Gender differences in the association of hazardous alcohol use with hypertension in an urban cohort of people living with HIV in South Florida.
TL;DR: Excessive hypertension burden in this population and its association with HAU and sub-optimal care indicate the need for preventive and educational intervention in PLWH.
Abstract: Objective
Industrialized countries are currently experiencing an epidemic of high blood pressure (HBP) extending to people living with HIV (PLWH). Given the prevalence of hazardous alcohol use (HAU), this study examines the relationship between alcohol consumption and hypertension in PLWH. Including a gender analysis is critical, given the high rates of HAU and HIV among females.
Method
We followed PLWH including both HAU and non-HAU (200 each). Participants were assessed twice for body weight, blood pressure, alcohol consumption, and other BP-associated lifestyle factors. High blood pressure (defined as systolic/diastolic blood pressure above 140/90 mmHg and/or treatment of HBP) was the primary outcome.
Results
Overall prevalence of hypertension was 38% and higher among HAU compared to non-HAU (42% vs. 34%, p = 0.02). Less than half with HBP (42%) were receiving treatment for hypertension. Overall, males had a 50% higher risk of HBP than women (odds ratio: 1.5, 95% CI: 1–2.6, p = 0.05). However among HAU, females were twice as likely to suffer HBP as their male counterparts (95% CI: 1–3.9, p = 0.02). Those HAU who preferred liquor, versus wine, had higher adjusted mean BP (132.6±18 vs. 122.3±14 mm Hg, p = 0.05). Additional analyses indicated that consumption of >1 standard drink of liquor or beer/day was associated with HBP. Risk of hypertension was noted in those with daily consumption of >3 glasses of wine. For those reporting <1 drink per day, the odds ratio of having HBP was 0.97 (CI: 0.6–0.99, p = 0.05). Factors associated with hypertension in the multivariate model included increased age, gender, BMI, HAU particularly of liquor, and smoking.
Conclusions
Excessive hypertension burden in this population and its association with HAU and sub-optimal care indicate the need for preventive and educational intervention in PLWH. Analyses highlight the necessity of gender and type-of-beverage specific approaches.
Citations
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TL;DR: The interaction effects of increased BMI and detectable pVL on hypertension on both multiplicative and additive scales suggested that PLWH with increased weight and detectable plasma viral load should be intensively managed and monitored for hypertension prevention and treatment.
Abstract: Increased body mass index (BMI) and HIV are each associated with hypertension. This study tested interactions between BMI and detectable plasma viral load (pVL) on hypertension among 659 persons li...
6 citations
TL;DR: The spatio-temporal variation of hypertension risks was associated with regional covariates, such as age, overweight, alcohol consumption, and smoking, with similar effects of age shared by both genders whereas gender-specific effects for other covariates were found.
Abstract: Previous studies which have shown the existence of gender disparities in hypertension risks often failed to take into account the participants’ spatial and temporal information. In this study, we explored the spatio-temporal variation for gender-specific hypertension risks in not only single-disease settings but also multiple-disease settings. From the longitudinal data of the China Health and Nutrition Survey (CHNS), 70,374 records of 21,006 individuals aged 12 years and over were selected for this study. Bayesian B-spline techniques along with the Besag, York, and Mollie (BYM) model and the Shared Component Model (SCM) model were then used to construct the spatio-temporal models. Our study found that the prevalence of hypertension in China increased from 11.7% to 34.5% during 1991 and 2015, with a higher rate in males than that in females. Moreover, hypertension was found mainly clustered in spatially adjacent regions, with a significant high-risk pattern in Eastern and Central China while a low-risk pattern in Western China, especially for males. The spatio-temporal variation of hypertension risks was associated with regional covariates, such as age, overweight, alcohol consumption, and smoking, with similar effects of age shared by both genders whereas gender-specific effects for other covariates. Thus, gender-specific hypertension prevention and control should be emphasized in the future in China, especially for the elderly population, overweight population, and females with a history of alcohol consumption and smoking who live in Eastern China and Central China.
6 citations
Cites background from "Gender differences in the associati..."
...(2018) [10] that there was more impact of alcohol consumption on females, other researchers identified a more significant association between alcohol intake and hypertension risk for males [9,11,49]....
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...However, the type-of alcohol, frequency, and the amount of alcohol intake may also matter [9,49]....
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TL;DR: A partir de la información de un estudio de cohorte con una poblacion en la medicion basal de 2.813 adolescentes del sistema de educacion publica, se determino the prevalencia (basal) e incidencia of the presion arterial elevada, junto con el consumo de tabaco, alcohol, drogas ilegales and las variables de actividad fisica, utilizando modelos de regresion logistica multiple.
Abstract: El articulo tiene como objetivo evaluar la asociacion entre el patron de conducta no saludable sobre la prevalencia y la incidencia de la presion arterial elevada en adolescentes. A partir de la informacion de un estudio de cohorte con una poblacion en la medicion basal de 2.813 adolescentes del sistema de educacion publica, se determino la prevalencia (basal) e incidencia de la presion arterial elevada, junto con el consumo de tabaco, alcohol, drogas ilegales y las variables de actividad fisica. Con estas variables, se construyo un modelo llamado "patron de conducta no saludable" y se evaluo su relacion con la presion arterial elevada en los adolescentes, utilizando modelos de regresion logistica multiple. Entre los resultados, se observa que la prevalencia de la presion arterial elevada fue 8,67%. La incidencia acumulada de la presion arterial elevada fue 7,58%. En el analisis multiple de la prevalencia de presion arterial elevada, ajustado por grado de adiposidad, hubo asociacion con un alto patron de conducta no saludable en el grupo de los hombres (OR = 3,13; IC95%: 1,67-5,84). La asociacion de la incidencia de la presion arterial elevada y alto patron de conducta no saludable se observa en el grupo de las mujeres, (OR = 2,34; IC95%: 1,11-4,95). Se concluye que la presion arterial elevada esta presente en la poblacion adolescente, asociado a conductas no saludables en ellos, como el tabaquismo, el alcohol, las drogas ilegales y la escasa actividad fisica, independientemente del grado de adiposidad.
3 citations
TL;DR: High blood pressure is present in the adolescent population, associated with unhealthy behaviors like smoking, alcohol and illegal drug use, and physical inactivity, independently of the degree of adiposity.
Abstract: This article aims to evaluate the association between unhealthy behavior pattern and prevalence and incidence of high blood pressure in adolescents. Based on data from a cohort study with a baseline population of 2,813 adolescents enrolled in a public school system, the study measured the baseline prevalence and incidence of high blood pressure as a function of smoking, alcohol and illegal drug use, and physical activity. These variables were used to build a model called "unhealthy behavior pattern", and its relationship was evaluated in relation to high blood pressure in adolescents, using multiple logistic regression models. Prevalence of high blood pressure was 8.67%. Accumulated incidence of high blood pressure was 7.58%. In the multivariate analysis of high blood pressure adjusted by degree of adiposity, there was an association with the unhealthy behavior pattern in males (OR = 3.13; 95%CI: 1.67-5.84). The association between incidence of high blood pressure and unhealthy behavior pattern was observed in females (OR = 2.34; 95%CI: 1.11-4.95). In conclusion, high blood pressure is present in the adolescent population, associated with unhealthy behaviors like smoking, alcohol and illegal drug use, and physical inactivity, independently of the degree of adiposity.
3 citations
TL;DR: Se concluye that the presion arterial elevada esta presente en the poblacion adolescente, asociado a conductas no saludables en ellos, como el tabaquismo, el alcohol, las drogas ilegales and the escasa actividad fisica, independientemente del grado of adiposidad.
Abstract: O artigo objetivou avaliar a associacao entre o padrao de conduta nao saudavel sobre a prevalencia e incidencia da pressao arterial elevada em adolescentes. A partir das informacoes de um estudo de coorte, com uma populacao na medicao basal de 2.813 adolescentes do sistema de ensino publico, foi determinada a prevalencia (basal) e incidencia da pressao arterial elevada, junto com o consumo de cigarro, bebidas alcoolicas, drogas ilegais e as variaveis de atividade fisica. Com estas variaveis, foi construido um modelo chamado "padrao de conduta nao saudavel" e foi avaliada sua relacao com a pressao arterial elevada nos adolescentes, usando modelos de regressao logistica multipla. Entre os resultados, foi observado que a prevalencia da pressao arterial elevada foi 8,67%. A incidencia acumulada da pressao arterial elevada foi 7,58%. Na analise multipla de prevalencia da pressao arterial elevada, ajustado por graus de gordura, houve associacao com um padrao alto de conduta nao saudavel no grupo dos homens (OR = 3,13; IC95%: 1,67-5,84). A associacao da incidencia da pressao arterial elevada e um alto padrao de conduta nao saudavel foram observados tambem no grupo das mulheres, (OR = 2,34; IC95%: 1,11-4,95). Concluimos que a pressao arterial elevada esta presente na populacao adolescente, associada a condutas nao saudaveis entre elas: o tabagismo, o alcool, as drogas ilegais e a insuficiente atividade fisica, independentemente do grau de gordura corporal.
1 citations
References
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TL;DR: In those older than age 50, systolic blood pressure of greater than 140 mm Hg is a more important cardiovascular disease (CVD) risk factor than diastolic BP, and hypertension will be controlled only if patients are motivated to stay on their treatment plan.
Abstract: The National High Blood Pressure Education Program presents the complete Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Like its predecessors, the purpose is to provide an evidence-based approach to the prevention and management of hypertension. The key messages of this report are these: in those older than age 50, systolic blood pressure (BP) of greater than 140 mm Hg is a more important cardiovascular disease (CVD) risk factor than diastolic BP; beginning at 115/75 mm Hg, CVD risk doubles for each increment of 20/10 mm Hg; those who are normotensive at 55 years of age will have a 90% lifetime risk of developing hypertension; prehypertensive individuals (systolic BP 120-139 mm Hg or diastolic BP 80-89 mm Hg) require health-promoting lifestyle modifications to prevent the progressive rise in blood pressure and CVD; for uncomplicated hypertension, thiazide diuretic should be used in drug treatment for most, either alone or combined with drugs from other classes; this report delineates specific high-risk conditions that are compelling indications for the use of other antihypertensive drug classes (angiotensin-converting enzyme inhibitors, angiotensin-receptor blockers, beta-blockers, calcium channel blockers); two or more antihypertensive medications will be required to achieve goal BP (<140/90 mm Hg, or <130/80 mm Hg) for patients with diabetes and chronic kidney disease; for patients whose BP is more than 20 mm Hg above the systolic BP goal or more than 10 mm Hg above the diastolic BP goal, initiation of therapy using two agents, one of which usually will be a thiazide diuretic, should be considered; regardless of therapy or care, hypertension will be controlled only if patients are motivated to stay on their treatment plan. Positive experiences, trust in the clinician, and empathy improve patient motivation and satisfaction. This report serves as a guide, and the committee continues to recognize that the responsible physician's judgment remains paramount.
14,975 citations
01 Jan 2001
TL;DR: This manual introduces the AUDIT, the Alcohol Use Disorders Identification Test, and describes how to use it to identify persons with hazardous and harmful patterns of alcohol consumption.
Abstract: This manual introduces the AUDIT, the Alcohol Use Disorders Identification Test, and describes how to use it to identify persons with hazardous and harmful patterns of alcohol consumption.
6,150 citations
TL;DR: Author(s): Go, Alan S; Mozaffarian, Dariush; Roger, Veronique L; Benjamin, Emelia J; Berry, Jarett D; Borden, William B; Bravata, Dawn M; Dai, Shifan; Ford, Earl S; Fox, Caroline S; Franco, Sheila; Fullerton, Heather J; Gillespie, Cathleen; Hailpern, Susan M; Heit, John A; Howard, Virginia J; Huff
Abstract: Author(s): Go, Alan S; Mozaffarian, Dariush; Roger, Veronique L; Benjamin, Emelia J; Berry, Jarett D; Borden, William B; Bravata, Dawn M; Dai, Shifan; Ford, Earl S; Fox, Caroline S; Franco, Sheila; Fullerton, Heather J; Gillespie, Cathleen; Hailpern, Susan M; Heit, John A; Howard, Virginia J; Huffman, Mark D; Kissela, Brett M; Kittner, Steven J; Lackland, Daniel T; Lichtman, Judith H; Lisabeth, Lynda D; Magid, David; Marcus, Gregory M; Marelli, Ariane; Matchar, David B; McGuire, Darren K; Mohler, Emile R; Moy, Claudia S; Mussolino, Michael E; Nichol, Graham; Paynter, Nina P; Schreiner, Pamela J; Sorlie, Paul D; Stein, Joel; Turan, Tanya N; Virani, Salim S; Wong, Nathan D; Woo, Daniel; Turner, Melanie B; American Heart Association Statistics Committee and Stroke Statistics Subcommittee
5,449 citations
TL;DR: Findings in animal studies show that there is a blunting of the pressure-natriuresis relationship in male spontaneously hypertensive rats and in ovariectomized female spontaneously hypertension rats treated chronically with testosterone, suggesting that the loss of estrogens may be the only component involved in the higher blood pressure in women after menopause.
Abstract: Men are at greater risk for cardiovascular and renal disease than are age-matched, premenopausal women. Recent studies using the technique of 24-hour ambulatory blood pressure monitoring have shown that blood pressure is higher in men than in women at similar ages. After menopause, however, blood pressure increases in women to levels even higher than in men. Hormone replacement therapy in most cases does not significantly reduce blood pressure in postmenopausal women, suggesting that the loss of estrogens may not be the only component involved in the higher blood pressure in women after menopause. In contrast, androgens may decrease only slightly, if at all, in postmenopausal women. In this review the possible mechanisms by which androgens may increase blood pressure are discussed. Findings in animal studies show that there is a blunting of the pressure-natriuresis relationship in male spontaneously hypertensive rats and in ovariectomized female spontaneously hypertensive rats treated chronically with testosterone. The key factor in controlling the pressure-natriuresis relationship is the renin-angiotensin system (RAS). The possibility that androgens increase blood pressure via the RAS is explored, and the possibility that the RAS also promotes oxidative stress leading to production of vasoconstrictor substances and reduction in nitric oxide availability is proposed.
1,081 citations
TL;DR: Increased active eNOS levels may antagonize the development of endothelial dysfunction and atherosclerosis, a hypothesis that supports the view that red wine indeed may have long-term protective cardiovascular properties mediated by its polyphenols.
Abstract: Background— Population-based studies suggest a reduced incidence of morbidity and mortality from coronary heart disease caused by moderate and regular consumption of red wine. Endothelial nitric oxide (NO) is a pivotal vasoprotective molecule. This study examines the influence of red wine polyphenols on the regulation of endothelial nitric oxide synthase (eNOS) expression and subsequent NO synthesis, focusing on the putative long-lasting antiatherosclerotic effects of red wine. Methods and Results— Treatment (20 hours) of human umbilical vein endothelial cells (HUVECs) and of the HUVEC-derived cell line EA.hy926 with a alcohol-free red wine polyphenol extract (RWPE) led to a concentration-dependent (100 to 600 μg/mL), significant increase in NO release (up to 3.0-fold/HUVEC and 2.0-fold/EA.hy926) as shown by use of the fluorescent probe DAF-2. This effect was corroborated by the [14C]l-arginine/l-citrulline conversion assay in intact EA.hy926 cells. RWPE (20 hours, 100 to 600 μg/mL) also significantly inc...
387 citations