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Within the Flemish Environment and Health studies (FLEHS I, 2002-2006, and FLEHS II, 2007-2012), pesticide exposure, hormone levels and degree of sexual maturation were measured in 14-15-year-old adolescents residing in Flanders (Belgium). In FLEHS II, geometric mean concentrations (with 95 % confidence interval (CI)) of 307 (277-341) and 36.5 ng L (34.0-39.2) were found for p,p′-dichlorophenyldichloroethylene ( p,p′-DDE) and hexachlorobenzene (HCB). These values were respectively 26 and 60 % lower than levels in FLEHS I, 5 years earlier. Metabolites of organophosphorus pesticides (OPPs) and of para-dichlorobenzene were measured for the first time in FLEHS II, yielding concentrations of 11.4, 3.27 and 1.57 μg L for the sum of dimethyl- and diethyl phosphate metabolites and 2,5-dichlorophenol (2,5-DCP), respectively. Data on internal exposure of HCB showed a positive correlation with sexual maturation, testosterone and the aromatase index for boys and with free thyroxine (fT4) and thyroid stimulating hormone (TSH) (both boys and girls). For both p,p′-DDE and HCB, a negative association with sexual development in girls was found. The OPP metabolites were negatively associated with sex hormone levels in the blood of boys and with sexual maturation (both boys and girls). The pesticide metabolite 2,5-DCP was negatively correlated with free T4, while a positive association with TSH was reported (boys and girls). These results show that even exposure to relatively low concentrations of pesticides can have significant influences on hormone levels and the degree of sexual maturation in 14-15-year-old adolescents. [ABSTRACT FROM AUTHOR]

Until now, no information is available about the effect of the presence of a doctor-in-training on a patient's blood pressure. We tested the hypothesis that the presence of a last year medical student might increase the blood pressure of the patient, in addition to the possible pressor response to the doctor-trainer. Normotensive and hypertensive patients with a minimum age of 25 years, visiting for any reason, were recruited at 22 teaching general practices. Patients were randomised into a‘trainee’group (n=133) and a‘no trainee’(n=129) group. The blood pressure was measured at two subsequent contacts. In the‘trainee’group, a student was present at the first visit only. In the‘no trainee’group, both visits were without student. Both groups had similar anthropometric characteristics at entry. At the first visit, systolic pressure was higher in the‘trainee’group than in the control group (139.5 vs 133.1?mmHg, P=0.004), with a similar trend for diastolic pressure (80.2 vs 77.8?mmHg, P=0.07). From the first contact to the follow-up visit, blood pressure decreased in the trainee group by 4.8?mmHg systolic (P<0.001) and 1.7?mmHg diastolic (P=0.03), whereas the corresponding changes in the control group were-0.1?mmHg (P=0.90) and+1.5?mmHg (P=0.03). Thus, the between group differences in these trends averaging 4.7?mmHg (CI 1.5-7.9, P=0.005) systolic and 3.2?mmHg (CI 1.1-5.3, P=0.003) diastolic were statistically significant. We conclude that in teaching-practices, the presence of a doctor-in-training has a significant pressor effect when an experienced general practitioner measures a patient's blood pressure. If confirmed, our findings imply that doctors should be cautious to initiate or adjust antihypertensive treatment when blood pressure readings are obtained in the presence of a student.Journal of Human Hypertension (2004) 18, 769-773. doi:10.1038/sj.jhh.1001744 Published online 13 May 2004 [ABSTRACT FROM AUTHOR]

There is no general agreement as to whether low-level lead exposure increases blood pressure. The present study examined the correlation between blood pressure and blood lead in the NHANES III database (1988-1994). Analyses were performed for all adults (≥20 years), and reported separately for white males (n = 4685), white females (n = 5138), black males (n = 1761) and black females (n = 2197). Significant covariates of blood pressure were selected by stepwise regression. The change in blood pressure that would be associated with a doubling of blood lead was calculated from the adjusted regression coefficients. Mean systolic/diastolic blood pressure was 123/76 mm Hg in white males, 119/70 mm Hg in white females, 126/77 mm Hg in black males and 121/72 mm Hg in black females. Median blood lead was 174 nmol/L (3.6 µg/dL), 101 nmol/L (2.1 µg/dL), 203nmol/L (4.2 µg/dL) and 111 nmol/L (2.3 µg/dL), respectively. For a doubling of blood lead, the changes in systolic blood pressure were 0.3 (95% confidence interval: -0.2 to 0.7, P = 0.29), 0.1 (-0.4 to 0.5, P = 0.80), 0.9 (0.04 to 1.8, P = 0.04) and 1.2 (0.4 to 2.0, P = 0.004) mm Hg, respectively and the changes in diastolic blood pressure were -0.6 (-0.9 to -0.3, P = 0.0003), -0.2 (-0.5 to -0.1, P = 0.13), 0.3 (-0.3 to 1.0, P = 0.28) and 0.5 (0.01 to 1.1, P = 0.047) mm Hg, respectively. In conclusion, there is no consistent relationship between blood pressure and blood lead in the NHANES III dataset. [ABSTRACT FROM AUTHOR]

In previous cross-sectional and longitudinal population studies, we found that the slope of systolic pressure on age was steeper in postmenopausal than in premenopausal women. We hypothesised that this observation could be due to a specific effect of menopause on the elasticity of the large arteries. We investigated 315 randomly selected women, aged 30 to 70 years. Based on 5.2 years of follow-up, 166 women were premenopausal and 149 menopausal (44 reaching menopause and 105 postmenopausal). These women were matched on age and body mass index with 315 men. We used a wall-tracking ultrasound system to measure the diameter, compliance and distensibility of the brachial and the common carotid and femoral arteries as well as carotid-femoral pulse wave velocity. Pulse pressure was determined from 24-h blood pressure recordings. Both in menopausal women (r = 0.37; P < 0.001) and in matching male controls (r = 0.16; P = 0.04), pulse pressure widened with increasing age. The slope of the 24-h pulse pressure on age was steeper in menopausal women than in their premenopausal counterparts (0.428 vs -0.066 mm Hg per year; P = 0.003) and than in the male controls (0.428 vs 0.188 mm Hg per year; P = 0.06). After adjustment for age, 24-h mean pressure, body mass index, antihypertensive drug treatment, smoking and the use of oral contraceptives or hormonal replacement therapy, postmenopausal women showed a higher carotid-femoral pulse wave velocity (7.77 vs 6.71 m/s; P = 0.02) and had a slightly greater diameter of the common carotid artery (7.09 vs 6.79 mm; P = 0.07) than their premenopausal counterparts. After similar adjustments, menopausal class was not significantly associated with other vascular measurements in women or with any vascular measurement in control men. In conclusion, menopause per se may increase aortic stiffness. We hypothesise that this phenomenon may contribute to the rise in systolic pressure and pulse pressure in women beyond age 50 and, in turn, may... [ABSTRACT FROM AUTHOR]