Prevalence, awareness, treatment and control of hypertension in a working Bulgarian population

Arterial hypertension is a major risk factor for coronary heart disease and stroke mortality. Few data exist on prevalence, awareness, and management of hypertension in Bulgaria, precluding development of potentially beneficial risk reduction initiatives. Between September 1996 and July 1997, an age-sex stratified sample of 847 male and 771 female employees (age 18–64 y) of the national transport industry resident in Sofia was recruited during their annual physical examination. A structured interview was conducted and resting blood pressure (BP) measured. Prevalence: Elevated BP (mean of two consecutive readings SBP 140 mmHg and/or DBP 90 mmHg) was observed among 24% of women and 58% of men (p < 0.001). Prevalence increased with age in both men and women. Awareness: Among 722 employees with elevated BP, 49% of women and 33% of men (p < 0.001) reported history of hypertension. Awareness increased with age. Management: Among 345 employees with history of hypertension, 37% of women and 36% of men (p > 0.05) reported taking antihypertensive treatment. The proportion under management increased with age. Control: Normal BP was measured in only 6% of men and 7% of women taking antihypertensive medication (p > 0.05; no consistent trends by age). Elevated BP is widespread and hypertension is underdiagnosed and poorly controlled in this urban working-age Bulgarian population, especially among those under 40 y. This may contribute to the high rates of coronary heart disease and stroke incidence and mortality in Bulgaria.     

The independent effect of habitual cigarette and coffee consumption on blood pressure

The authors investigated the possible relation between habitual cigarette and coffee consumption and blood pressure (BP) levels in 7506 men and 2095 women. The study population were managers and employees examined in northern Italy between 1986–1988. In particular, the hypothesis of a substantial independence between smoking-BP and coffee-BP was tested. BP levels were corrected for age, body mass index, physical activity, and alcohol consumption by analysis of covariance. Significantly, smoking was inversely related to BP, both in men (SBP, P < 0.001, DBP, P < 0.001) and women (SBP, P = 0.001, DBP, P = 0.012). In particular, the BP of non-smoking men, SBP/DBP, was 131.0/83.5, whereas in male smokers up to and over 20 cigarette/day, BP was 128.1/82.0 and 128.1/82.1 respectively. Coffee consumption was related to BP levels in men (SBP, P < 0.001; DBP, P = 0.009), but not in women (SBP, P = 0.320; DBP, P = 0.982). BP in male subjects was 131.3/83.5 in non-drinkers, 130.7/83.3 in those drinking 1–3 cups/day, 128.4/82.6 and 127.2/81.8 in drinkers of 4–5 and over 5 cups/day, respectively. No significant interactions were demonstrated, thus the relationship between habitual smoking and coffee consumption with BP appears to agree with an additive model.Corresponding author.     

Casein-Derived Lactotripeptides Reduce Systolic and Diastolic Blood Pressure in a Meta-Analysis of Randomised Clinical Trials

There is an urgent need to treat individuals with high blood pressure (BP) with effective dietary strategies. Previous studies suggest a small, but significant decrease in BP after lactotripeptides (LTP) ingestion, although the data are inconsistent. The study aim was to perform a comprehensive meta-analysis of data from all relevant randomised controlled trials (RCT). Medline, Cochrane library, EMBASE and Web of Science were searched until May 2014. Eligibility criteria were RCT that examined the effects of LTP on BP in adults, with systolic BP (SBP) and diastolic BP (DBP) as outcome measures. Thirty RCT met the inclusion criteria, which resulted in 33 sets of data. The pooled treatment effect for SBP was −2.95 mmHg (95% CI: −4.17, −1.73; p < 0.001), and for DBP was −1.51 mmHg (95% CI: −2.21, −0.80; p < 0.001). Sub-group analyses revealed that reduction of BP in Japanese studies was significantly greater, compared with European studies (p = 0.002 for SBP and p < 0.001 for DBP). The 24-h ambulatory BP (AMBP) response to LTP supplementation was statistically non-significant (p = 0.101 for SBP and p = 0.166 for DBP). Both publication bias and “small-study effect” were identified, which shifted the treatment effect towards less significant SBP and non-significant DBP reduction after LTP consumption. LTP may be effective in BP reduction, especially in Japanese individuals; however sub-group, meta-regression analyses and statistically significant publication biases suggest inconsistencies.     

Influence of albuminuria and glomerular filtration rate on blood pressure response to antihypertensive drug therapy

Background

Albuminuria and glomerular filtration rate (GFR), two factors linked to kidney and vascular function, may influence longitudinal blood pressure (BP) responses to complex antihypertensive drug regimens.

Methods

We reviewed the clinic records of 459 patients with hypertension in an urban, academic practice.

Results

Mean patient age was 57-years, 89% of patients were African American, and 69% were women. Mean patient systolic/diastolic BP (SBP/DBP) at baseline was 171/98 mmHg while taking an average of 3.3 antihypertensive medications. At baseline, 27% of patients had estimated (e)GFR <60 ml/min/1.73², 28% had micro-albuminuria (30–300 mg/g) and 16% had macro-albuminuria (>300 mg/g). The average longitudinal BP decline over the observation period (mean 7.2 visits) was 25/12 mmHg. In adjusted regression models, macro-albuminuria predicted a 10.3 mmHg lesser longitudinal SBP reduction (p < 0.001) and a 7.9 mmHg lesser longitudinal DBP reduction (p < 0.001); similarly eGFR <60 ml/min/1.73² predicted an 8.4 mmHg lesser longitudinal SBP reduction (p < 0.001) and a 4.5 lesser longitudinal DBP reduction (p < 0.001). Presence of either micro- or macro-albuminuria, or lower eGFR, also significantly delayed the time to attainment of goal BP.

Conclusions

These data suggest that an attenuated decline in BP in drug-treated hypertensives, resulting in higher average BP levels over the long-term, may mediate a portion of the increased risk of cardiovascular-renal disease linked to elevated urinary albumin excretion and reduced eGFR.     

Noise-induced hearing loss and blood pressure

Summary A sample of 188 male and 92 female engineering industry workers was investigated. Pure-tone audiometric measurements were used as an estimator of prolonged noise exposure. Using the air conductance thresholds at frequencies of 3,4 and 6 kHz, subjects were classified into three hearing classes. Their systolic (SBP) and diastolic blood pressure (DBP) was measured.In the older age group (41–64 years), the mean SBP of subjects with moderate hearing loss was 12 mmHg higher among men (n=35) and 18 mmHg higher among women (n=7) than among subjects with normal hearing (n=27). The mean DBP levels of subjects with moderate hearing loss were 5 mmHg and 4 mmHg higher, respectively. However, in the class of severe hearing loss (n=38; only male workers) the mean SBP was only 2 mmHg and the mean DBP only 1 mmHg higher than among subjects with normal hearing. In the younger age group (26–40 years) no differences in either SBP or DBP between the hearing classes were found.     

Relationship of blood pressure to cardiovascular death: the effects of pulse pressure in the elderly

PURPOSE: To investigate the relationship of systolic and diastolic blood pressure to fatal myocardial infarction, fatal stroke and other death related to cardiovascular diseases (CVD). METHODS: The study was based on a prospective longitudinal study conducted by the Veterans Administration at the Boston Outpatient Clinic. Participants are male volunteers from the greater Boston area. Main outcome measures are fatal myocardial infarction, fatal stroke and other deaths related to cardiovascular diseases. The method of pooled logistic regression was used for statistical analysis. RESULTS: For younger men (age 21-59), after adjusting for effects of other risk factors, when systolic and diastolic blood pressure were considered separately, SBP was predictive of cardiovascular death (SBP: RR = 1.23; 95% CI = (1.05, 1.45) per 10 mmHg of increase), and DBP showed a nonsignificant positive trend in relation to cardiovascular death (DBP: RR = 1.27; 95% CI = (0.95, 1.69) per 10 mmHg of increase). For older men (age 60-85), when SBP and DBP were considered separately, SBP (RR = 1.26; 95% CI = (1.02, 1.55) per 15 mmHg of increase) was directly related, but DBP (RR = 1.05; 95% CI = (0.83, 1.32) per 8 mmHg of increase) was not related to cardiovascular death. However, for the elderly group, when SBP and DBP were considered jointly in the regression model, then the regression coefficient of DBP (beta = -0.018, p = 0.30) was of approximately the same absolute magnitude as that of SBP (beta = 0.021, p = 0.02) but opposite in sign. For younger men, when SBP and DBP were considered jointly, SBP (beta = 0.021, p = 0.049) but not DBP (beta = -0.001, p = 0.953) was positively related to cardiovascular death. CONCLUSIONS: We found that, for the elderly, pulse pressure (SBP-DBP) may be a more accurate predictor of cardiovascular death than either SBP or DBP alone. The relative risk per 35 mmHg of increase of pulse pressure, which equals the approximate interval from the 10th to the 90th percentile in the elderly group, is 2.1 with 95% CI = (1.1, 3.8). In younger subjects, SBP, but not DBP, is an independent predictor of fatal CVD.     

Body composition, ethnicity and alcohol consumption as determinants for the development of blood pressure in a birth cohort of young middle-aged men

Aim: To investigate the development of blood pressure (BP) determinants over a period of 6 years in a birth cohort of middle-aged Swedish men. Methods: Men born 1953 and 1954 living in Helsingborg, Southern Sweden, were surveyed at 37, 40 and 43 years of age. Baseline participation rate was 68% (n = 991). S-Cholesterol, HDL-Cholesterol, systolic and diastolic blood pressure (SBP and DBP) and anthropomorphic measurements were collected and a questionnaire covering ethnicity, smoking, leisure time physical activity (LTPA) and alcohol consumption was completed. Results: At these surveys, SBP means were: 131, 132, 135 mm Hg and DBP were 83, 83 and 85 mm Hg respectively. Body mass index (BMI), waist hip ratio (WHR), S-Cholesterol and alcohol consumption consistently showed cross-sectional positive associations with SBP and DBP. One mmol/L higher S-Cholesterol at baseline predicted an increase in SBP by 1.16 mm Hg (confidence interval, CI: 0.25; 2.07) over 6 years. At age 40, there was a 4.4 mm Hg (p < 0.020) difference in SBP and a 2.64 mm Hg (p < 0.056) difference in DBP means between the low and high alcohol consumption. Corresponding differences at age 43 were SBP 5.28 mm Hg (p < 0.023) and DBP 5.4 mm Hg (p < 0.000). Men born in Sweden had a higher baseline SBP ( = 4 mm Hg, CI: 2.11; 6.35) and showed a higher 6 year increase in SBP (2.80 mm Hg CI: 0.07; 5.53) than men born abroad. Conclusions: Body composition, ethnicity and alcohol consumption are strong determinants for the development of BP. These findings have to be considered in strategies for primary prevention of hypertension in younger middle-aged men.     

Effects of environmental noise exposure on ambulatory blood pressure in young adults

Epidemiological studies have demonstrated that environmental noise exposure is associated with hypertension in middle-aged and older populations, but the relationship in the young subpopulation and between the genders is still unclear. This panel study investigated effects of environmental noise exposure on 24-h ambulatory blood pressure in 60 adults aged 18-32 years. Individual noise exposure and personal blood pressure were measured simultaneously for 30 males and 30 females. Linear mixed-effects regression models were applied to estimate effects. Total subjects (56.6±16.5 A-weighted decibels (dBA)) had transient elevations of 1.15 (95% CI=0.86-1.43) mmHg SBP and 1.16 (0.93-1.38) mmHg DBP at daytime, as well as 0.74 (0.21-1.26) mmHg SBP and 0.77 (0.34-1.20) mmHg DBP at nighttime, significantly associated with a 5-dBA increase in noise exposure. Such effects on SBP and DBP still persisted at the 30- and 60-min time-lagged noise exposure. Per 5-dBA increase in 24-h average noise exposure was significantly associated with sustained increments of 1.15 (0.76-1.54) mmHg SBP and 1.27 (0.96-1.58) mmHg DBP in males (57.4±16.0 dBA), as well as the higher levels of 1.65 (1.36-1.94) mmHg SBP and 1.51 (1.27-1.75) mmHg DBP in females (55.9±17.0 dBA). We found that environmental noise exposure may have elevated effects on adults’ blood pressure. Young females are more susceptible to noise exposure than males.     

体质指数、腰围、腰臀比、腰围身高比与城乡居民血压关系的研究

目的探讨反映肥胖的体格测量指标与血压的关系,并通过肥胖指标预测血压值。方法利用2006年"中国居民健康与营养调查"的数据,对我国九省城乡18～60岁的成年居民6 433人的体质指数(BMI)、腰围、腰臀比、腰围身高比,以及超重率、肥胖率、中心肥胖率、高血压患病率进行横断面分析,同时分析体质指数、腰围、腰臀比、腰围身高比与血压的关系,并通过多元回归方程以肥胖指标预测血压值。结果城市男性居民的平均BMI值、腰围、腰臀比、腰围身高比、收缩压、舒张压均显著高于农村居民(P<0.05)。城市女性居民的平均BMI值、腰围、超重率、肥胖率、中心肥胖率和高血压患病率均低于农村居民,但两者比较差异无显著性(P>0.05)。无论是收缩压还是舒张压,均随着BMI值、腰围、腰臀比和腰围身高比的增加而升高。多元线性回归的结果显示,女性的年龄回归系数要高于男性。男性BMI值每增加0.77、腰围每增加2.43cm、腰臀比每增加2.66%和腰围身高比每增加1.54%,其收缩压升高1mmHg;而女性,相应的值分别为0.75、2.12cm、2.54%和1.53%时,其收缩压升高1mmHg。多元逐步回归方程中,腰围身高比仅和女性舒张压有相关关系。结论肥胖指标与血压之间具有稳定的正向线性关系。腰围身高比对收缩压和舒张压的预测作用并不好于其他反映肥胖的指标。     

An inverse relationship between serum vitamin C and blood pressure in a Japanese community

To examine the relationship between serum vitamin C concentration and blood pressure level, a cross-sectional study was conducted. The subjects were 919 men and 1,266 women aged 40 years and over in a Japanese provincial city, Shibata, Niigata Prefecture. The mean and standard deviation of systolic blood pressure (SBP) were 134.0 +/- 20.0 mmHg for men and 128.3 +/- 20.8 mmHg for women, and those of diastolic blood pressure (DBP) were 81.0 +/- 11.7 mmHg and 75.8 +/- 11.4 mmHg, respectively. The mean and standard deviation of serum vitamin C were 42.5 +/- 18.6 mumol/L for men and 56.8 +/- 16.5 mumol/L for women. SBP and DBP were both inversely correlated with serum vitamin C concentration. The means of SBP or DBP were calculated for quartiles of serum vitamin C, and the significant inverse relationship was observed in any sex and age group. The inverse association persisted after adjustment for possible confounders: body mass index, serum total cholesterol, alcohol consumption, smoking, physical activity, antihypertensive medication, and dietary intake of salt, calcium, and potassium. Serum vitamin C appeared to be inversely related with both SBP and DBP in this Japanese population, although further intervention and experimental studies were required to establish the cause-effect relationship.     

The Association of Body Mass Index and Waist Circumference with Blood Pressure Depends on Age and Gender: A Study of 10,928 Non-Smoking Adults in the Greek EPIC Cohort

Body mass index (BMI) and waist circumference are independently associated with blood pressure, but the dependence of these associations on gender and age has not been clarified. We investigated the associations of BMI and waist circumference with systolic (SBP) and diastolic (DBP) blood pressure and assessed possible interactions with gender and age. Data concerning blood pressure and anthropometric variables were collected at enrollment in a cohort study from 10,928 non-smoking adults, all over Greece, who have never received antihypertensive treatment. Multiple regression-derived standardized coefficients were estimated to compare effects among variables. Among men, waist circumference appears more important than BMI in the prediction of SBP (standardized coefficients 2.26 vs. 1.52 mmHg/SD), and to a lesser extent DBP. In contrast, among women, BMI is more important than waist circumference, in the prediction of SBP (standardized coefficients 3.97 vs. 1.56 mmHg/ SD) and to a lesser extent DBP. The different effects of BMI and waist circumference on blood pressure by gender are evident among older individuals (> 55 years); among younger individuals BMI and waist circumference have comparable effects in both genders. Among younger individuals, BMI and waist circumference are independent and equally important predictors of SBP and DBP in both genders, whereas among older individuals waist circumference is the dominant predictor of blood pressure among men and BMI is the dominant predictor of blood pressure among women. Associations are more evident with respect to SBP than DBP.     

Blood and Urine Cadmium,Blood Pressure,and Hypertension: A Systematic Review and Meta-analysis

Background

Cadmium exposure has been inconsistently related to blood pressure.

Objectives

We updated and reevaluated the evidence regarding the relationships of blood cadmium (BCd) and urine cadmium (UCd) with blood pressure (BP) and hypertension (HTN) in nonoccupationally exposed populations.

Data sources and extraction

We searched PubMed and Web of Science for articles on BCd or UCd and BP or HTN in nonoccupationally exposed populations and extracted information from studies that provided sufficient data on population, smoking status, exposure, outcomes, and design.

Data synthesis

Twelve articles met inclusion criteria: eight provided data adequate for comparison, and five reported enough data for meta-analysis. Individual studies reported significant positive associations between BCd and systolic BP (SBP) among nonsmoking women [β = 3.14 mmHg per 1 μg/L untransformed BCd; 95% confidence interval (CI), 0.14–6.14] and among premenopausal women (β = 4.83 mmHg per 1 nmol/L log-transformed BCd; 95% CI, 0.17–9.49), and between BCd and diastolic BP (DBP) among women (β = 1.78 mmHg comparing BCd in the 90th and 10th percentiles; 95% CI, 0.64–2.92) and among premenopausal women (β = 3.84 mmHg per 1 nmol/L log-transformed BCd; 95% CI, 0.86–6.82). Three meta-analyses, each of three studies, showed positive associations between BCd and SBP (p = 0.006) and DBP (p < 0.001) among women, with minimal heterogeneity (I² = 3%), and a significant inverse association between UCd and HTN among men and women, with substantial heterogeneity (I² = 80%).

Conclusion

Our results suggest a positive association between BCd and BP among women; the results, however, are inconclusive because of the limited number of representative population-based studies of never-smokers. Associations between UCd and HTN suggest inverse relationships, but inconsistent outcome definitions limit interpretation. We believe a longitudinal study is merited.     

Association of dietary sodium intake and blood pressure in the German population

Aim

The present study investigated the association of dietary sodium intake and blood pressure (BP) based on existing data from the German National Health Interview and Examination Survey (GNHIES) and the associated German Nutrition Survey (GeNuS).

Subject and methods

After exclusion of participants with known hypertension and/or anti-hypertensive medication use, complete data of the GeNuS subsample of the 1998 GNHIES were analysed for 1,539 men and 1,553 women aged 18–79?years. The survey included a health and lifestyle questionnaire, a medical examination and a comprehensive diet history interview. Sodium density (g/1,000?kcal) was examined in quartiles of systolic and diastolic BP (SBP and DBP). Multiple linear regression models were used to investigate associations of sodium density and SBP or DBP. Adjustments were made for sex, age and socio- and health-behavioral risk factors previously found to be related to BP in univariate analysis.

Results

Participants with a high SBP and DBP (fourth quartile of SBP: ≥ 142?mmHg in men; ≥ 139?mmHg in women) had a significantly higher dietary sodium intake than individuals with a lower BP. In the multiple models, both SBP and DBP were significantly associated with sodium density when adjusted for other factors such as sex, age, body mass index and alcohol consumption.

Conclusion

An association of dietary sodium intake and BP in the German population could be found. Further research using sodium data collected via 24-h urine samples is urgently needed for evidence-based public health policy reducing risk of BP associated morbidities and mortalities in Germany.     

Randomized Trial on the Effects of Dietary Potassium on Blood Pressure and Serum Potassium Levels in Adults with Chronic Kidney Disease

In the general population, an increased potassium (K) intake lowers blood pressure (BP). The effects of K have not been well-studied in individuals with chronic kidney disease (CKD). This randomized feeding trial with a 2-period crossover design compared the effects of diets containing 100 and 40 mmol K/day on BP in 29 adults with stage 3 CKD and treated or untreated systolic BP (SBP) 120–159 mmHg and diastolic BP (DBP) <100 mmHg. The primary outcome was 24 h ambulatory systolic BP. The higher-versus lower-K diet had no significant effect on 24 h SBP (−2.12 mm Hg; p = 0.16) and DBP (−0.70 mm Hg; p = 0.44). Corresponding differences in clinic BP were −4.21 mm Hg for SBP (p = 0.054) and −0.08 mm Hg for DBP (p = 0.94). On the higher-K diet, mean serum K increased by 0.21 mmol/L (p = 0.003) compared to the lower-K diet; two participants had confirmed hyperkalemia (serum K ≥ 5.5 mmol/L). In conclusion, a higher dietary intake of K did not lower 24 h SBP, while clinic SBP reduction was of borderline statistical significance. Additional trials are warranted to understand the health effects of increased K intake in individuals with CKD.     

Relation of vegetable, fruit, and meat intake to 7-year blood pressure change in middle-aged men: the Chicago Western Electric Study

Information is sparse on the role of foods in long-term blood pressure (BP) change. The investigators examined relations of food intake to BP change in a prospective cohort study of 1,710 employed men in Chicago, Illinois, initially aged 41-57 years. In 1958 and 1959, BP was measured and nutrient intake assessed by comprehensive interview. In 1959, intake of 26 specific food groups was also assessed. BP was remeasured annually through 1966. The generalized estimating equation method was used to analyze relations of food group intakes to average annual BP change, adjusting for age, weight at each year, alcohol consumption, calories, and other foods. Average systolic blood pressure (SBP)/diastolic blood pressure (DBP) increase was 1.9/0.3 mmHg per year. The SBP of men who consumed 14-42 cups of vegetables a month (0.5-1.5 cups/day) versus <14 cups a month (<0.5 cups/day) was estimated to rise 2.8 mmHg less in 7 years (p < 0.01). The SBP of men who consumed 14-42 cups of fruit a month versus <14 cups a month was estimated to increase 2.2 mmHg less in 7 years (p < 0.05). Beef-veal-lamb and poultry intakes were related directly to a greater SBP/DBP increase (p < 0.05). These results support the concept that diets higher in fruits and vegetables and lower in meats (except fish) may reduce the risk of developing high BP.     

Oral contraceptives: a risk factor for uncontrolled blood pressure among hypertensive women

The objective of the study was to assess the association between systolic and diastolic blood pressure (SBP and DBP) and the use of oral contraceptives (OC) in hypertensive women. In a prospective cross-sectional study, we evaluated 171 women who were referred to the Hypertension Outpatient Clinic of Hospital de Clínicas de Porto Alegre; 66 current users of OC, 26 users of other contraceptive methods and 79 women who were not using contraception. The average of six blood pressure readings was used to establish the usual blood pressure of the participants. Current OC users were compared with users of other methods and with patients not using contraception. Main outcome measures were SBP and DBP among the different groups, and prevalence of uncontrolled hypertension (SBP >or= 140 mmHg and DBP >or= 90 mmHg). DBP was higher in OC users (100.2 +/- 15.9 mmHg) than in patients using other contraceptive methods (93.4 +/- 14.7 mmHg) and not using contraceptives (93.3 +/- 14.4 mmHg, p = 0.016). Women using OC for more than 8 years presented higher age-adjusted blood pressure levels than women using OC for shorter periods. Patients using OC had poor blood pressure control (p for trend = 0.046) and a higher proportion of them presented moderate-severe hypertension. These results were independent of antihypertensive drug use. In a logistic regression model, we found that current OC use was independently and significantly associated with prevalence of uncontrolled hypertension. It is concluded that hypertensive women using OC present a significant increase in DBP and poor blood pressure control, independent of age, weight and antihypertensive drug treatment.     

Sex May Modulate the Effects of Combined Polyphenol Extract and L-citrulline Supplementation on Ambulatory Blood Pressure in Adults with Prehypertension: A Randomized Controlled Trial

Increased blood pressure (BP), vascular dysfunction and inflammation are involved in the etiology of cardiovascular disease (CVD). Although several dietary components such as polyphenols and L-citrulline may help to control BP, their combined impact on ambulatory BP in individuals at risk of CVD remains unknown. The objective of this research was to investigate the short-term impact of supplementation with a combination of polyphenol extract and L-citrulline on ambulatory BP, endothelial function and inflammation. In a randomized double-blind parallel trial, 73 men and women with prehypertension were supplemented with a placebo (cellulose, n = 34, Plac) or 548 mg/day of polyphenols and 2 g/day of L-citrulline (n = 35, Suppl) for 6 weeks. The primary outcome of this study was the difference between groups in 24-h ambulatory diastolic BP (DBP) at week six. Secondary outcomes were a difference between groups at week six in ambulatory systolic BP (SBP), casual BP, serum lipids and high-sensitivity C-reactive protein (hs-CRP) concentrations and skin advanced glycation end products (AGEs). Potential interaction of treatment with sex was examined. Suppl had no impact on mean ambulatory SBP and DBP (p > 0.10 vs. placebo). Daytime and 24-h SBP were reduced with Suppl in women (p ≤ 0.01), but not in men (p ≥ 0.27). A non-significant reduction in AGEs was observed after Suppl compared to Plac among all participants (p = 0.07) and there was no difference in the concentrations of blood lipids (p > 0.20) or CRP (p = 0.36) between treatments at week six. Therefore, supplementation with polyphenol extract and L-citrulline for 6 weeks has no impact on ambulatory BP, blood lipids and CRP in adults with prehypertension. However, the polyphenol extract/L-citrulline supplement may reduce ambulatory SBP in women, but not in men. These preliminary results need further research efforts towards further documenting this sex-dependent BP response to supplementation with polyphenols and L-citrulline.     

A High-Protein and Low-Glycemic Formula Diet Improves Blood Pressure and Other Hemodynamic Parameters in High-Risk Individuals

Low-caloric formula diets can improve hemodynamic parameters of patients with type 2 diabetes. We, therefore, hypothesized that persons with overweight or obesity can benefit from a high-protein, low-glycemic but moderate-caloric formula diet. This post-hoc analysis of the Almased Concept against Overweight and Obesity and Related Health Risk- (ACOORH) trial investigated the impact of a lifestyle intervention combined with a formula diet (INT, n = 308) compared to a control group with lifestyle intervention alone (CON, n = 155) on hemodynamic parameters (systolic and diastolic blood pressure (SBP, DBP), resting heart rate (HR), and pulse wave velocity (PWV)) in high-risk individuals with prehypertension or hypertension. INT replaced meals during the first 6 months (1 week: 3 meals/day; 2–4 weeks: 2 meals/day; 5–26 weeks: 1 meal/day). Study duration was 12 months. From the starting cohort, 304 (68.3%, INT: n = 216; CON: n = 101) participants had a complete dataset. Compared to CON, INT significantly reduced more SBP (−7.3 mmHg 95% CI [−9.2; −5.3] vs. −3.3 mmHg [−5.9; −0.8], p < 0.049) and DBP (−3.7 mmHg [−4.9; −2.5] vs. −1.4 mmHg [−3.1; 0.2], p < 0.028) after 12 months. Compared to CON, INT showed a pronounced reduction in resting HR and PWV after 6 months but both lost significance after 12 months. Changes in SBP, DBP, and PWV were significantly associated positively with changes in body weight and fat mass (all p < 0.05) and resting HR correlated positively with fasting insulin (p < 0.001) after 12 months. Combining a lifestyle intervention with a high-protein and low-glycemic formula diet improves hemodynamic parameters to a greater extent than lifestyle intervention alone in high-risk individuals with overweight and obesity.     

Effect of two dosages of sodium chloride intake on the blood pressure response to caffeinated coffee in humans in vivo

Abstract

High sodium intake increases cardiovascular risk by increasing blood pressure. The intake of coffee elevates blood pressure acutely. Preclinical evidence shows that this action of caffeine is enhanced by high salt intake. We hypothesised that high sodium intake augments the acute blood pressure response to coffee in humans. A randomised cross-over study (n?=?15) was performed comparing the effect of lower (6?g/d; LS) with higher (12?g/d; HS) sodium chloride diet on blood pressure before and 2?h after regular coffee intake. Baseline blood pressure was 115?±?4/84?±?2/68?±?1 during LS and 121?±?4/89?±?2/69?±?1?mmHg during HS (SBP/Mean Arterial Pressure (MAP)/DBP; mean?±?SE, p?<?0.05 for SBP). During LS, blood pressure increased to 121?±?4/91?±?2/73?±?1 (p?<?0.05 for SBP, MAP, DBP versus baseline). HS did not significantly affect the impact of coffee on blood pressure (p?>?0.3 for SBP, DBP; p?>?0.05 for MAP). Sodium intake does not relevantly modulate the impact of regular coffee consumption on blood pressure.     

Relationship between change in body mass index and blood pressure in urban residents

PURPOSE: The aim of this study was to assess the relationship between change in body mass index (BMI) and blood pressure in urban residents. METHODS: The data for this study were obtained at health checkups carried out between 1984 and 1998 in city A in Osaka Prefecture. The subjects comprised 4,760 men and 9,318 women aged 40-69. Individuals who had taken anti-hypertensives as medical treatment were not included. Hypertension was defined as a systolic blood pressure (SBP) > or = 140 mmHg or as a diastolic blood pressure (DBP) > or = 90 mmHg. We divided the 15 year period into three of five-years each and divided the subjects with reference to their BMI (Body Mass Index: kg/m2). We calculated the averages of systolic blood pressure and those of diastolic blood pressure in every group and the regression equations of BMI to blood pressure by means of single regression analyses. Hypertension incidences were determined in every ten years. Among the subjects who had taken health checkups between 1984 and 1988, we analyzed the relationship between change in BMI and blood pressure. RESULTS: 1. In all three-period groups, the averages for SBP and DBP in the highest BMI group were significantly larger than in the lowest group. 2. Linear regression coefficients for the relation of BMI to blood pressure were significantly positive in all age groups for both men and women. 3. The incidence of hypertension displayed a tendency to depend on BMI values positively. Especially, rising BMI values in women were significantly associated with increase of the incidence of hypertension. 4. In each of the years (1984-1988), in the group with decreasing BMI the average values for blood pressure were smaller than those in the increasing group. In some years, the statistical significance was attained. CONCLUSION: According to the present analyses of health checkup data for urban residents, both blood pressure and the incidence of hypertension positively depend on BMI. This study of transitions showed decrease of BMI to exert a beneficial influence on blood pressure.