Risk Of Prehypertension Research Articles

Prevalence of hypertension and prehypertension and its association with anthropometrics among children: a cross-sectional survey in Tianjin, China.

To characterize the prevalence of hypertension and prehypertension and its association with four anthropometrics among children aged 7-15 years in Tianjin, China, a school-based cross-sectional survey was conducted from May to August 2010. Multistage random cluster sampling was used to select the participants. Body mass index (BMI), waist circumference (WC), waist-to-height ratio (WHtR), and waist-to-hip ratio (WHR) were measured. Hypertension and prehypertension were identified according to the definition of United State Fourth Report. Logistic regression, linear regression and the area under receiver operating curves (AUC) was used for assessing the association. Among 1898 eligible children, the prevalence of hypertension and prehypertension was 6% and 6.6%, respectively. No statistically significant differences were found between boys and girls. Both linear and logistic regression showed that the four anthropometrics were all positively related to blood pressure value or the risk of prehypertension and hypertension. Of the four anthropometrics, BMI might be the most sensitive indicator for predicting elevated blood pressure, followed by WC and WHtR, whereas WHR had the lowest predicting capacity, with the AUCs being 0.72 (0.68,0.75), 0.69 (0.65,0.73), 0.67 (0.63,0.71), and 0.61 (0.57,0.65), respectively. A significantly increased prevalence of hypertension was observed when BMI > P90 percentiles, but for prehypertension, the risk of prehypertension began to increase when BMI was still at a median level. In conclusion, four anthropometrics all had positive relationship with elevated blood pressure. BMI and WC were superior to WHtR and WHR in predicting elevated blood pressure among children and adolescents.

Erythrocyte heme‑oxygenation status indicated as a risk factor in prehypertension by Raman spectroscopy

Raman spectroscopy of erythrocytes provides detailed information about the structure and status of heme moiety, which can be used to provide new insights into molecular pathogenesis of several diseases. In this study, we present the first Raman spectroscopy investigations of the effect of hemoglobin oxygenation in the context of hypertensive disease. The experimental data was subjected to Logistic Regression, which indicated heme‑oxygenation status as an important risk factor alongside other clinical parameters. The 1605/1621 cm−1 band ratio was selected as an optimal Raman metric for risk assessment and along with other band ratios (1583, 1639, 1310 cm−1) related to heme status and when combined with clinical data via logistic regression gave an Area Under the Curve (AUC) >0.95 for prehypertension risk prediction. The work demonstrates the feasibility of Raman spectroscopy to distinguish between prehypertensive and normotensive states. Simultaneously, it is implied that the etiology of the high blood pressure progression may be connected with the changes in hemoglobin oxygenation.

ASSOCIATION BETWEEN SALT INTAKE AND URIC ACID, AND ITS INTERACTION ON THE INCIDENCE OF PREHYPERTENSION AMONG CHINESE YOUNG ADULTS

Objective: High uric acid (UA) level and high salt intake are reportedly associated with cardiovascular disease. This study investigated the association between UA and daily salt intake, as well as its interaction on the risk of prehypertension. Design and method: A total of 1869 participants without hypertension were recruited from a previously established cohort in Shaanxi Province, China. The participants were classified as normotensive or prehypertensive on the basis of their blood pressure. Salt intake was estimated from early-morning urine specimens using an equation validated for this study population. Results: Increasing quartiles of salt intake were associated with high urinary UA/creatinine levels in prehypertensive participants (from quartile 1 to quartile 4: 0.12, 0.17, 0.24, and 0.33, P for trend < 0.001)). Estimated salt intake positively correlated with urinary UA/creatinine excretions in the prehypertensive group (r = 0.496; P < 0.001). In addition, the prehypertensive group had higher levels of salt intake and serum UA than the normotensive group [salt intake: 13.22 ± 3.52 vs. 12.35 ± 3.42 g/day, P < 0.001; serum UA: 290.0 (233.6–340.6) vs. 255.6 (211.6–305.0) μmol/L, P < 0.001]. The multivariate-adjusted odds ratios (95% confidence interval) for prehypertension compared with normotension were 1.68 (1.27–2.22) for salt intake and 1.71 (1.21–2.42) for serum UA. Increasing salt intake and serum UA were associated with higher risk of prehypertension. Compared with the lowest quartiles, the highest salt intake and serum UA quartiles entailed 3.48 times greater risk of prehypertension.Conclusions: Salt intake is associated with urinary UA excretion in prehypertensive participants. High levels of salt intake and serum UA simultaneously are associated with a higher risk of prehypertension.

Association between urinary sodium excretion and uric acid, and its interaction on the risk of prehypertension among Chinese young adults

High uric acid (UA) level and high salt intake are reportedly associated with cardiovascular disease. This study investigated the association between UA and urinary sodium excretion, as well as its interaction on the risk of prehypertension. A total of 1869 participants without hypertension were recruited from a previously established cohort in Shaanxi Province, China. The participants were classified as normotensive or prehypertensive on the basis of their blood pressure. Increasing quartiles of sodium excretion were associated with high urinary UA/creatinine levels in prehypertensive participants. Estimated sodium excretion positively correlated with urinary UA/creatinine excretions in the prehypertensive group. In addition, the multivariate-adjusted odds ratios for prehypertension compared with normotension were 1.68 (1.27–2.22) for sodium excretion and 1.71 (1.21–2.42) for serum UA. Increasing sodium excretion and serum UA were associated with higher risk of prehypertension. Compared with the lowest quartiles, the highest sodium excretion and serum UA quartiles entailed 3.48 times greater risk of prehypertension. Sodium excretion is associated with urinary UA excretion in prehypertensive participants. The present study shows that high levels of salt intake and serum UA simultaneously are associated with a higher risk of prehypertension.

Association of Habitually Low Intake of Dietary Calcium with Blood Pressure and Hypertension in a Population with Predominantly Plant-Based Diets.

This study aimed to assess the association of habitually low dietary calcium intake with blood pressure or hypertensive risk using data from the China Health and Nutrition Survey (CHNS) in 2009. We included 6298 participants (2890 men and 3408 women) aged 18 years or older in this analysis. Food intakes were measured by 3-day 24-h individual recalls combined with a weighing and measuring of household food inventory. The participants were divided into normotensive, pre-hypertensive and hypertensive groups according to their mean blood pressure of three repeated measurements. Six intake levels were decided by percentiles of gender-specific dietary calcium intakes (P0–10, P10–30, P30–50, P50–70, P70–90, and P90–100). Average dietary calcium intakes were 405 mg/day for men and 370 mg/day for women, 80% and 84% of which were derived from plant-based food in men and women, respectively. Multiple linear regression analyses showed that dietary calcium intakes were not related with blood pressure in both genders (all P > 0.05). Logistic regression analyses showed a lower risk of pre-hypertension with higher dietary calcium intakes in women (all Pfor trend < 0.001), but not in men; no association between dietary calcium intake and hypertensive risk was found in both genders (all Pfor trend > 0.05). This study suggests that there are no conclusive associations of habitually low dietary calcium intake with blood pressure or hypertensive risk in Chinese individuals consuming predominantly plant-based diets.

Association of Blood Pressure with Blood Lead and Cadmium Levels in Korean Adolescents: Analysis of Data from the 2010-2016 Korean National Health and Nutrition Examination Survey.

BackgroundWe evaluated the association of blood pressure (BP) with blood levels of cadmium, lead, and cadmium and lead together (cadmium + lead) in a representative sample of adolescents from Korea.MethodsWe used 2010–2016 data from the Korean National Health and Nutrition Examination Survey. This cross-sectional study enrolled adolescents aged at 10–18 years-old who completed a health examination survey and had blood measurements of lead and cadmium. The association of adjusted mean differences in diastolic and systolic BP with doubling of blood lead and cadmium were estimated by regression of BP against log2-transformed blood metals and their quartiles after covariate adjustment. Adjusted odds ratio for prehypertension were calculated for log2-transformed blood levels of lead and cadmium and their quartiles.ResultsOur analysis of adolescents in Korea indicated that blood levels of lead and cadmium were not significantly associated with increased BP or risk of prehypertension. However, the cadmium + lead level was associated with prehypertension. Previous studies showed that blood levels of lead and cadmium were associated with increased BP and risk of hypertension in adult populations. We found no such association in Korean adolescents.ConclusionWe found that the cadmium + lead level was associated with prehypertension. The differences between adults and adolescents are because adolescents generally have lower levels of these blood metals or because adolescents only rarely have hypertension.

Hypertension in Adolescent School Girls in Riyadh City, KSA

Background: Recent data from large samples of healthy adolescents show that the rates of hypertension and prehypertension in adolescents are greater than expected and are increasing. Children with elevated blood pressure can develop target organ damage. This work aimed to estimate the prevalence of hypertension and to describe some related characteristics of cases in adolescent preparatory and secondary school girls of Riyadh city, KSA. Methods: A cross-sectional study conducted among a cluster sample of adolescent preparatory and secondary school girls of Riyadh city, KSA during the academic year 2016- 2017. Data collected via a predesigned and pretested questionnaire to collect the relevant data. Results: In the studied adolescent girls, 6 (3.8%) were hypertensive; previously diagnosed and on treatment, 0.6% were ex-smoker and 1.9% were smokers. Two girls (1.2%) had renal disease, 2.4% had bronchial asthma, one girl (0.6%) had hypothyroidism and 0.6% had depression. Half of the cases aged 18 years, 33.3% aged 17 years and 16.7% aged 19 years (Mean (±SD) age of cases was 15.3 (± 2.8)). Conclusion: in adolescent preparatory and secondary school girls of Riyadh city, KSA, 3.8% were hypertensive. So health-care providers should recognize the increased risk of prehypertension and hypertension and should seek to identify and manage the modifiable risk factors in those adolescent girls.

Prehypertension and Hypertension in Medical Students of Northern Border University in Arar, Saudi Arabia

Aim of the work: hypertension is the commonest cardiovascular disorder. Prehypertension in adolescents and young adults is a risk factor for developing hypertension in later years of life. The objective of this study was to determine the prevalence rate and risk factor associated with prehypertension and hypertension in the medical students of Northern Border University in Arar city, Saudi Arabia. Methods: this cross-sectional study included 232 students. The study subjects were selected by systematic random sampling method. This study included 232 medical students (136 male and 96 female). The study period was from 1 March to 31 May 2017. Students were given a predesigned and pretested questionnaire to collect the relevant data. Results: Fifty (52.1%) of females and 58.8% of males were pre-hypertensive and 1.5% from males were hypertensive. Family history of hypertension was positive in 66.7% of hypertensive or pre-hypertensive students (P 0.05), 31.8% were smokers (P>0.05), 10.6% were drug addicts (P>0.05), 18.2% only performing muscular exercise (P>0.05), 62.1% consume >5g salt /day (P 0.05). Conclusion: in medical students of the Northern Border University, 52.1% of females and 58.8% of males were pre-hypertensive and 1.5% of males were hypertensive. Risk factors included obesity, family history, sedentary life and excess salt intake. So health-care providers should recognize the increased risk of prehypertension and hypertension and should seek to identify and manage the modifiable risk factors in those students.

Association of reproductive history with hypertension and prehypertension in Chinese postmenopausal women: a population-based cross-sectional study.

Hypertension and prehypertension may have important roles in the etiology of cardiovascular disease. However, the risk factors of hypertension and prehypertension have not been thoroughly elucidated to date. This study intended to explore the relative effects between reproductive history and the prevalence of hypertension and prehypertension. A population-based cross-sectional survey of postmenopausal women (n=6252), aged 41-93 years, was conducted from August 2013 to August 2015. All subjects, selected by the multistage random sampling method in Henan province, were categorized as normotension, prehypertension and hypertension according to blood pressure (BP) levels. Ordinal logistic regression models were used to estimate the risks of prehypertension and hypertension with three categories of BP as dependent variables. Hypertension was associated with a positive history of induced abortion (adjusted odds ratio (OR)=1.190, 95% confidence interval (CI): 1.020, 1.388), but there was no association between hypertension and a positive history of spontaneous abortion (adjusted OR=1.126, 95% CI: 0.973, 1.303) after adjusting for age, alcohol consumption, education status, smoking, body mass index, physical activity and occupation. Compared with women with one or no children, those with two or three children were at a lower risk of hypertension (adjusted OR=0.605, 95% CI: 0.434, 0.845). In addition, individuals with an age of menopause between 46 and 51 years may have a decreased risk of both prehypertension and hypertension, especially in terms of systolic BP. In conclusion, a positive history of induced abortion may be a predictive risk factor for hypertension and prehypertension. However, a menopausal age of 46-51 years or having two children may be protective factors against hypertension and prehypertension.

Prehypertension and psychosocial risk factors among university students in ASEAN countries

BackgroundExisting evidence suggests that the cardiovascular morbidities are increasing among pre-hypertensive individuals compared to normal. The aim of this study was to evaluate the prevalence of prehypertension, hypertension and to identify psychosocial risk factors for prehypertension among university students in Association of South East Asian Nation (ASEAN) countries.MethodsBased on a cross-sectional survey, the total sample included 4649 undergraduate university students (females = 65.3%; mean age 20.5, SD = 2.9, age range of 18–30 years) from 7 ASEAN countries (Indonesia, Laos, Malaysia, Myanmar, Philippines, Thailand and Vietnam). Blood pressure, anthropometric, health behaviour and psychosocial variables were measured.ResultsOverall, 19.0% of the undergraduate university students across ASEAN countries had prehypertension, 6.7% hypertension and 74.2% were normotensives. There was country variation in prehypertension prevalence, ranging from 11.3% in Indonesia and 11.5% in Malaysia to above 18% in Laos, Myanmar and Thailand. In multivariate analysis, sociodemographic variables (male gender, living in an upper middle income country, and living on campus or off campus on their own), nutrition and weight variables (not being underweight and obese, having once or more times soft drinks in a day and never or rarely having chocolate or candy), heavy drinking and having depressive symptoms were associated with prehypertension.ConclusionThe study found a high prevalence of prehypertension in ASEAN university students. Several psychosocial risk factors including male gender, obesity, soft drinks consumption, heavy drinking and depression symptoms have been identified which can help in intervention programmes.

Prehypertension and cardiometabolic risk factors (data of the ESSE-RF study)

Theobjectiveof our work was to assess the prevalence of prehypertension (PHT) and the relationship with cardiovascular risk factors in the population sample of the inhabitants of the Russian Federation.Design and methods.The ESSE-RF study was carried out in 12 regions of the Russian Federation (Volgograd, Vologda, Voronezh, Vladivostok, Ivanovo, Kemerovo, Krasnoyarsk, Orenburg, Tomsk, Tyumen, St Petersburg, and North Ossetia (Alania)) with different climatic, geographic, economic and demographic characteristics. A stratified random sample was formed in each region. In total, 20652 inhabitants of the Russian Federation aged 25–65 years were examined. All participants signed informed consent and completed approved questionnaires regarding behavioral risk factors, socioeconomic status and concomitant diseases/therapy. Anthropometry, fasting blood sampling, measurement of blood pressure (BP) were performed. BP was measured by the OMRON device (Japan) twice on the right arm in the sitting position with calculation of the mean BP. The optimal blood pressure corresponds to the BP level &lt; 120/80 mm Hg. The normal BP is 120–129/80–84 mm Hg. High normal BP is 130–139/85–89 mm Hg. PHT is diagnosed in case of BP 120–139/80–89 mm Hg. Hypertension is diagnosed case of BP ≥ 140/90 mm Hg or antihypertensive therapy. PHT includes groups of normal and high normal blood pressure. The statistical analysis was carried out using SPSS Statistics 20.Results.Data of 20607 participants were analyzed, among them 7806 men (37,9 %) and 12801 women (62,1 %). The optimal BP was registered in 3848 (23,4 %), normal BP in 3551 (20,1 %), high normal BP in 2861 (14,9 %), PHT — in 6412 (35,0 %), hypertension — in 10347 (41,6 %). The prevalence is standardized according to the age structure of the World Health Organization (2000). Among men, compared with women, PHT was significantly more frequent (41,2 % and 30,1 %, respectively). The probability of PHT, adjusted for sex, age and obesity is associated with hypercholesterolemia &gt; 4,9 mmol / l (OR 1,27 [1,15, 1,39]), increased HDL &gt; 3,0 mmol / l (1,25 [1,14, 1,37]), triglycerides &gt; 1,7 mmol / l (OR 1,39 [1,23, 1,58]), hyperglycemia ≥ 5,6 mmol / l (OR 1,46 [1,28, 1,67], p &lt; 0,05). The presence of higher education reduced the likelihood of PHT, behavioral risk factors were not significant predictors.Conclusions.The results demonstrate the high prevalence of PHT and the association of metabolic abnormalities with the transformation of optimal blood pressure in PHT, which emphasizes the importance of timely diagnosis of PHT and correction of cardiometabolic risk factors in the Russian population.

Prehypertension and socioeconomic status: A cross-sectional study in Chongqing, China

ABSTRACTBackground: A large amount of research is available on the relationship between socioeconomic status (SES) and hypertension. However, the relationship between SES and prehypertension remains complex and unclear. Prehypertension is defined as a systolic blood pressure (SBP) between 120 and 139 mmHg or diastolic blood pressure (DBP) 80 and 89 mmHg. This paper focuses on the impact of SES on the prevalence of prehypertension and provides suggestions for the prevention and control measures of prehypertension and health resource allocation. Method: Using multistage random sampling, 11,773 subjects were selected. Subjects aged above 15 years old and subjects who had been living in the eight selected districts for more than 6 months were analyzed using a multivariable logistical model. Results: The prevalence of prehypertension at the present time reaches 55.17%, with it being higher among men than that among women (63.15% vs. 47.19%, p < 0.05). After adjustment for other factors such as age and gender, a logistic regression showed that a higher education level and a history of marital status were significantly associated with prehypertension. Conclusions: People of different SES indicate different working and living conditions. They also face different risk factors for prehypertension. Lower education and a history of marital status were associated with a higher risk of prehypertension among residents in Chongqing, China

Prehypertension and its optimal indicator among adults in Hubei Province, Central China, 2013–2015

ABSTRACTBackground: Hypertension accounts for 7% of the annual global disease burden, despite great efforts to counter this trend. Thus, interventions targeted at prehypertension might lead to a breakthrough for hypertension prevention. This study focused on the prevalence of prehypertension among adults in Central China and the best indicator of prehypertension, which would provide the basis for future interventions. Methods: This cross-sectional study was conducted using multistage stratified random sampling in seven counties in Hubei Province. Data from 30,634 survey respondents were analyzed using logistic regression and receiver operating characteristic (ROC) curve statistical tests, for the prevalence of prehypertension and the predictive ability of body mass index (BMI), waist-to-height ratio (WHtR), and waist circumference (WC) for prehypertension. Results: The prevalence of prehypertension in adults was 42.2%. The following factors contributed to the risk of prehypertension: male sex, elder age, divorce/separation, drinking, heavy labor intensity, and high BMI (p < 0.05). Being a farmer and exercise exhibited positive associations with prehypertension (p < 0.05). Compared with BMI and WHtR, WC had a higher predictive value for prehypertension (area under ROC curve, AUC = 0.630, 95% confidence interval: 0.623–0.637, p < 0.0001), especially for men. The optimal cutoffs of WC for prehypertension were 79.95 cm in men and 76.85 cm in women. Conclusions: The prehypertension rate in adults was high in Central China. Significant factors related to hypertension were identified. More interventions targeting individuals with WC above the cutoff level are needed for timely awareness of prehypertension and early prevention of hypertension.

Prehypertension among 2.19 million adolescents and future risk for end-stage renal disease.

Persistent hypertension in adulthood is a leading cause of end-stage renal disease (ESRD). Whether lower blood pressure (BP) values, in the range of prehypertension, are also associated with future occurrence of ESRD is unclear. Even less clear is the potential risk of early prehypertension appearing in adolescence. To address this question, we examined whether BP measurements in the prehypertensive range at age 16-19 years predict adult ESRD. Medical data on 2194 635 16-19-year-old adolescents examined for medical fitness prior to military service from 1977 to 2013 were linked to the Israeli ESRD registry in this nationwide population-based cohort study. Incident cases of ESRD were recorded. Survival models were applied. During 35 007 506 person-years of follow-up (median follow-up 16.8 years), there were 690 ESRD cases, with an overall incidence rate of 1.97 cases per 100 000 person-years. Examinees with elevated BP readings in the prehypertensive range (BP between the 90th and 95th percentiles or between 120 and 139/80-89 mmHg) had increased incidence of ESRD with a hazard ratio of 1.32 (95% confidence interval, 1.11-1.58) adjusted for year of birth, age at examination, sex, BMI, education, socioeconomic status, and country of origin. Hypertension (BP above the 95th percentile or above 140/90 mmHg) was associated with a hazard ratio of 1.44 (95% confidence interval, 1.17-1.79). A spline model demonstrated a nadir of risk at SBP values as low as 94 mmHg. Asymptomatic, healthy adolescents with prehypertension have a 32% increased risk for subsequent ESRD, compared with adolescents with optimal BP.

Postnatal height and adiposity gain, childhood blood pressure and prehypertension risk in an Asian birth cohort.

There have been hypotheses that early life adiposity gain may influence blood pressure (BP) later in life. We examined associations between timing of height, body mass index (BMI) and adiposity gains in early life with BP at 48 months in an Asian pregnancy-birth cohort. In 719 children, velocities for height, BMI and abdominal circumference (AC) were calculated at five intervals [0-3, 3-12, 12-24, 24-36 and 36-48 months]. Triceps (TS) and subscapular skinfold (SS) velocities were calculated between 0-18, 18-36 and 36-48 months. Systolic (SBP) and diastolic blood pressure (DBP) was measured at 48 months. Growth velocities at later periods were adjusted for growth velocities in preceding intervals, as well as measurements at birth. After adjusting for confounders and child height at BP measurement, each unit z-score gain in BMI, AC, TS and SS velocities at 36-48 months were associated with 2.3 (95% CI:1.6, 3.1), 2.1 (1.3, 2.8), 1.4 (0.6, 2.2) and 1.8 (1, 2.6) mmHg higher SBP respectively, and 0.9 (0.4, 1.4), 0.9 (0.4, 1.3), 0.6 (0.1, 1.1) and 0.8 (0.3, 1.3) mmHg higher DBP respectively. BMI and adiposity velocities (AC, TS or SS) at various intervals in the first 36 months however, were not associated with BP. Faster BMI, AC, TS and SS velocities, but not height, at 36-48 months were associated with 0.22 (0.15, 0.29), 0.17 (0.10, 0.24), 0.11 (0.04, 0.19) and 0.15 (0.08, 0.23) units higher SBP z-score respectively, and OR=1.46 (95% CI: 1.13-1.90), 1.49 (1.17-1.92), 1.45 (1.09-1.92) and 1.43 (1.09, 1.88) times higher risk of prehypertension/hypertension respectively at 48 months. Our results indicated that faster BMI and adiposity (AC, TS or SS) velocities only at the preceding interval before 48 months (36-48 months), but not at earlier intervals in the first 36 months, are predictive of BP and prehypertension/hypertension at 48 months.

Dietary sodium and potassium intake and their association with blood pressure in a non-hypertensive Iranian adult population: Isfahan salt study.

The association of sodium (Na) and potassium (K) intake with blood pressure (BP) is an ongoing debate, especially in central Iran. We aimed to examine the mean Na and K intake, major sources of Na and the relationship between BP and dietary and urinary Na and K. This cross-sectional study was performed in central Iran in 2013-2014. A total of 796 non-hypertensive adults aged >18 years were randomly recruited. The semi-quantitative food frequency questionnaire was used to assess dietary Na and K intake. Moreover, 24-hour urine samples were collected to measure 24-hour urinary Na (UNa) and K (UK) as biomarkers. BP was measured twice on each arm using a standard protocol. The mean Na and K intake were 4309.6 ± 1344.4 and 2732.7 ± 1050.5 mg/day, respectively. Table and cooking salt were the main sources of Na. Odds ratio (OR) (95% confidence interval (CI)) of the crude model in the highest quartile of UNa indicated a significant association with the higher risk of prehypertension (OR (95% CI): 2.09 (1.09-4.05); P for trend = 0.007). After adjustment for potential confounders, prehypertension was significantly associated with increasing dietary Na/K ratio (OR (95% CI): 1.28 (1.01-1.57); P for trend = 0.046) and UNa/UK ratio (OR (95% CI): 2.15(1.08-4.55); P for trend = 0.029). Increasing dietary and urinary Na/K ratios and UNa were associated with elevated BP and prehypertension occurrence. These findings support the necessity of developing a salt reduction programme in our country.

OS 24-02 ASSOCIATION BETWEEN INFLAMMATION, OBESITY AND PREHYPERTENSION IN 16–25 YEAR OLD AUSTRALIAN FEMALES

Objective: The relationship between inflammation and prehypertension has never been documented in adolescent females in Australia, where obesity is prevalent. We aimed to investigate the association between high sensitivity C-Reactive Protein (hs-CRP), obesity and prehypertension in young Australian females. Design and Method: Women aged 16–25 years, living in Victoria, were randomly recruited via targeted Facebook advertising for the Young Female Health Initiative and Safe-D studies. Socio-demographic information was collected via a web-based questionnaire. Anthropometric and blood pressure measurements were conducted by trained staff. Hs-CRP was measured using the Abbott Architect assay. Multivariable logistic regression was used to determine associations between body mass index (BMI), hs-CRP and prehypertension, adjusted for age, socio-economic indices, physical activity and smoking. Results: Demographic data were available for 639 females (mean ± SD age 22 ± 3) and blood pressure data for 513 participants. Approximately 28% had prehypertension (≥ 120–139/80–89 mmHg) and 3% had morbid hypertension (≥ 140/90 mmHg). Approximately 26% had a hs-CRP level ≥ 3.0 mg/L (reference range: 1.0–3.0 mg/L). Additionally, 20% were overweight (BMI ≥ 25 kg/m2) and 10% were obese (BMI ≥ 30 kg/m2). In multivariable analyses, females who were overweight (OR 1.9, 95% CI 1.1–3.3, p = 0.02) or obese (OR, 6.0 95% CI 2.7–13.3, p < 0.001) were more likely to have prehypertension compared with those with a BMI in the normal range (18.5–24.9 kg/m2). Elevated hs-CRP levels (≥ 5 mg/L) were also associated with an increased risk of prehypertension (OR, 2.2 95% CI 1.2–4.0, p = 0.01). Conclusions: The high prevalence of prehypertension is of concern in this sample of 16 to 25 year old Australian females. Positive associations were detected between hs-CRP, obesity and prehypertension, despite the absence of cardiovascular disease in this sample. Therefore, blood pressure lowering strategies directed at young Australian females should be developed to potentially reduce future risk of cardiovascular disease.

Short sleep duration is associated with increased risk of pre-hypertension and hypertension in Chinese early middle-aged females.

The aim of this study is to investigate the relationship between sleep duration and hypertension in a middle-aged Chinese population. Cross-sectional data of 20,505 individuals aged 35-64years from Taizhou longitudinal study was used. Logistic regression models were used to calculate odds ratios (ORs) for the risk of pre-hypertension and hypertension in association with sleep duration. Short sleep duration was associated with high systolic and diastolic blood pressure in comparison with sleep duration of 7-8h in females. Short sleep duration was also associated with an increased risk of hypertension in females. Age-stratified analysis showed that as compared with sleep duration of 7-8h, sleep duration <6h increased risk of hypertension after controlling for multiple covariates with an OR of 1.766 (1.024-2.775) in early middle-aged females of 35-44years. More importantly, sleeping less than 6h is associated with increased risk of pre-hypertension in females of this age category, after controlling for multiple covariates with an OR of 1.769 (1.058-2.958). Sleeping less than 6h a day is associated with increased risk of pre-hypertension and hypertension in Chinese early middle-aged females. The high-risk populations require sufficient sleep, which could probably prevent the increased risk of pre-hypertension as well as hypertension.

Serum uric acid levels and risk of prehypertension: a meta-analysis.

Elevated serum uric acid (SUA) levels may increase the risk of prehypertension. However, the findings from these studies remain conflicting. The objective of this study was to determine the relationship between SUA levels and risk of prehypertension by conducting a meta-analysis. We conducted a comprehensive literature search of PubMed, Embase, China National Knowledge Infrastructure, VIP, and the Wangfang database without language restrictions through May 2015. Observational studies assessing the relationship between SUA levels and prevalence of prehypertension were included. Pooled adjust odds ratio (OR) and corresponding 95% confidence intervals (CI) of prehypertension were calculated for the highest vs. lowest SUA levels. Prehypertension was defined as systolic blood pressure (BP) ranging from 120 to 139 mmHg or diastolic BP ranging from 80 to 89 mmHg. Eight cross-sectional studies with a total of 21,832 prehypertensive individuals were included. Meta-analysis showed that elevated SUA levels were associated with increased risk of prehypertension (OR: 1.84; 95% CI: 1.42-2.38) comparing the highest vs. lowest level of SUA levels. Subgroup analyses showed that elevated SUA levels significantly increased the risk of prehypertension among men (OR: 1.60; 95% CI: 1.12-2.21) and women (OR: 1.59; 95% CI: 1.17-2.16). Elevated SUA levels are positively associated with the risk of prehypertension in the general population. However, more well-designed longitudinal studies are needed before a definitive conclusion can be drawn due to the cross-sectional studies included are susceptible to bias.

Hypertensive disorders first identified in pregnancy increase risk for incident prehypertension and hypertension in the year after delivery.

Hypertensive disorders in pregnancy, including preeclampsia/eclampsia (PE/E) are associated with long-term cardiovascular disease risk. However, little is known about the effect of these conditions on risk for prehypertension (preHTN) or hypertension (HTN) in the early years after delivery. The cohort consisted of women who had prenatal care and delivered a live singleton neonate at Kaiser Permanente Bellflower Medical Center in 2005-2010. Women with prepregnancy HTN or preHTN were excluded from analysis. Multivariable robust Poisson regression models were used to assess associations between any hypertensive disorder or PE/E and development of preHTN/HTN in the year after delivery, adjusted for maternal age, race/ethnicity, parity, smoking, prepregnancy weight status, gestational weight gain, gestational diabetes, and gestational age. Among 5960 women who were normotensive prior to pregnancy, 358 (6.0%) developed a hypertensive disorder in pregnancy, of whom 215 (60.1%) had PE/E. Overall, 63 (1.1%) developed HTN and 902 (15.1%) preHTN in the year after delivery. After accounting for all potential confounders, women with a hypertensive disorder in pregnancy and those with PE/E were 2.36 (95% confidence interval: 1.97-2.83) and 2.48 (95% confidence interval: 1.99-3.11) times as likely, respectively, to develop preHTN/HTN in the year after delivery as those without pregnancy-related HTN. Results were similar with and without adjustment for gestational diabetes. Our findings highlight the need for prospective studies aimed at determining whether early postpartum screening and improved follow-up of women with hypertensive disorders first identified in pregnancy may prevent future cardiovascular disease.