Blood pressure studies in black and white inner-city and suburban adolescents

Blood pressures and anthropometric and demographic variables were assessed in 536 students, ages 14–17 years, in integrated suburban and urban schools with comparison of blood pressures between black and white adolescents within and between suburban and urban schools. Of the 536 students, 339 were in a suburban school (237 white and 102 black), and of the 197 students in an urban school, 63 were white and 134 were black. Using multiple regression, explanatory variables significantly entering the equation for systolic blood pressure included sex, geographic area (urban higher), and left-arm circumference; significant explanatory variables in the equation for diastolic blood pressure included geographic area (urban higher), age, and left-arm circumference. These variables were consequently used in analysis of covariance as covariables (age and left-arm circumference), or as independent variables (sex and geographic area). After covariance adjustment for the explanatory variables above, differences in systolic and diastolic blood pressure between geographic areas remained significant (urban higher), while differences between races remained nonsignificant. After covariance adjustment, urban-suburban differences in both systolic and diastolic blood pressures were greater for blacks than whites, a significant race-geographic area interaction. Within geographic areas, there were no significant black-white systolic and diastolic blood pressure differences, save for higher pressures in suburban white females compared with suburban black females. Urban students of both races had higher blood pressures than their suburban counterparts. This finding suggests that shared environments for both races leads to shared blood pressures.     

Alcohol and blood pressure: results from the Luebeck Blood Pressure Study

Data from the Luebeck Blood Pressure Study, a cross-sectional study on a random sample (n = 3,100) of the 30- to 69-year-old population of Luebeck, were analyzed with regard to alcohol consumption and blood pressure. Putative confounders such as obesity, smoking, physical activity, and educational attainment were controlled for by multiple regression analyses. Luebeck men who consumed more than 40 g of alcohol per day revealed 5-6 mm Hg higher mean systolic and 4-5 mm Hg higher mean diastolic blood pressure values. A J-shaped relationship between alcohol consumption and systolic blood pressure was seen in Luebeck men. According to our calculations, about 7% of hypertension among Luebeck men is due to alcohol consumption of greater than or equal to 40 g/day. Among women, strong interactions between age and alcohol consumption were found, therefore two age groups, 30-44 and 45-69 years, were analyzed separately. In the younger age group the alcohol-blood pressure relationship was not pronounced. In the older age group a strong interaction between alcohol consumption and smoking was found. For female smokers steep increases in the adjusted mean diastolic (5.2 mm Hg) and systolic (9.6 mm Hg) blood pressure values were seen for the alcohol consumption category greater than or equal to 20 g/day. For female nonsmokers a flat curve was seen with regard to mean diastolic and systolic blood pressure values. The data from the Munich Blood Pressure Study show a very similar relationship between alcohol consumption and mean systolic and diastolic blood pressure values.     

Racial discrimination and blood pressure: the CARDIA Study of young black and white adults.

OBJECTIVES: This study examined associations between blood pressure and self reported experiences of racial discrimination and responses to unfair treatment. METHODS: Survey data were collected in year 7 (1992/93) of the Coronary Artery Risk Development in Young Adults (CARDIA) study, a prospective multisite community-based investigation. Participants included 831 Black men, 1143 Black women, 1006 White men, and 1106 White women 25 to 37 years old. RESULTS: Systolic blood pressure among working-class Black adults reporting that they typically accepted unfair treatment and had experienced racial discrimination in none of seven situations was about 7 mm Hg higher than among those reporting that they challenged unfair treatment and experienced racial discrimination in one or two of the situations. Among professional Black adults, systolic blood pressure was 9 to 10 mm Hg lower among those reporting that they typically challenged unfair treatment and had not experienced racial discrimination. Black-White differences in blood pressure were substantially reduced by taking into account reported experiences of racial discrimination and responses to unfair treatment. CONCLUSIONS: Research on racial/ ethnic distributions of blood pressure should take into account how discrimination may harm health.     

Systolic blood pressure differences in black, colored, and white infants

Systolic blood pressure was measured in a random cluster sample of three-month-old black (n = 532), colored (n = 496), and white (n = 637) infants in Johannesburg, South Africa, by means of a Parks Doppler ultrasound device with a random zero sphygmomanometer. The study was conducted during a nine-month period in 1981. Major predictors of systolic pressure measurements were which fieldworker had taken the measurement and whether the child was quiet or agitated. After adjustment for predictors as necessary, the mean systolic blood pressure of black infants was about 2 mmHg higher than that of coloreds, which was statistically significant, with suggestive evidence that coloreds have a systolic pressure about 1 mmHg higher than that of whites. Findings at age three months may represent ethnic differences in blood pressure distributions of genetic origin.     

Infant blood pressure and heart rate: relation to ethnic group (black or white), nutrition and electrolyte intake.

Blood pressure (BP) and heart rate were measured during non-rapid-eye-movement sleep in 392 full-term newborns and in 318 of these infants at age six months. Two-day records of food intake were collected at age six months for 150 infants. Black babies did not differ substantially in BP from white babies either at birth or at six months. The earliest BP tracking was from age six to 15 months (systolic (SBP): r = .29, p less than .001; diastolic:r = .45, p less than .001). No relationship was found between BP at six months and breast- or bottle-feeding, infant weight or weight change, or nutrient intake. The relationship between parental BP, on the one hand, and infant electrolyte intake and BP on the other, suggested that electrolyte intake was related to BP in the six-month-old infant, and that the relationship was different in white babies than in black babies. Among 56 white infants whose mother's mean BP was above the median for this population, infant sodium intake correlated with infant SBP (r = .31, p less than .009). Among 32 black infants, regardless of parents' BP, sodium intake was negatively correlated with SBP (r = -.36, p less than .021).     

Psychosocial factors and blood pressure in the Michigan Statewide Blood Pressure Survey

The relationships between various psychosocial factors and blood pressure were examined in a probability sample of the adult population of the state of Michigan in 1980-1983. Excluding individuals diagnosed by a physician as having high blood pressure and controlling for the major risk factors for hypertension, a number of psychosocial factors significantly predicted blood pressure. Among both men and women, those who generally did not express their emotions (including anger) and who harbored grudges and aggressive impulses had higher diastolic blood pressure. Among men only, those with low self-confidence and less perceived control over their lives had higher systolic and diastolic blood pressures. Those who reported poorer mental health had higher diastolic blood pressure. Among women only, those who rated their relationships with family and best friend more poorly had higher systolic blood pressure. Possible explanations are discussed for the gender-specific relationships between blood pressure and certain psychosocial factors.     

杭州市区儿童青少年血压分布情况及影响因素

目的了解浙江省杭州市区儿童青少年血压分布情况及相关影响因素。方法采用分层整群随机抽样方法抽取杭州市52所中小学校共56 803名6~19岁儿童青少年,对2008-2009年的体格检查资料进行统计分析。结果共筛查出血压偏高7 744人,血压偏高率为13.63%,其中以仅收缩压偏高者为主,占58.9%,其次为仅舒张压偏高者,占22.0%,而收缩压舒张压均偏高者占19.1%;在低年龄段(12岁)收缩压和舒张压均高于全国城市同年龄、性别组平均水平(P0.01),除18,19岁高年龄组外,其他年龄组均低于全国平均水平(P0.05);多元Logistic回归结果表明,体质指数收是缩压和舒张压偏高的主要影响因素,其OR值分别为1.15(95%CI=1.14~1.16)和1.21(95%CI=1.20~1.22)。结论杭州市区儿童血压偏高发生情况较青少年严重,而超重和肥胖是引起血压高的主要危险因素。     

Alcohol consumption and blood pressure in black adults: the Pitt County Study

While there is a clear consensus in the epidemiologic literature on the direct association between alcohol consumption and blood pressure, the shape of this relation and its strength in blacks are uncertain. Therefore, the association between alcohol and blood pressure was examined in a community-based random sample of 1,784 black adults aged 25 to 50 years living in eastern North Carolina. These individuals were interviewed in 1988 for a study of psychosocial and dietary risk factors for elevated blood pressure. Alcohol consumption was estimated from responses to a food frequency questionnaire and was divided into four categories, which ranged from abstention (52% of the sample) to greater than or equal to seven drinks/week (12%). After adjustment for age and body mass, the systolic blood pressure of adults reporting greater than or equal to seven drinks/week exceeded that of nondrinkers by 6.8 mmHg for men and women (p less than 0.001). There was no evidence of a threshold effect, and similar patterns were observed for diastolic blood pressure. Being in the highest category of alcohol consumption was related to low socioeconomic status, lower social integration, and higher levels of socioeconomic stressors. These data are consistent with a graded association between alcohol and blood pressure in black adults and suggest the importance of social factors underlying this association.     

青少年握力与血压的相关性研究

目的  应用2014年辽宁省学生体质与健康调研资料分析青少年握力与血压的相关性。 方法  本研究选取16 892例13~18岁汉族初、高中学生为研究对象。握力的测量为用有力手最大力紧握握力计, 测试2次取最大值。采用一般线性回归模型分析握力与血压的关系。将相关变量按照年龄、性别Z评分转换后进行分析。 结果  调节年龄、性别、地区、体重指数(body mass index, BMI)、每天体育锻炼时间和心肺功能后, 在男生及女生中, 握力与收缩压及舒张压均呈正相关(均有P < 0.001)。将握力四分位分组, 随着握力的增加, 收缩压及舒张压值均逐渐增大(均有P_趋势 < 0.001)。 结论  青少年肌肉力量与血压之间呈正相关关系。今后将探索青少年握力与血压相关性的机制, 以进一步确定增加肌肉力量的抗阻训练是否可以在青少年中广泛开展。     

Relation between vegetarian/nonvegetarian diets and blood pressure in black and white adults.

We examined the possible interaction of race and diet on blood pressure (BP) in volunteer Black Seventh Day Adventists compared to volunteer White church members. Height, weight, waist and hip circumference, and resting seated BP were recorded in Black vegetarians (n = 55; age: 54.7 +/- 16.9 yrs), Black nonvegetarians (n = 59; 56.1 +/- 14.1 yrs), White vegetarians (n = 164; 52.2 +/- 16.7 yrs), and White nonvegetarians (n = 100; 52.6 +/- 15.6 yrs) attending a regional conference. Forty-four percent of the Black nonvegetarians were medicated hypertensives, compared to only 18 percent of the Black vegetarians, 7 percent of the White vegetarians, and 22 percent of the White nonvegetarians. Black vegetarians exhibited lower age and sex-adjusted systolic BP (means = 122.9/74.4 mm Hg) than Black nonvegetarians (means = 132.2/75.9 mm Hg). After further adjusting BP for body mass index and waist/hip ratio, the systolic BP among Black vegetarians remained lower (122.8) than Black nonvegetarians (129.7) but higher than that of the Whites who showed no diet-related BP differences.     

山东省儿童青少年血压偏高的流行分布

目的分析山东省儿童青少年血压偏高的流行分布,为成年期高血压相关疾病的早期预防提供依据。方法依据2010年山东省学生体质健康调研资料,分析7～17岁儿童青少年血压水平和血压偏高的检出情况。结果山东省7～17岁儿童青少年血压偏高的检出率分别为28.58%(城男)、23.85%(乡男)、20.99%(城女)和19.68(乡女),城市高于乡村,男生高于女生,城乡及性别差异均有统计学意义(P值均<0.05)。儿童青少年血压水平与体重状况关系密切,收缩压和舒张压均表现为肥胖组>超重组>体重正常组。血压偏高的总检出率表现为肥胖组(男48.97%,女40.91%)>超重组(男36.96%,女31.22%)>体重正常组(男24.29%,女21.05%),差异均有统计学意义(P值均<0.01)。结论儿童青少年血压偏高已成为严重的健康问题,控制青少年超重肥胖是预防血压偏高的关键。     

Tobacco use by black and white adolescents: the validity of self-reports.

OBJECTIVES. Previous studies concluded that Black adolescents use tobacco and other drugs less than White adolescents. The Black-White differences typically were attributed to variations in background and life-style. The objective of the research reported in this paper was to determine whether the presumed difference in tobacco use is due to Black-White differences in the validity of self-reports. METHODS. We used biochemical measures to compare the validity of self-reports of tobacco use by 1823 Black and White adolescents and to assess the contribution of variation in validity to Black-White differences in reported tobacco use. RESULTS. The sensitivity of Blacks' reports was significantly less than the sensitivity of Whites' reports. The specificity of Whites' reports was significantly less than the specificity of Blacks' reports. Much of the Black-White differences in reports of cigarette smoking and tobacco use were due to Black-White differences in validity. CONCLUSIONS. Studies of Black-White differences should adjust for the invalidity of reports or acknowledge that much of the difference may be due to measurement error.     

Obesity and elevated blood pressure among adolescents in Lagos, Nigeria: a cross-sectional study

ABSTRACT: BACKGROUND: Childhood obesity and associated hypertension are major public health concerns globally. This study aimed to determine the prevalence of obesity and the associated risk of high blood pressure among Nigerian adolescents. METHODS: A cross-sectional school-based study of 885 apparently healthy adolescents was performed. Weight, height and blood pressure (BP) were measured using standard methods. Body mass index (BMI) was calculated and categorized by age, sex and percentile. Obesity and overweight were defined as: [greater than or equal to] 95th and 85th to < 95th percentiles, respectively, for age, sex and height. Subjects were sub-categorized into age 10-13 years (A) and 14-17 years (B). The odds ratio for pre-hypertensive and hypertensive range BP by age and BMI were generated. Significance was set at P < 0.05. RESULTS: The prevalence of overweight and obesity were 13.8% and 9.4%, respectively. The prevalence of hypertensive range systolic BP and diastolic BP in obese subjects was 16% compared with 2.3% in normal BMI subjects (P = 0.00), and was 12.1% for females versus 6.4% in males (P = 0.27). The prevalence of hypertensive range diastolic BP was 15.2% in obese subjects versus 3.5% in normal subjects (P = 0.01), and 12% in females versus 1.4% in males (P = 0.00). BMI in group B was significantly associated with pre-hypertensive and hypertensive range systolic BP in overweight (P = 0.01, P = 0.002) and obese subjects (P = 0.00, P = 0.00) and with hypertensive range diastolic BP (P = 0.00) only in obese subjects. The only significant association in group A was between obesity and pre-hypertensive range diastolic BP (P = 0.00). CONCLUSION: The prevalence of hypertensive range BP among obese Nigerian adolescents was high. Screening for childhood obesity and hypertension, and long-term follow-up of obese adolescents into adulthood are recommended.     

兰州市中小学生睡眠时间和血压的关系

探讨兰州市7~18岁中小学生睡眠时间和血压的关系,为预防青少年高血压提供参考.方法 采用分层随机整群抽样的方法,选取兰州市4 200名中小学生进行身高、体重和血压测量,并调查睡眠时间.采用t检验和多元线性回归分析睡眠时间和血压之间的关系.结果 男生收缩压和舒张压均高于女生,差异有统计学意义(t值分别为11.115,4.402,P值均<0.01);在7~12,13~15,16~18岁3个年龄组中,无论男女,睡眠时间充足学生的收缩压和舒张压均低于睡眠时间不足的学生,差异均有统计学意义(P值均<0.01).在调整了身高、体重、体质量指数等因素的多元线性回归模型中,中小学生的睡眠时间与收缩压、舒张压的关联均有统计学意义(JP值均<0.05).结论 兰州市中小学生睡眠时间和血压之间存在关联性,保证学生睡眠时间可能有助于儿童青少年高血压的预防.     

苏州市儿童青少年身高别血压筛查简表的效果评价

目的 基于苏州市7~17岁儿童青少年评价身高别血压筛查简表的效果,为制定儿童青少年血压综合防控策略和措施提供参考。方法 采用分层整群随机抽样方法,2017-2018年抽取苏州市7~17岁学生6 972名,进行问卷调查,测量其身高、体重和血压。依据《7～18岁儿童青少年血压偏高筛查界值(WS/T 610-2018)》为“金标准”,评价根据金标准建立的身高别血压筛查简表筛查正常血压高值和血压偏高的效果。结果 根据金标准和身高别血压筛查简表,苏州7~17岁儿童青少年正常血压高值检出率分别为16.7%和16.6%,血压偏高检出率分别为12.7%和12.8%;配对χ²检验显示两标准评价效果差异无统计学意义(χ²=1.376,P=0.711)。与金标准相比,身高别血压筛查简表筛查正常血压高值,血压偏高具有较好的一致性。筛查正常血压高值的受试者工作特征曲线下面积(95%置信区间)、灵敏度、特异度和Kappa值分别为0.900(0.887~0.913)、83.2%、96.8%和0.803,对应的筛查血压偏高值分别为0.925(0.911~0.938)、86.9%、98.0%和0.848。结论 身高别血压筛查简表使用方便,筛查正常血压高值和血压偏高效果很好。     

Blood pressure among overweight adolescents from urban school children in Pune, India

OBJECTIVES: To examine the magnitude of overweight and its association with blood pressure (BP) among adolescents. DESIGN: Cross-sectional study with all children in age range 9-16 years (n=1146 boys and 1077 girls) from two schools catering to urban affluent high socio-economic class (HSE), for anthropometric measurements by trained investigators and BP measurement by a pediatrician using sphygmomanometer. RESULTS: The prevalence of overweight based on conventional body mass index (BMI) cutoff was 27.5% for boys and 20.9% for girls but varied for different indicators. Prevalence of high systolic blood pressure (HSBP) was 12.0% in boys and 9.7% in girls and increased with increasing levels of BMI, weight, triceps skin fold thickness (TSFT) and percent body fat. Mean level of SBP among overweight children was significantly (P<0.001) higher by about 12 mm Hg, whereas that for diastolic blood pressure was higher by 8 mm Hg (P<0.001) as compared to their non-overweight (age, sex-matched) counterparts. This was true in both sexes and for all indicators used for assessing overweight. Prevalence of HSBP increased suddenly beyond BMI value of 20 kg/m2 in boys and 21.5 kg/m2 in girls, beyond TSFT value of 12 mm for boys and 14 mm for girls whereas such cutoffs for body fat were above 25% in both sexes. These cutoffs appear much lower than the conventional ones and therefore indicate the need for validation of conventional cutoffs in different populations. CONCLUSIONS: Our findings highlight that BP measurement needs to be a routine part of physical examination in school children, and the use of cutoffs anchored to metabolic risks may be essential for assessment of obesity.     

State-specific changes in singleton preterm births among black and white women--United States, 1990 and 1997

National infant mortality rates among non-Hispanic black women are twice those of non-Hispanic white women (1). Nearly two-thirds of this disparity is attributable to a higher rate of preterm delivery (PTD) (i.e., < or = 37 weeks' gestation) among blacks (2). To investigate state-specific changes in PTD rates among blacks and whites, natality data for 1990 and 1997 were analyzed from 50 states and the District of Columbia (DC). These data indicated that, although the PTD rate was twice as high among blacks than among whites, the disparity decreased as the result of an increase in preterm births among whites and a decrease among blacks (3).     

Blood Pressure Success Zone: You Auto Know. A worksite-based program to improve blood pressure control among auto workers

Worksite-based wellness programs can be a means to improve employee health awareness and potentially reduce health care costs. The "BP Success Zone: You Auto Know" program was a worksite-based intervention to reduce the incidence of hypertension among auto workers at Chrysler LLC. This 6-month program comprised an intervention consisting of education, awareness, and support intended to intensify the engagement of Chrysler employees at moderate-to-high cardiovascular risk who were not adequately controlling their blood pressure. The 539 participants had systolic blood pressure of ≥ 120 mmHg, diastolic blood pressure of ≥ 80?mmHg, or were told by a health care provider that they had hypertension. Questionnaires compared awareness and knowledge of hypertension and lifestyle choices before and at the end of the intervention. After the 6-month intervention, mean systolic blood pressure had decreased from a baseline value of 133 mmHg to 129 mmHg (P < 0.0001) and mean blood diastolic pressure had decreased from 85 mmHg to 82 mmHg (P < 0.0001). The proportion of participants with controlled blood pressure increased from 52% to 62% (P < 0.0001) over the course of the intervention. Eighty-six percent of the participants reported that the program helped them to better understand and control their blood pressure and 84% reported that they had a better understanding of their treatment options. In conclusion, a program of hypertension awareness, education, and lifestyle modification helped to improve blood pressure control among a group of Chrysler LLC employees.