Alcohol consumption, %CDT, GGT and blood pressure change during alcohol treatment

AIMS: Blood pressure (BP) changes in alcohol-dependent individuals during a 12-week alcohol relapse prevention study were examined in light of drinking status and biomarkers of alcohol consumption [carbohydrate-deficient transferrin (%CDT) and gamma-glutamyl transpeptidase (GGT)]. METHODS: Of 160 randomized alcoholic individuals, 120 who had hypertension and in whom daily drinking data was available, at 6 and 12 weeks of treatment were included. The impact of alcohol consumption on change in systolic BP (SBP) and diastolic BP (DBP) was examined. Further analysis determined the relationship between BP and alcohol-use biomarkers. RESULTS: A significant effect of complete abstinence on both SBP (-10 mmHg; P = 0.003) and DBP (-7 mmHg; P = 0.001) when compared to any drinking (SBP and DBP = -1 mmHg) was observed. At week 12, participants with a positive %CDT (> or =2.6) had 7 mmHg greater SBP (P = 0.01) and DBP (P < 0.001) than those with negative %CDT. Participants with positive GGT (> or =50 IU) had 10 mmHg greater SBP (P = 0.12) and 9 mmHg greater DBP (P = 0.03) than those with negative GGT. The percent change in SBP was correlated with percent change in %CDT (P = 0.003) but not GGT (P = ns). The percent change in DBP was correlated with both percent change in %CDT (P < 0.0001) and GGT (P = 0.03). CONCLUSIONS: Abstinence from alcohol significantly decreased the BP and a positive relationship between BP and both alcohol-use biomarkers was illustrated. Since %CDT is more specific than GGT for heavy alcohol consumption, clinicians may monitor the role of alcohol in hypertension using %CDT as a supplemental aid, providing an objective assessment of drinking to influence BP treatment decisions.     

低钠富钾替代盐对农村社区人群血压影响的现场观察

目的 评价市售低钠富钾替代盐对农村社区居民血压的影响效果。方法采用流行病学类实验设计,在山东省莱芜市2个农村社区,经过血压筛查,将411名30～ 60岁的研究对象分为高血压组和非高血压组,两组均以家庭为单位给予3个月的低钠富钾替代盐替换普通食盐进行干预,定期观察血压及其24 h尿钠的变化。结果用低钠富钾替代盐干预1个月时高血压组和非高血压组人群血压开始呈下降趋势,3个月后评估时高血压组收缩压(SBP)平均下降7.4 mm Hg(1 mm Hg=0.133 kPa;t= 10.096,P=0.000),舒张压(DBP)下降3.8 mm Hg(t=8.017,P=0.000);非高血压组SBP平均下降1.2 mm Hg(t=2.507,P= 0.007),DBP下降1.0 mm Hg(t=2.987,P=0.002)。干预3个月后评估时高血压组24 h尿钠平均下降15.5 mmol(t= 1.803,P=0.037),尿钾上升4.2 mmol(t’=2.132,P=0.018),钠钾比下降1.2(t=2.786,P=0.003);非高血压组24 h尿钠平均下降1.7 mmol(t =0.211,P=0.417),尿钾上升3.7 mmol(t’=2.207,P=0.015),钠钾比值下降0.7(t= 1.818,P=0.036)。结论低钠富钾替代盐能有效降低人群血压水平,且人群依从性较好,是一种有效的非药物预防控制高血压方法。     

Prevalence of actions to control high blood pressure--20 states, 2005

High blood pressure (HBP) increases the risk for heart disease and stroke, the first and third leading causes of death in the United States, respectively. The association between HBP and cardiovascular disease is independent of other risk factors. Nearly 30% of the U.S. adult population had HBP during 2001-2004, according to the National Health and Nutrition Examination Survey (NHANES), and the prevalence has increased compared with 1988-1994 NHANES data. Although HBP is easily detectable and can be controlled with treatment, the condition is not controlled (i.e., systolic blood pressure <140 mm Hg and diastolic pressure <90 mm Hg) in approximately 70% of persons. A Healthy People 2010 objective (objective 12-11) is to increase the proportion of adults with HBP who are taking action to help control their blood pressure. To assess the prevalence of self-reported HBP and actions to control HBP, CDC analyzed 2005 data from an optional module in the Behavioral Risk Factor Surveillance System (BRFSS) in the 20 states that participated. The results indicated that although nearly all adults with HBP in the 20 states were taking some action to control their blood pressure, some persons can take additional actions to control their HBP, if indicated, including dietary changes, exercise, and taking prescribed medication.     

Association Between Late-Life Blood Pressure and the Incidence of Cognitive Impairment: A Community-Based Prospective Cohort Study

Objectives

To investigate the association between late-life blood pressure and the incidence of cognitive impairment in older adults.

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.     

Ethnic differences in blood pressure level between Japanese school children in Bolivia and native Bolivians

Blood pressure levels were measured in 626 children (138 Japanese, 477 Bolivian and 11 of mixed blood) in a Japanese agricultural settlement in Bolivia. Systolic (SBP) and diastolic (DBP) blood pressure was higher in Japanese children than in Bolivian children at each measured age by 4.09 mmHg (P = 0.0001) and 2.25 mmHg (P = 0.0038), respectively, using analysis of covariance. Although the slope of the regression line both for SBP and for DBP with age tended to be greater in Japanese, this was not statistically significant. There were no ethnic differences in height, weight or body mass index, however, which are usually indicators that correlate well with blood pressure. Ethnic differences in blood pressure were also shown at each of the measured values of height (SBP: 3.93, DBP: 2.19) and weight (SBP: 4.03, DBP: 2.23). Factors causing these ethnic differences are discussed in relation to cultural and genetic considerations.     

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.     

儿童期血压偏高对成年期高血压的影响研究

目的 本研究旨在探讨儿童期血压偏高对成年期高血压的影响,为成人高血压的早期防控提供科学依据。方法 基于“中国居民健康与营养调查”资料(1991-2011年),纳入儿童期(6~17岁)和成年期(18~38岁)均进行至少1次随访的研究对象。儿童期血压偏高前期定义采用中国儿童青少年血压参考值性别和年龄的第90百分位(P₉₀)至第95百分位(P₉₅),儿童期血压偏高采用≥P₉₅。成年期高血压前期为收缩压/舒张压≥120/80 mmHg且<140/90 mmHg;成年期高血压为收缩压/舒张压≥140/90 mmHg,或有高血压史,或目前正服用降压药物。采用协方差分析和Cox比例风险回归模型分析儿童期血压偏高对成年期高血压前期和高血压的影响,控制混杂因素包括儿童期性别和年龄,成年期的体重指数(BMI)、吸烟和饮酒。结果 本研究共纳入1 984名数据完整的研究对象,中位随访时间为11.7年。基线儿童期共有108人(5.4%)为血压偏高前期,199人(10.0%)为血压偏高。随访成年期共有697人(35.1%)为高血压前期,104人(5.2%)为高血压。协方差分析表明,成年期收缩压和舒张压水平均随着儿童期血压百分位的增加而增加(P_趋势<0.001)。多因素Cox回归分析显示,儿童期血压偏高者成年后为高血压前期的风险增加(HR=1.41,95%CI:1.12~1.77)。儿童期血压偏高者成年后为高血压的风险显著增加(HR=1.73,95%CI:1.01~2.98)。结论 儿童期血压偏高会增加成年期罹患高血压的风险。应该重视儿童青少年血压监测,对血压偏高的高危儿童应及时采取干预措施。     

Interrelations among smoking habits, casual blood pressure and intraocular pressure in middle and old-aged Japanese residents

Objectives To investigate the association of smoking habits with blood pressure (BP) and intraocular pressure (IOP), and to examine whether the smoking-BP association is related to the IOP level. Methods This study was conducted on the basis of a cross-sectional design using annual health check-up data during one-year between August, 1999 and August, 2000 for 611 middle and old-aged Japanese residents living in Ibaraki prefecture, Japan. Results After adjustment for age, gender, body mass index and alcohol intake score, the proportion of hypertensives, and the mean systolic and diastolic blood pressure (SBP and DBP) of the subjects without antihypertensive medications were the highest (50.4%, 129.6 mmHg and 75.9 mmHg, respectively) in the “smokers of 25 or more cigarettes per day with intraocular pressure (IOP)≥15 mmHg” of six subgroups crossed by three smoking categories (non-smokers, 1 to 24 cigarettes per day, and 25 or more cigarettes per day) and two IOP categories (less than 15 mmHg, and 15mmHg or greater). On the other hand, the adjusted proportion of hypertensives, and the adjusted mean SBP and DBP decreased with increasing smoking category in the individuals with less than 15 mmHg of the IOP (p for trend=0.028 for proportion of hypertensives 0.008 for the SBP, and 0.001 for the DBP, respectively). Conclusions Heavy smoking may be specifically related to ‘high BP accompanied by high IOP’, although the BP may be inversely associated with smoking under the condition without high IOP.     

A prospective study of blood pressure and risk of cataract in men

PURPOSE: Cataract is the leading cause of blindness worldwide. Blood pressure has been identified as a risk factor in some, but not all, previous studies. We aimed to test prospectively the hypothesis that high blood pressure increases risk of age-related cataract. METHODS: Participants in the Physicians' Health Study of 22,071 men aged 40 to 84 years in 1982 completed annual questionnaires that provided medical history including self-reported blood pressure, treatment for hypertension, and cataract. Over 12 years, 1392 cataracts were confirmed by medical record review among 17,762 physicians with complete data and no reported cataract at baseline. We used proportional hazards regression models to examine relations of systolic blood pressure (SBP), diastolic blood pressure (DBP), hypertension, as well as antihypertensive medications with cataract, after control for potential confounding factors. RESULTS: In models adjusting for age and randomized treatment assignment, there was a significant relationship of SBP, but not DBP, hypertension, or antihypertensive medications (each p > or = 0.23) with incident cataract. Estimates were attenuated after adjusting for multiple potential confounders, although the relationship of SBP with incident cataract remained significant. The multivariate adjusted rate ratio (95% confidence interval) of cataract for SBP > or = 150 versus < 120 mm Hg was 1.31 (1.04-1.66), p for trend = 0.04. For DBP > or = 90 versus < 70 mm Hg, the estimate was 1.11 (0.84-1.45), p for trend = 0.33.CONCLUSIONS: Overall, these data suggest that the relationship of blood pressure with cataract is not strong, and is subject to confounding by other risk factors. The modest magnitude of the association with SBP and lack of significant relationships with DBP and hypertension may suggest a non-causal relationship of blood pressure with cataract.     

Birth cohort evidence of population influences on blood pressure in the United States, 1887-1994

PURPOSE: Mean blood pressure (BP) has declined in the U.S. for several decades. It is unknown to what extent this decline was due to treatment of persons with recognized high BP or to population-wide influences on BP. Treatment would shift only the highest values lower, whereas, population-wide influences on BP would shift the entire distribution downward. METHODS: We examined changes in the distributions of systolic and diastolic BP (SBP, DBP) across birth cohorts born between 1887 and 1975 in 52,646 individuals examined in the National Health (and Nutrition) Examination Surveys between 1960 and 1994. The BP distributions were estimated as functions of age and birth-year to examine changes between birth cohorts. We postulated that the age-adjusted 10th, 50th and 90th percentiles of SBP and DBP had decreased in more recent versus earlier birth cohorts. RESULTS: The series of birth cohorts exhibited successively lower SBP and DBP at low, middle and high percentiles. In general, the 10th percentile of SBP decreased approximately 1.19 mmHg per decade of birth-year, whereas the 50th percentile decreased 2.40 mmHg per decade, and the 90th percentile decreased 4.62 mmHg per decade. A similar pattern of results was seen for DBP. CONCLUSIONS: The entire distribution of both SBP and DBP shifted downward. The downward shifts at the 50th percentile and below unequivocally demonstrate a strong prevention effect in the U.S. population during the period 1887 through 1975. This epidemiologic analysis indicates that population-wide influences can alter favorably the distribution of BP throughout the whole population.     

Oat consumption does not affect resting casual and ambulatory 24-h arterial blood pressure in men with high-normal blood pressure to stage I hypertension

The results of epidemiologic studies suggest that increased intake of dietary fiber is associated with lower levels of arterial blood pressure (BP). However, there is little information available addressing the possibility that increased oat consumption may reduce arterial BP in individuals with elevated arterial BP. To test this hypothesis, middle-aged and older men (n = 36; body mass index, 25-35 kg/m(2); aged 50-75 y) with elevated BP (systolic BP 130-159 mmHg and/or diastolic BP 85-99 mmHg) were randomly assigned to consume an additional 14 g/d of dietary fiber in the form of oat (5.5 g beta-glucan, n = 18) or wheat cereals (no beta-glucan, n = 18) for 12 wk. Casual resting arterial BP was measured at baseline and after 4, 8 and 12 wk of intervention. The 24-h ambulatory arterial BP was measured at baseline and after 12 wk of intervention. There were no differences in casual resting or 24-h ambulatory BP at baseline in the two groups. Casual systolic BP (SBP) did not change as a result of the 12-wk intervention in the oat (138 plus minus 2 vs. 135 plus minus 3 mmHg) or wheat (142 plus minus 2 vs. 140 plus minus 3 mmHg) groups, respectively (all P > 0.05). Casual diastolic BP (DBP) also did not change in the oat (89 plus minus 2 vs. 88 plus minus 2 mmHg) or wheat (90 plus minus 2 vs. 91 plus minus 2 mmHg) group during this period (all P > 0.05). Further, 24-h, daytime and nighttime SBP and DBP did not decrease with the intervention. Therefore, the results of the present study suggest that any cardioprotective benefit of regular oat consumption may not be conferred via an arterial BP-lowering effect.     

Assessing cardiovascular reactivity in working women with the social competence interview

The Social Competence Interview (SCI), an interview to induce cardiovascular reactivity through recounting a stressful life experience, was used with a sample of 120 working women employed as childcare providers. Women recounted their most stressful work factor while cardiovascular reactions were monitored at 2-minute intervals (data points included 4 baseline, 6 SCI, and 3 recovery). Increases were found when comparing mean baseline and SCI measures: systolic blood pressure (SBP) increased 10.00 mmHg; diastolic blood pressure (DBP)increased 10.63 mmHg; and heart rate increased 4.57 beats per minute. Consistent with the literature SBP and DBP were higher for some subgroups of women (those who were 50 years or older, were obese, or had 4 or more risk factors) across all data points. There were no time by individual difference interactions, indicating that the patterns of change over time were the same across groups. In a logistic regression, comparing women who reached SBP > or = 140 mmHg and/or DBP > or = 90 mmHg during the SCI versus those who did not, higher BP was associated with being older and obese, having a higher level of acceptance coping, and a lower level of suppression of competing activities coping.     

Relation of mass screening blood pressure to usual 24-hour working day blood pressure variation and left ventricular hypertrophy]

Fifty-three regularly employed hypertensive men (HT group) aged 38 to 68 years, whose blood pressure measured at a health evaluation clinic was systolic blood pressure (SBP) greater than or equal to 160 mmHg and/or diastolic pressure (DBP) greater than or equal to 95, and 21 age-matched normal controls (NC group), whose SBP was less than 140 and DBP was less than 90 had their blood pressure monitored over 24 hours during a usual working day. Age and clinical pressure were 53.1 +/- 7.1 years (mean +/- SD) and 147 +/- 18/97 +/- 10 mmHg (SBP/DBP) in the HT group, and 52.7 +/- 8.9 and 117 +/- 8/78 +/- 7 in the NC group. In the HT group, blood pressure during work (146/96 mmHg) was similar to clinical blood pressure, while blood pressure at home (135/89 mmHg) was considerably lower than clinic measured values. In contrast, blood pressure variabilities in the NC group during non-sleep hours were less, and clinical measurement was lower than that at home (122/80 mmHg), and during work (126/82 mmHg). For those examined by echocardiogram (46 in HT and 21 in NC), end-diastolic left ventricular wall thickness (LVT), and left ventricular mass index (LVMI) correlated most strongly with pressure during work by partial correlation analysis with age as a covariant (LVT:: SBP: r = 0.47, DBP: r = 0.53 both p less than 0.001, and LVMI:: SBP: r = 0.29, DBP: r = 0.25 both p less than 0.25). Clinical blood pressure as well as blood pressure at home and during sleep correlated significantly with LVT. These findings suggest that the blood pressure measurements obtained at a mass screening clinic, although infrequent, have important implications in relation to cardiac organ damage and for providing an estimate of blood pressure during work for hypertensives.     

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.     

Low job control is associated with higher diastolic blood pressure in men with mildly elevated blood pressure: the Rosai Karoshi study

Job strain is a risk factor for hypertension, but it is not fully understood if components of job strain, or job demand or job control per se could be related to blood pressure (BP), and if so, whether the relationship differs between normotension and mildly elevated BP. We examined resting BP, and job stress components in 113 Japanese male hospital clerks (38.1 ± 4.4 yr). Subjects were classified into normotensive (NT) (<130/85 mmHg, n=83) and mildly elevated BP (ME) (≥130/85 mmHg) groups. Diastolic BP (DBP) showed a significant interaction between group and job control level (p=0.013). Subjects with low job control demonstrated higher DBP than those with high job control (89.1 ± 2.1 vs. 82.3 ± 2.3 mmHg, p=0.042) in ME group even after adjustments for covariates while DBP did not differ between low and high job control subjects in NT group. Systolic BP (SBP) did not differ between high and low job control subjects in both groups. Neither SBP nor DBP differed between high and low demand groups in either group. Among job strain components, job control may be independently related to BP in Japanese male workers with mildly elevated BP.     

Racial/ethnic disparities in prevalence, treatment, and control of hypertension--United States, 1999-2002

High blood pressure (HBP) is a major risk factor for heart disease and stroke, end-stage renal disease, and peripheral vascular disease and is a chief contributor to adult disability. Approximately one in four adults in the United States has hypertension. Although effective therapy has been available for more than 50 years, most persons with hypertension do not have their blood pressure (BP) under control. National health objectives for 2010 include reducing the proportion of adults with HBP to 16% (baseline: 28%), increasing the proportion of adults with hypertension who are taking action to control it to 95% (baseline: 82%), and increasing the proportion of adults with controlled BP to 50% (baseline: 18%). During 1990-2000, the prevalence of hypertension, the percentage of those with hypertension who were aware of their condition, and treatment and control of hypertension increased among non-Hispanic whites, non-Hispanic blacks, and Hispanics. CDC analyzed data from the National Health and Nutrition Examination Surveys (NHANES) for 1999-2002. This report summarizes the results of that analysis, which determined that racial/ethnic disparities in awareness of, treatment for, and control of hypertension persist. If national health objectives are to be met, public health efforts must continue to focus on the prevention of HBP and must improve awareness, treatment, and control of hypertension among minority populations.     

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.     

Trimester-specific blood pressure levels in relation to maternal pre-pregnancy body mass index

We evaluated the influence of maternal pre-pregnancy body mass index (BMI), based on reported pre-pregnancy weight and height, on blood pressure (BP) levels during pregnancy by using information from a prospective cohort of 1733 women recruited before 20 weeks' gestation. Maternal antenatal BP values were abstracted from medical records, and we evaluated the mean BP differences according to BMI group in regression models, using generalised estimating equations to account for repeated BP records within each pregnancy. In each trimester, mean systolic BP (SBP) and diastolic BP (DBP) values were positively associated with maternal pre-gestational BMI. This association persisted after adjustment for maternal age, parity, smoking, education, marital status and physical activity. Overweight women (25-29 kg/m(2)) had first-, second- and third-trimester mean SBPs that were 8.1, 7.7 and 8.2 mmHg, respectively, higher than values observed in lean women (<20 kg/m(2)). Mean DBP values were 4.5, 5.4 and 5.6 mmHg higher for each successive trimester in overweight vs. lean women. Obese (>30 kg/m(2)) women consistently had the highest mean SBP and DBP values. Trimester-specific mean SBP values were 10.7-12.0 mmHg higher among obese women vs. lean women. Corresponding trimester-specific mean DBP values were 6.9-7.4 mmHg higher in obese vs. lean women. Similar patterns were observed when trimester-specific average mean arterial pressures were evaluated. Elevated pregnancy BPs associated with maternal pre-gestational BMI are consistent with a large body of literature that documents increased pre-eclampsia risk among overweight and obese women.     

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.