Trajectory of blood pressure, body mass index, cholesterol and incident dementia: systematic review

2019 ◽  
Vol 216 (1) ◽  
pp. 16-28 ◽  
Author(s):  
Ruth Peters ◽  
Jean Peters ◽  
Andrew Booth ◽  
Kaarin J. Anstey
Keyword(s):  
Systematic Review ◽  
Blood Pressure ◽  
Body Mass Index ◽  
Risk Factor ◽  
Cognitive Decline ◽  
Body Mass ◽  
Current Evidence ◽  
Ageing Population ◽  
Published Evidence ◽  
Current Evidence Base

BackgroundThe global ageing population and the long prodromal period for the development of cognitive decline and dementia brings a need to understand the antecedents of both successful and impaired cognitive ageing. It is increasingly apparent that the trajectory of risk-factor change, as well as the level of the risk factor, may be associated with an increased or decreased risk of cognitive decline or dementia.AimsOur aim was to summarise the published evidence and to generate hypotheses related to risk-factor trajectories and risk of incident cognitive decline or dementia.MethodWe collated data from longitudinal observational studies relating to trajectory of blood pressure, obesity and cholesterol and later cognitive decline or dementia using standard systematic review methodology. The databases MEDLINE, Embase and PsycINFO were searched from inception to 26 April 2018.ResultsThirteen articles were retained for inclusion. Analytical methods varied. Our summary of the current evidence base suggests that first body mass index and then blood pressure rises and then falls more steeply in those who go on to develop dementia. The evidence for cholesterol was less consistent.ConclusionBased on our review we present the hypothesis that weight falls around 10 years and blood pressure around 5 years before diagnosis. Confirmatory work is required. However, characterisation of risk according to combinations and patterns of risk factors may ultimately be integrated into the assessments used to identify those at risk of receiving a diagnosis of cognitive decline or dementia in late life.

scholarly journals Investigation of antihypertensive class, dementia, and cognitive decline

Neurology ◽  
2019 ◽  
Vol 94 (3) ◽  
pp. e267-e281 ◽  
Author(s):  
Ruth Peters ◽  
Sevil Yasar ◽  
Craig S. Anderson ◽  
Shea Andrews ◽  
Riitta Antikainen ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cognitive Decline ◽  
Meta Analysis ◽  
Evidence Base ◽  
Reliable Change Index ◽  
Current Evidence ◽  
Index Method ◽  
Current Evidence Base ◽  
Registration Number ◽  
Prospective Longitudinal

ObjectiveHigh blood pressure is one of the main modifiable risk factors for dementia. However, there is conflicting evidence regarding the best antihypertensive class for optimizing cognition. Our objective was to determine whether any particular antihypertensive class was associated with a reduced risk of cognitive decline or dementia using comprehensive meta-analysis including reanalysis of original participant data.MethodsTo identify suitable studies, MEDLINE, Embase, and PsycINFO and preexisting study consortia were searched from inception to December 2017. Authors of prospective longitudinal human studies or trials of antihypertensives were contacted for data sharing and collaboration. Outcome measures were incident dementia or incident cognitive decline (classified using the reliable change index method). Data were separated into mid and late-life (>65 years) and each antihypertensive class was compared to no treatment and to treatment with other antihypertensives. Meta-analysis was used to synthesize data.ResultsOver 50,000 participants from 27 studies were included. Among those aged >65 years, with the exception of diuretics, we found no relationship by class with incident cognitive decline or dementia. Diuretic use was suggestive of benefit in some analyses but results were not consistent across follow-up time, comparator group, and outcome. Limited data precluded meaningful analyses in those ≤65 years of age.ConclusionOur findings, drawn from the current evidence base, support clinical freedom in the selection of antihypertensive regimens to achieve blood pressure goals.Clinical trials registrationThe review was registered with the international prospective register of systematic reviews (PROSPERO), registration number CRD42016045454.

scholarly journals Relation of blood pressure and body mass index during childhood to cardiovascular risk factor levels in young adults

2009 ◽  
Vol 27 (9) ◽  
pp. 1766-1774 ◽  
Author(s):  
Erin R Rademacher ◽  
David R Jacobs ◽  
Antoinette Moran ◽  
Julia Steinberger ◽  
Ronald J Prineas ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Body Mass Index ◽  
Young Adults ◽  
Risk Factor ◽  
Cardiovascular Risk ◽  
Body Mass ◽  
Cardiovascular Risk Factor

scholarly journals Body mass index and subfertility: multivariable regression and Mendelian randomization analyses in the Norwegian Mother, Father and Child Cohort Study

2021 ◽  
Author(s):  
Alvaro Hernaez ◽  
Tormod Rogne ◽  
Karoline H. Skara ◽  
Siri E. Haberg ◽  
Christian M. Page ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Cohort Study ◽  
Body Mass ◽  
Mendelian Randomization ◽  
European Ancestry ◽  
Current Evidence ◽  
Obese Women ◽  
Time To Pregnancy ◽  
Current Evidence Base ◽  
Multivariable Regression

Background. Higher body mass index (BMI) is associated with subfertility in women and men. This relationship is further substantiated by a few small randomized-controlled trials of weight reduction and success of assisted reproduction. The aim of the current study was to expand the current evidence-base by investigating the association between BMI and subfertility in men and women using multivariable regression and Mendelian randomization. Methods and findings. We studied 34,157 women (average age 30, average BMI 23.1 kg/m2) and 31,496 men (average age 33, average BMI 25.4 kg/m2) who were genotyped and are participating in the Norwegian Mother, Father and Child Cohort Study. Self-reported information was available on time-to-pregnancy and BMI. A total of 10% of couples were subfertile (time-to-pregnancy ≥12 months). Our findings support a J-shaped association between BMI and subfertility in both sexes using multivariable logistic regression models. Non-linear Mendelian randomization validated this relationship. A 1 kg/m2 greater genetically predicted BMI was linked to 15% greater odds of subfertility (95% confidence interval 4% to 28%) in obese women (>=30.0 kg/m2) and 14% lower odds of subfertility (-25% to -3%) in women with BMI <20.0 kg/m2. A 1 kg/m2 higher genetically predicted BMI was linked to 23% greater odds of subfertility (6% to 43%) among obese men and 36% decreased odds (-62% to 7%) among men BMI <20.0 kg/m2. A genetically predicted BMI of 23 and 25 kg/m2 was linked to the lowest subfertility risk in women and men, respectively. The main limitations of our study were that we did not know whether the subfertility was driven by the woman, man, or both; the exclusive consideration of individuals of northern European ancestry; and the limited amount of participants with obesity or BMI values <20.0 kg/m2. Conclusions. We observed a J-shaped relationship between BMI and subfertility in both sexes, when using both a standard multivariable regression and Mendelian randomization analysis, further supporting a potential causal role of BMI on subfertility.

scholarly journals Associations of blood glucose levels with some diabetes risk factors (body mass index, blood pressure and total body fat) in inhabitants of Ho Municipality, Ghana: A cross-sectional survey

2021 ◽  
Vol 21` (01) ◽  
pp. 17365-17378
Author(s):  
Nii Korley Kortei ◽  
◽  
A Koryo-Dabrah ◽  
SK Angmorterh ◽  
D Adedia ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Body Mass Index ◽  
Risk Factor ◽  
Blood Glucose ◽  
Correlation Analysis ◽  
Body Mass ◽  
Body Fat ◽  
Lifestyle Modification ◽  
Total Body Fat ◽  
Total Body

One complex metabolic disorder that can unenviably affect the normal human physiology is diabetes mellitus(DM). It is indeed one of the commonest non-communicable diseases that has heightened to an epidemic level worldwide. For diseases like DM, hypertension, cardiovascular disease, type II DM, and other chronic diseases, body mass index (BMI) is identified as a positive and independent risk factor associated with morbidity and mortality. The objective of the study was to determine the relationships between BMI,blood pressure, and total body fat among inhabitants of peri-urban Ho, Ghana. Across-sectional survey was carried out between May and June,2018,among 132 inhabitants of Ho to determine the prevalence and associations among DM risk factors.The participants were selected by systematic random sampling. Standardized international protocols were used to measure BMI, blood pressure, blood glucose, and total body fat. Out of 132 respondents, majority 96 (72.7%) were female and the most common age group was 54-60 (31.1%). From the BMI classifications, 65 (49.2%) people were of normal weight while 6 (4.5%) were underweight. Total body fat (%) and blood pressure, likewise total body fat and BMI recorded significant associations of values (0.299, p<0.001-systolic; 0.298, p=0.001-diastolic), and 0.585(p<0.001),respectively. On the contrary, there were insignificant associations found between blood glucose and diastolic blood pressure and also blood glucose and systolic blood pressure(0.100, p=0.253)and (0.057. p=0.514),respectively using the Spearman’s correlation analysis. Lastly,the test of association of socio-demographics and anthropometrics revealed there was a significant (p<0.001)correlation between total body fat and BMI using Pearson’s correlation analysis. BMI is closely related to total body fat and blood pressure;hence,education on lifestyle modification needs to be intensified to create awareness among the inhabitants of Ho municipality of Ghana.It is imperative to educate Ghanaians and beyond about the risk factor associations that predispose an individual to DM.

scholarly journals Shift Work Is a Risk Factor for Increased Blood Pressure in Japanese Men

Hypertension ◽  
2008 ◽  
Vol 52 (3) ◽  
pp. 581-586 ◽  
Author(s):  
Yasushi Suwazono ◽  
Mirei Dochi ◽  
Kouichi Sakata ◽  
Yasushi Okubo ◽  
Mitsuhiro Oishi ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Body Mass Index ◽  
Risk Factor ◽  
Systolic Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Body Mass ◽  
Shift Work ◽  
Total Serum ◽  
Japanese Men ◽  
End Points

To clarify the effect of shift work on blood pressure in Japanese men, a 14-year historical cohort study was conducted in day workers (n=3963) and alternating shift workers (n=2748) who received annual health checkups between 1991 and 2005 in a Japanese steel company. The end points were a ≥10%, ≥15%, ≥20%, ≥25%, or ≥30% increase in systolic blood pressure or diastolic blood pressure from baseline during the period of observation. The association between shift work and an increase in blood pressure was investigated adjusting for age, body mass index, hemoglobin A1c, total serum cholesterol, creatinine, aspartate aminotransferase, γ-glutamyl transpeptidase, uric acid, drinking habit, smoking habit, and habitual exercise by multivariate pooled logistic regression analyses. Shift work was significantly associated with the various end points. The odds ratios (and 95% CIs) were as follows: ≥10%, 1.15 (1.07 to 1.23); ≥15%, 1.21 (1.12 to 1.31); ≥20%, 1.15 (1.04 to 1.28); ≥25%, 1.20 (1.06 to 1.37); and ≥30%, 1.23 (1.03 to 1.47) for systolic blood pressure and ≥10%, 1.19 (1.11 to 1.28); ≥15%, 1.22 (1.13 to 1.33); ≥20%, 1.24 (1.13 to 1.37); and ≥25%, 1.16 (1.03 to 1.30) for diastolic blood pressure. Our study in male Japanese workers revealed that alternating shift work was a significant independent risk factor for an increase in blood pressure. Moreover, the effect of shift work on blood pressure was more pronounced than other well-established factors, such as age and body mass index.

scholarly journals BODY MASS INDEX AND COGNITIVE FUNCTION DECLINE

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S815-S815
Author(s):  
Yingxiao Hua ◽  
Yingxiao Hua ◽  
Dexia Kong ◽  
XinQi Dong
Keyword(s):  
Older Adults ◽  
Body Mass Index ◽  
Risk Factor ◽  
Cognitive Function ◽  
Cognitive Decline ◽  
Body Mass ◽  
Work Memory ◽  
Normal Weight ◽  
Overweight And Obesity ◽  
Chinese Older Adults

Abstract Body composition has been proposed as an important modifiable risk factor of cognitive decline in multiple epidemiological studies. However, the relationship between body mass index (BMI) and cognitive function remains controversial and conflicting in diverse populations. This study aims to investigate the association between BMI and cognitive decline in U.S. Chinese older adults. Classifications of BMI are based on Asian criteria recommended by WHO (underweight: BMI&lt;18.5, normal weight: 18.5≤BMI&lt;23, overweight: 23≤bmi&lt;27.5, obesity: bmi≥27.5). Logistic regression models were conducted. Compared with normal-weight participants, underweight participants were more likely to experience decline in episodic memory (OR=1.68, p=0.002) and work memory (OR=1.38, p=0.05). Being overweight and obesity were not associated with cognitive function decline. The findings indicate that underweight could potentially be a risk factor of cognitive function decline among U.S. Chinese older adults. Perspective studies may further investigate the association between weight loss and cognitive decline for the development of prevention strategies.

scholarly journals Risk Factors for Cesarean Section Surgical Site Infections: A Systematic Review

2020 ◽  
Vol 41 (S1) ◽  
pp. s377-s377
Author(s):  
Feah Visan ◽  
Jenalyn Castro ◽  
Yousra Siam Shahada ◽  
Naser Al Ansari ◽  
Almunzer Zakaria
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Body Mass Index ◽  
Risk Factor ◽  
Cesarean Section ◽  
Surgical Site Infection ◽  
Body Mass ◽  
Surgical Site Infections ◽  
Site Infection ◽  
Inclusion Criteria

Background: According to the CDC NHSN, surgical site infections (SSI) are wound infections that develop within 30 days postoperatively for nonimplanted surgeries such as cesarean sections. SSIs is shown to manifest in a continuum of a purulent discharge from surgical site to severe sepsis. It contributes to rising morbidity, mortality and prolonged length of stay. Objective: To describe risk factors to the development of SSI in cesarean section in descriptive studies. Methods: The Preferred Reporting Items for Systematic Reviews (PRISMA) reporting guidelines is used as method for this systematic review. A PubMed literature search was conducted, limited to published articles in English from 1998 to 2016 using the broad key terms “cesarean section,” “surgical site infection,” and “risk factor.” The following inclusion criteria were applied to all reviews: (1) peer-reviewed journal, (2) computed risk factor for SSI development, and (3) calculated SSI rate. Reviews of references of the include studies were conducted, and 7 studies were appraised, with only 1 accepted. Results: After extracting data from 52 article reviews, 23 were finally accepted based on the inclusion criteria. Most studies were multivariate studies (n = 8) followed by cohort studies (n = 6). Unique numerators and denominators for SSI reviews were mentioned in all 23 studies, of which 22 studies followed the CDC NHSN definitions for SSI. Within the 23 studies, most studies showed that obesity (11.46%) is a common maternal risk factor for the development of postoperative cesarean section SSI. Conclusions: Identifying that obesity is a major contributor of surgical site infection in postoperative cesarean section women is a topic that warrants exploration. The relationship of cesarean section SSI to obesity should be investigated, specifically highlighting the level of obesity based on the WHO international body mass index (BMI) classification and the development of SSI. A correlation between increasing wound infection rates and increasing body mass index should be studied further. Published recommendations for preventing SSIs in this population should be reviewed.Funding: NoneDisclosures: None

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