有高血压家族史血压正常的青少年血清抵抗素测定及临床意义

目的:探讨有高血压家族史但血压正常的青少年血清抵抗素的变化。方法:研究对象为30例有高血压家族史、本人血压正常的青少年(家族史阳性组,FH+组)和30例无高血压家族史、血压正常的青少年(对照组,FH-组),测定其身高、体重、体重指数(BMI)、血压、空腹血糖(FBG)、血总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白(LDL-C)、高密度脂蛋白(HDL-C)和血清抵抗素(Resistin)。结果:FH+组青少年的BMI、收缩压、FBG、TC、LDL-C和血清抵抗素均高于FH-组,差异有统计学意义(P<0.05)。血清抵抗素水平与收缩压(SBP)和FBG呈正相关(P<0.05)。结论:有高血压家族史的青少年即使在血压尚处于正常范围时,已发生血清抵抗素水平升高,血清抵抗素水平可能与血压相关。     

Effects of short-term aerobic conditioning and high cholesterol feeding on plasma total and lipoprotein cholesterol levels in sedentary young men

The plasma total cholesterol (TC) and lipoprotein cholesterol concentrations of sedentary young men (n = 23) were determined during 4 wk of controlled feeding and 6 wk of supervised aerobic conditioning. Subjects were assigned to dietary treatments of 400 mg cholesterol per day (M) or 1400 mg cholesterol per day (H); both diets had a P/S ratio of about 0.6. Dietary groups M and H were subdivided into exercise (MX and HX) and sedentary (MS and HS) groups. Compared to the sedentary groups, MX and HX exhibited significant (p less than 0.01) improvements in cardiorespiratory fitness. After 2 and 4 wk of high cholesterol feeding, group HS exhibited significant (p less than 0.05) elevations in TC (+30 +/- 7 and +32 +/- 9 mg/dl) with nonsignificant increases in very low-density lipoprotein cholesterol and low-density lipoprotein cholesterol. Group HX exhibited consistent weekly increases in high-density lipoprotein cholesterol (HDL-C) (from 46 +/- 3 mg/dl, the base level, to 53 +/- 4 mg/dl at wk 4) with aerobic conditioning. By combining exercise and sedentary group data at each level of dietary cholesterol it was shown that TC and HDL-C levels significantly (p less than 0.05) increased by the 4th wk of high cholesterol feeding. The TC/HDL-C ratio significantly (p less than 0.05) increased for the sedentary subjects as compared to all the exercising subjects by wk 4 of controlled feeding.     

Blood pressure response to the Canadian Aerobic Fitness Test

Persons who are normotensive or borderline hypertensive at rest but who have an exaggerated blood pressure response to exercise incur a higher risk of developing sustained hypertension. Our purpose was to develop provisional norms for immediate post-exercise blood pressure responses to the Canadian Aerobic Fitness Test (CAFT) for men and women 20-69 years and to recommend threshold values for exercise hypertension. We studied 986 males and females. Blood pressure criteria for inclusion were less than 150/100 mmHg for men and less than 160/100 mmHg for women. The blood pressure values for the 3 stages of the CAFT specific to each age group and sex were appropriately summarized for each workload. An exaggerated blood pressure to exercise was defined as the mean + 1 SD while a grossly exaggerated blood pressure was defined as the mean + 2 SD. As such, the following values are recommended as criteria for the first stage of the CAFT regardless of age: Men: exaggerated response greater than or equal to 170 mmHg, grossly exaggerated, greater than or equal to 190 mmHg; women greater than or equal to 160 mmHg and 180 mmHg respectively. The delta SBP (exercise SBP minus resting SBP) at the first stage of the CAFT could also be utilized to identify persons who demonstrate an abnormal pressure response to exercise. An increase of 10 mmHg above resting diastolic pressure at any stage of exercise should also be cause for concern and counselling.     

Isolated systolic hypertension in Dutch middle aged and all-cause mortality: a 25-year prospective study

In the early 1950s, the blood pressure of 3901 Dutch civil servants and their spouses aged 40-65 years was measured in a general health survey. Isolated systolic hypertension (systolic pressure greater than 160 mmHg, diastolic pressure less than 90 mmHg) was observed in 6.3% of the women and 3.0% of the men. The prevalence increased with age and it was more common in women in all age groups. Using logistic regression, with adjustment for potential confounders (age, smoking, serum cholesterol, Quetelet index, alcohol consumption, haemoglobin level, pulse rate and diastolic blood pressure) the association of 15- and 25-year total mortality with isolated systolic hypertension was determined. Compared to normotensive people (systolic pressure less than or equal to 135 mmHg, diastolic pressure less than 90 mmHg), the risk of death from all causes was significantly higher for men with isolated systolic hypertension after 15 and 25 years of follow-up (odds ratio OR = 2.4, 95% confidence interval (CI) 1.2-4.8 and OR = 3.2, 95% CI 1.3-8.0). For women 15-years mortality risk was strongly associated with isolated systolic hypertension (OR = 3.7, 95% CI 1.4-9.7). The increased risk was less pronounced after 25 years of follow-up (OR = 1.7, 95% CI 0.96-3.0). Our results support those of other studies and indicate that isolated systolic hypertension is an important independent risk factor for all-cause mortality. Since isolated systolic hypertension may be an indicator for the early onset of ageing, it is important to study its determinants and to pay more attention to its diagnosis and treatment in middle-aged populations.     

饮食干预结合运动对超重者血脂血糖血压的作用

目的观察饮食干预与运动疗法相结合,使超重者的高血脂、高血糖、高血压逐步达到健康标准的效果。方法从2005年8～12月来我院健康管理中心进行健康查体的企事业单位6789人中筛选出104名35～60岁的男性(75例)与女性(29例),体重指数(BMI)在24～28,并有血脂异常或血糖或血压偏高者,作为观察对象。要求从未使用过任何药物并排除心、肝、肾功能缺陷及影响身体活动的骨关节疾病。进行半年的饮食控制和运动疗法,观察对体重(BW)、体重指数(BMI)、腰臀比(WHR)、胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、空腹血糖(FPG)、餐后2h血糖(2hPG)、糖化血红蛋白(HbA1c)和收缩压(SBP)及舒张压(DBP)的变化。结果通过24周的饮食控制及运动疗法,患者的BW、BMI、WHR、FPG、2hPG、HbA1c、TC、TG、LDL-C及SBP均有显著性下降。HDL-C与DBP无改变。结论科学合理的膳食结构与持之以恒的运动锻炼,可使超重者血脂、血糖及血压下降。     

Relationship of urinary sodium/potassium excretion and calcium intake to blood pressure and prevalence of hypertension among older Chinese vegetarians

OBJECTIVE: To examine the associations of dietary sodium and potassium, as reflected by the urinary sodium/potassium excretion, and calcium intake with blood pressure and the prevalence of hypertension among older Chinese vegetarians in Hong Kong. DESIGN: Cross-sectional study. SETTING: Research clinic in a teaching hospital in Hong Kong. SUBJECTS: A total of 111 ambulatory vegetarians over the age of 55 were recruited from members of religious organizations or old age hostels. MAIN OUTCOME MEASURES: Hypertension was defined as supine blood pressure >140/90 mmHg or a history of hypertension. Dietary sodium, potassium and calcium intakes were assessed by 24 h recall method or fasting urinary sodium or potassium/creatinine ratios. RESULTS: Seventy-one subjects (64%) were found to have hypertension. Compared with normotensive subjects, hypertensive subjects had lower calcium intake (411+/-s.d. 324 vs 589+/-428 mg, P=0.04), but higher urinary sodium/creatinine ratio (32.6+/-19.3 vs 21.0+/-12.4, P=0.00) and sodium/potassium ratio (4.7+/-2.8 vs 3.4+/-2.3, P=0.02). Among 88 subjects not taking diuretics or antihypertensive drugs, systolic blood pressure was related to calcium intake (r=-0.40), urinary sodium/creatinine ratio (r=0.39), urinary sodium/potassium ratio (r=0.30) and age (r=0.23). Diastolic blood pressure was related to urinary sodium/creatinine (r=0.29). Twenty-three subjects with high urinary sodium/potassium and low calcium intake and 16 subjects with low urinary sodium/potassium ratio and high calcium intake differed markedly with respect to systolic blood pressure (159+/-26 vs 130+/-15 mmHg) and prevalence of hypertension (78% vs 25%). CONCLUSIONS: Older Chinese vegetarians are predisposed to hypertension because of their sodium-rich but calcium-deficient diets.     

Strategy for primary prevention of coronary heart disease based on results of health check-up]

To investigate one of the strategies for effective primary prevention of coronary heart disease (CHD) in employees, the future morbidity of CHD was predicted from the results of an annual health check-up. The decrease in morbidity by measures against coronary risk factors was estimated with simulations. By a CHD risk prediction algorithm based on the Framingham Study, the 10-yr incidence of CHD was predicted in 6,444 male employees of a manufacturing company according to the results of a health check-up in 1998: age, total cholesterol (TC), HDL-cholesterol (HDL-C), blood pressure (BP), diabetes mellitus, and smoking habit. The decrease in CHD incidence obtained by a decrease in TC, increase in HDL-C, decrease in BP, control of diabetes mellitus, or quitting the smoking habit was estimated with simulations by means of the algorithm. The mean +/- SD in 6,444 employees was 45 +/- 11 yr for age; 121 +/- 16 and 79 +/- 10 mmHg for systolic and diastolic BP, respectively; 193 +/- 34, 53 +/- 13, and 98 +/- 18 mg/dl for TC, HDL-C, and fasting blood sugar, respectively; 4.80 +/- 0.58% for HbA1c; and 44% for the frequency of the smoking habit. Among 6,444 males, 455 (7.1%) were predicted to suffer from CHD for 10 yr ahead. If TC was decreased to less than 200 mg/dl in all 2,614 males (N) with TC > or = 200 mg/dl, the decrease (D) in the predicted number of employees with CHD was 64; namely, a reduction of TC to less than 200 mg/dl in 41 males (N/D) with TC > or = 200 mg/dl was estimated to decrease the number of CHD patients by one. Similarly, the D and N/D were 38 and 35 for reduction in BP to less than 140/90 mmHg; 20 and 17 for control of diabetes mellitus; and 90 and 32 for quitting the smoking habit, respectively. A measure against diabetes mellitus was the most effective in respect of N/D, but the predicted total reduction was small (D = 20). On the other hand, a measure against the smoking habit was estimated to have a relatively small N/D as well as the largest D. In 5,386 employees with at least one of the risk factors of TC > or = 200 mg/dl, HDL-C < 45 mg/dl, BP > or = 130/85 mmHg, diabetes mellitus, and the smoking habit, the normalization of all risk factors was estimated to decrease by 230 CHD patients (D = 230, N/D = 23). These results suggest that the strategy for effective primary prevention of CHD in employees of a company should include at first, quitting the smoking habit supported by total prohibition of smoking within company facilities, followed by measures against hyperlipidemia, hypertension and diabetes mellitus.     

Risk factors for hypertension. A longitudinal study of middle-aged Japanese male workers

OBJECTIVE: To identify factors related to the development of hypertension among middle-aged Japanese men. METHODS AND RESULTS: A cohort of normotensive male workers aged 30-59 years (n = 6,306) were followed from 1991 through 1998 to observe the development of hypertension, using data from annual health checkups in a Japanese company. With hypertension defined as initiation of antihypertensive therapy or a systolic blood pressure of 140 mmHg or higher and/or a diastolic blood pressure of 90 mmHg or higher, the incidence rate was 33.4/1000 person-years in the 30-39 year old group, 63.8/1000 person-years in the 40-49 year old group, and 75.4/1000 person-years in the 50-59 year old group. Multivariate analysis by using Cox's proportional hazard model indicated that high-normal blood pressure at baseline, obesity (body mass index > or = 25 kg/m2), drinking 5 days/week or more, and no regular exercise were independent factors related to the development of hypertension. Although each age group had a different pattern of risk factors, high-normal blood pressure at baseline was the strongest risk factor in all cases. Glucose intolerance was significantly observed as a hazard only in the 30-39 year old group, hazard rations for obesity and physical inactivity also being highest in this younger age group. CONCLUSIONS: High-normal blood pressure, obesity, glucose intolerance, regular alcohol intake, and physical inactivity are risk factors for hypertension among middle-aged Japanese men. Insulin resistance may play an important role in the development of hypertension in young males.     

An eight-month controlled study of a low-fat high-fibre diet: effects on blood lipids and blood pressure in healthy young subjects.

The effects on blood lipids and blood pressure of a diet corresponding to present Nordic Nutrition Recommendations, i.e. less than 30% of energy from fat and with a fibre content exceeding 3 g/MJ, were studied in 18 men and 12 women (mean age, 24 years) under strict dietary control over 8 months. Blood sampling, blood pressure and body weight measurement were performed at four occasions on their habitual diet and once a month during the intervention period. An age-matched control group (17 men, 8 women) was followed with monthly measurements parallel to the intervention group. The habitual diets, assessed by 7-day records, showed an average fat content corresponding to 36% of energy. Initial levels of total cholesterol and HDL cholesterol (X +/- SD) were 4.21 +/- 0.61 and 1.23 +/- 0.23 mmol/l for the men in the intervention group; 4.35 +/- 0.79 and 1.21 +/- 0.26 mmol/l for the male controls; 4.61 +/- 0.59 and 1.46 +/- 0.31 mmol/l for the women in the intervention group and 4.48 +/- 0.64 and 1.48 +/- 0.29 mmol/l for the female controls. Significantly decreased levels of total cholesterol and HDL cholesterol throughout the experimental period were seen for both sexes in the intervention group. Total cholesterol fell 0.49 mmol/l (95% CI: 0.41-0.56) in the male subjects and 0.49 mmol/l (95% CI: 0.39-0.59) in the female subjects. The fall in HDL cholesterol was 0.16 mmol/l (95% C: 0.13-0.18) and 0.18 mmol/l (95% CI: 0.12-0.23), respectively. Total cholesterol changes were independent of initial values. All subjects were normotensive at the start of the study with an average blood pressure of 122/68 mmHg for men and 112/68 mmHg for the women. Systolic blood pressure dropped gradually and significantly in the male subjects of the intervention group. A minimum of 6 mmHg below initial values was noted after six months of dietary intervention. No significant changes in dietary intake and blood lipids were observed in the control group. Thus, changes of present dietary habits of young healthy Danish subjects to an intake in accordance with the Nordic Nutrition Recommendations 1989 will favourably affect suggested risk factors for disease.     

Effects of aerobic exercise on lipids and lipoproteins in adults with type 2 diabetes: a meta-analysis of randomized-controlled trials

OBJECTIVE: To conduct a meta-analysis of randomized-controlled trials in order to examine the effects of 8 weeks or more of aerobic exercise on lipids and lipoproteins in adults with Type 2 diabetes. METHODS: Studies were included if total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), ratio of TC to HDL-C (TC/HDL-C), triglycerides (TG), or all of the above, were assessed. A secondary outcome was glycosylated haemoglobin (HbA1). RESULTS: Seven studies representing 220 men and women (112 exercise, 108 control) were available for pooling. Using a random-effects model, a statistically significant reduction of about 5% was found for LDL-C, whereas no statistically significant improvements were found for TC, HDL-C, TC/HDL-C or TG. A trend for a statistically significant reduction in HbA1 was also found. CONCLUSIONS: Although our overall results suggest that aerobic exercise lowers LDL-C in adults with Type 2 diabetes, additional randomized-controlled trials are needed on this topic.     

血脂水平对血压正常高值人群脉搏波传导速度的影响

目的 探讨血脂和脂蛋白比值对血压正常高值人群脉搏波传导速度的影响.方法 选择11 611名血压正常的健康体检者,分为正常血压值组(血压＜ 120/80 mmHg)和血压正常高值组(血压为120 ～ 139/80 ～ 89 mmHg).应用全自动动脉硬化仪测定人选者肱踝脉搏波传导速度(baPWV),同时测量身高、体重、FPG、TC、TG、HDL-C、LDL-C等指标,并计算HDL-C和TC/HDL-C比值、LDL-C/HDL-C比值.分析血脂和脂蛋白比值异常情况对不同血压组脉搏波传导速度的影响.结果 血压正常高值组的baPWV异常率均高于血压正常组.血压正常组中除HDL-C外,TC、TG、LDL-C、TC/HDL-C、LDL-C/HDL-C的升高均使baPWV的异常率显著增加(P＜0.001).血压正常高值组中,TC和LDL-C的升高使baPWV的异常率显著增加(P＜0.001).多元logistic回归分析显示,除年龄、BMI、FPG外,TC/HDL-C异常是血压正常组动脉僵硬度增高的独立危险因子(OR=1.732),TG异常是血压正常高值组的独立危险因素(OR=1.301).结论 在正常血压不同水平下,血脂和脂蛋白比值的异常是动脉僵硬度增高的独立危险因素.     

Randomised, controlled, cross-over trial of soy protein with isoflavones on blood pressure and arterial function in hypertensive subjects

OBJECTIVE: To examine the effects of dietary soy/isoflavones on 24 hr blood pressure profiles and arterial function [systemic arterial compliance (SAC), pulse wave velocity (PWV) and brachial arterial flow mediated vasodilation (FMD)] compared to non legume-based plant protein without isoflavones, in hypertensive subjects. DESIGN: In a 6 month double-blind, placebo controlled, cross-over trial, 41 hypertensive subjects (26 men, 15 postmenopausal women), 30-75 years, received soy cereal (40 g soy protein, 118 mg isoflavones) and gluten placebo cereal, each for 3 months. RESULTS: Thirty-eight subjects completed protocol with results expressed as mean or mean change (+/-SEM) with each intervention. Soy increased urinary isoflavones (daidzein: 8-fold; genistein: 8-fold; equol: 9-fold; ODMA: 18-fold) with no change during gluten placebo. There was no difference in the change in individual 24 hr ambulatory BP parameters (SBP: 2 +/- 2 vs -1 +/- 1 mmHg, p = 0.21; DBP: 1 +/- 1 vs -1 +/- 1 mmHg, p = 0.06) central BP (cSBP: -4 +/- 2 vs 0 +/- 2 mmHg, p = 0.2) or the change in arterial function (FMD: 0.3 +/- 0.5 vs -0.2 +/- 0.5%, p = NS; SAC: 0.02 +/- 0.02 vs -0.02 +/- 0.02 U/mmHg, p = NS; PWV central: -0.2 +/- 0.2 vs 0.0 +/- 0.2 m/sec, p = NS; PWV peripheral: 0.01 +/- 0.3 vs -0.4 +/- 0.4 m/sec, p = NS) noted between interventions. Analysis of the area under curve of 24 hr BP outputs demonstrated that soy protein compared to gluten protein resulted in higher 24 hr systolic BP by 2.3 mmHg (p = 0.003), a higher daytime systolic BP by 3.4 mmHg (p = 0.0002) and a higher daytime diastolic BP by 1.4 mmHg (p = 0.008). Overall 24 hr diastolic BP, night systolic BP and night diastolic BP were not significantly different between groups. Furthermore, soy protein compared to gluten protein resulted in higher 24 hr heart rates by 3.5 bpm (p < 0.0001). CONCLUSIONS: In hypertensive subjects, compared to gluten placebo, soy dietary supplementation containing isoflavones had no effect on arterial function, on average 24 hr ambulatory blood pressure parameters or central blood pressure in men and women with hypertension. Area under the curve of 24 hr profiles demonstrated that daytime BP was higher after soy compared to gluten.     

高血压病患者血脂综合指标与大动脉僵硬度异常的相关性

  目的  通过引入血脂综合指标探讨高血压病患者血脂异常与大动脉僵硬度异常的相关性。  方法  本研究共纳入高血压病随诊或疑诊动脉粥样硬化相关疾病患者431例。对所有入组患者依据有无高血压病及血脂异常病史分为无高血压病和血脂异常病史组（A组）、有血脂异常病史但无高血压病史组（B组）、有高血压病史但无血脂异常病史组（C组）、有高血压病及血脂异常病史组（D组）。依据总胆固醇（total cholesterol,TC）、甘油三酯（triglyceride,TG）、高密度脂蛋白胆固醇（high density lipoprotein-cholesterol,HDL-C）、低密度脂蛋白胆固醇（low density lipoprotein-cholesterol,LDL-C）等血脂指标分别计算血浆致动脉粥样硬化指数（atherogenic index of plasma,AIP）、非高密度脂蛋白胆固醇（non-high density lipoprotein-cholesterol,non-HDL-C）、TC/HDL-C、动脉硬化指数（atherogenic index,AI）等血脂综合指标,比较各指标组间差异。采用多元线性偏相关分析探讨各血脂指标与肱踝动脉脉搏波传导速度（brachial-ankle pulse wave velocity,baPWV）的相关性。  结果  TC、TG、HDL-C、AIP、AI、non-HDL-C及TC/HDL-C在各组间总体比较差异均存在统计学意义（均有P < 0.05）。针对高血压病患者（C组、D组）进行多元线性偏相关分析,结果显示,TG、HDL-C、AIP、AI、TC/HDL-C与baPWV均呈正相关关系（均有P < 0.05）,TC、LDL-C、non-HDL-C与baPWV均无明显相关性（均有P>0.05）。  结论  高血压患者血脂水平与大动脉僵硬度可能存在相关性,AI、AIP及TC/HDL-C等血脂综合指标可能更好反映高血压病患者血脂异常与大动脉僵硬度异常的相关趋势。     

踝肱指数在2型糖尿病下肢动脉病变中的作用及相关因素分析

目的：探讨踝肱指数在诊断2型糖尿病患者下肢动脉病变（PAD）中的作用及相关危险因素。方法：根据踝肱比值（ABI）将78例2型糖尿病患者分为观察组（ABI≤0．90）及对照组,对比分析两组性别、年龄、糖尿病病程、收缩压、舒张压、空腹血糖（FPG）、餐后两小时血糖（2hPG）、糖化血红蛋白（HbA1c）、高密度脂蛋白胆固醇（HDL—C）、总胆固醇（TG）、甘油三酯（TG）、低密度脂蛋白胆固醇（LDL—c）。结果：78例糖尿病患者中检出PAD患者共53例,检出率67．9％,与对照组相比较,PAD患者年龄、病程、收缩压、舒张压、FPG、2hPG、HbA1c、HDL—C、TG、TC、LDL—C均明显高于对照组。结论：ABI可作为PAD的无创早期诊断方法,其中年龄、病程、高血压、高血糖、高血脂是2型糖尿病患者PAD的危险因素。     

Prediction of metabolic syndrome among postmenopausal Ghanaian women using obesity and atherogenic markers

ABSTRACT: BACKGROUND: Metabolic syndrome (MetS) is an important health problem which puts individuals at risk for cardiovascular diseases and type 2 diabetes as well as obesity-related cancers such as colon and renal cell in men, and endometrial and oesophageal in women. OBJECTIVE: This study was aimed at examining how obesity indicators and related determinants influence metabolic syndrome, and how the factors can be used to predict the syndrome and its cut-offs in postmenopausal Ghanaian women. METHODS: Two hundred and fifty (250) Ghanaian subjects were involved in the study with one hundred and forty-three (143) being premenopausal women and one hundred and seven (107) postmenopausal women. The influence of traditional metabolic risk factors including high blood pressure, dyslipidemia and glucose intolerance on obesity and atherogenic indices i.e. body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), Waist-to-thigh ratio (WTR), waist-to-height ratio (WHtR), high density lipoprotein cholesterol to total cholesterol ratio (HDL-C/TC), high density lipoprotein cholesterol to low density lipoprotein ratio (HDL-C/LDL-C) and triglyceride to high density lipoprotein cholesterol ratio (TG/HDL-C) were identified according to the Harmonization (H_MS) criterion. RESULTS: The most significant anthropometric marker that significantly influence metabolic risk factors among the pre- and postmenopausal women was waist-to-hip ratio (premenopausal: p- 0.004, 0.026 and 0.002 for systolic blood pressure (SBP), fasting blood glucose (FBG) and HDL-C; postmenopausal: p-0.012, 0.048, 0.007 and 0.0061 for diastolic blood pressure (DBP), FBG, triglyceride (TG) and high density lipoprotein cholesterol (HDL-C) respectively). Using the receiver operating characteristic (ROC) analysis, the area under the curve for WC, WHR, TG/HDL-C and HDL-C/TC among postmenopausal women were estimated at 0.6, 0.6, 0.8 and 0.8 respectively. The appropriate cut-off values for WC, WHR, TG/HDL-C and HDL-C/TC that predicted the presence of metabolic syndrome were 80.5 cm, 0.84, 0.61 and 0.34 respectively. CONCLUSION: The presence of metabolic syndrome among Ghanaian postmenopausal women can be predicted using WC, WHR, TG/HDL-C and HDL-C/TC.     

Lack of effect on blood pressure by polyunsaturated and monounsaturated fat diets.

We carried out a blind highly controlled study to investigate the effects of a sunflower-oil-rich diet and a rapeseed-oil-rich diet on the blood pressure of normotensive subjects. Twenty-nine men and 30 women, average age 30 years (range 18-65) were first fed a baseline diet high in saturated fatty acids (19 E% (percentage of total energy), total fat 36 E%) for 2 weeks. According to the crossover design 30 subjects then received a sunflower oil diet high in polyunsaturated fatty acids (13 E%, total fat 38 E%) followed by a low erucic acid rapeseed oil diet high in monounsaturated fatty acids (16 E%, total fat 38 E%) for 3.5 weeks each. The other 29 subjects had the same diets in reverse order. At the end of the saturated fat period systolic blood pressure was 122.6 +/- 11.5(mean +/- SD) mmHg and diastolic blood pressure 75.4 +/- 7.5 mmHg; during the sunflower oil diet the figures were 119.6 +/- 10.3 and 73.9 +/- 7.4 mmHg, and during the rapeseed oil diet 120.1 +/- 11.2 and 72.6 +/- 6.4 mmHg, respectively. There was a significant difference in diastolic blood pressure only between the two oil diets (P less than 0.01). At the end of a 4 weeks' recovery period the systolic and diastolic blood pressures of the subjects were even lower (118.6 +/- 10.6 and 72.3 +/- 8.3 mmHg, respectively) than during the study. These results suggest that the dietary changes had only minor effects - if any at all - on blood pressure in healthy normotensive subjects.     

Phytosterols/stanols lower cholesterol concentrations in familial hypercholesterolemic subjects: a systematic review with meta-analysis

BACKGROUND: To-date, reviews regarding the cholesterol lowering capacity of phytosterols/stanols have focused on normo- and hypercholesterolemic (HC) subjects. Familial hypercholestrolemia (FH) is characterized by very high low-density lipoprotein cholesterol (LDL-C) concentrations and is considered a world public health problem due to the high incidence of premature coronary heart disease (CHD) in these patients. OBJECTIVE: To conduct a systematic review that investigates the efficacy of phytosterols/stanols in lowering total cholesterol (TC) and LDL-C concentrations in FH subjects. DESIGN: Randomized controlled intervention trials with the primary objective to investigate the effects of phytosterols/stanols on lipid concentrations in FH subjects were identified through selected international journal databases and reference lists of relevant publications. Two researchers extracted data from each identified trial and only trials of sufficient quality (e.g. controlled, randomized, double-blind, good compliance, sufficient statistical power) were included in the review. The main outcome measures were differences between treatment and control groups for LDL-C, TC, high-density lipoprotein cholesterol (HDL-C) and triacylglycerol (TG). RESULTS: Six out of 13 studies were of sufficient quality. Two were excluded from the meta-analysis because the sterols were administered in the granulate form at very high dosages (12 g/day and 24 g/day) compared to the other studies that used fat spreads as vehicle with dosages ranging from 1.6-2.8 g/day. The subjects were heterozygous, aged 2-69 years with baseline TC and LDL-C concentrations of +/-7 mmol/L and +/-5.4 mmol/L, respectively. The duration of the studies ranged from 4 weeks to 3 months. Fat spreads enriched with 2.3 +/- 0.5 g phytosterols/stanols per day significantly reduced TC from 7 to 11% with a mean decrease of 0.65 mmol/L [95% CI -0.88, -0.42 mmol/L], p < 0.00001 and LDL-C from 10-15% with a mean decrease of 0.64 mmol/L [95% CI -0.86, -0.43 mmol/L], p < 0.00001 in 6.5 +/- 1.9 weeks compared to control treatment, without any adverse effects. TG and HDL-C concentrations were not affected. CONCLUSION: Phytosterols/stanols may offer an effective adjunct to the cholesterol lowering treatment strategy of FH patients.     

Clinical validation of an automatic device measuring blood pressure in the fingers.

BACKGROUND: To assess the agreement between a new automatic device (FS-20D) using a cuff-oscillometric method to measure arterial blood pressure (BP) in the fingers and a standard mercury sphygmomanometer. METHODS: The blood pressure measurements were taken in a sequential order, in a sample of both normotensive subjects (n. 57) and slight to moderate hypertensive patients (n. 28) without vascular complications. RESULTS: The mean sphygmomanometer-monitor difference was 0.52 +/- 4.57 mmHg for systolic and 0.25 +/- 4.41 mmHg for diastolic values; the agreement limits were: SBP -8.6 divided by 9.6 mmHg, 95% CI: -0.5 divided by 1.5; DBP: -8.6 divided by 9.1 mmHg, 95% CI: -0.7 divided by 1.2. The grade of agreement between the monitor and the sphygmomanometer was "A" (British Hypertension Society) for both systolic and diastolic values (difference of readings < 5 mmHg: 82%; < 10 mmHg: 97% for systolic blood pressure, 98% of diastolic blood pressure). CONCLUSIONS: The monitor was proved to be reliable with a good level of precision and accuracy. The FS-20D monitor may be used in self-monitoring of blood pressure of patients with slight to moderate hypertension.     

Differential effects of aging, drinking and exercise on serum cholesterol levels dependent on the PPARA-V227A polymorphism

Peroxisome proliferator-activated receptor alpha (PPARA alpha) plays a pivotal role in lipid metabolism. Our previous study reported that PPARA-V227A was a major polymorphism in Japanese, which was associated with markedly lower serum total cholesterol (TC) levels, which were significantly affected by alcohol drinking compared to subjects with the wild-type (PPARA-WT) allele. However, serum lipids are also associated with aging and exercise frequency. The objective of the present study was to evaluate the relationship between PPARA-V227A and these factors. Genetic analysis of the polymorphism was performed in 1058 Japanese men and 281 women, and the relationship with aging, drinking and exercise on serum lipids was analyzed in 989 men and 245 women after exclusion criteria had been applied. In men, drinking increased high-density lipoprotein cholesterol (HDL-C) levels in both PPARA-WT and A227 carriers, but to a significantly higher degree in the latter. In women, TC and low-density lipoprotein cholesterol (LDL-C) levels in the A227 carriers drinking at least once a week were significantly higher than in PPARA-WT carriers. TC and LDL-C levels in males with PPARA-WT increased with aging regardless of drinking habit, while LDL-C levels in the A227 drinking carriers were significantly lower in 45-yr-old or older subjects than in 35- to 45-yr-olds. In addition, no effect of exercising was observed in the A227 carriers, while increase in the HDL-C of the PPARA-WT carriers was exercise frequency dependent. These results suggest that the influence of drinking, aging or exercise on TC, LDL-C and HDL-C levels in the A227 carriers may be different from those in the PPARA-WT subjects.     

High-density lipoprotein cholesterol: Correlation with biochemical, anthropometric, behavioral, and clinical parameters in 6,500 Israeli men

Correlations of high-density lipoprotein cholesterol (HDL-C), expressed in either absolute or relative terms, with a series of coronary risk factors and other variables were examined in the Israeli Ischemic Heart Disease Study sample. The Quetelet overweight index showed the highest correlations with HDL-C (r = -0.21) as well as with HDL-C as a percentage of total cholesterol (TC) (HDL/TC; r = -0.28). Additional negative inverse associations were statistically different from zero but small. High-density lipoprotein cholesterol and HDL/TC were significantly reduced in cigarette smokers, and HDL/TC was significantly reduced in men with myocardial infarction or angina pectoris and (albeit marginally) in diabetes mellitus as well. The presence of these diseases correlated poorly with HDL-C (absolute values). The associations of HDL-C and HDL/TC with the Quetelet index persisted after adjustment for cigarette smoking and vice versa. Reported dietary intake failed to explain HDL-C or HDL/TC variability among individuals. The "net" relationship of HDL-C to several variables was examined in a multiple regression analysis. The Quetelet index accounted for 0.21 of a multiple correlation coefficient of 0.28 (i.e., a very small proportion of explained variability). This magnitude is of an order similar to multiple correlations found in our study for total cholesterol, systolic blood pressure, and serum uric acid. It indicates that our knowledge of the determinants of HDL-C in adults is insufficient. The possible roles of several anthropometric and behavioral variables in determining HDL-C levels are considered, as is the possible genetic factor in dictating interindividual HDL-C variability.