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
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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.
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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
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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
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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
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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 _-___-___--__--__---------------__--
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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.
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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