Clinical and Experimental Hypertension. Part A: Theory and Practice

ISSN: 0730-0077 (Print) (Online) Journal homepage: http://www.tandfonline.com/loi/iceh19

The Gubbio Data Epidemiology and Pathophysiology Martino Laurenzi, Massimo Cirillo & Maurizio Trevisan To cite this article: Martino Laurenzi, Massimo Cirillo & Maurizio Trevisan (1992) The Gubbio Data Epidemiology and Pathophysiology, Clinical and Experimental Hypertension. Part A: Theory and Practice, 14:1-2, 261-269, DOI: 10.3109/10641969209036187 To link to this article: http://dx.doi.org/10.3109/10641969209036187

Published online: 03 Jul 2009.

Submit your article to this journal

Article views: 1

View related articles

Full Terms & Conditions of access and use can be found at http://www.tandfonline.com/action/journalInformation?journalCode=iceh19 Download by: [RMIT University Library]

Date: 06 May 2016, At: 15:24

CLIN. AND EXPER. HYPER.-THEORY AND PRACTICE, A14(1&2),

261-269 (1992)

THE GUBBIO DATA. EPIDEMIOLOGY AND PATHOPHYSIOLOGY.

Martino Laurenzi, Massimo Cirillo*, Maurizio TrevisanA, on behalf of the Gubbio Study Research Group.

Downloaded by [RMIT University Library] at 15:24 06 May 2016

Merck Sharp

&

Dohme, Italy

-

*University of Naples, Italy

-

^SUNY at Buffalo, USA.

ABSTRACT The relation between the maximal velocity of red blood cell sodium-lithium countertransport and blood pressurejhypertension has been studied in 2,748 men and women aged 25-74 years who participated in the 1983-85 baseline examination of the Gubbio Population Study, an epidemiologic investigation performed in a hill town of north central Italy. Men had a higher sodium-lithium countertransport velocity than women at all ages, and, in both sexes, a higher velocity was observed at successive ages. Hypertensives of both sexes had a higher sodium-lithium countertransport velocity than normotensive individuals, the difference remaining significant after control €or age, body mass index and plasma uric acid concentration. Individuals with high sodium-lithium countertransport velocity had significantly greater prevalence of hypertension in both sexes. The data show the existence of a cross-sectional association between sodium-lithium countertransport velocity and hypertension in general population. Prospective study of the Gubbio population is now in progress to investigate the relation between baseline sodium-lithium countertransport velocity, its change over the years and the incidence of hypertension. INTRODUCTION Several membrane pressure.

studies have

electrolyte A

focused

transport

in

attention on the

the

regulation

red

of

consistent positive association has been

between high blood pressure and the maximal velocity

role

of

blood

reported (Vmax) of

blood cell (RBC) sodium-lithium countertransport (Na-Li CT),

a parameter which reflects the activity of the RBC membrane Na-Na

261 Copyright 0 1992 by Marcel Dekker, Inc.

262

LAURENZI, CIRILLO, AND TREVISAN

antiporter. Most

of

investigations

these previous studies have

comparing

hypertensive

with

been

clinic

normotensive

individuals (1-3). The

Gubbio

Population

epidemiologic project both

(4)

Study

is

a

population-based

whit the primary aim

cross-sectionally and longitudinally the

to

investigate

relation between

Na-Li CT and blood pressure/ hypertension, independently of other

Downloaded by [RMIT University Library] at 15:24 06 May 2016

traits possibly related to blood pressure level as well as to NaLi CT. The

present

paper

reports data obtained

sectional phase of the Gubbio Study about blood

in

the

cross-

pressure

level

and prevalence of hypertension in the Gubbio population, and data supporting the existence of a cross-sectional association between the Vmaxof RBC Na-Li CT and the level of blood pressure.

METHODS Gubbio population

is

a hill town in north-central Italy.

The

target

for the study was defined as all persons aged

5

and

older living within the confines of the medieval city walls.

The

cross-sectional phase

of

March 1983 to December 1985.

the Gubbio Study was

performed

from

The population sample consisted

of

3836 individuals, of whom 3536 (92.2%) participated in the study.

An

additional

part

1840 individuals resident outside the walls

in the study on a voluntary basis,

5376 participants.

living both

took

thus making a total

of

Since findings were similar for participants

within and outside the city walls, the two

groups

were combined for the analysis. The

participants

underwent

a

comprehensive

baseline

examination performed by trained physicians in a facility set up in premises demographic

of the municipality.

Information was collected

data (including occupation and

habit, personal

and family medical

on

education),

smoking

history, habitual

alcohol

consumption, and drug and/or dietary treatment status.

THE GUBBIO DATA

263

The participants were asked to refrain from eating, smoking and

strenuous exercise

heparinized

blood

for two hours before the visit.

sample was used for the preparation

aliquots; one of packed solution was

RBC

resuspended

the

Downloaded by [RMIT University Library] at 15:24 06 May 2016

for

4

Institute of

Internal Medicine and Metabolic Diseases, University of

Laboratory

of

in a preservation

shipped to the Laboratory of

for Na-Li CT measurement (5);

A

Naples

one of plasma was shipped to the

of Clinical Biochemistry, Institute of Health, Rome

lipid determination. Another aliquot of plasma and

one

of

whole blood was processed by the Laboratory of the Gubbio Civil Hospital for routine investigations

--

including hematological

parameters, plasma concentrations of glucose, urea, uric acid, sodium and potassium. A first voided morning urine sample was used

for determination of

concentration. At

least

creatinine, sodium, and 10%

of

all samples were

submitted as blind replicates to each of

the

potassium split and

laboratories to

monitor technical errors. Blood mercury

pressure was measured by

trained physicians with

sphygmomanometers using cuffs of appropriate size on the

right arm

with the participant in a

pressure values

sitting position. Blood

reported in this paper are the average of

the

second and third readings. Weight

and height were measured using a beam balance and

stadiometer with

the participant wearing

a

light clothing but

without shoes. The present report deals with data on adult paticipants aged 25

to

blood

74

with complete data.

Hypertension is defined as systolic

pressure (SBP) greater than or equal to 140 nun Hq, and/or

diastolic blood pressure (DBP) greater than or equal to 90 mm Hg, and/or current regular drug treatment for hypertension regardless of the measured blood pressure.

264

LAURENZI, CIRILLO, AND TREVISAN

Table 1 .................................................................. Mean systolic and diastolic pressure by gender and age. .................................................................. Systolic pressure mean SD

n

Diastolic pressure mean SD

WOMEN Age group

Downloaded by [RMIT University Library] at 15:24 06 May 2016

25 35 45 55 65

-

34 44 54 64 74

323 378 417 526 378

12.3 17.3 21.3 21.2 23.0

114.3 120.9 134.1 144.5 155.0

68.8 75.8 80.7 82.4 79.6

9.6 11.1 11.0 11.0 12.2

73.7 78.5 82.5 81.4 78.0

9.4 9.9 10.5 10.8 10.8

MEN Age group

11.4 328 121.4 - 34 12.8 123.2 44 345 19.4 132.4 - 54 353 22.1 140.4 - 64 395 22.2 148.0 74 263 -----------------------------------------------------------------. 25 35 45 55 65

-

RESULTS shown

As

in

Table

1 mean

systolic

blood

progressively higher with age in both sexes, for

men

values

pressure

with higher

than women in the age range 25 to 44 years

and

was

values higher

for women thereafter.

Mean diastolic blood pressure also was higher with age, less markedly so for systolic blood pressure, with the peak in the age range men.

55-64 years for women and in the age range 45-54 years €or

Men

age 25 to 54 years had higher mean diastolic

pressure

than women, while women had higher mean at ages 55 to 74 years. Prevalence of hypertension (Table 2) pressure

equal

--

to or greater than 140 mm Hg,

pressure equal to or greater than 90 mm Hg, treatment

defined as

for hypertension

--

and/or

systolic diastolic

and/or regular

was progressively higher with

drug age

in both sexes, with higher values for men than women age 25 to 44 years and higher values for women thereafter. Mean in

value of RBC Na-Li CT was higher in hypertensives than

normotensives in all age groups of men and

exception

of women aged 25-34 (n=12,

women,

Table 3)).

with

the

The difference

THE GUBBIQ

265

DATA

Table 2 ............................................................ Percent prevalence of hypertension by gender, age, pressure level, and treatment status.

blood

............................................................ percent of hypertensives ............................................ not on drug treatment treated all _-___-___--__--__---------------__--

Downloaded by [RMIT University Library] at 15:24 06 May 2016

SBP 140-159 and/or DBP 90-94

----------WOMEN Age group 25 35 45 55 65

-

-

34 44 54 64 74

MEN Age group

SBP 1604and/or DBP 95+

---------

n 323 378 417 526 378

2.9 5.6 15.6 22.0 22.5

1.6 4.5 10.8 17.8 24.1

0.3 4.8 16.1 26.9 33.3

4.7 14.8 42.4 66.8 79.8

n

2.1 8.5 0.3 10.9 - 34 328 9.9 4.1 6.1 20.1 - 44 345 13.6 12.5 16.1 42.2 - 54 353 21.8 13.4 20.5 55.8 - 64 395 27.8 22.4 19.4 69.6 - 74 263 ............................................. ---------------

25 35 45 55 65

hypertension :

SBP equal to or greater than 140 or DBP equal to or greater than 9 0 mmHg or regular antihypertensive drug treatment regardless of the observed blood pressure.

Downloaded by [RMIT University Library] at 15:24 06 May 2016

2 66

LAURENZI, CIRILLO, AND TREVISAN

WOMEN ...............................

MEN ...............................

RBC Na-Li CT quintile

RBC Na-Li CT quintile

.353

percent of hypertensives

n 359 325 363 371 411

35.9 38.2 43.8 51.5 54.7

percent of hypertensives

n

C.210 .210-. 272 .273-.337 .338-.431 >.431

3 02 292 292 293 344

35.1 31.2 35.7 42.7 50.3

2

X

40.3

30.7

P

The Gubbio data. Epidemiology and pathophysiology. Gubbio Study Research Group.

The relation between the maximal velocity of red blood cell sodium-lithium countertransport and blood pressure/hypertension has been studied in 2,748 ...
488KB Sizes 0 Downloads 0 Views