2002, Number 5
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salud publica mex 2002; 44 (5)
Risk factors associated to the prevalence of hypertension among adults in Bucamaranga, Colombia.
Bautista LE, Vera-Cala LM, Villamil L, Silva SM, Peña IM, Luna LV
Language: Spanish
References: 46
Page: 399-405
PDF size: 52.13 Kb.
ABSTRACT
Objective. To assess the prevalence of high blood pressure (PHBP) and its association with age, sex, socioeconomic status (SES), and body mass index (BMI=kg/m
2).
Material and Methods. A cross-sectional survey was carried out in 1996, in a random sample of 356 adults aged 20 and older, residents of Bucaramanga, Colombia. Weight, height, and blood pressure readings were obtained, plus data on age and gender. Robust linear and log-binomial regression was used to estimate the independent effect of different risk factors on systolic (SBP) and diastolic (DBP) blood pressure and HBP.
Results. Mean SBP and DBP were significantly higher in men (122.5 and 88.1 mmHg) than in women(117.2 and 75.4 mmHg). The adjusted SBP increased with age, more in men than in women; DBP did not change with age. For each unit increase in BMI, SBP and DBP increased 0.76 and 0.69 mmHg, respectively. SBP was 6.8 and DBP was 9.8 mmHg higher in low-SES than in high-SES subjects. The adjusted PHBP increased with age and was higher in subjects adultos ≥50 years than in those 20-30 years old. Sex had no significant effect on PHBP (p=0.795). For each unit increase in BMI the PHBP increased 3%, and low-SES subjects had a PHBP 1.84 times higher than high-SES subjects.
Conclusions. A high PHBP was found. There is a great potential for prevention by weight control. Further studies are needed to confirm the increasing PHBP in low-SES subjects and to identify its causes.
REFERENCES
INCLEN Multicentre Collaborative Group. Risk factors for cardiovascular disease in the developing world. A multicentre collaborative study in the International Clinical Epidemiology Network. J Clin Epidemiol 1992;45(8):841-847.
Dyer AR, Elliot P, Shipley M for the INTERSALT Cooperative Research Group. Body mass index versus high and weight in relation to blood pressure: Findings for the 10 079 persons of the INTERSALT Study. Am J Epidemiol 1990;131(4):589-596.
Srinivasan SR, Bao W, Wattigney WA, Berenson GS. Adolescent overweight is associated with adult overweight and related multiple cardiovascular risk factors: The Bogalusa Heart Study. Metabolism 1996 Feb;45(2):235-240.
Neser WB, Thomas J, Semenya K, Thomas DJ, Gillum RF. Obesity and hypertension in a longitudinal study of black physicians: The Meharry cohort study. J Chronic Dis 1986;39(2):105-113.
Walker AR, Walker BF, Manetsi B, Tsotesi NG, Walker AJ. Obesity in black women in Soweto, South Africa: Minimal effects on hypertension, hyperlipidaemia and hyperglycaemia. J R Soc Health 1990;110(3):101-103.
Walker ARP, Walker BF, Manetsi B, Molefe O, Walker AJ, Vorster HH. Obesity in indigent elderly rural African women: Effects on hypertension, hyperlipidaemia and hyperglycaemia. Int J Vitam Nutr Res 1990;61(3): 244-250.
Dyer AR, Elliot P. The INTERSALT Study: Relation of body mass index to blood pressure. INTERSALT Cooperative Research Group. J Hum Hypertens 1989;3(5):299-308.
Poulter N, Khaw KT, Hopwood BE, Mugambi M, Peart WS, Rose G et al. Blood pressure and its correlates in an African tribe in urban and rural environments. J Epidemiol Community Health 1984;38(3):181-186.
Shaper AG. Communities without hypertension. En: Shaper AG, Hutt MSR, Feifar Z, ed. Cardiovascular disease in the tropics. London: British Medical Association, 1974:77-83.
He J, Klag MJ, Whelton PK, Chen J-Y, Mo J-P, Quian MC et al. Migration, blood pressure pattern, and hypertension: The Yi Migrant Study. Am J Epidemiol 1991;134(10):1085-1101.
Cooper R, Rotimi C, Ataman S, McGee D, Osotimehin B, Kadiri S et al. The prevalence of hypertension in seven populations of West African origin. Am J Public Health 1997;87(2):160-168.
Drizd T, Dannenberg AL, Engel A. Blood pressure levels in persons 18- 74 years of age in 1976-80, and trends in blood pressure from 1960 to 1980 in the United States. Vital Health Stat 1986;11(234):1-68.
Dustan HP. Gender differences in hypertension. J Hum Hypertens 1996;10(6):337-340.
Singh RB, Beegom R, Ghosh S, Niaz MA, Rastogi V, Rastogi SS et al. Epidemiological study of hypertension and its determinants in an urban population of North India. J Hum Hypertens 1997;11(10):679-685.
Hypertension Detection and Follow-up Program Cooperative Group. Race, education and prevalence of hypertension. Am J Epidemiol 1977;106(5):351-361.
Stamler R, Shipley M, Elliot P, Dyer A, Sans S, Stamler J. Higher blood pressure in adults with less education: Some explanations from INTERSALT. Hypertension 1992;19(3):237-241.
Hazuda HP. Hypertension in the San Antonio Heart Study and the Mexico City Diabetes Study: Sociocultural correlates. Public Health Rep 1996;111(Suppl 2):18-21.
McKetney EC, Ragland DR. Henryism J. Education, and blood pressure in young adults. The CARDIA study. Coronary Artery Risk Development in Young Adults Study. Am J Epidemiol 1996;143(8):787-791.
Siziya S, Marufu T, Matchaba-Hove RB. Relationship of causal blood pressure to smoking, education and occupation in a high density town near Harare, Zimbabwe. Cent Afr J Med 1995;41(7):219-224.
INTERSALT Cooperative Research Group. INTERSALT: An international study of electrolyte excretion and blood pressure: Results for 24 hour urinary sodium and potassium excretion. BMJ 1988;297(6644):319-328.
Newman A, Herrera JA. Prevalencia de hipertensión arterial y el estrés psicosocial en una comunidad de Cali. Colombia Med 1993;24(2): 44- 46.
Naranjo P. Hipertensión y prevalencia de algunos factores de riesgo en área rural de San Pedro, Antioquia 1994. Boletín Epidemiológico de Antioquia 1995;XX:42-45.
Pradilla G, Rosselli D, Bautista L, Morillo L, Uribe C, Takeuchi Y et al. Estudio neuroepidemiológico nacional. Bucaramanga, Colombia: Ministerio de Salud - Universidad Industrial de Santander, 1995.
Seidell JC, Flegal KM. Assessing obesity: Classification and epidemiology. Br Med Bull 1997;53(2):238-252.
Perloff D, Grim C, Flack J, Frohlich ED, Hill M, McDonald M et al. Human blood pressure determination by sphygmomanometry. Circulation 1993;88(5 Pt 1):2460-2470.
Departamento Nacional de Planeación. Estratificación socioeconómica. Manual general. Cabeceras municipales Tipo 3 y localidades o centros poblados hasta con tres mil habitantes. Santafé de Bogotá: DNP 1994.
Gao S, Hui SL, Hall KS, Hendrie HC. Estimating prevalence from twophase surveys with non’response at the second phase. Stat Med 2000;19:2101-2114.
Weisberg S. Applied linear regression. 2nd ed. Nueva York: John Wiley & Sons, 1985:252-253.
Wacholder S. Binomial regression in GLIM: Estimating risk ratios and risk differences. Am J Epidemiol 1986;121(1):174-184.
StataCorp. Stata Statistical Software: Release 6.0. College Station, TX: Stat Corporation, 1999.
Wilking SV, Belanger A, Kannel WB, D’Agostino RB, Steel K. Determinants of isolated systolic hypertension. JAMA 1988;260(23):3451-3455.
van den Ban GC, Kampman E, Schouten EG, Kok FJ, van der Heide RM, van der Heide-Wessel C et al. Isolated systolic hypertension in Dutch middle age and all-cause mortality: A 25-year prospective study. Int J Epidemiol 1989;18(1):95-99.
Franklin SS, Gustin W 4th, Wong ND, Larson MG, Weber MA, Kannel WB et al. Hemodynamic patterns of age-related changes in blood pressure. The Framingham Heart Study. Circulation 1997;96(1):308-315.
Stamler R, Stamler J, Riedlinger WF, Algera G, Roberts RH. Weight and blood pressure. Findings in hypertension screening of 1 million Americans. JAMA 1978;240(15):1607-1610.
He J, Klag MJ, Whelton PK, Chen JY, Qian MC, He GQ. Body mass and blood pressure in a lean population in Southwestern China. Am J Epidemiol 1994;139(4):380-389.
Kaufman J, Asuzu M, Mufunda J, Forrester T, Wilks R, Luke A et al. Relationship between blood pressure and body mass index in lean populations. Hypertension 1997;30(6):1511-1516.
Raven GM, Chen YD. Insulin resistance, its consequences, and coronary heart disease. Must we choose one culprit? Circulation 1996;93(10): 1780-1783.
Visser M, Bouter LM, McQuillan GM, Wener MH, Harris TB. Low-grade systemic inflammation in overweight children. Pediatrics 2001; 107: E13.
Yudkin JS, Stehouwer CD, Emeis JJ, Coppack SW. C-reactive protein in healthy subjects: Associations with obesity, insulin resistance, and endothelial dysfunction: A potential role for cytokines originating from adipose tissue? Arterioscler Thromb Vasc Biol 1999;19:972-978.
Sinisalo J, Paronen J, Mattila KJ, Syrjala M, Alfthan G, Palosuo T et al. Relation of inflammation to vascular function in patients with coronary heart disease. Atherosclerosis 2000;149:403-411.
Hingorani AD, Cross J, Kharbanda RK, Mullen MJ, Bhagat K, Taylor M et al. Acute systemic inflammation impairs endothelium-dependent dilatation in humans. Circulation 2000;102:994-999.
Panza JA, Quyyumi AA, Brush JE Jr, Epstein SE. Abnormal endotheliumdependent vascular relaxation in patients with essential hypertension. N Engl J Med 1990;323:22-27.
Liyama K, Nagano M, Yo Y, Nagano N, Kamide K, Higaki J et al. Impaired endothelial function with essential hypertension assessed by ultrasonography. Am Heart J 1996;132:779-782.
Bautista LE, López-Jaramillo P, Vera LM, Casas JP, Otero AP, Guaracao AI. Is C-reactive protein an independent risk factor for essential hypertension? J Hypertens 2001;19:857-861.
Chae CU, Lee RT, Rifai N, Ridker PM. Blood pressure and inflammation in apparently healthy men. Hypertension 2001 sep;38(3):399-403.
Nilsson P, Ostergren PO, Lindholm L, Schersten B. Can social class differentials in hypertension be explained by the general susceptibility hypothesis? Soc Sci Med 1994;38:1235-1242.