Age is the major risk factor for cardiovascular diseases (CVD) and this is attributable in part to stiffening of large elastic arteries and development of vascular endothelial dysfunction. In contrast, regular aerobic exercise is associated with reduced risk of CVD. Swimming is an attractive form of aerobic exercise and always recommended for health promotion as well as prevention and treatment of risk factors for CVD. However, there is little scientific evidence to date indicating that swimming is equally efficacious to land-based exercise modes in reducing cardiovascular risks. Accordingly, the aim of the research was to determine the role of regular swimming exercise on both CVD traditional risk factors and vascular functions. To comprehensively address this aim, 2 different approaches were used: Study 1 (cross-sectional study) was designed to determine the potential benefit of regular swimming exercise in the primary prevention of age-related decreases in vascular function. Key measurements of vascular function were performed in middle-aged and older swimmers, runners, and sedentary controls. Central arterial compliance was higher in swimmers and runners than in sedentary controls. Study 2 (intervention study) was designed to determine whether regular swimming exercise could reverse the age-associated decline in vascular function. Middle-aged and older subjects completed either a 12-week swim training program or relaxation/ stretching exercise (attention control) program. Short-term swim training improved arterial blood pressure and vascular functions. In summary, regular swimming exercise can attenuate reductions in and partially restore the loss of vascular function including central arterial compliance and endothelial function in middle-aged and older adults. Swimming exercise exhibited typical central arterial compliance and endothelial function phenotypes that are often displayed in land-based exercise. / text

Pirminė arterinė hipertenzija diagnozuojama kas trečiam suaugusiam. Liga jaunėja, ypač tarp vyrų, šios tendencijos nepavyksta paaiškinti vien bendraisiais kardiovaskulinės rizikos veiksniais. Mažai kreipiamas dėmesys į galimą hipertenzijos ryšį su gimimo parametrais ir augimo ypatumais. Nebuvo aišku, kurie iš bendrųjų hipertenzijos rizikos veiksnių ir kokie kritinių augimo tarpsnių ypatumai daro didžiausią įtaką mūsų šalies jaunimo kraujospūdžio raidai. Todėl disertacija skirta įvertinti jaunuolystės amžiaus vyrų (18-21 metų) padidėjusio kraujospūdžio ryšį su skirtingų kritinių augimo periodų ypatumais, kardiovaskulinės rizikos veiksniais, paveldimumu ir jaunuolio šeimos socioekonominėmis sąlygomis. Ištirtas 231 asmuo (48 atvejo grupėje, 183 kontrolinėje grupėje). Darbe nustatyta, kad mažesnė galvos ir krūtinės apimtis gimus kartu su jaunuolystės kūno masės indeksu yra reikšmingi padidėjusio kraujospūdžio prognostiniai veiksniai. Greitesnis ūgio augimas per pirmus septynerius gyvenimo metus ir paauglystės tarpsnio kūno masės indekso bei svorio intensyvesnis augimo greitis turi reikšmingų sąsajų su padidėjusiu kraujospūdžiu jaunuolystėje. Nustatyta skirtinga liesos kūno masės ir riebalų masės įtaka kraujospūdžiui. Konstatuota, kad padidėjusį kraujospūdį turintys jaunuoliai yra stambesnio skeleto. Reikšmingą įtaką jo kraujospūdžiui turi rizikingais kiekiais vartojamas alkoholis ir mažesnis fizinis aktyvumas. Įvertinta mamos ankstyvo sergamumo pirmine arterine hipertenzija ir... [toliau žr. visą tekstą] / Primary arterial hypertension is diagnosed in every third adult. The disease tends to appear in younger individuals, especially men. However, general cardiovascular disease risk factors fail to explain this trend. Insufficient attention is given to the possible relation between hypertension and birth parameters as well as growth characteristics. It was not known which of the general hypertension risk factors and which of the critical growth period characteristics have major influence on the development of elevated blood pressure in young men in our country. Therefore, this dissertation aims at evaluating the relation of elevated blood pressure in young men (18-21 years old) to the characteristics of different critical growth periods, cardiovascular risk factors, heredity and the socio-economic conditions of the young man‘s family. The research showed the following results: smaller head and chest circumferences at birth along with the body mass index at young adult age are significant prognostic factors for elevated blood pressure; higher velocity of height growth within the first seven years of life and more intensive growth of the body mass index and weight in adolescence have significant relation to elevated blood pressure at young adult age; lean body mass and fat body mass have different influence on blood pressure; young men with elevated blood pressure have bigger skeletons; risky amounts of alcohol consumed and lower physical activity have significant influence on... [to full text]

Primary arterial hypertension is diagnosed in every third adult. The disease tends to appear in younger individuals, especially men. However, general cardiovascular disease risk factors fail to explain this trend. Insufficient attention is given to the possible relation between hypertension and birth parameters as well as growth characteristics. It was not known which of the general hypertension risk factors and which of the critical growth period characteristics have major influence on the development of elevated blood pressure in young men in our country. Therefore, this dissertation aims at evaluating the relation of elevated blood pressure in young men (18-21 years old) to the characteristics of different critical growth periods, cardiovascular risk factors, heredity and the socio-economic conditions of the young man‘s family. The research showed the following results: smaller head and chest circumferences at birth along with the body mass index at young adult age are significant prognostic factors for elevated blood pressure; higher velocity of height growth within the first seven years of life and more intensive growth of the body mass index and weight in adolescence have significant relation to elevated blood pressure at young adult age; lean body mass and fat body mass have different influence on blood pressure; young men with elevated blood pressure have bigger skeletons; risky amounts of alcohol consumed and lower physical activity have significant influence on... [to full text] / Pirminė arterinė hipertenzija diagnozuojama kas trečiam suaugusiam. Liga jaunėja, ypač tarp vyrų, šios tendencijos nepavyksta paaiškinti vien bendraisiais kardiovaskulinės rizikos veiksniais. Mažai kreipiamas dėmesys į galimą hipertenzijos ryšį su gimimo parametrais ir augimo ypatumais. Nebuvo aišku, kurie iš bendrųjų hipertenzijos rizikos veiksnių ir kokie kritinių augimo tarpsnių ypatumai daro didžiausią įtaką mūsų šalies jaunimo kraujospūdžio raidai. Todėl disertacija skirta įvertinti jaunuolystės amžiaus vyrų (18-21 metų) padidėjusio kraujospūdžio ryšį su skirtingų kritinių augimo periodų ypatumais, kardiovaskulinės rizikos veiksniais, paveldimumu ir jaunuolio šeimos socioekonominėmis sąlygomis. Ištirtas 231 asmuo (48 atvejo grupėje, 183 kontrolinėje grupėje). Darbe nustatyta, kad mažesnė galvos ir krūtinės apimtis gimus kartu su jaunuolystės kūno masės indeksu yra reikšmingi padidėjusio kraujospūdžio prognostiniai veiksniai. Greitesnis ūgio augimas per pirmus septynerius gyvenimo metus ir paauglystės tarpsnio kūno masės indekso bei svorio intensyvesnis augimo greitis turi reikšmingų sąsajų su padidėjusiu kraujospūdžiu jaunuolystėje. Nustatyta skirtinga liesos kūno masės ir riebalų masės įtaka kraujospūdžiui. Konstatuota, kad padidėjusį kraujospūdį turintys jaunuoliai yra stambesnio skeleto. Reikšmingą įtaką jo kraujospūdžiui turi rizikingais kiekiais vartojamas alkoholis ir mažesnis fizinis aktyvumas. Įvertinta mamos ankstyvo sergamumo pirmine arterine hipertenzija ir... [toliau žr. visą tekstą]

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High sugar-sweetened beverage (SSB) intake and poor vitamin D status have both been associated with increased risk of elevated systolic blood pressure (SBP) in previous research. However, these associations have never been investigated in the same study population, leaving the question of a possible interaction uninvestigated. One potential mechanism for an interaction is that SSB intake may increase serum uric acid (UA) and UA may interfere with utilization of vitamin D. This study examined these relationships in a sample of men and women (n=2,875) aged 20-74 using data collected in the 2003-2006 NHANES survey. No statistically significant association was found between SSB intake and risk of elevated SBP (defined as SBP>120mmHg) in whole group analysis. In subgroup analysis by gender, women (n=1,550) showed a 68% (OR: 1.68, 95% CI: 1.12-2.50, p-value 0.011) increased risk of elevated SBP in the highest SSB intake quartile (mean intake of 3.27 servings/day) compared to the lowest (mean intake of 0.03 servings/day) after adjustment for age, race, BMI, alcohol use, physical activity, and smoking, but no association was found in men (n=1,325). A statistically significant association was found between 25(OH)D and SBP, with a 30% decrease in risk of elevated SBP (OR: 0.70, 95% CI: 0.55-0.90, p-value 0.005) for those in the highest serum 25(OH)D group (>75nmol/L) compared to the lowest (<50nmol/L) in the fully adjusted model. However, no association was found between SSB intake and serum UA. Assessing potential effect modification between SSB and vitamin D in their impact on blood pressure using a multiplicative term and stratified analysis did not provided evidence of an interaction effect.

Background: The epidemic of chronic diseases is largely neglected. Although a threatening burden of chronic diseases is emerging, developing public health efforts for their prevention and control is not yet a priority for trans-national and national health policy makers. Understanding the population burden of risk factors which predict chronic diseases is an important step in reducing the impact of the diseases themselves. Objective: This thesis responds to the increasing burden of chronic diseases worldwide, and aims to illustrate the gap in chronic disease risk factor research in developing countries. The thesis describes and analyses the distribution of chronic disease risk factors in a rural setting in Indonesia. It also describes how smoking, one of the most common risk factors, is viewed by rural Javanese boys. Ultimately, therefore, this thesis aims to contribute to policy and programme recommendations for community interventions in a rural setting in Indonesia Methods: The studies were conducted in Purworejo District, where a Demographic Surveillance System (DSS) has been running since 1994. The Purworejo DSS is part of the INDEPTH network (International Network of field sites for continuous Demographic Evaluation of Populations and Their Health in developing countries). Two representative cross-sectional studies (in 2001 and 2005) were conducted to assess the chronic disease risk factors (including smoking, elevated blood pressure, and overweight and obesity). The first cross-sectional study was followed up in 2002 and 2004. In each study, a total of 3 250 participants (approximately 250 individuals in each sex and age group among 15–74 year olds stratified into 10-year intervals) were randomly selected from the surveillance database from each enumeration area in the surveillance area. Instruments were adopted from the WHO STEPS survey and adapted to local setting. Since many Indonesians start to smoke at an earlier age, a qualitative study using a focus group discussion approach was conducted among school boys aged 13-17 years old to describe and explore beliefs, norms, and values about smoking in a rural setting in Java. Result: Both the rural and urban populations in Purworejo face an unequal distribution of risk factors for chronic diseases. The burden among the most well-off group in the rural area has already reached a level similar to that found in the urban area. Most of the risk factors increased in all age, sex and socioeconomic groups during the period of 2001 to 2005. However, women and the poorest group experienced the greatest increase in risk factor prevalence. The qualitative study showed that cultural resistance against women smoking in Indonesia remains strong. Smoking is being viewed as a culturally internalised habit that signifies transition into maturity and adulthood for boys. Smoking is utilised as a means for socialisation and signifies better socioeconomic status. The use of tobacco in the construction of masculinity underlines the importance of gender specific interventions. National tobacco control policy should emphasise a smoking free society as the norm, especially among boys and men, and regulations regarding the banning of smoking should be enforced at all levels and areas of the community. Within the demographic surveillance setting, it is possible to assess the population and health dynamics. Utilisation of a standardised methodology across sites in INDEPTH will produce comparable population-based data in developing countries. Such comparisons are important in global health. A comparison of smoking transition patterns between a Vietnamese DSS and an Indonesian DSS shows that Indonesian men started smoking regularly earlier and ceased less than Vietnamese men. Compared with Vietnam, which has already signed and ratified the Framework Convention on Tobacco Control, tobacco control activities in Indonesia are still deficient. Conclusion: The thesis concludes that the rural population is not spared from the emerging burden of chronic disease risk factors. The patterning of risks across different socioeconomic groups provides a macro picture of the vicious cycle between poverty and chronic diseases. Understanding of risk factors in a local context through a qualitative study provides insight into cultural aspects relating to risk factor adoption, and will allow the fostering and tailoring of culturally appropriate interventions. Combining data from demographic surveillance sites with the WHO STEP approach to chronic disease risk factor Surveillance addresses basic epidemiological questions on chronic diseases. The use of such data is a powerful advocacy tool in public health decision-making for chronic disease prevention in developing countries. With substantial existing evidence on the effectiveness of chronic disease prevention and intervention programmes, it is vital that Indonesia to starts planning intervention programmes to control the impending chronic disease epidemic, and most importantly, to translate all this evidence into public health action. Keywords: chronic disease, risk factor, demographic surveillance system, smoking, elevated blood pressure, overweight and obesity, population-based intervention

Background. Maternal obesity and physical inactivity have been identified as correlates of overweight and obesity and physical inactivity in older preadolescents; however, no study has explored this relationship in Hispanic preadolescents. Furthermore, the relation between maternal physical activity (PA) and blood pressure (BP) in Hispanic preadolescents has not been examined. Purpose. This study aimed to assess the associations between Hispanic mothers’ PA and body mass index (BMI) and their preadolescents’ PA, screen time, BP, and BMI. Methods. Data of 118 mother-child (aged 2–10 years) dyads enrolled in a crosssectional study of metabolic syndrome in Hispanic preadolescents at a community health center in Johnson City, TN were used. Parent and child questionnaires were used to ascertain mothers’ BMI and PA and preadolescents’ PA and screen time.