Influence of pre-hypertension on all-cause and cardiovascular mortality: The Singapore Cardiovascular Cohort Study

Lee, Jeannette; Heng, Derrick; Ma, Stefan; Chew, Suok‐Kai; Hughes, Kenneth; Tai, E. Shyong

doi:10.1016/j.ijcard.2008.03.067

Cited by 17 publications

(18 citation statements)

References 20 publications

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“…With a prevalence similar to that observed in the U.S. (23) (31%, NHANES 1999-2000) and Singapore (34), Inuit in the preHTN group have multiple risk factors for HTN, such as obesity, smoking and alcohol consumption, but they are significantly younger than the HTN group. Consequently, one may speculate that these individuals may develop HTN disease in the near future.…”

Section: Hypertension and Obesity In Nunavik Inuitsupporting

confidence: 68%

“…Consequently, one may speculate that these individuals may develop HTN disease in the near future. Although preHTN was not found to be an independent risk factor for all-cause mortality as well as CVD (34), this condition appears to be associated with mortality when combined with other CVD risk factors, such as diabetes and smoking (34).…”

Section: Hypertension and Obesity In Nunavik Inuitmentioning

confidence: 75%

See 1 more Smart Citation

Hypertension among the Inuit from Nunavik: should we expect an increase because of obesity?

Château-Degat

Dewailly²,

Noël³

et al. 2010

International Journal of Circumpolar Health

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Objectives. Because of their recent adoption of a Westernized lifestyle, an increased risk of developing hypertension (HTN) is suspected among Inuit populations. This study aimed to assess the exact prevalence of HTN in Nunavik Inuit and to examine its association with other major risk factors of cardiovascular disease. Study design. A cross-sectional population-based study. Methods. We analysed biological and anthropometric data and the medical history of 832 Inuit. Results. The overall prevalence of HTN (≥140/90 mmHg or the use of medication) was 19% with no gender difference. Obesity (body mass index [BMI] ≥30 kg/m 2 ) was the highest prevalent cardiovascular risk factor (23%), and was significantly associated with HTN (OR for BMI<25 kg/m 2 vs. BMI 30-34 kg/m 2 : 7.9 [3.5-17.9]; OR for BMI<25 kg/m 2 vs. BMI ≥35 kg/m 2 : 14. 4 [5.6-36.7]). An increase in odds of prehypertension (preHTN) (130-139/80-89 mmHg) was also observed as the BMI increased (p for trend, p<0.0001). Conclusion. The prevalence of HTN in the Inuit populations has reached values similar to those of their Westernized counterparts. Furthermore, not only HTN but also preHTN states are significantly associated with obesity even after adjusting for confounding variables. These results clearly indicate that HTN is becoming a growing health challenge in Nunavik because of pandemic obesity.

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Section: Hypertension and Obesity In Nunavik Inuitsupporting

confidence: 68%

Section: Hypertension and Obesity In Nunavik Inuitmentioning

confidence: 75%

Hypertension among the Inuit from Nunavik: should we expect an increase because of obesity?

Château-Degat

Dewailly²,

Noël³

et al. 2010

International Journal of Circumpolar Health

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“…This study was likely unpowered because the finding was based on 30 CVD deaths in prehypertension group and did not provide information about cause‐specific mortality, such as CHD and stroke mortality 3. Notably, apart from ethnic mix, the participants were much younger than ours (mean age, 39 versus 63 years).…”

Section: Discussionmentioning

confidence: 80%

Association of “Elevated Blood Pressure” and “Stage 1 Hypertension” With Cardiovascular Mortality Among an Asian Population

Talaei

Hosseini

Koh

et al. 2018

JAHA

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BackgroundThe new American College of Cardiology/American Heart Association high blood pressure (BP) guidelines in the United States have lowered definition of hypertension by defining normal as systolic/diastolic BP <120/80 mm Hg; elevated BP as systolic between 120 and 129 mm Hg and diastolic <80 mm Hg; and stage 1 hypertension as systolic between 130 and 139 mm Hg or diastolic between 80 and 89 mm Hg.Methods and ResultsWe investigated the association between the new hypertension definition and cardiovascular disease mortality among Chinese in Singapore. We used data from 30 636 participants of a population‐based cohort, the SCHS (Singapore Chinese Health Study), who had BPs measured using a standard protocol at ages 46 to 85 years between 1994 and 2005. Information on lifestyle factors was collected at recruitment (1993–1998) and follow‐up 1 interviews (1999 and 2004). Mortality was identified via nationwide registry linkage up to December 31, 2016. Neither elevated BP (hazard ratio, 0.89; 95% confidence interval, 0.74–1.07) nor stage 1 hypertension (hazard ratio, 0.94; 95% confidence interval, 0.81–1.11) was associated with increased risk of cardiovascular mortality compared with normal BP in the whole cohort. Stage 1 hypertension was associated with increased cardiovascular risk only in those <65 years of age and without a history of cardiovascular disease (hazard ratio, 1.40; 95% confidence interval, 1.01–1.94), but not in those ≥65 years of age or with a history of cardiovascular disease.ConclusionsOur data suggest that the newly defined stage 1 hypertension may not be associated with increased cardiovascular mortality across all ages among Chinese in Singapore, but that the at‐risk subpopulation is limited to those <65 years of age and without a prior cardiovascular disease.

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“…The positive association between obesity measurements and prehypertension had been consistently observed independent of population and age. [5][6][7]15,17,20,21 Central and peripheral abnormalities can explain the development or maintenance of high BP in obesity: activation of both, the sympathetic nervous system and the reninangiotensin-aldosterone system. Obesity is also associated with endothelial dysfunction and renal functional abnormalities that may play a role in the development of hypertension.…”

Section: Discussionmentioning

confidence: 99%

“…Insulin resistance is a hallmark of metabolic disorders, characterized by endothelial dysfunction that contributes to CVD. 16,17 The mechanisms described for association of hypertension with obesity, hyperuricaemia, and diabetes can conceivably apply to prehypertension. However, we could not find studies relating such mechanisms to the genesis of prehypertension.…”

Section: Discussionmentioning

confidence: 99%

Prehypertension and cardiovascular risk factors in adults enrolled in a primary care programme

Nery

Mesquita

Lugon

et al. 2011

European Journal of Cardiovascular Prevention & Rehabilitat

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Influence of pre-hypertension on all-cause and cardiovascular mortality: The Singapore Cardiovascular Cohort Study

Cited by 17 publications

References 20 publications

Hypertension among the Inuit from Nunavik: should we expect an increase because of obesity?

Hypertension among the Inuit from Nunavik: should we expect an increase because of obesity?

Association of “Elevated Blood Pressure” and “Stage 1 Hypertension” With Cardiovascular Mortality Among an Asian Population

Prehypertension and cardiovascular risk factors in adults enrolled in a primary care programme

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