Left ventricular mass, blood pressure, and lowered cognitive performance in the Framingham offspring

The purpose of this study was to determine whether echocardiographic left ventricular mass is related to cognitive performance beyond casual blood pressure adjusting for the influence of other vascular risk factors. We used multivariable regression analyses to relate left ventricular mass assessed at a routine examination (1995-1998) to measures of cognitive ability obtained routinely (1998-2001) in 1673 Framingham Offspring Study participants (56% women; mean age: 57 years) free from stroke, transient ischemic attack, and dementia. We adjusted for the following covariates hierarchically: (1) age, education, sex, body weight, height, interval between left ventricular mass measurement and neuropsychological testing (basic model); (2) basic model+blood pressure+treatment for hypertension; and (3) basic model+blood pressure+treatment for hypertension+vascular risk factors and prevalent cardiovascular disease. For the basic model, left ventricular mass was inversely associated with abstract reasoning (similarities), visual-spatial memory and organization, and verbal memory. For the basic model+blood pressure+treatment for hypertension, left ventricular mass was inversely associated with similarities and visual-spatial memory and organization. For the basic+blood pressure+treatment for hypertension+risk factors+cardiovascular disease model, no significant associations were observed. Echocardiographic left ventricular mass is associated with cognitive performance beyond casual and time-averaged systolic blood pressure, but this association is attenuated and rendered nonsignificant with additional adjustment for cardiovascular risk factors and cardiovascular disease, thus suggesting that these variables play an important role in mediating the association between left ventricular mass and cognition.     

Association of the human Y chromosome with high blood pressure in the general population

Genetic variation in the Y chromosome has significant effects on male blood pressure in experimental animals, but the effects in humans are unknown. We examined the relationship between blood pressure and a polymorphic HINdIII restriction site in the nonrecombining region of the Y chromosome in 409 randomly selected men from the general population. Carefully standardized measures of systolic and diastolic blood pressures were made. The HINdIII restriction site was significantly more common (43.2%) in men in the lowest decile of the diastolic blood pressure distribution than men in the highest decile (15.9%, P=0.007). No significant difference in genotype frequency was observed between the lowest and highest deciles for systolic pressure (32.4% versus 27.8%, P=0.66). In the entire group, men with the HIN:dIII restriction site had significantly lower diastolic blood pressures (81.2 mm Hg, SD:8.3, versus 83.2 mm Hg, SD:8.7, P=0.03). No significant differences in systolic blood pressure (130.6 mm Hg, SD:14.7, versus 128.3 mm Hg, SD:13.6) were observed in relation to genotypes. Our results indicate that genetic variation in the human Y chromosome is associated with high blood pressure and contributes significantly to the quantitative variation of male diastolic blood pressure in the general population.     

自然人群血糖、体重指数、腰臀比与血压的关系

目的：探讨自然人群中血糖、体重指数（BMI）、腰臀比（WHR）的水平对血压的影响及作用的大小。方法：应用1998年广东省糖尿病流行病学调查资料，采用分层整群抽样方法，调查对象年龄在20-74岁。血糖值为早晨空腹口服75g葡萄糖2h后的血糖值。糖悄病及糖耐量低减（IGT）的诊断标准采用1999年WHO糖尿病诊断标准。高血压诊断标准采用1999年中国高血压防治指南。结果：共调查11377人，其中男性5183人，女性6194人，平均年龄43岁，平均收缩压、舒张压、血糖、体重指数、腰臀比分别为117mmHg、74mmHg、104mg/dL、22kg/m^2和0.84。糖尿病高血压患病率明显高于血糖正常，为45.3％比14.4％，糖耐量低减高血压患病率明显高于糖耐量正常，为32.2％比14.5％，肥胖高血压患病率明显高于非肥胖，为21.5％比10.4％。多重线性回归模型分析显示，年龄、血糖体重指数、腰臀比对男女性收缩压和舒张压有显影响。结论：广东省自然人群的分析结果显示，血糖、体重指数和腰臀比是影响血压的重要因素，在控制我省高血压患病率不断增加的同时，尚须要注意控制血糖、体重指数和腰臀比的升高。     

Characteristics of Framingham offspring participants with long-lived parents

BACKGROUND: Prior research has suggested that delay or avoidance of cardiovascular disease and cardiovascular disease risk factors plays an important role in longevity. METHODS: We studied 1697 Framingham Heart Study (FHS) offspring members 30 years or older, whose parents (1) participated in the original FHS cohort and (2) achieved age 85 years or died before January 1, 2005. Offspring participants (mean +/- SD age, 40 +/- 7 years; 51% women) were grouped according to whether neither (n = 705), one (n = 804), or both parents (n = 188) survived to 85 years or older. We examined offspring risk factors at examination cycle 1 (1971-1975) including age, sex, education, cigarette smoking, systolic and diastolic blood pressures, total-high-density lipoprotein cholesterol ratio, body mass index, and Framingham Risk Score. Participants returning for examination cycle 3 (1983-1987; n = 1319) were eligible for inclusion in longitudinal analyses evaluating risk factor progression from baseline to a higher follow-up risk category. RESULTS: For all factors studied, except body mass index, we observed statistically significant linear trends for lower offspring examination 1 risk factor levels with increasing parental survival category. The mean Framingham Risk Score was most favorable in offspring with both parents surviving to 85 years or older and was progressively worse in those with one or no long-lived parent (0.55, 1.08, and 1.71, respectively; P value for trend, <.001). Longitudinally, offspring of parents who lived longer had lower risk of blood pressure and Framingham Risk Score progression. CONCLUSIONS: Our findings suggest that individuals with long-lived parents have advantageous cardiovascular risk profiles in middle age compared with those whose parents died younger. The risk factor advantage persists over time.     

Association of echocardiographic left ventricular mass with body size, blood pressure and physical activity (the Framingham Study)

Left ventricular (LV) hypertrophy has been found to predispose to increased cardiovascular morbidity and mortality. To assess the clinical correlates and potential determinants of LV mass, the relation of echocardiographically determined LV mass to a variety of clinical parameters was examined in a general population. From 1979 to 1983 Framingham Heart Study participants underwent routine evaluation including medical history, physical examination and M-mode echocardiography. LV mass was determined using an anatomically validated formula that incorporates measurements of LV wall thickness and LV internal diameter. The study population consisted of 2,226 men and 2,746 women (mean age 51 years, range 17 to 90). Age, height, systolic blood pressure and body mass index (a measure of obesity) were statistically significant and independent correlates of LV mass in both sexes (p less than 0.001). In men under age 50, leisure-time physical activity was associated with LV mass (p less than 0.05), but this was not observed in women. Results from multivariate analyses in which body mass index and subscapular skinfold thickness were included suggest that lean body mass is correlated with LV mass. Maintenance of ideal body weight and normal blood pressure, weight reduction in obese persons and blood pressure control in hypertensive patients may contribute to the primary and secondary prevention of LV hypertrophy and its sequelae. Clinical interpretation of echocardiograms should include consideration of the correlates of LV mass to gain better insight into the pathogenesis of LV hypertrophy.     

High-normal blood pressure progression to hypertension in the Framingham Heart Study

This study sought to determine if individuals with high-normal blood pressure (diastolic blood pressure of 85-89 mm Hg) progress to hypertension more frequently than those with normal blood pressure (diastolic blood pressure less than 85 mm Hg), thus advancing to a higher cardiovascular risk category. Individuals from the Framingham Heart Study were placed in normal and high-normal blood pressure categories and followed for 26 years for the development of hypertension. With hypertension defined as a diastolic blood pressure of 95 mm Hg or greater or the initiation of antihypertensive therapy, 23.6% of men and 36.2% of women with normal blood pressure developed hypertension compared with 54.2% of men and 60.6% of women with high-normal blood pressure. The relative risk for the development of hypertension associated with high-normal blood pressure was 2.25 for men (95% confidence interval [CI], 1.8-2.8; p less than 0.0001) and 1.89 for women (95% CI, 1.5-2.3; p less than 0.0001). The age-adjusted relative risks estimated by the proportional hazards model were 3.36 for men and 3.37 for women (p less than 0.001). Among those risk factors examined, baseline systolic and diastolic blood pressure, Metropolitan relative weight, and change in weight over time were significant predictors of future hypertension in men and women whose initial blood pressure was normal. For men with high-normal blood pressure, systolic blood pressure and change in weight were identified as risk factors for future hypertension. These results indicate that the probability of individuals with blood pressure in the high-normal range developing hypertension is twofold to threefold higher than in those with normal blood pressure.(ABSTRACT TRUNCATED AT 250 WORDS)     

Serum potassium is not associated with blood pressure tracking in the Framingham heart study

BackgroundAbnormal potassium homeostasis accompanies many secondary forms of hypertension as well as uncommon inherited, monogenic forms of hypertension. We hypothesized that serum potassium may be associated with longitudinal tracking of blood pressure (BP) and development of hypertension.MethodsA total of 2358 participants (1292 women, 1066 men) in the Framingham Heart Study who were free of hypertension, were not taking drugs affecting potassium homeostasis, and had serum potassium measured in 1979 to 1983 were followed for longitudinal tracking of BP and development of hypertension at examination 4 years later. Progression of BP stage was defined as an increment of one or more BP category, as defined by the sixth report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC-VI), between baseline and follow-up examinations.ResultsAt baseline, there were no differences in systolic or diastolic BP across serum potassium quartiles. Over 4 years of follow up, 37% (457 women, 412 men) of subjects progressed by one or more JNC-VI BP category. In a logistic regression model adjusting for multiple confounders, serum potassium quartile was not associated with risk of BP progression. During follow-up, 14% (162 women, 175 men) of subjects progressed to hypertension. After adjustment for multiple confounders, there was no significant association between serum potassium quartile and risk for progression to hypertension.ConclusionsIn our community-based study sample, serum potassium was not associated with current BP, longitudinal BP tracking, or progression to hypertension.     

Gestational calcium supplementation and blood pressure in the offspring

BACKGROUND: The current study examined the relationship between calcium supplementation during pregnancy and blood pressure (BP) in the mother and offspring at 3 months and at 2 years postpartum. METHODS: Nulliparous pregnant women were assigned to either receive 2 g of calcium or placebo daily beginning between weeks 13 to 21 of gestation and continuing until delivery. Blood pressure was measured in children and their mothers at 3 months (n = 260) and (n = 57) at 2 years postpartum. Systolic BP was measured in the infants using a sphygmomanometer with ultrasonic amplification. For the toddlers, three supine BP measurements were taken from the right arm using a Critikon automated sphygmomanometer just after measurement of left ventricular wall thickness. RESULTS: Systolic BP in the calcium-supplemented infants was 2.2 mm Hg lower than in the placebo group (P >.05). At 2 years of age, systolic BP was 4.8 mm Hg lower in the calcium supplemented group (P <.05), whereas diastolic BP was 3 mm Hg lower (P >.05). There was no difference in left ventricular mass index between groups, although there was a significant correlation between systolic BP and wall thickness (P <.05). Maternal BP was positively correlated with circulating 1,25(OH)(2)D3 (P <.001) but did not differ between calcium groups at 3 months postpartum. CONCLUSIONS: The data on BP in the children are in agreement with previous studies and argue strongly for additional research into the effects of prenatal calcium supplementation on BP regulation in the offspring.     

Association between renin-angiotensin-aldosterone system-related genes and blood pressure in a Korean population

AIMS. Blood pressure control is influenced by various genetic and environmental factors, and genetic susceptibility is important in the development of essential hypertension. Because the renin-angiotensin-aldosterone system (RAAS) has a key role in vasoconstriction, vasodilation, and sodium and electrolyte balance, it is central in blood pressure control and so is an appropriate target in hypertension treatments. The present study assessed the association of RAAS-related genes with blood pressure and hypertension in a Korean population. Single nucleotide polymorphisms (SNPs, n = 114) in nine RAAS-related genes (AGT, REN, ACE, ACE2, AGTR1, CYP11B2, NR3C2, MAS1, and CMA1) were assessed for their correlation with blood pressure and hypertension using genotype data of 8842 individuals from the Korea Association Resource subject pool. MAJOR FINDINGS. Linear regression analysis revealed a statistically significant association with blood pressure of 10 SNPs in six genes (ACE, ACE2, CYP11B2, NR3C2, MAS1, and CMA1). An additional hypertension case-control study identified 10 SNPs in NR3C2 and ACE that were linked to hypertension. PRINCIPAL CONCLUSION. Three SNPs (rs11737660, rs6810951, and rs10519963) in NR3C2 correlate with both blood pressure and hypertension. Genetic polymorphisms in RAAS-related genes appear to be associated with hypertension in a Korean population.     

Association between blood pressure and intracranial artery stenosis in a Chinese population

The association between blood pressure and intracranial artery stenosis (ICAS) in different age groups has not been elucidated. Using data from the “China Hypertension Survey,” we conducted a cross‐sectional analysis of the association between blood pressure parameters and ICAS. In this study, participants older than 35 years were selected by stratified, multistage random sampling. Blood pressure was measured repeatedly at rest, and ICAS was assessed by transcranial doppler ultrasound. Binary logistic regression analysis was used to demonstrate the association between different blood pressure indicators and ICAS. Of the 3640 participants included (mean age 63 ± 13 years old, 57.8% female), systolic blood pressure (SBP) and pulse pressure (PP) were associated with ICAS in the general population; the multivariable adjusted odds ratio (OR) and corresponding 95% confidence interval (95% CI) of ICAS and multivessel stenosis were 1.32 (1.21, 1.45) and 1.29 (1.14, 1.46) per standard deviation (SD) increase in SBP and 1.44 (1.30, 1.59) and 1.52 (1.33, 1.74) for PP, respectively. Further analysis of this association in different age groups revealed inconsistent results between SBP and ICAS. Prehypertension (120 ≤ SBP < 140) could predict ICAS in the older group but not in the younger group, and the positive association between SBP and multivessel stenosis disappeared in the younger age group (P > .05 in all SBP subgroups). In conclusion, SBP and PP could not only identify ICAS in the middle‐aged and elderly population but could also provide some information about ICAS burden; however, these associations need to be interpreted differentially based on age subgroup.     

21322名科技人员血压分类及其与临床心电图诊断类型的关系

目的　研究科技人员的血压水平及其与临床心电图类型的关系。方法　对中国科学院的 2 132 2名科技人员进行了查体 ,计算不同性别的血压分类及高血压患病率 ,分析不同血压水平的临床心电图表现。结果　 (1)血压水平随年龄增高而增高 ,收缩压平均为男 (12 1 3± 2 0 5 )mmHg(1mmHg =0 133kPa) ,女 (116 3± 2 3 4)mmHg ,舒张压平均为男 (79 9± 2 7 8)mmHg ,女 (76 0± 2 7 30mmHg ,均为男性显著高于女性 (P <0 0 1)。 (2 )男性正常高限血压占 10 1% ,高血压病占 2 8 8% ;女性正常高限血压占 8 5 % ,高血压病占 2 0 4% ,男性高血压病患病率显著高于女性 (P <0 0 1)。经过年龄调整后 ,仍存在这种关系。 (3)随着血压升高 ,临床心电图异常分类如左室肥厚、左室高电压、ST T改变、束支传导阻滞、陈旧性心梗、室性早搏等的检出率显著升高。结论　随着血压升高 ,临床心电图异常特别是心室性异常心电图的发生率显著升高。血压达正常高限时 ,临床心电图异常的检出率已开始升高。     

Association between insulin and blood pressure in a community population with normal glucose tolerance.

The purpose of this study was to examine the relationship between insulin and BP in patients with normal glucose tolerance. The associations between systolic and diastolic BP, age, body mass index, waist/hip ratio, fasting glucose, insulin, fructosamine, glycosylated haemoglobin, lipid profile, and glucose and insulin two hours after 75 g oral glucose were examined in 1,520 employees of a public utility company and non-medical staff of a district hospital. Patients with impaired glucose tolerance or diabetes mellitus (using WHO criteria) were excluded. In men (mean age 35.6 +/- 8.7 years, n = 769), both systolic and diastolic BP were positively associated with age, body mass index, waist/hip ratio, fasting and 2h glucose and insulin, triglycerides and apolipoprotein B, and were negatively associated with glucose/insulin ration, and high density lipoprotein and cholesterol and its subfractions. However, in multivariate analysis only body mass index, age, fasting glucose and insulin were independent predictors of systolic BP, while only body mass index and age predicted diastolic BP. In women, age, glycosylated haemoglobin, 2h glucose/insulin ratio, 2h glucose, fructosamine and triglycerides were predictors of systolic BP. Fasting or 2h insulin, and glucose/insulin ratios did not predict diastolic BP. The results are compatible with the hypothesis that systolic hypertension may reflect a hyper-insulinaemic state even in those with normal glucose tolerance, independent of age and obesity. The association between plasma lipids and blood pressure is probably mediated by insulin and obesity.     

β2肾上腺素能受体基因多态性与岳西地区高血压患者血压的关系

目的探讨岳西地区人群β2肾上腺素能受体（ADRB2）基因Arg16Gly多态性与血压相关性。方法用RFLP方法对安徽省岳西地区487例高血压病患者及672例家属的B：。肾上腺素能受体基因的Arg16／Gly多态性位点进行了检测,应用了以家系为基础的分析方法,分析了岳西地区成年高血压人群ADRB2多态位点与高血压的相关性。结果在岳西人群中,带有ADRB2 Arg16等位基因的高血压病患者的收缩压（P=0．003）和舒张压（P=0．003）水平都较低,遗传对血压的影响更适合于共显性模型。结论ADRB2基因Gly16等位基因与高血压可能存在相关关系。     

Obesity and lipoprotein cholesterol in the Framingham offspring study

This study examines the relationship between obesity and low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, and very-low-density lipoprotein (VLDL) cholesterol in 4260 young adult men and women. The strongest association between obesity and LDL cholesterol was found in 20–29 yr-old males, the weakest in 40–49-yr-old males. Conversely, in women the relationship between LDL cholesterol and obesity was modest except in the oldes (40–49 yr) age group. An inverse relationship between obesity and HDL cholesterol was of similar shape and strength in all sex and age-specific groups. When the ratio of total cholesterol (TCHOL) to HDL cholesterol was compared in lean and grossly obese 20–29-yr-old males, substantial differences were found. Since other data show this index of the lipoprotein profile to be the single best indicator of CHD risk, it would appear that the atherogenic potential of obesity is greater than would be suggested by the relatively weak association between obesity and TCHOL or any single lipoprotein cholesterol. These data also suggest that the impact of obesity as a risk factor for CHD may have been underestimated. The paucity of lean males 40–49-yr-old prevents firm conclusions about the CHD risk in such a group. Indirect evidence indicates that lean 40–49-yr-old men would have a markedly more favorable lipoprotein profile and consequently a much lower risk of CHD.     

老年人衰弱综合征与血压等心血管危险因素的相互关系

目的 探讨动态血压与衰弱综合征患者心血管危险因素的关系。 方法 选择2018年11月～2021年9月在北部战区总医院干部病房住院的老年患者,最终纳入67名患者并分为3组[非衰弱组（n=23）,衰弱前期组（n=31）和衰弱组（n=13）]。收集整理各组患者24 h动态血压监测 （ambulatory blood pressure monitoring,ABPM）数据、腹围以及空腹血糖、血脂、低密度脂蛋白（low density lipoprotein,LDL）、高密度脂蛋白（high density lipoprotein,HDL）等生化指标,并进行统计分析。 结果 与非衰弱组相比,衰弱组的腹围较大,HDL较低（均P<0.05）。与非衰弱组相比,衰弱前期组SBP（24 h）数值升高（P<0.05）,DBP（24 h）数值升高（P<0.05）,SBP（清醒）数值升高（P<0.05）,DBP（清醒）数值升高（P<0.05）,SBP （睡眠）数值升高（P<0.05）,DBP （睡眠）数值升高（P<0.05）;衰弱组SBP（24 h）数值升高（P<0.01）,DBP（24 h）数值升高（P<0.01）,SBP（清醒）数值升高（P<0.01）,DBP（清醒）数值升高（P<0.01）,SBP （睡眠）数值升高（P<0.01）,DBP （睡眠）数值升高（P<0.01）。与衰弱前期组比较,衰弱组SBP（24 h）数值升高（P<0.05）,DBP（24 h）数值升高（P<0.05）,SBP（清醒）数值升高（P<0.05）,DBP（清醒）数值未见明显变化,SBP （睡眠）数值升高（P<0.05）,DBP （睡眠）数值未见明显变化. 结论 衰弱综合征与较高的血压、较大的腹围和较低的HDL相关,并可能存在肥胖、肌肉减少症,衰弱评估对住院老年患者的病情综合评估和治疗策略的选择具有重要意义。     

浙江景宁人群中α-内收蛋白基因Gly460Trp多态性与外周及中心动脉血压的关系

目的探讨在中国畲族人群中α-内收蛋白基因Gly460Trp多态性与外周及中心动脉血压的关系。方法在浙江省景宁县随机选择6个村,以核心家系为单位募集人群样本,运用水银柱血压计听诊法连续测量坐位非优势臂血压5次,取平均值用做统计分析。运用标准化问卷收集饮酒、吸烟、高血压用药史。采用SphygmoCor动脉脉搏波分析仪测量中心动脉血压。采集静脉血,分离DNA,以限制性酶切长度多态性方法检测α-内收蛋白基因的基因型。使用方差分析、广义估计方程(generalizedestimatingequations,GEE)进行关联分析。结果442例受检者中包括230例(52·0%)女性,116例(26·2%)高血压患者,其中49例(11·1%)服用抗高血压药物。α-内收蛋白GlyGly、GlyTrp、TrpTrp三个基因型的频率分别为21·3%、54·5%和24·2%。α-内收蛋白Gly460Trp多态性与肱动脉收缩压、舒张压及脉压无显著性关联,但在调整性别、年龄、年龄2、体重指数、有无吸烟、饮酒、抗高血压药物治疗等协变量前后,该多态性与中心动脉收缩压及中心脉压均有显著相关性(P<0·02)。GlyGly、GlyTrp、TrpTrp三个基因型的中心动脉收缩压分别为(122·5±3·5)mmHg、(114·1±1·5)mmHg、(109·1±1·8)mmHg(P=0·01)。相应的中心脉压值分别为(39·4±1·3)mmHg、(36·4±1·0)mmHg、(32·9±0·9)mmHg(P=0·002)。结论在浙江景宁畲族人群中,α-内收蛋白基因Gly460Trp多态性与中心动脉的收缩压及脉压有显著相关性,Trp等位基因可能对中心动脉血压增高有保护作用。