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ABSTRACT Aim Design Methods Results Conclusion Implications for the Profession and/or Patient Care Reporting Method Patient or Public Contribution To explore men's health status and lifestyle risk profile and understand how they engage with preventive health care.A cross‐sectional survey within a sequential mixed‐methods project.Four hundred thirty‐one adult males, working or volunteering for the New South Wales Rural Fire Service (NSW RFS) completed the survey between September and November 2022. The survey captured demographic data, health status and lifestyle characteristics, as well as engagement with preventive health care.Nearly three‐quarters of respondents (n = 314; 72.8%) described themselves as being in good or very good health. Just 18.6% of respondents recorded a ‘healthy’ body mass index (BMI), despite only 29.9% having been told by a doctor that they were overweight/obese. Most (n = 344; 79.8%) respondents identified having a regular general practitioner (GP)/general practice. Nearly all respondents described having had blood pressure measurements (n = 403; 93.5%) and lipid profile (n = 346, 80.3%) in the last 2 years. Having a regular GP/general practice was significantly associated with engaging in all preventive and screening activities, except having a dental check.Our findings demonstrate a significant opportunity to support men to reduce lifestyle risk, despite their current engagement with general practice. Strategies need to support men and health professionals to have conversations about risk and risk reduction to promote behaviour change. Nurses are well placed to provide preventive health care to men in general practice. The general practice nurse has a key role in communicating lifestyle risk, supporting patients in modifying their behaviours and reducing the impact of such factors on their health and well‐being.Communicating the importance of lifestyle risk factors is imperative in supporting men to achieve behavioural change in the reduction in lifestyle risk. Nurses are well‐placed to take a leading role in this area.The STROBE checklist guided reporting.Survey development was undertaken in collaboration with members of the NSW RFS. Key contacts within the organisation were involved in reviewing the analysis and interpretation of findings. [ABSTRACT FROM AUTHOR]

Short and insufficient sleep are prevalent and associated with cardiovascular disease, with the sympathetic nervous system as a suspected mediator. The purpose of the present study was to investigate the association between objective, actigraphy-based total sleep time (TST), sleep efficiency (SE), and cardiovascular and sympathetic regulation in healthy adults. We hypothesized that short TST and low SE would be associated with elevated resting blood pressure, heart rate (HR), and muscle sympathetic nerve activity (MSNA). Participants included 94 individuals [46 males, 48 females, age: 30 ± 15 yr, body mass index (BMI): 26 ± 4 kg/m2]. All participants underwent at least 7 days of at-home, wristwatch actigraphy monitoring (avg: 10 ± 3 days). Seated blood pressures were assessed using brachial blood pressure measurements, followed by a 10-minute supine autonomic testing session consisting of continuous HR (electrocardiogram), beat-by-beat blood pressure (finger plethysmograph), and MSNA (microneurography) monitoring. Partial correlations were used to determine the relationship between sleep and cardiovascular parameters while accounting for the influence of age, sex, and BMI. TST was not associated with MAP (R = −0.105, P = 0.321), HR (R = 0.093, P = 0.383), or MSNA burst frequency (BF; R = −0.168, P = 0.112) and burst incidence (BI; R = −0.162, P = 0.124). Similarly, SE was not associated with MAP (R = −0.088, P = 0.408), HR (R = −0.118, P = 0.263), MSNA BF (R = 0.038, P = 0.723), or MSNA BI (R = 0.079, P = 0.459). In contrast to recent preliminary findings, our results do not support a significant association between actigraphy-based sleep duration or efficiency and measures of resting blood pressure, heart rate, and MSNA. NEW & NOTEWORTHY: The present study investigated the independent association between actigraphy-based sleep duration, efficiency, and measures of blood pressure, heart rate, and muscle sympathetic nerve activity (MSNA) in adult males and females. Contrary to our hypothesis, the findings do not support an independent association between habitual sleep and cardiovascular or sympathetic neural activity. However, these findings do not preclude a potential association between these parameters in populations with sleep disorders and/or cardiovascular disease. [ABSTRACT FROM AUTHOR]

Background: Elevated blood pressure, or hypertension, is one of the main health problems among adolescents globally. However, there are limited data on hypertension among adolescents in Sudan. This survey aimed to investigate the prevalence of elevated blood pressure/hypertension and associated factors among adolescents in Gadarif City, Sudan. Methods: A community-based cross-sectional survey was conducted during a three-month period (August to October 2023) in Gadarif City, Eastern Sudan. A face-to-face interview questionnaire was used to collect sociodemographic information. Adolescents' anthropometric (weight and height) measurements were taken, and blood pressure was measured. Multivariate binary and linear regression analyses were performed to analyze the data. Results: A total of 384 adolescents (178 [46.4%] boys and 206 [53.6%] girls) were included in the study. The median (interquartile range, IQR) of the age was 14.0 (12.1–16.1) years, and that of the body mass index (BMI) was 16.9 (15.2–20.0) kg/m2. Thirty-four (8.9%) adolescents had hypertension/elevated blood pressure (≥95th percentile). After adjusting for confounders, multivariable binary regression analysis showed that age (adjusted odds ratio [AOR], 1.20; 95% confidence interval [CI], 1.03–1.42) and BMI (AOR, 1.12; 95% CI, 1.04–1.20) were associated with hypertension. Conclusion: Approximately one in ten adolescents in Eastern Sudan was hypertensive. Adolescents with higher age and BMI were at higher risk for hypertension. Maintaining a healthy BMI during adolescence is recommended to promote adolescents' health. [ABSTRACT FROM AUTHOR]

BACKGROUND Previous studies have demonstrated the benefits of ideal cardiovascular health (CVH) in reducing cardiovascular risk. However, its role in subclinical atherosclerosis (SA) progression remains unclear. We aim to examine the association of CVH, estimated by the American Heart Association's new Life's Essential 8 (LE8), with the progression of SA. METHODS This prospective cohort study was conducted among 972 asymptomatic Chinese participants and followed up for 5.7 years. The LE8 score (range, 0–100) consisted of blood pressure, lipids, glucose, body mass index, smoking status, diet health, physical activity and sleep health was evaluated in 1998 and 2008–2009. Progression of SA was determined by carotid plaque and coronary artery calcification (CAC) in 2008–2009 and 2013–2014. Log-binomial regression model was used to estimate the association of LE8 score with SA progression. RESULTS Each 10 points increment in LE8 score was associated with 15.2% (RR: 0.848, 95% CI: 0.797–0.902), 17.7% (RR: 0.823, 95% CI: 0.766–0.884) and 12.0% (RR: 0.880, 95% CI: 0.845–0.916) lower risks of carotid plaque, CAC and overall SA progression, respectively. Compared with participants with non-ideal CVH at both visits, the participants with ideal CVH at both visits had 39.1% (RR: 0.609, 95% CI: 0.494–0.752), 41.0% (RR: 0.590, 95% CI: 0.456–0.764) and 29.7% (RR: 0.703, 95% CI: 0.598–0.825) lower risks of carotid plaque, CAC and overall SA progression, respectively. CONCLUSIONS Higher LE8 scores were associated with lower risks of SA progression. Besides, long-term maintenance of optimal CVH was more beneficial to prevent SA progression. [ABSTRACT FROM AUTHOR]

Summary: Objective: To prospectively evaluate the relationship between cumulative environmental stress and cardiometabolic risk in middle childhood, and to examine whether hair cortisol, a measure of hypothalamic pituitary adrenal‐axis activity, mediates this relationship. Methods: In a cohort of children from low‐income households (n = 320; 59% Hispanic, 23% Black, body mass index (BMI) percentile >50th at enrollment), environmental stressors including family and neighbourhood factors representing disadvantage/deprivation, and cortisol concentrations from hair samples, were measured over five timepoints beginning when children were 2–4 years old. Cardiometabolic risk factors (i.e., BMI, blood pressure, lipids, blood sugar, C‐reactive protein) were measured at the final timepoint when children were 7–11 years of age. Results: In adjusted logistic regression models, greater cumulative environmental stress was associated with a higher likelihood of elevated cardiometabolic risk in middle childhood (p = 0.01). Children from minoritized racial/ethnic groups had a higher prevalence of both stressors and cardiometabolic risk factors. Cumulative environmental stress was associated with higher hair cortisol concentrations (p < 0.01). However, hair cortisol was not directly associated with cardiometabolic risk factors and did not explain the association between environmental stress and cardiometabolic risk in causal mediation analysis. Conclusions: The influence of cumulative stress on cardiometabolic health can be observed in middle childhood and may contribute to cardiometabolic health disparities, highlighting the importance of public health interventions to mitigate disadvantage. [ABSTRACT FROM AUTHOR]

Summary: Introduction: Prevalence and risk factors for elevated glycated haemoglobin (HbA1c) and blood pressure (BP) are poorly understood among Pacific children. We examined associations of HbA1c and BP in 6–9 year‐olds with body mass index (BMI) at ages 2, 5, and BMI velocity between 2–9 years in Samoa. Methods: HbA1c (capillary blood) and BP were measured in n = 410 Samoan children who were part of an ongoing cohort study. Multilevel models predicted BMI trajectory characteristics. Generalized linear regressions assessed associations of childhood characteristics and BMI trajectories with HbA1c and BP treated as both continuous and categorical outcomes. Primary caregiver‐reported childhood characteristics were used as covariates. Results: Overall, 12.90% (n = 53) of children had high HbA1c (≥5.7%) and 33.17% (n = 136) had elevated BP. BMI at 5‐years and BMI velocity were positively associated with high HbA1c prevalence in males. A 1 kg/m2 per year higher velocity was associated with a 1.71 (95% CI: 1.07, 2.75) times higher prevalence of high HbA1c. In females, higher BMI at 5‐years and greater BMI velocity were associated with higher BP at 6–9 years (95% CI: 1.12, 1.40, and 1.42, 2.74, respectively). Conclusion: Monitoring childhood BMI trajectories may inform cardiometabolic disease screening and prevention efforts in this at‐risk population. [ABSTRACT FROM AUTHOR]

Background: Betaine, an osmolyte derivative of the metabolite choline and the amino acid glycine, acts as a methyl donor in the conversion of homocysteine to methionine and is involved in the maintenance of adequate lipid metabolism. There is growing evidence for the role of betaine in the development of various lipid-related diseases, including dyslipidemia and cardiovascular risk. This study aimed to analyze associations between betaine intake and blood lipid profiles in Mexican subjects. Methods: A total of 212 adults were randomly recruited in the city of Tijuana, Baja California, Mexico. Betaine intake was estimated using Nutritionist Pro software. Body composition and metabolic measurements were obtained by conventional methods. In the total sample, the average intake of betaine was 14.32 mg/d. Individuals were categorized into three groups according to tertiles of betaine consumption: tertile/group 1 (<4.16 mg/d), tertile/group 2 (4.16–12.02 mg/d), and tertile/group 3 (>12.02 mg/d). Results: Compared to group 3, subjects within group 1 had higher serum levels of total cholesterol (p = 0.001), LDL-c (p = 0.026), and non-HDL-c (p = 0.021). In addition, significant negative Pearson correlations were found between betaine intake and the serum levels of total cholesterol (r = −0.432, 95% CI, −0.684, −0.185, p = 0.001), LDL-c (r = −0.370, 95% CI, −0.606, −0.134, p = 0.002), and non-HDL-c (r = −0.351, 95%CI, −0.604, −0.098, p = 0.007). Conclusions: Our results show that a low intake of betaine is associated with elevated blood cholesterol levels in Mexican subjects. On this basis, betaine consumption could be used as an additional dietary measure for cardiovascular care. However, additional studies are required to confirm our results in other Mexican regions as well as in other populations worldwide. [ABSTRACT FROM AUTHOR]

Previous research has highlighted the positive impact of greater health-related quality of life (Hr-QoL) and subjective well-being (SWB) on chronic diseases' severity and progression. There is a paucity of studies investigating the long-term trajectories of these variables among hypertensive patients. The present study aims to investigate the relationships between psychological variables (Type A and D personality, locus of control—LoC, self-esteem, and trait anxiety) with SWB and Hr-QoL in patients with hypertension and comorbid metabolic syndrome. A total of 185 volunteer patients (130 males, 70.3%; mean age 54 ± 10.93) were enrolled. Patients filled out measures of Hr-QoL and SWB, LoC, and self-esteem at three time points—Type A and D behaviors and anxiety measures only at baseline. Analyses were run through two-level hierarchical mixed models with repeated measures (Level 1) nested within participants (Level 2), controlling for sociodemographic and clinical confounders. Neither Hr-QoL nor SWB changed over time. Patients with greater self-esteem and internal LoC (and lower external LoC) increased their SWB and Hr-QoL up to 1-year follow-up. A greater Type A behavior and trait anxiety at baseline predicted a longitudinal increase in most of the dependent variables. Results suggest that it could be useful to tailor interventions targeting specific variables to increase Hr-QoL and SWB among hypertensive patients. [ABSTRACT FROM AUTHOR]

Are There Interindividual Responses of Cardiovascular Disease Risk Markers to Acute Exercise? A Replicate Crossover Trial. Med. Sci. Sports Exerc., Vol. 56, No. 1, pp. 63-72, 2024. Purpose: Using a replicated crossover design, we quantified the response heterogeneity of postprandial cardiovascular disease risk marker responses to acute exercise. Methods: Twenty men (mean (SD) age, 26 (6) yr; body mass index, 23.9 (2.4) kg·m−2 ) completed four 2-d conditions (two control, two exercise) in randomized orders. On days 1 and 2, participants rested and consumed two high-fat meals over 9 h. Participants ran for 60 min (61 (7)% of peak oxygen uptake) on day 1 (6.5 to 7.5 h) of both exercise conditions. Time-averaged total area under the curve (TAUC) for triacylglycerol, glucose, and insulin were calculated from 11 venous blood samples on day 2. Arterial stiffness and blood pressure responses were calculated from measurements at baseline on day 1 and at 2.5 h on day 2. Consistency of individual differences was explored by correlating the two replicates of control-adjusted exercise responses for each outcome. Within-participant covariate-adjusted linear mixed models quantified participant-by-condition interactions and individual response SDs. Results: Acute exercise reduced mean TAUC-triacylglycerol (−0.27 mmol·L-1 ·h; Cohen’s d = 0.29, P = 0.017) and TAUC-insulin (−25 pmol·L-1 ·h; Cohen’s d = 0.35, P = 0.022) versus control, but led to negligible changes in TAUC-glucose and the vascular outcomes (Cohen’s d ≤ 0.36, P ≥ 0.106). Small-to-moderate, but nonsignificant, correlations were observed between the two response replicates (r = −0.42 to 0.15, P ≥ 0.066). We did not detect any individual response heterogeneity. All participant-by-condition interactions were P ≥ 0.137, and all individual response SDs were small with wide 95% confidence intervals overlapping zero. Conclusions: Large trial-to-trial within-subject variability inhibited detection of consistent interindividual variability in postprandial metabolic and vascular responses to acute exercise. [ABSTRACT FROM AUTHOR]

Background: The association between different sedentary behaviors and hypertension risk remains unclear. We aimed to explore the relationship between different domains of sedentary behaviors and new‐onset hypertension, investigate whether genetic susceptibility to hypertension modifies the relationship, and examine the extent to which the relationship is mediated by body mass index (BMI) and grip strength. Methods: 212 714 participants without baseline hypertension in the UK Biobank were enrolled. The three major sedentary behaviors (TV‐watching, nonoccupational computer use, and driving) were measured using touch screen questionnaires. The primary outcome was new‐onset hypertension. Results: During a median follow‐up of 11.9 years, 13 983 participants developed hypertension. There was a linear positive association between TV‐watching time and new‐onset hypertension (p for nonlinearity =0.868). A J‐shaped association was found for nonoccupational computer use time and driving time with new‐onset hypertension, with an inflection point of 0.5 h/day for both (both p for nonlinearity <0.001). Polygenetic risk scores for hypertension (based on 118 related single‐nucleotide polymorphisms) did not significantly modify these associations (all p‐interactions >0.05). Furthermore, the detrimental effects of long‐term sedentary behaviors on hypertension were mediated by BMI by 21%–30%, and the beneficial effects of limited sitting time (within 0.5 h/day) for driving and nonoccupational computer use were mediated by grip strength by 6–25%. Conclusions: There was a positive association for hands‐independence sedentary behavior (TV‐watching), and a J‐shaped association for hands‐dependence sedentary behaviors (nonoccupational computer use and driving) with new‐onset hypertension, regardless of genetic risks of hypertension. These relationships were partly mediated by BMI and grip strength. [ABSTRACT FROM AUTHOR]

Introduction: Child marriage, defined as marriage before the age of 18 years, is a precocious transition from adolescence to adulthood, which may take a long-term toll on health. Aim: This study aims to assess whether child marriage was associated with added risk of adverse cardiovascular outcomes in a nationally representative sample of Indian adults. Methods: Applying the non-laboratory-based Framingham algorithm to data on 336,953 women aged 30–49 years and 49,617 men aged 30–54 years, we estimated individual's predicted heart age (PHA). Comparing the PHA with chronological age (CA), we categorized individuals in four groups: (i) low PHA: PHA < CA, (ii) equal PHA: PHA = CA (reference category), (iii) high PHA: PHA > CA by at most 4 years, and (iv) very high PHA: PHA > CA by 5 + years. We estimated multivariable multinomial logistic regressions to obtain relative risks of respective categories for the child marriage indicator. Results: We found that women who were married in childhood had 1.06 (95% CI 1.01–1.10) and 1.22 (95% CI 1.16–1.27) times higher adjusted risks of having high and very high PHA, respectively, compared to women who were married as adults. For men, no differential risks were found between those who were married as children and as adults. These results were generally robust across various socioeconomic sub-groups. Conclusions: These findings add to the relatively new and evolving strand of literature that examines the role of child marriage on later life chronic health outcomes and provide important insights for public health policies aimed at improving women's health and wellbeing. [ABSTRACT FROM AUTHOR]

Background: Obesity is considered a widespread concern internationally. Few studies have investigated the relationships between dairy consumption and hypertension and obesity. Therefore, this study examined the above concern in students. Methods: This cross-sectional study was conducted on 292 male students (18--30 y) living in the dormitories of Tabriz University of Medical Sciences. Students were selected via the multistage stratified random sampling method. Demographic information, anthropometric measurements, blood pressure (BP) readings, and a semi-quantitative validated questionnaire assessing dairy consumption (including a 24-hour dietary record covering 2 typical days and a holiday) were collected. After all the questionnaires were reviewed, they were coded and analyzed with Nutritionist IV software. Results: The average age of the subjects was 22.36 years. The mean±SD values of body mass index (BMI), waist circumference, waist-to-hip ratio, and waist circumference-to-standing height ratio were 22.68±2.58 kg/m², 80.95±7.81 cm, 0.85±0.04, and 0.46±0.04 among the studied population, respectively. The mean±SD values of systolic and diastolic blood pressure were 111.84±10 mm Hg and 70.99±8 mm Hg, respectively. Milk consumption was associated with a low waist circumference (95% credible interval, 1.005 to 4.580; P=0.046). The odds of hypertension (defined as BP>120/90 mm Hg) were 2.686 times higher in the overweight and obese group than in the normal BMI group. The risk of hypertension was 1.045 times higher for individuals with abdominal obesity than for those who did not consume dairy products. Conclusion: Milk consumption was associated with a low waist circumference. The correlations between systolic blood pressure and anthropometric factors were statistically significant. BMI, waist circumference, and waist-to-hip ratio were positively associated with systolic blood pressure. [ABSTRACT FROM AUTHOR]

Aim: The lifestyle habits of young people are often associated with that of middle-aged and older adults, and intervention from a young age is important for the prevention of lifestyle-related diseases. Hypertension is a lifestyle-related disease, and an increasing number of patients are suffering from it. Therefore, in this study, we investigated the factors that cause fluctuations in blood pressure in university students. Subject and methods: The survey was conducted from 2011 to 2019 and included 14,720 male and 6,039 female university students. The questionnaire included items such as age, sex, weight control orientation, and lifestyle habits. Height, weight, and systolic and diastolic blood pressures were measured. Body mass indices (BMI) were calculated, and the participants were classified as underweight, normal body type, or obese. In addition, abnormal blood pressure (ABP) was defined as systolic/diastolic blood pressure above 120 and/or 80 mmHg. Results: A multivariate logistic regression analysis revealed that ABP was significantly associated with snacking (odds ratio, 95% confidence interval 0.68, 0.52–0.90) in males with underweight; sleep duration ≥ 6 h (1.10, 1.02–1.19), snacking (0.84, 0.75–0.96), and weight decreasing orientation (1.22, 1.12–1.32) in males with normal body types; exercise habits (0.75, 0.56–1.00) in females with normal body types. Conclusion: The present study revealed different risk factors by body type associated with ABP in Japanese university students. In particular, weight loss orientation in a standard-bodied male may be a risk factor for ABP. Our study suggests that interventions by body type may prevent lifestyle-related diseases. [ABSTRACT FROM AUTHOR]

We aimed to investigate the association of main meals' specific protein intake with cardiometabolic risk factors, including general and abdominal obesity, serum lipid profile, and blood pressure (BP). This cross-sectional study was conducted on 850 subjects aged 20–59 years. Dietary intakes were assessed by completing three 24-h recalls, and the protein intake of each meal was extracted. Anthropometric measures, lipid profile, fasting blood sugar and BP were measured. Multivariate logistic regression controlling for age, physical activity, sex, marital status, smoking status, BMI and energy intake was applied to obtain OR and CI. The mean age was 42 years, and the mean BMI of the participants was 27·2. The mean protein intake for breakfast, lunch and dinner was 12·5, 22·2 and 18·7 g/d, respectively. After adjustment for confounders, higher protein intake was not associated with any of the cardiometabolic risk factors, including LDL-cholesterol, HDL-cholesterol, total cholesterol (TC), TAG, body weight, BP and fasting plasma glucose, in any of the three main meals consumed within a day. Adherence to a higher protein intake at each meal was not associated with cardiometabolic risk factors in Iranian adults. Further prospective studies are needed to justify our findings. [ABSTRACT FROM AUTHOR]

Objectives: To examine the discrepancy between ‘told’ and screened blood pressure (BP) category, and the association between body composition and told BP category. Methods: Between 08/2019-03/2020 college students (n=1057) were asked what category they had previously been told their BP falls into prior to having their BP and body composition (waist circumference, body mass index (BMI), and body fat percentage) objectively assessed. Results: A disproportionate number (>80%) who were told that they had normal BP were categorized as having elevated BP. Men told they had borderline/high BP had less favorable body compositions than those told they had low/normal BP. Less favorable body composition was associated with increased likelihood of men being told that they had borderline/high BP. Conclusions: Better BP screening policies and procedures would ensure healthcare providers discuss elevated BP with emerging adults regardless of body composition and avoid missing opportunities to delivery of early and cost-effective interventions. [ABSTRACT FROM AUTHOR]

Background: Few studies have considered outcomes among low body mass index (BMI) cohorts undergoing coronary artery bypass grafting (CABG). This study aims to investigate the effects of low body weight on blood transfusion and perioperative outcomes in patients undergoing isolated CABG. Methods: This retrospective study enrolled consecutive cases from a single-center between January 2008 and December 2018. Low body weight/underweight was defined as a BMI < 18.5 kg/m², while normal BMI was defined as 18.5 ≤ BMI < 24.0 kg/m². The primary endpoint was the perioperative red blood cell (RBC) transfusion rate. Secondary endpoints include platelet and plasma transfusion rates, transfusion volume for all blood components, hospital length of stay, and the occurrence of adverse events including prolonged mechanical ventilation, re-intubation, re-operation, acute kidney injury, and 30-day all-cause mortality. Results: A total of 7,620 patients were included in this study. After 1:1 propensity score matching, 130 pairs were formed, with 61 pairs in the on-pump group and 69 pairs in the off-pump group. Baseline characteristics were comparable between the matched groups. Low body weight independently increased the risk of RBC transfusion (on-pump: OR = 3.837, 95% CI = 1.213–12.144, p = 0.022; off-pump: OR = 3.630, 95% CI = 1.875–5.313, p < 0.001). Moreover, within the on-pump group of the original cohort, BMI of < 18.5 kg/m² was independently correlated with increased risk of re-intubation (OR = 5.365, 95% CI = 1.159 to 24.833, p = 0.032), re-operation (OR = 4.650, 95% CI = 1.019 to 21.210, p = 0.047), and 30-day all-cause mortality (OR = 10.325, 95% CI = 2.011 to 53.020, p = 0.005). Conclusion: BMI < 18.5 kg/m² was identified as an independent risk factor for increased perioperative RBC transfusion rate in patient underwent isolated CABG with or without CPB. Only on-pump underweight patients in the original cohort exhibited an increased risk for re-intubation, re-operation, and 30-day all-cause mortality. Physicians and healthcare systems should consider these findings to improve management for this population. [ABSTRACT FROM AUTHOR]

Objective: To evaluate prospectively the effects of surgical excision of renal tumours on blood pressure (BP). Patients and Methods: In a multicentre prospective study, we evaluated 200 patients who underwent nephrectomy for renal tumour between 2018 and 2020 at seven departments of the French Network for Kidney Cancer, the UroCCR. All patients had localized cancer without pre‐existing hypertension (HTN). Blood pressure was measured the week before nephrectomy, and at 1 month and 6 months after nephrectomy, according to the recommendations for home BP monitoring. Plasma renin was measured 1 week before surgery and 6 months after surgery. The primary endpoint was the occurrence of de novo HTN. The secondary endpoint was clinically significant increase in BP at 6 months, defined by an increase in systolic and/or diastolic ambulatory BP ≥10 mmHg or requirement for medical antihypertensive treatment. Results: Blood pressure and renin measurements were available for 182 (91%) and 136 patients (68%), respectively. We excluded from the analysis 18 patients who had undeclared HTN detected on preoperative measurements. At 6 months, 31 patients (19.2%) had de novo HTN and 43 patients (26.3%) had a significant increase in their BP. Type of surgery was not associated with an increased risk of HTN (21.7% partial nephrectomy [PN] vs 15.7% radical nephrectomy [RN]; P = 0.59). There was no difference between plasmatic renin levels before and after surgery (18.5 vs 16; P = 0.46). In multivariable analysis, age (odds ratio [OR] 1.07, 95% confidence interval [CI] 1.02–1.12; P = 0.03) and body mass index (OR 1.14, 95% CI 1.03–1.26; P = 0.01) were the only predictors of de novo HTN. Conclusion: Surgical treatment of renal tumours is associated with significant changes in BP, with de novo HTN occurring in almost 20% of the patients. These changes are not impacted by the type of surgery (PN vs RN). Patients who are scheduled to undergo kidney cancer surgery should be informed of these findings and have their BP closely monitored after the operation. [ABSTRACT FROM AUTHOR]

Community service aims to determine the health picture of Indonesian soldiers in the 1st Infantry Division of Kostrad Cilodong. Therefore, researchers conduct general health screening by measuring body mass index, blood pressure, and glucose levels in the blood. This study used a descriptive method. This method describes a subject or object under study in depth, detail, and breadth. This study used two types of data: primary and secondary. The results of community service as a whole, when viewed from blood pressure measurement data and glucose levels in the blood, can be said to be normal. The routine of Indonesian soldiers is like regular exercise, a healthy and stable diet, and adequate rest influences to reduce risk factors for diabetes mellitus. [ABSTRACT FROM AUTHOR]

Objectives: Although the physiological mechanisms are not fully understood, race/ethnicity differences vary across cardiometabolic disease risk factors. Resistance training (RT) is an effective therapy for improving these risk factors in addition to body composition and physical performance. Thus, the purpose of this study was to determine the effects of RT over time on different racial and ethnic populations across cardiometabolic, body composition, and physical performance outcomes. Design: Electronic databases Scopus and PubMed were searched for studies that compared different racial/ethnic responses to RT across cardiometabolic, body composition, and physical performance parameters. Inclusion criteria for the studies were as follows: (1) published in the English language; (2) compared races or ethnicities across cardiometabolic risk factors, body composition, or physical performance variables following a RT intervention; (3) included adults 18 years or older, and (4) included an isolated RT intervention group. Results: Nine studies were found that met the inclusion criteria. The identified studies involved cohorts of White American (WA), South Asian, European Chilean, Mapuche Chilean, White Scottish, and African American (AA) males and females. Race/ethnicity differences following a RT intervention were found for fat-free mass preservation and changes in blood pressure, endothelial function, brachial artery stiffness, cardiac autonomic function, inflammatory and oxidative stress markers, insulin sensitivity, body mass index, waist circumference, % body fat, and muscular strength. With the exception of changes in systolic blood pressure and brachial artery stiffness, AAs consistently showed more beneficial adaptations compared to WAs to RT across studies. Conclusion: Race and ethnicity play a role in how adults adapt to chronic RT. These data may aid in better understanding the social, biological, and environmental factors that likely influenced these racial/ethnic differences in response to RT, assist in creating tailored exercise prescriptions for various racial/ethnic populations, and inform policies for determining resource allocations to address health inequities. [ABSTRACT FROM AUTHOR]

Aim: To determine low‐density lipoprotein cholesterol (LDL‐C) screening frequency and levels, and factors associated with elevated LDL‐C, in Australasian youth with type 1 diabetes (T1D). Methods: Data were extracted from the Australasian Diabetes Data Network (ADDN), a prospective clinical quality registry, on all T1D healthcare visits attended by young people aged 16–25 years (with T1D duration of >1 year) between January 2011 and December 2020. The primary outcomes were elevated LDL‐C > 2.6 mmol/L (100 mg/dL) and threshold for treatment: >3.4 mmol/L (130 mg/dL), according to consensus guidelines. Multivariable Generalised Estimated Equations (GEE) were used to examine factors associated with elevated LDL‐C across all visits. Results: A cohort of 6338 young people (52.6% men) were identified, of whom 1603 (25.3%) had ≥1 LDL‐C measurement documented. At last measurement, mean age, age at T1D diagnosis and T1D duration were 18.3 ± 2.4, 8.8 ± 4.5 and 8.9 ± 4.8 years, respectively. LDL‐C was elevated in 737 (46.0%) and at the treatment threshold in 250 (15.6%). In multivariable GEE elevated LDL‐C continuously was associated with older age (OR = 0.07; 0.01–0.13, p = 0.02), female sex (OR = 0.31; 0.18–0.43; p < 0.001), higher HbA1c (OR = 0.04; 0.01–0.08; p = 0.01) and having an elevated BMI (OR = 0.17, 0.06–0.39, p < 0.001). Conclusions: LDL‐C screening and levels are suboptimal in this cohort, increasing future cardiovascular complication risk. There is an urgent need to understand how healthcare services can support improved screening and management of dyslipidaemia in this population. [ABSTRACT FROM AUTHOR]

Background: The achievement of adequately controlled blood pressure has been a global challenge due to potential barriers within the healthcare system and within the patient population. Identification of the specific barriers and their modification is an urgent healthcare priority. Objectives: This study aimed to determine the level of blood pressure control and its associated factors at Chuka and Embu County Referral Hospitals. Design and setting: This was a descriptive cross-sectional study conducted at the two county referral hospitals. Participants: A total of 328 patients with hypertension (166 in Chuka and 162 in Embu) were randomly selected and consented to participate in the study. Demographic and health-related data was collected using self-administered questionnaires and in-depth interviews. Measurements of BP and anthropometrics were done using standard tools and standard procedures. Data analysis methods included descriptive statistics, chi-square tests of independence, and logistic regression models. The level of statistical significance was 0.05. Results: The mean BP control level for the two sites was 143.58±18.76/85.29±11 mmHg. Less than half of the participants (34.4%) had controlled BP (i.e., BP reading < 140/90 mmHg). Participants who were younger and had attained formal education, engaged their doctors in the discussion, reported positive views of their health had higher odds of having controlled BP. Conclusion: The level of BP control was suboptimal in the two facilities. Formal education, adequate communication with doctors' and a positive self-view positively influenced BP control among the participants. [ABSTRACT FROM AUTHOR]

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OBJECTIVES: Chronic hypertension stands as the primary contributing factor for cardiovascular ailments among women who have experienced preeclampsia. The purpose of this research is to examine how often preeclamptic symptoms persist at the postpartum 6th week. STUDY DESIGN: This prospective cohort study included 50 singleton pregnant women in the third trimester who were diagnosed with preeclampsia according to ACOG criteria, were older than 18 years, had no known hypertension before the 20th gestational week, had no additional systemic disease, did not use medication, had no fetal chromosomal or structural abnormalities and delivered within 24-48 hours of hospitalization. RESULTS: The mean age of preeclamptic pregnant patients was 29.26±7.15 years, the mean gestational week was 35.6±2.8, and the mean BMI was 31.3±4.9. Twenty (40%) of 50 preeclamptic patients had severe preeclampsia. The mean decrease in systolic blood pressure was 34.6±15.2 mmHg, while the mean decrease in diastolic blood pressure was 22.88±11.68 mmHg (p<0.001). The decrease in systolic and diastolic blood pressure at postpartum 6th week was statistically significant. The mean change in 24-hour urine protein value at postpartum 6th week was 2313.52 ± 2696.48 and the difference was statistically significant (p<0.001). There were 14 patients (28%) with persistent hypertension and 19 patients (38%) with persistent proteinuria. CONCLUSIONS: Although preeclampsia is considered a complication of pregnancy, persistent hypertension, and proteinuria after delivery show us that preeclampsia is a disease that threatens maternal health even after delivery. These women should be followed up long-term period. [ABSTRACT FROM AUTHOR]

Introduction: Blood pressure measurement is important for treating patients. It is known that there is a discrepancy between cuff blood pressure vs arterial blood pressure measurement. However few studies have explored the clinical significance of discrepancies between cuff (CPB) vs arterial blood pressure (ABP). Our study investigated whether differences in CBP and ABP led to change in management for patients with hypertensive emergencies and factors associated with this change. Methods: This prospective observational study included adult patients admitted between January 2019-May 2021 to a resuscitation unit with hypertensive emergencies. We defined clinical significance of discrepancies as a discrepancy between CBP and ABP that resulted in change of clinical management. We used stepwise multivariable logistic regression to measure associations between clinical factors and outcomes. Results: Of 212 patients we analyzed, 88 (42%) had change in management. Mean difference between CBP and ABP was 17 milligrams of mercury (SD 14). Increasing the existing rate of antihypertensive infusion occurred in 38 (44%) patients. Higher body mass index (odds ratio [OR] 1.04, 95% confidence Interval [CI] 1.0001-1.08, P-value <0.05) and history of peripheral arterial disease (OR 0.16, 95% CI 0.03-0.97, P-value <0.05) were factors associated with clinical significance of discrepancies. Conclusion: Approximately 40% of hypertensive emergencies had a clinical significance of discrepancy warranting management change when arterial blood pressure was initiated. Further studies are necessary to confirm our observations and to investigate the benefit-risk ratio of ABP monitoring. [ABSTRACT FROM AUTHOR]

Heavy episodic drinking (HED) is associated with negative health consequences. The goal of the study was to assess HED among the general adult population in Central African Republic (CAR). In a cross-sectional survey in CAR (Bangui city and Ombella M'Poko region), 3 301 people (range = 25 - 64 years) completed structured interview questions, including on alcohol use, and anthropometric and blood pressure measurements were taken. Logistic regression was used to assess associations between sociodemographic indicators, health factors, and past-month HED. Results indicated that 33.0% of participants reported HED (26.4% in women and 44.4% in men), and among past 12-month drinkers 63.1% reported HED. In the final logistic regression model, male sex, aged 35 to 44 years, ten or more years of education, current tobacco smoking, current smokeless tobacco use, second-hand smoke exposure, and having four or more meals outside the home in the past week increased the odds of HED. One-third of the study population reported HED, suggesting a need for population-level interventions to reduce HED. [ABSTRACT FROM AUTHOR]

Objectives The objective of the study was to examine the association of screen time with body adiposity and hypertension among the school-going adolescents of Manipur. Methods Data were collected from 728 school-going adolescents of both sexes aged between 15 and 19 years. Anthropometric measurements, blood pressure, and self-response to screen time were collected. Chi-squared test and odds ratio were done to check the association between screen time and overweight/obesity and hypertension. Results About 78.8% of males spent less than or equal to 6 hours at the screen, while 21.3% spent more than 6 hours at the screen. Eighty-six percent of females spent less than or equal to 6 hours at the screen, and 14% spent more than 6 hours at the screen. Chi-squared analysis shows a significant association between abdominal obesity (waist circumference, WC) and screen time in males (p < 0.05), while no association is observed in females. However, screen time shows no correlation with body mass index, weight-to-height ratio, and hypertension. Conclusion This study highlights a high percentage of adolescents engaged in longer screen time, more than 6 hours. Furthermore, the study put forth the association of abdominal obesity as measured by WC with the screen time among the adolescents of Manipur. Longer screen time may deteriorate adolescents' health status as it reduces physical activity time. [ABSTRACT FROM AUTHOR]

This study aims to analyze associations between lifestyle-related factors and body mass index (BMI) and blood pressure (BP) in middle-aged and older people in Japan. An association analysis using a multilevel model with demographic and lifestyle-related factors as variables and with BMI, systolic blood pressure (SBP), and diastolic blood pressure (DBP) as outcomes was conducted. Among the modifiable lifestyle factors, we found a significant dose-response association for BMI and slower eating (fast: reference; normal: −0.123 kg/m2 and slow: −0.256 kg/m2). Consuming >60 g/d ethanol was significantly associated, before and after adjustment for BMI, with an increase in SBP of 3.109 and 2.893 mm Hg, respectively. These findings suggested that health guidance should focus on factors such as the eating rate and drinking habits. [ABSTRACT FROM AUTHOR]

Reduction of blood flow to the limb using cuffs before or during exercise has become increasingly popular for training and rehabilitation. Our study tested the effects of cuff brand/width on pressures required to reach limb occlusion pressure (LOP) and developed, cross-validated, and compared accuracy of two LOP prediction equations to previously created methods. Supine LOP was determined in the distal popliteal artery using four different cuff brands/widths in 23 adult participants. Participants then had demographic and resting variables assessed, and two LOP prediction equations were developed from these variables and were compared to five previously developed models and a method using posterior tibial artery palpation for LOP assessment in an independent sample (n = 14 adult runners). For cuff comparison, the widest two cuffs had significantly lower LOP (mean ~149 mmHg) than the narrowest cuffs (mean ~176 mmHg), with the narrowest cuff unable to reach LOP. The eight methods used to predict LOP ranged in accuracy (mean absolute percent errors 3.9–23.0%), with highest accuracy in equations using mean arterial pressure (MAP) and BMI. Practitioners using blood flow reduction methods should be consistent with cuff use due to demonstrated differences across brands/widths. Equations using MAP and BMI appear best for prediction of leg LOP. [ABSTRACT FROM AUTHOR]

Purpose: Diabetes remission is a phenomenon described in the context of drastic weight loss due to bariatric surgery or low-calorie diets. Evidence suggests that increasing the intake of plant protein could reduce the risk of type 2 diabetes. We sought for association between changes in plant protein intake in the context of 2 healthy diets without weight loss nor glucose-lowering medication, and diabetes remission in coronary heart disease patients from the CORDIOPREV study. Methods: Newly diagnosed type 2 diabetes participants without glucose-lowering treatment were randomized to consume a Mediterranean or a low-fat diet. Type 2 diabetes remission was assessed with a median follow-up of 60 months according to the ADA recommendation. Information on patient's dietary intake was collected using food-frequency questionnaires. At first year of intervention, 177 patients were classified according to changes in plant protein consumption into those who increased or decreased its intake, in order to perform an observational analysis on the association between protein intake and diabetes remission. Results: Cox regression showed that patients increasing plant protein intake were more likely to remit from diabetes than those who decreased its intake (HR = 1.71(1.05–2.77)). The remission occurred mainly at first and second year of follow-up with diminished number of patients achieving remission in the third year onwards. The increase in plant protein was associated with lower intake of animal protein, cholesterol, saturated fatty acids, and fat, and with higher intake of whole grains, fibre, carbohydrates, legumes, and tree nuts. Conclusion: These results support the need to increase protein intake of vegetal origin as dietary therapy to reverse type 2 diabetes in the context of healthy diets without weight loss. [ABSTRACT FROM AUTHOR]

Labor pain is one of the most severe pains experienced by a woman during her life. Interferential current (IFC) is a type of transcutaneous electrical stimulation that can reduce pain, especially deep ones. This randomized controlled clinical trial (RCT) aimed to study the effects of quadripolar IFC on pain and the duration of the active phase of labor in primiparous women. In this RCT, 60 primiparous women were randomized into two groups of IFC and sham IFC. The IFC group received IFC in two periods. The sham group received sham IFC. Primary outcomes were labor pain in different times of active phase and duration of active phase, and secondary outcomes were delivery satisfaction; the number of infants transferred to neonatal intensive care units (NICUs), fetal heart rate (FHR) disorders, Apgar score, partograph variables, and adverse side effects were recorded. Between-group changes showed a significant decrease in labor pain during the active phase in the IFC group compared to the sham IFC group (mean difference (MD) = −0.95; 95% confidence interval (95% CI) = −1.35 to −0.55; P <.001). The mean of active phase duration was significantly shorter in the IFC group than in the sham IFC group (MD = −38.25; 95% CI = −62.84 to −13.67; P =.003). This study showed the effectiveness of interferential electrical stimulation during labor to reduce pain and duration of the active phase, which can be valuable in improving the quality of care and encouraging natural childbirth. [ABSTRACT FROM AUTHOR]

Background: The current childhood obesity pandemic is likely to result in an increased risk of chronic kidney disease (CKD) later in life. Correlations between obesity-related comorbidities and kidney function can be found, but it is unclear to what extent this is caused by bias due to different mathematical forms of the estimated glomerular filtration rate (eGFR) equations. The present study aimed to analyze correlations between obesity-related comorbidities and different eGFR equations and to investigate whether rescaled serum creatinine (SCr/Q) for sex and age or height might be an alternative biomarker for kidney function estimation. Methods: This cross-sectional cohort study included 600 children with overweight and obesity. Mean age was 12.20 ± 3.28 years, 53.5% were female, and mean BMI z-score was 3.31 ± 0.75. All children underwent a comprehensive assessment that included anthropometrical and blood pressure measurements, laboratory examination, air displacement plethysmography, and polysomnography. Qage and Qheight polynomials were used to rescale SCr and multiple creatinine-based eGFR equations were compared. Results: SCr/Q and almost all GFR estimations significantly correlated with a waist-to-hip ratio, fat mass, homeostasis model assessment for insulin resistance, and triacylglyceride, HDL cholesterol, alanine transaminase, and serum uric acid concentrations. Multiple correlations, however, were not confirmed by all equations, which suggests dependency on the mathematical form of the different eGFR equations. Conclusions: Correlations between obesity-related comorbidities and creatinine-based eGFR are present in children with overweight and obesity, but depend to a large extent on the eGFR equation of choice. SCr/Q might be an alternative biomarker for assessing correlations between obesity-related comorbidities and kidney function in children with overweight and obesity. [ABSTRACT FROM AUTHOR]

The prevalence of hypertension (HTN) among Black women in the United States has increased over the past 10 years with a decline in levels of HTN awareness, treatment, and control. Higher death rates occur in Black women from HTN‐related diseases when compared with women of other racial/ethnic groups. Although interventions aimed at self‐care/self‐management are vital to adults becoming the cornerstone of their own health and well‐being, there is a paucity of research in Black women. This randomized controlled pilot trial substudy examined the influence of a Chronic Disease Self‐Management Program (CDSMP) with tailored coaching versus the CDSMP alone on blood pressure (BP), weight, and scores on self‐care questionnaires and medication adherence for Black women with HTN over 9 months. Eighty‐three women who had completed the CDSMP were randomly assigned to coaching or no coaching. Median age was 54 years and the time since the HTN diagnosis was 9 years. Significant differences were noted in self‐care maintenance and management over time with better self‐care in the treatment group. Though not significant, both groups denoted a trend toward better medication adherence. Almost 60% of the participants in both groups showed improvements in their systolic and/or diastolic BP. However, there was no significant difference between the study groups' BP and weight variables. The CDSMP was effective in decreasing BP and improving medication adherence. Further research is needed to evaluate effective coaching strategies that motivate Black women with HTN toward self‐care management. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to identify physical activity patterns and examine their association with cardiometabolic biomarkers in a cross-sectional design. Methods: Overall 6072 participants (mean age, 60.2 yr; SD 8.6 yr, 50% women) from The Maastricht Study provided daily physical activity data collected with thigh-worn activPAL3 accelerometers. The patterns of daily physical activity over weekdays and weekend days were identified by using Group Based Trajectory Modeling. Cardiometabolic biomarkers included body mass index, waist circumference, office blood pressure, glucose, HbA1c, and cholesterol levels. Associations between the physical activity patterns and cardiometabolic outcomes were examined using the analyses of covariance adjusted for sex, age, education, smoking, and diet. Because of statistically significant interaction, the analyses were stratified by type 2 diabetes status. Results: Overall, seven physical activity patterns were identified: consistently inactive (21% of participants), consistently low active (41%), active on weekdays (15%), early birds (2%), consistently moderately active (7%), weekend warriors (8%), and consistently highly active (6%). The consistently inactive and low active patterns had higher body mass index, waist, and glucose levels compared with the consistently moderately and highly active patterns, and these associations were more pronounced for participants with type 2 diabetes. The more irregular patterns accumulated moderate daily total activity levels but had rather similar cardiometabolic profiles compared with the consistently active groups. Conclusions: The cardiometabolic profile was most favorable in the consistently highly active group. All patterns accumulating moderate to high levels of daily total physical activity had similar health profile suggesting that the amount of daily physical activity rather than the pattern is more important for cardiometabolic health. [ABSTRACT FROM AUTHOR]

To assess the effect of exergaming on the microcirculation function of adolescents with overweight or obesity, this non-randomized clinical trial efficacy was conducted with 61 adolescents aged between 10 and 16 years. The intervention group (n = 31) performed exergaming three times per week for 8 weeks. Both groups received guidelines for a healthy diet and staying physically active. Microcirculation was assessed using a laser Doppler flowmetry (LDF) at baseline and after intervention. Primary outcomes derived from LDF assessment included resting flow, maximum flow, maximum/resting flow ratio, area under hyperemia, and post-occlusive reactive hyperemia (PORH). Secondary outcomes were body mass index and systemic blood pressure. Unpaired Student's t test compared intergroup analyses, and paired Student's t test compared intragroup analyses. The significance was set at 5%. Statistical analysis intergroup and intragroup was done by fitting a two-way mixed effects model. Microcirculation was similar between groups. Maximum flow (109.0 ± 38.3 versus 124.6 ± 43.0, P = 0.022), area under hyperemia (1614 ± 472 versus. 1755 ± 461, P = 0.023), and PORH (2.18 ± 0.49 versus 2.01 ± 0.52, P = 0.031) were statistically different after intervention. Body mass index decreased in intervention (24.5 ± 3.8–24.1 ± 4.0 kg/m2, P = 0.002) and control (25.2 ± 3.2–25.1 ± 3.3 kg/m2, P = 0.031) groups. Systolic blood pressure decreased significantly in the intervention group (110 ± 10–106 ± 9 mm Hg; P = 0.041) but not diastolic blood pressure (66.0 ± 7–68.8 ± 8 mm Hg; P = 0.089). Exergaming for 8 weeks led to improvements in the microcirculation function in adolescents with overweighed or obesity. Clinical trials: NTC03532659. [ABSTRACT FROM AUTHOR]

Background: Aboriginal and Torres Strait Islander people have higher rates of diabetes and its complications than non‐Aboriginal people. Rumbalara Aboriginal Co‐operative is the major primary healthcare provider for Aboriginal people in the Greater Shepparton region. Aims: To evaluate the baseline metabolic parameters and presence of diabetes complications in people with type 2 diabetes attending Rumbalara Aboriginal Co‐operative in 2017 and compare it with other Aboriginal and Torres Strait Islander studies and Australian specialist diabetes services. Methods: Clinical and biochemical characteristics, including diabetes type, age, weight, body mass index (BMI), blood pressure, micro‐ and macrovascular complications, glycosylated haemoglobin (HbA1c), haemoglobin, renal function, lipid profile, urine albumin:creatinine ratio, diabetes medications, renin angiotensin system inhibition therapies, HMG‐CoA reductase inhibitors and antiplatelet agents, were determined. Results: One hundred and twenty‐six individuals had diabetes, 121 had type 2 diabetes. One hundred and thirteen identified as Aboriginal and/or Torres Strait Islander. Median age was 57.5 (48–68) years, median HbA1c was 7.8% (6.8–9.6) and median BMI was 33.4 kg/m2 (29–42.3). Compared with other Australian Aboriginal and Torres Strait Islander populations, this population was older and had more obesity, but with better glycaemia management. Compared with specialist diabetes services, this population was of similar age, with greater BMI but comparable HbA1c. Conclusions: Aboriginal people living with type 2 diabetes attending this regional Aboriginal health service have comparable glycaemic management to specialist diabetes services in Australia, managed largely by primary care physicians with limited access to specialist care for the past 5 years. [ABSTRACT FROM AUTHOR]

Noise exposure and hypertension are associated with hearing loss. Occupational noise exposure for more than 10 years may increase the risk of hearing loss by 29%. Occupational noise exposure for more than 10 years and hypertension may increase the risk of hearing loss by 55%. Background: Combined effect of elevated blood pressure and occupational noise exposure on hearing loss have rarely been evaluated among Chinese population. Methods: This cross-sectional study was conducted in 242,811 participants. Logistic regression model was performed to estimate the independent and combined associations. Results: Compared with participants without occupational noise exposure, the risk of bilateral high-frequency hearing loss (BHFHL) was significantly higher for noise exposure 10 years or more (odds ratio [OR] = 1.29, 95% confidence interval [95% CI] = 1.23–1.35). Compared with no hypertension, participants with grade 1 hypertension had higher risk of BHFHL in all age groups (OR, 1.14; 95% CI, 1.09–1.20). As to the combined effect, the highest BHFHL risk was found in males (OR, 1.51; 95% CI, 1.37–1.67), especially among participants with grade 1 hypertension older than 50 years (OR, 1.65; 95% CI, 1.46–1.88). Conclusions: Elevated blood pressure may synergistically influence hearing loss combined with occupational noise exposure. [ABSTRACT FROM AUTHOR]

Background: Gout is triggered by high urate levels and causes inflammation, pain, and an impaired quality of life. Immersion in water at 20-30°C reduces inflammation and pain in arthritis. Yet, relationships of immersion in water at 20-30°C with urate levels and the nucleotide-binding domain (NOD)-like receptor protein 1 (NLRP1) inflammasome have never been clarified. Objectives: We aimed to investigate the effects of immersion in water at 20-30°C on urate levels, the NLRP1 inflammasome, pain, and quality of life among acute gout patients. Methods: A community-based randomized control trial design was used with 2 parallel-intervention groups: immersion in water at 20-30°C (20 min/day for 4 weeks) group and a control group. In total, 76 eligible participants in Tomohon City, Indonesia, were assigned using block randomization. We analyze the results (coef. ß) and 95% confidence intervals (CIs) using a generalized estimating equation model. We analyzed mediating effects using a path analysis. Results: Significant pain alleviation (ß = -2.06 [95% CI = -2.67~-1.45]; ß = -2.42 [95% CI = -2.97~-1.87]) and improved quality of life (ß = 5.34 [95% CI = 3.12-7.57]; ß = 9.93 [95% CI = 7.02-12.83]) were detected at 2 and 4 weeks of follow-up compared to the pre-test and control group. Urate levels (ß = -0.34 [95% CI = -0.52~-0.16]) were reduced at the 2-week follow-up, but there was no significant change in the NLRP1 inflammasome compared to the pre-test and control group after immersion in water at 20-30°C. Both the NLRP1 inflammasome (ß = -0.48 [95% CI = -0.63~-0.34]); water 0.01) and urate levels (ß = -0.11 [95% CI = -0.24~-0.03]; p < 0.01) had partial indirect (mediating) effects on the link between immersion in water at 20-30°C and pain at the 4-week follow-up. Conclusions: Immersion in water at 20-30°C significantly decreased pain and increased the quality of life. Immersion in water at 20-30°C mediated NLRP1 and urate levels to decrease pain, although it had no significant effect on the NLRP1 inflammasome concentration after 4 weeks of follow-up and reduced urate levels only at 2 weeks after immersion in water at 20-30°C. [ABSTRACT FROM AUTHOR]

Objectives: Hypertension is one of the essential modifiable risk factors in causing stroke, renal disease, cardiovascular diseases, and peripheral artery disease. Epicardial fat tissue is regarded as endocrine organ and is metabolically active as it produces angiotensinogen and free fatty acids which are proinflammatory cytokines and are atherogenic. The presence of microalbuminuria has been associated with endothelial dysfunction that predisposes to cardiovascular events. The aim of this study is to determine the association of epicardial fat tissue with age, sex, serum creatinine, left ventricular (LV) mass, serum albumin, low-density lipoprotein (LDL), and triglycerides in patients with essential hypertension. Materials and Methods: One hundred patients with essential hypertension were divided into two groups each having 50 patients. Group A included urinary albumin creatinine ratio (UACR) <30 mg/g. Group B included UACR >30 mg/g. Age, body mass index, blood pressure, creatinine, urea, albumin, LDL, triglycerides, and epicardial adipose tissue thickness (EAT) were evaluated and compared between two groups. All patients underwent UACR, transthoracic echocardiography to determine EAT, LV mass, and ejection fraction. Results: In our study, EAT ranged from 2 mm to 6.9 mm, with mean value of 3.21 mm and 5.12 mm in Groups A and B, respectively. Mean EAT values were found to be higher in Group B compared to A and was found to be statistically significant. Similarly, LDL, triglycerides, serum albumin levels, and LV mass showed significant difference among two groups. Serum albumin level in Group B was significantly reduced than the patients with normal urine albumin creatinine ratio. Conclusion: EAT serve as an important indicator in patients with essential hypertension to determine target organ damage and to stratify high risk group. [ABSTRACT FROM AUTHOR]

Obstructive sleep apnea (OSA) severity can vary markedly from night-to-night. However, the impact of night-to-night variability in OSA severity on key cardiovascular outcomes such as hypertension is unknown. Thus, the primary aim of this study is to determine the effects of night-to-night variability in OSA severity on hypertension likelihood. This study uses in-home monitoring of 15,526 adults with ~180 nights per participant with an under-mattress sleep sensor device, plus ~30 repeat blood pressure measures. OSA severity is defined from the mean estimated apnea–hypopnoea index (AHI) over the ~6-month recording period for each participant. Night-to-night variability in severity is determined from the standard deviation of the estimated AHI across recording nights. Uncontrolled hypertension is defined as mean systolic blood pressure ≥140 mmHg and/or mean diastolic blood pressure ≥90 mmHg. Regression analyses are performed adjusted for age, sex, and body mass index. A total of 12,287 participants (12% female) are included in the analyses. Participants in the highest night-to-night variability quartile within each OSA severity category, have a 50–70% increase in uncontrolled hypertension likelihood versus the lowest variability quartile, independent of OSA severity. This study demonstrates that high night-to-night variability in OSA severity is a predictor of uncontrolled hypertension, independent of OSA severity. These findings have important implications for the identification of which OSA patients are most at risk of cardiovascular harm. [ABSTRACT FROM AUTHOR]

Background: Bereavement is a common traumatic event associated with adverse health outcomes across the life course. Despite these risks, not all bereaved individuals experience these negative effects. Limited scientific consensus exists on how to define resilience in individuals who have experienced the death of a loved one. Methods: Using a sample of N = 3766 youth from the Avon Longitudinal Study of Parents and Children birth cohort, we identified bereavement of a family member between ages 7 and 8.5. We derived and compared three different approaches to assess resilience among bereaved youth. Trajectory-based psychological resilience identified sub-groups with similar psychological symptom profiles between ages 6 and 16 using latent growth mixture models. Relative psychological resilience at age 16 leveraged standardized residuals from a model regressing psychological symptoms on bereavement to determine better-than-expected psychological functioning relative to bereavement status. Relative cross-domain resilience around age 16 was a sum score of the residuals approach applied to eight unique domains of health. Predictive validity of each approach was assessed using depressive symptoms at age 17.5 Results: Overall, N = 877 (23%) youth were bereaved of a family member between ages 7 and 8.5. Using latent growth mixture models, a three-class solution described 84% of bereaved youth with low and stable psychological symptoms over time, 8% with worsening symptoms, and 8% with improving yet elevated symptoms. Each relative resilience score was largely concordant with the trajectory-based approach in identifying individuals as resilient or not, though relative psychological resilience demonstrated a stronger degree of concordance than the cross-domain score. Relative psychological and cross-domain resilience exhibited moderate to low correlation, depending on the domains included (r = 0.14–0.43). For each approach, resilience significantly predicted lower depressive symptoms at age 17.5, highlighting predictive validity of these measures. Conclusions: Psychological symptom trajectories among bereaved youth aligned with those previously identified among bereaved adults. The residual-based approach to defining resilience exhibited limited utility in the context of bereavement. When identifying risk and resilience after bereavement, researchers and clinicians must address the interplay across psychosocial and physical health domains, as bereaved youth considered resilient from a mental health perspective may benefit from intervention in other domains. [ABSTRACT FROM AUTHOR]

Using a sample of US adults aged 65 years and older, we examined the role of dietary quality in cystatin C change over 4 years and whether this association varied by race/ethnicity. The Health and Retirement Study provided observations with biomarkers collected in 2012 and 2016, participant attributes measured in 2012, and dietary intake assessed in 2013. The sample was restricted to respondents who were non-Hispanic/Latino White (n 789), non-Hispanic/Latino Black (n 108) or Hispanic/Latino (n 61). Serum cystatin C was constructed to be equivalent to the 1999–2002 National Health and Nutrition Examination Survey (NHANES) scale. Dietary intake was assessed by a semi-quantitative FFQ with diet quality measured using an energy-adjusted form of the Alternative Healthy Eating Index-2010 (AHEI-2010). Statistical analyses were conducted using autoregressive linear modelling adjusting for covariates and complex sampling design. Cystatin C slightly increased from 1·2 mg/l to 1·3 mg/l over the observational period. Greater energy-adjusted AHEI-2010 scores were associated with slower increase in cystatin C from 2012 to 2016. Among respondents reporting moderately low to low dietary quality, Hispanic/Latinos had significantly slower increases in cystatin C than their non-Hispanic/Latino White counterparts. Our results speak to the importance of considering racial/ethnic determinants of dietary intake and subsequent changes in health in ageing populations. Further work is needed to address measurement issues including further validation of dietary intake questionnaires in diverse samples of older adults. [ABSTRACT FROM AUTHOR]

Introduction: Aging is accompanied by physiological changes in cardiovascular regulation that can be evaluated using a variety of metrics. In this study, we employ machine learning on autonomic cardiovascular indices in order to estimate participants' age. Methods: We analyzed a database including resting state electrocardiogram and continuous blood pressure recordings of healthy volunteers. A total of 884 data sets met the inclusion criteria. Data of 72 other participants with an BMI indicating obesity (>30 kg/m²) were withheld as an evaluation sample. For all participants, 29 different cardiovascular indices were calculated including heart rate variability, blood pressure variability, baroreflex function, pulse wave dynamics, and QT interval characteristics. Based on cardiovascular indices, sex and device, four different approaches were applied in order to estimate the calendar age of healthy subjects, i.e., relevance vector regression (RVR), Gaussian process regression (GPR), support vector regression (SVR), and linear regression (LR). To estimate age in the obese group, we drew normal-weight controls from the large sample to build a training set and a validation set that had an age distribution similar to the obesity test sample. Results: In a five-fold cross validation scheme, we found the GPR model to be suited best to estimate calendar age, with a correlation of r=0.81 and a mean absolute error of MAE=5.6 years. In men, the error (MAE=5.4 years) seemed to be lower than that in women (MAE=6.0 years). In comparison to normalweight subjects, GPR and SVR significantly overestimated the age of obese participants compared with controls. The highest age gap indicated advanced cardiovascular aging by 5.7 years in obese participants. Discussion: In conclusion, machine learning can be used to estimate age on cardiovascular function in a healthy population when considering previous models of biological aging. The estimated age might serve as a comprehensive and readily interpretable marker of cardiovascular function. Whether it is a useful risk predictor should be investigated in future studies. [ABSTRACT FROM AUTHOR]

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Background Undiagnosed diabetes is a significant public health concern in India, considering the accumulative burden of diabetes and its long-term complications. We have estimated the prevalence and factors associated with undiagnosed diabetes in India. Methods We used data from the fifth round of the National Family Health Survey (NFHS-5, 2019-21) to estimate undiagnosed diabetes prevalence aged under 50 (15-49) years. A log-binomial model with survey-adjusted Poisson regression was used to estimate the prevalence risk ratio (PR) between undiagnosed diabetes and various factors. Multinomial logistic regression analysis was performed to examine the factors associated with diagnosed diabetes (vs. healthy) and undiagnosed diabetes (vs. healthy). All the analyses were survey-weighted and stratified by gender and reported with 95% confidence intervals. Results The prevalence of diabetes for individuals aged 15-49 years was found to be 4.90% (4.80 to 5.00%) from the NFHS-5. Among them, the proportion of individuals with undiagnosed diabetes was 24.82% (24.07 to 25.59%), with higher among males (28.82% (26.45 to 31.30%)) than females (24.22% (23.44 to 25.01%)). The overall prevalence of undiagnosed diabetes was 1.22% (1.18 to 1.26%), with a higher prevalence among males (1.60% (1.46 to 1.76%)) than females (1.17% (1.13 to 1.21%)). Individuals who are middle-aged (45-49), have a higher body mass index (BMI), and are in a lower wealth index group, or live in the southern regions of India are at a higher risk of being undiagnosed for diabetes. Conclusion One in every four having diabetes is undiagnosed. The study highlights the need for public health interventions to improve diabetes screening and access to health care, particularly among middle-aged individuals, and those with higher BMI, as well as addressing lifestyle and dietary factors. The findings also reveal disparities in diabetes burden among population subgroups in India, underscoring the need for targeted efforts. [ABSTRACT FROM AUTHOR]

Independently of absolute BMI values, the amount, onset date, and duration of early body weight gain may influence cardio-metabolic health later in adulthood. Values of cardiac and metabolic variables from a cohort study of morbidly obese patients were retrospectively analyzed to study the association between early weight history and metabolic syndrome (MetS) occurrence in adults. Of 950 patients with severe morbid obesity (age 44.3 ± 13.8 y, BMI 42.5 ± 7.0 kg/m2), 31.4% had started excess weight gain in childhood (CH), 19.9% in adolescence (ADO), and 48.7% in adulthood (AD). Despite different BMI values, MetS prevalence (57.8%) was not significantly different in the three groups (54.4% CH vs. 57.7% ADO vs. 59.8% AD, p = 0.59). The overweight onset period was not significantly associated with the development of MetS in adults (ADO: OR = 1.14 [0.69–1.92], p = 0.60; AD: OR = 0.99 [0.62–1.56], p = 0.95) despite a higher BMI in the early obesity onset group. Weight gain of more than 50% after age 18 years significantly increased the risk of MetS (OR = 1.75 [1.07–2.88], p = 0.026). In addition to crude BMI values, analysis of body mass trajectories is a relevant clinical tool in the assessment of metabolic risk, suggesting that the magnitude of weight gain may be more important for metabolic syndrome progression than the period of obesity onset. [ABSTRACT FROM AUTHOR]

Introduction: Some authors have been able to determine that cardiovascular disease has its origins in early life stages and that the risk of suffering them is determined by the effect associated with exposure to cardiovascular risk factors over a long time, all of which produce a negative effect on the quality of life. Objective: We aimed to identify cardiovascular risk factors in schooled adolescents within public institutions of education in Villavicencio. Methods: This was a cross-sectional, prospective, observational study developed in eight high schools with children between 13 and 17 years old. A written standardised survey was applied (questionnaire type), which was auto-administered from the instrument denominated Global School-based Student Health Survey (GSHS) of the World Health Organisation (WHO). The modules were physical activity, eating behaviour, and drugs and alcohol consumption. In addition, the researchers took measures of weight, size, waist circumference, blood pressure and blood tests to measure total cholesterol, high-density lipoproteins (HDL), low-density lipoproteins (LDL), triglycerides and glucose, with each student's informed consent and that of his or her guardian. Statistics used were: average, standard deviation, interquartile ranges, proportions, Chi-square, and logistic regression. Results: A total of 1 504 students were analysed. Age and physical activity were not significantly associated with cardiovascular risk. Conclusions: The results allow us to establish that the predominant risk factors for cardiovascular disease in young adolescents between 13 and 17 years old school in high school in Villavicencio are: smoking, alcohol consumption, body mass index (BMI), and family antecedents (such as precursor pathologies and chronic renal insufficiency), the latter with a risk opportunity of 15.5 times of having cardiovascular disease in this population group. [ABSTRACT FROM AUTHOR]

Dietary preworkout supplements are popular among recreational exercisers and athletes. However, the effects of these supplements on the vasculature, both at rest and during exercise, are not well studied. Therefore, the purpose of this study was to determine the effect of 1 week of supplementation with a multi-ingredient dietary preworkout supplement on measures of vascular function at rest and immediately following acute resistance exercise in young, recreationally active adults. Twelve participants (9 males and 3 females; mean ± SD: age = 24.5 ± 3.4 years and body mass index = 24.3 ± 4.7 kg/m2) completed this double-blind, randomized, crossover design study. After familiarization, participants were randomized to either a taste-matched placebo or the preworkout supplement for 1 week preceding the testing visits. Participants underwent measures of vascular function, including brachial artery flow-mediated dilation, measures of central and peripheral blood pressure, and measures of arterial stiffness via pulse wave analysis and pulse wave velocity. All measures were taken at rest and immediately following an acute bilateral leg press exercise session. Resting and postacute exercise flow-mediated dilation, blood pressure, and arterial stiffness were similar between the placebo and the preworkout supplement visits. One week of multi-ingredient preworkout supplementation does not affect vascular function at rest or in response to an acute bout of resistance exercise in young, healthy, recreationally active individuals. [ABSTRACT FROM AUTHOR]

Background: Features of metabolic syndrome such as abdominal obesity, insulin resistance, hypertension and dyslipidemia are commonly encountered in polycystic ovary syndrome (PCOS). Recent evidence has suggested an association between high serum uric acid/creatinine (UA/Cr) ratio and metabolic syndrome however, no studies have investigated this association in PCOS. The current study was conducted to investigate the relationship between UA/Cr ratio and PCOS and to identify whether UA/Cr ratio and free androgen index (FAI) have an additive interaction for detection of PCOS risk in obese women. Methods: This study enrolled 40 obese women with PCOS and 40 control women with regular menstrual cycles matched for age and body mass index (BMI). Anthropometric measurements, fasting glucose, fasting insulin, homeostasis model assessment of insulin resistance (HOMA-IR), lipids profile, luteinizing hormone (LH), follicle stimulating hormone (FSH), estradiol, dehydroepiandrosterone sulfate (DHEAS), sex hormone binding globulin (SHBG), total testosterone, free androgen index (FAI), UA/Cr ratio were assessed. Results: Serum UA/Cr ratio was significantly higher in obese women with PCOS than in non-PCOS women. UA/Cr ratio was correlated with BMI, waist and neck circumferences, blood pressure, fasting insulin, HOMA-IR, lipids, LH/FSH, estradiol, DHEAS, total testosterone, FAI and SHBG. UA/Cr ratio and FAI were independent risk factors for PCOS in obese women however, the addictive interaction between UA/Cr ratio and FAI had a higher fold risk (OR: 4.3, 95% CI, 3.4–7.58) and a more significance (P = 0.002) for determination of PCOS. Conclusion: Serum UA/Cr ratio combined with FAI can exert an additive or synergistic impact on prediction of PCOS in obese women. [ABSTRACT FROM AUTHOR]

Uncontrolled prediabetes can develop into Type 2 Diabetes mellitus (T2DM). The incidence of T2DM among adults in Pontianak, Indonesia was reported remarkably high. Therefore, this study aimed to investigate the risk factors for prediabetes in adults living in urban areas of Pontianak, Indonesia. A cross-sectional study was conducted in 5 subdistricts of Pontianak. A total of 506 adults underwent screening to obtain subjects with fasting blood glucose (FBS) of ≤124 mg/dL and aged >30 years. Blood pressure and body mass index (BMI) were measured. Interview using a structured questionnaire were performed to obtain data on predictor variables (age, sex, education, income, health insurance, tobacco use, history of hypertension, gout, high cholesterol level, frequency of exercise per week, and diabetic education). The prevalence of prediabetes among subjects was significantly high (76.4%). Subjects were predominantly above 40 years, female, had low income, low education level, and had health insurance. About a third of the subjects had a history of hypertension, gout, and high cholesterol level, respectively. The exercise frequency was mostly less than 3 times/week, and the BMI was mainly classified as overweight and obese. The result of spearman's rho correlation showed that age (r = 0.146; p = 0.022) and BMI (r = 0.130; p = 0.041) significantly correlated with prediabetes incidence. Moreover, the chi-square analysis demonstrated that health insurance ownership (OR = 4.473; 95% CI 1.824–10.972; p ≤ 0.001), history of hypertension (OR = 3.096; 95% CI 1.542–6.218; p = 0.001), and history of gout (OR = 2.419; 95% CI 1.148–5.099; p = 0.018), were associated with prediabetes incidence. For all these significant risk predictors except BMI, the significant associations were found only among female subjects after specific sex analysis. Moreover, multivariate logistic regression showed that health insurance ownerships (OR = 5.956; 95% CI 2.256–15.661; p ≤ 0.001) and history of hypertension (OR = 3.257; 95% CI 1.451–7.311; p = 0.004), and systolic blood pressure (OR = 2.141; 95% CI 1.092–4.196; p = 0.027) were the risk factors for prediabetes. It is concluded that the prevalence of prediabetes is probably high especially among urban people in Pontianak, Indonesia. Health insurance ownership and hypertension may have an important role in prediabetes management. The risk factors might be different between male and female. [ABSTRACT FROM AUTHOR]