To study sex and age characteristics of overweight, arterial hypertension (AH) and hyperglycemia prevalence as well as prevalence of their combination.
Complex examination of Veliky Novgorod and Novgorod region 4837 residents (2081 men and 2756 women, age 20-87 years) comprised anthropometric measurements with calculation of the body mass index (Ketle index), measurements of blood pressure, fasting blood glucose, cholesterol levels, oral glucose tolerance test (GTT).
Prevalence of overweight and obesity in males was 50.4%, in females - 63.1%. Stage I obesity occurs twice more frequently in women than in men, stage II and III obesity four and six times more frequently, respectively. 46.8% of adults suffer from AH, hyperglycemia was found in 6.03% cases. Overweight patients had metabolic carbohydrate disturbances three times more frequently than normal weight subjects. In women prevalence of overweight combination with AH was 1.5 times higher vs men (39.9 vs 26.3%); the prevalence of overweight combination with hyperglycemia was 1.7 times higher (5.5 vs 3.2%); prevalence of AH combination with hyperglycemia was 1.7 times higher (7.72 vs 2.71%). Hyperglycemia in obese persons occurred more frequently in women under 40 and men over 40 years of age.
High prevalence of overweight, obesity, AH, hyperglycemia and their combinations have been revealed. This prevalence closely depended on sex and age. Prevalence of obesity and hyperglycemia, combination of overweight with AH and hyperglycemia, combination of AH with hyperglycemia is significantly higher in female subpopulation and in older cohorts.
To estimate the expressiveness of involutive sarcopenia and its influences on the development of myocardial dysfunctions 88 patients of 60+ years with arterial hypertension (AH) II stage (middle age 66.9 +/- 0.7 years, 76 women and 12 men) and 32 persons who do not have cardiovascular diseases were surveyed. It is revealed that expressiveness of involutive sarcopenia is non-uniform at senior patients; structural and functional changes of heart in elderly patients with AH clinically shown by myocardial dysfunction, decreased tolerance to physical activity, are more pronounced in the group of patients with a low index of muscular weight. High values of the indicators of oxidative modification of lipids in the blood serum and the insufficiency of mechanisms of antioxidant protection in elderly patients with AH who have low index of muscle mass point to the negative role of oxidative stress in the pathogenesis of involutive sarcopenia.
Arterial hypertension represents the most prevalent disease on our country. Due to cardiovascular complications, early invalidism and increased mortality are common. There is general agreement that genetic influences, overweight and increased uptake of salt are predisposing factors. In about 5--10% of all hypertensive patients an underlying cause can be incriminated. Among these cases of secondary hypertension less than 10% can be treated by surgery alone. Hypertension teaching programs in other countries using conventional treatment protocols have met with considerable success in all types including borderline-hypertension.
To examine the validity of self-reported information on obesity and high blood pressure (HBP) in relation to gender and age, and to explore the impacts of their misclassification on the association between obesity and HBP.
Community based cross-sectional study.
1791 adult subjects living in Humboldt, Saskatchewan, Canada.
Objectively measured HBP was positive if systolic blood pressure (BP) was > or = 140 mm Hg, diastolic BP was > or = 90 mm Hg or the subject was currently using antihypertensive medication. Self-reported HBP was positive if the subjects gave an affirmative response to the question: 'Has a doctor ever said you had high blood pressure?' Body mass index (BMI) was calculated as weight (kg)/height (m)2. Obesity was defined as a BMI > 27 kg/m2. Measured obesity and reported obesity were based on measured and self-reported information on height and weight, respectively.
The sensitivity of self-reported HBP was low, and was lower for men than for women, and for younger subjects than for older subjects. The specificity was similar for both genders. Obese individuals had higher sensitivity and lower specificity than non-obese individuals. The differential misclassification of self-reported HBP caused a bias away from the null when the relative risk for HBP in relation to obesity was estimated.
As a result of the gender- and age-related misclassification of self-reported HBP, the modification role of gender and age on the association between obesity and HBP could be altered. The bias caused by self-reported obesity was relatively small and was either toward or away from the null.
The pesticide metabolite p,p'-DDE has been associated with left ventricular (LV) mass and known risk factors for LV hypertrophy in humans and in experimental models. We hypothesized that the associations of p,p'-DDE with LV hypertrophy risk factors, namely elevated glucose, adiposity and hypertension, mediate the association of p,p'-DDE with LV mass.
p,p'-DDE was measured in plasma from 70-year-old subjects (n = 988) of the Prospective Study of the Vasculature in Uppsala Seniors (PIVUS). When these subjects were 70-, 75- and 80- years old, LV characteristics were measured by echocardiography, while fasting glucose, body mass index (BMI) and blood pressure were assessed with standard clinical techniques.
We found that p,p'-DDE levels were associated with increased fasting glucose, BMI, hypertension and LV mass in separate models adjusted for sex. Structural equation modeling revealed that the association between p,p'-DDE and LV mass was almost entirely mediated by BMI (70%), and also by hypertension (19%).
The obesogenic effect of p,p'-DDE is a major determinant responsible for the association of p,p'-DDE with LV mass.
Few studies have explored the association of COPD, based on GOLD definition, with heart diseases. The relationship between restrictive lung function impairment and heart diseases is still poorly studied on a population level.
To explore the association of COPD and restrictive lung function impairment, respectively, with heart diseases in the general population.
This is a cross-sectional study of 642 randomly selected 22- to 72-year-old subjects in northern Sweden. COPD was defined according to GOLD. Restrictive lung function was defined as pre-bronchodilator FVC
Silent electrocardiographic ST change predicts future coronary events in patients with coronary heart disease (CHD), but the prognostic significance of asymptomatic ST-segment depression with respect to sudden cardiac death in subjects without apparent CHD is not well known.
We investigated the association between silent ST-segment depression during and after maximal symptom-limited exercise test and the risk of sudden cardiac death in a population-based sample of 1769 men without evident CHD. A total of 72 sudden cardiac death occurred during the median follow-up of 18 years. The risk of sudden cardiac death was increased among men with asymptomatic ST-segment depression during exercise [hazard ratio (HR) 2.1, 95% confidence interval (CI) 1.2-3.9] as well as among those with asymptomatic ST-segment depression during recovery period (HR 3.2, 95% CI 1.7-6.0). Asymptomatic ST-depression during exercise testing was a stronger predictor for the risk of sudden cardiac death especially among smokers as well as in hypercholesterolaemic and hypertensive men than in men without these risk factors.
Asymptomatic ST-segment depression was a very strong predictor of sudden cardiac death in men with any conventional risk factor but no previously diagnosed CHD, emphasizing the value of exercise testing to identify asymptomatic high-risk men who could benefit from preventive measures.
Cites: N Engl J Med. 1983 Nov 3;309(18):1085-96621650
Cites: Lancet. 1983 Oct 1;2(8353):753-86137600
Cites: N Engl J Med. 1984 Nov 1;311(18):1144-76482932
AIM: To explore the prevalence of atrial fibrillation in patients with hypertension and type 2 diabetes and to identify possible mechanisms for the development of atrial fibrillation. METHODS: A community-based, cross-sectional observational study was conducted in the primary health care in Skara, Sweden, and 1739 subjects (798 men, 941 women) were surveyed. Patients were categorized as those with hypertension only (n = 597); those with both hypertension and type 2 diabetes (n = 171), and those with type 2 diabetes only (n = 147). In the reference population, 824 normotensive subjects without diabetes were identified and used as controls. Participants were examined for cardiovascular risk factors including fasting blood glucose, serum insulin, blood pressure, lipids and anthropometric measures. Resting electrocardiogram (ECG) was recorded and Minnesota-coded. Insulin resistance was measured by the homeostasis model assessment (HOMA). RESULTS: Age-adjusted prevalence of atrial fibrillation was 2% in patients with hypertension only, 6% in patients with both hypertension and type 2 diabetes, 4% in patients with type 2 diabetes only and 2% in controls, respectively. Age and sex adjusted odds ratios (OR) (95% CI) were; hypertension 0.7 (0.30-1.5), combined hypertension and type 2 diabetes 3.3 (1.6-6.7), and type 2 diabetes 2.0 (0.9-4.7). The association with combined hypertension and type 2 diabetes remained significant when adjusted for cardiovascular disease (CVD) risk factors and body mass index (BMI), was attenuated with adjustment for ischemic ECG; 2.4 (1.1-5.0) and lost significance with adjustment for insulin resistance; 1.3 (0.5-3.1). CONCLUSIONS: Atrial fibrillation is associated with the combined occurrence of type 2 diabetes and hypertension. Insulin resistance may be a common underlying mechanism.
From the Department of Health Care Evaluation, Regionens Hus, Gothenburg, Sweden (S.B., B.P.); Department of Cardiology, Danderyd Hospital, Karolinska Institute, Stockholm, Sweden (L.F.); and Department of Molecular and Clinical Medicine/Cardiology, Sahlgrenska Academy, University of Gothenburg, Sweden (L.B.).
Atrial fibrillation (AF) is a major risk factor for ischemic stroke. This study aims to update the knowledge about AF and associated stroke risk and benefits of anticoagulation.
We extracted data from the hospital, specialized outpatient, and primary healthcare and drug registries in a Swedish region with 1.56 million residents. We identified all individuals who had received an AF diagnosis during the previous 5 years; all stroke events during 2010; and patients with AF aged =50 years who had received warfarin during 2009.
AF had been diagnosed in 38 446 subjects who were alive at the beginning of 2010 (prevalence of 3.2% in the adult [=20 years] population); ˜46% received warfarin therapy. In 2010, there were 4565 ischemic stroke events and 861 intracranial hemorrhages. AF had been diagnosed in 38% of ischemic events (=50% among those aged =80 years) and in 23% of intracranial hemorrhages. An AF diagnosis was often lacking in hospital discharge records after stroke events. Warfarin therapy was associated with an odds ratio of 0.50 (confidence interval, 0.43-0.57) for ischemic stroke and, despite an increased risk of intracranial hemorrhage, an odds ratio of 0.57 (confidence interval, 0.50-0.64) for the overall risk for stroke.
AF is more common than present guidelines suggest. The attributable risk of AF for ischemic stroke increases with age and is close to that of hypertension in individuals aged =80 years. Because a majority of patients with AF with increased risk for stroke had not received anticoagulation therapy, there is a large potential for improvement.