Gender and Age Differences in Lifestyle Factors Related to Hypertension in Middle-Aged Civil Service Employees.

Hori, Yoko; Toyoshima, Hideaki; Kondo, Takaaki; Koji, Takehiko; Yatsuya, Hiroshi; Zhu, Shankuan; Kawamura, Takashi; Toyama, Junji; Okamoto, Noboru

doi:10.2188/jea.13.38

Cited by 15 publications

(19 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Results from unadjusted analyses can be misleading, if not in direction certainly in magnitude, because of gender, 17 pretreatment BP severity, 18 and body size. 19,20 Further, in most hypertension trials, racial contrasts are post-hoc analyses that are not "protected" by the randomization procedure unless randomization was stratified by race. Among ATIME participants, blacks had a higher prevalence of several characteristics that predicted lesser BP response, including female sex, obesity, and lower mean baseline SBP.…”

Section: Discussionmentioning

confidence: 99%

Determinants of Blood Pressure Response to Quinapril in Black and White Hypertensive Patients

et al. 2004

View full text Add to dashboard Cite

Abstract-Race has been considered an important factor in determining blood pressure response to treatment and selection of antihypertensive drug therapy. Data collected during a clinical trial that evaluated rapidity of medication up-titration with blood pressure response to monotherapy with the angiotensin-converting enzyme (ACE) inhibitor quinapril were used to characterize response in 533 black and 2046 white participants. Our objectives were to examine the influence of race and other factors on blood pressure response and to assess the degree to which nonrace factors account for apparent racial differences in response. Average systolic and diastolic blood pressure responses (baseline minus follow-up) to treatment were assessed with treatment groups combined. Crude systolic and diastolic blood pressure responses averaged 4.7 and 2.4 mm Hg less, respectively, in black compared with white participants; however, the response distributions largely overlapped. In multivariate linear regression models adjusted for study design variables and measured participant characteristics, the racial difference in systolic response was reduced by 51% to 2.3 mm Hg, and diastolic response by 21% to 1.9 mm Hg. In these models, participant characteristics, including age, gender, body size, and pretreatment blood pressure severity, significantly predicted either attenuated or enhanced blood pressure response to treatment. Our findings demonstrate that a large source of variability of blood pressure response to treatment is within, not between, racial groups, and that factors that vary at the level of the individual contribute to apparent racial differences in response to treatment. Key Words: ACE inhibitors Ⅲ antihypertensive therapy Ⅲ blood pressure response Ⅲ hypertension Ⅲ race R ace has long been considered an important factor in determining blood pressure (BP) response to treatment, at least to single antihypertensive drugs. [1][2][3][4] More specifically, blacks with hypertension have been reported to be less responsive to monotherapy with angiotensin-converting enzyme (ACE) inhibitors, 5 ␤-blockers, 6 -8 and angiotensin receptor blockers 9 than to diuretics and calcium antagonists. Many of these same studies have reported that white hypertensive patients respond better to these antihypertensive agents than do blacks. 10,11,1,3,4 Authoritative treatment guidelines such as the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure 12 have acknowledged this evidence of lesser BP response among blacks to certain drug classes and have not dismissed the notion that race be considered when selecting antihypertensive drug therapy.There are concerns, however, with the interpretation of data from these studies. First, black and white hypertensives typically differ on baseline characteristics 13,14 that may confound racial differences in BP response; observed response differences have almost never been adjusted for potential confounding factors other than baseline BP. Second, when racial BP ...

show abstract

Section: Discussionmentioning

confidence: 99%

Determinants of Blood Pressure Response to Quinapril in Black and White Hypertensive Patients

et al. 2004

View full text Add to dashboard Cite

show abstract

“…However, the mean BMI of the Japanese population increased significantly over subsequent decades [2,9,11]. As a result, obesity may now be playing a more important role in the high prevalence of hypertension in Japan than it was before [2,4,[11][12][13][14]. Therefore, it is important to clarify how much obesity is contributing to the high prevalence of hypertension in Japan.…”

Section: Introductionmentioning

confidence: 99%

The proportion of individuals with obesity-induced hypertension among total hypertensives in a general Japanese population: NIPPON DATA80, 90

et al. 2007

View full text Add to dashboard Cite

The increased prevalence of obesity in Japan may contribute to the high prevalence of hypertension in Japan. In the present study, we calculated the odds ratio for hypertension in obesity (body mass index (BMI) >or= 25.0 kg/m(2)) using data from independent nationwide surveys conducted in 1980 and 1990. We estimated the percentage of hypertensives whose condition was due to obesity among total hypertensives in the general Japanese population. In the 1980 survey, 18.8% of 4,623 male participants were obese and 50.4% were hypertensive, whereas 22.6% of 5,893 female participants were obese and 41.1% were hypertensive. For both sexes, obese participants had a higher odds ratio for hypertension than non-obese participants (BMI < 25.0 kg/m(2)), and there was a significant dose-response relationship between BMI and the odds ratio for hypertension. Among all hypertensives, the percentage whose hypertension was due to obesity in 1980 and 1990 was 11.4% (95% confidence interval (CI): 4.7-17.7%) and 15.3% (95% CI: 6.8-23.1%) for men and 19.3% (95% CI: 12.1-25.9%) and 22.3% (95% CI: 14.6-29.3%) for women, respectively. Approximately 80-90% of individuals with obesity-induced hypertension were in the 25.0

show abstract

“…Our result showing that current smokers are at a lower risk for BP elevation than neversmokers is seemingly contrary to common expectations, but is consistent with a number of previous studies. 10,23,24) Differences between acute and habitual exposure to smoking in the effect on blood pressure may provide a partial explanation of this unexpected association. 25) Another possibility is that intensive advice by health care workers to those with high BP would have elevated their health awareness, thus resulting in a lower rate of smokers than in other groups.…”

Section: Discussionmentioning

confidence: 99%

“…In line with this historic shift in risk factors related to hypertension, we have recently revealed a highly significant association of hypertension with obesity but not with a preference for salty taste in a study of middle-aged civil servant employees in Japan. 10) However, that study was conducted using a cross-sectional design to uncover risk factors related to BP elevation, and did not consider the effect of year-to-year weight variation on BP. Thus, the present study was intended to follow and extend our previous one to evaluate the impact of weight change on the corresponding BP.…”

Section: Discussionmentioning

confidence: 99%

“…More details of the BP measurements have been given in our previous study. 10) The current study protocol was approved by the Ethical Board of the Nagoya University School of Medicine. Statistical Analysis --Because the data used for this present study were regarded as forming a hierarchical structure with individual repeated BP measurements (level-1) nested within individuals (level-2), a general mixed model was chosen for the multilevel analysis.…”

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Effects of Short-term Variation in Body Mass Index on Blood Pressure in Middle-aged Japanese Male Workers

Kondo

Kimata

Yamamoto

et al. 2009

JOURNAL OF HEALTH SCIENCE

Self Cite

View full text Add to dashboard Cite

We attempted to perform multilevel analyses to explore whether a year-to-year weight variation causes any corresponding effects on blood pressure (BP) among middle-aged Japanese workers. Subjects were 4547 healthy male workers 40-59 in age from whom serial data of systolic and diastolic BP were collected during health checkups conducted in the years 1997-2000. The effects on BP of a time-varying body mass index (BMI) that was rescaled to center around the individual-specific mean of 4 examinations on BP were investigated by statistical analysis with multilevel modeling to adjust for the wide variability among individuals. A significant relationship between the time-varying BMI and both systolic and diastolic BP was confirmed. None of the interaction terms for BMI × potential effect modifiers (smoking history, drinking status, leisure-time physical activity, and preference for salty taste) included in the subanalysis model showed any significant modifying effect. Our result indicated that the year-to-year weight variation, though usually in a much narrower range than the between-individual variation, has a strong impact on the corresponding BP. This result supports the public health significance of interventions in short-term weight control to prevent the development of hypertension among an otherwise healthy workplace population.

show abstract

Gender and Age Differences in Lifestyle Factors Related to Hypertension in Middle-Aged Civil Service Employees.

Cited by 15 publications

References 29 publications

Determinants of Blood Pressure Response to Quinapril in Black and White Hypertensive Patients

Determinants of Blood Pressure Response to Quinapril in Black and White Hypertensive Patients

The proportion of individuals with obesity-induced hypertension among total hypertensives in a general Japanese population: NIPPON DATA80, 90

Effects of Short-term Variation in Body Mass Index on Blood Pressure in Middle-aged Japanese Male Workers

Contact Info

Product

Resources

About