PubMed Health⌕ Search

Biomedical subjects

F Rodríguez-Artalejo

Publications and source records attributed to F Rodríguez-Artalejo.

At least 19 recordsLinked to original sources
PubMed2006

Influence of childhood socioeconomic circumstances, height, and obesity on pulse pressure and systolic and diastolic blood pressure in older people.

This study assesses the association of childhood socioeconomic circumstances, height, and obesity with components of blood pressure. We selected 4009 people representative of the Spanish population aged 60 years and older, and estimated systolic blood pressure (SBP), diastolic blood pressure (DBP), and pulse pressure (PP) according to childhood social class, height, and obesity. No association was found between childhood social class and blood pressure. SBP showed an inverse gradient and DBP a direct gradient with height, although an independent association between height and DBP was found only in women. Stature was independently associated with increased DBP in women with central obesity, but there was no association between height and DBP in women without central obesity. Short stature was independently associated with increased PP. Body mass index and waist-to-hip ratio were independently associated with increased DBP in women, and waist-to-hip ratio was independently associated with increased PP in men, while waist circumference was independently associated with increased DBP and increased PP in women. These results do not support the assumed effect of socioeconomic circumstances in early life on blood pressure, which may depend on the context and/or study population. The relations observed between height and blood pressure support the hypothesis that PP could be a mediator of the association between short stature and increased cardiovascular risk. The relationship between obesity measures and components of blood pressure reinforces the recommendation to reduce body weight in order to reduce blood pressure.

Adult↗
PubMed2006

Saturated fat in the diet of Spanish children: relationship with anthropometric, alimentary, nutritional and lipid profiles.

OBJECTIVE: To compare the anthropometric, alimentary, nutritional and lipid profiles and global diet quality of Spanish children according to saturated fat intake. DESIGN: This was a cross-sectional study. Food data were collected using a food-frequency questionnaire. SUBJECTS AND METHODS: The sample included 1112 children of both sexes, aged between 6 and 7 years, selected by means of random cluster sampling in schools. The plasma lipid profile included measurements of low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglycerides, apolipoprotein A1 (apoA1) and apolipoprotein B (apoB). Global diet quality was evaluated by the Dietary Variety Index (DVI) and the Healthy Eating Index (HEI). RESULTS: Energy intake, DVI and HEI of children from the lower quartile of saturated fat intake (LL) were higher (P<001) than in the remaining children (UL). However, there were no significant differences in average height or weight between groups. The UL children had lower intakes of meat, fish, vegetables, fruits and olive oil and a higher intake of dairy products (P<0.001). The intakes of fibre, vitamins C, D, B6, E and folic acid were higher in the LL children, who had lower intakes of vitamin A and calcium. The ratios LDL-C/HDL-C and apoB/apoA1 were lower (P=0.04) in the LL children (1.87 and 0.52, respectively) than in the UL children (2.02 and 0.54, respectively). CONCLUSIONS: The growth rate of children does not seem to be affected by the level of saturated fat intake. Furthermore, at the levels of intake observed in this study, diets with less saturated fat are associated with better alimentary, nutritional and plasma lipid profiles.

Anthropometry↗
PubMed2006

Use of antisecretory drugs among consumers of non-steroidal anti-inflammatory drugs in the general population.

BACKGROUND: Overall success of prophylactic strategies against non-steroidal anti-inflammatory drug (NSAID) complications depends on the use of gastroprotective drugs. AIM: We examined the use of antisecretory drugs in NSAID users in the general population of Spain. PARTICIPANTS AND METHODS: In 2002, a phone interview was conducted with 2500 persons representative of the general population of Spain. Using a validated questionnaire, we asked about the use of NSAID, aspirin and antisecretory drugs, and history of digestive diseases. We estimated the use of antisecretory drugs in NSAID users, according to risk factors for gastrointestinal (GI) lesions associated with NSAID. RESULTS: In total, 425 persons [17.0% (95% CI 15.5-18.5%)] were NSAID users. Of them, 69 persons (16.2%; 95% CI 12.7-19.7%) used antisecretory drugs [proton pump inhibitor (PPI) 11.8% and H2-blocker 4.9%]. Forty-four of the 224 NSAID users (19.6%) with one risk factor for GI lesions were antisecretory drug users (PPI 16%; H2-blocker 4%), compared with 24 of the 197 NSAID users (12.7%) without risk factors (PPI 6.6%; H2-blocker 6.1%). NSAID users with risk factors for GI lesions but without upper GI (UGI) symptoms did not consume more antisecretory drugs than equivalent non-NSAID users (12.9% vs. 10.7%). CONCLUSION: Current strategies to prevent GI lesions in NSAID users are not effective from a population perspective, especially in subjects without UGI symptoms.

Adult↗
PubMed2005

Social network and health-related quality of life in older adults: a population-based study in Spain.

This study examined the association between social network and health-related quality of life (HRQL) in older adults and compared this against the association between HRQL and a disabling disease such as osteoarthritis. A cross-sectional survey was done on 3600 subjects representative of the Spanish non-institutionalised population aged 60 years and over. Data were collected through home-based personal interview and physical examination. HRQL was measured with the SF-36 health questionnaire. Data analysis was performed with multiple linear regression models with adjustment for the main confounders. Of the total sample, 38.6% of subjects were unmarried, 17.6% were living alone, 4.7% saw their family seldom or never, and 2.9% saw their friends seldom or never. Unmarried status and living alone were associated with lower scores in the social and mental quality-of-life components, though statistical significance was not in general attained (p > 0.05). Seeing family members seldom or never was associated (p < 0.05) with worse scores in the following scales of SF-36 questionnaire: role-physical, body pain, general health and mental health. HRQL was lower among those who saw friends seldom or never, and the reduction in HRQL proved similar to that associated with osteoarthritis, on the physical functioning (coefficients -8.4 vs. -8.1) and general health scales (-7.8 vs. -6.6); the reduction in HRQL was even greater than that associated with osteoarthritis for other scales, such as vitality (-9.6 vs. -6.7; p > 0.05) and social functioning (-14.5 vs. -3.7; p < 0.05). We conclude that only a small proportion of Spain's elderly population lack frequent social relationships, yet low frequency of relationships with friends is associated with a decline in quality of life similar to or greater than that associated with osteoarthritis.

Aged↗
PubMed2005

Acute health problems among subjects involved in the cleanup operation following the Prestige oil spill in Asturias and Cantabria (Spain).

The purpose of this study was to evaluate exposure conditions and acute health effects in subjects participating in the Prestige oil spill cleanup activities and the association between these and the nature of the work and use of protection devices in the regions of Asturias and Cantabria (Spain). The sample comprised 400 subjects in each region, selected from a random sampling of all persons involved in cleanup activities, stratified by type of worker and number of working days. Data were obtained via a structured questionnaire and included information on specific tasks, number of working days, use of protective materials, and acute health effects. These effects were classified into two broad groups: injuries and toxic effects. Data analysis was performed using complex survey methods. Significant differences between groups were evaluated using Pearson's chi(2) test. Unconditional logistic regression was used to compute odds ratios and 95% confidence intervals. Bird cleaners accounted for the highest prevalence of injuries (19% presented with lesions). Working more than 20 days in highly polluted areas was associated with increased risk of injury in all workers. Occurrence of toxic effects was higher among seamen, possibly due to higher exposure to fuel oil and its components. Toxic effects were more frequent among those working longer than 20 days in highly polluted areas, performing three or more different cleaning activities, having skin contact with fuel oil on head/neck or upper limbs, and eating while in contact with fuel or perceiving disturbing odors. No severe disorders were identified among individuals who performed these tasks. However, potential health impact should be considered when organizing cleanup activities in similar environmental disasters.

Accidents↗
PubMed2005

Changes in body weight and health-related quality-of-life in the older adult population.

BACKGROUND: No other study has ascertained the short-term impact of weight change on health-related quality-of-life (HRQL) on a national sample of older adults. OBJECTIVE: To examine the relationship between change in body weight and HRQL among the older adult population. METHODS: We carried out a prospective study from 2001 to 2003 of a cohort of 2364 persons, representative of the noninstitutionalized Spanish population aged 60 y and over. Weight changes during the period 2001-2003 were self-reported, and HRQL in 2003 was measured with the SF-36 questionnaire. Analyses adjusted for the principal confounders. RESULTS: Among nonobese women (body mass index (BMI) 18.5-29.9 kg/m(2)), and compared to those who underwent no important weight change, weight loss was associated with a clinically significant worsening in the role-physical, vitality, and social functioning SF-36 scales. Among obese women (BMI> or =30 kg/m(2)), weight gain led to a reduction in HRQL for four of the eight SF-36 scales, while weight loss was associated with worse scores in role-emotional and mental health scales. Results were usually similar for men, though of lower magnitude. In both sexes, weight change was associated with a reduction of over 5 points on several physical and mental scales of the SF-36, which indicates a clinically relevant worsening in HRQL. CONCLUSION: Weight change is associated with worse HRQL among the older adults, principally women. From the stance of HRQL, it is desirable to prevent weight gain, especially among the obese, and weight loss, especially among the nonobese.

Aged↗
PubMed2004

Obesity and socioeconomic position measured at three stages of the life course in the elderly.

OBJECTIVE: To investigate the association between socioeconomic position, measured at three stages of the life course, and obesity in the elderly. DESIGN: Cross-sectional study carried out in 2000-2001. SUBJECTS: In total, 4009 subjects aged 60 y and older, representative of the Spanish noninstitutionalised population. RESEARCH METHODS AND PROCEDURES: We estimated body mass index (BMI) and waist circumference (WC) by social class in childhood, by educational level and by adult social class, as well as the association between these two obesity measures and each socioeconomic characteristic after adjusting for the other two. RESULTS: In men, no relation was found between the two measures of obesity studied and socioeconomic circumstances throughout the life course. Nor was any relation found in women between social class in childhood and the two measures of obesity after adjusting for the other two socioeconomic variables. In contrast, BMI and WC in women showed a statistically significant inverse gradient with educational level and with adult social class after adjusting for age and the rest of the socioeconomic variables. CONCLUSIONS: In general, these results support the small amount of existing evidence on the association between obesity and abdominal obesity and socioeconomic position by educational level and adult social class. The results for social class in childhood do not support the existing evidence, and suggest that this association may depend on specific historic and cultural circumstances.

Abdomen↗
PubMed2003

Greater dietary variety is associated with better biochemical nutritional status in Spanish children: the Four Provinces Study.

BACKGROUND AND AIM: Although dietary variety has been associated with a better nutritional profile, its possible role in obesity raises doubts about its overall health benefits. In this study, we examined the association between dietary variety and anthropometric variables, food intake and various food intake biomarkers in Spanish children. METHODS AND RESULTS: This was a cross-sectional study of 1112 children aged 6-7 years from Cadiz, Murcia, Orense and Madrid, who were selected by means of the random cluster-sampling of schools. Information concerning food and nutrient intake was obtained using a food frequency questionnaire, and a dietary variety index (DVI) was calculated on the basis of the number of different foods consumed more than once a month. The anthropometric variables (weight and height), and plasma lipid and vitamin levels were determined using standardised methods. Our results show that the body mass index (BMI) did not vary substantially as a function of DVI: it was 16.9 in the lowest DVI tertile and 17.2 in the highest (p=0.20). Unlike BMI, the DVI positively correlated (p<0.05) with the plasma levels of alpha and beta-carotene, lycopene, retinol, alpha-tocopherol and vitamin E, with energy intake, and with most of the foods, particularly vegetables, fruit and sausages (respective correlation coefficients of 0.43, 0.26 and 0.23). CONCLUSIONS: Dietary variety is associated with a better food and nutritional profile in Spanish children. Nevertheless, the presence of a positive association between the DVI and energy intake, and the consumption of sausages and pre-cooked products calls for the recommendation of a varied diet of healthy foods, such as cereals (especially whole grains), fruits and vegetables.

Biomarkers↗
PubMed2003

A simple estimate of mortality attributable to excess weight in the European Union.

OBJECTIVE: To estimate the current burden of mortality attributable to excess weight in the European Union (EU). METHODS: Prevalence of overweight (body mass index, BMI 25-29.9 kg/m(2)) and obesity (BMI >or=30 kg/m(2)) were based on self-reported data from a survey with samples representative of the 15 EU Member States in 1997. Primary source of relative risk (RR) of death by BMI was the first American Cancer Prevention Study (CPS I). Additional calculations were performed to account for effect of smoking (using CPS I data for non- or never-smokers), for pre-existing illness (using the second CPS, CPS II, data for healthy never-smokers) and using RRs derived from European rather than US data (using data from a meta-analysis of prospective studies). Mortality attributable to excess weight was calculated by combining the prevalences of overweight and obesity, the RRs, and the number of deaths in the EU countries. RESULTS: Annual deaths attributable to overweight and obesity totalled approximately 279 000 when RRs for all subjects were used. When RRs for nonsmokers only were applied to the entire population, about 304 000 deaths were attributable to excess weight. In analyses using RRs which controlled for both smoking and history of disease, the number of deaths attributable to excess weight was estimated at about 337 000 based on European data and at about 401 000 based on US data. In the EU, therefore, a minimum of 279 000 deaths were attributable to excess weight (7.7% of all deaths, varying from 5.8% for France through 8.7% for the UK). More attributable deaths occurred among the obese (175 000) than among the overweight (104 000). Around 70% were cardiovascular disease deaths (195 000) and 20% cancer deaths (53 000). CONCLUSION: Mortality attributable to excess weight is a major public health problem in the EU. At least one in 13 annual deaths in the EU are likely to be related to excess weight.

Adult↗
PubMed2003

Spanish children's diet: compliance with nutrient and food intake guidelines.

OBJECTIVE: To compare the diet of Spanish children against the nutrient and food intake guidelines. To calculate an index of overall diet quality and check its validity against nutrient intake. DESIGN AND SETTING: Cross-sectional study in four cities in Spain, where information on food and nutrient intake was obtained from schoolchildren through a food frequency questionnaire. PARTICIPANTS: The sample included 1112 children (overall response rate of 85%) attending public and private schools and aged 6-7 y. Children were selected through random cluster sampling in schools, and stratified by sex and socioeconomic level. MAIN OUTCOME MEASURES: Mean nutrient intake, number of food servings, and the percentage of children who meet recommended nutrient and food-serving intake levels. The overall dietary quality was assessed using the Healthy Eating Index (HEI). RESULTS: Mean micronutrient intake exceeded 100% of the recommended dietary allowances, except for vitamin B6, which registered a mean intake of 77.1%. For almost all children, intake of saturated fat was above, and that of carbohydrate below, the recommended level, in contrast to the relatively high compliance with the recommendations for poly- and monounsaturated fatty acid, salt and fiber intake (69.7, 43.7, 40.7, and 30.1%, respectively). Consumption of food servings for each of the five American pyramid food groups came close to or exceeded USDA guidelines, with the exception of cereals, with 5.4 servings per day. The mean score obtained in the HEI was 64.6. Children who complied with all the food guide pyramid recommendations registered a higher dietary variety and a healthier nutritional profile. CONCLUSIONS: Children aged 6-7 y show scant compliance with the macronutrient goals for healthy eating. Micronutrient intake is adequate in general, yet there are small groups of children with risk of deficient intake of vitamins B6 and D. While Spanish children's eating habits are reasonably in line with American food guide pyramid guidelines, consumptions of cereals and fruit should be improved.

Child↗
PubMed2003

Mortality attributable to cardiovascular risk factors in Spain.

OBJECTIVE: To present the current burden of mortality attributable to some of the main cardiovascular risk factors in adults in Spain. METHODS: Mortality attributable to risk factors was calculated by combining their prevalence, the relative risks for death, and the number of deaths in Spain. Prevalence of hypertension (>/=140/90 mmHg), tobacco smoking, excess weight (body mass index >/=25 kg/m(2)), and self-reported diabetes were based on representative samples of the Spanish population in the 1990s. The relative risks came from valid international studies. RESULTS: About 14 000 total deaths (25% of all deaths) were attributable to hypertension in Spain's middle-aged population. A quarter of them were cardiovascular deaths. About 56 000 deaths were attributable to tobacco use in adults >/=35 y (16% of all deaths). Two-thirds of them were deaths for: lung cancer (26.5%), chronic obstructive pulmonary disease (20.9%), coronary heart disease (12.8%), and stroke (9.2%). About 28 000 deaths (8.5% of all deaths) were attributable to excess weight in adults. Two-thirds of them were cardiovascular deaths. About 2800 cardiovascular deaths were attributable to diabetes in adults >/=35 y (6% of all cardiovascular deaths). CONCLUSIONS: Mortality attributable to the risk factors studied is a major avoidable public health problem in Spain. The results presented are only illustrative but clearly show that there is considerable scope for prevention.

Adult↗
PubMed2003

Relation between body weight and health-related quality of life among the elderly in Spain.

OBJECTIVE: This study examines the relation between body weight and the physical and mental components of health-related quality of life (HRQL) in the population aged 60 y and over in Spain. RESEARCH METHODS AND PROCEDURES: Cross-sectional study covering 3605 subjects, representative of the noninstitutionalised Spanish population aged 60 y and over. Information was collected through home-based personal interview and measurement of blood pressure and anthropometric variables. Logistic regression was used to examine the relation of suboptimal HRQL (score<100) on each SF-36 questionnaire scale with body mass index (BMI) and waist circumference. Separate regression models were constructed for each sex and adjusted for sociodemographic variables, tobacco and alcohol consumption, physical activity, arterial hypertension and diagnosed chronic disease. RESULTS: Mean age of the study population was 70.9 y for men and 72.2 y for women. The percentage of overweight subjects was 48.5% in men and 39.8% in women, and of obese subjects, 31.9 and 41.1% respectively. Men registered a better HRQL than women on most of the SF-36 scales. Compared to normal-weight subjects (BMI: 18.5-24.9 kg/m(2)), frequency of suboptimal physical functioning was higher among obese subjects (BMI>or=30 kg/m(2)), both male (OR: 1.91; 95% CI: 1.22-3.00) and female (OR: 2.58; 95% CI: 1.59-4.19). The aspects of physical functioning most affected were bending, kneeling or stooping, climbing stairs and strenuous effort. Male, though not female, obesity was nonetheless associated with a better HRQL on the SF-36 mental scales. Frequencies of suboptimal scores for overweight persons (BMI: 25-29.9 kg/m(2)) were similar to those for normal-weight subjects on most of the SF-36 scales. Results proved similar for subjects in both the 60-74 and 75-and-over age groups, and also when waist circumference was used as the measure of obesity (>102 cm in men and >88 cm in women). CONCLUSIONS: Obese men and women showed worse physical functioning than normal-weight persons. This occurred irrespective of whether subjects were over or under 74 y of age, or whether obesity was measured by BMI or waist circumference, and was not explained by unhealthy lifestyles or obesity-related chronic disease.

Aged↗
PubMed2003

Food sources of nutrients in the diet of Spanish children: the Four Provinces Study.

The aim of the present study was to assess the principal food sources of energy and nutrients among Spanish children. We used a cross-sectional study design, based on results obtained from a food-frequency questionnaire. The sample included 1112 children, aged 6-7 years, from Cadiz, Madrid, Orense and Murcia, Spain. Children were selected through random cluster-sampling in schools. We analysed the percentage contributed by each food item to total energy and nutrient intake. The most important food sources were: white bread in the case of carbohydrate (13.4 %); olive oil in the case of total lipids (18.3 %) and monounsaturated fatty acids (29.2 %); whole milk in the case of protein (10.2 %) and saturated fatty acids (14.9 %); chips (French fried potatoes) in the case of polyunsaturated fatty acids (30.4 %). The greatest proportion of Na, consumed in excess, came from salt added to meals. Ham ranked second as a source of saturated fats. Fruits and green leafy vegetables proved to have great relevance as sources of fibre and vitamins, though with regard to the latter, it was observed that fortified foods (breakfast cereals, dairy products, fruit juices, etc.) had come to play a relevant role in many cases. In conclusion, the nutritional profile of Spanish school-aged children aged 6-7 years could be improved by nutritional policies targeted at limiting their consumption of ham (cured or cooked) and of salt added to meals, replacing whole milk with semi-skimmed milk, encouraging the consumption of products rich in complex carbohydrates already present in children's diets (bread, pasta, rice) and promoting less fatty ways of cooking food.

Child↗
PubMed2003

One year effectiveness of an individualised smoking cessation intervention at the workplace: a randomised controlled trial.

AIMS: To assess the effectiveness of a smoking cessation intervention at the workplace. The intervention was adapted to smokers' tobacco dependence, and included minimal structured counselling at the first visit (5-8 minutes), nicotine patches for three months, and three sessions of counselling for reinforcement of abstinence (2-3 minutes) over a three month period. METHODS: Open randomised trial with two groups: the intervention group, and the control group which was subjected to standard clinical practice, consisting of short (30 seconds to one minute) sporadic sessions of unstructured medical antismoking advice. The trial was carried out among 217 smokers of both sexes, aged 20-63 years, motivated to quit smoking and without contraindications for nicotine patches, who were employees at a public transport company and at two worksites of an electric company. The main outcome measure was self reported tobacco abstinence confirmed by carbon monoxide in expired air </=10 ppm. Analysis was performed according to intention-to-treat. RESULTS: The rate of continuous abstinence at 12 months was 20.2% for the intervention versus 8.7% for the control group (OR: 2.58; 95% CI: 1.13 to 5.90; p = 0.025). In subgroup analyses, effectiveness of the intervention did not vary substantially with age, tobacco dependence, number of cigarettes smoked per day, number of years of tobacco consumption, degree of desire to quit smoking, time spent with smokers, subjective health, and presence of tobacco related symptoms. Weight gain at 12 months was similar for both groups (1.69 kg in the intervention v 2.01 kg in the control group; p = 0.21). CONCLUSIONS: A simple and easily generalisable intervention at the workplace is effective to achieve long term smoking cessation. In a setting similar to ours, nine subjects would have to be treated for three months for one to achieve continuous abstinence for 12 months.

Adolescent↗
PubMed2002

Dietary patterns among children aged 6-7 y in four Spanish cities with widely differing cardiovascular mortality.

OBJECTIVE: Classic cardiovascular risk factors, such as smoking, arterial hypertension and hypercholesterolaemia, cannot explain a substantial part of the geographic differences in cardiovascular mortality. Anthropometric and nutritional factors in early stages of life may contribute to adult cardiovascular disease. Therefore, this work examines certain anthropometric variables and diet among children aged 6-7 y, living in four Spanish cities with widely differing ischaemic heart disease (IHD) mortality. DESIGN AND SETTING: Cross-sectional anthropometric and dietary survey in four cities in Spain. SUBJECTS: A total of 1112 children (50.1% males, 49.9% females) attending public and private schools in Cadiz and Murcia, cities with a relatively high IHD mortality, and Madrid and Orense, cities with a relatively low IHD mortality. A standardized method was used to measure anthropometric variables, and a food-frequency questionnaire completed by subjects' mothers, to measure diet. OUTCOME MEASURES: Body mass index (BMI), overweight (BMI>17.6 kg/m(2)), obesity (BMI>20.1 kg/m(2)) and intake of food and nutrients. RESULTS: Children in the four cities showed a high prevalence of overweight (range across cities, 28.9-34.5%) and obesity (8.5-15.7%). They also had a moderately hypercaloric diet (range, 2078-2218 kcal/day), marked by an excessive intake of lipids (45.0-47.3% kcal), particularly saturated fats (16.6-16.9% kcal), proteins (17.0-17.3% kcal), sugars (20.0-21.9% kcal) and cholesterol (161.6-182.9 mg/1000 kcal/day), and a low intake of complex carbohydrates (17.5-18.1% kcal) and fibre (19.6-19.9 g/day). Compared with children in the two low-IHD-mortality cities, those in the two high-IHD-mortality cities had a greater BMI (mean difference, 0.61 kg/m(2); P=0.0001) and ponderal index (0.58 kg/m(3); P=0.0001) and a higher intake of energy (104 kcal/day; P=0.007), cholesterol (16.00 mg/1000 kcal/day; P=0.0001) and sodium (321 mg/day; P=0.0001). Inter-city differences in anthropometric variables remained after adjustment for birthweight. CONCLUSIONS: Intake of fats, especially saturated fats, and cholesterol should be reduced among Spanish children. It could contribute to a needed reduction of the high prevalence of overweight and obesity in children. If the differences in anthropometric variables and diet between children from the cities with high and low coronary mortality are maintained in future or continue into adulthood, this could contribute to consolidate or even increase the IHD mortality gradient across cities. The finding that differences in anthropometric variables are independent of birthweight suggests that the childhood, rather than intrauterine environment, is involved in the development of such differences. SPONSORSHIP: This study was partly funded by grants from the International Olive Oil Board (Consejo Oleícola Internacional), Comunidad Autónoma de Madrid, Fundación Pedro Barrié de la Maza, and Fundación Eugenio Rodríguez Pascual.

Anthropometry↗
PubMed2002

Systolic vs diastolic blood pressure: community burden and impact on blood pressure staging.

Systolic blood pressure (SBP) is a more frequent cardiovascular risk factor than diastolic blood pressure (DBP), and has a greater impact on blood pressure staging, though this can vary with age, sex and country. Therefore this paper compares SBP and DBP in terms of community burden and impact on blood pressure staging, among Spain's middle-aged population. Data were drawn from a cross-sectional study on a representative sample of the Spanish population aged 35-64 years. Blood pressure was determined under standardised conditions, and was classified as per WHO-ISH and JNC-VI criteria. Prevalence of SBP > or =140 mm Hg was 34.1%, and that of DBP > or =90 mm Hg, 30.9%. A total of 12% of subjects had isolated systolic hypertension (ISH) and 8.7% had isolated diastolic hypertension (IDH). Of treated hypertensives, 31% had their SBP controlled and 34% their DBP controlled. Of subjects not undergoing antihypertensive drug therapy, 60.8% had congruent SBP and DBP levels, 22.5% were up-staged on the basis of their SBP, and 16.7% were up-staged on the basis of their DBP. SBP alone thus correctly classified JNC-VI staging in 83.3% of subjects vs 77.5% for DBP alone. It was solely among the population >50 years of age, in both sexes, that systolic proved more frequent than diastolic hypertension, ISH greater than IDH prevalence, SBP worse than DBP control, and the percentage of SBP higher than that of DBP up-staged subjects. SBP constitutes a greater community burden than does DBP, and has a greater impact on blood pressure staging in Spain's middle-aged population. However, the differential impact of SBP and DBP upon blood pressure burden and staging is favourable to SBP only among subjects >50 years old. These findings are in accordance with recent guidelines on hypertension management.

Adult↗