Impacts of mid- to later childhood body build, social circumstance and blood pressure on early-adult arterial stiffness in different ethnic groups

OBJECTIVE: Arterial stiffness, measured as aortic pulse wave velocity [PWV], is a powerful prognostic indicator for cardiovascular events, displacing blood pressure (BP). Little is known of its determinants. We tested how factors measured twice previously in childhood in the MRC ‘DASH’ study, particularly body mass (BMI) components and BP, affected PWV in young adults. DESIGN AND METHODS: Of 6643 London children, aged 11-13y, from 51 schools in samples of about 1000 in 6 ethnic groups, 4785 (72% of the cohort), were seen again at 14-16y. In 2013, 666 (97% of invited) took part in a young-adult pilot (21-23y). With psychosocial, anthropometric and BP measures, PWV was recorded via an upper arm cuff on the calibrated Arteriograph device. RESULTS: PWV reproducibility was excellent, with mean differences across 3 x 6-8 cardiac cycles each of -0.06, 0.03 and 0.06 m/sec. Unadjusted PWVs in Caribbean-origin and White UK young men were similar (mean+SD 7.9+0.3 vs 7.6 +0.4 m/sec) and lower in other groups at similar SBPs (120mmHg), BMIs (24.6kg/m2) and waists (84.3cm). In full regression models, while Caribbean (higher BMIs and waists), African and Indian young women had lower PWV (by 0.5-0.8, 95%CI 0.1-1.1,m/sec) than did white UK women (6.9+0.2), values were still increased by age, BP, a powerful impact from waist/height, with a racism effect (+0.4m/sec) in women. Childhood effects of waist/hip were also detectable. CONCLUSION: Even by young adulthood, increased waist/height ratios, BP and psychosocial variables such as perceived racism were independent determinants of arterial stiffness, likely to increase with age.

The association between indices of obesity and common clinical measures in adults with and without type 2 diabetes

OBJECTIVE: To determine if there are any differences in anthropometric measurements, lipid profile, blood pressure and body shape between diabetics and non-diabetics. DESIGN AND METHODS: This cross-sectional study comprised 309 subjects with 91 males and 218 females; there were 217 diabetics and 92 non-diabetics. The sample was taken from three hospitals in Trinidad. Lipid profile and blood pressure were taken from each facility’s physicians’ notes while anthropometric measurements were taken from the patients themselves. RESULTS: The diabetic group had elevated body mass index, and waist to hip ratios were significantly higher (p<0.05) when compared to non-diabetics. There was no significant difference in lipid profile and blood pressure between diabetics and non-diabetics. As age increased, the prevalence of type 2 diabetes mellitus was higher. Of the 217 diabetics, 173 were of East Indian descent. With regards to gender, more males were found to be diabetics resulting from having an android body shape as compared to females (gynoid body shape). It was deduced that waist to hip ratio was the best indicator of type 2 diabetes mellitus based on the area under the curve analysis. CONCLUSION: Of all the anthropometric measurements used, waist to hip ratio was found to be the most effective indicator of type 2 diabetes mellitus in Trinidadians, while body mass index was found to be the least.

Insulin sensitivity in Jamaicans with hyperglycaemia (IGT and NIDDM) - abstract

Non-insulin dependent diabetes (NIDDM) is one of the major causes of morbidity and mortality in Jamaica. The relative contributions of insulin resistance (IR) and B-cell dysfunction (percent b-cell) in the aetiology of NIDDM are unknown. We looked at three indices of insulin sensitivity: (1) the fasting insulin/glucose ratio (IGR); and (2) IR and (3) percent B-cell in Jamaicans with hyperglycaemia. (2) and (3) were calculated using the HOMA model. Subjects were selected from the lowest and highest 15 percent of a post challenge 2 h glucose distribution. The IGR distribution of the normoglycaemic group was used to establish a normal range. IGR correlated well with IR (r = 0.89) and with percent B-cell (r = 0.60). 46.7 percent of the hyperglycaemic subjects had a low IGR suggesting impaired insulin production; 31.4 percent had high IGR indicating hyperinsulinaemia and insulin resistance. The remaining 22.9 percent was probably due to a mixture of both.(AU)

Gall bladder disease at the University Hospital, Jamaica

A review of 250 patients with gall bladder disease seen at the University Hospital in Jamaica is presented. The striking feature is the early age of presentation. It is suggested that this may be related to early and multiple pregnancies in the women. The condition, except in its associated diseases, follows the patterns classically described, and the study also confirms that surgical treatment of acute cholecystitis is safe and to be performed (AU)

Body size of contemporary groups of pre-school children studied in different parts of the world

Comparisons are made among means for measures of body size on 160 samples of 4-year-old children. The samples assembled were drawn mainly between 1950 and 1960 in Africa, Asia, Australia, Europe, North and South American, the West Indies, and the Malay Archipelago. Variables examined are standing height; sitting height; body weight; width, depth, and girth of head; chest circumference; hip width; lower limb length; and girth of calf. At age 4 years, contemporary populations of children are found to differ as much a 7 inches in mean height and 13 pounds in mean weight. There is moderately strong, positive association of height and weight averages among coeval groups. (AU)

Factors influencing arterial pressure in the general population in Jamaica

Representative rural and urban populations in Jamaica were defined geographically, enumerated by private census, and visited at home by two physicians who carried out indirect arterial blood-pressure measurements. These readings have been related to a number of personal and environmental factors,and this analysis shows the following facts. 1. There was a considerable difference in the prevalence of hypertension, particularly among women, between neighbouring rural and urban negro populations, with relative higher prevalence in the women from the rural area. This was not attributable to differences in survey technique, weight, or pulse rate, nor to differnces in the prevalence of hypertension secondary to renal disease as detected by proteinuria. 2. Bacteriuria (the presence of Gram-negative rods in a concentration of 10E5 or more bacteria per ml. in repeated specimens of clean-voided urine), which was usually asymptomatic, was a common finding among women (4.4 percent of women investigated), was significantly more common in the rural area, was related to hypertension, and was found in 15 percent of females with diastolic pressures exceeding 110 mm Hg in these surveys. Bacteriuria was found in only 0.5 percent of males. 3. The relationship between bacteriuria, as detected in one prevalence study, and hypertension was not sufficient to account for the differences in the prevalence of hypertension between these two female populations. 4. Mean arterial pressures as found in these Jamaican populations were lower than those reported in other surveys of Western Negro populations. 5. Pregnant women in Jamaica had significantly lower systolic and diastolic pressures than those who were not pregnant. The prevalence of diastolic hypertension (100 mm Hg or more) was higher in nulliparous than in parous women, and was least in those with moderate sized families of two to five children. The prevalence of hypertension increased again in those with very large families, as did the presence of bacteriuria. 6. Body build, as measured by the ponderal index, had a small but consistent influence on arterial pressure as measured indirectly, in Jamaican subjects under age 55. The absence of this relationship in the elderly may be due to increased mortality among obese hypertensives. 7. The use of a qualitative method for determining the genetic factor in arterial pressure suggests that its inheritance is graded, the resemblance in pressure between close relatives being independent of the range of pressure considered, and closely similar to the genetic factor in blood-pressure found in the Welsh. 8. The pressures of middle-aged siblings of middle-age hypertensives showed no bimodality in their distribution (Summary)

A sampling study of blood pressure levels in white and negro residents of Nassau, Bahamas

Results of a study of blood pressure levels in Negro and white residents of Nassau, Bahamas, have been presented. Persons for study were selected by means of a probability sample design. The purpose of the study was to describe as accurately as possible the differing patterns of blood pressure with regard to race, age and sex. The site was selected because of the opportunity to study the two races in a somewhat different environment and perhaps mode of life than previously reported by others. Also the water supply of the area is known to be high in salt. The following facts were disclosed: 1. A definite racial difference is seen. The pattern of progression of blood pressure with age is almost linear in the Negro. The white race, however, shows a flattening or plateau effect from the time adult ages are reached until middle life, when mean blood pressure again tends to rise. This is seen in the means of both systolic and diastolic pressure, but most noticeably in regard to the systolic. 2. Sex differences are shown. Women of both races have lower mean systolic pressures during the reproductive years than men of their race. Negro men have slightly but consistently higher mean diastolic pressures than women throughout life. 3. Comparison with population studies elsewhere leads to the conclusion that Bahamian Negroes resemble Negroes elsewhere in the Western Hemisphere and Bahamian white persons resemble white people in other geographic locations in regard to blood pressure. A particularly provocative comparison is that of Bahamian Negroes in St. Kitts (Leeward Islands), since blood pressure patterns appear similar despite high salt intake in the Bahamas and low salt intake in St. Kitts (Summary)