Young adults with spina bifida may have higher occurrence of prehypertension and hypertension.

OBJECTIVE: The aims of this study were to determine the occurrence of prehypertension and high blood pressure in adults with spina bifida (SB) and to examine relationships among blood pressure, cardiovascular disease risk factors, and SB-specific factors. DESIGN: This is a cross-sectional, retrospective analysis of adults with SB. SB-specific factors and cardiovascular disease risk factors were compared among subjects with high blood pressure, subjects with blood pressure in the prehypertensive range, and normotensive subjects using the χ, Kruskal-Wallis, or Fisher's exact tests. RESULTS: Of 225 subjects, the occurrence of prehypertension and high blood pressure was 27% (n = 22) and 27% (n = 22) for ages 18-29 yrs, 35% (n = 26) and 41% (n = 30) for ages 30-39 yrs, 18% (n = 8) and 66% (n = 29) for ages 40-49 yrs, and 21% (n = 5) and 67% (n = 16) for 50 yrs or older, respectively. Of the subjects with high blood pressure, 56% were men, 14% had obstructive sleep apnea, 14% had diabetes, 19% had renal dysfunction, 38% used tobacco, 16% had hydronephrosis, and 71% had a shunt. The groups differed significantly with respect to diabetes (P = 0.004), bladder procedures (P = 0.001), and renal dysfunction (P < 0.001), with higher proportions of subjects with high blood pressure having these comorbidities. CONCLUSIONS: Fewer than half of the subjects were considered normotensive. A greater proportion of young adults with SB appear to have high blood pressure compared with the general United States population. Because elevated blood pressure is an independent, modifiable risk factor of cardiovascular disease, these findings support early screening and intervention for elevated blood pressure in individuals with SB.

Women's and men's exercise adherence after a cardiac event.

The purpose of this secondary analysis was to determine whether age affects women's and men's exercise adherence after a cardiac event. In a convenience sample of 248 adults ages 38 to 86 who had a cardiac event, exercise adherence (three exercise sessions per week) was compared between men and women in three age groups (younger than 60, 61 to 70, and older than 70). Exercise patterns were recorded by heart rate monitors worn during exercise. No differences were found in adherence between the age groups for women; older men were nonadherent sooner than younger men when controlling for fitness level, pain, comorbidity, self-efficacy, depressed mood, and social support. Exercise adherence after a cardiac event was higher for younger men compared with older men. For all age groups, less than 37% of the total sample adhered to a three-times-per-week exercise regimen after 1 year, suggesting that interventions to maintain exercise adherence are needed.