Among individuals with a high BP PRS, low ASCVD risk was associated with a 69% lower hazard for the primary outcome (HR: 0.31, [0.27-0.35]) compared with those with high ASCVD risk. A similar pattern was noted in intermediate and low BP PRS groups. Comparable results were noted for all the secondary outcomes. Conclusions: In a multiethnic cohort of &gt;21,000 US adults, genome-wide BP PRS was associated with BP traits and adverse CV events. Adequate CV risk factor control may reduce this increased predisposition to adverse CV events by 69% in those with high BP PRS.

Association of a Multiancestry Genome-Wide Blood Pressure Polygenic Risk Score With Adverse Cardiovascular Events.

Traditional cardiovascular risk factors and the underlying genetic risk of elevated blood pressure (BP) determine an individual's composite risk of developing adverse cardiovascular events. We sought to evaluate the relative contributions of the traditional cardiovascular risk factors to the development of adverse cardiovascular events in the context of varying BP genetic risk profiles. Genome-wide polygenic risk score (PRS) was computed using multiancestry genome-wide association estimates among US adults who underwent whole-genome sequencing in the Trans-Omics for Precision program. Individuals were stratified into high, intermediate, and low genetic risk groups (>80th, 20-80th, and <20th centiles of systolic BP [SBP] PRS). Based on the ACC/AHA Pooled Cohort Equations, participants were stratified into low and high (10 year-atherosclerotic cardiovascular disease [CVD] risk: <10% or ≥10%) cardiovascular risk factor profile groups. The primary study outcome was incident cardiovascular event (composite of incident heart failure, incident stroke, and incident coronary heart disease). Among 21 897 US adults (median age: 56 years; 56.0% women; 35.8% non-White race/ethnicity), 1 SD increase in the SBP PRS, computed using 1.08 million variants, was associated with SBP (β: 4.39 [95% CI, 4.13-4.65]) and hypertension (odds ratio, 1.50 [95% CI, 1.46-1.55]), respectively. This association was robustly seen across racial/ethnic groups. Each SD increase in SBP PRS was associated with a higher risk of the incident CVD (multivariable-adjusted hazards ratio, 1.07 [95% CI, 1.04-1.10]) after controlling for ACC/AHA Pooled Cohort Equations risk scores. Among individuals with a high SBP PRS, low atherosclerotic CVD risk was associated with a 58% lower hazard for incident CVD (multivariable-adjusted hazards ratio, 0.42 [95% CI, 0.36-0.50]) compared to those with high atherosclerotic CVD risk. A similar pattern was noted in intermediate and low genetic risk groups. In a multiancestry cohort of >21 000 US adults, genome-wide SBP PRS was associated with BP traits and adverse cardiovascular events. Adequate control of modifiable cardiovascular risk factors may reduce the predisposition to adverse cardiovascular events among those with a high SBP PRS.

Association of egg intake with risks of cardiometabolic factors among adults in China.

To explore the association between egg intake and cardiometabolic factors (CMFs) in Chinese adults. The subjects were 6,182 adults aged 18-64 who had complete survey data and had no CMFs at baseline. Egg intake was assessed with 3 days-24 h dietary recalls in all waves of the China Health and Nutrition Survey (CHNS). Multivariate Cox proportional risk regression model and restricted cubic spline (RCS) model were used to analyze the association and dose-response relationship between egg intake and CMFs. Of the 6,182 participants who did not have metabolic syndrome (MetS) at baseline, 1,921 developed this disease during an average follow-up of 5.71 years, with an incidence of 31.07%. Central obesity, elevated TG, decreased HDL-C, elevated blood pressure and elevated plasma glucose were 38.65, 26.74, 30.21, 40.64, and 30.64%, respectively. After adjusting for demographic characteristics, lifestyle, energy and BMI, using the lowest quintile (Q1) as a reference, the risk of central obesity, elevated TG, decreased HDL-C, and elevated plasma glucose in the highest quintile (Q5) were reduced by 15% (HR = 0.85, 95% CI = 0.73-0.98, P = 0.16), 33% (HR = 0.67, 95% CI = 0.57-0.78), 25% (HR = 0.75, 95% CI = 0.63 0.90, p = 0.05), and 28% (HR = 0.72, 95% CI = 0.63-0.83, p < 0.05), respectively. The risk of elevated blood pressure was reduced by 26% in the fourth quintile (HR = 0.74, 95% CI = 0.64-0.85, P = 0.85). RCS analysis show that the overall correlation and nonlinear relationship between egg intake and CMFs were statistically significant (P < 0.05). When the intake was lower than 20 g/days, the risk of MetS, central obesity, elevated blood pressure and elevated plasma glucose were negatively correlated with egg intake, while elevated TG was negatively correlated with eggs when the intake was lower than 60 g/days. There was no statistically significant association between egg intake and CMFs at higher egg intake. There was a U-shaped association between egg intake and CMFs in Chinese adults.

Metabolome-Wide Association Study of Cord Blood Metabolites With Blood Pressure in Childhood and Adolescence.

No studies have examined whether the cord blood metabolome-a reflection of in utero metabolism-influences blood pressure (BP) in children. To examine prospective associations of cord blood metabolites with systolic BP (SBP), diastolic BP (DBP), and risk of elevated BP in childhood and adolescence. In the Boston Birth Cohort, we measured metabolites in cord blood plasma, and SBP and DBP at clinic visits between 3 and 18 years. We examined associations of cord metabolites with SBP and DBP percentiles using linear mixed models and with elevated BP using mixed-effects Poisson regression. Our study included 902 mother-child dyads (60% Black, 23% Hispanic, 45% female). Children were followed for a median of 9.2 (interquartile range, 6.7-11.7) years, and the median number of BP observations per child was 7 (interquartile range, 4-11). After false discovery rate correction, 3 metabolites were associated with SBP, 96 with DBP, and 24 with elevated BP; 2 metabolites (1-methylnicotinamide, dimethylguanidino valeric acid) were associated with all 3 outcomes, and 21 metabolites were associated with both DBP and elevated BP. After multivariable adjustment, 48 metabolites remained significantly associated with DBP. Metabolites that showed the strongest associations with SBP, DBP, and elevated BP included nucleotides (eg, xanthosine, hypoxanthine, xanthine) and acylcarnitines (eg, C6 and C7 carnitines), which represent fatty acid oxidation and purine metabolism pathways. In our urban and predominantly racial/ethnic minority cohort, we provide evidence that metabolomic alterations in utero, in particular, acylcarnitine- and purine-metabolism metabolites, may be involved in the early life origins of hypertension.

Weight status related early changes in blood pressure, cardiac structure and function in 4-year-old children

Objective: To explore the association between weight status and early changes in blood pressure, cardiac structure and function in children at 4 years of age. Methods: A cross-sectional study of the relationship between weight status and cardiovascular parameters was performed on the platform of "Shanghai Birth Cohort" in Shanghai Xinhua Hospital between 2017 and 2020. Height, weight, blood pressure and echocardiography were measured in 1 477 children at 4 years of age. According to body mass index (BMI), participants were classified into five groups: underweight, lean, normal weight, overweight and obese. Blood pressure, cardiac structure and function indexes were compared among different groups using one-way ANOVA. The associations between blood pressure, cardiac structure and function and weight status in children were analyzed by linear regression models. Multivariate logistic regression models were used to analyze whether weight status was an independent risk factor for elevated blood pressure or left ventricular hypertrophy (LVH) in children. Results: A total of 1 477 children including 772 boys and 705 girls were included in this study. There were 115 overweight and obese boys (14.9%) and 68 overweight and obese girls (9.6%). The majority of children had normal weight (916 cases, 62.0%), followed by underweight (303 cases, 20.5%), overweight (130 cases, 8.8%), lean (75 cases, 5.1%), and obese (53 cases, 3.6%). With the increase of BMI, systolic blood pressure, diastolic blood pressure, left ventricular mass index (LVMI), left ventricular posterior wall thickness in systole, left ventricular posterior wall thickness in diastole, left ventricular diameter in end-systole, left ventricular diameter in end-diastole, interventricular septum thickness in systole and left ventricular ejection fraction showed significantly positive trend, and the differences among the groups were significant (F=31.73, 6.59, 14.22, 4.96, 3.01, 31.50, 39.79, 5.91, 3.09, all P<0.05). Multiple linear regression showed that overweight and obese were all positively associated with systolic blood pressure (β=5.2, 95%CI 3.6-6.8), LVMI (β=1.9, 95%CI 0.8-3.1), left ventricular diameter in end-systole (β=1.3, 95%CI 0.9-1.8), and left ventricular diameter in end-diastole (β=1.6, 95%CI 1.0-2.2). In the Logistic regression model, compared with normal weight children, overweight (OR=2.37, 95%CI 1.37-4.41) and obese children (OR=10.90, 95%CI 4.47-26.60) both had significantly increased risk of elevated blood pressure. However, the risk of LVH did not significantly increased. Conclusions: Overweight and obesity in 4-year-old children are associated with increased blood pressure, increased left ventricle diameter and LVMI. Overweight and obesity are independent risk factors for elevated blood pressure in children at 4 years of age.

Association of Total, Added, and Natural Phosphorus Intakes with Biomarkers of Health Status and Mortality in Healthy Adults in the United States.

The Western diet is high in dietary phosphorus, partially due to added phosphorus, (i.e., phosphates) predominantly present in processed food products. Elevated serum phosphate levels, otherwise known as hyperphosphatemia, have been associated with changes in health status, of note detrimental effects on cardiovascular and renal health. However, the extent to which highly absorbed added phosphorus contributes to these changes is relatively unknown, due to its poor characterization among food composition databases. Industry-provided data on phosphorus source ingredients and ranges of added phosphorus present in food categories to enable a more accurate estimation of the total, added, and natural phosphorus intakes in the U.S. population. Using regression analyses, we then assessed relationships between estimated total, added, and natural phosphorus intakes on biomarkers of health status and mortality in individuals enrolled in the National Health and Nutrition Examination Survey (NHANES) 1988–1994 and 2001–2016 datasets. Total, added, and natural phosphorus intakes were associated with several biomarkers of health status. Added phosphorus intake was consistently inversely associated with HDL cholesterol in both men and women, whereas naturally occurring phosphorus intake was inversely correlated with the risk of elevated blood pressure. However, in most cases, the predicted impact of increases in phosphorus intake would result in small percentage changes in biomarkers. No meaningful associations between phosphorus and mortality were found, but indications of a correlation between mortality with quintiles of naturally occurring phosphorus were present, depending on covariate sets used. The disparate results for natural and added phosphorus intakes within the current study provide increased support for updating current food composition databases to more accurately account for dietary phosphorus intake as total, naturally occurring, and added phosphorus.