A1 Refereed original research article in a scientific journal
The Interdependence of Blood Pressure and Glucose in Vietnam
Authors: Nga Tran Thi Thu, Blizzard Christopher Leigh, Khue Luong Ngoc, Ngoc Truong Le Van, Bao Tran Quoc, Otahal Petr, Nelson Mark R., Magnussen Costan G., Tan Bui Van, Srikanth Velandai, Thuy Au Bich, Son Ha Thai, Hai Phung Ngoc, Mai Tran Hoang, Callisaya Michele, Gall Seana
Publisher: ADIS INT LTD
Publication year: 2021
Journal: High Blood Pressure and Cardiovascular Prevention
Journal name in source: HIGH BLOOD PRESSURE & CARDIOVASCULAR PREVENTION
Journal acronym: HIGH BLOOD PRESS CAR
Volume: 28
Issue: 2
First page : 141
Last page: 150
Number of pages: 10
ISSN: 1120-9879
eISSN: 1179-1985
DOI: https://doi.org/10.1007/s40292-020-00431-9
Introduction
Modelling of associations of systolic blood pressure (BP) and blood glucose (BG) with their explanatory factors in separate regressions treats them as having independent biological mechanisms. This can lead to statistical inferences that are unreliable because the substantial overlap in their etiologic and disease mechanisms is ignored.
Aim
This study aimed to examine the relationship of systolic blood pressure (BP) and blood glucose (BG) with measures of obesity and central fat distribution and other factors whilst taking account of the inter-dependence between them.
Methods
Participants (n = 14706, 53.5 % females) aged 25-64 years were selected by multi-stage stratified cluster sampling from eight provinces each representing one of the eight geographical regions of Vietnam. Measurements were made using the World Health Organization STEPS protocols.
Results
Structural modelling identified direct effects for BG (men P = 0.000, women P = 0.029), age (men P = 0.000, women P = 0.000) and body mass index (BMI) (men P = 0.000, women P = 0.000) in the estimation of systolic BP, and for systolic BP (men P = 0.036, women P = 0.000) and waist circumference (WC) (men P = 0.032, women P = 0.009) in the estimation of BG. There were indirect effects of age, cholesterol, physical activity and tobacco smoking via their influence on WC and BMI. The errors in estimation of systolic BP and BG were correlated (men P = 0.000, women P = 0.004), the stability indices (men 0.466, women 0.495) showed the non-recursive models were stable, and the proportion of variance explained was mid-range (men 0.553, women 0.579).
Conclusion
This study provided statistical evidence of a feedback loop between systolic BP and BG. BMI and WC were confirmed to be their primary explanatory factors. Saturated fat intake and physical activity were identified as possible targets of intervention for overweight and obesity, and indirectly for reducing systolic BP and BG. Harmful/hazardous alcohol intake was identified as a target of intervention for systolic BP.
