Association between relative handgrip strength and hypertension in Chinese adults: An analysis of four successive national surveys with 712,442 individuals (2000-2014)

Objectives This study aimed to identify the 15-year trends of handgrip strength-to-weight (relative HS) and assess the association between relative HS and hypertension among Chinese adults aged 20–69. Methods Using a complex, stratified, multistage probability cluster sampling, we analyzed data collected from 712,442 adults aged 20–69 years in four successive national surveys (2000–2014). We used a handheld dynamometer to measure strength and divided by body weight to calculate the relative HS. Blood pressure was recorded with a sphygmomanometer and hypertension was defined as resting systolic blood pressure at least 140 mmHg or diastolic at least 90 mmHg. The Mann-Kendall trend test examined trends in relative HS over time. We also computed odd ratios (OR) and 95% confidence intervals (95% CI) by tertile of relative HS and examined the association between relative HS and hypertension. Results The relative HS level decreased with the increase of age in both male and females (p trend <0.001). In each of four surveys, one interquartile decrease in relative HS was associated with an increased risk of hypertension by 44% (OR = 1.44, 95%CI: 1.40–1.47), 58% (OR = 1.58, 95%CI: 1.54–1.62), 48% (OR = 1.48, 95%CI: 1.45–1.52), 43% (OR = 1.43, 95%CI: 1.40–1.47), respectively. Conclusion In the Chinese adult population, the relative HS level decreased from 2000 to 2014 across all ages in both males and females. A lower relative HS was associated with a higher risk of hypertension. The findings provided evidence for the association between muscle strength and hypertension in large-scaled population.

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Abstract 14854: Optimal Cut-off Points of Waist Circumference for Detecting Central Obesity and Severe Central Obesity in Chinese Adults

Circulation ◽

10.1161/circ.132.suppl_3.14854 ◽

2015 ◽

Vol 132 (suppl_3) ◽

Author(s):

Xiaoxiao Wen ◽

Jinzhuang Mai ◽

Xiangmin Gao ◽

Min Guo ◽

Yong Wu ◽

...

Keyword(s):

Risk Factors ◽

Waist Circumference ◽

Roc Curve ◽

Central Obesity ◽

Adult Population ◽

Overweight And Obesity ◽

Chinese Adults ◽

Chinese Adult ◽

Increased Risk ◽

Left Corner

Introduction: Given that no consensus has yet been reached over the optimal cut-off points of waist circumference (WC) for Chinese, this study aimed to determine the appropriate cut-off points of WC for detecting central obesity and severe central obesity in a Chinese adult population. Methods: Data from the cross-sectional survey of the PRC-USA Collaborative study of Cardiovascular and Cardiopulmonary Epidemiology in 1993-1994 was used, including 10265 subjects (4921 men and 5344 women) aged 35-69 years. Each integer of WC in centimeters was used as the cut-off point to detect clustering of cardiovascular risk factors, which was defined as the presence of two or more risk factors among hypertension, diabetes, hypercholesterolemia, hypertriglyceridemia and low levels of high-density lipoprotein cholesterol. Based on the Receiver operating characteristic (ROC) curve analysis, the WC value corresponding to the point on the ROC curve nearest to the upper left corner of the ROC graph was considered the optimal cut-off for central obesity and the value corresponding to the point with specificity of 90% or more was considered the optimal cut-off for severe central obesity. Results: The optimal cut-off value of WC to detect clustering of risk factors was ≥84 cm for men and was ≥80 cm for women with the shortest distance to the upper left corner being 0.4304 and 0.4504, respectively. The cut-off values of WC with specificity above 90% were ≥93 cm and ≥91 cm for men and women respectively. Conclusions: These results were equal or similar to the WC cut-off points proposed by the Guidelines for Prevention and Control of Overweight and Obesity in Chinese Adults, i.e., ≥85/80 cm (men/women) for increased risk for obesity related diseases and ≥95/90 cm (men/women) for much higher risk. For practical reasons, WC≥85/80 cm and ≥95/90 cm (men/women) could be the optimal cut-off values for detecting central obesity and severe central obesity, respectively, in Chinese adult population.

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Abdominal obesity and the prevalence of diabetes and intermediate hyperglycaemia in Chinese adults

Public Health Nutrition ◽

10.1017/s1368980008003856 ◽

2009 ◽

Vol 12 (8) ◽

pp. 1078-1084 ◽

Cited By ~ 43

Author(s):

Yuna He ◽

Fengying Zhai ◽

Guansheng Ma ◽

Edith JM Feskens ◽

Jian Zhang ◽

...

Keyword(s):

Glucose Tolerance ◽

Abdominal Obesity ◽

Adult Population ◽

Prevalence Ratio ◽

Roc Curves ◽

Chinese Adults ◽

Chinese Adult ◽

Increased Risk ◽

High Bmi

AbstractObjectiveTo assess the association of indicators of general and abdominal obesity with the prevalence of type 2 diabetes (T2DM) and intermediate hyperglycaemia (IHG) in the Chinese population.MethodsWe used data of 50 905 adults aged 18–79 years in the 2002 China National Nutrition and Health Survey. Recommended Chinese cut-off values were used for BMI (24 kg/m2) and waist circumference (WC; 85 cm in men, 80 cm in women). Optimal cut-offs for waist:height ratio (WHtR) were determined from analyses of receiver-operating characteristic (ROC) curves.ResultsThe prevalence of T2DM and IHG was 2·6 % and 1·9 % respectively. ROC curve analyses indicated 0·5 as the optimal cut-off value for WHtR in both sexes. High BMI, WC and WHtR were all associated with the prevalence of glucose tolerance abnormalities, with the highest prevalence ratio (PR) for high WHtR (men: PR = 2·85, 95 % CI 2·54, 3·21; women: PR = 3·10, 95 % CI 2·74, 3·51). When combining BMI and WHtR, in men either a high BMI or a high WHtR alone was associated with increased risk. Among women, a high BMI without a concomitant high WHtR was not associated with increased glucose tolerance abnormalities risk, whereas a high WHtR was associated with risk irrespective of BMI.ConclusionsAmong the Chinese adult population measures of central obesity are better predictors of glucose tolerance abnormalities prevalence than BMI. A WHtR cut-off point of 0·5 for both men and women can be considered as optimum for predicting (pre-) diabetes and may be a useful tool for screening and health education.

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Low potassium intake and its association with blood pressure among adults in Malaysia: findings from the MyCoSS (Malaysian Community Salt Survey)

Journal of Health Population and Nutrition ◽

10.1186/s41043-021-00238-x ◽

2021 ◽

Vol 40 (S1) ◽

Author(s):

Lalitha Palaniveloo ◽

Rashidah Ambak ◽

Fatimah Othman ◽

Nor Azian Mohd Zaki ◽

Azli Baharudin ◽

...

Keyword(s):

Blood Pressure ◽

Rural Areas ◽

Adult Population ◽

Further Education ◽

Cluster Sampling ◽

Potassium Excretion ◽

Daily Consumption ◽

Blood Pressure Monitor ◽

Potassium Intake ◽

Urinary Potassium

Abstract Background High blood pressure or hypertension is well recognized as an important modifiable risk factor for cardiovascular diseases. Several studies had indicated potassium intake has a blood pressure lowering effect. This study aimed to estimate potassium intake via 24-h urinary potassium excretion and to determine the association between potassium intake and blood pressure among adults in Malaysia. Methods Data for 424 respondents in this study were drawn from MyCoSS, a nationwide cross- sectional study conducted among Malaysians who were 18 years and above. Respondents were recruited using stratified cluster sampling, covering urban and rural areas in each state in Malaysia. Data collection was undertaken from October 2017 until March 2018. A single urine sample was collected over 24 h for quantification of potassium excreted. Information on socio-demography and medical history of the respondents were collected by interviewer-administered questionnaires. Anthropometric measurements were measured using validated equipment. BMI was estimated using measured body weight and height. Digital blood pressure monitor (Omron HBP-1300) was used to measure blood pressure. Descriptive statistics, analysis of variance (ANOVA), and multivariable linear regression were used to analyze the data in SPSS Version 21. Results Mean 24-h urinary potassium excretion for the 424 respondents was 37 mmol (95% CI 36, 38). Gender and ethnicity showed statistically significant associations with 24-h urinary potassium excretion. However, potassium excretion was not significantly associated with blood pressure in this study. Conclusion Potassium intake is very low among the adults in Malaysia. Therefore, further education and promotional campaigns regarding daily consumption of potassium-rich diet and its benefits to health need to be tailored for the Malaysian adult population.

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Reference values for handgrip strength: data from the TCLSIH cohort study

Age and Ageing ◽

10.1093/ageing/afz148 ◽

2019 ◽

Author(s):

Hongmei Wu ◽

Mingyue Liu ◽

Qing Zhang ◽

Li Liu ◽

Ge Meng ◽

...

Keyword(s):

Cohort Study ◽

Reference Values ◽

Handgrip Strength ◽

Adult Population ◽

Cross Sectional Study ◽

Mean Value ◽

Low Grade ◽

Cross Sectional ◽

Chinese Adult ◽

Health Cohort Study

Abstract Background although handgrip strength (HGS) is considered an excellent predictor of morbidity and mortality, there are few reference data available, especially across life from young to old populations. Objective to investigate the reference values and determinants for HGS in a large Chinese adult population. Design this cross-sectional study used data from the Tianjin Chronic Low-Grade Systemic Inflammation and Health Cohort Study ranging from 2013 to 2017. Setting and subjects in total, 37,707 Chinese adults aged 18–93 years with measures of HGS were included. Methods HGS was measured using a handheld digital dynamometer. The percentile distribution of HGS, as well as mean (standard deviation) values of HGS, was calculated according to sex and age categories. The Pearson’s or Spearman’s correlation coefficient and multiple linear regression were also used. Results the peak mean value of HGS was 45.2 ± 6.88 kg in men and 26.8 ± 4.65 kg in women. Different reference values for each sex and age category are present. The prevalence of low HGS was 7.69% in men and 6.46% in women. Multiple regression analysis showed that almost 72.5% of HGS variability can be explained by sex, age, height and weight. Conclusions the HGS reached peak at 40 years old, maintained or slightly lowered between ages 40 and50 and then start an accelerated decline after 50 years old. Reference values of HGS should be stratified by sex and age group. HGS variability can be largely explained by sex, age, height and weight.

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Prevalence of and factors associated with self-reported high blood pressure in Brazilian adults

Revista de Saúde Pública ◽

10.1590/s1518-8787.2017051000006 ◽

2017 ◽

Vol 51 (suppl 1) ◽

Cited By ~ 19

Author(s):

Deborah Carvalho Malta ◽

Regina Tomie Ivata Bernal ◽

Silvânia Suely Caribé de Araújo Andrade ◽

Marta Maria Alves da Silva ◽

Gustavo Velasquez-Melendez

Keyword(s):

Blood Pressure ◽

High Blood Pressure ◽

Skin Color ◽

Adult Population ◽

Age Groups ◽

Federal District ◽

Noncommunicable Diseases ◽

Factors Associated ◽

Brazilian State ◽

Increased Risk

ABSTRACT OBJECTIVE To analyze factors associated with self-reported high blood pressure among adults in Brazilian state capitals. METHODS The study uses data from Sistema de Vigilância de Fatores de Risco e Proteção para Doenças Crônicas por Inquérito Telefônico (Vigitel – Surveillance System of Risk and Protection Factors of Noncommunicable Diseases by Telephone Survey) collected in 2013. Prevalence rates and their respective 95% confidence intervals by gender were estimated according to sociodemographic variables, lifestyle, reported noncommunicable diseases and self-rated health status. Multivariate logistic regression modeling was used to identify variables associated with self-reported high blood pressure with α < 0.05. RESULTS Prevalence of self-reported high blood pressure among adults living in Brazilian state capitals and the Federal District was 24.1%. The following variables were associated with self-reported high blood pressure: age group, taking 18-24 as reference (all age groups presented increased risk – from 25-34 years [OR = 2.6; 95%CI 2.0–3.4] up to 65 years or more [OR = 28.1; 95%CI 21.7–36.4]); low education level (9 to 11 years of study [OR = 0.8; 95%CI 0.7–0.9] and 12 years or more [OR = 0.6; 95%CI 0.6–0.7]); Black race or skin color (OR = 1.3; 95%CI 1.1–1.5); being a former smoker (OR = 1.2; 95%CI 1.1–1.3); obesity (OR = 2.7; 95%CI 2.4–3.0); diabetes (OR = 2.9; 95%CI 2.5–3.5%), and high cholesterol (OR = 1.9; 95%CI 1.8–2.2). CONCLUSIONS Approximately one quarter of the adult population living in Brazilian state capitals reported having high blood pressure. Information from Vigitel is useful to monitor high blood pressure and identity its associated factors, supporting public policies for health promotion, surveillance and care.

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Platelet Rich Plasma Therapy and Understanding the Risk Factors of Heel Pain Syndrome

Foot & Ankle Orthopaedics ◽

10.1177/2473011419s00342 ◽

2019 ◽

Vol 4 (4) ◽

pp. 2473011419S0034

Author(s):

Astuti Pitarini ◽

Wilson Tham ◽

See Kwok Hong ◽

Abinaya Prabhakaran ◽

Chee Yu Han

Keyword(s):

Blood Pressure ◽

Plantar Fasciitis ◽

Lifestyle Modification ◽

Platelet Rich Plasma ◽

Adult Population ◽

Pain Syndrome ◽

Heel Pain ◽

Posterior Tibial Tendon ◽

Plasma Therapy ◽

Increased Risk

Category: Basic Sciences/Biologics, Hindfoot, Sports Introduction/Purpose: Heel pain syndrome is a complex condition causing morbidity and decreases the quality of life in our adult population. It is known that individuals with a body mass index (BMI) of more than >30 kg/m2 have increased risk of plantar fasciitis. However, heel pain consists of larger entities not merely to plantar fasciitis alone. Limited study mentioned the association between hypertension and musculoskeletal pain. Platelet rich plasma (PRP) therapy is an emerging treatment option for its regenerative properties in the treatment of degenerative enthesopathic conditions as in plantar fasciitis and lateral elbow epicondylitis. We hypothesize that obesity (BMI>30 kg/m2) and hypertension do influence the poorer outcome after PRP injection in individuals with heel pain. Methods: We analysed 154 heel pain cases from orthopaedic outpatient clinic that were treated with PRP injection. BMI and BP were taken as preadmission measurements with at least three readings for blood pressure. PRP was harvested from the antecubital vein, and spun in a centrifuge machine. Follow-up was conducted with AOFAS Ankle Hindfoot system before injection, 6 weeks and up to 2 years after injection. Results: Mean age was 49.96 (range 20-81 years old) with 52.60% female and 47.4% male. Plantar fasciitis was the majority source of heel pain (71.43%) followed by achilles tendinopathy (26.62%), posterior tibial tendon disorder (1.3%), and peroneal tendinopathy (0.65%). One hundred and twenty-eight (83.1%) patients achieved resolution of heel pain and related symptoms after injection. Statistical analysis was performed using one sample student t-test. No statistical significant result was found in both overweight (p =0.29) and obesity grade 1 (p = 0.40). Statistical significant result found in the prehypertension group (p<0.04). Conclusion: Based on this preliminary data, we recommend weight loss with trials of lifestyle modification in individuals with obesity, and better control of our patients’ blood pressure in order to achieve comparable outcome with normal BMI population.

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The Correlation between Dietary Selenium Intake and Type 2 Diabetes: A Cross-Sectional Population-Based Study on North Chinese Adults

BioMed Research International ◽

10.1155/2020/8058463 ◽

2020 ◽

Vol 2020 ◽

pp. 1-10

Author(s):

Sultan Mehmood Siddiqi ◽

Changhao Sun ◽

Xiaoyan Wu ◽

Imranullah Shah ◽

Anam Mehmood

Keyword(s):

Type 2 Diabetes ◽

Logistic Regression ◽

Glucose Metabolism ◽

Linear Trend ◽

Multivariate Logistic Regression Analysis ◽

Cluster Sampling ◽

Chinese Adults ◽

Anthropometric Measures ◽

Increased Risk

The relationship between selenium (Se) and type 2 diabetes (T2D) remains controversial. In previous animal and cell studies, Se was found to be insulin mimic and antidiabetic, whereas recent epidemiological and interventional trials have shown an unexpected association between high Se intake and increased risk of T2D. The present study aimed to investigate the significance of dietary Se and T2D in North Chinese adults. A large sample of the population was enrolled through cluster sampling in Northern China (N=8824). Information on basic characteristics, anthropometric measures, and dietary Se intake was collected from each subject for analysis. Multivariable logistic regression was used to investigate the association between dietary Se and T2D through adjusted odds ratio (OR) and the corresponding 95% confidence interval (CI). The average nutritional Se intake was 52.43 μg/day, and the prevalence of T2D was 20.4% in the studied population. The OR for developing T2D was 1.66 (95% CI: 1.38, 1.99; P for linear trend <0.005), comparing the highest to the lowest quintile of energy-adjusted Se intake in multivariate logistic regression analysis. The mediation analysis discovered that glucose metabolism (indicated by FBG and HbA1c) mediated this association. In conclusion, our research adds further support to the role of high dietary Se in the incidence of T2D. The results also suggested that this association was mediated by glucose metabolism.

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Occupational Physical Activity and New-Onset Hypertension: A Nationwide Cohort Study in China

Hypertension ◽

10.1161/hypertensionaha.121.17281 ◽

2021 ◽

Author(s):

Qinqin Li ◽

Rui Li ◽

Shaojie Zhang ◽

Yuanyuan Zhang ◽

Panpan He ◽

...

Keyword(s):

Physical Activity ◽

Blood Pressure ◽

Occupational Physical Activity ◽

Nutrition Survey ◽

Metabolic Equivalent ◽

Health And Nutrition ◽

Increased Risk ◽

Males And Females ◽

New Onset

The association between occupational physical activity (OPA) and the risk of hypertension remains uncertain. We aimed to examine the prospective relations of OPA and new-onset hypertension among Chinese males and females. A total of 9350 adults who were free of hypertension at baseline were enrolled from the CHNS study (China Health and Nutrition Survey). Data on OPA were obtained by using self-reported questionnaires and calculated as metabolic equivalent task (MET)–hours per week. MET–hours per week may account for both intensity and time spent on activities. The study outcome was new-onset hypertension, defined as systolic blood pressure ≥140 mm Hg or diastolic blood pressure ≥90 mm Hg or diagnosed by physician or under antihypertensive treatment during the follow-up. During a median of 6.1 years (82 410 person-years) of follow-up, a total of 2949 participants developed hypertension. Overall, there was a L-shaped association between the OPA and new-onset hypertension in males and a U-shaped association in females (all P values for nonlinearity <0.001). Accordingly, when OPA was categorized as four groups (<80, 80–<160, 160–<240, and ≥240 metabolic MET–hours per week), in males, the risk of new-onset hypertension was significantly increased only among participants with OPA <80 MET–hours per week; however, in females, the lowest risk of new-onset hypertension was found among those with OPA 80 to 240 MET–hours per week. In summary, moderate OPA, in terms of both duration and intensity, is associated with a lower risk of new-onset hypertension among both males and females, whereas heavy OPA was related to increased risk of new-onset hypertension in females.

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Association between Osteoporosis and Low Hemoglobin Levels: A Nested Case–Control Study Using a National Health Screening Cohort

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18168598 ◽

2021 ◽

Vol 18 (16) ◽

pp. 8598

Author(s):

So-Young Kim ◽

Dae-Myoung Yoo ◽

Chanyang Min ◽

Hyo-Geun Choi

Keyword(s):

Blood Pressure ◽

National Health ◽

Smoking Status ◽

Conditional Logistic Regression ◽

Adult Population ◽

Fasting Blood Glucose ◽

Health Screening ◽

Charlson Comorbidity Index Score ◽

Conditional Logistic Regression Model ◽

Increased Risk

An association between anemia and an increased risk of osteoporosis has been suggested. The goal of this study was to estimate the association of hemoglobin (Hb) level with osteoporosis. A total of 69,760 osteoporosis patients aged ≥ 40 years old from the Korean National Health Insurance Service Health Screening Cohort were enrolled. From an identical cohort database, 69,760 comparison participants were randomly selected. Hb levels before the onset of osteoporosis were evaluated. The association of Hb level with osteoporosis was analyzed using a conditional logistic regression model adjusted for obesity, smoking status, alcohol consumption, systolic blood pressure, diastolic blood pressure, fasting blood glucose, total cholesterol, and the Charlson comorbidity index score. Fifteen percent of the osteoporosis group and 14.17% of the comparison group had anemia. The Hb level was associated with 0.98-fold lower odds for osteoporosis (95% confidence intervals = 0.97–0.99, p < 0.001). A low Hb level was associated with a high risk of osteoporosis in the adult population. There was a consistent association between a low Hb level and osteoporosis in patients with comorbidities.

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Elderly Women Are Disproportionately Vulnerable to Hypertension in Bangladesh: Evidence from the National Nutrition Surveillance Study

Current Developments in Nutrition ◽

10.1093/cdn/nzaa040_030 ◽

2020 ◽

Vol 4 (Supplement_2) ◽

pp. 30-30

Author(s):

Abu Abdullah Mohammad Hanif ◽

Abu Ahmed Shamim ◽

Md Mokbul Hossain ◽

Mehedi Hasan ◽

Moyazzam Hossaine ◽

...

Keyword(s):

Physical Activity ◽

Blood Pressure ◽

Waist Circumference ◽

Elderly Women ◽

Family Welfare ◽

Cluster Sampling ◽

Ministry Of Health ◽

Female Population ◽

Factors Associated ◽

Males And Females

Abstract Objectives Bangladesh has a dearth of information on the prevalence and factors associated with hypertension among elderlies. We assessed the prevalence, sex differences in prevalence, and factors associated with hypertension in the most recent national nutrition surveillance round (2018–19). Methods We analyzed data of 4817 elderlies (≥60 years) from 82 clusters (57 rural, 15 urban and 10 slum) selected by multistage cluster sampling. Hypertension was defined as systolic blood pressure ≥140 mmHg and/or diastolic blood pressure ≥90 mmHg and/or having a history of hypertension. We analyzed data using Stata 15.0. Results The weighted prevalence of hypertension was 42%, and 56% for elderly males, and females, respectively; and was higher among females for many socio-demographic, behavioural and anthropetric variables including age 70 + years (58% vs. 46%); high waist circumference (69% vs. 65%); diabetes (69% vs. 65%); living in rural (55% vs. 41%), urban (63% vs. 45%) and slum (50% vs. 30%) area; Muslim (56% vs. 42%); insufficient physical activity (60% vs 52%); and inadequate fruits/vegetables intake (56% vs. 43%). Among females, the factors associated with hypertension were age 70 + years (AOR: 1.40, 95% CI: 1.15–1.71), waist circumference ≥80 cm (AOR: 2.20, 95% CI: 1.82–2.67), diabetes (AOR: 1.82, 95% CI: 1.35–2.45), and inadequate physical activity (AOR: 1.38, 95% CI: 1.15–1.67). Among males, these factors were age 70 + years (AOR: 1.32, 95% CI: 1.09–1.60), waist circumference ≥90 cm (AOR: 2.76, 95% CI: 2.22–3.43), diabetes (AOR: 1.36, 95% CI: 1.02–1.82), slum-dwelling (AOR: 0.71, 95% CI: 0.52–0.96), > 10 years of education (AOR: 1.83; 95% CI: 1.38, 2.44), inadequate physical activity (AOR: 1.50, 95% CI: 1.25–1.81), and current smoking (AOR: 0.74; 95% CI: 0.61, 0.89). In both males and females, fruits and vegetables intake was not assicaited with hypertension. Conclusions In Bangladesh, the elderly female population is disproportionately affected by hypertension. They were found having a consistent pattern of higher prevalence of hypertension for many socio-demographic, behavioral, and anthropometric variables. The ministry of health of Bangladesh should consider this disproportionately high prevalence of hypertension among elderly females while designing and implementing health programs. Funding Sources Ministry of Health and Family Welfare, Bangladesh.

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