Tag: hypertension

Categories : Cardiovascular DiseaseTags :

Controlling 8 Risk Factors may Eliminate Early Death Risk from Hypertension

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A new study led by researchers at Tulane University suggests that people with hypertension can significantly reduce, and possibly eliminate, their increased risk of premature death by controlling several key health risk factors at once.

The study, appearing in Precision Clinical Medicine, tracked more than 70 000 people with hypertension and over 224 000 without it, using data from the UK Biobank. Researchers followed participants for nearly 14 years to understand how managing these risk factors affected early mortality, defined as dying before age 80.

The eight health risk factors evaluated in the study include: blood pressure, body mass index, waist circumference, LDL “bad” cholesterol, blood sugar, kidney function, smoking status and physical activity. Notably, researchers found that hypertensive patients who had addressed at least four of these risk factors had no greater risk of an early death than those without hypertension. 

“Our study shows that controlling blood pressure is not the only way to treat hypertensive patients, because high blood pressure can affect these other factors,” said corresponding author Dr Lu Qi, professor of epidemiology at Tulane University. “By addressing the individual risk factors, we can help prevent early death for those with hypertension.” 

Hypertension, defined as a blood pressure of 130mmHg or higher, is the leading preventable risk factor for premature death worldwide. 

The study found that addressing each additional risk factor was associated with a 13% lower risk of early death, 12% lower risk of early death due to cancer and 21% lower risk of death due to cardiovascular disease, the leading cause of premature death globally.

“Optimal risk control” – having 7 or more of the risk factors addressed – was linked to 40% less risk of early death, 39% less risk of early death due to cancer and 53% less risk of early death due to cardiovascular disease. 

“To our knowledge, this is the first study to explore the association between controlling joint risk factors and premature mortality in patients with hypertension,” Qi said. “Importantly, we found that any hypertension-related excess risk of an early death could be entirely eliminated by addressing these risk factors.” 

Only 7% of hypertensive participants in the study had seven or more risk factors under control, highlighting a major opportunity for prevention. Researchers say the findings underscore the importance of personalised, multifaceted care – not just prescribing medication for blood pressure, but addressing a broader range of health behaviours and conditions.

Source: Tulane University

Categories : GenderTags :

Males Are More Likely to Get Sick and Less Likely to Seek Care for Three Common Diseases

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A global analysis finds sex-based health disparities for hypertension, diabetes and HIV and AIDS

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In many countries, males are more likely than females to get sick and die from three common conditions, and less likely to get medical care, according to a new study by Angela Chang of the University of Southern Denmark, and colleagues, published May 1st in the open-access journal PLOS Medicine.

Many health policies are the same for males and females, even though there is strong evidence that sex and gender can substantially influence a person’s health outcomes. In the new study, researchers gathered global health data for people of different sexes and ages for three conditions, hypertension, diabetes, and HIV and AIDS. By comparing rates of diseases between males and females and differences in diagnosis and treatment, the researchers sought to illuminate and reduce health inequities between the sexes.

The analysis identified significant differences between the sexes at each step in the “health pathway,” which includes exposure to a risk factor, development of the condition, diagnosis, treatment and death. Males and females received different care for hypertension, diabetes and HIV and AIDS in 200, 39, and 76 countries, respectively. Males had higher rates of disease and higher rates of death compared to females, and in some countries, were less likely to seek out health care and adhere to treatment. In most countries, males were also more likely to smoke, while females were more like to be obese and engage in unsafe sex.

Overall, the study suggests that public health professionals need to develop strategies to encourage males to participate in preventive and health care services. The researchers also highlight the importance of examining health data by sex to understand health inequities and guide appropriate interventions at multiple points along the health pathway. They conclude that we need more comprehensive datasets for these and other conditions so that we can monitor for sex differences and implement equitable health care policies.

Professors Kent Buse and Sarah Hawkes, co-founders and co-CEOs of Global 50/50 say, “We have long advocated the benefits of publishing sex disaggregated data.  As our Gendered Health Pathways demonstrates, such data can reveal where the health journeys of men and women diverge be it in relation to the risk factors they are exposed to, their health care seeking behaviors or their experiences in health care systems. That is an important first step towards health equity. Most of these differences are not explained by sex (biology) alone, but by socially-constructed gender – highlighting the importance of taking a gender justice approach to reducing health inequities.  A gender analysis can help to shape systems of health for all.”

Angela Chang, senior author, adds, “The evidence is clear: sex differences persist at nearly every point along the health pathway, from higher smoking rates in men to higher obesity prevalence in women, yet interventions rarely reflect this. Without sex-disaggregated cascade data, we’re flying blind – unable to detect who is falling through the cracks in prevention, diagnosis, and care.”

Provided by PLOS

Categories : Cardiovascular Disease IT in HealthcareTags :

A New Way of Visualising BP Data to Better Manage Hypertension

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If a picture is worth a thousand words, how much is a graph worth? For doctors trying to determine whether a patient’s blood pressure is within normal range, the answer may depend on the type of graph they’re looking at.

A new study from the University of Missouri highlights how different graph formats can affect clinical decision-making. Because blood pressure fluctuates moment to moment, day to day, it can be tricky for doctors to accurately assess it.

“Sometimes a patient’s blood pressure is high at the doctor’s office but normal at home, a condition called white coat hypertension,” said Victoria Shaffer, a psychology professor in the College of Arts and Science and lead author of the study published in the Journal of General Internal Medicine. “There are some estimates that 10% to 20% of the high blood pressure that gets diagnosed in the clinic is actually controlled – it’s just white coat hypertension – and if you take those same people’s blood pressure at home, it is really controlled.”

In the study, Shaffer and the team showed 57 doctors how a hypothetical patient’s blood pressure data would change over time using two different types of graphs. One raw graph showed the actual numbers, which displayed peaks and valleys, while the other graph was a new visual tool they created: a smoothed graph that averages out fluctuations in data.  

When the blood pressure of the patient was under control but had a lot of fluctuation, the doctors were more likely to accurately assess the patient’s health using the new smoothed graph compared to the raw graph.

“Raw data can be visually noisy and hard to interpret because it is easy to get distracted by outliers in the data,” Shaffer said. “At the end of the day, patients and their doctors just want to know if blood pressure is under control, and this new smoothed graph can be an additional tool to make it easier and faster for busy doctors to accurately assess that.”

This proof-of-concept study is the foundation for Shaffer’s ongoing research with Richelle Koopman, a professor in the School of Medicine, which includes working with Vanderbilt University and Oregon Health & Science University to determine whether the new smoothed graph can one day be shown to patients taking their own blood pressure at home. The research team is working to get the technology integrated with HIPAA-compliant electronic health records that patients and their care team have access to.

This could alleviate pressure on the health care system by potentially reducing the need for in-person visits when blood pressure is under control, reducing the risk for false positives that may lead to over-treatment.

 “There are some people who are being over-treated with unnecessary blood pressure medication that can make them dizzy and lower their heart rate,” Shaffer said. “This is particularly risky for older adults who are more at risk for falling. Hopefully, this work can help identify those who are being over-treated.”

The findings were not particularly surprising to Shaffer.

“As a psychologist, I know that, as humans, we have these biases that underlie a lot of our judgments and decisions,” Shaffer said. “We tend to be visually drawn to extreme cases and perceive extreme cases as threats. It’s hard to ignore, whether you’re a patient or a provider. We are all humans.”

Given the increasing popularity of health informatics and smart wearable devices that track vital signs, the smoothed graphs could one day be applied to interpreting other health metrics.

“We have access to all this data now like never before, but how do we make use of it in a meaningful way, so we are not constantly overwhelming people?” Shaffer said. “With better visualisation tools, we can give people better context for their health information and help them take action when needed.”

Source: EurekAlert!

Categories : Cardiovascular DiseaseTags :

CVD and Obesity: When Protective Lipids Decline, Health Risks Increase

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The mesenteric arteries from obese and lean mice, pictured above, supply oxygen and nutrients to the intestines. Immunofluorescence staining revealed that the NOGO-B protein increases in the vascular walls of mice fed a high fat diet compared to mice fed a standard diet. As a result, ceramides decrease in the mesenteric arteries of the obese mice, damaging endothelial cells lining blood vessels. Credit: Annarita Di Lorenzo/Weill Cornell Medicine

New research from Weill Cornell Medicine has uncovered a surprising culprit underlying cardiovascular diseases in obesity and diabetes—not the presence of certain fats, but their suppression. The study, published in Nature Communications, challenges the conventional belief that a type of fat called ceramides accumulates in blood vessels causing inflammation and health risks. Instead, their findings reveal that when ceramides decrease in endothelial cells lining blood vessels, it can be damaging and cause chronic illnesses. Ironically, the findings could ultimately lead to therapies that maintain high levels of these protective lipids in patients with obesity.

Ceramides are found throughout the body and in the endothelium, the thin lining inside blood vessels. These waxy lipids regulate blood vessel tone, dilating or contracting vessels to modulate blood pressure. They also help prevent blood clots, keeping blood flowing easily through the body’s extensive highway of arteries and veins.

“The common assumption in the field was that high levels of ceramides in the endothelium of blood vessels contributed to cardiovascular disease, but this conclusion was extrapolated from in vitro data in cells,” said Dr Annarita Di Lorenzo, professor of pathology and laboratory medicine at Weill Cornell Medicine. “Ours is the first in vivo study that measures the levels of the lipids in the endothelial cells of an animal model. In obese mice fed a high-fat diet, ceramides do not build up—they decrease compared to lean mice.” Also working on this research are co-first authors Dr Onorina L. Manzo, postdoctoral associate and Luisa Rubinelli, both in Dr Di Lorenzo’s lab.

Ceramide to the Rescue

Dr Di Lorenzo and her team discovered the importance of ceramides in blood vessels two years ago. Together with Dr Giuseppe Faraco, assistant professor of neuroscience at Weill Cornell Medicine, they found that decreased levels of ceramides in otherwise healthy mice causes severe blood vessel inflammation in the brain, clot formation and death. Last year, the team reported that ceramide production increases as a protective response in a mouse model of coronary artery disease. Ultimately, when ceramide is broken down by the body it produces a compound called sphingosine-1-phosphate (S1P), which builds up and protects mice against cardiovascular disease. But when this process doesn’t work the mice are left vulnerable.

The researchers also found that two proteins, Nogo-B and ORMDL, decreased the production of ceramides and S1P in obesity. This decrease leads to increased blood pressure, impaired vascular regulation and higher glucose levels—all of which contribute to cardiometabolic conditions that affect the heart (cardiovascular system) and energy processing (metabolism), like diabetes like diabetes, hypertension, coronary artery disease and stroke.

Maintaining Balance

To understand how these different molecules interact, the researchers tested what happens in animal models. Mice with obesity fed a high-fat diet had low levels of ceramides and S1P, but high levels of Nogo-B. These mice showed signs of inflammation, diabetes and high blood pressure.

But what happens if the Nogo-B inhibitor wasn’t present? The researchers knocked out Nogo-B only in the endothelium of blood vessels in a mouse model to find out. “These mice have the same body weight and diabetes as controls, but their blood vessel health is much better,” said Dr. Di Lorenzo. “By knocking out this inhibitor, we preserved vascular health. This also showed that the regulation of ceramide metabolism causes vascular dysfunction and inflammation in obesity.”

The paper suggests that targeting this metabolic pathway could have multiple beneficial effects in the treatment of cardiometabolic diseases related to obesity. “Nogo suppresses biosynthesis of ceramides, so if we can identify a drug that can block Nogo-B, we could restore ceramide levels to a healthy balance and this would fight not only obesity and diabetes, but would directly keep blood vessels functioning properly,” she said.

Source: Weill Cornell Medicine

Categories : Cardiovascular Disease Mental HealthTags :

New Study Investigates Effects of ADHD Medications on the Heart

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A new study led by the University of Southampton has found that medications for ADHD have overall small effects on blood pressure and heart rate after weeks or a few months of use.

There have been concerns about the side effects of ADHD medications but the new findings, coupled with other studies, suggest that the benefits of taking these medications outweigh the risks, while highlighting the need for careful monitoring.

The study, published in The Lancet Psychiatry, conducted the largest and most comprehensive analysis of the cardiovascular effects of ADHD medications based on the results of randomised controlled trials – the most rigorous type of clinical study to assess medication effects.

Professor Samuele Cortese, senior lead author of the study from the University of Southampton said: “When it comes to taking any medication, risks and benefits should always be assessed together. We found an overall small increase in blood pressure and pulse for the majority of children taking ADHD medications.

“Other studies show clear benefits in terms of reductions in mortality risk and improvement in academic functions, as well as a small increased risk of hypertension, but not other cardiovascular diseases. Overall, the risk-benefit ratio is reassuring for people taking ADHD medications.”

The study was funded by the National Institute for Health and Care Research (NIHR), within the framework of the NIHR Research Professorships scheme to Professor Samuele Cortese, with Dr Luis Farhat (University of São Paulo, Brazil) as first author and Professor Alexis Revet (University of Toulouse, France) as co-senior author.

It is estimated that attention-deficit/hyperactivity disorder (ADHD) affects around 4 per cent of children in the UK. Of these, around 45 per cent are treated with medication.

The international team of investigators analysed data from 102 randomized controlled trials, including a total of 22,702 participants with ADHD. They used an advanced statistical approach – network meta-analysis – that allowed them to compare the effects of several medications, even when the medications were not directly compared in the trials included in the analysis.

They found that all ADHD medications were generally associated with overall small effects on blood pressure, heart rate, and ECG parameters. With the exception of guanfacine (which leads to decreased blood pressure and heart rate), other medications led to increases in the values of these parameters.

No significant differences were found between stimulants (including methylphenidate and amphetamine) and non-stimulants (atomoxetine and viloxazine) with regard to their effects on blood pressure and heart rate.

“Our findings should inform future clinical guidelines, stressing the need to systematically monitor blood pressure and heart rate, both for stimulants and non-stimulants. This should be particularly relevant for practitioners who might assume that only stimulants have a negative effect on the cardiovascular system,” said Dr Farhat.

The researchers say that those with existing heart conditions should discuss the side effects of ADHD medications with a specialist cardiologist before starting treatment.

Professor Revet added: “Our findings, based on randomised controlled trials that tend to be of short duration due to ethical issues, should be complemented by results from real-world, longer-term studies.”

The research team will now look to see if some groups might be more vulnerable to cardiovascular side effects than others.

NIHR Research Professor Cortese concluded: “While our findings are informative at the group level, that is, on average, we cannot exclude that a subgroup of individuals may have a higher risk of more substantial cardiovascular alterations.

“While it is currently not possible to identify those individuals at higher risk, efforts based on precision medicine approaches will hopefully provide important insights in the future.”

Source: University of Southampton

Categories : Cardiovascular Disease Obstetrics & GynaecologyTags :

Study Probes How to Predict Complications from Preeclampsia

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Data from 8843 women diagnosed with preeclampsia during pregnancy showed that existing risk prediction models are most accurate only in the days after diagnosis

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The existing prediction models for severe complications of preeclampsia are most accurate only in the two days after hospital admission, with deteriorating performance over time, according to a new study published February 4th in the open-access journal PLOS Medicine by Henk Groen of University of Groningen, the Netherlands, and colleagues.

Preeclampsia is a potentially life-threatening condition that can occur during pregnancy; of women diagnosed with preeclampsia, 5-20% will develop severe complications. Two existing PIERS (Pre-eclampsia Integrated Estimate of RiSk) models, PIERS Machine Learning (PIERS-ML) and the logistic-regression-based fullPIERS, are designed to identify individuals at greatest or least risk of adverse maternal outcomes in the 48 hours following hospital admission for preeclampsia. However, both models are regularly used for ongoing assessment beyond the first 48 hours.

In the new study, researchers used data from 8843 women diagnosed with preeclampsia at a median gestational age of 36 weeks between 2003 and 2016. Data included PIERS-ML and fullPIERS assessments as well as health outcomes.

The study found that neither the PIERS-ML nor fullPIERS model maintained good performance over time for repeated risk stratification in women with preeclampsia. The PIERS-ML remained generally good at identifying the very high-risk and very-low risk groups over time, but performance of the larger high-risk and low-risk groups deteriorated significantly after 48 hours. The fullPIERS model underperformed compared to the PIERS-ML model.

“Since there are no better options, clinicians may still use these two models for ongoing assessments after the first admission with pre-eclampsia, but the predictions should be treated with increasing caution as the pregnancy progresses,” the authors say. More prediction models are needed that perform well over time, they add.

The authors add, “Pregnancy hypertension outcome prediction models were designed and validated for initial assessment of risks for mothers; this study shows that such ‘static’ models if used repeatedly over days yield increasingly inaccurate predictions.”

Provided by PLOS

Categories : Cardiovascular Disease PaediatricsTags :

Adequate Sleep Significantly Reduces Hypertension Risk in Teens

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Adolescents who meet the recommended guidelines of nine to 11 hours of sleep per day were shown to have a significantly lower risk of hypertension, according to a new study from UTHealth Houston.  

Recently published in the Journal of the American Heart Association, the research revealed that adolescents had a 37% lower risk of developing incidents of high blood pressure by meeting healthy sleep patterns, and underscoring the importance of adequate sleep behaviour. The research further explored the impact of environmental factors potentially impacting sleep.  

“Disrupted sleep can lead to changes in the body’s stress response, including elevated levels of stress hormones like cortisol, which in turn can increase blood pressure,” said first author Augusto César Ferreira De Moraes, PhD, assistant professor in the Department of Epidemiology at UTHealth Houston School of Public Health. 

De Moraes and his team analysed data from 3320 adolescents across the US to investigate incidents of high blood pressure during nighttime sleep cycles. Scientists identified a rise in hypertension incidents over two data periods, 2018-2020 and 2020-2022, showing an increase from 1.7% to 2.9%. The data included blood pressure readings and Fitbit assessments, which measured total sleep time and REM sleep duration at night. The study’s design analysed covariates such as Fitbit-tracked sleep, blood pressure, and neighbourhood noise by residential geocodes, allowing for a thorough examination of environmental noise exposure for each participant. 

Neighbourhood/community noise was not significantly associated with the incidence of hypertension. Environmental factors, such as neighbourhood noise, point to the need for longer-term studies to investigate the relationship between sleep health and hypertension, particularly in relation to socioeconomic status, stress levels, and genetic predispositions. 

The study emphasises the importance of improved sleep behaviours and meeting recommendations. “Consistent sleep schedules, minimising screen time before bed, and creating a calm, quiet sleep environment can all contribute to better sleep quality,” advises Martin Ma, MPH, second author of the study and recent graduate of the school. “Although environmental noise didn’t directly affect hypertension in this study, maintaining a quiet and restful sleep environment is still important for overall well-being.” 

Source: University of Texas Health Science Center at Houston

Categories : Cardiovascular Disease ExerciseTags :

An Extra Five Minutes of Exercise a Day could Reduce Blood Pressure

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New research suggests that adding a small amount of daily physical activity, such as uphill walking or stair-climbing, may help to lower blood pressure. The findings were published in Circulation. 

Just five minutes of activity a day was estimated to potentially reduce blood pressure, while replacing sedentary behaviours with 20–27 minutes of exercise per day, including uphill walking, stair-climbing, running and cycling, was also estimated to lead to a clinically meaningful reduction in blood pressure. The study was done by experts from the ProPASS (Prospective Physical Activity, Sitting and Sleep) Consortium, an international academic collaboration led by the University of Sydney and University College London (UCL)

Joint senior author Professor Emmanuel Stamatakis, Director of the ProPASS Consortium said: “High blood pressure is one of the biggest health issues globally, but unlike some major causes of cardiovascular mortality there may be relatively accessible ways to tackle the problem in addition to medication.”

“The finding that doing as little as five extra minutes of exercise per day could be associated with measurably lower blood pressure readings emphasises how powerful short bouts of higher intensity movement could be for blood pressure management.”

The research team analysed health data from 14 761 volunteers in five countries to see how replacing one type of movement behaviour with another across the day is associated with blood pressure.

Each participant used a wearable accelerometer device on their thigh to measure their activity and blood pressure throughout the day and night. 

Daily activity was split into six categories: sleep, sedentary behaviour (such as sitting), slow walking, fast walking, standing, and more vigorous exercise such as running, cycling or stair climbing.

The team modelled statistically what would happen if an individual changed various amounts of one behaviour for another in order to estimate the effect on blood pressure for each scenario and found that replacing sedentary behaviour with 20-27 minutes of exercise per day could potentially reduce cardiovascular disease by up to 28 percent at a population level.

First author Dr Jo Blodgett from UCL said: “Our findings suggest that, for most people, exercise is key to reducing blood pressure, rather than less strenuous forms of movement such as walking.

“The good news is that whatever your physical ability, it doesn’t take long to have a positive effect on blood pressure. What’s unique about our exercise variable is that it includes all exercise-like activities, from running for a bus or a short cycling errand, many of which can be integrated into daily routines.

“For those who don’t do a lot of exercise, walking did still have some positive benefits for blood pressure. But if you want to change your blood pressure, putting more demand on the cardiovascular system through exercise will have the greatest effect.”

Professor Mark Hamer, joint senior author of the study and ProPASS Deputy Director from UCL, said: “Our findings show how powerful research platforms like the ProPASS consortium are for identifying relatively subtle patterns of exercise, sleep, and sedentary behaviour, that have  significant clinical and public health importance.”

Source: University of Sydney

Categories : Cardiovascular DiseaseTags : 1 Comment

Commonly Used Arm Positions can Greatly Overestimate BP Readings

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A study led by Johns Hopkins Medicine researchers concludes that commonly used ways of positioning the patient’s arm during blood pressure (BP) screenings can substantially overestimate test results and may lead to a misdiagnosis of hypertension.

In a report on the study, published in JAMA Internal Medicine, investigators examined the effects of three different arm positions: an arm supported on a desk, arm supported on a lap, and an unsupported arm hanging at the patient’s side. Researchers found that lap support overestimated systolic pressure by nearly 4mmHg, and an unsupported arm hanging at the side overestimated systolic pressure by nearly 7mmHg.

The findings confirm that arm position makes a “huge difference” when it comes to an accurate blood pressure measurement, says Tammy Brady, MD, PhD, senior author of the study. And they underscore the importance of adhering to clinical guidelines calling for firm support on a desk or other surface when measuring blood pressure, the investigators add.

The latest clinical practice guidelines from the American Heart Association emphasise several key steps for an accurate measurement – including appropriate cuff size, back support, feet flat on the floor with legs uncrossed, and an appropriate arm position, in which the middle of an adjustable BP cuff is positioned at mid-heart level on an arm supported on a desk or table.

Despite these recommendations, the researchers say BP is too often measured with patients seated on an exam table without any, or inadequate, arm support. In some cases, a clinician holds the arm, or the patient holds an arm in their lap. In the new Johns Hopkins study, the researchers recruited 133 adult participants (78% Black, 52% female) between Aug. 9, 2022, and June 1, 2023. Study participants, who ranged from age 18 to 80, were sorted at random into one of six possible groups that differed by order of the three seated arm positions. Measurements were taken during a single visit between 9 a.m. and 6 p.m. Before BP measures were taken, all participants first emptied their bladders and then walked for two minutes to mimic a typical clinical scenario in which people walk into a clinic or office before screening takes place. They then underwent a five-minute, seated rest period with their backs and feet supported. Each person, wearing an upper arm BP cuff selected and sized based on their upper arm size, had three sets of triplicate measurements taken with a digital blood pressure device 30 seconds apart.

Upon completion of each set of three measurements, the cuff was removed, participants walked for two minutes and rested for five minutes. In the same visit, they then underwent a fourth set of triplicate measurements with their arm supported on a desk, a set used to account for well-known variations in BP readings. All of the measurements were conducted in a quiet and private space, and participants were asked not to talk to researchers or use their phones during the screening.

Researchers found that BP measurements obtained with arm positions frequently used in clinical practice – an arm on the lap or unsupported at the side – were markedly higher than those obtained when the arm was supported on a desk, the standard, recommended arm position. Supporting the arm on the lap overestimated systolic and diastolic BP by 3.9mmHg and 4.0mmHg, respectively. An unsupported arm at the side overestimated systolic by 6.5mmHg and diastolic by 4.4mmHg.

“If you are consistently measuring blood pressure with an unsupported arm, and that gives you an overestimated BP of 6.5mmHg, that’s a potential difference between a systolic BP of 123 and 130, or 133 and 140 – which is considered stage 2 hypertension,” says study author Sherry Liu, MHS, an epidemiology research coordinator at Johns Hopkins Bloomberg School of Public Health.

Investigators caution that their study results may only apply during screenings with automated BP devices, and may not apply to readings done with other BP devices.

However, Brady says, the findings suggest that clinicians need to pay better attention to best practice guidelines, and that patients “must advocate for themselves in the clinical setting and when measuring their BP at home.”

Source: Johns Hopkins Medicine

Categories : Cardiovascular Disease Environmental EffectsTags :

Exposure to Chronic Occupational Noise Drives up Blood Pressure

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Noise exposure is a known occupational hazard in some jobs, particularly for hearing loss, physical and psychological stress, and reduced concentration. A new study presented at the ACC Asia 2024 conference found in adult power loom weavers, chronic noise exposure not only increased their blood pressure overall, but also each year of exposure increased their odds of having high blood pressure by 10%.

“While the mechanism is still not well-explored, it is thought that the stress response by the body to chronic sound exposure causes hormonal imbalances that gradually leads to a permanent elevation of blood pressure,” said Golam Dastageer Prince, MBBS, MPH, medical officer at DGHS Bangladesh and the study’s lead author. “High blood pressure impacts more than a billion people worldwide and just 1 in 5 have it under control, yet it is a major cause of premature death. In addition to treating the high blood pressure through appropriate means, we must find ways to mitigate the exposure to the noise if we want to reduce the cardiovascular risk of these patients.”

Researchers at the Directorate of General Health Services in Bangladesh looked at 289 adult workers in selected weaving factories in the Araihazar sub-district of Narayanganj, Bangladesh, from January to December 2023. Participants took a face-to-face interview to complete a questionnaire covering sociodemographic variables, behaviour, dietary habits and family medical history. Blood pressure, height, weight and noise intensity were measured following standard procedures by the researchers.

The study cohort was predominantly male and married and were about 34 years of age on average. According to the researchers, a notable proportion of the cohort was illiterate. Workplace exposure duration averaged nearly 16 years, with noise intensity ranging from 96–111 decibels. In the United States the National Institute for Occupational Safety and Health has established the recommended exposure limits for occupational noise exposures to be 85 decibels on average over an eight-hour workday. Sounds at or below 70 decibels are generally considered safe.

According to Prince, none of the study population was found to be wearing ear protection personal protective equipment.

“Hopefully we can raise awareness of not only noise-induced hearing loss, but the impact of noise on blood pressure and workers’ behaviors and attitudes towards using personal protective equipment,” Prince said. “Pushing for structural improvements to industries may also help us improve the health safety of these workers.”

The study population had a 31.5% rate of high blood pressure with an additional 53.3% being prehypertensive. The study also found a positive correlation between blood pressure and noise exposure duration. Each year of exposure was found to increase high blood pressure odds by 10%, even after adjusting for age, body mass index and smoking status.

“As the study focused on workers exposed to more than 85 decibels noise for long periods of time, any profession causing workers to experience similar exposure might experience similar blood pressure impacts,” Prince said. “We definitely need more exploratory studies to reveal more information about the potential mechanisms and long-term health outcomes.”

Recent studies have shown that living near noise pollution, including highways, trains and air traffic, can have an impact on cardiovascular health. However, the current study may not apply to noise experienced during daily life. Noise pollution experienced near home typically ebbs and flows, while the industrial exposures in the study are typically continuous in pattern due to the machinery and remain at a constant sound level, according to Prince.

Source: American College of Cardiology