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Background: Most adults ingest alcoholic beverages. Alcohol shows strong and positive associations with blood pressure (BP). We hypothesized that intake of red wine, white wine, beer, and spirits and dessert wine show similar associations with BP in the general population., Methods: We included 104,467 males and females aged 20-100 years in the analysis of the Danish general population. Alcohol use and type of alcohol were assessed by questionnaire. Blood pressure was measured by automated digital BP manometer. Multivariable linear regression models were used when analyzing the association between number of drinks per week and BP, stratified by sex and adjusted for relevant confounders. Each alcohol type (red wine, white wine, beer, and spirits and dessert wine) was analyzed in similar models including adjustment for other alcohol types., Results: Most of the subjects (76,943 [73.7%]) drank more than 1 type of alcohol. However, 12,093 (12.6%) consumed red wine only, 4288 (4.5%) beer only, 1815 (1.9%) white wine only, and 926 (1.0%) spirits and dessert wine only. There was a dose-response association between total drinks per week and systolic and diastolic BP (SBP, DBP) (P < .001). The crude difference was 11 mmHg SBP and 7 mmHg DBP between high (>35 drinks per week) and low (1-2 drinks per week) alcohol intake. Overall, SBP was increased by 0.15-0.17 mmHG, and DBP was increased by 0.08-0.15 mmHg per weekly drink. After stratification for age and sex, effects were slightly higher among females and among individuals aged less than 60 years., Conclusion: Alcohol intake is associated with highly significant increased SPB and DBP. The effect is similar for red wine, white wine, beer, and spirits., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Aim: The latest guidelines from ACC/AHA define hypertension at systolic blood pressure (SBP) 130-139 mmHg or diastolic blood pressure (DBP) 80-89 mmHg in contrast to guidelines from ESC/ESH defining hypertension at SBP ≥ 140 mmHg or DBP ≥ 90 mmHg. The aim was to determine whether the ACC/AHA definition of hypertension identifies persons at elevated risk for future cardiovascular outcome., Methods: In a Danish prospective cardiovascular study, 19,721 white men and women aged 20-98 years were examined up to five occasions between 1976 and 2015. The population was followed until December 2018. The ACC/AHA definition of the BP levels were applied: Normal: SBP <120 mmHg and DBP <80 mmHg, Elevated: SBP 120-129 mmHg and DBP <80 mmHg, Stage 1: SBP 130-139 mmHg or DBP 80-89 mmHg, Stage 2: SBP ≥140 mmHg or DBP ≥90 mmHg. Absolute 10-year risk was calculated taking repeated examinations, covariates, and competing risk into account., Results: For all outcomes, the 10-year risk in stage 1 hypertension did not differ significantly from risk in subjects with normal BP: The 10-year risk of cardiovascular events in stage 1 hypertension was 14.1% [95% CI 13.2;15.0] and did not differ significantly from the risk in normal BP at 12.8% [95% CI 11.1;14.5] ( p  = 0.19). The risk was highest in stage 2 hypertension 19.4% [95% CI 18.9;20.0] and differed significantly from normal BP, elevated BP, and stage 1 hypertension ( p  < 0.001). The 10-year risk of cardiovascular death was 6.6% [95% CI 5.9;7.4] in stage 1 hypertension and did not differ significantly from the risk in normal BP at 5.7% [95% CI 4.1;7.3] ( p  = 0.33)., Conclusions: Stage 1 hypertension as defined by the ACC/AHA guidelines has the same risk for future cardiovascular events as normal BP. In contrast, the definition of hypertension as suggested by ESC/ESH identifies patients with elevated risk of cardiovascular events.

Objective: To test the hypothesis that the associations of body mass index (BMI) and BMI-related risk factors with risk of stroke have attenuated over time using cohorts recruited from the general population over 4 decades., Methods: We undertook prospective studies of 2 cohorts enrolled in 1976 to 1978 (13,567 participants from the Copenhagen City Heart Study) and 2003 to 2015 (107,040 participants from the Copenhagen General Population Study). Each cohort was recruited randomly from the Danish general population 20 to 100 years of age. Participants were followed up from the date of examination to date of emigration, death, or stroke event, whichever occurred first. Follow-up ended in March 2017. We did not lose track of any individual. BMI and blood pressure were modeled with splines and in categories. Main outcome was incident stroke, including ischemic stroke, intracerebral hemorrhage, and subarachnoid hemorrhage., Results: The crude incidence of stroke declined in extreme categories of BMI and blood pressure from 1977 to 2017. The multivariable-adjusted hazard ratios for stroke in participants with BMI ≥30 vs 18.5 to 24.9 kg/m 2 were 1.4 (95% confidence interval 1.2-1.6) in the 1976-1978 cohort and 1.1 (1.0-1.2) in the 2003-2015 cohort ( p = 0.008 for 1976-1978 vs 2003-2015). The corresponding hazard ratios (confidence intervals) in participants with blood pressure ≥160/100 vs <140/90 mm Hg were 2.1 (1.9-2.3) and 1.5 (1.4-1.7), respectively ( p < 0.001). Similar secular trends were observed for diabetes mellitus but were not obvious for other risk factors., Conclusion: The associations of high BMI and high blood pressure with higher risk of stroke were attenuated across 2 Danish cohorts enrolled from 1976 through 2015., (© 2019 American Academy of Neurology.)

Unlabelled: To a large extent population blood pressure (PBP) affects morbidity and mortality in the society. Reports indicated that PBP decreased in many western countries. The associations between the main cardiovascular risk factors and the changing PBP have been described. The aim of this study was to investigate association between income factors and trends in population BP and hypertension. Copenhagen City Heart Study is a prospective longitudinal epidemiological study on almost 20000 individuals through four surveys from 1976 to 2003. The BP measurement was fully standardised. Questionnaires on household income and CV risk factors were completed by the participants. After adjustment for cardiovascular risk factors there were no significant differences in systolic BP (SBP) trend associated to income among men. Among women, however, there was a reverse relationship between SBP and income. In addition, there was a trend towards a lowering of risk-factor adjusted SBP in the high income women with time. The mechanism that lies behind the associations between trend in SBP and income is not known but data suggest that poor lifestyle may explain some of the differences. The treated hypertensives are treated without income associated treatment differences., In Conclusion: Women in higher income groups have lower SBP than women in low-income groups and the gap between SBP in high-income women and low-income women increased with time. There were no significant differences in SBP-trend associated to income among men. Results in treating hypertension did not differ between the income groups., (Copyright © 2013 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.)

OBJECTIVE. The mechanisms by which overweight and physical inactivity lead to hypertension are complex. Leptin, an adipocyte-derived hormone, has been linked with hypertension. We wanted to investigate the relationship between leptin, physical activity and new-onset hypertension. METHODS. The study was a prospective cohort study of 744 women and 367 men, who were normotensive in the third Copenhagen City Heart Study (CCHS) examination, performed 1991−94. Based on questionnaire items, the participants were divided into two groups with low (n = 674) and high (n = 437) levels of leisure-time physical activity, respectively. RESULTS. Between the third and the fourth CCHS examination, performed 2001?03, 304 had developed hypertension, defined as systolic blood pressure (SBP) ≥140 mmHg or diastolic blood pressure (DBP) ≥90 mmHg or use of antihypertensive medication. In a logistic regression model, including age, sex, body mass index, SBP, DBP, level of physical activity and leptin, we found a significant interaction between leptin and level of physical activity with new-onset hypertension as outcome variable (p = 0.012). When we entered the interaction variables, effect of leptin with low level of physical activity and with high level of physical activity, respectively, in the original model, leptin predicted new-onset hypertension in participants with low level of physical activity [odds ratio (95% confidence interval): 1.16 (1.01−1.33) for one unit increase in log-transformed leptin levels, p = 0.038], but not in participants with high level of physical activity [0.88 (0.74−1.05), p = 0.15]. CONCLUSION. We found that leptin predicted new-onset hypertension but only in participants with low level of physical activity.

Unlabelled: The aim of this study is to evaluate whether a changing population alcohol intake is capable of setting off a shift in the blood pressure distribution in the untreated part of a population. The focus is on subjects with an alcohol intake well below the limits of alcoholism because these subjects make out the majority of the population. The Copenhagen City Heart Study is a prospective longitudinal epidemiological study. The untreated study population was followed over 20years. Specially trained technicians using a blinded sphygmomanometer measured BP once with the subject in the sitting position. The BP measurement was fully standardised and the measurement method was unchanged throughout the observation period. A questionnaire concerning drinking habits was completed by the participants and double-checked by the technicians. The results were a decreasing population systolic BP and an increasing self-reported alcohol intake. The population increase was based on an increasing proportion of light to moderate drinkers. There was no effect of a moderately increasing alcohol intake as a covariate in a multivariate analysis of population systolic BP., Conclusion: A moderately increasing population alcohol intake cannot explain the observed changes in population systolic blood pressure., (Copyright © 2011 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.)

Objective: The aim of the present study was to evaluate developments in 30 years mortality risk that may be associated with developments in population systolic blood pressure (SBP) and to evaluate possible secular trends in BP-associated mortality risk in the untreated population., Design: The Copenhagen City Heart Study is a prospective longitudinal epidemiological study. The present analysis comprised participants from survey 1 (1976-78) and 3 (1991-94)., Methods: BP measurements and other methods were fully standardized and unchanged throughout the observation period. Questionnaires were completed by the participants and double checked by the technicians while they were interviewing the participants., Results: 18 077 persons participated. Age, systolic BP, diastolic BP, cholesterol, BMI, diabetes, gender and habitual physical activity were significant predictors of all-cause death in all age groups. Risk factor adjusted risk for all-cause death was significantly lower in survey 3 compared with survey 1. Among elderly people, there was no development in mortality risk. In the age groups 40-49 years and 50-59 years there were survey differences indicating a significant trend towards longer life expectancy compared with their age-matched counterparts in survey 1. The association between BP and mortality remained unchanged., Conclusion: A declining risk of all-cause death was observed in the younger and middle-aged cohorts of the population. The decrease in systolic BP and decline in mortality risk in the same age groups points to a role of systolic BP in age-cohort differentiated improvements of life expectancy. The effect of systolic BP on mortality did not change during follow-up.

Objective: This study aimed to evaluate within-population trends in population blood pressure (BP) over 25 years and to identify important determinants for a changing population BP., Design: Copenhagen City Heart Study is a prospective longitudinal epidemiological study. The study population (15 508) did not receive antihypertensive therapy., Methods: The BP measurement was fully standardized and measurement method was unchanged throughout the observation period. A questionnaire concerning drinking habits, smoking, medical therapy and physical exercise was completed by the participants and double checked by the technicians., Results: After an initial increase, population systolic BP (SBP) decreased. All risk factors were tested in the longitudinal model by means of a residual likelihood ratio test. The final model included sex, age and body mass index as significant factors and covariates. Two interactions were included. The first interaction 'age×sex' showed that the sex differences diminished with age. The second interaction 'age×survey' showed that the value of SBP in the young generations decreased survey by survey. SBP in the elderly also decreased survey by survey, but to a lesser degree. Diastolic BP (DBP) increased to a peak value in survey 3 and hereafter decreased., Conclusion: SBP decreased. body mass index, sex and age have an effect on population BP. A decreasing trend in SBP among new entrants is responsible for (part of) the observed decrease in population SBP. The decreasing SBP among the elderly was affected by the fact that an increasing number of the elderly population started antihypertensive medication. DBP decreased, but none of the investigated factors affected DBP.

The inverse associations between birth weight and later adverse health outcomes and the positive associations between adult body size and poor health imply that increases in relative body size between birth and adulthood may be undesirable. In this paper, the authors describe life course path analysis, a method that can be used to jointly estimate associations between body sizes at different time points and associations of body sizes throughout life with health outcomes. Additionally, this method makes it possible to assess both the direct effect and the indirect effect mediated through later body size, and thereby the total effect, of size and changes in size on later outcomes. Using data on childhood body size and adult systolic blood pressure from a sample of 1,284 Danish men born between 1936 and 1970, the authors compared results from path analysis with results from 3 standard regression methods. Path analysis produced easily interpretable results, and compared with standard regression methods it produced a noteworthy gain in statistical power. The effect of change in relative body size on adult blood pressure was more pronounced after age 11 years than in earlier childhood. These results suggest that increases in body size prior to age 11 years are less harmful to adult blood pressure than increases occurring after this age.

Objective: Population blood pressure (PBP) is the average BP shared by all members of a population. In PBP research, the main focus is on the great majority of individuals who are healthy in respect to blood pressure. From previous studies, we know that PBP decreased 2 mmHg during 15 years of follow-up. This decrease leads to significant reductions in cardiovascular (CV) and cerebrovascular risk. The major aim of the present study was to evaluate the effect of habitual physical activity on PBP., Design: Copenhagen City Heart Study is a longitudinal epidemiological study of CV risk in a random population sample. Three surveys were performed with 15 years of follow-up., Methods: BP was measured under standardized circumstances. A questionnaire concerning physical exercise was completed. Two scales were used, describing physical activity at work and during leisure-time, respectively., Results: Most of the subjects belonged to the sedentary or low physical activity categories. The population did not change physical activity habits during the observation time. There was no significant difference in either systolic or diastolic BP between the categories., Conclusions: The previously observed reduction in PBP is not explained by a change in the population physical activity habits. This fact illustrates the difference between the high-risk strategy and the population strategy. In the first, the preventive strategy identifies hypertensive individuals and offers them antihypertensive medication and lifestyle modulation such as more and regular physical activity to improve blood pressure and lower individual CV and cerebrovascular risk. In contrast, the "population strategy" seeks to control the determinants of incidence in the population as a whole. This paper demonstrates that physical activity is not a determinant of PBP.

Information is limited on the co-existence and prognostic association of the ischemic electrocardiogram (ECG) and blood pressure. Prospectively collected data sets from 28,118 examinations in the Copenhagen City Heart Study were analyzed for cardiac morbidity and mortality for a 5.9-year follow-up. The prognosis of the ECG, independently of blood pressure, was examined. The Cox proportional hazard model was employed to evaluate the prognostic implications of ECG findings and relative risk was adjusted for age and multivariately adjusted for traditional cardiovascular risk factors. End-points were (1) fatal and non-fatal ischemic heart disease (IHD) events and (2) cardiovascular disease (CVD) mortality. During a total follow-up period of 166,471 person years (mean: 5.9 years) 1.481 IHD events were recorded and 1.051 CVD deaths. The relative risk of an ischemic ECG was independent of the blood pressure level. The multivariately adjusted relative risk for fatal and non-fatal IHD for the ischemic ECG was 1.70 (95% CI: 1.39-2.09, p < 0.001) in women, and 1.96 (95% CI: 1.67-2.30, p < 0.001) in men, and for CVD mortality 1.71 (95% CI: 1.34-2.17, p < 0.001) in women and 2.08 (95% CI: 1.74-2.49, p < 0.001) in men. An ECG with left ventricular hypertrophy (LVH) and ST-depression was the finding with the highest risk for future events. LVH by ECG voltage-only was associated with no statistically increased risk, except for men treated for arterial hypertension.

Objective: Population blood pressure (BP) levels from a longitudinal study were analysed for trends during a period of 15 years. Trends from unadjusted data are reported as well as trends adjusted for major cardiovascular (CV) risk factors and use of antihypertensive therapy, thus allowing assessment of independent BP trends., Design: The Copenhagen City Heart Study is a longitudinal epidemiological study of CV risk in a random population sample of both genders aged 20 and above. Three cross-sectional population surveys were performed: 1976-78 (n=14000), 1981-83 (n=12675) and 1991-94 (n=9661)., Methods: BP was measured by a London School of Hygiene Sphygmomanometer. Weight and height were measured and body mass index (BMI) calculated. Non-fasting plasma cholesterol was determined. A questionnaire concerning smoking status and diabetes was completed. Measurement methods were strictly standardized and unchanged in the three cross-sectional surveys., Results: Unadjusted systolic BP (SBP) levels decreased during 15 years of follow-up, and unadjusted diastolic BP (DBP) levels increased. An investigation of the effect of major CV risk factors, both singly and jointly on BP levels, revealed a pattern of correlations contributing to BP variability. Adjustments for BMI, cholesterol, diabetes, use of antihypertensive therapy and smoking status were made in the final analyses of BP trend. The adjusted trend model demonstrated that SBP levels remained lower than SBP levels in the first survey. DBP levels increased slightly., Conclusions: The results demonstrate a decrease in population SBP. The decrease is independent of major CV risk factors. Possible contributing factors are discussed.

In this study of 10 690 individuals, associations with elevated blood pressure, ischemic heart disease, and ischemic cerebrovascular disease were determined for two noncoding [A(-20)C, G(-6)A] and two coding (T174M, M235T) single nucleotide polymorphisms, analyzed alone and in combination (haplotypes). Participants from the general population with (n=4950) and without (n=4234) elevated blood pressure were compared (study 1), as were participants from the general population without ischemic heart disease and ischemic cerebrovascular disease (n=7965) and cases with either ischemic heart disease (n=1850, study 2) or ischemic cerebrovascular disease (n=848, study 3). Finally, 22-year follow-up of 9184 individuals from the general population examined risk of ischemic heart disease (study 4) and ischemic cerebrovascular disease (study 5). Individuals with -6AA, 174TT, or 235TT had plasma angiotensinogen levels increased by 80 ng/mL (P=0.01 and 0.05 for women and men) compared with individuals with -6GG, 174TT, or 235 MM. In women, this difference was associated with an odds ratio of elevated blood pressure of 1.25 (1.03 to 1.51), which increased to 1.63 (1.05 to 2.51) in postmenopausal women receiving hormone replacement therapy. The promoter single nucleotide polymorphisms alone or as haplotypes did not predict the continuous variables of systolic, diastolic, or pulse pressure in cross section or the risk of ischemic heart disease or ischemic cerebrovascular disease in either gender in case-control or prospective studies. Individuals with -6AA, 174TT, or 235TT in the angiotensinogen gene have increased plasma angiotensinogen levels and moderately increased risk of elevated blood pressure (women only) but unaltered blood pressure examined as a continuous variable and unaltered risk of ischemic heart disease and ischemic cerebrovascular disease.

Background: Because elastase in alpha(1)-antitrypsin deficiency may attack elastin in the arterial wall, we tested whether alpha(1)-antitrypsin deficiency is associated with reduced blood pressure, risk of ischemic cerebrovascular (ICVD) and ischemic heart disease (IHD), and longevity., Methods and Results: We genotyped 7963 control subjects from the adult general population of Denmark, 1131 Danish patients with ICVD, and 2221 Danish patients with IHD. Compared with MM/MS individuals, systolic blood pressure was lower by 15 mm Hg in ZZ homozygotes (n=6, P=0.03) and 9 mm Hg in MZ heterozygotes with IHD (n=39, P=0.02). Odds ratios for ICVD and IHD in MZ versus MM/MS individuals were 0.70 (0.51 to 0.96) and 0.77 (0.61 to 0.98). Finally, mean ages of MZ and MM/MS control subjects were 58 and 56 years (Mann-Whitney: P=0.008), and relative alpha(1)-antitrypsin MZ genotype frequencies increased from 20 to 93 years among control subjects (chi(2), P=0.002)., Conclusions: ZZ alpha(1)-antitrypsin deficiency and MZ intermediate deficiency in the context of IHD are associated with reduced blood pressure, and MZ is associated with reduced risk of ICVD and IHD. Because MZ heterozygosity was associated with increased age, MZ heterozygosity could be a beneficial condition.

The Copenhagen City Heart Study (CCHS) is a longitudinal epidemiological study of 19698 subjects followed up since 1976. Variation in blood pressure (BP) measurement in the first three CCHS surveys is evaluated by assessing two components, systematic variation and random variation [daytime and seasonally variation, observer bias, non-response bias, variation with explanatory variables, such as diabetes, hypertension, body mass index (BMI), height, plasma cholesterol and smoking] for the purpose of identifying relevant errors in population surveys. BP was measured in the seated position after a 5 min rest, with the cuff around the non-dominating arm, in accordance with recommended guidelines. The participation rate fell from 74% in survey 1 to 63% in survey 3. Significant non-response bias with respect to BP values was not found. No daytime variability was noted either in systolic (SBP) or diastolic (DBP) BPs. A trend towards a lower BP was seen during the summertime. Random variation, expressed as the standard deviation of the measured values, increased with increasing BP values (SBP: 11.9-13.4 to 21.2-25.1 mmHg; DBP: 10.6-11.2 to 11.9-13.4 mmHg). SBP was positively correlated to BMI and plasma cholesterol. SBP was 5-10 mmHg higher in diabetics (p = 0.000-0.04) than in age- and sex-matched non-diabetics. DBP did not differ between the two groups. Smokers from the age of 50 years had a 2-4 mmHg lower SBP (p = 0.000-0.01) and 1-3 mmHg lower DBP (p = 0.000-0.005) than had non-smokers. In addition, significantly fewer smokers took antihypertensive medication than did non-smokers (p = 0.000). In conclusion, judging from the degree of association with BP and/or differences between the three surveys, the most important factors to consider were seasonal variation, BMI, the use of antihypertensive drug therapy, plasma cholesterol, smoking status and diabetes. An inter-survey comparison of BP in population cohorts requires controlling for these factors.

Background: The ratio of transmitral early filling velocity to early diastolic strain rate (E/e'sr) may be a more accurate measure of LV filling pressure then ratio of early filling pressure to early tissue velocity. The aim of the study was to investigate the impact of age, sex, obesity, smoking, hypertension, hypercholesterolemia, diabetes, physical activity level, socioeconomic, and psychosocial status on E/e'sr over a decade. Additionally, the predictive value of ΔE/e'sr on future major adverse cardiovascular events (MACE) has never been explored. Method: The study included 623 participants from the general population, who participated in the 4th and 5th Copenhagen City Heart Study (CCHS4 and CCHS5). Examinations were median 10 years apart. MACE was the composite endpoint of heart failure, myocardial infarction, and all‐cause death. Results: Follow‐up time was median 5.7 years, and 43 (7%) experienced MACE. Mean age was 51 ± 14 years, and 43% were male. Mean ΔE/e'sr was 2.1 ± 23.0 cm. After multivariable adjustment for demographic, clinical, and biochemistry variables, high age (stand. β‐coef. =.24, P <.001) and mean arterial blood pressure (MAP) (stand. β‐coef. =.17, P <.001) were significantly associated with an accelerated increase in E/e'sr In multivariable Cox regression, E/e'sr at CCHS5 and ΔE/e'sr were independent predictors of MACE (HR = 1.20, 95% CI [1.01; 1.42] per 10 cm increase for both). ΔE/e'sr did only provide incremental prognostic value to change in left atrial volume index of the conventional diastolic measurements. Conclusion: In the general population, age and MAP were predictors of an accelerated increase in E/e'sr over a decade. E/e'sr at CCHS5 and ΔE/e'sr were independent predictors of future MACE. [ABSTRACT FROM AUTHOR]

Life-course epidemiology seeks to better understand the mechanisms that lead to the development of chronic diseases. An example is the mechanism leading from body size to coronary heart disease (CHD); one way to acquire a better understanding of this mechanism is to investigate to what extent it works through other risk factors. In this paper, the dynamic path analysis model is presented as a tool to analyze these dynamic mechanisms in life-course epidemiology. A key feature of dynamic path analysis is its ability to decompose the total effect of a risk factor into a direct effect (not mediated by other variables) and indirect effects (mediated through other variables). This is illustrated by examining the associations between repeated measurements of body mass index (BMI) and systolic blood pressure (SBP) and the risk of CHD in a sample of Danish men between 1976 and 2006. The effect of baseline BMI on the risk of CHD is decomposed into a direct effect and indirect effects going through later BMI, concurrent SBP, or later SBP. In conclusion, dynamic path analysis is a flexible tool that by the decomposition of effects can be used to increase the understanding of mechanisms that underlie the etiology of chronic disease. [ABSTRACT FROM AUTHOR]

BackgroundLeptin and adiponectin are hormones secreted by adipose tissue, and both hormones are candidate intermediaries between adipose tissue and overweight-related diseases. So far, no prospective study has been published where the independent effects of these two hormones on the development of hypertension have been directly compared. The objective of this study was to investigate the relationships between plasma levels of leptin and adiponectin and new-onset hypertension in the Copenhagen City Heart Study (CCHS).MethodsIn a prospective study design, we examined new-onset hypertension in 620 women and 300 men who were normotensive in the third CCHS examination, which was performed in 1991–1994.ResultsBetween the third and the fourth CCHS examination, which was performed in 2001–2003, 254 had developed hypertension, defined as systolic blood pressure (SBP) ≥140 mm Hg, or diastolic blood pressure (DBP) ≥90 mm Hg, or use of antihypertensive medication. Using logistic regression analysis, adjusting for age, sex, estimated glomerular filtration rate, triglycerides, high-density lipoprotein cholesterol (HDL-C), fibrinogen, and glucose, and with leptin and adiponectin included in the same model, leptin was significantly associated with new-onset hypertension with an odds ratio (95% confidence interval) of 1.28 (1.08–1.53; P < 0.005) for 1 s.d. higher level of log-transformed leptin, whereas adiponectin was not significantly associated with new-onset hypertension having an odds ratio of 1.02 (0.84–1.24; P = 0.83) for 1 s.d. higher level of log-transformed adiponectin.ConclusionsIn the CCHS, leptin, but not adiponectin, was a significant independent predictor of new-onset hypertension.American Journal of Hypertension 2010; doi:10.1038/ajh.2009.244 [ABSTRACT FROM AUTHOR]

BackgroundLow-grade chronic inflammation has been proposed to play a major role in the pathogenesis of hypertension. Low-grade chronic inflammation is also closely associated with obesity, an established causative factor in the development of hypertension. The purpose of this study was to investigate the relationship between two markers of inflammation, C-reactive protein (CRP) and fibrinogen, and blood pressure (BP) and other hemodynamic variables in obese subjects.MethodsFrom a large cardiovascular study based in the general population, we selected subjects with a body mass index (BMI) ≥30 kg/m2, free of major cardiovascular diseases, not taking BP-lowering or lipid-lowering drugs (n = 487; women = 51.1%; median (5th to 95th percentile) age = 62 years (36–80)). The cardiovascular study included measurements of traditional and new risk factors, including ankle brachial BP index, a measure of subclinical atherosclerosis. CRP was determined by a high-sensitive assay.ResultsIn partial Spearman rank correlation analysis, adjusted for age and sex, we found no significant relationships between either CRP or fibrinogen and systolic BP, diastolic BP, pulse pressure, or ankle brachial index (ρ: −0.057 to 0.068; P > 0.13). However, fibrinogen and CRP were found to be significantly related to heart rate (ρ: 0.127–0.169; P < 0.01).ConclusionsIn this study of generally healthy obese subjects from the general population, we found no significant relationships between markers of inflammation and systolic BP or diastolic BP, showing that obese subjects with higher levels of inflammatory markers do not have higher BP levels than their obese counterparts with lower levels of inflammatory markers.American Journal of Hypertension 2009; doi:10.1038/ajh.2009.1American Journal of Hypertension (2009); 22, 4, 451–456. doi:10.1038/ajh.2009.1 [ABSTRACT FROM AUTHOR]

Our study evaluates the long-term effect of microalbuminuria on mortality among patients with acute myocardial infarction. We followed 151 patients from 1996 to 2007 to investigate if microalbuminuria is a risk factor in coronary heart disease. All patients admitted with acute myocardial infarction in 1996 were included. At baseline, we recorded urinary albumin/creatinine concentration ratio, body mass index, blood pressure, left ventricle ejection fraction by echocardiography, smoking status, medication, diabetes, age, and gender. Deaths were traced in 2007 by means of the Danish Personal Identification Register. Microalbuminuria, defined as a urinary albumin/creatinine concentration ratio above 0.65 mg/mmoL, occurred in 50% of the patients and was associated with increased all-cause mortality. Thus, 68% of the patients with microalbuminuria versus 48% of the patients without microalbuminuria had died during the 10 years of follow-up (P=0.04). The crude hazard ratio for death associated with microalbuminuria was 1.78 (CI: 1.18-2.68) (P=0.006), whereas the gender- and age-adjusted hazard ratio was 1.71 (CI: 1.03-2.83) (P=0.04). We concluded that microalbuminuria in hospitalized patients with acute myocardial infarction is prognostic for increased long-term mortality. mortality. We recommend measurement of microalbuminuria to be included as a baseline risk factor in patients with acute myocardial infarction and in future trials in patients with coronary heart disease. [ABSTRACT FROM AUTHOR]

Since β2-adrenergic receptors are important regulators of blood pressure, genetic variation in this receptor could explain risk of elevated blood pressure in selected individuals. We tested the hypothesis that Gly16Arg, Gln27Glu, and Thr164Ile in the β2-adrenergic receptor gene associated with elevated blood pressure.We genotyped 9185 individuals from the adult Danish general population.Allele frequencies of 16Arg, 27Glu, and 164Ile were 0.38, 0.44, and 0.01, respectively. Among women never treated with antihypertensive medication those heterozygous for Thr164Ile versus non-carriers had increased diastolic blood pressure (P=0.02). Women heterozygous for Thr164Ile versus non-carriers had an odds ratio for elevated blood pressure of 1.93 (95% CI: 1.30-2.86). Finally, women double heterozygous for Thr164Ile and Gln27Glu or Gly16Arg versus non-carriers at all 3 loci had an odds ratio for elevated blood pressure of 2.49 (1.28-4.85) or 3.19 (1.46-6.97). In men, blood pressure was not influenced by this genetic variation.In women Thr164Ile heterozygosity is associated with increased diastolic blood pressure, and represent a risk factor for elevated blood pressure in women in the general population. This was most pronounced in those women also heterozygous for Gln27Glu or Gly16Arg. [ABSTRACT FROM AUTHOR]

Children with a growth trajectory of overweight have higher levels of cardiovascular disease (CVD) risk factors than children with a normal-weight trajectory. However, less is known about how trajectories of body mass index (BMI) across the rest of the BMI spectrum relate to CVD risk factors and whether adult BMI affects these associations. Our aim was to examine associations between childhood BMI trajectories and adult CVD risk factors. We included 2466 individuals with childhood weights and heights (ages 6–14) from the Copenhagen School Health Records Register and adult CVD risk factors (ages 20–81) from the Copenhagen City Heart Study. Associations between childhood BMI trajectories identified by latent class modelling and CVD risk factors were examined using generalized linear regression analyses with and without adjustment for adult BMI. Normal-weight and overweight were defined by growth references from the Centers for Disease Control and Prevention. We identified four childhood trajectories within the normal-weight spectrum and one trajectory of overweight. Compared to the trajectory with the lowest BMI level, several higher BMI trajectories were associated with worse circumference, HDL and glucose homeostasis in adulthood. The highest trajectory was additionally associated with higher total cholesterol and triglycerides. When adjusting for adult BMI, the higher BMI trajectories had lower waist circumference, blood pressure and triglycerides. Trajectories of BMI within the normal-weight range and in the overweight range are associated with a worse CVD risk profile than in the lowest BMI trajectory, and these associations are modifiable by growth after childhood. Image 1 • Five different trajectories of body mass index from ages 6-14 were identified in a population of 2466 Danish children. • The trajectory above overweight cutoffs was associated with the worst cardiovascular disease risk factor profile. • Even trajectories below overweight cutoffs had worse cardiovascular disease risk factor profiles than the lowest trajectory. • These associations appeared to be modifiable by body mass index development after age 14. [ABSTRACT FROM AUTHOR]

Abstract: Objectives: To compare the new Patient Rule Induction Method (PRIM) Score and common clinical practice with the Framingham Point Score for classification of individuals with respect to coronary heart disease (CHD) risk. Methods and results: PRIM Score and the Framingham Point Score were estimated for 11,444 participants from the Copenhagen City Heart Study. Gender specific cumulative incidences and 10 year absolute CHD risks were estimated for subsets defined by age, total cholesterol, high-density lipoprotein (HDL) cholesterol, blood pressure, diabetes and smoking categories. PRIM defined seven mutually exclusive subsets in women and men, with cumulative incidences of CHD from 0.01 to 0.22 in women, and from 0.03 to 0.26 in men. PRIM versus Framingham Point Score found 11% versus 4% of all women, and 31% versus 35% of all men to have 10 year CHD risks>20%. Among women≥65 years with hypertension and/or with diabetes, 10 year CHD risk>20% was found for 100% with PRIM scoring but for only 18% with the Framingham Point Score. Conclusion: Compared to the PRIM Score, common clinical practice with the Framingham Point Score underestimates CHD risk in women, especially in women≥65 years with hypertension and/or with diabetes. [ABSTRACT FROM AUTHOR]