High Blood Pressure Reasons Differ by Gender in Teens and Young Adults

There are marked gender differences in what drives blood pressure in middle-age in adulthood, suggesting the need for gender-specific treatments for high blood pressure, according to research presented today at the American Heart Association (AHA) Council on Hypertension, AHA Council on Kidney in Cardiovascular Disease, American Society of Hypertension Joint Scientific Sessions 2017, in San Francisco.

Background

“Blood pressure is determined mainly by three factors: heart rate; stroke volume, which is the volume of blood pumped by the heart; and the resistance to blood flow through the vessels, called total peripheral resistance. An increase in any one of the three factors can lead to an increase in blood pressure,” said study author Catriona Syme, Ph.D., postdoctoral fellow at The Hospital for Sick Children (SickKids) in Toronto, Ontario, Canada. “The key takeaway from this study is that, for young and middle-aged women, stroke volume was the main determinant of blood pressure, while, in men, vascular resistance was the main determinant of blood pressure.”

Syme and colleagues studied 1,347 Canadians from the Saguenay Youth Study, including 911 adolescents and 426 adults ages 36 to 65 years. The researchers used a device that measures beat-by-beat blood pressure and the underlying forces of heart rate, stroke volume and total peripheral resistance. In the approximately hour-long protocol, they measured these variables at rest, and during posture changes and a mental stressor – all designed to mimic daily life activities, according to Syme.

Researchers found:

  • In females, stroke volume explains 55 percent of the variance in systolic blood pressure (the top number in a blood pressure reading), versus only 35 percent in males.
  • In males, the major determinant of systolic blood pressure was total peripheral resistance, which explained 47 percent of the variance, versus only 30 percent in females.
  • These gender differences were seen across most of the 52-minute protocol, being most prominent during standing and least evident during mental stress, according to the abstract.

This study is novel in that it looks at the relative contributions of the three parameters determining blood pressure, which have not been evaluated in a large population-based study, and it assesses these factors over time, in a way that mimics daily life activities. The study also looks at high blood pressure culprits in adolescents and young to middle aged adults, who are not frequently studied despite being affected by hypertension, according to Syme.

“For example, there have been many studies looking at sex differences in the usefulness of blood pressure medications. But, most of those studies have been done in people whose average age was 60-70 years — many of the women being post-menopausal,” Syme said. “We think pre-menopausal women and men of a similar age may have elevated blood pressure for different reasons, and thus may need to be treated for hypertension differently. After menopause, when the production of female sex hormones decreases, reasons for hypertension may be more similar in men and women.”

While current treatment recommendations for hypertension do not differ by gender across all ages, this study suggests potential benefits to prescribing blood pressure-lowering medications with consideration for gender differences in the underlying physiology of elevated blood pressure in young and middle-aged adults.

This study was conducted in Caucasians. Future studies should investigate whether the relative contributions of these parameters differ by race.

Source: American Heart Association


Today’s Comic

Advertisements

Hong Kong Begins to Cut Salt in Students’ Lunches

Naomi Ng wrote . . . . . . .

Officials revealed that since the start of the academic year this month, the 13 suppliers had already reduced sodium levels by nine per cent in meals served at 440 primary schools, exceeding the yearly target of five per cent, or a 50 mg reduction per meal.

A government study in 2013 revealed that 99 per cent of school lunch samples contained an average of 950 mg of salt per meal, exceeding the recommended intake of 500mg.

Primary school pupils only need a teaspoon, or 1,500 mg of salt a day, according to the Department of Health.

Although participation in the low-salt drive will not be mandatory, the government hopes to cut down sodium levels in primary school lunches by 47 per cent by 2027.

Health authorities will also conduct a citywide test to evaluate nutrition levels in all primary school lunches early next year, which will also ascertain how much sodium levels have gone down since 2013.

Dr Anne Fung Yu-kei, the department’s assistant director for health promotion, said the drive would gradually improve children’s health in the long run.

“Excessive intake of sodium could lead to hypertension, or high blood pressure. It is also the major cause of cardiovascular diseases and stroke,” Fung said.

Condiments and seasonings such as chicken powder, soy sauce, ketchup and Worcester sauce are known to be major sources of high sodium levels in the Chinese diet.

Fung added it was important for schools not to label the lunchboxes as “reduced sodium” meals.

“We worry that children will form subjective connotations [if they are labelled]. A phased sodium reduction approach will help [pupils’] palates gradually adapt to the change in taste and increases their acceptance of less sodium in food,” she said.

A 47 per cent reduction target was in line with international standards, the department said. In the United States, a nationwide programme was introduced in 2012 to help schools reduce sodium in lunches by 53 per cent to 640mg by 2022.

There are no statistics on the prevalence of hypertension in children and adolescents, but government figures show an increasing rate of students with abnormal blood pressure levels being referred to hospitals.

Lunch suppliers have had to make alterations to recipes to meet the annual target, but they say that less salt does not necessarily mean bland meals.

In a pilot project last year, six suppliers sold more than 107,000 sodium-reduced lunchboxes to 306 primary schools, with only one complaint that the meal was tasteless.

Nicole Wong Ho-yan, a nutritionist at Danny Catering Service, said the company was able to meet the goal by reducing one tablespoon of sauce per lunchbox.

Another caterer said it used alternative seasonings in its marinade, such as ginger and herbs, which contained less salt.

Source: SCMP

Health Canada Trans Fat Ban Takes Effect Next Year

Artificial trans fat will finally be off our plates, Heart & Stroke says, nearly 12 years after the move was recommended to the federal government.

Health Minister Ginette Petitpas Taylor announced Friday the final step to ban partially hydrogenated oils in all foods sold in Canada.

The oils are the main source of trans fats in foods that raise levels of low-density lipoprotein (LDL), or “bad” cholesterol and lower “good” cholesterol, which can take a toll on our heart health.

Trans fats are used in the production of pastries, other baked goods and some packaged goods to extend shelf life. 

Eliminating the main source of industrially produced trans fat from the food supply will help to protect the health of Canadians, Petitpas Taylor said in a statement.

Canadian researchers estimate a ban could prevent 12,000 heart attacks in Canada over 20 years.

The ban will come into force one year from today on Sept. 15, 2018, to give the food industry enough time to find suitable alternatives, the regulator said.

It will apply to all foods sold in the country, including imported products and foods prepared and served in restaurants and food service establishments.

Heart & Stroke said it will reduce the number of heart attacks in Canada and save lives.

Heart & Stroke co-chaired a task force with Health Canada in 2006 that first recommended the ban. 

In the U.S., manufacturers must ensure that their food products no longer contain trans fats unless otherwise authorized by June 18, 2018, the U.S. Food and Drug Administration  says.

Source: CBC

A Fast and Hearty Breakfast Treat with Crisp, Egg-dipped Multigrain Bread

Ingredients

1/4 cup orange juice
2 eggs
1/4 teaspoon cinnamon
2 tablespoons butter or margarine
4 slices multigrain bread

Topping

1/2 cup extra orange juice
2 tablespoons strawberry jam

Method

  1. In shallow dish, whisk together orange juice, eggs and cinnamon. Set aside.
  2. In frying pan, melt half the butter over moderate heat.
  3. Dip bread slices into egg mixture, turning to thoroughly soak both sides.
  4. Add bread to pan in batches, adding more butter as needed, and fry until golden brown, about 1 minute per side. Place on heated serving plates.
  5. In small saucepan, combine extra orange juice and jam. Heat, stirring until jam is melted. Drizzle as desired over french toast.

Makes 2 servings.

Source: Family Circle magazine

In Pictures: Breakfast Toasts