Factors in predicting blood pressure change.

Sparrow, David; Garvey, Arthur J.; Rosner, Bernard; Thomas, Howard

doi:10.1161/01.cir.65.4.789

Cited by 41 publications

(36 citation statements)

References 31 publications

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“…specificity, evidenced by the fact that 79% of subjects who developed hypertension were receiving drug therapy for hypertension. Using 160/95 mm Hg, however, is consistent with previous analyses in this 20,34 and other cohorts. 9,10,12 Also, the current definition of hypertension was not established until 1993, 35 30 years after the initiation of this cohort.…”

Section: Discussionsupporting

confidence: 90%

“…33 In a previous report from this cohort, uric acid was not found to be associated with the development of hypertension. 34 The primary aim of that report was to determine predictors of the change in blood pressure over 10 years of follow-up. Of the 1166 men included, only 29 cases of hypertension occurred; therefore, that study had limited power.…”

Section: Discussionmentioning

confidence: 99%

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Uric Acid and the Development of Hypertension

Perlstein

Gumieniak²,

Williams³

et al. 2006

Hypertension

261

105

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Abstract-Experimental evidence supports a causative role for uric acid in the pathogenesis of hypertension. Prospective studies have variably adjusted for relevant confounders and have been of relatively limited duration. We prospectively examined the relationship between uric acid level and the development of hypertension in the Normative Aging Study, a longitudinal cohort of healthy adult men. Key Words: uric acid Ⅲ hypertension Ⅲ renal function Ⅲ prospective studies Ⅲ aging T he association of hyperuricemia with hypertension has long been recognized. 1 It remains unresolved whether the association of hyperuricemia with hypertension is solely because of underlying renal and metabolic abnormalities. Decreased renal blood flow 2 and decreased tubular secretion of uric acid 3 have been associated with hyperuricemia in hypertension. Hyperinsulinemia secondary to insulin resistance may also contribute to the association of hyperuricemia with hypertension. 4,5 Recent observations in experimental hyperuricemia suggest that uric acid may in fact have a pathogenic role in hypertension. 6 Hyperuricemia induces hypertension in experimental animals that corrects with hypouricemic therapy. 7 Elevated serum uric acid level has been associated with increased risk for developing hypertension. 8 -18 The Normative Aging Study (NAS), a longitudinal study of aging begun in 1963 and with ongoing follow-up, presented a unique opportunity to examine the relationship between serum uric acid level and the development of hypertension. The duration of follow-up, Յ40 years, allowed us to assess the durability of the prospective association of uric acid level with hypertension. The comprehensive data collection allowed adjustment for key potential confounding covariates, such as central adiposity, alcohol intake, metabolic parameters, and, in a subset of study subjects, the serum creatinine level. Previous studies have variably accounted for these confounders. Specifically, some did not adjust for blood pressure, 8,9,17,18 Ն2 elements of the metabolic syndrome, 8 -11,13-15 or alcohol intake, 11,12 and only 1 adjusted for renal function. 13 We, therefore, examined the prospective association of serum uric acid level with the development of hypertension among subjects at risk for the development of hypertension within the NAS cohort, including an analysis of those at risk for the development of hypertension at the time of their first serum creatinine determination. We have included in our multivariable model(s) covariates of the metabolic syndrome, alcohol intake, and renal function. MethodsSubjects were participants in the NAS, a longitudinal study of aging established by the Veterans Administration in 1961. 19 The study cohort consists of 2280 community-dwelling men from the greater Boston area who were 21 to 80 years of age on enrollment. Volunteers were screened at entry according to specific health criteria and were free of known chronic medical conditions at the

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Uric Acid and the Development of Hypertension

Perlstein

Gumieniak²,

Williams³

et al. 2006

Hypertension

261

105

View full text Add to dashboard Cite

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“…14 ' 15 These longitudinal blood pressure studies have studied only white men who were normotensive at the onset of the study. The Evans County (GA, USA) Study provides the opportunity to study differences in the correlates of blood pressure change among the four major race-sex groups with subjects representing the entire range of blood pressure at the initiation of the study.…”

mentioning

confidence: 99%

“…Sparrow et al 15 found that baseline skinfold thickness was associated with systolic pressure change, while baseline body mass index was associated with diastolic pressure change in white men. However, they did not investigate the change in these measures of ponderosity over time.…”

mentioning

confidence: 99%

Race and sex differences in the correlates of blood pressure change.

et al. 1988

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SUMMARY Potential predictors of systolic and diastolic blood pressure change between 1960 and 1967 in the biracial population of Evans County, Georgia, were investigated. An all possible regressions multiple linear regression analysis was used. For systolic blood pressure change, the level of systolic blood pressure, age, and change in Quetelet index were significant (p < 0.05) correlates in white men. The level of systolic blood pressure, the level and change of socioeconomic status, change in Quetelet index, and change in cholesterol were significant correlates for white women. The level of Quetelet index was of borderline significance (p < 0.055) when the other significant variables were included in the model for white women. The change in Quetelet index was the only significant correlate of systolic blood pressure change in blacks. For diastolic blood pressure change, age, change in hematocrit, and change in Quetelet index were significant correlates for white men. Age, level and change of socioeconomic status,'level and change of Quetelet index, and change in hematocrit were the significant correlates in white women. In black men, change in Quetelet index and age were significant. In black women, only age was a significant correlate of diastolic blood pressure change. These results indicate that there may be important differences in these correlates between race-sex groups and thus in the mechanism of blood pressure change for different race-sex groups. (Hypertension 11: 249-255, 1988) KEY WORDS race • sex blood pressure Quetelet index systolic blood pressure • diastolic blood pressure E LEVATED blood pressure has been shown to be a major risk factor for cardiovascular disease morbidity and mortality. 1 " 4 Epidemiological studies have shown that blood pressure is continuously distributed in populations, with the associated risk of morbidity and mortality increasing as blood pressure levels increase. 4 In a number of studies, age, sex, race, obesity, heart rate, blood glucose, hematocrit, and socioeconomic status have been shown to correlate with blood pressure levels. 5 ' 13Blood pressure levels in individuals are not static, however. Most of the studies on the determinants of the level of blood pressure have been cross-sectional in From the

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“…Our finding of an association between SUA and BP in young adults in Seychelles concurs with the findings in adults: a positive relationship between SUA levels and BP was found in most studies, 2,3,5,6 although not in all. 34,35 It is important that this association be corroborated in children and young adults because studies in older adults are prone to confounding by many factors such as treatment, co-morbidity, reverse causation and so on.…”

Section: Discussionmentioning

confidence: 99%

Impact of different adiposity measures on the relation between serum uric acid and blood pressure in young adults

et al. 2011

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Serum uric acid (SUA) concentration is independently associated with blood pressure (BP) in adults. We examined this association in young adults at an age where anti-hypertension treatment, other potential confounding factors and co-morbidity are unlikely to occur. We assessed BP, anthropometric variables including weight, height, waist circumference (WC), body fat percent (using bioimpedance), lifestyle behaviors, SUA and blood lipids in 549 participants aged 19-20 years from a population-based cohort study (Seychelles Child Development Study). Mean (s.d.) SUA was higher in males than females, 0.33 (0.08) and 0.24 (0.07) mmol l À1 , respectively. Body mass index (BMI) was higher in females than males but BP was markedly higher in males than in females. SUA was associated with both systolic and diastolic BP. However, the magnitude of the linear regression coefficients relating BP and SUA decreased by up to 50% upon adjustment for BMI, WC or body fat percent. The association between SUA and BP was not altered upon further adjustment for alcohol intake, smoking, triglycerides or renal function. In fully adjusted models, SUA remained associated with BP (Po0.05) in females. In conclusion, adiposity substantially decreased the association between SUA and BP in young adults, and BP was independently associated with SUA in females. These findings suggest a role of adiposity in the link between hyperuricemia and hypertension.

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Factors in predicting blood pressure change.

Cited by 41 publications

References 31 publications

Uric Acid and the Development of Hypertension

Uric Acid and the Development of Hypertension

Race and sex differences in the correlates of blood pressure change.

Impact of different adiposity measures on the relation between serum uric acid and blood pressure in young adults

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