Parental history of hypertension and dietary intakes in early adolescent offspring: a population-based study
ABSTRACT We investigated the cross-sectional association between parental history of hypertension and dietary intakes among early adolescent schoolchildren. A total of 1845 participants aged 12 years had complete data on diet and parental medical history, and thus they were included in the final analyses. Dietary data were assessed from validated semi-quantitative food-frequency questionnaires. Parents completed questionnaires about their medical conditions. Cases where the biological mother and/or father had hypertension were classified as positive parental history of hypertension. After multivariable adjustment, participants with positive versus negative parental history of hypertension had 33% greater likelihood of consuming soft drinks 1 per week. Boys with a parental history versus boys without a parental history of hypertension consumed more energy-dense, nutrient-poor foods: 379.4 g per day and 318.0 g per day, respectively, P=0.02. Girls with a positive versus a negative parental history consumed more vegetables: 164.1 versus 142.6 g per day, P=0.01. Significant associations were not observed between those with and those without a positive parental history in mean dietary intakes of carbohydrates, fats, sugars and sodium. Children with a positive parental history of hypertension were 67% more likely to simultaneously engage in three unhealthy lifestyle behaviors (excessive recreational screen viewing, high consumption of snacks and and high consumption of soft drinks). Parental hypertension was associated with unhealthy dietary behaviors among offspring, including higher consumption of soft drinks and energy-dense, nutrient-poor foods.Journal of Human Hypertension advance online publication, 27 February 2014; doi:10.1038/jhh.2014.12.
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ABSTRACT: While most intervention studies on coronary heart disease have focused on the high-risk person only, the present study used the family as the unit of intervention. In the study 1373 high-risk men, ages 30-54 years, were identified on the basis of high total cholesterol (TC) and/or low relative high-density lipoprotein cholesterol (HDL-C) (HDL-C/TC) following the 1979/1980 survey in Tromsø. The men and their families were randomly allocated to a control or intervention condition. The intervention families were given advice on diet, smoking, and exercise. At rescreening in 1986/1987, significantly lower risk factor levels were found in both the intervention men and their spouses compared with those in the control group. For children, the differences were small and mostly nonsignificant. Men, spouses, and children in the intervention group reported more favorable dietary habits than those in the control group. No differences were found in smoking or leisure time physical activity.Preventive Medicine 04/1991; 20(2):197-212. DOI:10.1016/0091-7435(91)90020-5 · 3.09 Impact Factor
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ABSTRACT: Although the association between parental coronary artery disease (CAD) and its risk factors in the offspring is known, the timing and the course of development of risk factors from childhood to adulthood in the offspring is not known. To examine the association between parental CAD and longitudinal changes in risk factor profile from childhood to young adulthood in offspring. Cohort study. Bogalusa, La, a semirural, biracial community. Individuals with clinically verified parental history of CAD (n=271) vs those without such a history (n = 1253) Mean age at first CAD event was 50 years for fathers and 52 years for mothers. Body mass index, subscapular skinfolds, blood pressure, and triglyceride, cholesterol (total, very low-density lipoprotein [VLDL-C], low-density lipoprotein [LDL-C], and high-density lipoprotein [HDL-C] cholesterols), glucose, and insulin levels. The offspring of parents with CAD were consistently overweight beginning in childhood. Their levels of total serum cholesterol, LDL-C, plasma glucose, and insulin became significantly higher at older ages, because of a higher rate of increase in these risk factors over time. In adulthood, the offspring with a positive parental history had a higher prevalence of obesity (body mass index >85th percentile in the National Health and Nutrition Examination Survey I, 35% vs 26%, P=.01), elevated total cholesterol (>6.2 mmol/L [240 mg/dL], 8.4% vs 4.8%, P=.05) and LDL-C levels (>4.1 mmol/L [160 mg/dL], 12.4% vs 4.7%, P=.05), and hyperglycemia (glucose, >6.6 mmol/L, 2.7% vs 0.4%, P<.001), as well as a higher coexistence of these conditions (P=.01). Further, the prevalence of dyslipidemia, either involving only LDL-C or LDL-C in combination with HDL-C or triglycerides or both, was significantly higher in the adult offspring with parental CAD. Offspring of parents with early CAD were overweight beginning in childhood and developed an adverse cardiovascular risk factor profile at an increased rate. These observations have important implications for prevention and intervention.JAMA The Journal of the American Medical Association 01/1998; 278(21):1749-54. DOI:10.1001/jama.278.21.1749 · 35.29 Impact Factor
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ABSTRACT: Although drug treatment for hypertension has been widely used for many years, overall control of this disease continues to be less than optimal. Hypertension treatment has had a positive impact on stroke rates, but rates of coronary heart disease remain high. One reason for this lack of success in treatment is that physicians have focused too narrowly on lowering blood pressure. Blood pressure is a critical element of hypertension, but many other interrelated risk factors contribute to form a complex syndrome of hypertension. Studies show that young adult subjects who do not yet have high blood pressure but do have a family history of hypertension exhibit increased incidence of other risk factors, such as high cholesterol, left ventricular dysfunction, reduced arterial compliance, and insulin resistance. These patients with "normotensive hypertension" share many characteristics with patients with fully developed hypertension, both uncontrolled and controlled. The link between these many risk factors and high blood pressure seems to lie in endothelial cell balance. If this balance is upset, elements of the hypertension syndrome start to become manifest, often before blood pressure becomes elevated. Angiotensin-converting enzyme inhibitors can restore this critical balance, improving overall arterial health and arterial compliance and thus preventing the progression of the hypertension syndrome to high blood pressure and, ultimately, target organ damage.Heart Disease 01/2000; 2(5):370-4.