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Beliefs about the potential for high blood pressure prevention were assessed during a telephone survey of cardiovascular risk factor awareness among black and Hispanic adults in Chicago, Illinois. A high proportion of those interviewed-82% of blacks and 69% of Hispanics--thought a person could do something to prevent getting high blood pressure and either selected one or more of several possible preventive measures listed by the interviewer or volunteered other measures. Awareness of two widely cited prevention possibilities that may be particularly important for black and Hispanic populations--lowering salt intake and maintaining ideal weight--was low. Fewer than half of the respondents in this survey (44% of blacks and 26% of Hispanics) thought that lowering salt intake would help prevent high blood pressure. An even smaller number (10% of blacks and 20% of Hispanics) thought that maintaining ideal weight would help prevent high blood pressure. Moreover, other measures that are unrelated to high blood pressure or for which a relation to high blood pressure is not well established were selected frequently. These findings were contrary to our expectations, because black and Hispanic populations have been targeted by the National High Blood Pressure Education campaign and because high levels of awareness in other areas of cardiovascular disease risk were observed in this sample. These data suggest that awareness of potential strategies for high blood pressure prevention among black and Hispanic communities needs to be addressed specifically in related educational campaigns.
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PMID:Beliefs about high blood pressure prevention in a survey of blacks and Hispanics. 274 86

Hypertension is common in hemodialyzed patients and constitutes an important cardiovascular risk factor. Fluid retention, inappropriate stimulation of the renin-angiotensin system, sympathetic overactivity and changes of vessel wall structure have been shown to be important factors in its pathogenesis. It has been claimed that hemofiltration permits a better control of hypertension in the interdialytic interval, although the evidence is not perfectly convincing; blood pressure tends to be lower with continuous ambulatory peritoneal dialysis. While fluid withdrawal and - within certain limits - adjustment of dialysate sodium concentration constitutes a primary line of therapy, antihypertensive medication is necessary in approximately 20% of patients. Specific problems with dialysis patients are cumulation of drugs (some cardioselective beta-blockers, alpha-methyldopa, captopril), altered dose-response relationship (diuretics) and particularly interaction with cardiovascular stability during fluid withdrawal.
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PMID:Treatment of hypertension in dialysis patients. 286 71

The incidence of definite hypertension increases with advancement of age, and one third of the elderly population is affected. Isolated systolic hypertension is frequent in this population (10 to 12 percent in subjects between 65 and 74 years of age). The role of hypertension as a cardiovascular risk factor has been confirmed in the elderly population by the increase in cerebrovascular accidents, and by the incidence of myocardial infarction with the rise in blood pressure. The relationship between elevated diastolic and systolic blood pressure and mortality rates in the elderly is also well documented (Framingham). Effective treatment of hypertension significantly reduces the risk of associated complications: cardiovascular death, congestive heart failure, and stroke. However, the goal of antihypertensive therapy in the elderly should be not only to reduce morbidity and mortality rates, but also to do so without adverse effects on the functional well-being of patients.
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PMID:Hypertension in the elderly. 327 24

Coexisting hypertension and diabetes mellitus is common particularly in the obese, minorities, and the socioeconomically disadvantaged. Hypertension contributes substantially to the vascular complications of diabetes mellitus and to the increased mortality of diabetes mellitus. Nondrug treatment of both conditions consists of cardiovascular risk factor reduction, emphasizing weight management, salt restriction, smoking cessation, and alcohol moderation. With observing a few precautions the drug treatment of hypertension in diabetes mellitus is similar to that of the nondiabetic.
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PMID:Diabetes, hypertension and other associated diseases. 329 Sep 18

Obesity has been associated with numerous metabolic complications, such as changes in the concentration and/or composition of plasma lipoproteins, glucose intolerance and hyperinsulinemia leading to diabetes and hypertension. The relation of obesity to cardiovascular disease has not, however, been consistently reported. Recent prospective studies have clearly indicated that the distribution of adipose tissue was a significant cardiovascular risk factor and numerous studies have shown that metabolic disturbances were more closely associated with the level of abdominal fat than excess adiposity per se. As obese men generally store their energy excess in the abdominal region and women in the peripheral fat depots, the metabolic complications of obesity seem to be more closely related to adiposity in men than in women. It is suggested that the sex dimorphism observed in adipose tissue localization could partly explain the greater cardiovascular risk associated with obesity in men than in women. Indeed, obese women with a "male" (abdominal) distribution of body fat have greater metabolic complications than women with lower body fat. When aerobic exercise-training is used to induce weight loss, men generally lose more fat than women. In men, the loss of adipose tissue appears to be central, potentially reducing the risk of cardiovascular disease, whereas a relative resistance to fat loss is observed in women compared to men. Although resistance to fat loss is noted in women, those with a "male" distribution of adipose tissue (high waist-to-hip ratio and high intra-abdominal fat deposition) and with associated metabolic complications greatly benefit from aerobic exercise-training.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Physical training and changes in regional adipose tissue distribution. 329 59

Large prospective studies and intervention trials have identified major risk factors for premature heart disease in men, while the Framingham Heart Disease Study has provided the leading evidence of predictors of cardiovascular disease in women. We evaluated the role of these risk factors in a 13-year follow-up study of 8935 premenopausal and 2716 postmenopausal women in the Walnut Creek Contraceptive Drug Study cohort in Northern California. Elevated cholesterol levels, high blood pressure, smoking, obesity, family history of heart disease, and diabetes were investigated for their contribution to premature death due to all causes and due to cardiovascular disease. In addition, risk factor profiles were developed separately for users and nonusers of Premarin (conjugated estrogen) in the postmenopausal cohort. The results show that the strongest predictors of cardiovascular mortality among premenopausal women were smoking, high blood pressure, and diabetes, with relative risks of 2.8, 10.5, and 11.6, respectively. A disparity between high cardiovascular risk factor prevalence and low rates of premature heart disease indicates that the high relative risks will not be accompanied by large attributable risks. Nevertheless, the study reconfirms the need for screening women for heart disease risk because life-style changes can improve cardiovascular risk factors and can potentially reduce the chance of premature death even further.
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PMID:Cardiovascular risk factors, premature heart disease, and all-cause mortality in a cohort of northern California women. 337 34

In the WHO MONICA Study, determinants and trends in cardiovascular disease are monitored during a 10-year period in 40 centers in 27 countries. The Northern Sweden MONICA Center is located furthest to the north of all participating centers. In this report, baseline data on cardiovascular risk factors are presented. In the first population screening, 1,625 of 2,000 (81%) invited individuals participated. Diastolic blood pressure greater than or equal to 90 mmHg was recorded in 19% and 9% were on drug treatment for hypertension. Median cholesterol level was 6.10 mmol/l and the frequency of hypercholesterolemia was high. A body mass index of greater than or equal to 30, indicating severe obesity, was observed in 9%, a lower proportion than in most other European populations. Among men, the total proportion of tobacco consumers was 49%, including 22% snuffers. Of the women, 31% were tobacco consumers, very few being snuffers. Women had, in general, a more favorable cardiovascular risk factor profile up to the age of 45. Thereafter, the two genders were similar. By international comparisons, the population in northern Sweden is characterized by high serum cholesterol levels, intermediate blood pressure levels, a relatively low prevalence of severe obesity and a high consumption of smokeless tobacco.
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PMID:Cardiovascular risk factors in the Northern Sweden MONICA Study. 342 Nov 50

We present our findings on cardiovascular risk factor knowledge and belief in prevention from a survey administered to adult family members of children participating in a Chicago school health education program. The major risk factor most frequently recognized and understood appeared to be hypertension. Cigarette smoking and cholesterol were least frequently recognized. Few respondents could identify all three of the major risk factors, high blood pressure, cigarette smoking, and cholesterol. Non-high-school graduates and the Hispanic subgroup demonstrated less knowledge and understanding. The results confirm the benefits of the extensive high blood pressure education programs of the past decade and support the need for similar interventions in nutrition and smoking prevention and cessation. Innovative approaches toward the less-educated and the Hispanic subgroups within the population also appear necessary to accelerate the encouraging decline in cardiovascular diseases seen over the past two decades.
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PMID:Cardiovascular risk factor knowledge and belief in prevention among adults in Chicago. 345 89

Altogether 6,523 persons aged 25-64 years were studied in eastern and south-western Finland to determine their cardiovascular risk factor levels. Among men, smoking was more prevalent in the south-western area (41 vs. 37%), serum cholesterol levels were higher in the eastern area (6.2 vs. 6.0 mmol/l) and blood pressure levels were the same in both areas (145/86 in the east vs. 144/86 in the south-west). Among women, smoking was also more common in the south-western area (24 vs. 16%) and serum cholesterol levels were higher in the eastern area (6.1 vs. 6.0 mmol/l) as well as blood pressure levels (142/84 vs. 138/81 mmHg). Among both genders, prevalence of hypertension and proportion of persons on antihypertensive drug therapy was higher in eastern Finland. The comparison of these findings with the results from previous studies carried out among men in these two areas indicates that the risk factor levels have been decreasing in both areas and that the previously observed differences in risk factor levels between eastern and south-western Finland (the levels used to be higher in the east) have levelled off. The favourable development in eastern Finland may be a result of the North Karelia Project.
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PMID:Comparison of the levels of cardiovascular risk factors between eastern and south-western Finland in 1982. 350 Dec 30

Control of hypertension, overweight, hypercholesterolemia, and smoking is a major objective of the CHAD program, a multifactorial cardiovascular risk factor program built into a family practice, which has operated in a neighborhood of western Jerusalem since 1971. By 1975-1976, there was a significantly larger decrease in risk factors in this population than in a neighboring population receiving ordinary medical care. Follow-up based on clinical records of a cohort of 441 people exposed to the program until 1981 revealed that the mean blood pressures decreased and the prevalence of hypertension continued to decrease between 1976 and 1981, from 12.5 to 9.1%. Prevalence of cigarette smoking among people ages 30 years or more also decreased in this period, mainly due to a decrease in heavy smoking, at a time when national surveys provided no evidence of a smoking decrease in this age group. Effects on overweight and cholesterol were not demonstrated during this period. This 10-year evaluation demonstrates the effects of intervention by primary care practitioners in the framework of a community-oriented program.
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PMID:Ten-year evaluation of hypertension, overweight, cholesterol, and smoking control: the CHAD program in Jerusalem. Community Syndrome of Hypertension, Atherosclerosis and Diabetes. 374 10


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