Risk Of Hypertension Research Articles

Lipoprotein(a) among normotensive patients and risk of incident hypertension.

Lipoprotein(a) has been shown to be disruptive to local endothelial cells, whose integrity is critical to blood pressure (BP) regulation. Cross-sectional analysis has shown an association between lipoprotein(a) and prevalent hypertension, though it is unclear if lipoprotein(a) increases risk of incident hypertension. To assess this, the authors measured baseline lipoprotein(a) among 5307 normotensive patients (median age 26years (interquartile range [IQR] 12-50) and used Cox proportional hazard models to generate hazard rations (HR) with 95% confidence intervals (CI; median follow-up 10-years). The authors categorized lipoprotein(a) as <15mg/dL, 15-<30mg/dL, 30-50mg/dL, >50mg/dL, and performed subgroup analysis of adults >50years at baseline. Incident hypertension was defined as a measured BP ≥140/90mm Hg or a new ICD-9/10 code. After adjustment, hypertension for patients with baseline lipoprotein(a) 15-<30mg/dL, 30-50mg/dL, and >50mg/dL was 0.91 (0.72-1.16), 1.05 (0.79-1.38), and 1.02 (0.83-1.26; vs. <15mg/dL). However, among adults >50years, lipoprotein(a) >50mg/dL was associated with increased incident hypertension (1.62 [1.17-2.26]).

Increased levels of urine volatile organic compounds are associated with hypertension risk.

Individuals are exposed to various volatile organic compounds (VOCs) in their surroundings. VOCs were associated with some cardiovascular and metabolic diseases, but the effects on blood pressure (BP) have not yet been clarified. This study aimed to ascertain the relationship between the urine levels of VOCs and the prevalence of hypertension (HTN) in the general population. This analysis utilized data from 4156 participants aged from 20 to 79 years in 2013-2018 National Health and Nutrition Examination Survey (NHANES). Exposure to VOCs was assessed through measurements of urinary VOC metabolites, with 16 VOCs selected for analysis. The relationships between VOCs and the risk of HTN in patients were examined through the weighted logistic regression and the weighted linear regression models. Generalized additive models were employed to analyze potential nonlinear associations between VOCs and the risk of HTN. Additionally, subgroup analyses and intergroup interaction tests were conducted. A total of 4156 participants with 16 VOCs were finally included for analysis. Multivariable logistic regression showed that ln-transformed urine levels of N-acetyl-S-(2-cyanoethyl)-L-cysteine (CYMA) [odds ratio (OR) 1.54; 95% confidence interval (CI) 1.18-2.02], N-acetyl-S-(3-hydroxypropyl)-L-cysteine (3HPMA; OR 1.33; 95% CI 1.03-1.74), N-acetyl-S-(4-hydroxy-2-butenyl)-L-cysteine (MHBMA3; OR 1.68; 95% CI 1.29-2.20), and N-acetyl-S-(1-phenyl-2-hydroxyethyl)-L-cysteine + N-acetyl-S-(2-phenyl-2-hydroxyethyl)-L-cysteine (PHEMA; OR 1.55; 95% CI 1.19-2.00) were significantly associated with an increased risk of HTN in US general population. A nonlinear relationship and a threshold effect were only observed between ln (N-acetyl-S-(2-hydroxypropyl)-L-cysteine or 2HPMA) and HTN. There was a significantly positive correlation between ln(2HPMA) and HTN when ln(2HPMA) at least 5.29. Sub-analysis revealed that there was a more pronounced association in the elderly group (age ≥60 years), the overweight group (BMI ≥25), and the alcohol consumption group. Our work presents novel epidemiological evidence supporting the establishment of the relationship between environmental pollutants and HTN, highlighting hitherto ignored positive correlations between nonoccupational VOC exposure and the entire population's risk of HTN.

Work hours and the risk of hypertension: the case of Indonesia

BackgroundIndividuals working excessive hours is a worldwide phenomenon. In Indonesia, over 32 million people work more than 40 h per week, contributing to around 26% of the workforce. Excessive working may affect health, increasing the risk of cardiovascular diseases such as hypertension. Hypertension affected around 34% of Indonesian adults, approximately 63.3 million people and led to about 427,000 deaths in 2018, and the prevalence remains high at 29.2% in 2023. This study aims to analyze the relationship between work hours and the risk of hypertension among working individuals in Indonesia.MethodsThis study used a pooled cross-sectional data from the Indonesian Family Life Survey (IFLS) wave 4 (2007) and wave 5 (2014) and performed a logit regression analysis to examine the likelihood of a working individual having hypertension based on the individual’s work hours. A dummy variable of hypertension is created based on the result of blood pressure measurement. The sample consists of 22,500 working individuals in Indonesia. This study controlled for job characteristics, sociodemographic status and health-behavioral risk factors such as BMI and smoking behavior, and performed additional regression analyses for alternative models to check for robustness.ResultsOur findings showed that there is a higher probability of having hypertension for workers who work longer hours by 0.06% points for each additional hour of work (p < 0.01). Other factors such as physical activity and smoking behavior have also been demonstrated to be significantly correlated to the risk of hypertension.ConclusionsThis study revealed a positive relationship between work hours and hypertension. Although this study cannot suggest causality, the strongly significant correlation may provide an idea and an overview regarding the risk of hypertension among working individuals in Indonesia. The Indonesian government could consider conducting further studies to implement and promote flexible working arrangements initiatives and incentive programs to improve workers’ health outcomes.

Long-term nighttime aircraft noise exposure and risk of hypertension in a prospective cohort of female nurses

There is growing interest in cardiometabolic outcomes associated with nighttime noise, given that noise can disturb sleep and sleep disturbance can increase cardiometabolic risk such as hypertension. However, there is little empirical research evaluating the association between nighttime aircraft noise and hypertension risk. In this study, we expand on previous work to evaluate associations between nighttime aircraft noise exposure and self-reported hypertension incidence in the Nurses' Health Studies (NHS/NHSII), two US-wide cohorts of female nurses. Annual nighttime average aircraft sound levels (Lnight) surrounding 90 airports for 1995–2015 (in 5-year intervals) were modeled using the Aviation Environmental Design Tool and assigned to participants’ geocoded addresses over time. Hypertension risk was estimated for each cohort using time-varying Cox proportional-hazards models for Lnight dichotomized at 45 dB (dB), adjusting for individual-level hypertension risk factors, area-level socioeconomic status, region, and air pollution. Random effects meta-analysis was used to combine cohort results. Among 63,229 NHS and 98,880 NHSII participants free of hypertension at study baseline (1994/1995), we observed 33,190 and 28,255 new hypertension cases by 2014/2013, respectively. Although ∼1% of participants were exposed to Lnight ≥45 dB, we observed an adjusted hazard ratio (HR) of 1.10 (95% CI: 0.96, 1.27) in NHS and adjusted HR of 1.12 (95% CI: 0.98, 1.28) in NHSII, comparing exposure to Lnight ≥45 versus <45 dB(A). In meta-analysis, we observed an adjusted HR of 1.11 (95% CI: 1.01, 1.23). These results were attenuated with adjustment for additional variables such as body mass index. Our findings support a modest positive association between nighttime aircraft noise and hypertension risk across NHS/NHSII, which may reinforce the concept that sleep disturbance contributes to noise-related disease burden.

Effect of a multidisciplinary program with seven color balls on non-communicable diseases prevention in a Muslim community: A real-world study

Prevalence of diabetes and hypertension are increasing. Health promotion is needed for the diseases prevention. The objective of this study was to determine the impact of a multidisciplinary program and a seven-color balls on fasting blood glucose and blood pressure in a Muslim community. A one-group pre-post test of participatory action research was employed. The screening test was administered and assigned a color to each of seven health statuses. All participants made a commitment to improve their weekly performance. They were instructed and practiced for three weeks on six health information topics. Then, each village health volunteer reminded the participants of health information, and a religious leader declared (Kutbah) during Friday prayer that tobacco and alcohol are contrary to Islam. Utilizing frequency and percentage, the study outcome at the end of the program was compared to that at baseline. The results revealed that the mean age of the participants was 33.92 years, with a range of 15 to 82 years. Six months after program finish, 87.5% of those at risk and 93.3% of high risk for hypertension returned to normal blood pressure levels. For FBS level, risk for diabetes participants improved to a normal level by 57.6%, participants who were possibly for diabetes improved to better level by 50%, and third level illness decreased to a lower level by 50%. The program could improve participants’ health status and encourage their self-esteem for health prevention. Prevention of hypertension, and diabetes is essential for promoting individual and community health.

Association between dietary antioxidant indices and hypertension among Chinese adults.

The effect of dietary antioxidants on blood pressure (BP) regulation and hypertension risk remains largely unknown. This study aimed to comprehensively assess the impacts of dietary antioxidants on systolic BP (SBP), diastolic BP (DBP), mean arterial pressure (MAP), and pulse pressure (PP), and hypertension risk among Chinese adults. The cross-sectional study assessed data from 12,046 Chinese adults, evaluating dietary antioxidant quality scores (DAQS) and total antioxidant capacity (DTAC) via a validated food frequency questionnaire. MAP was derived using the formula DBP + (0.412 ×PP), with PP calculated as SBP - DBP. The relationship between DAQS, DTAC, and hypertension prevalence was analyzed using multivariable logistic regression. Among participants not taking antihypertensive medications, those in the highest groups of DTAC and DAQS had significantly lower SBP, DBP, MAP, and PP compared to those in the lowest groups (all p-trends <0.001). Relative to the lowest quintile (Q1) ofDTAC (adjusted odds ratios (OR) for hypertension decreased in Q2 (OR 0.90, 95%CI 0.79-1.03), Q3 (OR 0.65, 95% CI 0.56-0.76), Q4 (OR 0.51, 95% CI 0.43-0.60), and Q5 (OR 0.38, 95% CI 0.31-0.46) (p trend <0.001). For DQAS, hypertension OR of category 5 was 0.38 (95% CI 0.32-0.46) compared to that of category 1. Increased vitamin A, Zinc, and selenium intake correlated with reduced hypertension risk. A significant non-linear DTAC and linear DAQS relationships were observed and hypertension risk. Antioxidant-rich diets markedly lowered SBP, DBP, MAP, PP, and hypertension risk.

Obstructive sleep apnea comorbid with insomnia symptoms and objective short sleep duration is associated with clinical and preclinical cardiometabolic risk factors: Clinical implications

BackgroundInsomnia with objective short sleep duration (ISSD) but not insomnia with normal sleep duration (INSD) is associated with cardiometabolic morbidity. It has been reported that sleep apnea comorbid with insomnia (COMISA) confers higher cardiovascular risk than each condition alone. We hypothesize that the association of COMISA with clinical (hypertension) and preclinical (inflammatory and metabolic) biomarkers is driven by the ISSD phenotype. MethodsA clinical sample of 101 adults with mild-to-moderate OSA (mmOSA) (5 ≤ AHI <30) and insomnia symptoms underwent polysomnography or home sleep apnea testing, blood pressure measures (BP), fasting blood glucose, insulin, CRP and IL-6 plasma levels. Insomnia was based on PSQI. Objective short sleep duration was based on the median total sleep time of the sample. Participants were classified into 2 groups based on objective sleep duration: mmOSA with ISSD vs. mmOSA with INSD. Analysis of covariance and logistic regression analysis were conducted controlling for confounders. ResultsSystolic and diastolic BP were elevated in the ISSD group compared to INSD group (p = 0.039 and p = 0.004, respectively). Also, the risk of hypertension was significantly higher in the ISSD (OR = 3.88, 95%CI = 1.26–11.95, p < 0.05) compared to INSD group. Plasma IL-6 concentrations and insulin resistance as indexed by glucose/insulin ratio were significantly higher in the ISSD group compared to INSD group (both p < 0.05). CRP levels were not different between the two groups. ConclusionIt appears that the additive adverse effects of COMISA on cardiometabolic risks are driven by the ISSD phenotype, a finding with potential implications for further phenotyping COMISA.

The clinical implication of nocturia in predicting hypertension among working aged Koreans.

Evidence has indicated that nocturia is a clinical manifestation of adverse health conditions including cardiovascular diseases and metabolic disorders. However, published data is less available for the clinical implication of nocturia on the development of hypertension. Study participants were 32,420 working aged Korean (21,355 men and 11,065 women) who periodically received health check-up. They were categorized into four groups by the frequency of nocturia (never, <1/week, 1-2/week, and ≥3/week). We used Cox proportional hazards models to analyze the multivariable-adjusted hazard ratio (HR) and 95% confidence intervals (CI) for incident hypertension (multivariable adjusted HR [95% CI]) in relation to the frequency of nocturia. Subgroup analysis was conducted by gender and sleep quality (good and poor sleep quality). In women, nocturia was associated with the increased risk of hypertension, compared with never nocturia (HR (95% CI); never: reference, <1/week: 1.33 [1.10 - 1.60], 1-2/week: 1.26 [1.00 - 1.58], and ≥3/week: 1.34 [1.05 - 1.72]). This association was not observed in men (HR (95% CI); never: reference, <1/week: 1.00 [0.93 - 1.08], 1-2/week: 1.00 [0.88 - 1.12], and ≥3/week: 1.06 [0.94 - 1.23]). In subgroup analysis by sleep quality, only women with good sleep quality showed the association between nocturia and the risk of hypertension However, women with poor sleep quality and men didn't show the association between the frequency of nocturia and the risk of hypertension. Nocturia is a potential risk factor for incident hypertension in working aged women with good sleep quality.

Association between coffee and tea consumption and the risk of dementia in individuals with hypertension: a prospective cohort study

Many studies have shown that drinking coffee and tea may be associated with the risk of hypertension and dementia. Limited research exists on their impact on dementia risk in hypertensive patients. This study aimed to determine the association between coffee and tea consumption and the risk of dementia development in hypertensive population by utilizing Cox proportional risk modeling with 453,913 participants from a UK biobank. Our findings reveal a J-shaped and U-shaped association between the risk of all-cause dementia and the consumption of coffee and tea respectively in hypertensive people. The hypertensive patients who drink 0.5–1 cup of coffee or 4–5 cups of tea per day have the lowest risk of dementia. A U-shaped relationship was observed between daily caffeine consumption and the risk of developing all-cause dementia and vascular dementia in the hypertensive population. Furthermore, the significant association between the amount of coffee and tea consumed and the risk of all-cause and vascular dementia were more likely to be found in hypertensive patients than in the non-hypertensive population.

Hypertension in children and adolescents: perspectives in Japan.

Hypertension in children and adolescents is associated with increased risk of hypertension and cardiovascular disease (CVD) in adulthood. Therefore, preventing hypertension among children and adolescents is an important public health objective worldwide. Although the importance of hypertension in children and adolescents has increasingly been recognized, the field of research is relatively new and evidence for etiologies, prevention and treatment is sparse. This review mainly summarizes the content regarding hypertension in children and adolescents published in Hypertension Research in 2023/24. Highlights include the following: The prevalence of hypertension was higher in female than male Japanese junior high school students (13.7% vs. 4.7%), but there was no significant gender difference among Japanese senior high school students (7.4% vs. 5.4%). Hematological parameters, including red blood cell counts, hemoglobin counts, hematocrit and iron levels, were positively associated with blood pressure (BP) levels in healthy children and adolescents. Higher-risk longitudinal BP trajectories in early life were associated with increased risk of target organ damage (TOD) and higher combined TOD load in midlife. BP phenotypes (e.g., masked hypertension, white-coat hypertension) assessed using office and 24-h ambulatory BP monitoring were not highly reproducible in children. The salt check sheet was a useful tool for evaluating the approximate dietary salt intake in Japanese children and adolescents. It is recommended that healthcare providers screen for hypertension in children and adolescents and recognize the importance of early intervention for those with elevated BP levels. Beginning in childhood, continuous education on hypertension and proper dietary salt intake are key to reducing the risk of hypertension and decreasing the burden of CVD in adulthood.

A Population-Based Linked Cohort Study of Maternal Exposure to Bioclimatic Stress and Hypertensive Disorders of Pregnancy in Australia.

ObjectiveTo identify critical susceptible periods for the associations between bioclimatic exposure (Universal Thermal Climate Index, UTCI) and the risks of gestational hypertension and preeclampsia. ApproachWe linked 415,091 singleton pregnancies of 20–42 weeks’ gestation between 1st January 2000 and 31st December 2015 to UTCI exposure in Western Australia. Distributed lag nonlinear logistic regressions were used to estimate weekly-specific adjusted odds of gestational hypertension and preeclampsia for UTCI exposure from twelve weeks of preconception through pregnancy. ResultsThe analysed pregnancies included 3.7% and 2.8% cases of gestational hypertension and preeclampsia, respectively. Exposures from early pregnancy up to 30th gestational weeks were associated with greater odds of hypertensive disorders of pregnancy (HDPs) with critical susceptible periods at all exposure thresholds, particularly elevated at the 1st (10.2 °C) and 99th (26.0 °C) exposure centiles as compared to the median (14.2 °C). The most elevated weekly OR and 95% CI estimated at 99th exposure centile was 1.07 (95% CI 1.06, 1.08) in gestational weeks 8–18 for gestational hypertension and 1.10 (95% CI 1.08, 1.11) in gestational weeks 11–16 for preeclampsia. Cumulative exposures associated with HDPs with relatively higher ORs, but less precise than weekly exposures. The effects of high exposure were disproportionately elevated in both HDPs for Caucasians, non-smokers, multiparous, and mothers in moderate/low SES residences. Conclusions and ImplicationsMaternal bioclimatic exposure increases the risk of HDPs, suggesting potentially susceptible periods and populations for climate-related targeted interventions. It highlights the need for advising women on environmental risks in early pregnancy.

Dietary Inflammatory Index and Blood Pressure Levels in Mexican Adults.

The relationship between the dietary inflammatory index and blood pressure has been evaluated in European and American populations. This association remains unexplored in Mexico, where outcomes may differ due to the populace's ancestral heritage and its diverse dietary habits. We used the Health Workers Cohort Study (2004 to 2018). DII intake was assessed using a food frequency questionnaire. Blood pressure was measured following standardized procedures and techniques. Fixed-effects linear regression and Cox regression models were utilized as the statistical approaches. In the first approach, we observed a positive association between changes in DII intake and changes in both systolic (SBP β: 3.23, 95% CI 1.11, 5.34) and diastolic blood pressure (DBP β: 1.01, 95% CI -0.43, 2.44). When stratified by hypertension, these associations were magnified in participants with hypertension (SBP β: 6.26, 95% CI 2.63, 9.89; DBP β: 1.64, 95% CI -0.73, 4.02). In the second approach, interactions between sex and age categories were explored. Participants in the highest DII category were associated with an increased risk of hypertension, particularly among young women (HR: 3.16, 95% CI 1.19, 8.43). Results suggest that a pro-inflammatory diet is associated with an increase in blood pressure over time among Mexican population.

Lifestyle Factors, Sociodemographic Characteristics and Incident Hypertension: A Prospective Analysis of the Korean National Health Insurance Service Sample Cohort.

Hypertension is a significant chronic disease globally, and lifestyle modifications are crucial for the prevention of this disease. We conducted a longitudinal analysis of the associations between lifestyle factors and the incidence of hypertension, stratified by sociodemographic characteristics. We analyzed 113,022 adults (65,315 men), aged 20 years or older from the Korean National Health Insurance Service-National Sample Cohort 2.0 who participated in health screening between 2002 and 2003. Lifestyle factors (smoking, drinking, physical activity) were assessed at baseline using self reports, and incident hypertension was defined based on physician diagnoses. Cox proportional hazards regression models were used to assess associations. During an 11.6-year follow-up, 26,812 new cases of hypertension were identified. The risk of hypertension was high among men and women who smoked over 20 cigarettes daily (men: hazard ratio [HR]: 1.15; 95% confidence interval [CI], 1.08-1.21; women: HR: 1.62; 95% CI 1.17-2.25) and those who drank over 1.5 bottles of alcohol daily (men, HR: 1.18; 95% CI, 1.12-1.24; women, HR: 1.23; 95% CI 1.02-1.47). These associations tended to be high in high-income men (HR: 1.09; 95% CI, 1.04-1.14), low-income women (HR: 1.19; 95% CI, 1.05-1.35) and non-obese women (HR: 1.13; 95% CI, 1.01-1.27) who currently smoked. Physical activity was inversely associated with incident hypertension in men (HR: 0.96; 95% CI, 0.93-0.99). Unhealthy lifestyle factors, such as heavy smoking and drinking, was associated with an increased risk of hypertension, with variations by income, BMI, and sex. These findings underscore the importance of tailored, population-specific prevention strategies to address hypertension disparities.

The Association between Diet Quality and Metabolic Syndrome among Older African American Women.

Diet is a modifiable lifestyle factor that could impact the development of Metabolic Syndrome (MetS) and its components. MetS prevalence is high and diet quality is suboptimal among older African American women. MetS has been associated with many individual food groups, however, emerging research suggests that analyzing overall diet quality provides insight into the synergistic effects of food groups on health outcomes. In the current cross-sectional study, we examined the relationship between diet quality and MetS, and investigated associations between diet quality and MetS components among older African American women. This study was based on 357 African American women between 45 and 65 years from the NHANES 2011-2018 datasets. This analysis utilized the NCEP ATP III (2001) criteria for women to diagnose MetS. MetS was dichotomized in addition to a MetS z-score being calculated for each participant using a sex- and race-specific equation. Participants' diet quality was measured using the HEI-2015. Linear and logistic regressions were performed to assess the association between HEI-2015 diet quality and metabolic syndrome and its components. 65% of African American women aged 45-65 in the NHANES 2011-2018 had MetS. Study participants had an average HEI-2015 score of 55.4 out of 100. As HEI-2015 quartiles increased, the mean MetS z-score decreased (p-value: 0.0011). Age-adjusted models demonstrated statistically significant inverse relationships between HEI-2015 and waist circumference (β: -0.217; 95% CI: -0.372, -0.063), systolic blood pressure (β: -0.215; 95% CI: -0.359, -0.072), blood glucose (β: -0.344; 95% CI: -0.681, -0.0066), and triglycerides (β: -0.652; 95% CI: -1.05, -0.251). Significant associations could not be established between MetS and diet quality, assessed with the HEI-2015, among African American women aged 45-65 enrolled in NHANES 2011-2018. However, statistically significant relationships were observed between increased HEI-2015 scores and lowered risks of abdominal obesity, hyperglycemia, hypertriglyceridemia, and systolic hypertension. The findings of this study affirm the necessity of public health strategies to improve diet quality among African-American women which could help to reduce their risks of chronic diseases.

The Effectiveness of a Self-Management and Multifactorial Program for Blood Pressure Control Among Older Home-Based Workers in Urban Bangkok, Thailand

Older adults aged between 50-65 years old have a high risk of hypertension. With the growing numbers of home-based workers among adults and older adults in Thailand, this study aimed to evaluate the effectiveness of self-management with a multifactorial program to control blood pressure among older adults. A randomized controlled trial was conducted. Participants who worked as home-based workers aged between 50-65 years old were recruited from a community in the western area of Bangkok. Approximately 70 participants were randomly and equally assigned to the intervention and control groups (35 participants in each group). Participants in the intervention group received the program that consisted of education regarding food selection, work time management and arm swinging; a practical protocol, an exercise program, a heart rate monitor, a recorded book for facilitating participants’ progress to ensure their safety and efficiency in a health professional manner for a week/month. While those in the control group received usual care. A Knowledge Attitude Practice questionnaire was utilized to assess their knowledge, attitude, and practice, which demonstrated a content validity index and Cronbach alpha of 0.80, respectively. The Citizen CH-403C was utilized to measure blood pressure and heart rate. Two-way Repeated Measures ANOVA was employed to analyze the differences in outcome scores at baseline, 3-month after program, and 6-month follow up. The results showed a significant increase in participant’s knowledge, attitudes, and behaviors toward hypertension and a decrease in blood pressure to nearly normal after 3months following the completion of the program and 6-month follow-up. Therefore, the self-management and multifactorial program could be an effective preventive intervention for older adults with pre-hypertension conditions to offer them valuable knowledge on work-life balance as well as to help prevent hypertension, and related stroke complications.

Assessing the Hypertension Risk: A Deep Dive into Cereal Consumption and Cooking Methods-Insights from China.

Cereal grains are rich in carbohydrates and could trigger a hyperglycemic response which is closely linked to blood pressure status. We aim to examine the associations between the consumption of cereals with different cooking methods and hypertension risk. We conducted a prospective analysis utilizing the nationwide data of 11,080 adult participants who were free of hypertension at baseline. Cereal intake was assessed using 3-day 24 h dietary recalls with a weighing technique. Hypertension incidence was identified in adherence with the Seventh Joint National Commission guidelines during the follow-up. Cox proportional hazards regression models were used to extrapolate hazard ratios associated with hypertension risk. Over an average follow-up span of 7 years (77,560 person-years), we identified 3643 new hypertension cases. The intake of total, fried, and baked cereals was associated with 15%, 20%, and 20% higher risk of hypertension, respectively. Whole grain consumers had an 8% lower risk of hypertension compared with non-consumers, while total refined grain consumers showed no significant association. Replacing one daily serving of fried or baked cereals with an equivalent serving of boiled cereals was related to a 28% or 14% lower risk, respectively. Total, fried, and baked cereal consumption was positively associated with hypertension risk, while consuming whole grains was related to a lower risk. Modifying cooking methods from frying or baking to boiling for cereals may be beneficial to lower risk. The current study underscores the significance of considering both the degree of processing and cooking methods applied to cereals in addressing hypertension prevention and management.

Cardiovascular and all-cause mortality outcomes of adrenalectomy versus medical treatment in primary aldosteronism: an umbrella review.

Primary aldosteronism (PA) is now recognized as the most prevalent form of secondary hypertension globally, contributing significantly to cardiovascular morbidity and mortality. This umbrella review aims to systematically compare cardiovascular outcomes and all-cause mortality in PA patients undergoing adrenalectomy versus mineralocorticoid receptor antagonist (MRA) treatment, aiming to inform optimal management strategies. Following PRISMA guidelines, Supplemental Digital Content 1, http://links.lww.com/JS9/D386, Supplemental Digital Content 2, http://links.lww.com/JS9/D387, a comprehensive search strategy was employed across multiple databases. Meta-analyses focusing on cardiovascular outcomes or all-cause mortality, comparing adrenalectomy and MRAs treatment in PA patients, were included. Studies were independently screened and assessed for quality using AMSTAR 2, Supplemental Digital Content 3, http://links.lww.com/JS9/D388 and GRADE checklists. A total of 8 studies met the inclusion criteria. Adrenalectomy showed potential benefits over MRAs in reducing the risk of arrhythmias (OR=2.17; 95% CI: 1.25-3.76) and major adverse cardiovascular events (OR=1.81; 95% CI: 1.33-2.46). Patients treated with MRAs exhibited a higher risk of cardiovascular events (OR=1.23; 95% CI: 1.05-1.44), hypertension (OR=3.22; 95% CI: 1.15-8.97), and all-cause mortality (OR=3.03; 95% CI: 1.36-6.70) compared to adrenalectomy. Adrenalectomy appears to offer favorable outcomes compared to MRAs treatment in PA patients, particularly in reducing the risk of major adverse cardiovascular events and all-cause mortality. These findings suggest the importance of considering surgical intervention as a primary treatment modality for PA.

Joint Trajectories of Lifestyle Indicators and Their Associations with Blood Pressure among Chinese Middle School Students.

Lifestyle behaviors, defined as a combination of dietary behavior, physical activity (PA), screen time (ST), and sleep duration indicators, are strongly associated with blood pressure (BP) in students. Our aim was to characterize the joint trajectories of lifestyle behaviors among middle school students and evaluate their association with BP. Data were obtained from the monitoring dataset on common diseases and health factors among students in Jiading District, Shanghai, China, conducted from 2019 to 2023. Lifestyle behavior data were collected annually from middle school students aged 12-18 years through questionnaires covering dietary behavior score, PA, ST, and sleep duration. Students' BP was measured in 2023. Joint trajectories of lifestyle behaviors were determined using group-based multi-trajectory modeling. Associations between lifestyle trajectories and students' BP were examined using multiple linear regression and modified Poisson regression. A total of 1378 middle school students (759 [58.98%] boys, median age 14.36 years [IQR: 13·30-13.28]) with lifestyle behaviors data assessed at least three times were included, and they were categorized into four joint lifestyle trajectories as follows: "remain unhealthy with low PA and increasing ST" (n = 141, 10.46%), "remain unhealthy with only low PA" (n = 305, 22.63%), "change towards unhealthy with decreasing sleep duration" (n = 776, 57.57%), and "relatively healthy" (n = 126, 9.35%). After adjusting for important confounders, the "remain unhealthy with low PA and increasing ST" group was associated with higher diastolic BP (DBP) [β: 3.49, 95% CI: 0.55-6.44] and higher mean arterial pressure (MAP) [β: 3.19, 95% CI: 0.37-6.01] in students compared with the "relatively healthy" group. Additionally, compared with the "relatively healthy" group, students in the "remain unhealthy with low PA and increasing ST" group had a 1.12-fold increase in the risk of hypertension (risk ratios: 1.12, 95% CI: 1.03-1.24). All trend p values in DBP, MAP, and hypertension from the "relatively healthy" group to the "remain unhealthy with low PA and increasing ST" group were less than 0.05. Four distinct lifestyle trajectories were identified among middle school students. Students who remained in the "unhealthy with low PA and increasing ST" lifestyle trajectory were associated with later elevations in BP.

Association between cMIND diet and hypertension among older adults in China: a nationwide survey

BackgroundExisting research indicates that the Mediterranean diet has a positive impact on preventing and treating hypertension. However, its specific effect on hypertension among elderly Chinese individuals is unclear.AimsThe objective of this research was to explore the association between the Chinese version of the Mediterranean-DASH Intervention for Neurodegenerative Delay (cMIND) diet and hypertension among elderly Chinese individuals, aiming to offer novel strategies for alleviating the burden of hypertension in this demographic.MethodsIn this study, we used cross-sectional data published in 2018 by the China Longitudinal Health and Longevity Survey (CLHLS) to develop a binary logistic regression model to investigate the correlation between cMIND diet and hypertension in a Chinese elderly population. Restricted cubic spline was used to test for linear associations, and further subgroup analyses were performed to test for interactions.ResultsIn total, 7,103 older adults were included in the study, with a prevalence of hypertension of 39.0%. When the cMIND diet score was used as a continuous variable, a significant protective effect against hypertension was present (OR = 0.955, 95% CI:0.923–0.988, p = 0.008); when used as a categorical variable, this protective effect was still present at higher levels (compared to lower levels) of the cMIND diet (OR = 0.869, 95% CI: 0.760–0.995, p = 0.042).DiscussionAlthough the Mediterranean diet has great potential to reduce the chance of hypertension, it should also consider the effect on the Chinese population. The results of this study provide new ways to reduce the disease burden of hypertension in Chinese older adults and improve quality of life in later life.ConclusionThe cMIND diet can considerably reduce the risk of hypertension among older adults in China.

Dietary Approaches to Stop Hypertension (DASH) and mortality risk among patients with liver cirrhosis: a prospective cohort study

Background and purposeThe relationship between dietary patterns and cirrhosis is undeniable. The present study aimed to investigate the association between the Dietary Approaches to Stop Hypertension (DASH) diet and the risk of mortality in patients with cirrhosis prospectively.MethodsIn this cohort study, 121 cirrhotic patients were enrolled and followed up annually for four years. Nutritional status and dietary intakes were assessed initially, and the DASH score was calculated accordingly. Crude and multivariable-adjusted hazard ratios (HR) with 95% confidence intervals (CI) were estimated using Cox proportional hazard analyses.ResultsDASH components including fruits, vegetables, legumes, nuts and seeds, and low-fat dairy products were significantly associated with lower mortality risk in cirrhotic patients. Also, a higher DASH score was significantly associated with a reduction in the risk of mortality in patients with cirrhosis, so that after adjusting for all confounders, the risk of mortality in the upper tertile was 89% lower than the first tertile (HR = 0.11, 95% CI: 0.03–0.42, P trend < 0.001). The 4-year survival rate among patients across tertiles of DASH was 32%, 37%, and 46%, respectively (P = 0.005).ConclusionIt can be concluded that a higher DASH diet score may be associated with a reduced risk of mortality in cirrhotic patients. However, larger studies are needed to confirm the findings and determine their potential mechanisms.