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- Kristjansson, Karl, 1958, et al.
(författare)
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Blood pressure and pulse pressure development in a population sample of women with special reference to basal body mass and distribution of body fat and their changes during 24 years
- 2003
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Ingår i: International Journal of Obesity. ; 27, s. 128-133
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Tidskriftsartikel (refereegranskat)abstract
- Department of Family Medicine, Solvangur Health Centre, University of Iceland, Hafnarfjördur, Iceland. karlk@hgsolvangur.is OBJECTIVE: To study blood pressure and pulse pressure longitudinally and their association with basal and change of body mass index (BMI) and waist to hip ratio (WHR). DESIGN: A prospective population study of 1462 women in Gothenburg, Sweden, aged 38-60 y at baseline, with a longitudinal follow-up of 24 y. OUTCOME MEASURES: Incidence of hypertension, systolic and diastolic blood pressure, and pulse pressure at baseline and after 12 and 24 y of follow-up. RESULTS: Systolic and diastolic blood pressure as well as pulse pressure increased with age and turned down again at high age. BMI and WHR at baseline were each independently associated with baseline systolic and diastolic blood pressure, but only BMI with pulse pressure. However, baseline BMI and WHR were not associated with change of systolic, diastolic or pulse pressure during 12 or 24 y of follow-up. Increase in BMI during the follow-up period was associated with increase in systolic and diastolic blood pressure but not with increase in pulse pressure. There were no such associations with WHR changes which, were either unrelated or in one analysis inversely related with blood pressure changes. When considering incidence of hypertension during the first 12 y of follow-up, BMI and change in BMI were significant predictors, independent of WHR. CONCLUSION: Age, BMI and increments in BMI seem to be strong predictors for hypertension and increased systolic and diastolic blood pressure in women. In contrast, WHR plays a lesser and uncertain role in the development of hypertension in middle-aged women. Changes in BMI seem not to be accompanied by changes in pulse pressure during a long time follow-up. PMID: 12532164 [PubMed - indexed for MEDLINE]
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| 2. |
- Kristjansson, Karl, 1958
(författare)
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Blood pressure, blood pressure development and potential risk factors for hypertension with special reference to metabolic factors and kidney function
- 2002
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Objectives: The overall aim of this thesis was to search for predictors of blood pressure development with special reference to anthropometric, metabolic and renal function variables.Study populations and methods: Two large long-term prospective population studies, The Population Study of Women in Gothenburg, Sweden carried out since 1968-69, with 1462 women between 38 and 60 years old at baseline and 24 year follow-up, and The Reykjavik Study, Iceland, which started in 1967 with an initial participation of 8285 men and 9183 women in various age groups. In this thesis the prospective part of the Reykjavik study included 2639 men and 2346 women, with a 3 to 8 year follow-up. Main outcome measures: Cardiovascular and renal morbidity and mortality data, systolic blood pressure, diastolic blood pressure, pulse pressure, body mass index (BMI), waist to hip ratio (WHR), glucose tolerance, serum insulin concentration, and microproteinuria. Results: · Blood pressure and pulse pressure increased with increasing age, while there seemed to be a secular trend with decreasing blood pressure during recent years.· Hypertensive women had an increased mortality and a higher incidence of myocardial infarction and stroke compared to non-hypertensive women, while renal failure was not a common reason for death either in hypertensive or in non-hypertensive women. Hypertensive women had a more than doubled risk of developing diabetes compared with non-hypertensive women.· There was a correlation between overweight and blood pressure, mainly to the measures indicating total amount of fat rather than its distribution.· oThere were correlations between glucose intolerance and blood pressure as observed in both sexes and irrespective of being obese or not.· There was also a correlation between fasting serum insulin and blood pressure, mainly seen in obese women and confined to women with the highest serum insulin concentrations.· Albuminuria and subclinical proteinuria were more common in hypertensive than in non-hypertensive women, but albuminuria and subclinical proteinuria were not found to be a predictor of increasing blood pressure.Conclusions: Age, BMI and increments in BMI, fasting and postload glucose and serum insulin seem to be predictors for hypertension and increased blood pressure in women. WHR plays an uncertain role in the development of hypertension. Microproteinuria in otherwise healthy normotensive or hypertensive women does not appear to impair the long-term prognosis.
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| 3. |
- Kristjansson, Karl, 1958, et al.
(författare)
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The interrelationships between fasting serum insulin level, obesity and blood pressure in women: Results from a cross-sectional population study of women in Gothenburg, Sweden
- 1993
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Ingår i: Hypertension Research. - 1348-4214. ; 16:3, s. 197-201
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Tidskriftsartikel (refereegranskat)abstract
- This study is based on a representative population sample of women in Gothenburg, Sweden. Three hundred and thirty-six 50-year-old nondiabetic women, not taking any antihypertensive medication, were included in the study. They underwent a comprehensive examination programme, where body weight, body height, waist and hip circumferences, systolic and diastolic blood pressures and fasting serum insulin concentration were measured. Fasting serum insulin concentration was significantly correlated with systolic and diastolic blood pressures. After controlling for both body mass index (BMI) and waist to hip circumference ratio (WHR), fasting serum insulin concentration remained independently associated with blood pressure (P=0.001 for systolic blood pressure, P=0.06 for diastolic blood pressure). When stratified for BMI or WHR the correlations between fasting serum insulin concentration and blood pressure remained significant only in the upper 50th precentiles of BMI and WHR. When relating pressure to different levels of fasting serum insulin concentration there seems to be a threshold at an insulin concentration corresponding to the upper quartile limit (at approximately 17μU/ml), above which level the blood pressure rises more obviously. The same phenomenon was seen for systolic and diastolic blood pressures.
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| 4. |
- Lissner, Lauren, 1956, et al.
(författare)
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Fasting insulin in relation to subsequent blood pressure changes and hypertension in women
- 1992
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Ingår i: Hypertension. ; 20, s. 797-801
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Tidskriftsartikel (refereegranskat)abstract
- Department of Primary Health Care, University of Göteborg, Sweden. The role of hyperinsulinemia in the development of hypertension is not well understood, particularly insofar as both conditions relate to obesity. The present analysis examines the hypothesis that hyperinsulinemia, independent of obesity, precedes hypertension and natural blood pressure increases in women. The subjects were 50-year-old women from a prospective population study in Gothenburg, Sweden. Fasting insulin levels were determined at baseline (1968-1969) and were evaluated in relation to subsequent hypertension. Blood pressures were measured at the initial physical examination and at the 6- and 12-year follow-up examinations. The first analysis presented here (n = 278) identified incident cases of hypertension during the 12-year follow-up period, whereas the second analysis (n = 219) examined continuous changes in blood pressure. In both analyses, degree, type, and changes in obesity were considered as possible confounding factors. High fasting insulin values were predictive of subsequent incidence of hypertension over the 12-year follow-up period. Subjects with insulin values above the 75th percentile experienced three times more hypertension than did those below the 25th percentile. There was also a significant association between insulin at baseline and increases in diastolic (but not systolic) blood pressure. The positive relations between fasting insulin, on one hand, and diastolic blood pressure changes and hypertension, on the other, could not be explained by confounding effects of body mass index, waist/hip ratio, or weight gain. These findings are consistent with the hypothesis that fasting insulin levels may be one predisposing factor in the etiology of hypertension.
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