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Indicators of accumulated fat are stronger associated with prehypertension compared with indicators of circulating fat: A cross-sectional study.

ABSTRACT: Recently, prehypertension has been considered as a risk factor for cardiovascular disease because it can progress to hypertension. The association between obesity and dyslipidemia with raised blood pressure has been reported in some studies; however, the ability of indicators of such conditions to predict prehypertension has been scarcely explored. In this cross-sectional study, we compared the ability of indicators of accumulated and circulating fat to discriminate between prehypertensive and normotensive Mexico City residents (n?=?1377). The indicators were classified based on the parameters needed for their calculation: including only circulating fat (IOCFi) (e.g., Castelli risk indexes), including only accumulated fat (IOAFi) (e.g., waist circumference [WC]), and mixed (e.g., lipid accumulation product [LAP]). We compared the areas under the receiving operating characteristic curves (AURCs) and estimated the cutoff points for each indicator and their associated risk of prehypertension. The IOAFi had the greatest AURCs, followed by mixed and IOCFi; the AURCs for WC were the highest (AURC?=?0.688 and 0.666 for women and men, respectively). The highest odds ratios for prehypertension were those associated with the cutoff points for IOAFi and LAP (e.g., OR?=?2.8 for women with WC?>?83.5?cm and OR?=?2.6 for men with WC?>?87.5?cm). Early detecting people at risk of cardiovascular disease is a necessity and given that WC had a better performance than the other indexes and it is relatively easy to measure, it has the potential of being used as a complementary measure in routine clinical examinations and by the general population as an auto-screening measurement to detect prehypertension.

SUBMITTER: Rivera-Mancia S

PROVIDER: S-EPMC6113050 | biostudies-literature | 2018 Aug

REPOSITORIES: biostudies-literature

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Indicators of accumulated fat are stronger associated with prehypertension compared with indicators of circulating fat: A cross-sectional study.

Rivera-Mancía Susana S Colín-Ramírez Eloisa E Cartas-Rosado Raúl R Infante Oscar O Vargas-Barrón Jesús J Vallejo Maite M

Medicine 20180801 34

Recently, prehypertension has been considered as a risk factor for cardiovascular disease because it can progress to hypertension. The association between obesity and dyslipidemia with raised blood pressure has been reported in some studies; however, the ability of indicators of such conditions to predict prehypertension has been scarcely explored. In this cross-sectional study, we compared the ability of indicators of accumulated and circulating fat to discriminate between prehypertensive and n ...[more]

PMID: 30142781

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Project description:BackgroundIndividuals with prehypertension are at higher risk of developing hypertension and cardiovascular diseases, while the interaction between factors may aggravate prehypertension risk. Therefore, this study aimed to evaluate the risk factors for prehypertension in Chinese middle-aged and elderly adults, and explore the potentially interactive effect of evaluated factors.MethodsAll the participants that came from a community based cross-sectional survey were investigated in Bengbu, China, by being interviewed with a questionnaire. Body mass index (BMI), Waist circumference (WC) and lipid accumulation product (LAP) that reflect participants' obesity were also calculated. In addition, logistic regression model was applied to explore the risk factors of prehypertension, followed by the assessment of the interactive effects between risk factors on prehypertension by the relative excess risk due to interaction (RERI), attributable proportion due to interaction (AP) and synergy index (SI).ResultsA total of 1777 participants were enrolled in this study, among which the prevalence of normtension, prehypertension and hypertension were 41.70%, 33.93% and 24.37% respectively. According to the multivariate logistic regression analysis, age (OR: 1.01, 95%CI: 1.00-1.02), smoking (OR: 1.67, 95%CI: 1.22-2.29), family history of cardiovascular diseases (OR: 1.52, 95%CI: 1.14-2.02), general obesity (OR: 1.51, 95%CI: 1.15-1.97) and LAP (OR: 2.58, 95%CI: 1.76-3.80) were all defined as the major factors that significantly related with the risk of prehypertension. When identifying prehypertension risk, the receiver-operating characteristics (ROC) curves (AUC) analysis indicated that LAP performed better than BMI in males (Z?=?2.05, P?=?0.03) and females (Z?=?2.12, P?=?0.03), but was superior to WC only in females (Z?=?2.43, P?=?0.01). What is more, there were significant interactive effects of LAP with family history of cardiovascular diseases (RERI: 1.88, 95%CI: 0.25-3.51; AP: 0.44, 95%CI: 0.20-0.69; SI: 2.37, 95%CI: 1.22-4.60) and smoking (RERI: 1.99, 95%CI: 0.04-3.93; AP: 0.42, 95%CI: 0.17-0.67; SI: 2.16, 95%CI: 1.68-4.00) on prehypertension risk. The value of AP (0.40, 95%CI: 0.03-0.77) also indicated a significant interaction between family history of cardiovascular diseases and smoking on prehypertension.ConclusionPrehypertension is currently prevalent in Chinese adults. This study indicated that age, family history of cardiovascular diseases, smoking, general obesity and LAP were significantly related with prehypertension risk. Furthermore, interactive effects on risk of prehypertension had been demonstrated in this study as well, which would help researchers to build strategy against prehypertension more comprehensively and scientifically.

Project description:ObjectivesTo assess the clustering of cardiovascular disease (CVD) risk factors in Han and Mongolian adults with prehypertension or hypertension in Northern China.MethodsWe selected 3227 Han and Mongolian participants (20-80 years old) using a multistage cluster sampling method in 2014. The participants were interviewed by standard questionnaires and underwent anthropometric measurement and biochemical testing. Han and Mongolian participants were divided into optimal, prehypertension, and hypertension groups based on blood pressure. A multinomial logit analysis was performed to explore relationships between CVD risk factor clustering and prehypertension or hypertension, and the heterogeneity between Han and Mongolian was evaluated by the Cochran Q test. The differences between the ethnic groups in the proportions of risk factors was tested with the ?2 test.ResultsThe clustering of two or?three?CVD risk factors in the prehypertension or hypertension groups was consistently higher than in the optimal group (Bonferroni, p<0.0167). The odds ratios (ORs) of prehypertension and hypertension increased with the number of CVD risk factors (ptrend <0.0001). In multivariate modelling, the adjusted ORs of one, two, and ?3?CVD risk factors versus no risk factors was, respectively, 1.95, 2.25, and 2.28 in Han prehypertensive participants, and 1.73, 2.83, and 3.69 in Mongolian prehypertensive participants. In addition, the adjusted ORs were 3.15, 4.75, and 6.49 in Han hypertensive participants, and 1.90, 5.29, and 8.13 in Mongolian hypertensive participants (all p<0.05). There was no significant heterogeneity between Han and Mongolian participants in the prehypertension or hypertension groups. The age-standardised prevalence of??3?risk factors was 38.30% in Han men and 39.79% in Mongolian men. The rate was significantly lower in Han women than Mongolian women (9.18% vs 14.55%, p=0.002).ConclusionsThese findings showed clustering of CVD risk factors in prehypertensive Han and Mongolian adults, and showed prehypertension may be a useful target for intervention.

Project description:BACKGROUND:At least six communities with unusually good health and longevity have been identified, but their lifestyles aren't adopted widely. Informal evidence suggests that women associated with Universal Medicine (UM), a complementary medicine health care organization in Eastern Australia and the United Kingdom with normal lifestyles, also have several unusual health indicators. OBJECTIVE:Our objective was to determine how UM participants compared with women in the Australian population at large on a variety of health indicators. METHODS:In an Internet survey conducted July to September 2015, a total of 449 female UM participants from 15 countries responded to 43 health indicator questions taken from the Australian Longitudinal Study on Women's Health (ALSWH). RESULTS:Survey responses revealed large positive differences in mental and physical health when compared with the ALSWH respondents, except for abnormal Pap test and low iron history. Differences and corresponding effect size estimates (Cohen d; ?0.8 is a high difference, ?0.5 a medium and ?0.2 a small one with P<.001 except where indicated) included body mass index (BMI; 1.11), stress level (0.20, P=.006), depression (0.44), summary physical (0.31) and mental health (0.37), general mental health (0.39), emotional (0.15, P=.009) and social functioning (0.22), vitality (0.58), and general health (0.49), as well as lower incidences of diabetes, hypertension, and thrombosis (P<.001 each). Neither education levels nor country of residence had predictive value. Neither education levels nor country of residence had predictive value. Age did not predict BMI. CONCLUSIONS:The women's responses notably claim substantially lower levels of illness and disease than in the general Australian population. TRIAL REGISTRATION:Australian New Zealand Clinical Trials Registry (ANZCTR): ACTRN12617000972325; https://www.anzctr. org.au/Trial/Registration/TrialReview.aspx?id=373120&isReview=true (Archived by WebCite at http://www.webcitation.org/ 6wEDDn45O). INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID):DERR2-10.2106/7993.

Project description:BackgroundThe unmet burden of surgical care is high in low-income and middle-income countries. The Lancet Commission on Global Surgery (LCoGS) proposed six indicators to guide the development of national plans for improving and monitoring access to essential surgical care. This study aimed to characterise the Somaliland surgical health system according to the LCoGS indicators and provide recommendations for next-step interventions.MethodsIn this cross-sectional nationwide study, the WHO's Surgical Assessment Tool-Hospital Walkthrough and geographical mapping were used for data collection at 15 surgically capable hospitals. LCoGS indicators for preparedness was defined as access to timely surgery and specialist surgical workforce density (surgeons, anaesthesiologists and obstetricians/SAO), delivery was defined as surgical volume, and impact was defined as protection against impoverishment and catastrophic expenditure. Indicators were compared with the LCoGS goals and were stratified by region.ResultsThe healthcare system in Somaliland does not meet any of the six LCoGS targets for preparedness, delivery or impact. We estimate that only 19% of the population has timely access to essential surgery, less than the LCoGS goal of 80% coverage. The number of specialist SAO providers is 0.8 per 100 000, compared with an LCoGS goal of 20 SAO per 100 000. Surgical volume is 368 procedures per 100 000 people, while the LCoGS goal is 5000 procedures per 100 000. Protection against impoverishing expenditures was only 18% and against catastrophic expenditures 1%, both far below the LCoGS goal of 100% protection.ConclusionWe found several gaps in the surgical system in Somaliland using the LCoGS indicators and target goals. These metrics provide a broad view of current status and gaps in surgical care, and can be used as benchmarks of progress towards universal health coverage for the provision of safe, affordable, and timely surgical, obstetric and anaesthesia care in Somaliland.

Dataset Information

Indicators of accumulated fat are stronger associated with prehypertension compared with indicators of circulating fat: A cross-sectional study.

Publications

Indicators of accumulated fat are stronger associated with prehypertension compared with indicators of circulating fat: A cross-sectional study.

Similar Datasets

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