高校教职工中超重和肥胖与心血管疾病危险因素关系的研究

目的探讨高校教工超重和肥胖与高血压、高血糖和高血脂的关系.方法选取云南省某高校1190名在职教职工进行问卷调查和体检.结果调整了相关因素后,男性中超重与高血压、高胆固醇、高甘油三酯呈正关联（P〈0.05）,而肥胖与高甘油三酯、高血糖呈正关联（P〈0.05）.女性中超重与高血压、高甘油三酯呈正关联（P〈0.05）,而肥胖与高血压呈正关联（P〈0.05）.结论超重和肥胖与高校教职工的高血压、高血糖、高血脂相关,应加强针对超重和肥胖的健康教育.     

Association between serum uric acid and some cardiovascular risk factors in a Chinese population.

The association between serum uric acid concentration and some cardiovascular risk factors was examined in a working Hong Kong Chinese population (mean age 38 years), consisting of 910 men and 603 women. There was no significant age-related rise in serum uric acid concentration. Positive associations were found between serum uric acid concentration and body mass index, waist hip ratio, systolic and diastolic blood pressure, urea, creatinine, protein, glucose (fasting and 2 hours after 75 g oral glucose load), 2 hour insulin, triglycerides, and apolipoprotein B in men. Similar, but fewer, associations were seen in women, with the addition of a positive association with age. In both sexes, serum uric acid was negatively associated with high-density lipoprotein cholesterol. These findings complement the well-known clinical association between gout and cardiovascular and metabolic diseases, such as hypertension, hyperlipidaemia and diabetes mellitus, and suggest that serum uric acid may be a marker for the presence of an adverse cardiovascular risk factor profile.     

Habitual physical activity and cardiovascular risk factors

The relationships between different levels of participation in physical activity and biological indices of cardiovascular risk were examined in a sample of 6814 male and female adults who took part in a national risk factor prevalence survey. Participation in physical activity was classified as "aerobic" (14.6% of total), "moderate" (53.6%) or "inactive" (31.8%). Bivariate analyses found significant associations between level of exercise participation and diastolic blood pressures in men, but not in women; significant associations were found between reported physical activity and systolic blood pressure, total serum cholesterol, high-density lipoprotein (HDL) cholesterol, HDL/total cholesterol ratio and triglycerides for both men and women. Further analyses were controlled for age, education, and the survey site, which were potential confounders of the association between physical activity and other coronary heart disease risk factors. After adjustment, significant associations remained between levels of exercise participation and HDL cholesterol level, HDL/total cholesterol ratio and serum triglyceride levels for both sexes. In women, there was also a significant relationship between activity level and body mass index. In addition, for men only, there was a significant inverse relationship between physical activity and total cholesterol, and, for older men, between physical activity and systolic blood pressure. It is well recognised that physical activity has an independent effect on reducing the risk of coronary heart disease. The results of this study suggest that there may be small supplementary effects mediated through the relationship between exercise and other biological cardiovascular risk factors.     

Risk factors for hypertension in Kimberley aborigines.

OBJECTIVE: To determine physical, biochemical and lifestyle factors associated with high blood pressure among Aborigines in the Kimberley region. DESIGN: Blood pressure and electrocardiographic (ECG) abnormalities in an age and sex stratified random sample of the Aboriginal population were related to other observations and measurements made at the same time specifically for the purpose of these comparisons. SETTING: A field study in which subjects were interviewed and measurements made mostly in community clinics. PARTICIPANTS: All 249 men and 241 women from the prevalence study were included although only complete data sets for the various comparisons were analysed. INTERVENTIONS: A sample of venous blood was obtained in addition to physical measurements and information at interview. MAIN OUTCOME MEASURES: Statistical analysis of the relationships between blood pressure or hypertension and alcohol consumption, plasma gamma-glutamyl transpeptidase (GGT) activity, use of tobacco, body mass index (BMI, kg/m2) and non-fasted plasma cholesterol level. Hypertension was defined as systolic blood pressure of 160 mmHg or greater or diastolic blood pressure of 95 mmHg or greater. RESULTS: High blood pressure in Aboriginal men below 30 years was associated both with current drinking status and with circulating GGT level. There was a positive association of diastolic hypertension with consumption of alcohol in middle aged men (30 to 49 years) and in older women. Drinking was highly prevalent among men, especially below 30 years, but was less prevalent among women. Both systolic and diastolic blood pressure were positively related to BMI across the population but obesity (BMI greater than or equal to 30 kg/m2) was highly prevalent only among middle-aged women. Both systolic and diastolic blood pressure were positively and strongly related to plasma cholesterol level independently of the latter's relationship to age and BMI. CONCLUSION: The high prevalence of drinking among Aboriginal men and of obesity among Aboriginal women involves a risk of hypertension. The association between plasma cholesterol and blood pressure in Aboriginal men and women may be relevant to the demonstrated link between systolic hypertension and ischaemic heart disease.     

Risk of coronary heart disease in women after menopause

An increase in the incidence of coronary heart disease risk has commonly been reported in postmenopausal women. The study population comprised 263 adult healthy men and 237 women (104 premenopausal and 133 postmenopausal) ranging in age group of 21-70 years who were examined for coronary heart disease risk factors from Nellore district in Andhra Pradesh. Anthropometric measurements, blood pressure and serum lipids were analysed using standard procedures. There were no significant differences for anthropometric variables between postmenopausal and premenopausal women. Postmenopausal women had significantly higher levels of blood pressure, pulse rate, serum total cholesterol, triglycerides, low-density lipoprotein cholesterol and ratios of total cholesterol:high-density lipoprotein cholesterol and low-density lipoprotein cholesterol:high-density lipoprotein cholesterol as atherogenic indices than premenopausal women and the corresponding age group of male counterparts. However, the variation of high-density lipoprotein cholesterol levels between these groups were not statistically significant. The prevalence of hypertension, hypercholesterolaemia, hypertriglyceridaemia and atherogenic indices was significantly greater in postmenopausal women than in premenopausal women. This study confirms a higher prevalence of risk factors for coronary heart disease among women in older age group and suggests that when oestrogen production ceases in menopausal women, the risk of coronary heart disease increases.     

Postmenopausal estrogen use and heart disease risk factors in the 1980s. Rancho Bernardo, Calif, revisited

Postmenopausal estrogen use and risk factors for heart disease were assessed in 1057 women, aged 50 to 79 years, who were enrolled in an ongoing study of residents of an upper-middle-class community. From 1984 through 1987, thirty-one percent of the women reported current estrogen use, a rate equivalent to that determined in one survey of the same population done from 1972 through 1974. Compared with nonusers, current users did not have a more favorable cardiac risk factor profile before use, but users were more likely to have had a surgically induced menopause and to have been estrogen users during the survey done from 1972 through 1974. Similar to our earlier findings, current estrogen use was associated with lower weight, diastolic blood pressure, and fasting plasma glucose level than nonuse. Levels of low-density lipoprotein cholesterol were inversely related to estrogen dose; levels of high-density lipoprotein cholesterol were positively related to the duration of use. In this cross-sectional study, blood pressure and lipoprotein and plasma glucose levels were similar in women receiving estrogen alone and in women receiving combination estrogen and progestin therapy.     

Education level and coronary risk factors in Australians

There is an inverse association between social class ranking and mortality from coronary heart disease in Australia and in some other countries. To explain whether this association is related to differences in risk factors, the relationship between coronary risk factors and the highest level of education completed was explored for a reasonably representative cross-section of the adult Australian population. After adjustment for the effects of age, relative weight and alcohol intake, blood pressure was found to vary inversely with education level in both sexes. In men only plasma cholesterol, triglycerides and high density lipoprotein cholesterol levels showed no significant variation with education level. In women, plasma triglycerides and high density lipoprotein cholesterol levels varied inversely with education level after adjustment. There was less cigarette smoking among more highly educated men but no clear smoking trends among women. The findings broadly confirm the results of similar analyses which used occupation as the measure of social class and have implications for future community education programmes in that present strategies may be inappropriate for less highly-educated members of society.     

Human serum albumin levels and cardiovascular risk factors in elderly Japanese-American men: the Honolulu Heart Program

The objective of this study is to investigate the relationship between lowlevels of human serum albumin (HSA) and the incidence of coronary heart disease (CHD) in a cohort of elderly Japanese-American men. Using data from the Honolulu Heart Program's fourth examination (1991-1993), HSA levels of 998 Japanese American men aged 71-93 years was compared with plasma levels of fibrinogen, total cholesterol, HDL cholesterol, LDL cholesterol, triglycerides, diastolic BP, BMI, and fasting blood glucose. HSA was significantly negatively associated with age and fibrinogen, and significantly positively associated with total cholesterol, HDL cholesterol, LDL cholesterol, triglycerides, diastolic BP, BMI and fasting blood glucose. After adjusting for age, tertiles of HSA were significantly positively associated with total cholesterol, HDL cholesterol and triglycerides, and significantly negatively associated with fibrinogen. Using multivariate stepwise regression, significant correlations were seen between HSA and fibrinogen, cholesterol, age, HDL cholesterol and triglycerides, and a borderline correlation was seen with systolic blood pressure. However, the model R-square for all variables was only 0.10. In conclusion, HSA levels are significantly associated with several traditional cardiovascular risk factors, particularly serum lipid levels.     

Body weight and risk of myocardial infarction and death in the adult population of eastern Finland

Body mass index (weight (kg) divided by height squared (m2] and its association with the risk of myocardial infarction and death from all causes were studied prospectively in a randomly selected population sample in eastern Finland aged 30-59 at outset in 1972. The study population consisted of 3786 men and 4120 women. The participation rate in the survey in 1972 was over 90%. All deaths and admissions to hospital in the sample were obtained from the National Death Certificate and Hospital Discharge Registers. During the seven years of follow up until 1978, 170 men and 52 women had acute myocardial infarction, and during the nine years up to 1980, 223 men and 92 women died. Independent of age, men with a body mass index of 28.5 or more had a significantly higher incidence of acute myocardial infarction. This effect was also independent of smoking but not independent of biological coronary risk factors--that is, serum cholesterol concentration and blood pressure. In the analysis stratified for smoking in men the body mass index total mortality curve was J shaped among non-smokers, whereas smoking entirely outweighed body mass index as a predictor of death. Body mass index did not contribute significantly to the risk of either acute myocardial infarction or death in women. It is concluded that a body mass index of around 29.0-31.0 or more is not only a marker for coronary risk factors but is also a predictor of acute myocardial infarction in men.     

Plasma lipids and lipoproteins and the prevalence of risk for coronary heart disease in Canadian adults. Canadian Heart Health Surveys Research Group.

OBJECTIVE: To report population reference values for blood lipids, to determine the prevalence of lipid risk factors and to assess their association with other risk factors. DESIGN: Population-based cross-sectional surveys. Survey participants were interviewed at home and provided a blood sample at a clinic. All blood lipid analyses were done in the Lipid Research Laboratory, University of Toronto. The laboratory is standardized in the National Heart, Lung Blood Institute-Centres for Disease Control Standardization Program. SETTING: Nine Canadian provinces, from 1986 to 1990. PARTICIPANTS: A probability sample of 26,293 men and women aged 18 to 74 was selected from the health insurance registers for each province. Blood samples were obtained from 16,924 participants who had fasted 8 hours or more. OUTCOME MEASURES: Concentration of total plasma cholesterol, triglycerides and high density lipoprotein (HDL) and low density lipoprotein (LDL) cholesterol in blood samples from fasting participants. MAIN RESULTS: Of the study population, 46% had total plasma cholesterol levels above 5.2 mmol/L, 15% had LDL-cholesterol levels above 4.1 mmol/L, 15% had triglyceride levels above 2.3 mmol/L and 8% had HDL-cholesterol levels below 0.9 mmol/L. Total plasma cholesterol, LDL-cholesterol and triglyceride levels rose with age in men to a maximum in the 45-54 age group; in women there was little change with age up to ages 45 to 54, at which time the level of each of these lipids increased appreciably. The age-standardized prevalence of obesity was positively associated with elevation of total plasma cholesterol. CONCLUSION: The results suggest the need for a multifactorial approach in health promotion efforts to lower blood cholesterol levels and reduce other risk factors in the population. A considerable number of adults were found to be at risk at all ages in both sexes. In the short term, men aged 34 and older and women aged 45 and older might benefit most from prevention programs.     

Associations of dietary fat, regional adiposity, and blood pressure in men

Mediterranean populations have low incidence rates of cardiovascular disease and hypertension that may be due, in part, to dietary factors, particularly a relatively high intake of monounsaturated fat as olive oil. In this study, nutritional components (as grams per 4200 kJ) (1 kcal = 4.2 kJ) from three-day food records were examined in association with resting blood pressure in a cross-sectional survey of 76 sedentary middle-aged American men, aged 30 to 55 years, with resting blood pressures below 160/100 mm Hg. Systolic and diastolic blood pressures correlated significantly and inversely with monounsaturated fat consumption. Polyunsaturated fat consumption also correlated inversely with diastolic blood pressure; however, this relationship became nonsignificant when adjusted for an index of regional adiposity that characterizes the male-type obesity pattern. Detailed analyses of specific fatty acids showed that the correlations with monounsaturates were specific to oleic acid, and the correlation with polyunsaturates was specific to linoleic acid. Multiple regression analysis suggested that 18.2% of the variance in systolic blood pressure and 23.2% of the variance in diastolic blood pressure were related to monounsaturated and polyunsaturated fat consumption and regional adiposity. Thus, increased consumption of monounsaturated fat is related inversely to resting blood pressure, although causality remains to be determined.     

Multiple cardiovascular disease risk factors in Canadian adults. Canadian Heart Health Surveys Research Group.

OBJECTIVE: To estimate the prevalence and distribution of the coexistence of major cardiovascular disease (CVD) risk factors among Canadian adults. DESIGN: Population-based cross-sectional surveys. SETTING: Nine Canadian provinces, from 1986 to 1990. PARTICIPANTS: A probability sample of 26,293 men and women, aged 18 to 74 years, was selected from provincial health insurance registries. For 20,582 of these participants, at least two blood pressure (BP) measurements were taken using a standardized technique. At a subsequent visit to a clinic, two additional BP readings, anthropometric measurements and a blood specimen for plasma lipid analysis were obtained. OUTCOME MEASURES: The percentage distribution of subjects by number of major risk factors (smoking, high BP and elevated blood cholesterol level) and by concomitant factors (body mass index [BMI], ratio of waist to hip circumference [WHR], physical activity, diabetes, awareness of CVD risk factors and education). MAIN RESULTS: Sixty-four percent of men and 63% of women had one or more of the major risk factors. Prevalence increased with age to reach 80% in men and 89% in women aged 65 to 74 years. Prevalence of two or three risk factors was highest among men in the 45-54 age group (34%) and in women in the 65-74 age group (37%). The most common associations were between smoking and high blood cholesterol level (10%) and between high BP and high blood cholesterol level (8%). Prevalence of high BP and elevated blood cholesterol, alone or in combination, increased with BMI and WHR. Smoking, elevated blood cholesterol, BMI and prevalence of one or more risk factors increased with lower level of education. Less than 48% of participants mentioned any single major risk factor as a cause of heart disease. Awareness was lowest in the group with fewest years of education. CONCLUSION: The findings of this study call for an approach to reduce CVD that stresses collaboration of the different health sectors to reach both the population as a whole and the individuals at high risk.     

老年人血压、血脂、血糖、血清胆红素与冠心病的相关性研究

目的研究老年人血压、血脂、血糖、血清胆红索与冠心病的相关性,以明确冠心病相关危险因素,并积极控制,预防并延缓冠心病的发生发展。方法选择2010年10月-2012年12月该院收治的冠心病患者60例作为观察组,同期健康体检者及门诊患者共50例作为对照组,比较两组血压、血脂、血糖、血清胆红素等方面资料。结果观察组血压、血糖、甘油三酯、低密度脂蛋白胆固醇水平均高于对照组,血清胆红素指标低于对照组,差异有统计学意义（P〈0．05）。结论高血压、高血脂、高血糖与冠心病呈正相关,血清胆红素与冠心病呈负相关。高血压、高血糖、高血脂均为冠心病的危险因素,血清胆红素浓度可提示冠心病发病几率,以及时给予有效的防治措施。     

Fatty-acid composition of serum lipids predicts myocardial infarction

During a follow-up of five to seven years 33 out of 1222 middle-aged men initially free of coronary heart disease sustained fatal or non-fatal myocardial infarction or died suddenly. The fatty-acid composition of serum triglycerides, phospholipids, and cholesterol esters had been measured at the start of the surveillance in these men and in a control group of 64 men matched for age, serum cholesterol and triglyceride concentrations, blood pressure, obesity, smoking, and one-hour glucose tolerance. Palmitic and stearic acids of phospholipids were significantly higher and linoleic and most polyunsaturated fatty acids, including arachidonic acid and eicosapentaenoic acid, of phospholipids were lower in the subjects who sustained coronary events compared with the controls. Linoleic acid tended to correlate negatively with blood pressure while other polyunsaturated fatty acids, especially eicosapentaenoic acid, exhibited a negative correlation with blood pressure and relative body weight in the controls but not in the subjects who sustained coronary events. These findings suggest that the fatty-acid pattern of serum phospholipids is an independent risk factor for coronary heart disease.     

Blood lipid concentrations and other cardiovascular risk factors: distribution, prevalence, and detection in Britain

To establish the distribution of blood lipid concentrations and the prevalences of other risk factors for cardiovascular disease in Britain 12,092 men and women aged 25-59 in Glasgow, Leicester, London, and Oxford were studied. Subjects were selected by opportunistic case finding, in which patients consulting their general practitioner for any reason were offered a health check by appointment, or random selection from age-sex registers, in which an invitation for a health check was posted. The overall rate of response was 73%, being 91-94% by opportunistic case finding and 36-63% by random selection. At the health check subjects answered a brief questionnaire about risk factors for cardiovascular disease, and their height, weight, and blood pressure were recorded; a blood sample was taken for measuring plasma concentrations of cholesterol, triglyceride, high density lipoprotein cholesterol, and glucose. The mean cholesterol concentrations were 5.9 (SD 1.2) and 5.8 (1.2) mmol/l in men and women, respectively. In London the mean value was 5.5 (1.2) mmol/l for both men and women and was significantly lower than mean values in the three other centres, among which there were no significant differences. In men and women aged 25-29 concentrations were similar but they increased in men until the age of 45-49, after which they showed no further increase; in women concentrations did not increase until the age of 40-44 and by the age of 50-59 values were higher than in men. Mean triglyceride concentrations were significantly higher in men than in women (1.8 (1.4) v 1.3 (0.9) mmol/l, respectively), and trends with age were similar to those for cholesterol concentrations, except that at no age were values higher in women than in men. Mean triglyceride values overall were higher in Glasgow and London than in Oxford and Leicester. Body mass index was higher in Glasgow and London than in the other two centres and correlated with systolic and diastolic blood pressures and triglyceride concentration. In addition, subjects in Glasgow smoked significantly more than those in the other centres. These observations could contribute to the higher rate of coronary heart disease in Glasgow. Plasma lipid concentrations and the prevalences of other risk factors for cardiovascular disease were similar in subjects selected by opportunistic case finding and by random selection. In Britain cholesterol values have changed little during the past 12 years despite dietary recommendations and health education.(ABSTRACT TRUNCATED AT 400 WORDS)     

尿酸与冠状动脉疾病危险因子的性别差异

目的探讨尿酸(UA)与冠状动脉疾病(CAD)危险因子的性别差异.方法通过血管造影术显示研究对象CAD的严重度并作计分;通过询问患者病史及治疗记录获取其心血管病史与危险因子;通过尿酸酶法测定UA值;用临床标准生化方法,在BECKMAN SYNCHRON CX9分析仪测定Cr,TC,TG,HDL-C,LDL-C,Glu,HbA1c;用放射免疫法(RIA)测定尿清蛋白(Alb)与血清胰岛素.结果 277例血管造影术显示218例为CAD,59例冠状动脉正常;女性UA水平与CAD严重度呈线性关系,而男性没此相关性;女性CAD严重度与代谢综合征危险因子的数量相关;而男性CAD只与少数危险因子相关,当根据分类定义作评估时,仅年龄及微Alb尿的差异具有显著性意义.结论女性UA水平与CAD严重度呈线性关系;女性代谢综合征危险因子及相关UA水平可预测CAD危险性及严重度.     

Association between serum lipids, blood pressure, and simple anthropometric measures in an adult Chinese population

BACKGROUND: Cardiovascular disease (CVD) is one of the leading causes of death in China. Although body mass index (BMI) of the Chinese population was lower than that of Western populations, it has shown a rapidly increasing trend. The objective of this study was to evaluate the association of anthropometric measurements such as BMI and waist circumference (WC) with blood pressure, total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), triglycerides (TG), and the prevalence of hypertension as well as dyslipidemia in Chinese adults. METHODS: A cross-sectional survey in a representative sample of 881 men and 1098 women >25 years old was conducted during the period between 2002 and 2003. Height, weight, WC, resting blood pressure and serum lipid profiles including TG, TC, HDL-C and LDL-C were measured. RESULTS: TC, TG, LDL-C, systolic blood pressure (SBP), and diastolic blood pressure (DBP), as well as the incidence rate of dyslipidemia or hypertension, kept increasing steadily with BMI and WC. Meanwhile, HDL-C decreased with the two anthropometric measurements. Multiple regression analysis showed that both WC and BMI were independent CVD risk-associated factors and central obesity had a stronger effect on the development of CVD. Adjusted odds ratios for having dyslipidemia or hypertension also increased significantly with the growth of BMI and WC. BMI and WC had similar areas under the receiver operating characteristic curves in predicting CVD risk factors. CONCLUSION: In the Chinese population, both BMI and WC provided independent information in assessing cardiovascular risks. Chinese subjects had a higher CVD risk and lower BMI and WC than Western population. Efforts to halt the trend of increasing BMI and WC should be undertaken.     

Is elevated serum cholesterol level a risk factor for coronary heart disease in the elderly?

Since serum cholesterol is a major component in the causal pathway of atherosclerosis, a pathological process that usually progresses with age, we have evaluated reported findings of a diminished association between serum cholesterol level and coronary heart disease in the elderly. In the Honolulu (Hawaii) Heart Program, 1480 men aged 65 years and older and free of coronary heart disease were followed up for an average of 12 years. Incidence rates of coronary heart disease increased progressively from the lowest to the highest quartile of serum cholesterol level. The independent role of serum cholesterol level as a predictor of coronary heart disease risk was evaluated with other major risk factors using a Cox multivariate regression model. The upper-lower quartile relative risk for serum cholesterol level was 1.64 (95% confidence interval, 1.14 to 2.36). The relative risk for middle-aged men was also 1.64. The results suggest that serum cholesterol level is an independent predictor of coronary heart disease, even among men older than 65 years. Thus, an elevated serum cholesterol level in the elderly should be regarded, as in middle-aged men, to be an indicator for further evaluation of lipoprotein levels and possible intervention.     

Blood pressure and associated cardiovascular risk factors in Iran: Isfahan Healthy Heart Programme

This study was done to estimate the prevalence of high blood pressure (BP) in treated and non-treated subjects with respect to age and gender and its association with other cardiovascular risk factors in Iran. This cross sectional study was performed in three cities of Iran on participants over 19 years at 2002. First a questionnaire consisting of demographic details, drug intake and smoking status was filled. Then physical examination including systolic and diastolic blood pressure (SBP, DBP), body mass index (BMI) and waist to hip circumference (WHC) was performed. Fasting blood sample was drawn for sugar (FBS), total cholesterol (TC) and triglyceride (TG) and a 2-hour postprandial glucose was also measured. In this study performed on 12494 subjects, 48% were males and 52% females. The mean age of men and women was 38.99+/-15.30 and 38.80+/-14.54 years respectively. The prevalence of high BP in men and women was 15.6% and 18.8% respectively. The prevalence of high BP was higher in women than in men, except in the younger age classes. Overall 26.7% of hypertensive men and 47.7% of hypertensive women were on anti-hypertensive pharmacological treatment. Among the treated patients, BP was under control in 6.4% of the men and 13.8% of the women. In 86.5% of men with high BP and 89.3% of women with high BP, at least one other cardiovascular risk factor was present and its prevalence increased with age in both genders. BMI >25 (especially abdominal obesity) was the most frequent associated risk factor (41.9% in male, 59% in female). Except for smoking, the prevalence of each cardiovascular risk factor increased with the severity of hypertension, except in young women. The prevalence of high BP- even in treated subjects- is high in Iran. Many subjects with high BP have at least one other associated cardiovascular risk factor. These data emphasize the necessity of implementing community-based interventions.     

Determinants of isolated systolic hypertension

Isolated systolic hypertension (ISH), defined as systolic blood pressure of 160 mm Hg or greater when the diastolic pressure is less than 95 mm Hg, is a common form of hypertension among the elderly. We collected incidence and prevalence data on ISH and evaluated several potential factors for its occurrence in the Framingham Heart Study during 16 biennial examinations. The factors evaluated were age, sex, all components of the blood pressure (systolic and diastolic blood pressure, pulse pressure, and mean arterial pressure), Metropolitan relative weight, serum cholesterol level, serum uric acid level, cigarette smoking, ventricular heart rate, glucose intolerance, and hematocrit. The population at risk (1687 men and 1992 women) were those members of the Framingham cohort with a systolic blood pressure less than 160 mm Hg in the first four biennial examinations. Results showed ISH in 14.4% of the men and 22.8% of the women. Cumulative incidence rates were 418 per 1000 in men and 533 per 1000 in women. Significant risk factors for ISH were age, sex, all components of the blood pressure, and increased relative weight in women. We conclude that ISH is a highly prevalent disorder. Its major determinants are age, sex, increasing levels of blood pressure, and obesity in women.