Effect of migration on blood pressure: the Yi People Study

The Yi People Study was conducted in Puge County, Sichuan Province, People's Republic of China. Four population groups were surveyed for risk factors for cardiovascular disease. Included were two groups of Yi farmers living either in a high mountainous area in extremely remote villages at or above 2,750 meters elevation, or in a mountainside area at about 1,800 meters elevation. A third study group consisted of Yi farmers who migrated to the county seat during the 1950s. Local residents of the county seat, the Han people, constituted the fourth group. Blood pressure rises very little with age after puberty in Yi farmers, but there was a trend of increasing blood pressure with age in Yi migrants and Han. Mean body mass index (kg/m2) and heart rate were higher in Yi migrants than in Yi farmers. For men, both systolic and diastolic blood pressure were greater among Yi migrants than among Yi farmers. These differences persisted after adjusting for age and body mass index. Among women, after adjusting for age, BMI, and altitude, only diastolic blood pressure was lower among Yi farmers than Yi migrants. Yi migrants and Han had similar blood pressures. In 1986, a sample of men participated in more detailed studies of diet, serum, and urine. The proportion of energy from fat ranged from less than 10% among high-mountain Yi farmers to almost 40% among Yi migrants and Han. Compared with Yi farmers, Yi migrants consumed more sodium and less potassium, calcium, and magnesium, had lower serum potassium, and a greater sodium/potassium ratio. Urinary excretion of sodium, calcium, and the sodium/potassium ratio were all greater in Yi migrants than in Yi farmers, while the reverse was seen for potassium. These data suggest that changes in life-style, including dietary changes, contribute importantly to the higher blood pressure among Yi migrants.     

四川省凉山彝族和汉族人群血压与胰岛素关系的研究

目的探讨不同民族人群血胰岛素与血压的关系，探讨是否胰岛素升高血压的作用存在民族差异。方法１９９６年１０～１２月，在凉山彝族自治州西昌市、布拖县和昭觉县的城镇和农村，整群抽样选择男性彝族农民、彝族移民和汉族居民作为研究对象，测量收缩压、舒张压、身高、体重和血胰岛素等指标。结果彝族农民的收缩压和舒张压水平显著低于彝族移民和汉族居民，彝族移民和汉族居民的收缩压和舒张压水平差异无显著性。彝族农民和彝族移民的血胰岛素水平差异无显著性，分别为９．０７８μＩＵ／ｍｌ和８．８９２μＩＵ／ｍｌ，但均显著高于汉族居民（６．５７７μＩＵ／ｍｌ）。多元回归分析结果表明，除彝族移民血胰岛素与收缩压呈弱相关外，各组人群血胰岛素与收缩压和舒张压均无显著性相关。结论进一步表明胰岛素与血压之间的联系尚不确定，提示血胰岛素影响血压的独立效应可能很小。     

Longitudinal analysis of the relationship between blood pressure and migration: the Tokelau Island Migrant Study

The Pacific atoll population of Tokelau has been followed since 1968 to assess the health consequences of migration to a western society. The blood pressure of a cohort of 532 adults who were still living in Tokelau in 1976 (nonmigrants) are compared with those of a cohort of 280 adults who had migrated to New Zealand (migrants). Significant differences between migrants and nonmigrants were detected in the rates of change of both systolic and diastolic pressures in men, and in the rates of change of diastolic pressures in women. The age-, body mass, and blood pressure-corrected rates of change were greater in migrants than in nonmigrants, and greater in men than in women. Blood pressures tend to rise 1 mmHg/year faster among male migrants than among male nonmigrants, and about 0.4 mmHg/year faster among female migrants than among female nonmigrants. These findings have clear implications for the health of migrants.     

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.     

Prevalence, awareness, treatment, and control of hypertension in Japanese rural communities]

BACKGROUND: In Japan, a national survey indicated that only 7% of hypertensive patients had a blood pressure less than 140/90 mmHg. There have been no reports of studies investigating all of the prevalence of hypertension, the percentage of subjects who are aware of hypertension, the percentage being treated, and the percentage that are well-controlled (awareness, treatment and control, respectively) among hypertensives in the Japanese general population. OBJECTIVE: To investigate the prevalence of hypertension, and awareness, treatment and control of hypertension among hypertensives in a Japanese rural population. DESIGN: A cross-sectional analysis of base-line data of the Jichi Medical School Cohort Study. SETTING: Twelve rural communities is 8 prefectures in Japan. PARTICIPANTS: Community-dwelling people who participated in the health examination program in 1992-1995. MAIN OUTCOME MEASURES: Blood pressure (BP) measured once in the sitting position after a 5-minute rest using oscillometric automatic BP monitors (BP203RV-II; Nippon Colin, Japan), and history of hypertension assessed using a self-administered questionnaire. RESULTS: We analyzed data from 11,302 subjects (4,415 men and 6,887 women). The mean (standard deviation) age was 55(12) years for men and 55(11) years for women. Mean systolic BP and diastolic BP levels were, respectively, 131(21) mmHg and 79(12) mmHg for men and 128(21) mmHg and 76(12) mmHg for women. Prevalence of hypertension (systolic BP > or = 140 mmHg or diastolic BP > or = 90 mmHg or on antihypertensive medication) was 37% for men and 33% for women. Percentages for awareness (on medication or present past history), treatment and control (both systolic BP < 140 mmHg and diastolic BP < 90 mmHg) were, respectively, 39%, 27% and 10% for men and 46%, 38% and 13% for women. CONCLUSIONS: About one third of the study popUlation were hypertensive, and awareness, treatment and control of hypertension among the hypertensives were 43%, 34% and 12%, respectively. Less than half of the hypertensives were well-controlled even when measurement bias was considered. In the rural Japanese population, improvements are required with regard to awareness, treatment and control of hypertension.     

Coronary heart disease risk factors in a random sample of Athenian adults. The Athens Study

Risk factors for cardiovascular diseases not previously investigated in Greece were studied in a random sample of 4,097 Athenian adults. Mean systolic and diastolic blood pressures increased with age in both sexes. Similar findings were observed for mean serum total cholesterol up to age 50 years, but no significant changes were observed in older persons. Smoking was more common for men than for women and less common in those aged more than 50 years. Mean values of body mass index were higher for men than for women in those less than 45 years, but the opposite was observed for the older age groups. The age-adjusted prevalence rate of borderline hypertension was 10.1% for men and 9.1% for women and of stable hypertension (greater than 160/95 mmHg), 8.1% and 8.6%, respectively; the age-adjusted prevalence rate of obesity was 23.5% for men and 23.2% for women and of hypercholesterolemia (total cholesterol greater than or equal to 260 mg/100 ml), 20.1% for men and 17.3% for women. The associations of age and systolic blood pressure and of age and diastolic blood pressure persisted even after controlling for body mass index, total cholesterol, and smoking. In the examined representative sample, the prevalence rates of risk factors for cardiovascular diseases are the same or greater than those in industrialized countries.     

四川凉山州彝族学生肱动脉血压长期变化趋势分析

目的了解四川省凉山彝族学生肱动脉血压变化趋势,为当地青少年高血压等慢性非传染性疾病的预防控制政策、策略和措施的制定提供可靠依据。方法课题采用体格检查的方法对当地彝族学生健康状况进行动态观察,通过分层随机抽样的方法收集调查样本,采用体格检查法获取肱动脉血压监测结果。结果 1985年、2010年和2015年凉山彝族男生肱动脉收缩压均值分别为101.66mmHg、106.38mmHg和102.20mmHg,女生为102.43mmHg、104.17mmHg和101.45mmHg;1985年、2010年和2015年凉山彝族男生肱动脉舒张压均值分别为66.56mmHg、68.71mmHg和67.88mmHg,女生为67.12mmHg、67.09mmHg和67.88mmHg。结论凉山彝族学生肱动脉血压均值逐年上升趋势明显,今后当地学生常见病防治工作应重视慢性非传染性疾病的早期预防。     

Trends in blood pressure and the prevalence and treatment of hypertension in young adults in the Netherlands, 1974–1986

To investigate trends in blood pressure and the prevalence and treatment of hypertension in the Netherlands between 1974 and 1986, data from two screening projects on cardiovascular risk factors were used. Between 1974 and 1980 about 30,000 men and women aged 37–43 were screened. Between 1981–1986 about 80,000 men aged 33–37 were examined. An increase in average systolic blood pressure by 2 mmHg in men in the period 1974–1980 was followed by an insignificant change during the period 1981–1986. Average diastolic blood pressure increased by 4 mmHg between 1974 and 1980 but decreased by the same amount between 1981 and 1986. The prevalence of hypertension in 40-year-old men increased from 12.7% in 1974 to 17.8% in 1980. The prevalence of hypertension in 35-year-old men did not change between 1981 and 1986 and amounted to 9.6%. Treatment of 40-year-old hypertensive men increased from 8% in 1974 to 21% in 1980 and from 9% in 1981 to 13% in 1986 among 35-year-old men. Average systolic blood pressure did not change in 40-year-old women between 1974–1980 but average diastolic blood pressure increased by 2 mmHg during that period. The percentage of hypertensive women was 8.5% and did not change between 1974 and 1980. Also, the percentage of treated hypertensive women did not change and amounted to 28%. It can be concluded that the prevalence of hypertension did not change in 40-year-old women while in 40-year-old men it increased between 1974–1980. In 35-year-old men the prevalence of hypertension did not change between 1981–1986. Treatment of hypertension was more common in young adult women than in young adult men. However, an increase in treatment of hypertension in young adult men was observed in both periods.     

Distribution of blood pressures in Gemlik District,north-west Turkey

The objectives of the present study were to evaluate the prevalence, awareness and control of hypertension among individuals over 30 years of age and to plan a follow-up programme for the same age group. A community-based sample of 1992 individuals (952 men and 1,040 women) was selected randomly. Out of the total study population, 1,388 (69.7%) individuals had normal blood pressure according to World Health Organisation criteria (systolic blood pressure < 140 mmHg and diastolic blood pressure < 90 mmHg), and the rest (n = 604, 30.3%) had hypertension to varying degrees. Since 61 individuals with normal blood pressure were using antihypertensive medication, the overall hypertension prevalence was 33.4%. Among the study subjects with hypertension, 44.4% were aware of their condition, 37.7% were using medication and 9.2% had controlled hypertension. One out of five individuals (n = 399, 20.0%) had never had their blood pressure measured before. Females had a higher hypertension prevalence than males (36.7% and 29.7%, respectively). Hypertension prevalence increased with age and individuals with a body mass index > 25 were at greater risk. The present findings suggest that there is a need to implement an effective, community-based and low-cost management programme.     

TRENDS IN CARDIOVASCULAR RISK FACTORS IN AUSTRALIA, 1966–1983: EVIDENCE FROM PREVALENCE SURVEYS

A review of published data from cardiovascular risk factor surveys among adults in Australia from 1966 to 1983 suggests that: — prevalence of cigarette smoking decreased significantly by up to 1.4 per cent per year among men but increased among younger women; — serum cholesterol mean levels decreased significantly by 0.03 - 0.04 mmol/1 per year among men and 0.04 - 0.07 mmol/1 per year among women; — systolic blood pressure mean levels decreased significantly by 0.05 - 0.3 mmHg per year among men and 0.2 - 0.6 mmHg per year among women; — diastolic blood pressure showed no significant or consistent changes among men but some decrease among women. During the same period death rates from ischaemic heart disease (IHD) declined by over 40 per cent. The changes in risk factor levels are estimated to account for about half of the decline in IHD mortality for men and about three quarters of the decline for women.     

Isolated systolic hypertension in 14 communities

In the Hypertension Detection and Follow-up Program, 158,906 individuals from 14 communities around the United States had their blood pressure measured in their homes in 1972-1973. Of the total population screened, 2.4% had isolated systolic hypertension (systolic blood pressure greater than or equal to 160 mmHg and diastolic blood pressure less than 90 mmHg). Isolated systolic hypertension was present for 0.5% of those aged 30-39 years and 6.8% among those aged 60-69 years. The prevalence in blacks and women was greater than the prevalences in both whites and men. The prevalence among those taking antihypertensive medications at the time of screening was 6.1%, and 1.9% among those not on antihypertensive medications. From the individuals with "normal" diastolic blood pressure on the single home measurement (less than 90 mmHg), a random sample of 5,032 individuals were followed for mortality for eight years. Prevalence of isolated systolic hypertension was similar in this sample to that in the total. Among those not on antihypertensive medications, 8-year life table all-cause mortality rates adjusted for age, race, and sex were 17.6% for those with systolic blood pressure greater than or equal to 160 mmHg and 7.7% for those with systolic blood pressure greater than 160 mmHg. Among this population, all of whom had a diastolic blood pressure less than 90 mmHg, a multiple logistic analysis adjusting for baseline treatment status, age, race, sex, education, smoking, weight, pulse, physical activity, and systolic blood pressure revealed that each millimeter increase in systolic blood pressure was associated with approximately a 1% increase in mortality over the eight years of follow-up (p less than 0.05). Isolated systolic hypertension is both relatively common and a significant risk factor for subsequent mortality.     

The prevalence and risk factors of hypertension in Klong Toey slum and Klong Toey government apartment houses

We have investigated the prevalence and factors associated with hypertension in 976 residents of Klong Toey Slum and 909 residents of government apartment houses, aged 30 and above, selected by probability sampling after systematic household surveys with an average response rate of over 80%. Hypertensives were those who had, on at least three measurements, average diastolic blood pressure equal to or above 95 mmHg and/or systolic blood pressure equal to or above 160 mmHg or had blood pressure below 160/95 mmHg but were currently on antihypertensive medication. The prevalence of total hypertensives were found to be 17.3% and 14.0% for residents of slum and government apartment houses respectively. Men and women had more or less equal mean blood pressure and similar prevalence of hypertension. The mean systolic blood pressure increased with age while the mean diastolic blood pressure, after an initial rise with age in lower age groups, tended to level off from the age group 55-64 years upwards. Only one quarter to one third were aware of their illness and less than 15% were receiving treatment. Significant risk factors include age, duration of smoking, duration of alcohol intake, high body mass index, high Cholesterol, high Triglyceride, high Low Density Lipoprotein Cholesterol (LDLC), low High Density Lipoprotein Cholesterol (HDLC), high Total Cholesterol (TC) to High Density Lipoprotein ratio (TC/HDLC), high LDLC to HDLC ratio and diabetes mellitus. The data suggested that hypertension was an important public health problem in low socioeconomic groups in Bangkok. Some of the risk factors were related to an unhealthy lifestyle which should receive due consideration in planning for appropriate control.     

Blutdruck in Deutschland 2008–2011

High blood pressure is one of the most important risk factors for cardiovascular diseases and chronic kidney disease. It is a main determinant of morbidity and mortality in Germany. In the German Health Interview and Examination Survey for Adults (DEGS1) the blood pressure of 7,096 adults aged 18–79 years was measured in a standardised way using oscillometric blood pressure devices (Datascope Accutorr Plus). The average of the second and third measurements was used for analysis. The mean systolic blood pressure was 120.8 mmHg in women and 127.4 mmHg in men, while the mean diastolic blood pressure was 71.2 mmHg in women and 75.3 mmHg in men. Blood pressure values were hypertensive (systolic blood pressure ≥?140 mmHg or diastolic blood pressure ≥?90 mmHg) in 12.7?% of women and in 18.1?% of men. Hypertension (defined as having hypertensive blood pressure or taking antihypertensive medication in known cases of hypertension) was present in 29.9?% of women and 33.3?% of men. Almost 75?% of the survey’s highest age group, 70–79, had hypertension. DEGS1 demonstrates that high blood pressure remains a highly prevalent risk factor in the population at large. The methodology employed in measuring blood pressure has been improved as compared to that of the German National Health Interview and Examination Survey 1998 (GNHIES98) and it will be possible to draw comparisons soon, once a procedure for calibrating the 1998 data has been finalised. An English full-text version of this article is available at SpringerLink as supplemental.     

Trends in hypertension prevalence and management in Southwestern France, 1985-1996

The changes occurring in Southwestern France between 1985 and 1996 in hypertension prevalence, awareness and control were assessed in 622 men and 626 women for 1985 and in 614 men and 569 women for 1996. In women, prevalence of hypertension (defined as systolic blood pressure 160 mmHg and/or diastolic blood pressure 95 mmHg and/or presence of antihypertensive treatment) was 19% and 19% (NS), awareness was 67% and 87% (P < 0.001), treatment was 85% and 87% (NS) and control was 44% and 68% (P < 0.01) in the first and the second surveys, respectively. In men, prevalence of hypertension was 28% and 21% (P < 0.01), awareness was 47% and 71% (P < 0.001), treatment was 81% and 80% (NS) and control was 41% and 58% (NS). After stratifying on survey, women received significantly more beta-blockers and significantly less calcium channel blockers and ACE inhibitors than men, but those differences became nonsignificant after adjusting for other cardiovascular risk factors. We conclude that in Southwestern France, screening and management of hypertension have improved significantly, but more than one-third of treated hypertensive subjects still lacks adequate control.     

四川彝族人群原发性高血压移民流行病学调查

目的比较四川省凉山彝族农民与移民原发性高血压患病率水平及其影响因素。方法2007-2008年对四川凉山地区(包括西昌市、金阳县、昭觉县、布拖县、喜德县、德阳县、宁南县)彝族人群进行问卷调查及血样生化检测,对原发性高血压可能危险因素进行多因素非条件Logistic回归分析。结果彝族农民原发性高血压患病率为3.19%,其中男性为4.73%,女性为1.92%。彝族移民原发性高血压患病率为15.10%,其中男性为17.74%,女性为10.83%。彝族农民和移民血压正常高值分别为12.53%(男性为16.05%,女性为9.68%)和25.93%(男性为32.65%,女性为16.52%)。年龄和糖尿病是彝族农民原发性高血压危险因素。年龄、超重或肥胖是彝族移民原发性高血压危险因素,而血压尿酸异常是其保护因素。结论彝族农民移居城镇后,生活环境发生变化,原发性高血压患病风险增加。     

我国成年人单纯性收缩期高血压患病率调查

目的评估我国成年人单纯性收缩期高血压的患病率及其人群分布。方法亚洲国际心血管病合作研究(InterASIA)于2000至2001年进行,应用多阶段抽样方法选择15540名35～74岁成年人为代表性样本,分析单纯性收缩期高血压和其他亚型高血压的患病率。应用标准问卷调查高血压病史及其治疗情况。血压值为休息5min后3次坐位血压测量值的平均值。未接受抗高血压治疗的个体通过以下标准确定高血压亚型单纯性收缩期高血压为收缩压≥140mmHg(1mmHg=0133kPa),舒张期血压<90mmHg;单纯性舒张期高血压为收缩压<140mmHg,舒张压≥90mmHg,而收缩期和舒张期联合性高血压为收缩压≥140mmHg,舒张压≥90mmHg。结果15540名35～74岁成年人样本中,76%(1181人)患有单纯性收缩期高血压,74%(1150人)患有收缩期和舒张期联合性高血压,而44%(683人)患有单纯性舒张期高血压。收缩期高血压的患病率随着年龄的增长而增加,且老年女性比老年男性更为常见。南方与北方地区的单纯性收缩期高血压患病率没有明显差异;农村单纯性收缩期高血压患病率高于城市。结论我国收缩期高血压患病率较高,应引起重视。     

Exposure to famine during gestation, size at birth, and blood pressure at age 59 y: evidence from the dutch famine

We compared blood pressure of individuals (mean age 59 y) born in western Holland between January 1945 and March 1946 (mothers exposed to the Dutch Famine before or during gestation; n = 359) to blood pressure of unexposed individuals born before or conceived after the famine (n = 299) or same-sex siblings of subjects in series 1 or 2 (n = 313). Mean (SD) systolic and diastolic blood pressure were 140.3 (20.3) and 85.8 (11.0) mmHg, respectively; prevalence of hypertension (prior diagnosis of hypertension or with measured systolic/diastolic blood pressure above 140/90 mmHg) was 61.8%. Birth weight was inversely related to systolic (−4.14 mmHg per kg; 95% confidence interval (CI) −7.24, −1.03; p < 0.01) and diastolic (−2.09 mmHg per kg; 95% CI −3.77, −0.41; p < 0.05) blood pressure and to the prevalence of hypertension (odds ratio 0.67 per kg, 95% CI: 0.49, 0.93) (all age- and sex-adjusted). Any famine exposure of at least 10 weeks duration was associated with elevated systolic (2.77 mmHg; 95% CI 0.25, 5.30; p < 0.05) and diastolic (1.27 mmHg; 95% CI −0.13, 2.66; p = 0.08) blood pressure and with hypertension prevalence (odds ratio 1.44; 95% CI 1.04, 2.00; p < 0.05) in age- and sex-adjusted models. Exposure to famine during gestation may predispose to the development of hypertension in middle age.     

Contributions of ovarian failure and aging to blood pressure in normotensive perimenopausal women: a mixed longitudinal study

Epidemiologic studies have shown that blood pressure increases more rapidly in middle-aged women than in middle-aged men. Whether or not ovarian failure contributes to this rapid rise is still not clear. In a follow-up study begun in 1979 and to continue for 10 years, the blood pressure of 193 healthy normotensive perimenopausal women, who lived in the mixed rural/industrial community of Ede, the Netherlands and who were initially aged between 49 and 56 years, was measured annually. During the course of the study, the onset of menopause of each participant could be established. Because of the mixed longitudinal design of the study, it was possible to evaluate the effects of both chronologic aging and time pre- or postmenopause on blood pressure. After the first seven years of follow-up, it was demonstrated that blood pressure did not increase in 168 women whose body weight was relatively stable. After multivariate analyses, systolic as well as diastolic pressure showed a significant negative relation (slope, 1.34 mmHg per year and 0.63 mmHg per year, respectively) with the years since menopause. On the other hand, the observed positive relation (slope, 0.81 mmHg per year) of systolic pressure with chronologic aging was not significant. No consistent association was found between diastolic pressure and chronologic aging. It is concluded that menopause cannot be regarded as a cause of hypertension; on the contrary, ovarian failure appears to have a protective effect on the increase in blood pressure as a result of chronologic aging. on the increase in blood pressure as a result of chronologic aging.