scholarly journals Hypertension in the United States Fire Service

2021 ◽  
Vol 18 (10) ◽  
pp. 5432
Author(s):  
Saeed U. Khaja ◽  
Kevin C. Mathias ◽  
Emilie D. Bode ◽  
Donald F. Stewart ◽  
Kepra Jack ◽  
...  
Keyword(s):  
Blood Pressure ◽  
General Population ◽  
Age Groups ◽  
Total Sample ◽  
The United States ◽  
Fire Service ◽  
Atherosclerotic Cardiovascular Disease ◽  
Cardiac Events ◽  
Antihypertensive Medications ◽  
Increased Risk

Hypertension is a major risk factor for atherosclerotic cardiovascular disease and cardiac remodeling and is associated with an increased risk of sudden cardiac events, the leading cause of duty-related death in the fire service. We assessed systemic blood pressures and prevalence of hypertension among US firefighters by decade of life. Medical records of career firefighters (5063 males and 274 females) from four geographically diverse occupational health clinics were assessed. Hypertension was defined as systolic blood pressure ≥130 mmHg or diastolic blood pressure ≥80 mmHg, or taking antihypertensive medication. Results from the firefighter sample were compared to the US general population (2015–2016 and 2017–2018 National Health and Nutrition Examination Surveys). Among the total sample, 69% of firefighters met the criteria for hypertension and 17% were taking antihypertensive medications. Percentages of hypertensive male and female firefighters were 45% and 11% among 20–29 years old, respectively, and increased to 78% and 79% among 50–59 years old, respectively. Compared to the general population, male firefighters had a higher prevalence of hypertension (p < 0.05) across all age groups (11–16% higher). In order to improve firefighter health and protect against sudden incapacitation in this public safety occupational group, increased efforts are necessary to screen for and manage high blood pressure.

Abstract W P153: Parental History of Stroke and Incident Atrial Fibrillation According to Blood Pressure Category in a General Urban Population: The Suita Study

Stroke ◽  
2014 ◽  
Vol 45 (suppl_1) ◽  
Author(s):  
Yoshihiro Kokubo ◽  
Makoto Watanabe ◽  
Takashi Kobayashi ◽  
Shiro Kamakura ◽  
Takeshi Aiba ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Blood Pressure ◽  
General Population ◽  
Health Examination ◽  
Antihypertensive Medications ◽  
Parental History ◽  
Hazard Ratios ◽  
Increased Risk ◽  
Drinking Status ◽  
History Of

Background and purpose: No prospective study has examined the relation between a parental history of stroke and the incidence of atrial fibrillation (AF) in a general population. We assessed the hypothesis that a parental history of stroke is associated with an increased risk of incident AF according to blood pressure (BP) category in a general population. Methods: A total of 6,918 participants (30 to 84 years old) initially free of AF were prospectively followed up for incident AF in the Suita Study. Standard 12-lead electrocardiograms were obtained from all subjects in the supine position. Each record was coded independently by 2 well-trained physicians using the Minnesota Code. Participants were diagnosed with AF if AF or atrial flutter was present on electrocardiograms obtained during a biannual routine health examination or if AF was indicated as a present illness by either annual questionnaires responses or participants' medical records. Well-trained nurses obtained information on parental history of stroke and on the participants' lifestyle. BPs were taken as the average of the second and third measurements. The category of systolic BP (SBP) was defined by the following criteria: normal SBP (<120 mm Hg), systolic prehypertension (120-139 mm Hg), and systolic hypertension (≥140 mm Hg and/or antihypertensive medications). Cox proportional hazard ratios (HRs) and 95% confidence intervals (CIs) were analyzed after adjusting for age, sex, body mass index, BP categories, diabetes, hyperlipidemia, smoking, and drinking status at baseline. Results: In 87,341 person-years of follow-up, 245 incident AF events occurred. A parental history of stroke was significance to the incidence of AF in men (adjusted HR, 1.47; 95% CIs, 1.03-2.10). Compared with normal SBP subjects without a parental history of stroke, the adjusted HRs (95% CIs) of incident AF in systolic hypertensive subjects were 2.18 (1.36-3.51) and 1.50 (1.01-2.23) for those with and without a parental history of stroke (P for interaction between parental history of stroke and SBP = 0.06). Conclusions: A parental history of stroke is a predictor of incident AF among systolic hypertensive subjects. For persons with a parental history of stroke, BP control would be important for AF prevention.

scholarly journals Surveillance of Colorectal Cancer (CRC) in Cystic Fibrosis (CF) Patients

2021 ◽  
Vol 3 (2) ◽  
pp. 84-95
Author(s):  
Fabio Ingravalle ◽  
Giovanni Casella ◽  
Adriana Ingravalle ◽  
Claudio Monti ◽  
Federica De Salvatore ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Cystic Fibrosis ◽  
General Population ◽  
Genetic Disorder ◽  
The United States ◽  
Screening Colonoscopy ◽  
Transmembrane Conductance Regulator ◽  
Transmembrane Conductance ◽  
Increased Risk ◽  
Speciality Training

Cystic Fibrosis (CF) is the commonest inherited genetic disorder in Caucasians due to a mutation in the gene CFTR (Cystic Fibrosis Transmembrane Conductance Regulator), and it should be considered as an Inherited Colorectal Cancer (CRC) Syndrome. In the United States, physicians of CF Foundation established the “Developing Innovative Gastroenterology Speciality Training Program” to increase the research on CF in gastrointestinal and hepatobiliary diseases. The risk to develop a CRC is 5–10 times higher in CF patients than in the general population and even greater in CF patients receiving immunosuppressive therapy due to organ transplantation (30-fold increased risk relative to the general population). Colonoscopy should be considered the best screening for CRC in CF patients. The screening colonoscopy should be started at the age of 40 in CF patients and, if negative, a new colonoscopy should be performed every 5 years and every 3 years if adenomas are detected. For transplanted CF patients, the screening colonoscopy could be started at the age of 35, in transplanted patients at the age of 30 and, if before, at the age of 30. CF transplanted patients, between the age of 35 and 55, must repeat colonoscopy every 3 years. Our review draws attention towards the clinically relevant development of CRC in CF patients, and it may pave the way for further screenings and studies.

scholarly journals Genetic Variation in Blood Pressure and Lifetime Risk of Peripheral Artery Disease: A Mendelian Randomization Study

2020 ◽  
Author(s):  
Michael G Levin ◽  
Derek Klarin ◽  
Venexia M Walker ◽  
Dipender Gill ◽  
Julie Lynch ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Calcium Channel ◽  
Peripheral Artery Disease ◽  
Genetic Correlations ◽  
Channel Blockers ◽  
Peripheral Artery ◽  
Antihypertensive Medications ◽  
Increased Risk ◽  
Genes Encoding ◽  
Artery Disease

Aims: We aimed to estimate the effect of blood pressure and blood pressure lowering medications (via genetic proxies) on peripheral artery disease. Methods and Results: GWAS summary statistics were obtained for BP (International Consortium for Blood Pressure + UK Biobank GWAS; N = up to 757,601 individuals), peripheral artery disease (PAD; VA Million Veteran Program; N = 24,009 cases, 150,983 controls), and coronary artery disease (CAD; CARDIoGRAMplusC4D 1000 Genomes; N = 60,801 cases, 123,504 controls). Genetic correlations between systolic BP (SBP), diastolic BP (DBP), pulse pressure (PP) and CAD and PAD were estimated using LD score regression. The strongest correlation was between SBP and CAD (rg = 0.36; p = 3.9 x 10-18). Causal effects were estimated by two-sample MR using a range of pleiotropy-robust methods. Increased SBP, DBP, and PP increased risk of both PAD (SBP OR 1.25 [1.19-1.31] per 10mmHg increase, p = 3 x 10-18; DBP OR 1.27 [1.17-1.39], p = 4 x 10-8; PP OR 1.51 [1.38-1.64], p = 1 x 10-20) and CAD (SBP OR 1.37 [1.29-1.45], p = 2 x 10-24; DBP OR 1.6 [1.45-1.76], p = 7 x 10-22; PP OR 1.56 [1.4-1.75], p = 1 x 10-15). The effects of SBP and DBP were greater for CAD than PAD (pdiff = 0.024 for SBP, pdiff = 4.9 x 10-4 for DBP). Increased liability to PAD increased PP (beta = 1.04 [0.62-1.45] mmHg per 1 unit increase in log-odds in liability to PAD, p = 1 x 10-6). MR was also used to estimate the effect of BP lowering through different classes of antihypertensive medications using genetic instruments containing BP-trait associated variants located within genes encoding protein targets of each medication. SBP lowering via calcium channel blocker-associated variants was protective of CAD (OR 0.38 per 10mmHg decrease in SBP; 95% CI 0.19-0.77; p = 0.007). Conclusions: Higher BP is likely to cause both PAD and CAD but may have a larger effect on CAD risk. BP-lowering through calcium-channel blockers (as proxied by genetic variants) decreased risk of CAD.

scholarly journals Pattern of Glucose Tolerance among Patients with Peripheral Spondyloarthritis

2020 ◽  
Vol 5 (9) ◽  
pp. 773-777
Author(s):  
A T M Tanveer Hasan ◽  
Al-Mamun .
Keyword(s):  
Diabetes Mellitus ◽  
General Population ◽  
Glucose Tolerance ◽  
Inflammatory Diseases ◽  
Age Groups ◽  
Oral Glucose ◽  
Increased Risk ◽  
Significant Difference ◽  
Study Population ◽  
Peripheral Spondyloarthritis

Peripheral spondyloarthritis is a variant of spondyloarthritis which usually has a chronic course. There is an increased risk of cardiovascular diseases among patients with chronic inflammatory diseases in general. Coexisting diabetes mellitus can potentially add to the risk. The objective of this study was to determine the frequency of glucose intolerance in patients with spondyloarthritis The study was conducted among 35 participants with peripheral spondyloarthritis who visited the Department of Rheumatology, Enam Medical College & Hospital, Savar, Dhaka, Bangladesh from September, 2018 to January, 2020. The participants underwent either oral glucose tolerance test or estimation of HbA1C. The mean age of participants was 43.96 years. The majority (80%) of them were young to muddle-aged (≤40 years). 22.9% of the participants were prediabetic. Diabetes mellitus was found to be present in 37.1% of the participants. There was no significant difference between the study population and the general population in terms of frequency of prediabetes. But the frequency of diabetes in the study population was higher than that in the general population. There was no significant difference between males and females with regard to the frequencies of prediabetes and DM. Moreover, there was no significant difference in the frequencies of prediabetes and DM between young and middle-aged to elderly population. Considering the greater burden of DM among patients with peripheral spondyloarthritis across all age groups, routine screening for DM may be indicated in these individuals.

The epidemiology of illicit and licit drug use in Greece: a nationwide general population survey

1995 ◽  
Vol 10 (4) ◽  
pp. 175-182 ◽  
Author(s):  
MG Madianos ◽  
D Gefou-Madianou ◽  
CN Stefanis
Keyword(s):  
Drug Use ◽  
General Population ◽  
Illicit Drug ◽  
Occupational Status ◽  
Population Sample ◽  
Age Groups ◽  
Illicit Drug Use ◽  
Total Sample ◽  
General Population Sample ◽  
Cross Sectional

SummaryA cross-sectional home survey on the epidemiology of drug use in Greece, with a nationwide general population sample of 4,291 respondents aged 12 to 64, was carried out. The weighted life prevalence of reported illicit drug use in the total sample was found to be 9% among males and 2.5% among females, with a ratio of 3.6: 1. Six and a half percent of males of all ages had used, at some time, licit psychotropic drugs without a doctor's order, while females presented much higher prevalence rates (14.9%). Young adults reported higher rates of both illicit and licit lifetime and past-year use, compared to the other age groups. Illicit drug use was less common, in females of all ages. Cannabis was the most common illicit drug used. Current as well as lifetime use of pain relievers without a doctor's prescription was found to be highest among all other licit substances. This holds true for all age groups and for both sexes. Tranquillizers were predominantly used by females of all ages. Certain sociodemographic variables, such as sex, educational level, marital status, place of residence and occupational status were found to be related to drug use in Greece.

scholarly journals Blood Pressure and Risks of Cognitive Impairment and Dementia

Hypertension ◽  
2020 ◽  
Vol 76 (1) ◽  
pp. 217-225 ◽  
Author(s):  
Ya-Nan Ou ◽  
Chen-Chen Tan ◽  
Xue-Ning Shen ◽  
Wei Xu ◽  
Xiao-He Hou ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cognitive Impairment ◽  
Dose Response ◽  
Meta Analysis ◽  
Cognitive Disorders ◽  
Late Life ◽  
Population Characteristics ◽  
Antihypertensive Medications ◽  
Dementia Risk ◽  
Increased Risk

Controversies persist regarding the association between blood pressure (BP) and the risks of cognitive impairment and dementia due to inconsistent definitions of BP exposure and varying population characteristics. Here, we searched PubMed and performed a meta-analysis of the influence of BP exposure on the risks of cognitive disorders in prospective studies. Dose-response analyses were performed to illustrate the existence of linear/nonlinear relationships. The credibility of each meta-analysis was evaluated according to the risk of bias, inconsistency, and imprecision. Of the 31 628 citations, 209 were included in our systematic review, among which 136 were eligible for the meta-analysis. Overall, stronger associations were found in midlife than late-life. Moderate-quality evidence indicated that midlife hypertension was related to a 1.19- to 1.55-fold excess risk of cognitive disorders. Dose-response analyses of 5 studies indicated that midlife systolic BP >130 mm Hg was associated with an increased risk of cognitive disorders. With regard to BP exposure in late-life, high systolic BP, low diastolic BP, excessive BP variability, and orthostatic hypotension were all associated with an increased dementia risk. Encouragingly, the use of antihypertensive medications exhibited a 21% reduction in dementia risk. The U-shaped dose-response curve indicated that the protective window of diastolic BP level was between 90 and 100 mm Hg for low risk of Alzheimer disease. The relationships between BP variables and cognitive disorders are age- and BP type-dependent. Antihypertensive medications were associated with a reduced risk of dementia. However, the optimal dose, duration, and type for preventing cognitive disorders warrant further investigation.

scholarly journals Association of APOL1 Genotypes With Measures of Microvascular and Endothelial Function, and Blood Pressure in MESA

2020 ◽  
Vol 9 (17) ◽  
Author(s):  
Teresa K. Chen ◽  
Ronit Katz ◽  
Michelle M. Estrella ◽  
Wendy S. Post ◽  
Holly Kramer ◽  
...  
Keyword(s):  
Blood Pressure ◽  
High Risk ◽  
Kidney Disease ◽  
Endothelial Function ◽  
Aortic Distensibility ◽  
The United States ◽  
Flow Mediated Dilation ◽  
Arterial Elasticity ◽  
Increased Risk ◽  
Significant Difference

Background APOL1 high‐risk genotypes are associated with increased risk for hypertension‐attributed kidney disease among Black adults in the United States. Biopsy studies show differences in kidney vasculature by APOL1 status; less is known about the variants' associations with systemic vascular and endothelial function. Whether APOL1 risk variants are associated with blood pressure (BP) is also uncertain. Methods and Results Using linear regression, we examined cross‐sectional associations of APOL1 risk genotypes (high=2 risk alleles, low=0 or 1 risk allele) with subclinical measures of vascular function (small arterial elasticity, n=1586; large arterial elasticity, n=1586; ascending aortic distensibility, n=985) and endothelial function (flow‐mediated dilation, n=777). Using linear mixed‐effects models, we studied longitudinal associations of APOL1 risk genotypes with BP (n=1619), adjusting for age, sex, and African ancestry. Among 1619 (12% APOL1 high‐risk) Black participants in MESA (Multi‐Ethnic Study of Atherosclerosis), mean age was 62 years old, 58% had hypertension, and mean systolic BP was 131 mm Hg at baseline. At examination 1 (2000–2002), there was no significant difference in small arterial elasticity, large arterial elasticity, ascending aortic distensibility, or flow‐mediated dilation in participants with APOL1 high‐ versus low‐risk genotypes ( P >0.05 for all). Over a mean follow‐up of 7.8 years, relative annual changes in systolic and diastolic BP and pulse pressure did not differ significantly by APOL1 risk status (between‐group differences of −0.20, −0.14, and −0.25, respectively; P >0.05 for all). Conclusions Among Black participants in MESA, APOL1 high‐risk genotypes were not associated with subclinical vascular and endothelial function or BP trajectories. The relationship of APOL1 with kidney disease may be intrinsic to the kidney rather than through peripheral effects on systemic vasculature or BP.

scholarly journals Rates of Chronic Medical Conditions in 1991 Gulf War Veterans Compared to the General Population

2019 ◽  
Vol 16 (6) ◽  
pp. 949 ◽  
Author(s):  
Clara Zundel ◽  
Maxine Krengel ◽  
Timothy Heeren ◽  
Megan Yee ◽  
Claudia Grasso ◽  
...  
Keyword(s):  
Blood Pressure ◽  
General Population ◽  
High Blood Pressure ◽  
Population Based ◽  
Chronic Medical Conditions ◽  
Medical Conditions ◽  
Gulf War Veterans ◽  
Increased Risk ◽  
Prevalence Estimates ◽  
The Difference

Prevalence of nine chronic medical conditions in the population-based Ft. Devens Cohort (FDC) of GW veterans were compared with the population-based 2013–2014 National Health and Nutrition Examination Survey (NHANES) cohort. Excess prevalence was calculated as the difference in prevalence estimates from the Ft. Devens and NHANES cohorts; and confidence intervals and p-values are based on the standard errors for the two prevalence estimates. FDC males were at increased risk for reporting seven chronic medical conditions compared with NHANES males. FDC females were at decreased risk for high blood pressure and increased risk for diabetes when compared with NHANES females. FDC veterans reporting war-related chemical weapons exposure showed higher risk of high blood pressure; diabetes; arthritis and chronic bronchitis while those reporting taking anti-nerve gas pills had increased risk of heart attack and diabetes. GW veterans are at higher risk of chronic conditions than the general population and these risks are associated with self-reported toxicant exposures.

scholarly journals Endocrine and Metabolic Diseases Among Colorectal Cancer Survivors in a Population-Based Cohort

2019 ◽  
Vol 112 (1) ◽  
pp. 78-86
Author(s):  
Makenzie L Hawkins ◽  
Brenna E Blackburn ◽  
Kerry Rowe ◽  
John Snyder ◽  
Vikrant G Deshmukh ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Risk Factor ◽  
General Population ◽  
Metabolic Diseases ◽  
The United States ◽  
Population Cohort ◽  
Increased Risk ◽  
General Population Cohort ◽  
Time Periods

Abstract Background There are an estimated 1.4 million colorectal cancer (CRC) survivors in the United States. Research on endocrine and metabolic diseases over the long term in CRC survivors is limited. Obesity is a risk factor for CRC; thus it is of interest to investigate diseases that may share this risk factor, such as diabetes, for long-term health outcomes among CRC survivors. Methods A total of 7114 CRC patients were identified from the Utah Population Database and matched to a general population cohort of 25 979 individuals on birth year, sex, and birth state. Disease diagnoses (assessed over three time periods of 1–5 years, 5–10 years, and &gt;10 years) were identified using electronic medical records and statewide ambulatory and inpatient discharge data. Cox proportional hazard models were used to estimate the risk of endocrine and metabolic disease. Results Across all three time periods, risks for endocrine and metabolic diseases were statistically significantly greater for CRC survivors compared with the general population cohort. At 1–5 years postdiagnosis, CRC survivors’ risk for diabetes mellitus with complications was statistically significantly elevated (hazard ratio [HR] = 1.36, 99% confidence interval [CI] = 1.09 to 1.70). CRC survivors also experienced a 40% increased risk of obesity at 1–5 years postcancer diagnosis (HR= 1.40, 99% CI= 1.66 to 2.18) and a 50% increased risk at 5–10 years postdiagnosis (HR = 1.50, 99% CI= 1.16 to 1.95). Conclusions Endocrine and metabolic diseases were statistically significantly higher in CRC survivors throughout the follow-up periods of 1–5 years, 5–10 years, and more than 10 years postdiagnosis. As the number of CRC survivors increases, understanding the long-term trajectory is critical for improved survivorship care.

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

2017 ◽  
Vol 51 (suppl 1) ◽  
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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