Associations between environmental exposure and blood pressure among participants in the Oslo Health Study (HUBRO)

Background It is well known that environmental conditions are related to the risk of developing cardiovascular diseases and events. However, the mechanisms behind these relations are␣not well understood. One mechanism could be elevation of blood pressure. In this study we assessed associations between blood pressure and environmental conditions among citizens in Oslo, Norway.Materials and methods We used the Oslo Health Study (HUBRO), a population based study of 18,770 Oslo citizens, to assess associations between blood pressure and environmental conditions including season, smoking, outdoor temperature and air pollution.Results Blood pressure was higher in the winter season, but the association disappeared when we adjusted for temperature. A 10 °C reduction in outdoor temperature, the day blood pressure was measured was related to an increase in blood pressure for both men [SBP: 1.5 mmHg (95% CI, 0.6–2.3); DBP: 1.3 mmHg (95% CI, 0.1–1.8)] and women [SBP: 2.4 mmHg (95% CI, 1.6–3.2); DBP: 1.8 mmHg (95% CI, 1.3–2.3)]. No convincing relation was found between indicators of air pollution exposure and blood pressure.Conclusion Several environmental conditions were related to blood pressure, and have similar associations with cardiovascular diseases or mortality. This could indicate that some of the effect these exposures have on the cardiovascular system is by increasing blood pressure.     

Smoking habits and risk of fatal stroke: 18 years follow up of the Oslo Study.

STUDY OBJECTIVE: To examine the risk of fatal stroke in relation to smoking habits in men screened for the Oslo study. DESIGN: The Oslo study is a prospective, cohort study of the epidemiology and preventive aspects of cardiovascular diseases in middle aged men. Screening started in May 1972 and results after 18 years of follow up are reported. PARTICIPANTS: There were 16209 men aged 40-49 years, of whom 16173 had no stroke history. Eighty five men died from stroke, of whom 48 were daily cigarettes smokers, 7 were pipe and cigar smokers, 15 smoked cigarettes and pipe or cigars daily, 11 were previous cigarette smokers, and 4 had never smoked cigarettes. MAIN RESULTS: Results of proportional hazards regression analysis adjusted for age, diastolic blood pressure, and glucose concentration showed the following rate ratios (RR) (95% confidence interval) of smoking groups compared with those who had never smoked or had previously smoked: combined cigarette and cigar or pipe smokers, RR = 6.1 (3.0, 12.5); cigarettes only, RR = 4.1 (2.3,7.4); and pipe and/or cigars only RR = 2.2 (0.9,5.5). The overall, age adjusted risk of smoking cigarettes daily was 3.5 and was found to increase with increasing cigarette consumption. Regardless of their smoking group, stroke cases had increased diastolic (DBP) and systolic blood pressure (SBP) when compared with men who had not had a stroke. The absolute differences in DBP and SBP between stroke cases and others for never and previous cigarette smokers versus daily smokers were twice as large: DBP, 12.1 mmHg versus 6.5 mmHg respectively and SBP, 16.0 mmHg versus 7.1 mmHg respectively. A high BMI increased the risk of fatal stroke of never and previous cigarette smokers. Men being treated for hypertension at the time of screening had three times the crude risk of fatal stroke of men who were not taking hypertensive treatment. CONCLUSIONS: Daily cigarette smoking increased the risk of fatal stroke three and a half times. Combined cigarette and pipe or cigar smoking had a higher risk than smoking cigarettes only. An increased risk was found in relation to increased daily cigarette consumption.     

Birthweight, childhood growth, and blood pressure at 43 years in a British birth cohort

BACKGROUND: Low birthweight is associated with high blood pressure in later life, but it is unclear whether the association is confounded with or modified by maternal and socioeconomic factors or childhood growth. METHODS: A total of 3157 men and women from a British birth cohort study where the survey members have been followed up regularly since their birth in 1946 were included in analyses. The associations between birthweight, childhood growth and blood pressure at 43 years of age were assessed using multiple regression models. RESULTS: Systolic blood pressure (SBP) decreased by 2.3 mmHg (95% CI: 0.8, 3.5) for men and 1.8 mmHg (95% CI: 0.1, 3.5) for women per 1-kg increase in birthweight. The effect was stronger in first born or those born to younger mothers. There was no confounding with any maternal, socioeconomic, or childhood growth variable. SBP increased by 1.45 mmHg (95% CI: 0.11, 2.78) in women and 0.46 mmHg (95% CI: -0.70, 1.62) in men per standard deviation of body mass index (BMI) change between ages 7 and 15 years. Among women this effect was not completely accounted for by adult size and was independent of birthweight. CONCLUSIONS: The determinants of birthweight, possibly related to maternal health during pregnancy, may impact on the relationship with SBP in middle life. The importance of tackling the increasing levels of childhood obesity seen in later cohorts is highlighted by the detrimental impact on SBP of large increases in BMI during adolescence.     

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.     

The Significance of Duration and Amount of Sodium Reduction Intervention in Normotensive and Hypertensive Individuals: A Meta-Analysis

The purpose of this meta-analysis was to establish the time for achievement of maximal blood pressure (BP) efficacy of a sodium reduction (SR) intervention and the relation between the amount of SR and the BP response in individuals with hypertension and normal BP. Relevant studies were retrieved from a pool of 167 randomized controlled trials (RCTs) published in the period 1973–2010 and integrated in meta-analyses. Fifteen relevant RCTs were included in the maximal efficacy analysis. After initiation of sodium reduction (range: 55–118 mmol/d), there were no significant differences in systolic blood pressure (SBP) or diastolic blood pressure (DBP) between measurements at weeks 1 and 2 (∆SBP: −0.18 mmHg/∆DBP: 0.12 mmHg), weeks 1 and 4 (∆SBP: −0.50 mmHg/∆DBP: 0.35 mmHg), weeks 2 and 4 (∆SBP: −0.20 mmHg/∆DBP: −0.10 mmHg), weeks 2 and 6 (∆SBP: −0.50 mmHg/∆DBP: −0.42 mmHg), and weeks 4 and 6 (∆SBP: 0.39 mmHg/∆DBP: −0.22 mmHg). Eight relevant RCTs were included in the dose-response analysis, which showed that within the established usual range of sodium intake [<248 mmol/d (5700 mg/d)], there was no relation between the amount of SR (range: 136–188 mmol) and BP outcome in normotensive populations [∆SBP: 0.99 mm Hg (95% CI: 2.12, 4.10), P = 0.53; ∆DBP: −0.49 mm Hg (95% CI: −4.0, 3.03), P = 0.79]. In contrast, prehypertensive and hypertensive populations showed a significant dose-response relation (range of sodium reduction: 77–140 mmol/d) [∆SBP: 6.87 mmHg (95% CI: 5.61, 8.12, P < 0.00001); ∆DBP: 3.61 mmHg (95% CI: 2.83, 4.39, P < 0.00001)]. Consequently, the importance of kinetic and dynamic properties of sodium reduction, as well as baseline BP, should probably be considered when establishing a policy of sodium reduction.     

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.

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.     

Pet ownership and blood pressure in old age

BACKGROUND: It has been proposed that pet ownership improves cardiovascular health. This study examines the relation of pet ownership with systolic and diastolic blood pressure, pulse pressure, mean arterial pressure, and hypertension in a large sample of older men and women. METHODS: Participants were 1179 community-dwelling men (n = 498) and women (n = 681) age 50-95 years. Participants responded to a 1991-1992 mailed questionnaire ascertaining pet ownership, and they attended a 1992-1996 clinic visit at which systolic (SBP) and diastolic (DBP) blood pressures were measured and use of antihypertensive medication was validated. Pulse pressure was calculated as SBP minus DBP. Mean arterial pressure was calculated as (SBP+DBP)/2. Body mass index, waist-hip ratio, and information on other potential confounders were obtained. RESULTS: Average age of participants was 70.4 +/- 10.8 years; 30.0% reported current pet ownership. Mean SBP was 137.5 +/- 21.4 mm Hg, and DBP was 76.1 +/- 9.3 mm Hg; 55.6% were hypertensive (SBP >or= 140, DBP >or= 90 or taking hypertension medication). Pet owners were younger and slightly more overweight and they exercised less than nonowners; owners were somewhat more likely to have diabetes and to use beta-blockers. In unadjusted analyses, pet owners had lower SBP, pulse pressure, and mean arterial pressure, and a reduced risk of hypertension (odds ratio = 0.62; 95% confidence interval = 0.49-0.80). However, after adjustment for age and other confounders, pet ownership was not associated with systolic or diastolic blood pressure, pulse pressure, mean arterial pressure or risk of hypertension. CONCLUSIONS: Results suggest that pet ownership is not independently associated with blood pressure, vascular reactivity, or hypertension.     

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.     

Associations between recent exposure to ambient fine particulate matter and blood pressure in the Multi-ethnic Study of Atherosclerosis (MESA)

BACKGROUND: Blood pressure (BP) may be implicated in associations observed between ambient particulate matter and cardiovascular morbidity and mortality. This study examined cross-sectional associations between short-term ambient fine particles (particulate matter 相似文献   

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.     

用动态血压监测老年高血压病心血管事件的危险性初探

目的研究动态血压监测(ABPM)对老年高血压病发生心血管事件危险性的预测价值。方法分析68例老年高血压病ABPM各项指标,与老年对照组比较。分析老年高血压组发生心血管事件的ABPM相关预测指标。结果老年高血压24h收缩压(包括日间及夜间)均升高,24h平均压也升高,而舒张压则多数不高。24h收缩压负荷值为(43.2±16.9)mmHg,正常老年组为(15.6±14.5)mmHg,p<0.05,老年高血压组非勺型40人,占59%。老年高血压组24h平均脉压(mPP)为(68.8±9.3)mmHg,正常老年人组为(42.2±9.5)mmHg,t=2.08,p<0.05。以mPP60mmHg为界,老年高血压组大于此值者,冠心病23例占58.9%,其中心血管事件共17例占43.6%,而mPP低于此值者发生冠心病9例,占31%,心血管事件仅6例,占20.6%。二者心血管事件总的发生率比较2>1.98,p<0.05。结论老年高血压患者ABPM出现平均脉压增大,非勺型、超勺型血压、负荷血压增大等指标时,预示着心血管事件发生的危险性增加,要加强对这些指标的干预,以减少心血管事件危险性的发生。     

Tracking of cardiovascular risk factors and a cohort study on hyperlipidemia in rural schoolchildren in Japan

A cohort study was conducted to explore the tracking stability of cardiovascular risk factors and relative risk (RR) of factors relating hyperlipidemia in children. The percentages of children remaining persistently at high risk over a four-year tracking were as follows: body mass index (BMI) 65.0%, total cholesterol (T-c) 60.6%, atherogenic index (AI) 56.4%, high density lipoprotein cholesterol (HDL-c) 50.7%, systolic blood pressure (SBP) 44.2% and diastolic blood pressure (DPB) 39.6%. The order of correlation coefficients over four years was BMI > AI > HDL-c > T-c > SBP > DBP and these coefficients in boys were slightly higher than those in girls. The relative risk (RR) of BMI for AI > or = 3 was elevated (RR=4.36, 95% CI: 1.3-14.1). The incidence and RR for AI > or = 3 increased along with the addition of the selected risk factor number. The RR in children with three selected risk factors rose to 8.39 ( 95% CI: 1.2-38.7 ). The stability of tracking was better for BMI, T-c, AI and HDL-c. As the number of multiple factors increased, so did the RR of higher AI in childhood. These results suggest that preventive activities for hyperlipidemia should be focused on children with multiple cardiovascular risk factors.     

Indoor air pollution and blood pressure in adult women living in rural China

Background: Almost half of the world’s population uses coal and biomass fuels for domestic energy. Limited evidence suggests that exposure to air pollutants from indoor biomass combustion may be associated with elevated blood pressure (BP).Objective: Our aim was to assess the relationship between air pollution exposure from indoor biomass combustion and BP in women in rural China.Methods: We measured 24-hr personal integrated gravimetric exposure to fine particles < 2.5 µm in aerodynamic diameter (PM_2.5) and systolic BP (SBP) and diastolic BP (DBP) in the winter and summer among 280 women ≥ 25 years of age living in rural households using biomass fuels in Yunnan, China. We investigated the association between PM_2.5 exposure and SBP and DBP using mixed-effects models with random intercepts to account for correlation among repeated measures.Results: Personal average 24-hr exposure to PM_2.5 ranged from 22 to 634 µg/m³ in winter and from 9 to 492 µg/m³ in summer. A 1-log-µg/m³ increase in PM_2.5 exposure was associated with 2.2 mm Hg higher SBP [95% confidence interval (CI), 0.8 to 3.7; p = 0.003] and 0.5 mm Hg higher DBP (95% CI, –0.4 to 1.3; p = 0.31) among all women; estimated effects varied by age group. Among women > 50 years of age, a 1-log-µg/m³ increase in PM_2.5 exposure was associated with 4.1 mm Hg higher SBP (95% CI, 1.5 to 6.6; p = 0.002) and 1.8 mm Hg higher DBP (95% CI, 0.4 to 3.2; p = 0.01). PM_2.5 exposure was positively associated with SBP among younger women, but the association was not statistically significant.Conclusion: PM_2.5 exposure from biomass combustion may be a risk factor for elevated BP and hence for cardiovascular events. Our findings should be corroborated in longitudinal studies.     

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.     

Resting heart rate is a risk factor for cardiovascular and noncardiovascular mortality: the Chicago Heart Association Detection Project in Industry

In a prospective cohort study, associations of resting heart rate with risk of coronary, cardiovascular disease, cancer, and all-cause mortality in age-specific cohorts of black and white men and women were examined over 22 years of follow-up. Participants were employees from 84 companies and organizations in the Chicago, Illinois, area who volunteered for a screening examination. Participants included 9,706 men aged 18-39 years, 7,760 men aged 40-59 years, 1,321 men aged 60-74 years, 6,928 women aged 18-39 years, 6,915 women aged 40-59 years, and 1,151 women aged 60-74 years at the baseline examination in 1967-1973. Vital status was ascertained through 1992. For fatal coronary disease, multivariate-adjusted relative risks associated with a 12 beats per minute higher heart rate (one standard deviation) were as follows: for men aged 18-39 years, relative risk (RR) = 1.27 (95% confidence interval (CI) 1.08-1.48); for men aged 40-59 years, RR = 1.13 (95% CI 1.05-1.21); for men aged 60-74 years, RR = 1.00 (95% CI 0.89-1.12); for women aged 40-59 years, RR = 1.21 (95% CI 1.07-1.36); and for women aged 60-74 years, RR = 1.16 (95% CI 0.99-1.37). Corresponding risks for all fatal cardiovascular diseases were similar to those for coronary death alone. Deaths from cancer were significantly associated with heart rate in men and women aged 40-59 years. All-cause mortality was associated with higher heart rate in men aged 18-39 years (RR = 1.11, 95% CI 1.01-1.20), men aged 40-59 years (RR = 1.16, 95% CI 1.11-1.21), and women aged 40-59 years (RR = 1.20, 95% CI 1.13-1.27). Heart rate was not associated with mortality in women aged 18-39 years. In summary, heart rate was a risk factor for mortality from coronary disease, all cardiovascular diseases, and all causes in younger men and in middle-aged men and women, and for cancer mortality in middle-aged men and women.     

Maternal and childhood nutrition and later blood pressure levels in young Guatemalan adults

BACKGROUND: Low birth weight and subsequent rapid child growth are associated with later blood pressure levels. The role of maternal and child nutrition in this association remains unclear. METHODS: We studied 450 men and women (ages 21-29 years) born during a randomized trial of protein-energy supplementation (Atole) vs low energy/no protein supplementation (Fresco) in pregnancy and early childhood in four rural Guatemalan villages from 1969 to 1977. RESULTS: Protein-energy supplementation was not associated with differences in blood pressure in adulthood (diastolic blood pressure (DBP): beta = 0.69 mm Hg, 95% confidence internal (CI) (20.82-2.19); P = 0.37; systolic blood pressure (SBP): beta = 0.17 mm Hg, 95% CI (21.68-2.02); P = 0.86). Within the Atole group, maternal height was associated with later SBP (0.22 mm Hg/cm, 95% CI (20.002-0.45); P = 0.05). No other associations between maternal nutritional status, birth size, child growth, or supplement intake were observed for adult blood pressure. CONCLUSIONS: Our data do not support the role of maternal nutrition during pregnancy, birth size, or early child growth in programming adult blood pressure. Likewise, we found no effect of protein-energy supplementation in pregnancy or in early childhood on blood pressure in young adults.     

Predictors of stroke mortality in elderly people from the general population. The CArdiovascular STudy in the ELderly

Stroke occurs particularly frequently in elderly people and, being more often disabling than fatal, entails a high social burden. The predictors of stroke mortality have been identified in 3282 subjects aged 65 years, taking part in the CArdiovascular STudy in the ELderly (CASTEL), a population-based study performed in Northeast Italy. Historical and clinical data, blood tests and 14-year fatal events were recorded. Continuous items were divided into quintiles and, for each quintile, adjusted relative risk (RR) with 95% confidence intervals [CI] was derived from multivariate Cox analysis. Age, historical stroke (RR: 5.2; 95% CI: 3.18–8.6) and coronary artery disease (RR: 1.38; CI: 1.18–2.1), atrial fibrillation (RR: 2.40; CI: 1.42–4.0), arterial hypertension (RR: 1.33; CI: 1.15–1.76), systolic blood pressure 163 mmHg (RR: 1.84; CI: 1.20–2.59), pulse pressure 74 mmHg (RR: 1.50; CI: 1.13–2.40), cigarette smoking (RR: 1.60; CI: 1.03–2.47), electrocardiographic left ventricular hypertrophy (RR: 1.72; CI: 1.10–2.61), impaired glucose tolerance (IGT, RR: 1.83; CI: 1.10–3.0), uric acid (UA) >0.38 mmol/l (RR: 1.61; CI: 1.14–2.10), serum potassium 5 mEq/l (RR: 1.70; CI: 1.24–2.50) and serum sodium 139 mEql/l (RR: 1.34; 1.10–2.10) increased the risk of stroke. In the CASTEL, stroke was the first cardiovascular cause of death. Some independent predictors usually unrelated to stroke mortality (namely pulse pressure, pre-diabetic IGT, UA and blood electrolytes disorders) have been identified.     

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.     

A relation between blood pressure and stiffness of joints and skin

BACKGROUND: Blood pressure, particularly pulse pressure, is associated with arterial wall stiffness, but little is known about its relation to stiffness of other parts of the body. We examined the extent to which blood pressure levels in young healthy children are related to stiffness of various tissues. METHODS: In November 2000, we studied 95 healthy prepubertal children (41 boys and 54 girls, within age range 8-10 years) from two primary schools in the city of Zeist, The Netherlands. Systolic and diastolic blood pressure and pulse pressure were analyzed in relation to various tissue indicators of stiffness, including active joint mobility and skin extensibility. All results were adjusted for age, sex, body height, body weight and muscle strength as possible confounders. RESULTS: Diastolic blood pressure was lower with increased active joint mobility (multivariate generalized linear regression coefficient = -4.5 mmHg per standard deviation [SD] joint mobility; 95% confidence interval [CI] = -7.8 to -1.2). Pulse pressure was lower with increased skin extensibility (-3.2 mmHg per SD skin extensibility; CI = -5.2 to -1.1), through a higher diastolic blood pressure (2.0 mmHg per SD skin extensibility; CI = 0.2-3.9) and possibly lower systolic blood pressure (-0.8 mmHg per SD skin extensibility; CI = -3.5 to 1.9). These associations were mutually independent. Additional adjustment for reported musculoskeletal problems or physical activity levels did not materially change the findings. CONCLUSIONS: Our findings support the hypothesis that constitutional stiffness of body tissues may be associated with blood pressure levels and eventually cardiovascular risk.