scholarly journals Associations Between the DASH Diet and Nocturnal Blood Pressure in a Sample of Chinese Elderly Subjects

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 550-550
Author(s):  
Muzi Na ◽  
Yanxiu Wang ◽  
Ming Gao ◽  
Aijun Xing ◽  
Shouling Wu ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Elderly Subjects ◽  
Linear Regression Models ◽  
Hypertension Status ◽  
Cross Sectional ◽  
Dash Diet ◽  
Funding Sources ◽  
Sleep Parameters ◽  
The Mean ◽  
Diet Score

Abstract Objectives The Dietary Approaches to Stop Hypertension (DASH) diet is known to reduce daytime blood pressure (BP). This study aims to examine the relationship between DASH diet and BP monitored during sleep in a sample of Chinese old adults. Methods A cross-sectional sample of 324 participants aged ≥ 60 years who did not take BP-lowering drugs were included (68.8% men; 70.1% with hypertension). Usual dietary intake was assessed using a validated food frequency questionnaire. The DSAH diet score was calculated based on the intake ranking of 9 dietary components. 24-hour ambulatory BP was measured and the mean and variability independent of the mean (VIM) for nocturnal systolic (SBP) and diastolic BP (DBP) were calculated. Multivariable linear regression models were constructed of each BP outcome as a function of the DASH diet score adjusting for socio-demographic characteristics (age, sex, and education), body mass index, hypertension, lifestyle factors (smoking, alcohol intake, and physical activity). The interaction between DASH diet and hypertension status was also tested in the above models. We further adjusted for three self-reported sleep parameters (duration, insomnia, snoring) to explore the potential impact of sleep on the diet-nocturnal BP relationship. Results Mean (SD) age of subjects was 66.3 (6.0) years. There was no significant relationship between the DASH diet score and mean nocturnal SBP or DBP. However, per one unit increase of DASH diet score, nocturnal VIM-SBP and VIM-DBP were significantly reduced by −0.16 SD (95%CI: −0.30, −0.01) and −0.16 SD (95%CI: −0.28, −0.05) in the adjusted model. No significant interaction was detected between DASH diet and hypertension status. The significant associations persisted after further adjustment for the sleep parameters. Conclusions Adherence to the DASH diet may contribute to lower nocturnal systolic and diastolic blood pressure variability in elderly people. Future studies are warrant to explore the effect of modifiable diet on blood pressure during sleep, which has significant predictive value of heart health and mortality in high-risk populations. Funding Sources Broadhurst Career Development Professorship for the Study of Health Promotion and Disease Prevention, College of Health and Human Development, Pennsylvania State University.

The Effects of Mean of Visit-to-Visit Blood Pressure on Incident Brain Vascular Lesions and Functional-Cognitive Decline

2021 ◽  
pp. 1-12
Author(s):  
Bibek Gyanwali ◽  
Celestine Xue Ting Cai ◽  
Christopher Chen ◽  
Henri Vrooman ◽  
Chuen Seng Tan ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cognitive Decline ◽  
Hippocampal Volume ◽  
Intracranial Stenosis ◽  
Vascular Lesions ◽  
Linear Regression Models ◽  
Volume Functional ◽  
Mri Scans ◽  
The Mean

Background: Cerebrovascular disease (CeVD) is an underlying cause of cognitive impairment and dementia. Hypertension is a known risk factor of CeVD, but the effects of mean of visit-to-visit blood pressure (BP) on incident CeVD and functional-cognitive decline remains unclear. Objective: To determine the association between mean of visit-to-visit BP with the incidence and progression of CeVD [white matter hyperintensities (WMH), infarcts (cortical infarcts and lacunes), cerebral microbleeds (CMBs), intracranial stenosis, and hippocampal volume] as well as functional-cognitive decline over 2 years of follow-up. Methods: 373 patients from a memory-clinic underwent BP measurements at baseline, year 1, and year 2. The mean of visit-to-visit systolic BP, diastolic BP, pulse pressure, and mean arterial pressure were calculated. Baseline and year 2 MRI scans were graded for WMH, infarcts, CMBs, intracranial stenosis, and hippocampal volume. Functional-cognitive decline was assessed using locally validated protocol. Logistic and linear regression models with odds ratios, mean difference, and 95%confidence interval were constructed to analyze associations of visit-to-visit BP on CeVD incidence and progression as well as functional-cognitive decline. Results: Higher mean of visit-to-visit diastolic BP was associated with WMH progression. Higher tertiles of diastolic BP was associated with WMH progression and incident CMBs. There was no association between mean of visit-to-visit BP measures with incident cerebral infarcts, intracranial stenosis, change in hippocampal volume, and functional-cognitive decline. Conclusion: These findings suggest the possibility of hypertension-related vascular brain damage. Careful monitoring and management of BP in elderly patients is essential to reduce the incidence and progression of CeVD.

scholarly journals Association between egg intake and blood pressure in the USA: the INTERnational study on MAcro/micronutrients and blood Pressure (INTERMAP)

2021 ◽  
pp. 1-9
Author(s):  
Thanh-Huyen T Vu ◽  
Linda Van Horn ◽  
Martha L Daviglus ◽  
Queenie Chan ◽  
Alan R Dyer ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Dietary Cholesterol ◽  
International Study ◽  
Obese Women ◽  
Linear Regression Models ◽  
Cross Sectional ◽  
Men And Women ◽  
The Usa ◽  
Underlying Mechanisms

Abstract Objectives: To investigate associations of egg intake with blood pressure (BP) and the role of dietary variables and other macro- and micro-nutrients in the association. Design: We used cross-sectional data for the USA as part of the INTERnational study on MAcro/micronutrients and blood Pressure (INTERMAP). INTERMAP was surveyed between 1996 and 1999, including four 24-h dietary recalls, two 24-h urine collections and eight measurements of systolic BP and diastolic BP (SBP, DBP). Average egg intake (g/d) was calculated. Multivariable linear regression models were used to estimate the association between egg intake (per each 50 g/d or per quintile) and BP. The roles of dietary variables and other macro- and micro-nutrients in this association were also investigated. Setting: In the USA. Participants: In total, 2195 US INTERMAP men and women aged 40–59 years. Results: Participants were 50 % female, 54 % non-Hispanic White and 16 % non-Hispanic Black. Mean egg intake (sd) in men and women was 30·4(29·8) and 21·6(20·5) g/d, respectively. Adjusting for demographics, socio-economics, lifestyle and urinary Na:K excretion ratios, we found non-linear associations with BP in non-obese women (P-quadratic terms: 0·004 for SBP and 0·035 for DBP).The associations remained after adjusting for dietary variables, macro/micro nutrients or minerals. Dietary cholesterol was highly correlated with egg intake and may factor in the association. No association was found in obese women and in obese or non-obese men. Conclusion: Egg intake was non-linearly associated with SBP and DBP in non-obese women, but not in obese women or men. Underlying mechanisms require additional study regarding the role of obesity and sex.

Abstract WMP14: Association of Systolic Blood Pressure, LDL Cholesterol, and Hgb A1c With White Matter Hyperintensity on MRI in the ACCORDION MIND Study

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Adam H de Havenon ◽  
Tanya Turan ◽  
Rebecca Gottesman ◽  
Sharon Yeatts ◽  
Shyam Prabhakaran ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Risk Factor ◽  
Regression Models ◽  
Ldl Cholesterol ◽  
Vascular Risk Factor ◽  
White Matter Hyperintensity ◽  
Vascular Risk ◽  
Linear Regression Models ◽  
Risk Factor Profile ◽  
The Mean

Introduction: While retrospective studies have shown that poor control of vascular risk factors is associated with progression of white matter hyperintensity (WMH), it has not been studied prospectively. Hypothesis: We hypothesize that higher systolic blood pressure (SBP) mean, LDL cholesterol, and Hgb A1c will be correlated with WMH progression in diabetics. Methods: This is a secondary analysis of the Memory in Diabetes (MIND) substudy of the Action to Control Cardiovascular Risk in Diabetes Follow-on Study (ACCORDION). The primary outcome was WMH progression, evaluated by fitting linear regression models to the WMH volume on the month 80 MRI and adjusting for the WMH volume on the baseline MRI. The primary predictors were the mean values of SBP, LDL, and A1c from baseline to month 80. We defined a good vascular risk factor profile as mean SBP <120 mm Hg and mean LDL <120 mg/dL. Results: We included 292 patients, with a mean (SD) age of 62.6 (5.3) years and 55.8% male. The mean number of SBP, LDL, and A1c measurements per patient was 17, 5, and 12. We identified 86 (29.4%) patients with good vascular risk factor profile. In the linear regression models, mean SBP and LDL were associated with WMH progression and in a second fully adjusted model they both remained associated with WMH progression (Table). Those with a good vascular risk factor profile had less WMH progression (β Coefficient -0.80, 95% CI -1.42, -0.18, p=0.012). Conclusions: Our data reinforce prior research showing that higher SBP and LDL is associated with progression of WMH in diabetics, likely secondary to chronic microvascular ischemia, and suggest that control of these factors may have protective effects. This study has unique strengths, including prospective serial measurement of the exposures, validated algorithmic measurement methodology for WMH, and rigorous adjudication of study data. Clinical trials are needed to investigate the effect of vascular risk factor reduction on WMH progression.

Abstract P125: Hypertension, Awareness, Treatment, And Control In Nepal: Results From May Measurement Month 2020 Blood Pressure Screening

Hypertension ◽  
2021 ◽  
Vol 78 (Suppl_1) ◽  
Author(s):  
Pawan Acharya ◽  
Sweta Koirala ◽  
Pabitra Babu Soti ◽  
Sneha Sharma ◽  
Abhishek Sapkota ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Smoking Status ◽  
Blood Pressure Measurement ◽  
Age Groups ◽  
Hypertension Status ◽  
Safety Measures ◽  
Treatment Of Hypertension ◽  
Hypertension Awareness ◽  
The Mean ◽  
And Control

Background: May Measurement Month (MMM) 2020 was not officially executed globally due to the COVID-19 pandemic. But in Nepal, the MMM 2020 was conducted by following COVID-19 safety measures. Methods: We used an opportunistic screening campaign for blood pressure measurement among individuals ≥18 years in Nepal. Of the three measurements, the second and third measurements were used to estimate the mean systolic and diastolic blood pressure(BP). We defined hypertension as the systolic BP ≥ 120 or diastolic BP≥90 mmHg and or currently taking antihypertensive medicine. Results: Among the total 11,486 participants, 57%(6568/11486) were females. The mean age of the screenees was 45years(SD=17.0). The mean systolic and diastolic BP were 125.8(SD= 18.0) and 81.6(SD=10.5) respectively. About 31.3%(3592/11481) participants had hypertension. Among the hypertensive persons, 40.2%(1444/3592) were aware of their hypertension status. Among these who were aware, 79.4%(1146/1444) were taking antihypertensive medicine. However, the overall proportion of hypertensive patients taking medicine was 32.0%(1146/3592). The BP was controlled among 46% ( 527/1444) of participants who were under medication. Logistic regression analysis adjusting age, sex, body mass index(BMI), and smoking status found males, higher age groups, higher BMI, and smokers had higher odds of being hypertensive. (Figure 1) Conclusion: The results suggest a need to address the gap in awareness, diagnosis, and treatment of hypertension in Nepal. The results are limited due to the non-random participation of screenees. Figure 1. Odds ratio plot

scholarly journals Waist Circumference, Blood Pressure and Lifestyle of Sudanese Population, Khartoum Locality, Sudan 2016

2019 ◽  
pp. 1-8
Author(s):  
Asma Abdelaal Abdalla ◽  
Siham Ahmed Balla ◽  
Amna Abdalla Babiker ◽  
Safaa Abdelhameed Medani ◽  
Rania Abdalla Osman Khalfa ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Waist Circumference ◽  
Physical Exercise ◽  
Age Distribution ◽  
Cross Sectional Study ◽  
P Value ◽  
Cross Sectional ◽  
Men And Women ◽  
Study Population ◽  
The Mean

Aims: To measure the waist circumference of Sudanese adults in Khartoum Locality and its relationship to blood pressure and lifestyle  during celebration of international day of hypertension in May 2016 . Study Design: It was a descriptive cross-sectional study. Place of the Celebration: Khartoum Locality at Alsahaa Alkhadraa (The Green Park). Methodology: A total of 364 adult participants, 196 men and 168 women were interviewed using structured questionnaire. Blood pressure (BP) was measured considering hypertension as ≥ 140 mmHg and ≥ 90 mmHg for systole and diastole BP respectively. Waist circumference was measured using an anthropometric measuring tape at cut-off point of 94 cm and 80 cm for men and women respectively. Data was managed by SPSS version 20 and Chi-square test at 95% CL was used to test the association between waist circumference, blood pressure and life style characteristics. Results: Age distribution of the study population showed 48.2% females and 45.4% males in the middle age group (38-57 years). Two thirds of the study population were hypertensive, 62.8% of males and 64.3% of females. The mean waist circumference of men was 97.82 cm + 16.7, mean Systolic BP was 127 + 22 and mean Diastolic BP was 85 + 15. The mean waist circumference of women was 99.31 + 16.2, mean Systolic was 128 + 24 and mean Diastolic BP was 84 +17. Abnormal waist circumference was found in 61.2% of males and 86.9% of females. Fifty nine (30.1%) of the males and 86 (51.2%) of the females with abnormal waist circumference were hypertensive. The association between abnormal waist circumference and high blood pressure was significant among both sexes, P value = 0.001. Physical exercise and fat and salt foods were not significantly associated waist circumference in both men and women. Conclusion: Two thirds of women and men in the celebrating areas were hypertensive.  Half of women and one third of men were significantly hypertensive and having abnormal waist circumference. Doing physical exercise, avoiding fat and salt foods was insignificantly associated with normal waist circumference. Large survey with representative sample is needed to estimate the real Sudanese waist circumference.  

scholarly journals The Physiological Effects of IPAD Digital Games on Children with Autism

2017 ◽  
Vol 5 (2) ◽  
Author(s):  
Nur Zakiah Mohd Saat ◽  
Najwa Suhaili Md Zin ◽  
Sazlina Kamaralzaman
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Children With Autism ◽  
Cross Sectional Study ◽  
Breathing Rate ◽  
Blood Pressure Monitor ◽  
Pressure Monitor ◽  
Cross Sectional ◽  
Strategy Games ◽  
The Mean

Background: Previous studies found that the use of an iPad® in intervention programmes benefited the skills of daily living of children with autism. The purpose of the study was to determine the physiological changes in children while playing action and strategy games on an iPad. Methodology: A cross-sectional study was conducted using Powerlab 24/6T, a blood pressure monitor, respiratory belt, and finger pulse transducer. The children were asked to play two types of game. The duration for each game was 10 minutes. The measurement of blood pressure - both systolic and diastolic, heart rate and breathing rate were taken at three consecutive times (before, during and after each game). The inclusion criteria are children aged 7 to 12 years old who have been diagnosed with a mild type of autism (Pervasive developmental disorder). The exclusion criteria were children who had co-morbidities such as epilepsy, migraine, heart, and lung problems, depression, physical disabilities and visual impairments.  Results: Nineteen children with autism participated in this study. The result indicated that the mean systolic and diastolic blood pressures increased before and after playing strategy games and action games. However, compared to pre-play values, the mean heart rate and breathing rate decreased both during and after playing both types of game. Meanwhile, there was significant mean difference for breathing rate for both types of game (p<0.05). Conclusion: Playing strategy and action games did not affect the measured physiological parameters of children with autism. 

scholarly journals Soft drinks consumption, diet quality and BMI in a Mediterranean population

2010 ◽  
Vol 14 (5) ◽  
pp. 778-784 ◽  
Author(s):  
Eva Balcells ◽  
Mario Delgado-Noguera ◽  
Ricardo Pardo-Lozano ◽  
Taïs Roig-González ◽  
Anna Renom ◽  
...  
Keyword(s):  
Mediterranean Diet ◽  
Sedentary Lifestyle ◽  
Population Based ◽  
Soft Drinks ◽  
Mediterranean Population ◽  
Regression Analyses ◽  
Cross Sectional ◽  
Independent Population ◽  
The Mean ◽  
Diet Score

AbstractObjectivesEvidence of the effects of soft drinks consumption on BMI and lifestyle in adult populations is mixed and quite limited. The aim of the present study was to determine the association of soft drinks consumption with BMI and lifestyle in a representative Mediterranean population.DesignTwo independent, population-based, cross-sectional (2000 and 2005) studies. Dietary intake was assessed using a validated FFQ. Weight and height were measured.SettingGirona, Spain.SubjectsRandom sample of the 35- to 74-year-old population (3910 men and 4285 women).ResultsLess than half (41·7 %) of the population consumed soft drinks; the mean consumption was 36·2 ml/d. The prevalence of sedentary lifestyle increased with the frequency of soft drinks consumption (P = 0·025). Daily soft drinks consumption significantly increased the risk of low adherence to the Mediterranean diet (OR = 0·57, 95 % CI 0·44, 0·74 v. top tertile of Mediterranean diet score). Multiple linear regression analyses, controlled for potential confounders, revealed that an increment in soft drinks consumption of 100 ml was associated with a 0·21 kg/m2 increase in BMI (P = 0·001). Only implausibly low reports of energy consumption showed a null association between soft drinks consumption and BMI.ConclusionsSoft drinks consumption was not embedded in a healthy diet context and was positively associated with BMI and sedentary lifestyle in this Mediterranean population.

Prevalence of Hypertension and Associated Risk Factors Among Women in a Rural Community in Bangladesh: A Cross-Sectional Study

2021 ◽  
pp. 1-19
Author(s):  
Anika Boitchia ◽  
Shabnam Naher ◽  
Sabbir Pervez ◽  
Moyazzem Hossainc
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Rural Women ◽  
Cross Sectional Study ◽  
Uncontrolled Hypertension ◽  
Background Characteristics ◽  
Cross Sectional ◽  
The Mean ◽  
Associated Risk Factors ◽  
Structured Questionnaire

Abstract The purpose of this cross-sectional quantitative study was to identify the prevalence and associated risk factors of hypertension among rural women. Data collection was carried out between March to June 2019 among 380 women in Kumarkhali Upazila, Kushtia, Bangladesh. Participants were interviewed with a structured questionnaire including background characteristics, anthropometric measurements, prevalence, and risk factors of hypertension. IBM SPSS version 25 was used for analyzing the data. The prevalence of hypertension and prehypertension among the total participants was 21.3% and 17.1%, respectively. The mean systolic and diastolic blood pressure was 126.65 (±19.31) mmHg and 77.21 (±12.51) mmHg. Association was found between the prevalence of hypertension and participant’s age, marital status, educational level, body mass index, intake of raw salt, secondary smoking, stress, and diabetes (p<0.05). Among the diabetic women, prehypertension and hypertension prevailed as 26.3% and 55.3% respectively. The lowest risk of hypertension was found with limited raw salt (aOR: 1.42) and red meat (aOR: 0.05) consumption. Hypertension was more likely to affect overweight (aOR: 3.98) and women aged 55 to 64 years (aOR: 13.44). Thus, effective and integrated intervention agendas are required for women, which can improve the rate of diagnosis and prevent uncontrolled hypertension in Bangladesh. Keywords: Prevalence, hypertension, women, blood pressure, risk factor, Bangladesh

Abstract P246: Relationship Between Urinary Sodium/potassium Ratio And Systolic Blood Pressure In Salt Sensitive Subjects In The Dash-sodium Trial

Hypertension ◽  
2021 ◽  
Vol 78 (Suppl_1) ◽  
Author(s):  
Rozalia Abramov ◽  
Elizabeth D Drugge ◽  
Khalid A Farhan ◽  
Nicholas R Ferreri
Keyword(s):  
Blood Pressure ◽  
Systolic Blood Pressure ◽  
Salt Intake ◽  
Control Diet ◽  
Dietary Sodium ◽  
Bivariate Analysis ◽  
Linear Regression Models ◽  
Unequal Distribution ◽  
Dash Diet ◽  
Black Females

Excessive salt intake is associated with hypertension and cardiovascular morbidity. However, identifying those at risk of salt sensitive hypertension (SSH) remains a challenge due to its unequal distribution among populations and inaccurate assessment of dietary sodium (Na) and potassium (K) intake. The objective of this study was to compare indices of dietary Na intake in relation to systolic blood pressure (SBP) in salt sensitive (SS) and salt resistant (SR) subjects from the Dietary Approaches to Stop Hypertension (DASH)-Sodium trial. We hypothesized that when compared to urinary Na or K independently, Na/K ratio is a better predictor of SSH when defined as a 5-10 mmHg change in SBP from low to high dietary Na. Among 404 Black and White subjects, baseline classifications included 177 SS and 227 SR. After diet randomization, on the control 107 were SS and 92 SR and on the DASH 70 were SS and 135 SR. Descriptive statistics, bivariate analysis, followed by linear regression models for baseline and multilevel mixed-effects models after intervention were used to assess the relationship between SBP and dietary Na (as measured by urinary Na/K ratio or Na and K independently) using SS as a categorical factor. SBP was consistently associated with SS, Na/K ratio, and age in all models . At baseline, SBP was significantly higher in SS and SR subjects of the same race and sex, after controlling for age and urinary Na/K ratio and was highest for White females, SS:142.3 (138.8, 145.7) vs. SR:133.2 (130.7, 135.7), and for Black males, SS:137.0 (133.8, 140.1) vs. SR: 129.6 (127.0, 132.3). On average, SBP increased 1.02 (0.065, 1.98) mmHg with each unit increase in Na/K ratio and 3.30 (2.41, 4.19) mmHg with each 10-year increase in age. After randomization and exposure to increasing levels of sodium, SBP increased in SS subjects on the control diet:125.3 (123.2, 127.3) to 136.8 (134.8, 138.9), an effect that was greater in White vs Black females and in Black vs White males. SBP increased in SS subjects on the DASH diet: 121.4 (118.8, 124.0) to 131.2 (128.7, 133.7), but there were no differences by race and sex. These results suggest that a 5-10 mmHg change in SBP in subjects on a typical American diet and Na/K ratio are good predictors of SSH and that the DASH diet may help to reduce race and sex disparities.

Abstract P067: Association of Number of Eating Episodes per Day with Blood Pressure: INTERMAP Study

Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Ghadeer S Aljuraiban ◽  
Queenie Chan ◽  
Ian Brown ◽  
Martha Daviglus ◽  
Jeremiah Stamler ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Food Intake ◽  
Population Sample ◽  
Average Energy ◽  
Linear Regression Models ◽  
Cross Sectional ◽  
Health History ◽  
Special Diet ◽  
Meal Timing ◽  
History Of

Background: Greater meal frequency per day may relate favorably to blood pressure (BP) levels of individuals. Aims: Explore associations of BP with frequency of food intake and meal timing among American participants of the INTERMAP Study. Whether differential nutrient intakes are contributing to observed BP differences is also explored. Methods: The INTERMAP Study is a cross-sectional epidemiologic investigation of 4,680 men and women ages 40–59 years in China, Japan, United Kingdom and United States (US). Data include findings from four 24-hour dietary recalls, two 24-hour urine collections, 8 BP measurements and health history questionnaires. Meals and snacks will be referred to as “eating episodes” (EP), where an eating episode is an intake of energy separated from the previous intake of food by a period of time. Results: Among 2,195 US participants, mean number of EP was 5.8 (SD 1.7) and average energy/EP was 423.0 kcal (SD 160.6) per day. About 57% of participants had less than 6 EP per day and had significantly higher systolic BP (SBP) compared to 43% of participants having 6 or more EP per day (119.3 mmHg, SD 13.9 vs. 117.7 mmHg, SD 13.9 P=0.01). Mean energy/EP, adjusted for sex, age, population sample and body mass index (BMI), was significantly higher among those having less than 6 EP per day then those with 6 or more EP per day (P<0.0001). Association of average number of EP with SBP was consistently negative in linear regression models adjusted for energy, sex, age, BMI, special diet, physical activity, cigarette smoking, and family history of hypertension (b=−0.04, P=0.04). Conclusions: Smaller more frequent intake of meals/snacks relates favorably to BP levels. Several mechanisms may be involved, e.g., improved glucose tolerance and insulin sensitivity, with spreading food intake throughout the day.

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