Preventive strategy for hypertension based on attributable risk measures

Objectives To examine the effective preventive strategy for hypertension in a Japanese male population, based on attributable risk measures. Methods A 7-year follow-up study of hypertension among 6,306 middle-aged male office workers in a Japanese telecommunication company. Results In terms of population attributable risk percentage (PAR%), regular alcohol intake and physical inactivity showed great contributions to the development of hypertension in the population no less than obesity. The PAR% of each risk factor varied by age group, and the total PAR% of the three modifiable risk factors was considerably higher in the 30–39 year old group (71%) than in the older groups. Conclusions Reduced alcohol intake and increased physical activity, as well as weight control, may have a larger impact on prevention of hypertension in younger groups than in older groups.     

Lifestyle and the development of hypertension: a 3-year follow-up study of middle-aged Japanese male office workers.

The association of lifestyle factors with the development of hypertension (blood pressure > or = 140/90 mmHg) over a 3-year follow-up period was studied in 949 hypertension-free Japanese male office workers aged 35 to 54 years. From the Cox proportional hazards model, age, alcohol intake, body mass index (BMI) and hours of work were independent factors associated with the development of hypertension. Adjusted hazard ratios for 5-year increases in age, daily consumption of alcohol, 5-kg/m2 increases in BMI and working 10 hours per day or more were 1.18 [95% confidence interval (CI) = 1.02-1.35]; 1.53 (CI = 1.14-2.05); 1.79 (CI = 1.38-2.33) and 0.58 (CI = 0.41-0.82), respectively. In the analysis using logistic regression, BMI was independently related to working 10 hours per day or more, controlling for other lifestyle factors. Adjusted odds ratio for 5-kg/m2 increase in BMI was 0.66 (CI = 0.49-0.88). These results suggest that the influences of long working hours on blood pressure are likely to be indirectly mediated through less overall obesity.     

An epidemiological approach to the metabolic syndrome

OBJECTIVE: To investigate four risk factors for the metabolic syndrome. METHODS: Using the health examination database of a Japanese company, 8,194 middle-aged male workers were assessed for the metabolic syndrome with reference to: (1) obesity (body mass index > or = 25 kg/m2); (2) hypertension (> or = 140/90 mmHg or taking antihypertensive drugs); (3) diabetes (fasting blood glucose > or = 110 mg/dl); and (4) hyperlipidemia (total cholesterol > or = 220 mg/dl or triglyceride > or = 150 mg/dl). (1) Those who had developed the metabolic syndrome (n = 148) were retrospectively followed for 5 years. Persistence rates for the four risk factors were calculated. (2) Those who had three risk factors (n = 1,100) were followed for 5 years to observe the development of metabolic syndrome. The incidence rates from Kaplan-Mayer analysis were compared among four different patterns for three risk factors. Adjusted hazard ratios (HRs) and their corresponding 95% confidence intervals (CIs) were calculated using the Cox's proportional hazard RESULTS: (1) The highest persistence rate was found for obesity, followed by hyperlipidemia, hypertension, and diabetes. (2) After adjusting for age, smoking, drinking, and exercise, significantly higher HRs (95%CIs) were found for those with obesity, hypertension, and diabetes (4.4; 2.9 to approximately 6.9), those with obesity, diabetes, and hyperlipidemia (3.2; 2.1 to approximately 4.9), and those with obesity, hypertension, and hyperlipidemia (2.1; 1.4 to approximately 3.0), compared with those with hypertension, diabetes, and hyperlipidemia. CONCLUSIONS: Obesity may be the key to developing the metabolic syndrome in those who demonstrate three risk factors.     

Epidemiological study of coronary artery disease and its risk factors in an elderly urban population of north India.

In view of the rapid increase in the prevalence of coronary artery disease (CAD) in developing countries, our aim was to determine the prevalence of CAD and its risk factors and lifestyle factors in an elderly population from north India.

A random sample of 595 elderly subjects between 50 to 84 years of age was obtained from the urban population of Moradabad. The response rate was 90.1%. The survey methods included a questionnaire containing information on 7-day food intake, other lifestyle factors, Rose questionnaire for diagnosis of angina pectoris, a standard 12-lead electrocardiogram, blood pressure measurements and blood examination.

The total prevalence of CAD based on clinical history and electrocardiogram was 121/1000 (95% CI 72 to 165). The prevalence rate was slightly higher in males (130/1000) than in females (110/1000). The prevalence of CAD based on the Rose questionnaire was 57/1000 and based on electrocardiogram in 561 asymptomatic subjects was 67/1000. CAD was significantly higher in the elderly (65 to 84 years) group than in the middle-aged (50 to 64 years) group (168 vs. 97 per 1000), respectively. While the prevalence of hypertension was significantly higher in the elderly than middle-aged group respectively (214 vs. 168 per 1000), the prevalence of central obesity was significantly higher in the middle-aged than elderly group (674 vs. 632 per 1000). Other risk factors including smoking were comparable in the two subgroups. Prevalence of major risk factors and central obesity were significantly higher among patients with CAD than in the rest of the subjects. Prevalence of CAD was significantly higher in the middle and higher socio-economic groups compared to the lower income group. These higher income groups were also eating significantly higher amounts of visible fat and had a higher prevalence of physical inactivity (93.3%) compared to the lower income group.

CAD and its risk factors such as hypertension, hypercholesterolemia, diabetes and central obesity are of sufficient magnitude in the elderly population of India to be a major public health problem. The findings also indicate that CAD is more commonly associated with middle and higher socio-economic status which may be due to greater consumption of dietary fat and more sedentariness compared to lower socioeconomic groups.     

Relationship between development of hypertension and a family history of high blood pressure in urban residents-analysis based on results of annual health examinations, 1984 to 1998

Relationship between development of hypertension and a family history of high blood pressure in urban residents-analysis based on results of annual health examinations, 1984 to 1998. OBJECTIVE: To clarify the relationship between development of hypertension and a family history of this condition in urban residents. METHODS: Findings from a 15-year follow-up study of annual health examinations carried out in a community adjoining Osaka city, from 1984 to 1998, were analyzed. Any person who indicated in a self-administered questionnaire that they had either a parent or a sibling with hypertension was considered as having a family history of hypertension. RESULTS: In each year analyzed, mean systolic and diastolic blood pressure, by both sex and age group, was generally higher for those with a family history of hypertension than those without. We examined the proportion of people with such a family history and found that among those who received examinations for 5 consecutive years, the number of times at which the proved normotensive was generally lower than in the control group. When we looked at the odds ratio for hypertension according to combinations of family history, obesity, and use of alcohol, those with all three risk factors had the largest values in each year, followed by those with a family history plus obesity, but without drinking. The population attributable risks were 6.6%-16.0% for family history in men and 6.6%-18.4% in women, 6.0%-18.1% and 9.0%-25.2% for obesity and 3.5%-29.4% and 0.3%-4.0% for drinking. These results show that the tree-distributions of normotensiven (optimal, normal, high-normal) were normotensive overall the first time (1984), and for those who received examinations in 1993 and 1998, hazard ratios with a positive family history were higher than with a negative family history. CONCLUSIONS: The main new findings of this study are that the incidence of hypertension is significantly higher in people with a family history of the disease than in those without, and looking at odds ratios for population attributable risk, family history proved to be a factor almost as important for high blood pressure as obesity and drinking. The results indicate family history is a significant risk factor for hypertension.     

Leptin predicts a worsening of the features of the metabolic syndrome independently of obesity

OBJECTIVE: The term metabolic syndrome (MS) describes a cluster of cardiovascular risk factors including dyslipidemia, glucose intolerance, insulin resistance, and hypertension. Obesity increases the risk of MS, but as obesity is neither necessary nor sufficient to cause the syndrome, there is considerable interest in identifying obesity-independent pathways. One such pathway may involve the actions of the adipokine leptin, which is associated cross-sectionally with MS and prospectively with coronary heart disease and stroke, independently of obesity. Our goal was to test the hypothesis that leptin predicts the development of the features of MS independently of obesity. RESEARCH METHODS AND PROCEDURES: This study used a prospective population-based cohort of 748 middle-aged whites in whom baseline measures of leptin and repeated measurement of the subcomponents of the MS at 5 and 10 years were available. The features of the MS were characterized as five factors (obesity, dyslipidemia, elevated blood pressure, glucose intolerance, and insulin resistance), which were combined to create an MS summary score. RESULTS: Baseline leptin significantly predicted the development of obesity (p = 0.001) and, after adjustment for BMI, development of glucose intolerance (p = 0.016) and insulin resistance (p < 0.0001). Leptin levels did not independently predict a change in lipids or blood pressure. Leptin levels significantly predicted the development of the MS (p = 0.036), independently of baseline BMI. DISCUSSION: Leptin predicts the development of the MS independently of baseline obesity. This association is specifically related to the development of glucose intolerance and insulin resistance. The extent to which these relationships are explained through residual confounding by obesity remains to be determined.     

Persistent insomnia is a predictor of hypertension in Japanese male workers

Insomnia is one of the most common complaints at worksites, as well as in the general population. This study aims to assess the effect of insomnia on the development of hypertension in Japanese male workers. Using the annual health examination database of a Japanese telecommunication company, eligible middle-aged male participants in the 1994 health examination were followed up until 1998 or the development of hypertension (either initiation of antihypertensive therapy or a systolic blood pressure > or = 140 mmHg and/or a diastolic blood pressure > or = 90 mmHg). The effect of difficulty initiating sleep (DIS) was assessed with a DIS dataset (n=4,794), which included non-DIS (n=4,602) and persistent-DIS (n=192) subjects. That of difficulty maintaining sleep (DMS) was assessed with a DMS dataset (n=4,443), which included non-DMS (n=4,157) and persistent-DMS (n=286) subjects. The incidence of hypertension among persistent-DIS (40.1%; 130.7 per 1,000 person-yr) was significantly higher than that among non-DIS (30.6%; 89.9 per 1,000 person-yr). The incidence of hypertension among persistent-DMS (42.3%; 136.7 per 1,000 person-yr) was significantly higher than that among non-DMS (30.7%; 90.8 per 1,000 person-yr). After adjusting for potential confounding factors (i.e. age, body mass index, smoking, alcohol drinking, and job stress), persistent complaints of DIS and DMS were significantly associated with an increased risk of hypertension (OR=1.96; 95%CI: 1.42-2.70 and OR=1.88; 95%CI: 1.45-2.45, respectively). Persistent insomnia may be a useful predictor of hypertension in Japanese male workers.     

Multiple risk factor clustering and risk of hypertension in Japanese male office workers

Major risk factors associated with hypertension (a family history of hypertension, obesity, diabetes mellitus, hypercholesterolemia, hypertriglyceridemia, hyperuricemia, and increased white blood cell counts) were assessed in 5275 Japanese male office workers aged 23-59 years. After controlling for potential risk factors of hypertension, the odds ratio of hypertension compared with the absence of risk factors was 1.91, 2.65, 3.88, 6.54, and 8.18 for the presence of 1, 2, 3, 4, and > or = 5 risk factors, respectively (P for trend < 0.001). Systolic and diastolic blood pressure levels also increased in a dose-dependent manner as the number of risk factors increased. Among men not taking antihypertensive medication, the adjusted mean differences in systolic and diastolic blood pressures (mmHg) were 11.2 and 9.2 between men with the presence of > or = 5 risk factors and men without risk factors, respectively. These results indicate that the accumulation of risk factors is highly associated with the increased risk of hypertension in Japanese men.     

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.     

新疆博尔塔拉地区多民族血压正常高值人群中伴随心血管病危险因素的分析

目的 分析新疆博尔塔拉州(博州)维吾尔族(维)、哈萨克族(哈)、蒙古族(蒙)、汉族正常高值血压(SBP 120～139 mm Hg和或DBP 80～89 mm Hg)的人群分布特点及其他心血管病(CVD)危险因素的伴随情况.方法 利用2004年博州维、哈、蒙、汉族高血压的流行病学调查资料(4325人,其中维、哈、蒙、汉族各1247、1047、817、1214人),比较分析多民族正常高值血压人群的其他CVD危险因素伴随情况.结果 (1)维、哈、蒙、汉族正常高值血压检出率分别为39.2%、34.5%、36.0%、36.5%,维、哈、蒙族<40岁组的正常高值血压比例高于同民族40～60岁(分别P=0.000、0.006、0.016)和>60岁组(均P=0.000).(2)正常高值血压人群中,SBP和DBP均高者最多(>45%),单纯DBP高者最少(>13%).(3)4民族正常高值血压者的超重肥胖(BMI≥24.0 kg/m~2)比例≥57%、腹型肥胖(腰围:男85 cm/女80 cm及以上)≥62%、血脂异常≥43%、1个其他CVD危险因素及以上≥82%.(4)多元回归分析表明,增龄、超重肥胖、男性是正常高值血压的危险因素.结论 新疆博州20～79岁维、哈、蒙、汉族正常高值血压比例很高,尤其在<40岁人群中,并伴多项其他CVD危险因素,应该加强对该人群的早期积极干预.     

桂林高考学生高血压现状及影响因素分析

探讨桂林汉族、壮族和瑶族青少年的血压水平、血压偏高检出率及其影响因素,为有效预防高血压的发生提供参考.方法 对桂林市2015年22 356名应届高考学生进行体检,比较3个民族青少年血压水平、血压偏高检出率,并分析其影响因素.结果 市区、县城及乡镇男生和女生的收缩压分别为(116.7±10.0),(114.6±11.6),(113.7±11.2)和(105.1± 9.3),(106.3±11.0),(106.9±10.5) mmHg,舒张压分别为(70.8±6.8),(71.7±8.2),(71.3±8.1)和(66.5±5.6),(68.2±7.8),(68.0±7.4)mmHg.男生血压水平高于女生,县城学生高于市区和乡镇(P值均<0.05).瑶族青少年血压水平较高,收缩压和舒张压均值为(110.3 ±12.5)和(70.6±8.6) mmHg,血压偏高检出率为36.4%;汉族青少年血压水平较低,收缩压和舒张压均值为(109.7±11.3)和(69.2±7.9)mmHg,血压偏高检出率为16.4%(P值均<0.05).血压偏高的检出率为肥胖组(42.8%)>超重组(24.5%)>体重正常组(19.1%)(P<0.05).结论 桂林高考学生的血压水平和高血压的检出率与民族、生活环境、肥胖相关,高血压的预防应从儿童青少年开始,倡导健康的生活方式.     

5种肥胖指标对不同性别及年龄组高血压的预测效果比较

目的 比较不同肥胖指标对不同性别、年龄人群高血压风险的预测价值。方法 基于深圳市龙华区2018年社区居民健康调查数据,对体质指数（BMI）、腰围（WC）、腰围身高比（WHtR）、腰臀比（WHR）和人体肥胖指数（BAI）共5种肥胖指标进行标准化转换,根据Logistic回归分析所得OR值,比较各肥胖指标与高血压的相关性;根据受试者工作特征曲线（ROC）下面积（AUC）,判断各肥胖指标对高血压的预测价值,进而综合评价各肥胖指标对高血压的预测能力。结果 在调整混杂因素后,WC和WHtR与男性和女性高血压的相关性强于其他肥胖指标。WHtR对于男性和女性高血压的预测能力均强于其他肥胖指标,其AUC及95%CI分别为0.694（0.659~0.728）和0.763（0.732~0.794）,其截断值分别为0.51和0.50;女性中各肥胖指标预测高血压的AUC均大于男性,各肥胖指标对女性高血压有更高的预测价值。对男女进行年龄分层后,在男性中除WHR外各肥胖指标对于青年组（18~44岁）高血压的预测价值优于中年组（45~59岁）和老年组（60~80岁）;在女性中各肥胖指标对于高血压的预测价值随着年龄的增长而降低,依次为青年组>中年组>老年组。结论 在综合考虑性别和年龄后,中心型肥胖指标中的WHtR对高血压的预测能力优于WC、BMI、WHR和BAI。     

Combined effects of obesity and objectively-measured daily physical activity on the risk of hypertension in middle-aged Japanese men: A 4-year prospective cohort study

BackgroundThe combined effects of physical inactivity and obesity on hypertension have been recognized; however, previous studies evaluated physical activity using questionnaires. We aimed to examine the effects of physical activity, measured using an accelerometer, and obesity on hypertension onset.MethodsAt baseline, 426 middle-aged Japanese men who were not on antihypertensive medications were included. Physical activity was measured for 7 consecutive days using an accelerometer. Mean daily moderate to vigorous physical activity (MVPA) and step count (SC) were calculated. Low MVPA and low SC were each defined as the first tertile. Obesity was defined as ≥25 kg/m2 of body mass index. The onset of hypertension was defined as receiving antihypertensive agents during the 4-year follow-up. The combined effects of obesity and physical inactivity on hypertension were examined using Cox regression analysis. Potential confounders included age, smoking, alcohol consumption, daily salt intake, dyslipidemia, diabetes mellitus, and systolic and diastolic blood pressures.ResultsCox regression analysis revealed that both obesity and low MVPA predicted hypertension in patients, independent of confounders (hazard ratio [HR]: 2.64, 95% confidence interval [CI]: 1.08–6.42, p = 0.033), unlike obesity alone (HR: 1.50, 95% CI: 0.50–3.26, p = 0.590). Stratification by obesity and SC revealed similar hypertension risks among the two groups (Obesity with low SC [HR: 2.10, 95% CI 0.88–5.24, p = 0.089]; Obesity without low SC [HR: 1.72, 95% CI 0.93–4.01, p = 0.082]).ConclusionsHere, findings suggest that the coexistence of obesity and decreased MVPA may increase the risk of hypertension onset.     

利津县中青年超重和肥胖与高血压及高同型半胱胺酸血症相关性的研究

目的通过观察利津县中青年体质量指数(BMI)、血压及血清同型半胱胺酸(HCY)水平,探讨中青年超重和肥胖与高血压及高HCY血症的相关性。方法选择利津县750例健康查体的中青年,计算BMI、监测血压及检测血清HCY(采用循环酶法)水平,根据分组情况进行统计学分析。结果①750例中青年超重和肥胖的检出率为43.20%,其中超重31.07%、肥胖12.13%;男性超重和/或肥胖的检出率均明显高于女性(P<0.01)。②750例中青年高血压及高HCY血症的检出率分别为17.07%、9.73%;超重和肥胖者分别为28.09%(91/324)和19.75%(64/324),分别显著高于正常组(P<0.01);超重组、肥胖组分别显著高于正常组(P<0.01);肥胖组也分别显著高于超重组(P<0.01)。③血压(收缩压、舒张压)及血清HCY水平与BMI值呈显著正相关(r=0.639、0.515、0.497,P<0.01),其相关性良好。结论利津县中青年尤其是男性超半数存在超重或肥胖,高血压及高HCY血症与BMI相关,超重和肥胖者高血压及高HCY血症的发生率高,应积极防治高血压及高HCY血症。     

Relation of high blood pressure to glucose intolerance, plasma lipids and educational status in an Arabian Gulf population

BACKGROUND: In Bahrain and other populations of the Arabian Peninsula, glucose intolerance is associated with raised plasma total cholesterol, postmenopausal status and low educational status. These associations are not generally seen in other populations with high diabetes prevalence. A study was undertaken in order to determine if hypertension in Bahrainis is associated with the same factors as those related to glucose intolerance. METHODS: A cross-sectional survey of 2120 Bahrainis aged 40-69 years. RESULTS: The age-adjusted prevalence of hypertension (defined as current treatment for hypertension, systolic blood pressure > or = 160 mmHg or diastolic blood pressure > or = 95 mmHg) rose with increasing degrees of glucose intolerance. Age- and sex-standardized prevalence of hypertension was 21% (95% CI: 19-24%) in those with normal glucose tolerance, 31% (95% CI: 27-36%) in those with impaired glucose tolerance, and 38% (95% CI: 34-42%) in those with diabetes. In a multivariate analysis adjusting for age and sex, raised blood pressure was independently associated with waist girth, plasma cholesterol, glucose intolerance, family history of hypertension and (in women) postmenopausal status. There was an inverse relationship between blood pressure and educational status that was independent of other variables. This association parallels the inverse relationship of diabetes to educational level and is consistent with low educational level being a marker for socioeconomic deprivation in early life in this population. CONCLUSION: The high prevalence rates of hypertension and diabetes in Bahrainis are manifestations of a pattern of metabolic disturbances that includes raised plasma cholesterol levels. Both hypertension and diabetes are associated with low educational status, which in this population is a marker for socioeconomic deprivation in early life. This suggests that the risk of hypertension may be set by environmental factors in early life.     

Migration, blood pressure pattern, and hypertension: the Yi Migrant Study.

Rural-urban migration provides an ideal opportunity to examine the effects of environment and genes on blood pressure. The effect of migration on the Yi people of China was studied. The Yi people live in a remote mountain area in southwestern China. In 1989, blood pressure was measured in 14,505 persons (8,241 Yi farmers, 2,575 urban Yi migrants, and 3,689 Han urban residents) aged 15-89 years. Different patterns were seen for men and women. Among the men, Yi farmers had the lowest mean blood pressure, the least rise in blood pressure with age (systolic blood pressure, 0.13 mmHg/year; diastolic blood pressure, 0.23 mmHg/year), and the lowest prevalence of hypertension (0.66%). In contrast, both Yi migrant men and Han men had higher levels of mean blood pressure, rise in blood pressure with age (Yi migrants: systolic pressure, 0.33 mmHg/year; diastolic pressure, 0.33 mmHg/year; Han: systolic pressure, 0.36 mmHg/year; diastolic pressure, 0.23 mmHg/year), and prevalence of hypertension (Yi migrants, 4.25%; Han, 4.91%). Among the women, however, mean systolic pressure was higher in Yi farmers than in Yi migrants or in Han. Diastolic pressure was similar among the three groups. However, the Yi farmer women's age-related rise in blood pressure (systolic pressure, 0.06 mmHg/year; diastolic pressure, 0.14 mmHg/year) and their prevalence of hypertension (0.33%) were lower than those in the other two groups. Yi migrant women had an intermediate rise in blood pressure with age (systolic pressure, 0.37 mmHg/year; diastolic pressure, 0.23 mmHg/year) and prevalence of hypertension (2.40%). Han women had the greatest rise in blood pressure with age (systolic pressure, 0.56 mmHg/year; diastolic pressure, 0.36 mmHg/year) and the highest prevalence of hypertension (4.76%). For both men and women, the above differences were only partially explained by age, body mass index, heart rate, smoking, and alcohol use. This study, using standardized methods, demonstrates an important effect of migration on rise in blood pressure with age and on the prevalence of hypertension.     

Effectiveness of lifestyle modification programs for control of blood pressure: a non-randomized controlled trial in Komatsu, Japan

PURPOSE: A non-randomized controlled trial was conducted to evaluate the effectiveness of three lifestyle modification programs to reduce blood pressure: individual counseling only; counseling using group dynamics; and individual support using mail. METHODS: We enrolled men and women ages 20-69 with a systolic blood pressure (SBP) of 130-159 mmHg and/or a diastolic blood pressure of 85-99 mmHg (high-normal or mild hypertension). Participants were assigned to one of 4 groups: individual counseling (n = 134); group counseling (n = 79); mailing support (n = 127); and controls (with usual care) (n = 178). The three intervention programs included behavioral support for each person's lifestyle problems once a month for 6 months. Sex and age adjusted net blood pressure change (and 95% confidence intervals [CIs]) compared with the control group was calculated for each of the intervention groups. RESULTS: Net SBP change was the largest for the group counseling group: sex and age adjusted net SBP change was -6.5 mmHg (95% CI: -10.0, -3.0). Net SBP change for the mailing support group was also significant (-4.3 mmHg [95% CI: -7.3, -1.3]). Net SBP change for the individual counseling group was -2.5 mmHg (95% CI: -5.5, 0.5). Looking at the results separately by sex, net SBP reduction was also largest in women of the group counseling group, whereas improvement in men was similar among 3 groups (approximately 4 mmHg). Body weights were reduced by about 1 kg in all 3 groups. CONCLUSIONS: Lifestyle modification programs using group dynamics or using individual support by mail, in addition to individual behavioral support, appear to be effective for blood pressure reduction. Group counseling may be more effective in women.     

贵州省常住居民血压与睡眠时间关系调查

目的调查贵州省常住居民的睡眠时间和高血压的现状并探讨两者的关系。方法于2015-2016年基于多阶段分层抽样法,使用"中国重要心血管病患病率调查及关键技术研究的调查问卷"对贵州省15岁以上常住居民进行调查,并对其身高、体重、血压等进行体格检查。使用SPSS 22.0软件对所得数据进行描述分析和协方差分析。结果在调查的7412名常住居民中,男性3242人(43.74%),女性4170人(56.26%),总体平均年龄为(49.97±19.54)岁。调查对象中,有313例(4.22%)为睡眠时间不足,2832例(38.21%)为睡眠时间过长;正常血压2264例(30.54%),高血压患者2118例(28.58%)。在控制了年龄、BMI、疾病家族史等混杂因素后进行协方差分析,因变量为舒张压时,睡眠不足的人群舒张压比标准睡眠的舒张压高1.860 mm Hg(95%CI:0.594~3.125 mmHg,P=0.004);睡眠过长的人群舒张压比标准睡眠的舒张压高2.267 mmHg(95%CI:1.214~3.319 mmHg,P<0.001)。因变量为收缩压时,睡眠不足的人群收缩压比标准睡眠的收缩压高3.609 mmHg(95%CI:1.001~6.216 mmHg,P=0.007);睡眠过长的人群收缩压比标准睡眠的收缩压高4.322 mmHg(95%CI:2.154~6.490 mmHg,P<0.001)。结论调查对象中睡眠时间不足和睡眠时间过长的发生率较高,睡眠时间对高血压存在影响,睡眠时间不足或睡眠时间过长都会导致舒张压和收缩压的上升。     

农村社区人群低钠盐干预后血压及尿钠和尿钾变化的随访观察

目的研究农村社区居民接受低钠富钾替代盐干预后血压的变化情况,为制定高血压防控措施提供依据。方法于2010年,整群抽取山东省莱芜市开展低钠盐干预研究中2个农村社区的农村居民共350例作为研究对象,对其进行为期3个月的低钠盐干预,干预结束后维持简单的健康教育内容。研究对象年龄30~60岁,分为高血压组167例和非高血压组183例。在干预前、干预3个月后、干预结束1年后进行随访,观察血压及24 h尿钠、尿钾的变化。结果低钠盐干预结束1年后,高血压组收缩压（SBP）相对于基线调查时下降了5.4mmHg,差异有统计学意义（t=4.451,P〈0.01）,但是,相对于低钠盐干预3个月结束时上升了2.1 mmHg,差异有统计学意义（t=2.194,P〈0.05）;非高血压组SBP变化差异无统计学意义（P〉0.05）。低钠盐干预结束1年后随访时24 h尿钾相对于基线调查时,高血压组上升了7.8 mmol/24 h,非高血压组则相对基线调查时上升了6.8 mmol/24 h,差异均有统计学意义（P〈0.01）;高血压组研究对象的钠钾比值相对于基线调查和低钠盐干预3个月结束时分别下降了2.3和1.0,非高血压组则分别下降了1.7和1.0,差异均有统计学意义（P〈0.01,P〈0.05）。结论单纯的健康教育所产生的降血压效果低于低钠盐干预所产生的降血压作用。     

青岛市中小学生肥胖与血压关系分析

目的 探讨儿童青少年肥胖与血压的关系,为心血管病的早期预防和干预提供依据。方法 以参加2010年全国学生体质与健康调研的青岛市7~17岁4 841名儿童青少年为研究对象,按照中国学龄儿童青少年超重肥胖筛查标准以及中国儿童青少年血压参考标准,采用χ²检验、标准离差法和多因素logistic回归分析等进行分析。结果 青岛市7~17岁超重和肥胖总检出率分别为15.37%和11.59%,男生高于女生。血压偏高的总检出率为30.4%,男生高于女生,城市高于乡村。血压Z分从高到低依次是肥胖组、超重组、体重正常组。血压偏高组的BMI值(20.58±4.42)高于正常组(18.85±3.47)。多因素分析显示,城乡、性别、年龄和BMI均是血压的影响因素。结论 青岛市中小学生血压偏高的总检出率高于山东省。年龄较大的城市肥胖男生发生高血压概率较高。