Coffee intake and incidence of hypertension

BACKGROUND: The long-term longitudinal evidence for a relation between coffee intake and hypertension is relatively scarce. OBJECTIVE: The objective was to assess whether coffee intake is associated with the incidence of hypertension. DESIGN: This study was conducted on a cohort of 2985 men and 3383 women who had a baseline visit and follow-up visits after 6 and 11 y. Baseline coffee intake was ascertained with questionnaires and categorized into 0, >0-3, >3-6, and >6 cups/d. Hypertension was defined as a mean systolic blood pressure (SBP) >or=140 mm Hg over both follow-up measurements, a mean diastolic blood pressure (DBP) >or=90 mm Hg over both follow-up measurements, or the use of antihypertensive medication at any follow-up measurement. RESULTS: Coffee abstainers at baseline had a lower risk of hypertension than did those with a coffee intake of >0-3 cups/d [odds ratio (OR): 0.54; 95% CI: 0.31, 0.92]. Women who drank >6 cups/d had a lower risk than did women who drank >0-3 cups/d (OR: 0.67; 95% CI: 0.46, 0.98). Subjects aged >or=39 y at baseline had 0.35 mm Hg (95% CI: -0.59, -0.11 mm Hg) lower SBP per cup intake/d and 0.11 mm Hg lower DBP (95% CI: -0.26, 0.03 mm Hg) than did those aged <39 y at baseline, although the difference in DBP was not statistically significant. CONCLUSIONS: Coffee abstinence is associated with a lower hypertension risk than is low coffee consumption. An inverse U-shaped relation between coffee intake and risk of hypertension was observed in the women.     

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.     

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.     

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.     

安徽省心血管病患病风险人群社区公共卫生综合干预对血压水平控制效果分析

  目的  分析不同心血管疾病(cardiovascular disease, CVD)患病风险人群社区公共卫生综合干预血压控制效果。  方法  收集2016—2020年安徽省社区公共卫生综合干预资料(包括基线、3个月、12个月随访数据),采用《中国心血管疾病风险评估和管理指南》推荐的10年CVD风险评估模型将研究对象分为心血管疾病高危和非高危人群,比较高危和非高危人群社区公共卫生综合干预血压控制效果。  结果  共随访3 755名研究对象,CVD高危人群645人,标化检出率10.9%。随访12个月与基线相比,高危人群SBP和DBP分别下降了16.47 mm Hg(95% CI:-18.09~-14.86)、2.66 mm Hg(95% CI:-3.63~-1.69),非高危人群SBP和DBP分别下降了10.43 mm Hg(95% CI:-11.16~-9.70)、2.41 mm Hg(95% CI:-2.81~-2.01);3个月与基线相比,高危人群SBP和DBP分别下降了12.27 mm Hg(95% CI:-13.88~-10.65)、3.66 mm Hg(95% CI:-4.54~-2.77),非高危人群SBP和DBP分别下降了6.05 mm Hg(95% CI:-6.80~-5.30)、2.61 mm Hg(95% CI:-3.00~-2.23)。高危人群随访3个月后SBP下降水平、随访12个月后SBP和DBP下降水平明显高于非高危组(t=-5.100,t=-5.873,t=-2.729,均有P＜0.05)。  结论  社区公共卫生综合干预对CVD高危人群血压改善优于非高危人群。因此,未来的公共卫生工作应进一步关注非高危人群。     

Body composition, ethnicity and alcohol consumption as determinants for the development of blood pressure in a birth cohort of young middle-aged men

Aim: To investigate the development of blood pressure (BP) determinants over a period of 6 years in a birth cohort of middle-aged Swedish men. Methods: Men born 1953 and 1954 living in Helsingborg, Southern Sweden, were surveyed at 37, 40 and 43 years of age. Baseline participation rate was 68% (n = 991). S-Cholesterol, HDL-Cholesterol, systolic and diastolic blood pressure (SBP and DBP) and anthropomorphic measurements were collected and a questionnaire covering ethnicity, smoking, leisure time physical activity (LTPA) and alcohol consumption was completed. Results: At these surveys, SBP means were: 131, 132, 135 mm Hg and DBP were 83, 83 and 85 mm Hg respectively. Body mass index (BMI), waist hip ratio (WHR), S-Cholesterol and alcohol consumption consistently showed cross-sectional positive associations with SBP and DBP. One mmol/L higher S-Cholesterol at baseline predicted an increase in SBP by 1.16 mm Hg (confidence interval, CI: 0.25; 2.07) over 6 years. At age 40, there was a 4.4 mm Hg (p < 0.020) difference in SBP and a 2.64 mm Hg (p < 0.056) difference in DBP means between the low and high alcohol consumption. Corresponding differences at age 43 were SBP 5.28 mm Hg (p < 0.023) and DBP 5.4 mm Hg (p < 0.000). Men born in Sweden had a higher baseline SBP ( = 4 mm Hg, CI: 2.11; 6.35) and showed a higher 6 year increase in SBP (2.80 mm Hg CI: 0.07; 5.53) than men born abroad. Conclusions: Body composition, ethnicity and alcohol consumption are strong determinants for the development of BP. These findings have to be considered in strategies for primary prevention of hypertension in younger middle-aged men.     

Effects of Val-Pro-Pro and Ile-Pro-Pro on nondipper patients: a preliminary study

Much clinical evidence on the antihypertensive effects of the milk-derived antihypertensive peptides Val-Pro-Pro and Ile-Pro-Pro (lactotripeptides) has been reported. However, circadian rhythm effects determined by ambulatory blood pressure monitoring (ABPM) to eliminate the confounding influence of the white-coat effect have not been fully studied. Twelve hypertensive patients not receiving antihypertensive medication (2 men, 10 women; mean age±standard deviation, 63.5±8.3 years) who had been visiting our clinic for more than 1 year participated in this study. Mean (±standard deviation) systolic blood pressure (SBP) and diastolic blood pressure (DBP) were 142.4±2.6 and 83.5±6.4?mm Hg, respectively, at the first office visit. After patients ingested a fermented milk product containing antihypertensive peptides (2.53?mg Val-Pro-Pro; 1.52?mg Ile-Pro-Pro) for more than 4 weeks, both office SBP and DBP were significantly reduced to a mean (±standard deviation) of 133.3±7.0?mm Hg and 76.5±8.4?mm Hg (P<.001 and P<.005 by paired t-test), respectively. The 24-hour SBP and DBP determined by ABPM were reduced from 127.3±2.4 and 78.7±2.3?mm Hg to 120.2±2.4 and 75.0±2.2?mm Hg (P<.001 and P<.05), respectively. Awake-time SBP (08:00-21:00), night-time SBP (0:00-05:00), and early-morning SBP (06:00-07:00) were reduced from 130.9±2.4 to 123.3±2.3?mm Hg, 118.7±2.9 to 113.2±3.4?mm Hg, and 132.8±4.3 to 122.4±3.9?mm Hg (by paired t-test: P<.001, P<.05, and P<.05), respectively. As seen with DBP measured by ABPM, 24-hour DBP and awake-time DBP were significantly reduced from 78.7±2.3 to 75.0±2.2?mm Hg and 82.1±2.5 to 77.3±2.2?mm Hg (P<.05 and P<.01), respectively. Office BP and 24-hour blood pressure did not significantly differ between the dipper and nondipper groups at baseline. However, after treatment, night-time and early-morning blood pressure were significantly reduced from baseline in the nondipper group (-8.5±2.5 and -15.6±3.7?mm Hg; P<.05 and P<.01, respectively) but not in the dipper group (-2.5±3.6 and -1.2±4.7?mm Hg; P not significant), and the reduction in early-morning blood pressure significantly differed between the groups (P<.05). These results suggest that Val-Pro-Pro and Ile-Pro-Pro decrease blood pressure in patients with stage I hypertension and result not only in lower blood pressure at night-time but also in lower early-morning SBP in nondipper patients.     

65岁及以上社区老年人高血压病收缩压控制情况与认知功能关联性

  目的  探究老年高血压病人SBP控制情况和认知功能的关系。  方法  采用多阶段整群抽样,对年龄≥65岁的社区老年人进行现场调查, 使用标准水银血压计连续两次测量右臂血压值,采用简明精神状态量表(mini-mental state examination, MMSE)评估认知功能,并采用多因素Logistic回归分析模型分析SBP控制情况和认知功能的关系。  结果  强化控制(SBP＜120 mm Hg)(OR=1.519,95% CI:1.187~1.945)增高认知障碍患病风险。年龄分层发现,强化控制增加70岁及以上老人的认知障碍患病风险(均有P < 0.05)。对高血压病史分层发现,10年以上高血压病程老人,强化控制和控制不良(SBP≥140 mm Hg)均与认知障碍患病率增加正相关(均有P < 0.05)。进一步对10年以上高血压病程老人年龄分层,发现65~69岁老人中,控制不良与认知障碍患病风险增加相关(P=0.023)。  结论  高血压病程较长的老人中,65~69岁老人应严格控制SBP,70岁及以上老人应谨慎控制SBP。     

Longitudinal study of soy food intake and blood pressure among middle-aged and elderly Chinese women

BACKGROUND: Several small-scale clinical trials have suggested a potential beneficial effect of short-term soy consumption on blood pressure (BP). Data are scanty on long-term effects of the usual intake of soy foods on BP in general populations. OBJECTIVE: Our aim was to examine the association between usual intake of soy foods and BP. DESIGN: The usual intake of soy foods was assessed at baseline, and BP was measured 2-3 y after the baseline survey among 45 694 participants of the Shanghai Women's Health Study aged 40-70 y who had no history of hypertension, diabetes, or cardiovascular disease at recruitment. Multiple regression models were used to estimate mean differences in BP associated with various intakes of soy foods. RESULTS: Soy protein intake was inversely associated with both systolic BP (P for trend = 0.01) and diastolic BP (P for trend = 0.009) after adjustment for age, body mass index, and lifestyle and other dietary factors. The adjusted mean systolic BP was 1.9 mm Hg lower (95% CI: -3.0, -0.8 mm Hg) and the diastolic BP was 0.9 mm Hg lower (-1.6, -0.2 mm Hg) in women who consumed > or =25 g soy protein/d than in women consuming <2.5 g/d. The inverse associations became stronger with increasing age (P for interaction < 0.05 for both BPs). Among women >60 y old, the corresponding differences were -4.9 mm Hg (95% CI: -8.0, -1.9 mm Hg) for systolic BP and -2.2 mm Hg (95% CI: -3.8, -0.6 mm Hg) for diastolic BP. CONCLUSION: Usual intake of soy foods was inversely associated with both systolic and diastolic BPs, particularly among elderly women.     

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.     

儿童期Korotkoff第Ⅳ、Ⅴ音的差异及对成年高血压的预测价值

目的 探讨儿童青少年期Korotkoff第Ⅳ音(K4)与第Ⅴ音(K5)的差异及对成年高血压的预测价值,为选择血压测量方案和制定儿童血压评价标准提供依据.方法 2005年追访1987年建立的"北京儿童血压研究"队列人群,基线儿童期K4、K5作为舒张压(DBP),采用WHO 1996年标准诊断基线儿童期高血压;成年期记录K5作为DBP,采用《中国高血压防治指南(2005年修订版)》诊断成年期高血压.比较儿童期K4、K5的差异及对成年高血压的预测价值.结果 1987年基线调查6～17岁学龄儿童2505人,2005年追访到412人.基线K4-K5差值的几何均数为(10.1±1.7)mm Hg(1 mm Hg=0.133 kPa),并随年龄增长而下降;除青春期外,其他年龄男女之间K4-K5的差异无统计学意义.各年龄组K4-K5差值的分布构成有统计学意义(P＜0.001),6～9岁、10～12岁、13～15岁、16～17岁分别有59.6%、60.5%、56.3%和45.1%的儿童K4与K5差值大于10 mm Hg.按WHO标准,采用K4、K5为DBP诊断高血压检出率分别为5.0%和2.4%.儿童期K4与成年期血压的相关程度优于K5;且能预测成年期高血压.结论 当使用汞测压计测量儿童血压时,采用K4记录DBP,能更真实地反映儿童血压水平,使不同儿童的DBP水平具有可比性;并且K4与成年DBP的关联度更高,即轨迹现象更强,更能体现儿童血压水平对成年高血压的预测价值.     

Effect of casein hydrolysate, prepared with protease derived from Aspergillus oryzae, on subjects with high-normal blood pressure or mild hypertension

Casein hydrolysate, prepared with Aspergillus oryzae protease, contains angiotensin I-converting enzyme inhibitory peptides, such as Val-Pro-Pro and Ile-Pro-Pro. We conducted a randomized, double-blind, placebo-controlled study to evaluate the effect of casein hydrolysate on the blood pressure of 144 subjects with high-normal blood pressure (n = 104) and mild hypertension (n = 40). Subjects were randomly assigned to two groups for a 12-week intake period. In the test group, both systolic (SBP) and diastolic (DBP) blood pressure decreased significantly compared with the placebo group: SBP/DBP significantly decreased from 138.2 +/- 6.5/84.4 +/- 5.3 mm Hg at week 0 to 132.3 +/- 7.3 (P < .001)/81.2 +/- 4.8 mm Hg (P < .001) at week 12. In the stratified analysis, the test product showed an antihypertensive effect in both the subject group with high-normal blood pressure and that with mild hypertension. No side effect was observed in any subjects in this study. These results demonstrate that the casein hydrolysate, prepared with A. oryzae protease, produced a significant reduction in blood pressure in a population of subjects with high-normal blood pressure or mild hypertension without an adverse event.     

社区人群综合干预对预防和控制高血压效果评价

目的评价社区人群综合干预对预防和控制高血压的效果。方法按照类实验设计,于1996年在北京市选取干预、对照社区各5万人群,对干预社区开展为期3.5 a的高血压一、二级预防,期间对确诊高血压患者进行随访管理,并分别于1997年和2000年先后对干预、对照社区各整群随机抽取800人左右进行基线和干预后血压水平及相关知识、态度、行为（KAB）调查。结果干预社区的2 478名确诊高血压患者的随访管理过程中,1998、1999和2000年确诊高血压患者管理率分别为64.15%,73.82%和82.56%,血压控制率分别为54.28%,62.04%和62.42%,管理率和血压控制率逐年提高。经过干预活动后,与对照社区比较,干预社区人群KAB水平及人群关心保健知识、受知识影响和规律性锻炼率变化更明显（P〈0.05）。干预社区高血压人群收缩压、舒张压水平降低幅度和高血压知晓率、治疗率、控制率提高程度均大于对照社区,但差别无统计学意义。结论社区综合干预措施能有效地规范人群的健康相关行为,对控制人群高血压具有重要意义。     

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.     

The Association Between Extent of Employment and Hypertension Among Women Participants of the Second National Health and Nutrition Survey

ABSTRACT

The association between extent of employment and hypertension was examined among 3,824 women participants of the Second National Health and Nutrition Examination Survey. Women in three employment groups (full-time, part-time, and short-term) were compared to homemakers. In covariate-adjusted, logistic regression models, women employed full-time had a somewhat lower, but not significantly different, prevalence of hypertension (OR = 0.8, 95% CI = 0.7, 1.1), whereas both part-time (OR = 0.6, 95% CI = 0.4, 0.7) and short-term (OR = 0.5, 95% CI = 0.4, 0.7) workers had significantly lower prevalences. Associations did not tend to vary by age, ethnicity, or occupation. Employment does not appear to increase the risk of hypertension in women; in fact, moderate levels were associated with lower risk.     

Multivitamin supplementation of HIV-positive women during pregnancy reduces hypertension

Hypertension during pregnancy increases fetal growth retardation, preterm deliveries, and perinatal deaths, and yet its causes remain unclear. In HIV-infected women, preterm birth additionally increases the risk of HIV transmission to the infant. Oxidative stress and endothelial cell dysfunction of the placenta have been implicated in the development of hypertension during pregnancy. Vitamin intake can reduce oxidative stress and improve endothelial function. We therefore evaluated the effect of multivitamin (20 mg thiamine, 20 mg riboflavin, 25 mg B-6, 50 microg B-12, 500 mg C, 30 mg E, and 0.8 mg folic acid) and vitamin A supplements (30 mg beta-carotene plus 5000 IU preformed vitamin A) in relation to hypertension during pregnancy (systolic blood pressure > or = 140 mm Hg or diastolic blood pressure > or = 90 mm Hg at any time during pregnancy). In a double-blind, placebo-controlled, randomized, clinical trial, conducted among 1078 HIV-positive pregnant Tanzanian women, those who received multivitamins were 38% less likely to develop hypertension during pregnancy than those who did not [relative risk (RR) = 0.62, 95% CI 0.40-0.94, P = 0.03]. There was no overall effect of vitamin A on hypertension during pregnancy (RR = 1.00, 95% CI 0.66-1.51, P = 0.98). Hypertension during pregnancy was more likely in women with high baseline systolic blood pressure (>120 vs. < or = 120 mm Hg) (RR = 6.02, 95%CI 2.59-13.97, P < 0.001), and those with higher mid-upper arm circumference (RR = 1.12, 95% CI 1.04-1.19, P = 0.002). Taking multivitamins containing vitamins B, C, and E during pregnancy may be an inexpensive and effective strategy to improve the health of the mother and baby.     

Assessing Cardiovascular Reactivity in Working Women with the Social Competence Interview

ABSTRACT

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 mm Hg; diastolic blood pressure (DBP) increased 10.63 mm Hg; 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 ≥ 140 mm Hg and/or DBP ≥ 90 mm Hg 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.     

The association between extent of employment and hypertension among women participants of the Second National Health and Nutrition Survey.

The association between extent of employment and hypertension was examined among 3,824 women participants of the Second National Health and Nutrition Examination Survey. Women in three employment groups (full-time, part-time, and short-term) were compared to homemakers. In covariate-adjusted, logistic regression models, women employed full-time had a somewhat lower, but not significantly different, prevalence of hypertension (OR = 0.8, 95% CI = 0.7, 1.1), whereas both part-time (OR = 0.6, 95% CI = 0.4, 0.7) and short-term (OR = 0.5, 95% CI = 0.4, 0.7) workers had significantly lower prevalences. Associations did not tend to vary by age, ethnicity, or occupation. Employment does not appear to increase the risk of hypertension in women; in fact, moderate levels were associated with lower risk.     

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.

中老年人血压水平与脑卒中患病率及患病风险的相关性研究

目的 研究中老年人群中血压水平与脑卒中患病率及患病风险之间的关系。方法 采用分层整群抽样方法,对扬州市广陵区40岁及以上常住居民开展问卷调查、体格检查和实验室检查。通过对年龄分层,采用单因素和多因素logistic回归分析不同年龄组血压与脑卒中患病率及患病风险的关系。结果 3 999例有效样本中,男性1 904例（47.61%）,女性2 095例（52.39%）;其中脑卒中243例（6.08%）,高血压1 900例（47.51%）,糖尿病929例（23.23%）,血脂异常943例（23.58%）,高血压患者中脑卒中211例（86.83%）。男性（χ2 = 9.539,P = 0.002）、高龄（t = - 13.683,P＜0.001）、缺乏运动（χ2 = 15.568,P＜0.001）、吸烟史（χ2 = 40.799,P＜0.001）、高血压（t = - 9.149,P＜0.001）、高血糖（t = - 6.832,P＜0.001）、低高密度脂蛋白胆固醇（t = 3.509,P＜0.001）、肥胖（t = - 4.964,P＜0.001）均是脑卒中重要危险因素。随着年龄和血压的增加,脑卒中的患病率增加。对年龄进行分层,并对危险因素进行校正,60岁以下人群中脑卒中患病风险随血压升高而显著增加;收缩压≥160 mm Hg脑卒中患病风险是收缩压＜130 mm Hg的8.13倍;舒张压≥110 mm Hg脑卒中患病风险是舒张压＜80 mm Hg的28.54倍。60岁及以上人群中收缩压≥150 mm Hg脑卒中患病风险开始增加;收缩压≥160 mm Hg脑卒中患病风险是收缩压＜130 mm Hg的2.12倍;舒张压与脑卒中患病风险之间无显著相关性。结论 高血压是脑卒中的重要危险因素,根据不同的年龄,设定相应的降压目标是有效预防脑卒中的重要途径。