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

Abstract

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

Increases in Weight and Body Size Increase the Odds for Hypertension During 7 Years of Follow‐up

“…The minimal effect of the adjustment is consistent with the observation that the relationship of body weight to the risks for becoming hypertensive is similar in low, moderate, and highly physically active men (41). However, the men and women studied in this report are generally leaner than those reported in other studies (9)(10)(11)(12)(13)(14)(15). Our analyses are also limited in their focus on physiciandiagnosed hypertension rather than blood pressure as a continuous outcome.…”

“…Clinical trials have also shown that weight loss lowers blood pressure (7,8); however, the results pertain primarily to overweight individuals followed for relatively short durations. Several prospective epidemiological studies relate hypertension to long-term changes in BMI or adiposity over time (9)(10)(11)(12)(13)(14)(15); however, most of these adjust for baseline BMI levels, which is statistically problematic and can produce statistical artifacts due to measurement error (16). Moreover, most involve largely sedentary individuals, many of whom are moderately overweight or obese individuals.…”

Associations between weight gain and incident hypertension in a bi-ethnic cohort: the Atherosclerosis Risk in Communities Study

“…This difference was smaller than that seen in the Evans County Study, which found associations between quetelet index gain and gains in both SBP and DBP were twice as great among white women, white men, and African-American men as in African-American women. 10 This study did show a significantly smaller association between weight gain and hypertension among AfricanAmerican women compared to other groups. A smaller association among African-American people is partly due to Incident hypertension between visits 1 and 2 was excluded from incidence measurement between visits 2 and 3. International Journal of Obesity Weight gain and hypertension Juhaeri et al a much higher base incidence rate of hypertension among this group compared to others.…”

“…9 To the best of our knowledge, associations between weight gain and an increased blood pressure have been compared in African-American and white people only in a cohort from Evans County, GA, initially examined between 1960 and 1962. 10 Daniels et al, showed that weight gain over a 7 y period was directly associated with increased systolic blood pressure (SBP) and diastolic blood pressure (DBP); however, the regression coefficients among white men and women and African-American men were twice as large as those among African-American women. 10 Using data from the same cohort and the same follow-up period, Tyroler et al showed that weight gain was associated with a higher incidence of hypertension, and the effects of weight gain on the incidence and remission of hypertension were greater in white than in African-American people.…”

Body mass index in primary and secondary pediatric hypertension

“…Secondary hypertension is caused by diseases of the kidney, lungs, central nervous system, endocrine and vascular systems. In the adult population, increased awareness and focus on hypertension has led to identification of modifiable factors (e.g., diet, physical activity, body weight, blood glucose) and non-modifiable factors (e.g., age, race, genetics, gender) related to the risk for development of hypertension [4,5,6,7,8,9,10,11]. In children and adolescents, body size (e.g., height, weight), gender, and age are important determinants of blood pressure, with obesity being a significant contributor to this health burden and its financial costs [12,13].…”