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Environmental Pollution (Barking, Essex... Apr 2022We aimed to explore the effects of mixtures of lead and various metals on blood pressure (BP) and the odds of pre-hypertension (systolic blood pressure (SBP)...
Effect of exposures to mixtures of lead and various metals on hypertension, pre-hypertension, and blood pressure: A cross-sectional study from the China National Human Biomonitoring.
We aimed to explore the effects of mixtures of lead and various metals on blood pressure (BP) and the odds of pre-hypertension (systolic blood pressure (SBP) 120-139 mmHg, and/or diastolic blood pressure (DBP) 80-89 mmHg) and hypertension (SBP/DBP ≥140/90 mmHg) among Chinese adults in a cross-sectional study. This study included 11,037 adults aged 18 years or older from the 2017-2018 China National Human Biomonitoring. Average BP and 13 metals (lead, antimony, arsenic, cadmium, mercury, thallium, chromium, cobalt, molybdenum, manganese, nickel, selenium, and tin) in blood and urine were measured and lifestyle and demographic data were collected. Weighted multiple linear regressions were used to estimate associations of metals with BP in both single and multiple metal models. Weighted quantile sum (WQS) regression was performed to assess the relationship between metal mixture levels and BP. In the single metal model, after adjusting for potential confounding factors, the blood lead levels in the highest quartile were associated with the greater odds of both pre-hypertension (odds ratio (OR): 1.56, 95% CI: 1.22-1.99) and hypertension (OR:1.75, 95% CI: 1.28-2.40) when compared with the lowest quartile. We also found that blood arsenic levels were associated with increased odds of pre-hypertension (OR:1.31, 95% CI:1.00-1.74), while urinary molybdenum levels were associated with lower odds of hypertension (OR:0.68, 95% CI:0.50-0.93). No significant associations were found for the other 10 metals. WQS regression analysis showed that metal mixture levels in blood were significantly associated with higher SBP (β = 1.56, P < 0.05) and DBP (β = 1.56, P < 0.05), with the largest contributor being lead (49.9% and 66.8%, respectively). The finding suggests that exposure to mixtures of metals as measured in blood were positively associated with BP, and that lead exposure may play a critical role in hypertension development.
Topics: Adolescent; Adult; Biological Monitoring; Blood Pressure; China; Cross-Sectional Studies; Humans; Hypertension; Lead; Prehypertension
PubMed: 35063540
DOI: 10.1016/j.envpol.2022.118864 -
Journal of Human Hypertension May 2022Hypertension (HTN) is an important cause of cardiovascular-related morbidity and mortality. The present study was conducted to investigate the prevalence and incidence...
Hypertension (HTN) is an important cause of cardiovascular-related morbidity and mortality. The present study was conducted to investigate the prevalence and incidence rate of pre-HTN, diagnosed and undiagnosed HTN, as well as its control and associated factors in adult population in southeast Iran. In a randomized household survey, 9987 participants aged 15-80 years were recruited into the study. HTN was confirmed through examination or using antihypertensive drug(s). Pre-HTN and HTN were defined as 120-139/80-89 and ≥140/90 mmHg for systolic and diastolic BP, respectively. The prevalence of pre-HTN was 28.5%. The prevalence of HTN was 19.2% (13.9% diagnosed and 5.3% undiagnosed). HTN increased with age (from 4% in 15-24 to 67.8% in 75-80 years). Men had higher pre-HTN (35.6% vs. 23.4%) and undiagnosed HTN (7.5% vs. 3.8%) than women. Of those diagnosed, 46.5% had uncontrolled BP, in which, women had better conditions than men (45.6% vs. 47.4%). Obesity, positive family history of HTN, anxiety, and low physical activity were the most significant predictors of HTN. The prevalence of pre-HTN decreased but there was no change in the prevalence of HTN during the last 5 years. The 5-year incidence rate/100 person-years of pre-HTN and HTN was 6.6 and 3.7, respectively. Although there are some promising signs of reducing pre-HTN and slowing HTN rise, currently, almost one-fifth of the adult population suffers from HTN. Given the poor BP control in patients with diagnosed HTN, especially in men, alarms that more effective interventions and strategies are needed to reduce deleterious consequences of HTN.
Topics: Adult; Coronary Artery Disease; Female; Humans; Hypertension; Incidence; Iran; Male; Prehypertension; Prevalence; Risk Factors
PubMed: 32929131
DOI: 10.1038/s41371-020-00392-5 -
Journal of Clinical Hypertension... Sep 2023Blood pressure (BP) is the main driver of mortality with 12.8% of all deaths worldwide. Adolescents are not spared, precisely in Cameroon where they constitute more than...
Blood pressure (BP) is the main driver of mortality with 12.8% of all deaths worldwide. Adolescents are not spared, precisely in Cameroon where they constitute more than half of its population. The objective of our work was to describe the prevalence and risk factors of pre-hypertension and high blood pressure (HBP) among adolescents in Cameroonian schools. Descriptive study over 5 months; from January to May 2019. The study population consisted of students from private and public schools in the city of Douala. Sociodemographic, anthropometric, and personal background data were collected. Physical activity (PA) was assessed using the short International Physical Activity Questionnaire (IPAQ). Multivariate logistic regression was used to determine factors associated with pre-hypertension and HBP. Differences were considered significant for p < .05. We recruited 771 students with an average age of 16 ± 1 years with female predominance (51.4%). The prevalences of pre-hypertension and HBP were 6.6% and 3%, respectively. Overweight/obesity (OR = 4.6; p < .0001), hyperglycemia [(OR = 4.06; p = .001)] physical inactivity (OR = 1.85; p = .019), and public institutions (OR = 1.87; p = .02) were associated with pre-hypertension. Similarly, overweight/obesity (OR = 2.99; p = .022), hyperglycemia (OR = 14.05; p < .0001), and physical inactivity (OR = 8.58; p < .0001) were correlated with HBP. Pre-hypertension and HBP are high in Cameroonian school adolescents and their risk factors are overweight/obesity, hyperglycemia, and physical inactivity.
Topics: Humans; Female; Adolescent; Male; Hypertension; Overweight; Prevalence; Cameroon; Prehypertension; Risk Factors; Obesity; Blood Pressure; Hyperglycemia
PubMed: 37561361
DOI: 10.1111/jch.14711 -
The Journal of Pediatrics Jan 2012To evaluate the risk for developing incident hypertension (HTN) in adolescents with pre-hypertension.
OBJECTIVE
To evaluate the risk for developing incident hypertension (HTN) in adolescents with pre-hypertension.
STUDY DESIGN
A secondary analysis of students participating in multiple school-based blood pressure (BP) screens from 2000 to 2007 was completed. At each screen, height, weight, and 2 to 4 BPs were measured on as many as 3 occasions when BP remained ≥ 95th percentile. Students with confirmed HTN at their initial screen were excluded, and incident HTN was defined as having a BP ≥ 95th percentile at all 3 visits of a later screen. Incidence rates (IR) and hazard ratios (HR) were calculated by using Cox Proportional models.
RESULTS
Of 1006 students, HTN developed in 11 (IR 0.5%/year) in a mean of 2.1 years of observation. IRs were higher in "at-risk" students (pre-hypertensive or hypertensive with follow-up BP <95th percentile), 1.4%/year (HR, 4.89; 1.48-16.19) and students with a BP ≥ 90th percentile at 3 baseline visits, 6.6%/year HR 24.33 (5.68-104.29)]. Although not significant, students with pre-hypertension by the 2004 Task Force definition also had an increased IR of 1.1%/year (HR, 2.98; 0.77-11.56)].
CONCLUSION
Elevated BP increases the risk for the development of HTN during adolescence. Effective strategies for preventing HTN in at-risk adolescents are needed.
Topics: Adolescent; Child; Disease Progression; Female; Humans; Hypertension; Male; Prehypertension; Risk Assessment; Young Adult
PubMed: 21868037
DOI: 10.1016/j.jpeds.2011.07.010 -
International Journal of Environmental... Oct 2020The intima-media thickness (IMT), luminal diameters (LDs), flow velocities (FVs), compliance, and β-stiffness of the carotid artery (CA) are considered as independent...
The intima-media thickness (IMT), luminal diameters (LDs), flow velocities (FVs), compliance, and β-stiffness of the carotid artery (CA) are considered as independent risk factors for cardiovascular diseases (CVDs). Pre-hypertension (PHT) is also an independent CVD risk factor. This study investigated the association between CA damage (CAD) and PHT. A total of 544 adults participated; their blood pressures (BPs) and CA characteristics were measured using a mercury-free sphygmomanometer and ultrasound. Analysis of covariance (ANCOVA) was performed to assess the differences in the CA characteristics according to the BPs, multinomial logistic regression to evaluate the risk of CAD associated with PHT. In ANCOVA, the CA characteristics of PHT were significantly different from normotensive. The odds ratios (ORs) of IMTmax, LDmax, LDmin, peak-systolic FV (PFV), end-diastolic FV (EFV), PFV/LDmin, EFV/LDmax, compliance, and β-stiffness of PHT were 4.20, 2.70, 3.52, 2.41, 3.06, 3.55, 3.29, 2.02, and 1.84 times higher than those of the normotensive, respectively, in Model 2. In Model 3 adjusted for age, the ORs of LDmax, LDmin, EFV, PFV/LDmin, and EFV/LDmax of PHT were 2.10, 2.55, 1.96, 2.20, and 2.04 times higher than those of the normotensive, respectively. Therefore, the present study revealed that CAD is closely correlated with pre-hypertensive status in adults.
Topics: Aged; Blood Pressure; Carotid Arteries; Carotid Intima-Media Thickness; Female; Humans; Hypertension; Male; Middle Aged; Prehypertension; Risk Factors
PubMed: 33096848
DOI: 10.3390/ijerph17207686 -
Epidemiology and Health 2018The aim of this study was to evaluate the effect of pre-hypertension and its sub-classification on the development of diabetes.
OBJECTIVES
The aim of this study was to evaluate the effect of pre-hypertension and its sub-classification on the development of diabetes.
METHODS
In this cohort study, 2,941 people 40 to 64 years old without hypertension or diabetes were followed from 2009 through 2014. According to the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC)-7 criteria, we classified participants into normal and pre-hypertension groups. The effect of pre-hypertension on the 5-year incidence rate of diabetes was studied using inverse probability of treatment weighting. We modeled the exposure and censored cases given confounding factors such as age, sex, body mass index, smoking, economic status, and education.
RESULTS
The 5-year incidence rate of diabetes among people with pre-hypertension and those with normal blood pressure (BP) was 12.7 and 9.7%, respectively. The risk ratio (RR) for people with pre-hypertension was estimated to be 1.13 (95% confidence interval [CI], 0.90 to 1.41). The RRs among people with normal BP and high-normal BP, according to the JNC-6 criteria, compared to those with optimal BP were 0.96 (95% CI, 0.73 to 1.25) and 1.31 (95% CI, 1.01 to 1.72), respectively.
CONCLUSIONS
Our results showed that participants who had higher levels of BP (high-normal compared to optimal BP) had a higher risk of diabetes development. With regard to the quantitative nature of BP, using the specifically distinguishing of stage 1 hypertension or high-normal BP may be a more meaningful categorization for diabetes risk assessment than the JNC-7 classification.
Topics: Adult; Diabetes Mellitus; Female; Humans; Incidence; Iran; Male; Middle Aged; Models, Statistical; Prehypertension; Prospective Studies; Risk
PubMed: 30056646
DOI: 10.4178/epih.e2018026 -
Hypertension (Dallas, Tex. : 1979) Apr 2017
Topics: Blood Pressure; Child; Humans; Hypertension; Prehypertension
PubMed: 28223473
DOI: 10.1161/HYPERTENSIONAHA.116.08883 -
BMC Public Health Feb 2015The people of low and middle income countries bear about 80% of the global burden of diseases that are attributable to high blood pressure. Hypertensive people...
BACKGROUND
The people of low and middle income countries bear about 80% of the global burden of diseases that are attributable to high blood pressure. Hypertensive people contribute half of this burden; the rest is among the people with lesser degrees of high blood pressure. Prehypertension elevates the risk of CVD, and that of end-stage renal disease. Bangladesh is a developing country, with more than 75% of the population live in rural area. This study aims to determine the prevalence and predictors of pre-hypertension and hypertension among the adults in rural Bangladesh.
METHODS
A cross-sectional study of major non-communicable disease risk factors (tobacco and alcohol use, fruit and vegetable intake, physical activity) was conducted in rural surveillance sites of Bangladesh. In addition to the self-reported information on risk factors, height and weight, and blood pressure were measured during household visits using standard protocols of the WHO STEPwise approach to Surveillance. The study population included 6,094 men and women aged 25 years and above. Adjusted and unadjusted logistic regression analyses were performed to evaluate the association of prehypertension and hypertension with various factors.
RESULTS
The prevalence of pre-hypertension and hypertension was 31.9% and 16.0%, respectively. The men had a higher prevalence (33.6%) of pre-hypertension compared to the women (30.3%). Multivariate analysis showed that increasing age [OR 2.30 (1.84-2.87)] and higher BMI [OR 4.67 (3.35-6.51) were positively associated with pre-hypertension. For hypertension, multivariate analysis showed that increasing age [OR 4.48 (3.38-5.94)] and higher BMI (specially the overweight category) was positively associated. Significant linear relationships of prehypertension were found with age [P for trend < 0.0001] and BMI [P for trend < 0.0001]. Linear regression for hypertension shows significant association with age [P for trend < 0.0001] but not with BMI [P for trend 0.3783].
CONCLUSION
Approximately one third and one-sixth of the adult population of rural Bangladesh are affected with pre-hypertension and hypertension, respectively. This poses a great challenge ahead, as most of the people with pre-hypertension will progress towards hypertension until otherwise undergo in any pharmacological or lifestyle intervention.
Topics: Adult; Alcohol Drinking; Bangladesh; Blood Pressure; Body Weight; Body Weights and Measures; Cross-Sectional Studies; Female; Fruit; Humans; Hypertension; Kidney Failure, Chronic; Life Style; Male; Middle Aged; Prehypertension; Prevalence; Risk Factors; Rural Population; Surveys and Questionnaires; Nicotiana
PubMed: 25880433
DOI: 10.1186/s12889-015-1520-0 -
PloS One 2023Hypertension (HTN) stands as the leading modifiable risk factor for cardiovascular disease(CVD) and premature death globally. Understanding its prevalence and risk...
Hypertension (HTN) stands as the leading modifiable risk factor for cardiovascular disease(CVD) and premature death globally. Understanding its prevalence and risk factors is essential for effective prevention and management of HTN. This study aimed to investigate the prevalence of Pre-hypertension (pre-HTN), HTN, and its risk factors in adults participating in the Zahedan adult cohort study (ZACS). This cross-sectional study used the baseline data of the ZACS. Ordinal logistic regression analysis was used to estimate crude and adjusted odds ratios (ORs) with 95% confidence intervals (CIs) for potential risk factors. Among the 10,016 participants in this study, 60.89% were women, with an average age of 50.44 ± 9.18 years. The prevalence of pre-HTN and HTN was 42.03% (men 45.44%, women 39.84%) and 18.47% (men 21.09%, women 16.79%), respectively. Being male, older age, having higher socioeconomic status (SES), being overweight and obese, having a family history of HTN, comorbidities such as diabetes and CVD, as well as abnormal blood lipid levels (triglycerides and HDL cholesterol) were the most significant predictors of pre-HTN and HTN. These findings highlight that more than half of the participants in this study exhibit pre-HTN or HTN, placing them at risk for CVD and stroke. Implementing comprehensive preventive strategies tailored to these identified risk factors is imperative to alleviate the disease burden, enhance disease management, and improve HTN treatment and control.
Topics: Adult; Humans; Male; Female; Middle Aged; Cohort Studies; Prehypertension; Prevalence; Iran; Cross-Sectional Studies; Hypertension; Risk Factors; Surveys and Questionnaires
PubMed: 38060532
DOI: 10.1371/journal.pone.0295270 -
PloS One 2016According to Joint National Committee-7 (JNC-7) guidelines, a systolic blood pressure (SBP) of 120 to 139 mm Hg and/or diastolic blood pressure (DBP) of 80 to 89 mm Hg...
INTRODUCTION
According to Joint National Committee-7 (JNC-7) guidelines, a systolic blood pressure (SBP) of 120 to 139 mm Hg and/or diastolic blood pressure (DBP) of 80 to 89 mm Hg is considered as pre-hypertension. Existing evidence suggest that the cardiovascular morbidities are increasing among pre-hypertensive individuals compared to normal.
OBJECTIVE
To assess the magnitude and factors associated with pre-hypertension among young adults (20-30 years) in coastal villages of Udupi Taluk (an area of land with a city or town that serves as its administrative centre and usually a number of villages), Udupi District, Karnataka state, India.
DESIGN
Community based cross sectional study.
SETTING
6 (out of total 14) coastal villages of Udupi Taluk, Karnataka state, India.
SAMPLE
1,152 young adults (age group: 20-30 years) selected by stratified random sampling in 6 coastal villages of Udupi Taluk, Karnataka state, India.
METHOD
A semi structured pre-tested questionnaire was used to elicit the details on socio-demographic variables, dietary habits, tobacco use, alcohol consumption, physical activity, family history of hypertension and stress levels. Anthropometric measurements and blood pressure were recorded according to standard protocols. Serum cholesterol was measured in a sub sample of the study population. Multivariate logistic regression was applied to identify the independent correlates of pre-hypertension among young adults (20-30 years).
MAIN OUTCOME MEASURES
Prevalence, Odds ratio (OR) and adjusted (adj) OR for pre-hypertension among young adults (20-30 years).
RESULTS
The prevalence of pre-hypertension in the study population was 45.2% (95%CI: 42.4-48). Multivariate logistic regression analysis revealed that age group of 25-30 years (adj OR: 4.25, 95% CI: 2.99-6.05), white collared (adj OR: 2.29, 95% CI: 1.08-4.85) and skilled occupation (adj OR: 3.24, 95% CI: 1.64-6.42), students (adj OR: 2.46, 95% CI: 1.22-4.95), using refined cooking oil (adj OR: 0.53, 95% CI: 0.29-0.95), extra salt in meals (adj OR: 2.46, 95% CI: 1.52-3.99), salty food items (adj OR: 6.99, 95% CI: 3.63-13.48), pre-obese (adj OR: 1.66, 95% CI: 1.03-2.67) and obese (adj OR: 9.16, 95% CI: 2.54, 36.4) were the significant correlates of pre-hypertension.
CONCLUSION
In the study population, prevalence of pre-hypertension among young adults (20-30 years) was high (45.2%). Biological (age 25-30 years, pre-obesity and obesity) and behavioral (sedentary occupation, intake of extra salt in meals/salty food and not using refined cooking oil) factors were associated with pre-hypertension. Study emphasizes the need of community based screening of pre-hypertension under National Rural Health Mission. It also provides apt information for the evidence based designing of interventions for lifestyle modifications among high risk young adults in the study area.
Topics: Adult; Cross-Sectional Studies; Feeding Behavior; Female; Humans; India; Life Style; Logistic Models; Male; Obesity; Occupations; Odds Ratio; Prehypertension; Prevalence; Risk Factors; Young Adult
PubMed: 27128029
DOI: 10.1371/journal.pone.0154538