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Query: UMLS:C0028754 (obesity)
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This research examined whether blood pressure measurement relates to an individual Self-Care Agency's (SCA) capabilities (self-concept, knowledge, and initiative) to exercise self-care. A sample of 110 hypertensive high-risk urban black Americans (61 males and 49 females) with a mean age of 46 years (range 18-75), was administered the 43 item 'Exercise of Self-Care Agency' scale and a demographic/health questionnaire. The blood pressure (BP) of each participant was measured at the time of the survey. A large number of subjects (72%) had normal BP and 80% low SCA capability scores. Twenty-eight percent had abnormal BP and 21% had high SCA scores. Blood pressure did not relate to self-care agency. The SCA subconstruct, 'Initiative' was significantly related to normal BP (r = 0.3354, P = 0.006). Self-care agency was inversely associated with obesity, cigarette smoking and excessive salt use. These findings suggest a deficit relationship between SCA and therapeutic self-care demand among urban black Americans who are at high risk for hypertension.
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PMID:Self-care agency and blood pressure control. 233 82

The effects of socioeconomic disadvantage on behavioral, psychosocial, and physiological risk factors for cardiovascular disease were investigated in an economically depressed agricultural area of New York State. After adjustment for age and sex, at least one and typically two of the three dichotomized socioeconomic factors (manual labor, lack of high school graduation, and poverty) were associated with an increased prevalence of smoking, obesity, frequent salt use, cholesterol consumption, low levels of leisure activity, and social isolation. Education and occupation also made independent contributions to systolic blood pressure. After adjustment for age, sex, behavioral, and social isolation variables, those with both risk factors (less than 12 years of school, and manual labor) had a higher mean systolic blood pressure than those with neither risk factor (9.5 mm Hg; 95 percent confidence interval = 5.5, 13.5). In contrast, after adjustment for the other variables, those with the two risk factors, less than 12 years of school and income below the poverty level, had a lower mean serum cholesterol than those with neither risk factor (11 mg/100 ml; 95 percent confidence interval = 3.1, 18.9). The policy implications of these pervasive social gradients of cardiovascular risk and the paradoxical relationship with serum cholesterol are discussed.
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PMID:The social origin of cardiovascular risk: an investigation in a rural community. 238 85

Nondrug measures have proven effective, to some extent, in lowering blood pressure, especially in mild hypertensives, in many well-controlled studies. The proven measures are reduction of a) salt (less than 5 g/day), b) alcohol (less than 30 ml/day) intake, and c) obesity, and d) regular physical exercise (30-60 minutes/day) and e) mental relaxation. The reported effectiveness of each of these measures ranges from one third to two thirds in mild hypertensives. Should all these nondrug measures, together with cessation of smoking, be applied in all mild hypertensives, it might help prevent their progression to moderate or even severe hypertension with complications, such as coronary heart disease in particular, thereby solving most of the problems that antihypertensive drugs have left behind.
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PMID:Non-pharmacologic measures for lowering blood pressure. 203 35

Hypertension in Africa represents a challenge and an opportunity. As the two epidemics of infection and malnutrition are increasingly brought under control, increasing morbidity and mortality from hypertension have been documented and offer a challenge for prevention. Heterogeneity within and between African populations offers opportunities for detecting clues to the etiology and pathogenesis of hypertension. For example, populations in urban areas have already shown a greater prevalence of obesity, hypertension, and hypertensive heart and kidney disease than those in rural areas. The generally better lipid profiles in African blacks compared with whites is associated not only with low rates of coronary heart disease, but also with low prevalences of hypertensive retinopathy, despite substantial prevalences of hypertension in African blacks. Areas of Africa with a natural abundance of salt, such as Gambia and Senegal, tend to have indigenes with less tendency to retain a salt load than those from areas that are traditionally salt poor.
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PMID:Current aspects of high blood pressure research in Africa. 262 Apr 76

The authors evaluated whole blood filterability (VB) in 29 post-menopausal obese women with (n = 14) or without (n = 15) hypertension, and in 22 age matched women with normal body weight. After 3 months of a low-calorie (18 kcal/kg IBW) and moderately low-salt (max 6 g NaCl/day) diet, the obese subjects were restudied. In all women plasma fibrinogen values and various indices of metabolic status were evaluated before and after the diet and correlated to VB values. VB values and plasma fibrinogen concentrations were similar in normal controls and in women with simple obesity, whereas they were, respectively, significantly lower and higher in obese subjects with hypertension. Three months of diet significantly improved whole blood filterability and decreased fibrinogen levels in these patients. Before the diet a significant negative correlation was found between VB and plasma fibrinogen values in hypertensive obese patients. Metabolic parameters did not change in the different groups before and after the diet and did not correlate with VB values. The present study indicates that low-calorie, low-salt diet decreases plasma fibrinogen levels and improves whole blood filterability in elderly obese women with hypertension.
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PMID:Effect of diet and weight loss on whole blood filterability and plasma fibrinogen values in hypertensive obese postmenopausal women. 262 50

In general, rises in systolic blood pressure to over 200 mm Hg during exercise with a workload of 100W are regarded as pathological. Excessive exercise blood pressure values are to be expected in principle in all hypertensives. However, there are so far no generally accepted criteria for diagnosis of isolated systolic exercise hypertension (with normal values of resting blood pressure). The incidence of isolated systolic exercise hypertension is estimated to be about 10% of a selected population. In patients with excessive rises in blood pressure during exercise who want to engage actively in sport, general measures (reduction of obesity, restriction of alcohol and salt intake) and endurance training should be recommended initially. For endurance training, sporting activities that involve dynamic exercise are to be recommended (walking, running, mountain hiking, cycling, swimming, cross-country skiing). Activities involving isometric exercise (rowing, diving, tennis) and sport of a competitive nature are not suitable. In moderately severe and severe hypertension (diastolic blood pressure values in excess of 105 mm Hg), sporting activities and endurance training are contraindicated. If the exercise blood pressure values cannot be lowered below 220 mm Hg with the general measures mentioned, pharmacotherapy is to be considered. The drugs of choice for suppressing excessive rises in blood pressure during exercise are beta-blockers. In this group, beta 1-blockers are to be preferred to non-selective beta-blockers because of the metabolic neutrality of the former. beta-Blockers without intrinsic sympathomimetic activity (ISA) lower the blood pressure-pulse rate product more effectively than beta-blockers with ISA. Alternatively, calcium antagonists of the verapamil type and ACE inhibitors can be employed.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Management of hypertension in actively exercising patients. Implications for drug selection. 264 57

To clarify the role of sodium intake in the regulation of blood pressure in obese subjects, we measured blood pressure in 60 obese and 18 nonobese adolescents after successive two-week periods of a high-salt diet (greater than 250 mmol of sodium per day) and a low-salt diet (less than 30 mmol per day). When they were changed from a high-salt to a low-salt diet, the obese group had a significantly larger mean change (+/- SE) in mean arterial pressure (-12 +/- 1 mm Hg) than did the nonobese group (+1 +/- 2 mm Hg; P less than 0.001). The variables that best predicted the degree of sodium sensitivity were the fasting plasma insulin level, the plasma aldosterone level while the low-salt diet was being given, the plasma norepinephrine level while the high-salt diet was being given, and the percentage of body weight made up by fat. Fifty-one of the obese adolescents were also studied before and after a 20-week weight-loss program. After the weight-loss program, the 36 subjects who lost more than 1 kg of body weight had a reduced sensitivity of blood pressure to sodium (difference from value during high-salt diet to that during low-salt diet, -1 +/- 1 mm Hg). The blood pressure of the remaining 15 adolescents was still sensitive to sodium intake (-11 +/- 3 mm Hg). These results support the hypothesis that the blood pressure of obese adolescents is sensitive to dietary sodium intake and that this sensitivity may be due to the combined effects of the hyperinsulinemia, hyperaldosteronism, and increased activity of the sympathetic nervous system that are characteristic of obesity.
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PMID:The effect of weight loss on the sensitivity of blood pressure to sodium in obese adolescents. 230 Jan 15

The coronary heart disease mortality rate in Italy--lower than in many other industrialized countries--has changed little in the last 20 years, whereas in the United States, a major decline in deaths resulting from coronary heart disease has occurred. These differing trends have reduced considerably the gap between the two countries in coronary mortality rates. Several recent population studies in Italy have found a change in the previously more favorable risk factor profile. In the northern hill town of Gubbio, studied in 1983-1985, median serum cholesterol level of men ages 40-59 was 223 mg/dl, considerably higher than was found in the 1960 Italian population samples of the Seven Countries Study (197-206 mg/dl). In the earlier study, the cholesterol levels in the Italian men who were still mainly consuming the traditional Mediterranean diet were 30-40 mg/dl lower than in the U.S. sample. The 1980 Gubbio levels, however, were at least as high as those of their U.S. contemporaries. Cigarette smoking was much higher among the middle-aged men of Gubbio than among a similar U.S. population sample (56% vs 36%). Hypertension prevalence was high, and several risk factors for hypertension--obesity, high salt intake, and alcohol--were common in the Gubbio as well as in other recent Italian population studies. The changing coronary risk profile in Italy, which now includes higher population levels of serum cholesterol as well as the other major coronary heart disease risk factors of cigarette smoking and hypertension, threatens to reduce markedly the "Mediterranean advantage" enjoyed by Italy in the past.
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PMID:Is Italy losing the "Mediterranean advantage?" Report on the Gubbio population study: cardiovascular risk factors at baseline. Gubbio Collaborative Study Group. 271 Jul 61

Data from the National Heart Foundation Risk Factor Prevalence Surveys of 1980 and 1983 were analysed to detect national trends in risk factors for vascular disease in Australia. After statistical adjustment for differences in the demographic characteristics of the two populations of survey participants, our results show trends in smoking and blood pressure that are likely to result in a continuing fall in the incidence of vascular disease. There was a fall in the prevalence of current smoking from 32% to 29% but little change in the average daily consumption of cigarettes by current smokers. The prevalence of previously-undetected hypertension fell significantly from 10% to 7%. A small increase occurred in the proportion of all hypertensive patients who were treated and whose blood pressure was controlled, and a decline of 2.0 mmHg (P less than 0.0001) in mean diastolic blood pressures, but no significant change in mean systolic pressures. Mean total plasma cholesterol levels did not change; average levels of plasma triglycerides fell by 0.11 mmol/L (P less than 0.0001); and mean high-density lipoprotein cholesterol levels increased by 0.03 mol/L (P less than 0.0001). All indices of relative body weight increased between 1980 and 1983; mean body mass index rose by 0.23 with associated rises in the prevalence of obesity and of overweight status. The changes in other factors such as use of added salt, the consumption of alcohol, the level of physical activity and adherence to a special diet, all were in the desirable direction, although minor changes in the survey questionnaire might have served to exaggerate the apparent trends.
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PMID:Trends in risk factors for vascular disease in Australia. 278 48

Dietary alteration or intervention is an ideal method of preventing or treating hypertension. Medication may be eliminated or reduced in many cases. Correction of obesity and alcohol abuse are confirmed methods of treating hypertension. Reduction of sodium intake is effective in that portion of the population which is salt-sensitive. Probably, the ratio of sodium to potassium is of importance and increasing potassium intake while reducing sodium intake is effective in many situations. Evidence is being reported which indicates that adequate intake of calcium, and perhaps magnesium, is effective in preventing hypertension. Limited information indicates that a sufficiency of dietary essential fatty acids and fibre are effective in hypertension prevention. The role of dietary protein, carbohydrates, fat, cholesterol, vitamins, and essential elements (other than those mentioned above) in the pathogenesis has not been fully elucidated at this time, but there are indications that adequate intakes are beneficial in hypertension. Water hardness may have some effect in reducing hypertension incidence, and any effectiveness would probably result from calcium and magnesium in the drinking water. Animal studies and limited human studies indicate some detrimental effects of heavy metals, such as lead and cadmium, upon the pathogenesis of hypertension. Information regarding caffeine intake is inconclusive.
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PMID:Dietary factors in essential hypertension. 300 94


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