Fruit and vegetable consumption is inversely associated with blood pressure in a Mediterranean population with a high vegetable-fat intake: the Seguimiento Universidad de Navarra (SUN) Study

There is evidence that a diet rich in fruit and vegetables reduces blood pressure (BP). Characteristically, the Mediterranean diet is rich in plant-derived foods and also in fat, but studies conducted in Mediterranean countries to relate diet to BP are scarce. We studied the association between fruit and vegetable consumption and BP in a cross-sectional analysis of 4393 participants in the Seguimiento Universidad de Navarra (SUN) Study, an ongoing dynamic cohort study in Spain. Diet was measured using a food-frequency questionnaire previously validated in Spain. Fat represented more than 37 % total energy intake. Subjects were considered to have undiagnosed hypertension if they reported systolic BP > or = 140 mmHg or diastolic BP > or = 90 mmHg, and not a medical diagnosis of hypertension. The adjusted prevalence odds ratio of undiagnosed hypertension (upper v. lowest quintile) was 0.58 (95 % CI 0.36, 0.91; P for trend 0.01) for vegetable consumption and 0.68 (95 % CI 0.43, 1.09; P for trend 0.10) for fruit consumption. Comparing those in the highest quintile of both fruit and vegetable consumption with those in the lowest quintile of both food groups, the prevalence odds ratio was 0.23 (95 % CI 0.10, 0.55; P = 0.001), after adjusting for risk factors for hypertension and other dietary exposures. In a Mediterranean population with an elevated fat consumption, a high fruit and vegetable intake is inversely associated with BP levels.     

Frequency and related factors of masked hypertension at a worksite in Korea

Objectives

Masked hypertension is associated with metabolic risks and increased risk of cardiovascular disease. The purpose of this study was to identify the frequency of and risk factors of masked hypertension in Korean workers.

Methods

The study was conducted among 121 employees at a hotel in Gyeongju, Korea, from December 2008 to February 2009. We measured blood pressure (BP) both in the clinic and using 24-hour ambulatory BP monitors for all subjects. Hypertension was defined independently by both methods, and subjects were classified into four groups: true normotension, masked hypertension, white coat hypertension, and sustained hypertension.

Results

The frequency of masked hypertension in our study group was 25.6%. Compared with true normotension, the factors related to masked hypertension were male gender (odds ratio [OR], 10.7; 95% confidence interval [CI], 1.41 to 81.09), aging one year (OR, 0.88; 95% CI, 0.78 to 0.99), clinic BP 120-129/80-84 mmHg (OR, 8.42; 95% CI, 1.51 to 46.82), clinic BP 130-139 / 85-89 mmHg (OR, 12.14; 95% CI, 1.80 to 81.85), smoking (OR, 5.51; 95% CI, 1.15 to 26.54), and increase of total cholesterol 1 mg / dL (OR, 1.05; 95% CI, 1.02 to 1.08). In males only, these factors were clinic BP 120-129 / 80-84 mmHg (OR, 15.07; 95% CI, 1.55 to 146.19), clinic BP 130-139 / 85-89 mmHg (OR, 17.16; 95% CI, 1.56 to 189.45), smoking (OR, 11.61; 95% CI, 1.52 to 88.62), and increase of total cholesterol 1 mg/dL (OR, 1.05; 95% CI, 1.01 to 1.09).

Conclusions

The frequency of masked hypertension was high in our study sample. Detection and management of masked hypertension, a known strong predictor of cardiovascular risk, could improve prognosis for at-risk populations.     

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

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

Analysis of risk factors for hypertension in Colima, Mexico]

OBJECTIVE: To evaluate the possible association that age, sex, excess weight, family history of hypertension, alcoholism, and sedentary lifestyle have with hypertension in the adult population of the city of Colima, Mexico. METHODS: This was a population-based analytic cross-sectional study. A structured survey was used with 280 adults older than 30 years of age who were living in the city of Colima in 2001 and 2002. The variables studied were sex, age, weight, height, family history of hypertension, engaging in physical exercise, smoking, and consuming alcohol. Blood pressure (BP) was measured with the auscultatory method. Borderline or doubtful measurements were checked again four or five days later. Hypertension was defined as systolic BP > or = 140 mm Hg and diastolic blood pressure > or = 90 mm Hg, or as the person being under antihypertensive treatment. The odds ratios (ORs) of the variables studied were calculated, along with their 95% confidence intervals (95% CIs). The association between the variables and hypertension was estimated through logistic regression, and their interaction through the coefficient of the interaction products. RESULTS: The overall prevalence of hypertension was 28.6%. The prevalence was higher in men than in women (42.1% vs. 19.2%; OR = 3.04, 95% CI: 1.8 to 5.2) and in people older than 49 years than in people 30 to 49 years old (36.8% vs. 21.9%; OR = 2.07, 95% CI: 1.22 to 3.50). A family history of hypertension and excess weight were associated with hypertension, while physical exercise had a protective effect (OR = 0.45; 95% CI: 0.23 to 0.86). There was interaction between hypertension and age > or = 50 years, a family history of hypertension, overweight, and physical exercise, especially among women. CONCLUSIONS: The prevalence of hypertension in Colima is very similar to that for Mexico as a whole. The strong association that hypertension had with male gender, regardless of the other variables, emphasizes the need for promoting prevention campaigns that focus more on men.     

Hypertension in Alaska natives: Association with overweight,glucose intolerance,diet and mechanized activity

Objective. Determine the prevalence of hypertension in Alaska Natives and evaluate risk factors.

Design. Population‐based univariate and multivariate analysis of blood pressure in 1124 Alaska Natives over 20 years of age.

Results. The sample had mean: age 45 years, body mass index 27, systolic pressure 123 mmHg and diastolic pressure 73 mmHg. The age‐adjusted rate of hypertension ≥ 160/95 mmHg was 9.1% and 6.8% among Athabascan Indians and Yup'ik Eskimos, respectively. After controlling for age and sex there was significantly more hypertension among Athabascan Indians (OR=1.53, CI = 1.07–2.2, p = 0.019) compared to Yup'ik Eskimos. Race was significantly associated with blood pressure 3 ≥ 140/90 when controlled for age and overweight (p = 0.07, OR = 0.78, CI = 0.69–0.95). The presence of hypertension was significantly associated with the following: intake of non‐indigenous food (p = 0.01); mechanized activities (p = 0.01); and glucose intolerance in both women (p = 0.043) and men (p = 0.001). Multiple regression analysis revealed age (OR = 1.06, CI= 1.05–1.08) and overweight in both men (OR = 3.02, Cl= 1.85–4.93) and women (OR = 2.76, CI= 1.81–4.19) to be significantly associated with BP ≥ 140/ 90.

Conclusion. Hypertension is no longer rare in Alaska Natives and is associated with overweight, non‐indigenous diet, mechanized activities, and glucose intolerance.     

Isolated systolic hypertension in Dutch middle aged and all-cause mortality: a 25-year prospective study

In the early 1950s, the blood pressure of 3901 Dutch civil servants and their spouses aged 40-65 years was measured in a general health survey. Isolated systolic hypertension (systolic pressure greater than 160 mmHg, diastolic pressure less than 90 mmHg) was observed in 6.3% of the women and 3.0% of the men. The prevalence increased with age and it was more common in women in all age groups. Using logistic regression, with adjustment for potential confounders (age, smoking, serum cholesterol, Quetelet index, alcohol consumption, haemoglobin level, pulse rate and diastolic blood pressure) the association of 15- and 25-year total mortality with isolated systolic hypertension was determined. Compared to normotensive people (systolic pressure less than or equal to 135 mmHg, diastolic pressure less than 90 mmHg), the risk of death from all causes was significantly higher for men with isolated systolic hypertension after 15 and 25 years of follow-up (odds ratio OR = 2.4, 95% confidence interval (CI) 1.2-4.8 and OR = 3.2, 95% CI 1.3-8.0). For women 15-years mortality risk was strongly associated with isolated systolic hypertension (OR = 3.7, 95% CI 1.4-9.7). The increased risk was less pronounced after 25 years of follow-up (OR = 1.7, 95% CI 0.96-3.0). Our results support those of other studies and indicate that isolated systolic hypertension is an important independent risk factor for all-cause mortality. Since isolated systolic hypertension may be an indicator for the early onset of ageing, it is important to study its determinants and to pay more attention to its diagnosis and treatment in middle-aged populations.     

Heavy drinking is associated with poor blood pressure control in the REasons for Geographic and Racial Differences in Stroke (REGARDS) study

Alcohol intake has been shown to have a J-shaped association with blood pressure (BP). However, this association has not been examined in mixed race populations or in people with diabetes where tighter blood pressure control is recommended. Participants in the REGARDS study who were 45 years or older (n = 30,239) were included. Medical history (including self-reported alcohol intake) was collected by telephone while blood collection and clinical measurements were done during an in-home visit. We defined diabetes as use of medications and/or fasting glucose ≥ 126 mg/dL and hypertension as use of blood pressure lowering medications and/or BP ≥ 140/90 mmHg or BP ≥ 130/80 mmHg in people with diabetes. After adjustment for confounders, heavy drinking was associated with an increased odds of hypertension (OR = 1.59; 95% CI = 1.37, 1.87). Diabetes and gender significantly modified (interaction P < 0.05 for both) the association between alcohol use and hypertension, although heavy drinking remained associated with increased odds of hypertension in sub-group analyses. We did not observe the previously described J-shaped relationship in any sub-group except white females. These data suggest heavy alcohol consumption is associated with poor BP control and that heavy drinkers may want to consider limiting alcohol intake in order to manage hypertension.     

Elevated blood pressure among U.S. adults with diabetes, 1988-1994.

BACKGROUND: Recent guidelines and clinical trial results emphasize the importance of controlling blood pressure among people with diabetes. We estimated the prevalence of elevated blood pressure among U.S. adults with diagnosed diabetes, and examined the extent to which elevated blood pressure is being treated and controlled. METHODS: The Third National Health and Nutrition Examination Survey (1988-1994), a probability survey of the civilian, non-institutionalized population of the United States, consisted of an interview and physical examination, which included blood pressure measurement. Survey participants included 1507 adults (aged > or = 18 years) with self-reported diabetes. Among people with self-reported diabetes, we estimated elevated blood pressure (mean blood pressure of > or = 130/85 mm Hg or use of antihypertensive medication); awareness (prior diagnosis of hypertension); treatment (antihypertensive medication use); and control (mean blood pressure of <130/85 or <140/90). RESULTS: In the 1988-1994 period, 71% (95% confidence interval [CI]=+/-4.4%) of all U.S. adults with diabetes had elevated blood pressure. The prevalence of elevated blood pressure increased with age and was high among both men and women and among Mexican Americans, non-Hispanic blacks, and non-Hispanic whites. Among those with elevated blood pressure, 71% (95% CI=+/-4.1%) were aware and 57% (95% CI=+/-4.2%) were treated, but only 12% (95% CI=+/-3.2%) had mean blood pressure <130/85 and 45% (95% CI=+/-4.9%) had mean blood pressure <140/90. Control of blood pressure was least common among older people. CONCLUSIONS: All people with diabetes-regardless of age, gender, and race and ethnicity-may benefit from efforts to prevent hypertension. The control of elevated blood pressure is inadequate and broad-based efforts are needed to improve blood pressure control.     

Distribution of blood pressure, body mass index and smoking habits in the urban population of Dar es Salaam, Tanzania, and associations with socioeconomic status

OBJECTIVE: To estimate the distribution of blood pressure (BP), body mass index (BMI), smoking habits and their associations with socioeconomic status (SES) in an urban population in early epidemiological transition. METHODS: Cross-sectional survey of the entire population aged 25-64 years in five branches of Dar es Salaam (Tanzania) through visits to all homes in the study area. Blood pressure was based on the mean of the second and third readings with an automated device. Socioeconomic status was estimated with indicators of education, occupation and wealth. RESULTS: In all 9254 people were examined. Age-adjusted prevalence (%) among men/ women aged 35-64 years was 27.1/30.2 for BP > or = 140/90 mmHg or antihypertensive medication, 13.1/17.7 for BP > or = 160/95 mmHg or antihypertensive medication, 28.0/27.4 for BMI of 25.0-29.9 kg/m(2), 6.9/17.4 for BMI > or = 30 kg/m(2), and 22.0/2.6 for smoking (> or = 1 cigarette per day). Prevalence of categories of drinking frequency and history of diabetes are also reported. After adjustment for covariates, SES was associated inversely with BP and smoking and directly with BMI. Body mass index was associated positively with BP (1.01 and 0.91 mmHg systolic BP per 1 kg/m(2) BMI in men and women, respectively) and inversely with smoking (-1.14 kg/m(2) in male smokers versus non-smokers). Hypertension treatment rates were low, particularly in people of low SES. CONCLUSIONS: High prevalence of several cardiovascular risk factors in the urban population of a low-income country stresses the need for early public health interventions and adaptation of the health care infrastructure to meet the emerging challenge of cardiovascular disease. The direct SES-BMI association may drive increasing BMI and BP while the population becomes more affluent.     

Women, employment status, and hypertension: cross-sectional and prospective findings from the Atherosclerosis Risk in Communities (ARIC) Study.

PURPOSE: This study examined the cross-sectional and prospective associations between employment status and hypertension among middle-aged, African-American (AA) and European-American (EA) women participating in the Atherosclerosis Risk in Communities Study. METHODS: Employed women and homemakers from the baseline examination (1987-89) were included in the cross-sectional study (n = 7351). Associations between employment and the incidence of hypertension ascertained at visit 2 (1990-92) were determined among those who at baseline, had low-normal blood pressure (not hypertensive and systolic blood pressure (SBP) < or = 120 mm Hg systolic and diastolic blood pressure (DBP) < or =80 mm Hg (n = 3194). Logistic regression analysis was used to examine the association between employment status and hypertension by ethnicity, taking into account covariates. RESULTS: At baseline, employed women were less likely to be hypertensive (SBP > or =140 mm Hg or DBP > or =90 mm Hg or current use of antihypertensive drugs) than were homemakers (prevalence odds ratio) (POR) = 0.70; 95% confidence interval (CI) = 0.62-0.79), controlling for age, body mass index, and education. Among the subgroup who had low-normal blood pressure at baseline, employed women were less likely to develop hypertension during the three-year time period than were homemakers (odds ratio (OR) = 0.68; 95% CI = 0.44-1.05). The inverse association was stronger among AA (RR = 0.37; 95% CI = 0.16-0.88) than EA (OR = 0.83; 95% CI = 0.50-1.38) women. CONCLUSIONS: These findings suggest that the inverse association between hypertension and employment status is not due to a healthy worker effect, and that employment may confer protection against incident hypertension in women.     

成都市就业流动人口高血压患病现状及相关因素分析

目的 了解成都市就业流动人口高血压患病现状并探索其相关因素,为制定流动人口高血压预防策略及措施提供依据。方法 采用应答推动抽样（RDS）法在成都市抽取≥18岁非成都市户籍就业人员进行问卷调查和体格检查。高血压患病率的比较采用x2检验,患病相关因素分析采用多因素logistic回归模型。结果 共调查就业流动人口2351人,高血压患病率为29.82%。Logistic回归结果显示,年龄≥31岁［31～45岁（OR=1.979,95%CI=1.466～2.670）、46～60岁（OR=3.673,95%CI=2.758～4.892）、≥61岁（OR=6.240,95%CI=4.272～9.116）］、吸烟（OR=1.597,95%CI=1.064～2.396）、经常在外就餐/点外卖（OR=1.429,95%CI=1.091～1.871）、超重（OR=2.577,95%CI=1.475～4.503）、肥胖（OR=3.954,95%CI=2.204～7.094）及职业为运输/仓储（OR=1.972,95%CI=1.177～3.304）为高血压患病的危险因素;女性（OR=0.614,95%CI=0.472～0.799）、不饮酒（OR=0.714,95%CI=0.557～0.916）、无高血压家族史（OR=0.687,95%CI=0.556～0.848）是保护因素。结论 成都市就业流动人口高血压患病率较高,需重点关注男性、老年、运输/仓储职业、有高血压家族史的人群高血压患病情况。积极制定和完善流动人口高血压防控策略,针对可改变的危险因素,采取多种干预措施,提高其健康水平。     

云南省某市锡矿工人性病与艾滋病的流行病学调查

目的 估计云南省某市矿区锡矿工人性病、艾滋病感染状况及相关知识,并分析可能的危险因素。方法 2006年3-6月在云南省某市的5个矿区开展以矿区为基础的横断面研究,共纳入1796名矿工。采用标准化问卷匿名收集研究对象的性病与艾滋病知识、性行为等信息,并采集7ml静脉血和15ml尿检测4种性病和艾滋病感染情况。结果 调查矿工中共检出12例人类免疫缺陷病毒（human immunodeficiency virus,HIV）抗体阳性者,阳性率为0．7％（12／1760）,其他性病阳性率分别为梅毒1．8％（31／1760）,2型单纯疱疹（herpes simplex virustype-2,HSV-2）9．6％（169／1760）,淋球菌0．8％（14／1773）,沙眼衣原体4．8％（85／1773）,除HIV外的其他性病总患病率为14．9％（264／1776）。HIV感染和吸毒（调整OR=17．8;95％CI：4．0—78．8）、12个月内嫖娼次数（调整OR=8．7,95％CI：1．9—39．0）、文身（调整OR=6．6;95％CI：1．8—24．0）、手术（调整OR：6．0;95％CI：1．6—22．5）、共用牙刷（调整OR=5．6;95％CI：1．0—31．3）等因素的联系有统计学意义。性病感染和民族（调整OR=2．0;95％CI：1．5—2．7）、年龄（调整OR=1．7;95％CI．1．0—2．9）、吸毒（调整OR=2．3;95％CI：1．0～5．2）、和配偶住一起（调整OR=1．4;95％CI：1．1—1．9）及嫖娼（调整OR=1．9;95％CI：1．4—2．6）等因素的联系有统计学意义。艾滋病相关知识全部回答正确率为4．1％（49／1201）,有性经历的矿工中自我报告嫖娼的比例为21．6％（339／1569）。结论 该地区矿工性病、艾滋病感染率较高,性病、艾滋病知识匮乏,不安全性行为比较普遍,安全套使用率低,自我保护意识差,存在多种性病、艾滋病的传播途径,应加强该人群教育干预工作。     

北京某社区不同性别老年人群血尿酸水平与高血压的现况研究

目的 在社区老年人群中,探讨血尿酸（serum uric acid,SUA）水平与高血压的关系。方法 在2009年9月~2010年6月期间,使用整群随机抽样的方法对北京市万寿路地区60岁及以上的老年人进行横断面调查。结果 本研究的分析样本为2 074例老年人（男性839例,女性1 235例）。在老年女性的研究对象中,血尿酸水平的增加使高血压的患病风险增加（OR=1.004,95% CI:1.002~1.006,P<0.001）;以血尿酸四分位数最低组作为参照组,随着血尿酸水平增加,高血压的患病风险增加（血尿酸水平Q2（OR=1.263,95% CI:0.902~1.773,P=0.187）,血尿酸水平Q3（OR=2.008,95% CI:1.412~2.872,P<0.001）和血尿酸水平Q4（OR=2.015,95% CI:1.403~2.922,P<0.001））;患有高尿酸血症者,罹患高血压的风险高于非高尿酸血症者（OR=1.563,95% CI:1.082~2.253,P=0.018）。在男性中,仅血尿酸水平使高血压的患病风险增加 （OR=1.002,95% CI:1.000~1.004,P=0.036）。结论 血尿酸水平与高血压有相关性,特别是在老年女性当中。临床医生应特别关注老年女性的血尿酸水平,维持正常的血尿酸水平可能对高血压的预防和控制具有重要作用。     

Diabetes in a Caribbean population: epidemiological profile and implications

OBJECTIVE: To examine the distribution and impact of diabetes, glycaemic status, and related factors, in a predominantly black adult Caribbean population. METHODS: The study included 4709 people, or 84% of a simple random sample of Barbadian-born citizens aged 40-84 years, examined between 1988 and 1992 and re-assessed 4 years later. Diabetes was evaluated according to physician-diagnosis and glycosylated haemoglobin (GHb). Associations were assessed by logistic regression analyses, cumulative mortality by product-limit methods and death-rate ratios by Cox proportional hazards regression. RESULTS: Among the 4314 black participants, the prevalence of known diabetes, predominantly type 2, was 9.1% at 40-49 years of age and increased to 24.0% at 70-79 years. The overall prevalence was 17.5%, while it was 12.5% in mixed (black/ white; n = 184) and 6.0% in white/other participants (n = 133), only 0.3% had younger-onset. Additionally, 2% had GHb >10% (>2 SD over the mean) without diabetes history. Sulphonylureas were the most frequent treatment, while insulin use was infrequent. In black participants, diabetes was positively associated with age (OR = 1.03 per year; 95% CI : 1.02-1.04), diabetes family history (OR = 2.85, 95% CI : 2.39-3.40), hypertension (OR = 1.71, 95% CI : 1.42-2.05), obesity (BMI > or = 25 kg/m(2); OR = 1.74, 95% CI : 1.44-2.10), and high waist-hip ratio (WHR > or = 0.92; OR = 1.29, 95% CI : 1.09-1.53). Ocular co-morbidities were increased among people with diabetes, as was 4-year-mortality (death rate ratio = 1.42, 95% CI : 1.10-1.83). There was a 9% increase in mortality for each 1% increase in GHb (death rate ratio = 1.09, 95% CI : 1.04-1.15). CONCLUSIONS: A markedly high prevalence of diabetes existed in the adult black population, affecting almost one in five people and increasing morbidity and mortality. Prevention strategies are urgently needed to reduce the adverse implications of diabetes in this and similar populations.     

Delayed Blood Pressure Recovery After Standing Independently Predicts Fracture in Community-Dwelling Older People

ObjectivesOrthostatic hypotension, characterized by delayed blood pressure (BP) recovery after standing, is a risk factor for falls but the longitudinal relationship with fracture is not yet known. The aim of this study was to examine the prospective risk of fracture associated with delayed BP recovery.DesignLongitudinal study with 8-year follow-up.Setting and ParticipantsMore than 3000 (54% female) community-dwelling people aged ≥50 years from a large longitudinal study on ageing.MethodsOrthostatic BP was measured using a finometer when standing from lying. Delayed BP recovery was defined as systolic BP ≥20 mm Hg lower and/or diastolic BP ≥10 mm Hg from the baseline value at 30, 60, and 90 seconds after standing. Participants with a fracture reported at any of waves 2 to 5 were defined as having incident fracture. Logistic regression models were used to estimate odds ratios (ORs) for the association between delayed BP recovery and incident fracture.ResultsSeven percent (212/3117) of participants sustained a fracture during follow-up. Delayed BP recovery at 30 seconds was a significant predictor of any fracture [OR 1.80, 95% confidence interval (CI) 1.28-2.53] and hip fracture (OR 4.44, 95% CI 2.03-9.71) in fully adjusted models. Delayed BP recovery at 30 seconds did not predict wrist or vertebral fracture. Delayed BP recovery at 60 seconds also predicted any fracture (OR 1.74, 95% CI 1.19-2.54) and hip fracture (OR 4.66, 95% CI 2.12-10.26) whereas delayed BP recovery at 90 seconds predicted any (OR 1.99, 95% CI 1.38-2.87), wrist (OR 1.87, 95% CI 1.19-2.95), and hip fracture (OR 3.39, 95% CI 1.45-7.93) in fully adjusted models.Conclusionand Implications: Delayed BP recovery independently predicts fracture in community-dwelling older people, is potentially modifiable, and can be measured in an ambulatory setting. Because of the morbidity and mortality associated with fractures, identification of such risk factors is crucial in order to inform preventative strategies.     

Occupational activity and prevalence of osteomuscular pain among dentists in Belo Horizonte, Minas Gerais State, Brazil: a contribution to the debate on work-related musculoskeletal disorders

The objective was to determine the prevalence of upper-limb and back pain among dentists (n = 358) and factors associated with these symptoms. Dentists were interviewed using a self-administered questionnaire containing data on sociodemographic, occupational, lifestyle, and psychosocial factors and presence, site, and characteristics of pain. Participation rate was 92.3%. 58% reported upper limb pain, with 22, 21, 20, and 17% for the arm, back, neck, and shoulder, respectively. 26% reported daily frequency and 40% classified pain as moderate or severe. In the multivariate analysis (multiple logistic regression), the factors associated with pain were: neck: anxiety/depression (OR = 2.3; CI95%: 1.2-4.5), compressor in the office (OR = 2.1; CI95%: 1.2-3.7), job satisfaction (OR = 0.3; CI95%: 0.1-0.9), and use of indirect vision (OR = 0.5; CI95%: 0.3-0.9); shoulder: income > 20 minimum wage (OR = 2.9; CI95%: 1.2-6.7), greater productivity (OR = 3.3; CI95%: 1.3-8.4), height > or = 160cm (OR = 0.3; CI95%: 0.2-0.7), and age 30-49 years (OR = 0.3; CI95%: 0.1-0.8); back: anxiety/depression (OR = 2.3; CI95%: 1.2-4.5), manual activity (OR = 0.4; CI95%: 0.2-0.9), and being married (OR = 0.5; CI95%: 0.3-0.9); arms: manual activity (OR = 1.8; CI95%: 1.0-3.2).     

河南省新乡县农村居民脑卒中流行现况及影响因素分析

目的 了解河南省新乡县农村地区成年常住居民脑卒中流行现况及其影响因素。方法 于2017年4月—2017年6月采用整群抽样方法,随机抽取河南省新乡县朗公庙、七里营2个乡镇17个农村村落的成年常住居民(≥18岁)10 691人进行脑卒中及相关因素的问卷调查、体格检查与实验室检测。结果 本次调查共纳入资料完整对象10 455人进行分析,河南省新乡县农村地区脑卒中粗患病率为6.60%,年龄标准化患病率为5.05%;其中40岁以上人群脑卒中粗患病率为6.58%,标准化患病率为2.89%;男性、女性的性别粗患病率分别为8.39%和5.35%,标准化患病率分别为3.63%和2.39%。在脑卒中常见慢性共患病中,高血压共病率最高,为55.94%,糖尿病共病率最低,为14.64%。多因素logistic回归分析显示,年龄≥50岁(50～59岁:OR = 3.968, 95%CI: 2.654～5.933; 60～69岁:OR = 8.694, 95%CI: 5.906～12.798; ≥70岁:OR = 8.854, 95%CI: 5.855～13.390)、职业为农民(OR = 1.821, 95%CI:1.174～2.824)、高血压(OR = 2.151, 95%CI: 1.816～2.547)、血脂异常(OR = 2.434, 95%CI: 1.950～3.038)、糖尿病(OR = 1.393, 95%CI: 1.091～1.778)、冠心病(OR = 1.385, 95%CI: 1.117～1.718)可能是脑卒中患病的危险因素(P＜0.05);女性(OR = 0.542, 95%CI: 0.455～0.646)、有适度(OR = 0.668, 95%CI: 0.544～0.819)/剧烈运动(OR = 0.696, 95%CI: 0.571～0.849)可能是脑卒中患病的保护因素(P＜0.05)。结论 河南省新乡县农村地区成年常住居民脑卒中患病率较高,男性、≥50岁、农民、无适度/剧烈运动者、合并高血压、血脂异常、冠心病和糖尿病者仍是脑卒中防治的重点人群。     

Validity of self-reported hypertension and its determinants (the Bambuí study)

OBJECTIVE: Assessing the validity of self-reported hypertension and its determinants among adults living in the community was the objective of this study. METHODS: A simple random sample of residents in the city of Bambuí, State of Minas Gerais, Brazil aged >18 years was selected. Three blood pressure measurements were performed in 970 inhabitants. Sensitivity, specificity as well as positive and negative predictive values of self-reported hypertension were assessed in relation to hypertension (mean blood pressure >90 or >140 mm Hg and/or present use of anti-hypertensive drugs). RESULTS: Sensibility and specificity of self-reported hypertension were 72.1% (95% CI: 69.3-75.0) and 86.4% (95% CI: 84.3-88.6), respectively. Its prevalence was 27.2% (95% CI: 24.4-30.1), being reasonably similar to the prevalence of hypertension (23.3%; 95% CI: 20.7-26.1%). The validity of self-reported hypertension was higher among women, among individuals aged 40-59 and > or =60 years, among those who visited a doctor more recently (< two years) and among those with higher body mass index (>25 kg/m2). CONCLUSIONS: The results of this study show that self-reported hypertension is an appropriate indicator of hypertension prevalence, even in a population not living in a large urban center.     

潮州市居民肥胖状态与高血压关联强度的剂量-反应关系

目的 分析潮州市居民肥胖状态与高血压间的剂量-反应关系,为提出适宜的血压控制方案提供参考.方法 采用多阶段整群随机抽样的方法,对潮州市常住居民进行问卷调查和体格检查.采用Logistic回归分析模型探讨BMI、腰围与高血压患病的关联;采用基于限制性立方样条的Logistic回归分析模型分析BMI、腰围与高血压间剂量-反...     

Predictors of successful, self-reported lifestyle changes in a defined middle-aged population: the Soderakra Cardiovascular Risk Factor Study, Sweden

AIMS: It is well established that the main cause of the development of cardiovascular disease can be found in unhealthy lifestyle habits. In our study, we wanted to explore the long-term predictors of self-reported lifestyle changes in a middle-aged population after screening for cardiovascular risk factors 10 years earlier. METHODS: We conducted a 10-year follow-up telephone interview on self-reported lifestyle changes in a rural population in south-eastern Sweden, after a cardiovascular screening programme. The population comprised 90% of all inhabitants (n=705) aged 40-59 years at baseline, and 90% of these (n=629) were reached for the telephone interview. RESULTS: When multivariate logistic regression was used, a higher success rate for lifestyle changes was independently associated with female gender (odds ratio (OR)=1.56, 95% confidence interval (CI) 1.11-2.18). When stratified for gender, significant predictors for success in men were prevalent cardiovascular risk conditions (OR=4.77, 95% CI 2.18-10.5; p<0.001) and previous myocardial infarction (OR=22.8, 95% CI 4.73-110; p<0.001) at baseline. For women, elevated blood pressure (> or = 160 and/or > or = 90 mmHg) measured at baseline (OR=1.84, 95% CI 1.12-3.02; p=0.016) was significantly associated with successful lifestyle changes. Smoking at baseline was also associated with significant success: OR=3.36 (95% CI:2.05-5.51; p<0.001) and OR=1.81 (95% CI 1.11-2.95; p=0.017) for men and women, respectively. CONCLUSIONS: Female gender was associated with significant improvements in self-reported lifestyle changes. Furthermore, smoking, a medical history of diabetes, hypertension, angina pectoris or myocardial infarction at baseline predicted success in lifestyle change in this 10-year follow-up study.