scholarly journals Blood Pressure Levels in Young Adulthood and Midlife Stroke Incidence in a Diverse Cohort

Hypertension ◽  
2021 ◽  
Vol 77 (5) ◽  
pp. 1683-1693 ◽  
Author(s):  
Yariv Gerber ◽  
Jamal S. Rana ◽  
David R. Jacobs ◽  
Yuichiro Yano ◽  
Deborah A. Levine ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Young Adults ◽  
Continuous Variable ◽  
Hazard Ratio ◽  
Time Dependent ◽  
Middle Aged ◽  
Cox Models ◽  
Stroke Incidence ◽  
Primordial Prevention ◽  
Middle Aged Adults

We examined the longitudinal association between blood pressure (BP) and stroke incidence in young and middle-aged adults. BP measured during 9 examinations of the CARDIA study (Coronary Artery Risk Development in Young Adults) from 1985-1986 to 2015-2016 was used to classify participants (n=5079) according to the 2017 Hypertension Clinical Practice Guidelines. We used the highest BP obtained through the third examination (1990–1991) to define baseline BP categories; time-dependent categories (accounting for change in BP over time) were determined incorporating follow-up measurements. BP groups at ages 30 and 40 years were also defined. Stroke events were adjudicated until 2018. Mean age at baseline was 29.8 years. Stroke occurred in 100 participants. Stroke incidence (per 100 000 person-years) was higher ( P <0.001) in Black (120 [95% CI, 95–149]) versus White (29 [95% CI, 18–46]) participants. After adjustment with Cox models for sociodemographic and cardiovascular risk factors, stage 2 hypertension was associated with a higher risk of stroke at baseline (hazard ratio, 3.72 [95% CI, 2.12–6.54]), as a time-dependent variable (hazard ratio, 5.84 [95% CI, 3.43–9.95]), at age 30 (hazard ratio, 4.14 [95% CI, 2.19–7.82]) and at age 40 (hazard ratio, 5.59 [95% CI, 3.35–9.31]), compared with normal BP. Elevated BP and stage 1 hypertension showed more modest increases in risk. As a continuous variable, systolic BP ≥90 mm Hg at age 40 was directly associated with stroke risk. These findings call for primordial prevention strategies to reduce population BP levels among young and middle-aged adults, particularly in Black young adults given ≈4-fold higher stroke incidence, including within values traditionally considered to be normal.

scholarly journals Peripheral venous distension elicits a blood pressure raising reflex in young and middle-aged adults

2016 ◽  
Vol 310 (11) ◽  
pp. R1128-R1133 ◽  
Author(s):  
Evan L. Matthews ◽  
Michael S. Brian ◽  
Dana E. Coyle ◽  
David G. Edwards ◽  
Sean D. Stocker ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Young Adults ◽  
Muscle Sympathetic Nerve Activity ◽  
Peripheral Resistance ◽  
Muscle Afferents ◽  
Middle Aged ◽  
Group Iii ◽  
Autonomic Reflexes ◽  
Middle Aged Adults ◽  
Sensory Fibers

Distension of peripheral veins in humans elicits a pressor and sympathoexcitatory response that is mediated through group III/IV skeletal muscle afferents. There is some evidence that autonomic reflexes mediated by these sensory fibers are blunted with increasing age, yet to date the venous distension reflex has only been studied in young adults. Therefore, we tested the hypothesis that the venous distension reflex would be attenuated in middle-aged compared with young adults. Nineteen young (14 men/5 women, 25 ± 1 yr) and 13 middle-aged (9 men/4 women, 50 ± 2 yr) healthy normotensive participants underwent venous distension via saline infusion through a retrograde intravenous catheter in an antecubital vein during limb occlusion. Beat-by-beat blood pressure, muscle sympathetic nerve activity (MSNA), and model flow-derived cardiac output (Q), and total peripheral resistance (TPR) were recorded throughout the trial. Mean arterial pressure (MAP) increased during the venous distension in both young (baseline 83 ± 2, peak 94 ± 3 mmHg; P < 0.05) and middle-aged adults (baseline 88 ± 2, peak 103 ± 3 mmHg; P < 0.05). MSNA also increased in both groups [young: baseline 886 ± 143, peak 1,961 ± 242 arbitrary units (AU)/min; middle-aged: baseline 1,164 ± 225, peak 2,515 ± 404 AU/min; both P < 0.05]. TPR ( P < 0.001), but not Q ( P = 0.76), increased during the trial. However, the observed increases in blood pressure, MSNA, and TPR were similar between young and middle-aged adults. Additionally, no correlation was found between age and the response to venous distension (all P > 0.05). These findings suggest that peripheral venous distension elicits a pressor and sympathetic response in middle-aged adults similar to the response observed in young adults.

Clinical and Radiological Differences in Patients Following Traumatic SCI at Different Ages

2021 ◽  
Vol 23 (4) ◽  
pp. 305-314
Author(s):  
Thalia Saraiva Mendonça ◽  
Vitor Dias de Arruda Andrade ◽  
Pedro Nogarotto Cembraneli ◽  
Julia Brasileiro de Faria Cavalcante ◽  
André Salotto Rocha ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Young Adults ◽  
Compression Fracture ◽  
Facial Trauma ◽  
Traumatic Spinal Cord Injury ◽  
Elderly Adults ◽  
Middle Aged ◽  
Cord Injury ◽  
Middle Aged Adults

Background. Traumatic spinal cord injury (SCI) is a lesion that can affect several spinal structures, including the vertebrae, spinal cord, ligaments, and other adjacent parts of the spine. Traumatic spinal cord injury (SCI) can cause functional changes in patients of different ages. Material and methods. The study aims to determine whether there are social, clinical, and radiological differences between young, middle-aged, and elderly adults with SCI caused by a ground-level fall. This retrospective study analyzed the records of patients with a clinical diagnosis of SCI. It enrolled patients with traumatic spinal cord injury after a ground-level fall divided as follows: young aged adults 18–35 years of age (G1); middle-aged adults aged 36–60 years (G2); and elderly adults aged over 60 years (G3). Their clinical, social, and radiological variables were analyzed. Results. It is observed that low schooling level, being widowed, and being a homemaker were more frequently encountered among elderly adults, whereas being single was more common in middle-aged adults. The morphologic diagnosis of compression fracture and the associated injury of facial trauma occurred more frequently in elderly adults, with an increasing tendency with age. Conservative therapeutic management was most commonly encountered in elderly adults, compared to surgery from a posterior approach in middle-aged adults. Listhesis was better identified in middle-aged adults by computed tomography (CT). Spinal cord contusion and injury to the C1 vertebra were demonstrated in young adults by magnetic resonance imaging (MRI). Conclusions. 1. Elderly adults with low education level, widowed, and homemakers were more susceptible to SCI caused by a fall. 2. Single marital status was more frequently noted in young adults. 3. The most frequent clinical aspects were the morphological aspect of compression fracture and fa­cial trauma as an associated injury in elderly adults, with the occurrence of facial trauma increasing with age. 4. Conservative therapeutic management was more common in elderly adults than surgery from a po­sterior approach in middle-aged adults. 5. Re­garding the radiological aspects of CT, listhesis was better identified in middle-aged adults. Spi­nal cord contusions and C1 vertebra lesions were better identified in young adults by MRI.

scholarly journals Fibroblast Growth Factor 23 and Incident Cardiovascular Disease and Mortality in Middle‐Aged Adults

2021 ◽  
Author(s):  
Shejuti Paul ◽  
Mandy Wong ◽  
Ehimare Akhabue ◽  
Rupal C. Mehta ◽  
Holly Kramer ◽  
...  
Keyword(s):  
Heart Failure ◽  
Cardiovascular Disease ◽  
Growth Factor ◽  
Fibroblast Growth Factor ◽  
Fibroblast Growth Factor 23 ◽  
Hazard Ratio ◽  
Fibroblast Growth ◽  
Heart Failure Hospitalization ◽  
Middle Aged ◽  
Middle Aged Adults

Background Higher circulating fibroblast growth factor 23 (FGF23) associates with greater risk of cardiovascular disease (CVD) and mortality in older adults. The association of FGF23 with cardiovascular outcomes in younger populations has been incompletely explored. Methods and Results We measured C‐terminal FGF23 (cFGF23) and intact FGF23 (iFGF23) in 3151 middle‐aged adults (mean age, 45±4) who participated in the year 20 examination of the CARDIA (Coronary Artery Risk Development in Young Adults) study. We used separate Cox proportional hazards models to examine the associations of cFGF23 and iFGF23 with incident CVD and mortality, adjusting models sequentially for sociodemographic, clinical, and laboratory factors. A total of 157 incident CVD events and 135 deaths occurred over a median 7.6 years of follow‐up (interquartile range, 4.1–9.9). In fully adjusted models, there were no statistically significant associations of FGF23 with incident CVD events (hazard ratio per doubling of cFGF23: 1.14, 95%CI 0.97,1.34; iFGF23: 0.76, 95%CI 0.57,1.02) or all‐cause mortality (hazard ratio per doubling of cFGF23, 1.17; 95% CI, 1.00–1.38; iFGF23, 0.86; 95% CI, 0.64–1.17). In analyses stratified by CVD subtypes, higher cFGF23 was associated with greater risk of heart failure hospitalization (hazard ratio per doubling of cFGF23, 1.52; 95% CI, 1.18–1.96) but not coronary heart disease or stroke, whereas iFGF23 was not associated with CVD subtypes in any model. Conclusions In middle‐aged adults with few comorbidities, higher cFGF23 and iFGF23 were not independently associated with greater risk of CVD events or death. Higher cFGF23 was independently associated with greater risk of heart failure hospitalization.

Abstract 071: Ten-year Change In Tv Viewing Is Associated With Concurrent Change In Pericardial Adipose Tissue In Middle-aged Adults: The Coronary Artery Risk Development In Young Adults (CARDIA) Study

Circulation ◽  
2021 ◽  
Vol 143 (Suppl_1) ◽  
Author(s):  
Minsuk Oh ◽  
Kelley Pettee Gabriel ◽  
David R Jacobs ◽  
James G Terry ◽  
Jingzhong Ding ◽  
...  
Keyword(s):  
Physical Activity ◽  
Young Adults ◽  
Adipose Tissue ◽  
Coronary Artery ◽  
Disease Risk ◽  
Viewing Time ◽  
Middle Aged ◽  
Tv Viewing ◽  
Pericardial Adipose Tissue ◽  
Middle Aged Adults

Introduction: Pericardial adipose tissue (PAT), an ectopic adipose depot surrounding the coronary arteries, is a pathogenic risk factor for cardiometabolic disease; however, the association of sedentary behavior with PAT is poorly understood. We examined the longitudinal association of 10-year change in TV viewing with concurrent change in PAT. Hypothesis: Increased h/day of TV viewing over 10 years are associated with larger mean increases in PAT during the same 10-year period. Methods: Middle-aged adults (N=1659, mean age=40.4, 912 females, 733 blacks) from the Coronary Artery Risk Development in Young Adults (CARDIA) Study at the exam years 15 (2000-2001) and 25 (2010-2011) were included. Both TV viewing (h/day) and the volume of PAT (mL) were measured at Years 15 and 25 using the CARDIA physical activity questionnaire and computed tomography, respectively. Covariates measured at year 15 included PAT, sociodemographic factors, cardiovascular disease risk factors, diet quality, TV viewing, moderate-to-vigorous intensity physical activity (MVPA), inflammatory cytokines, and waist circumference. Multivariable linear regression was used to estimate 10-year change in PAT across increasing tertiles (≤ -1, > -1 to < 1, ≥ 1 h/day) of 10-year changes in TV viewing. Results: On average, TV viewing and PAT increased between the two exam years by 0.2 h/day (8.7% increase, mean: 2.3 → 2.5 h/day) and 11.8 mL (25.9% increase, mean: 45.6 → 57.4 mL), respectively (all p < 0.01). In the fully adjusted model including MVPA and other major confounders, the highest tertile of 10-year change in TV viewing was associated with greater change in PAT (β = 2.97 mL, p < 0.01) when compared with the lowest tertile (see Figure 1 ), while mean PAT change was intermediate in the middle tertile. Conclusions: A greater 10-year increase in TV viewing is associated with a greater concurrent increase in PAT, independent of MVPA and other important confounders. Reducing TV viewing time may be associated with less PAT accumulation with age.

scholarly journals KNOWLEDGE OF AGING, NEGATIVE AGE BIAS, AND POSITIVE AGE BIAS: AGE GROUP DIFFERENCES

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S80-S81
Author(s):  
Grace Caskie ◽  
Anastasia E Canell ◽  
Hannah M Bashian
Keyword(s):  
Older Adults ◽  
Young Adults ◽  
Well Being ◽  
Total Sample ◽  
Group Differences ◽  
Age Group ◽  
Middle Aged ◽  
Age Bias ◽  
Negative Beliefs ◽  
Middle Aged Adults

Abstract Attitudes towards aging include both positive and negative beliefs about older adults (Iverson et al., 2017; Palmore, 1999). Palmore’s (1998) Facts on Aging Quiz, a widely used assessment of knowledge about aging, also identifies common societal misconceptions about aging. Findings regarding age group differences in attitudes toward aging are mixed (Bodner et al., 2012; Cherry & Palmore, 2008; Rupp et al., 2005). The current study compared knowledge of aging, negative age bias, and positive age bias between young adults (18-35 years, n=268) and middle-aged adults (40-55 years; n=277). Middle-aged adults reported significantly greater average knowledge of aging than young adults (p=.019), although both groups had relatively low knowledge (MA: M=13.0, YA: M=12.2). Middle-aged adults also showed significantly less negative age bias (p&lt;.001) and significantly more positive age bias than young adults (p=.026). Although the total sample was significantly more likely to be incorrect than correct on 23 of the 25 facts (p&lt;.001), young adults were significantly more likely than middle-aged adults (p&lt;.001) to respond incorrectly for only 2 of 25 facts. Both facts reflected greater negative age bias among young adults than middle-aged adults. These facts concerned older adults’ ability to work as effectively as young adults (fact 9) and frequency of depression in older adults (fact 13). Results demonstrate that age bias is not limited to young adults and may continue through midlife, though negative age bias in particular may be lower for individuals approaching older adulthood, which could have implications for their psychological and physical well-being.

scholarly journals Lead Exposure and Cardiovascular Disease among Young and Middle-Aged Adults

2019 ◽  
Vol 7 (11) ◽  
pp. 103 ◽  
Author(s):  
Emmanuel Obeng-Gyasi
Keyword(s):  
Blood Pressure ◽  
Logistic Regression ◽  
Lead Exposure ◽  
Binary Logistic Regression ◽  
The United States ◽  
Gamma Glutamyl Transferase ◽  
Middle Aged ◽  
The Mean ◽  
Glutamyl Transferase ◽  
Middle Aged Adults

Lead and its effects on cardiovascular-related markers were explored in this cross-sectional study of young adults (18–44 years) and middle-aged adults (45–65 years) from the United States using the National Health and Nutrition Examination Survey (NHANES), 2009–2016. Degrees of exposure were created using blood lead level (BLL) as the biomarker of exposure based on the epidemiologically relevant threshold of BLL > 5 μg/dL. The mean values, in addition to the percentages of people represented for the markers of interest (systolic blood pressure [SBP], diastolic blood pressure [DBP], gamma-glutamyl transferase [GGT], non-high-density lipoprotein cholesterol [non-HDL-C]) were explored. Among those exposed to lead, the likelihood of elevated clinical markers (as defined by clinically relevant thresholds of above normal) were examined using binary logistic regression. In exploring exposure at the 5 μg/dL levels, there were significant differences in all the mean variables of interest between young and middle-aged adults. The binary logistic regression showed young and middle-aged adults exposed to lead were significantly more likely to have elevated markers (apart from DBP). In all, lead affects cardiovascular-related markers in young and middle-aged U.S. adults and thus we must continue to monitor lead exposure to promote health.

Acute effects of body-weight resistance exercises on blood pressure and glycemia in middle-aged adults with hypertension

2020 ◽  
Vol 43 (1) ◽  
pp. 63-68
Author(s):  
Rodrigo Ferrari ◽  
Eduardo Lusa Cadore ◽  
Bibiana Périco ◽  
Gabriela Bartholomay Kothe
Keyword(s):  
Blood Pressure ◽  
Body Weight ◽  
Acute Effects ◽  
Middle Aged ◽  
Resistance Exercises ◽  
Middle Aged Adults

The “How” and “When” of Parental Loss in Adulthood

2015 ◽  
Vol 71 (1) ◽  
pp. 3-18 ◽  
Author(s):  
Bert Hayslip ◽  
Jessica H. Pruett ◽  
Daniela M. Caballero
Keyword(s):  
Young Adults ◽  
Cause Of Death ◽  
Adult Child ◽  
Parental Loss ◽  
Middle Aged ◽  
Adult Lifespan ◽  
Precise Understanding ◽  
Grief Responses ◽  
Middle Aged Adults ◽  
Loss Of A Parent

In order to evaluate the role of cause of death on the grief responses of parentally bereaved young and middle-aged adults, 400 individuals completed measures assessing their experiences and feelings surrounding the loss of a parent. Respondents included 247 young adults and 155 middle-aged adults. Cause of death was categorized as acute or anticipated with 209 participants reporting the parent’s death as acute, while anticipated death was reported by 191 individuals. Results suggested that gender of the adult child and age level of the participant were important factors contributing to the grief response, and women were found to have more difficulty adjusting to the loss of a parent as well as demonstrating a more intense grief response. Young adults were found to be more impacted by the loss of a parent than were middle-aged adults. Those who were single or separated were similarly more impacted versus those who were married, where more young adults were single/separated and more middle-aged adults were married. Cause of death was only mildly influential in influencing responses to parental loss and did not interact with other studied variables. These results point to the importance of support from others in coping with a parent’s death as well as for the counseling of bereaved persons who may be at risk for difficulties in coping with the death of a parent and enable a more precise understanding of individual grief processes across the adult lifespan.

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