BACKGROUND: There may be a link among stress, adrenal medullary activation, and the development of hypertension. Obesity is characterized by sympathetic activation and predisposes to hypertension, but may be associated with low or normal adrenal medullary activity. We hypothesized that plasma epinephrine (E) levels and adrenal medullary responsiveness to mental stress are lower in overweight than in lean borderline hypertensive subjects. METHODS: We compared groups of lean (n = 62) and overweight (n = 29) borderline hypertensive young men as well as lean (n = 36) and overweight (n = 7) normotensive young men from the same population. Plasma catecholamines and heart rate (HR) were measured at rest during a hyperinsulinemic glucose clamp and during mental arithmetic-induced stress. RESULTS: Plasma norepinephrine (NE) and E, HR, and responses to stress were increased in borderline hypertensive subjects. Our results showed that NE was increased only in lean borderline hypertensive subjects at rest, but in overweight subjects as well during stress, with DeltaNE being similar in lean and overweight subjects. We found that E was higher in lean than in overweight borderline hypertensive subjects at rest and during stress (both P
OBJECTIVES. To investigate the relationship between gonadal function, insulin and psychosocial stress in middle-aged men. DESIGN. A population-based, cross-sectional, observational study. SETTING. Glostrup Hospital, Copenhagen, Denmark. SUBJECTS. Four hundred and thirty-nine males, all aged 51 years. MAIN VARIABLES. Body-mass index (BMI), waist-to-hip ratio (WHR), insulin, C-peptide, free testosterone, luteinizing hormone (LH), lipids, fibrinogen, lung function tests (FVC, FEV1, PEF), blood pressure, a self-administered questionnaire with questions on psychosocial variables, lifestyle and self-rated health. RESULTS. Free testosterone correlated inversely (P
We report the influence of aging on multiple markers of oxidative-nitrosative stress in the heart of adult (6-month), aged (30-month) and very aged (36-month) Fischer 344/NNiaHSd x Brown Norway/BiNia (F344/NXBN) rats. Compared to adult (6-month) hearts, indices of oxidative (superoxide anion [O2*-], 4-hydroxy-2-nonenal [4-HNE]) and nitrosative (protein nitrotyrosylation) stress were 34.1 +/- 28.1%, 186 +/- 28.1% and 94 +/- 5.8% higher, respectively, in 36-month hearts and these findings were highly correlated with increases in left ventricular wall thickness (r > 0.669; r > 0.710 and P
The Copenhagen City Heart Study is a prospective cardiovascular population study designed to evaluate the incidence of and risk factors for cardiovascular disease. A random population sample comprising approximately 20,000 individuals was invited to participate. Blood pressure was measured, and information regarding the use of antihypertensive medication was collected in an initial survey during the period 1976-1978 (attendance rate 74%) and from a second survey during the period 1981-1983 (attendance rate 70%). A significant increase in systolic and diastolic blood pressure between survey 1 and survey 2 was found among both men and women greater than 40 years of age and not using antihypertensive medication. The increase in blood pressure in the follow-up survey could not be explained by changes in methods, changes in the prescription of antihypertensive medication, or selection bias. Factors associated with changes in systolic and diastolic blood pressure were examined by multiple linear regression analysis. Both increase in body mass index and increase in alcohol consumption were positively correlated with changes in systolic and diastolic blood pressure, while use of antihypertensive medication, a high value of body mass index at survey 1 and a high level of education were negatively correlated with changes in systolic and diastolic blood pressure. Female sex and advanced age were also negatively correlated with changes in diastolic blood pressure. Consumption of tobacco and alcohol, income and changes in consumption of tobacco were not significantly correlated with changes in systolic and diastolic blood pressure.
A representative population sample was studied to elucidate relationships of arterial pressure (AR) with muscular performance (MP) and arterial hypertension risk factors. Power working capacity (PWCx) was measured by means of exercise tolerance test at rest, under physical loading and after the exercise. The findings were processed using a multivariate step-by-step regression analysis which established independent relations between exercise and postexercise MP and arterial hypertension. In normal and hypertensive males a rise in systolic pressure (SP) after the initial exercise (load 1) was dependent on PWC1 after more intensive exercise (load 2) on relations of MP with heart rate, SP and diastolic pressure (DP). In hypertensive males the SP elevation depended also on the age, B. W. index and heart rate. In normal AP males a DP rise depended on PWC2 and MP, the increment being limited by relationships between MP, DP, heart rate and SP. In hypertensive males the influence of PWC1 is defined through a SP rise after load 1. In normal AP and hypertensive females PWC1 is decisive for a SP rise. In normal AP females growth of DP after load 2 was dependent on PWC2 in relation to heart rate growth after load 2, while in hypertensive females PWC1 resulted in DP elevation after load 1. On comparison of the groups with normal and high AP the degree of AP increment under exercise depended on the relations of MP with heart rate, SP and DP.
OBJECTIVE: To examine the relation between a parental history of hypertension and blood pressure and cardiac structure in children aged 8-10 years. DESIGN: Cross-sectional study of a sample of children drawn from a population survey of coronary risk factors in children. SETTING: Odense, Denmark. SUBJECTS: Sixty-nine children of hypertensive parents (5.2% of the eligible population). MAIN OUTCOME MEASURES: Physical fitness assessed by calculation of maximum oxygen uptake, blood pressure recorded by one blind observer and left ventricular structure determined by echocardiography. RESULTS: Children with a parental history of hypertension displayed a significant decrease in physical fitness and a significant increase in obesity and systolic and diastolic blood pressure compared with the rest of the population. After controlling for differences in body size and physical fitness, they also showed significantly higher levels of systolic and diastolic blood pressure. Apart from a significant increase in thickness of the interventricular septum during systole, no significant differences in echocardiographic measures or indices could be demonstrated between children with a parental history of hypertension and a normotensive control group. CONCLUSION: Our results indicate that a higher level of blood pressure in children with a parental history of hypertension is apparent before the age of 10 years.
SUBJECT: Hypertension represents the most commonly encountered complication of pregnancy. Normal levels of blood pressure (BP) need to be established in each pregnant population in order to recognize pathology. A lack of studies from our own country and certain methodological objections to early studies motivated this study. PATIENTS AND METHODS: Six hundred pregnant women were included in a historical cohort. The maternal BP had been measured with a mercury sphygmomanometer and standardized routines at each antenatal visit. Data regarding age, baseline BMI, weight gain and smoking habits as well as parity had been recorded. RESULTS: BP values were overall somewhat higher than in international studies, the SBP increasing slightly towards term. The diastolic blood pressure (DBP) decreased slightly until 25-28 weeks of gestation. A steady increase thereafter led to values at term 7.3% above initial values. In nulliparae the increase was significantly greater, 9.9% versus 5.4% in multiparae. Primigravidae showed mean DBP levels significantly higher than all multigravidae towards term. The DBP was correlated with the baseline BMI, but not with age or weight gain. In smoking pregnant women the DBP showed a significantly greater initial decrease and failed to follow the subsequent rise to the same degree as in non-smokers. CONCLUSION: Slightly higher blood pressure levels were found in this study compared to other international studies. Multiple regression analysis showed that parity, baseline BMI and smoking all significantly influenced the DBP at term. Multiparae have significantly lower DBP levels in pregnancy compared to nulliparae. The first pregnancy seems to have the greatest impact in lowering the blood pressure in subsequent pregnancies.
OBJECTIVE. To test the relationship between physical activity and physical fitness, and the relationship between these variables and the primordial risk factor blood pressure (BP). DESIGN. A cross-sectional study of all Danish pupils in the same grade at 'gymnasium' (the Danish upper secondary school). SETTING. Tests and questionnaires were administered by physical education and biology teachers according to a prescribed scheme. SUBJECTS. Study subjects were 13810 adolescents with a mean age of 17.1 years. Physical activity, smoking habits, and physical performance were measured in 4862 boys and 6573 girls. Blood pressure was measured in 2474 boys and 3535 girls. No difference was found in BP, physical activity and fitness variables between this group and a representative group of Danish school children at the same age. MAIN OUTCOME. Blood pressure and health-related physical performance such as strength, muscle endurance, flexibility and maximal oxygen uptake (VO2max) estimated from heart rate at submaximal workload were measured. Sports activity, other physical activity and smoking habits were assessed by questionnaires. RESULTS. There was a negative relationship between BP and VO2max up to the 50% percentile (50 ml min-1 kg-1) in boys and up to the upper 80-90% percentile (45 ml min-1 kg-1) in girls. In a multiple regression model with BP as dependent variable, VO2max related highly significant, also after adjustment for body weight and physical activity (P
We investigated the association of systolic and diastolic blood pressure and hypertension with two different manifestations of carotid atherosclerosis in a random population sample of 1165 Eastern Finnish men aged 42, 48, 54 or 60 years, examined in the Kuopio Ischaemic Heart Disease Risk Factor Study. Carotid atherosclerosis was assessed with high-resolution B-mode ultrasonography. Men with a casual sitting systolic blood pressure of 175 mmHg or more had a 3.17-fold (95% confidence interval 1.79-5.61) prevalence of intima-media thickening--adjusted for age, smoking, S-LDL-cholesterol, IHD history and diabetes--compared to men with lower systolic pressures. The relative prevalence of carotid plaques in men with raised systolic pressures. The relative prevalence of carotid plaques in men with raised systolic blood pressure was 2.61 (95% confidence interval 1.44-4.72) in relation to men with no lesions. Our findings suggest that systolic but not diastolic hypertension is associated with an increased prevalence of both early and advanced atherosclerotic lesions in carotid arteries.
To examine the levels and relationship of blood pressure and insulin during puberty, blood pressure and serum insulin were measured in 3596 subjects, aged 3-18 y, whose pubertal status was graded according to the Tanner classification. The same study protocol was repeated in two follow-up surveys 3 and 6 y later for 2991 6-21-y-old subjects and 2799 9-24-y-old subjects, respectively. There was a 37-66% increase in insulin at Tanner stage 3 (pubic hair) among the female subjects and at Tanner stage 5 (pubic hair) among the male subjects, after which insulin started to decrease. The mean systolic and diastolic blood pressure increased steadily throughout puberty. The rise in blood pressure continued during early adulthood, despite the decrease in serum insulin. The correlation between systolic blood pressure and insulin measured in the same year was weak at each pubertal stage after standardization for weight, except among the female subjects at mid puberty. There was no relation between diastolic blood pressure and insulin. Adult systolic blood pressure could be predicted by pubertal insulin among the male subjects after adjustment for age and weight (partial correlation coefficient 0.21), but among the female subjects this relation was trivial (partial correlation coefficient 0.08). We conclude that the correlation between insulin and actual blood pressure vanishes during puberty, whereas pubertal insulin and future adult male systolic blood pressure seem to correlate.