title: Determinants of the components of arterial pressure among older adults--the role of anthropometric and clinical factors: a multi-continent study.
abstract: OBJECTIVE
  The aim of this study was to evaluate the factors associated with different components of arterial blood pressure in nine nationally-representative samples of people aged ≥50 years.
  
  
  METHODS
  Data were available for 53,289 people aged ≥18 years who participated in the SAGE (WHO Study on global AGEing and adult health) study conducted in China, Ghana, India, Mexico, Russia, and South Africa, and the COURAGE (Collaborative Research on Ageing in Europe) study conducted in Finland, Poland, and Spain, between 2007 and 2012. Standard procedures were used to obtain diastolic and systolic blood pressure (DBP, SBP) measurements to identify hypertensive participants, and to determine mean arterial blood pressure (MAP) and pulse pressure (PP).
  
  
  RESULTS
  The analytical sample consisted of 42,116 people aged 50 years or older. South Africa had the highest prevalence of hypertension (78.3%), and the highest measurements of MAP ± SD (113.6 ± 36.4 mmHg), SBP ± SD (146.4 ± 49.5 mmHg), and DBP ± SD (97.2 ± 33.9 mmHg). In the adjusted models, dose-dependent positive associations between Body Mass Index (BMI) and MAP or PP were observed in most countries (p < 0.05). Diabetes was positively associated with PP in most countries but the association between diabetes and MAP was less consistent. Stroke was associated with both higher MAP and PP in China, Ghana, and South Africa (p < 0.05).
  
  
  CONCLUSIONS
  Obesity and diabetes remain important modifiable risk factors for arterial peripheral resistance and stiffness as reflected by MAP and PP respectively. Controlling arterial pressure abnormalities after stroke events may be important for secondary prevention, particularly in developing countries.
authors.affiliation: Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Dr Antoni Pujades, 42, 08830 Sant Boi de Llobregat, Barcelona, Spain; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Monforte de Lemos 3-5. Pabellón 11, 28029 Madrid, Spain.
authors.forename: Stefanos
authors.initials: S
authors.lastname: Tyrovolas
authors.affiliation: Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Dr Antoni Pujades, 42, 08830 Sant Boi de Llobregat, Barcelona, Spain; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Monforte de Lemos 3-5. Pabellón 11, 28029 Madrid, Spain.
authors.forename: Ai
authors.initials: A
authors.lastname: Koyanagi
authors.affiliation: Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Dr Antoni Pujades, 42, 08830 Sant Boi de Llobregat, Barcelona, Spain; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Monforte de Lemos 3-5. Pabellón 11, 28029 Madrid, Spain.
authors.forename: Noe
authors.initials: N
authors.lastname: Garin
authors.affiliation: Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Dr Antoni Pujades, 42, 08830 Sant Boi de Llobregat, Barcelona, Spain; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Monforte de Lemos 3-5. Pabellón 11, 28029 Madrid, Spain.
authors.forename: Beatriz
authors.initials: B
authors.lastname: Olaya
authors.affiliation: Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Monforte de Lemos 3-5. Pabellón 11, 28029 Madrid, Spain; Department of Psychiatry, Universidad Autónoma de Madrid, Instituto de Investigación Sanitaria Princesa (IP), Hospital Universitario la Princesa, Madrid, Spain.
authors.forename: Jose Luis
authors.initials: JL
authors.lastname: Ayuso-Mateos
authors.affiliation: Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Monforte de Lemos 3-5. Pabellón 11, 28029 Madrid, Spain; Department of Psychiatry, Universidad Autónoma de Madrid, Instituto de Investigación Sanitaria Princesa (IP), Hospital Universitario la Princesa, Madrid, Spain.
authors.forename: Marta
authors.initials: M
authors.lastname: Miret
authors.affiliation: Department of Health Statistics and Information Systems, World Health Organization, Geneva, Switzerland.
authors.forename: Somnath
authors.initials: S
authors.lastname: Chatterji
authors.affiliation: Department of Medical Sociology, Jagiellonian University Medical College, Krakow, Poland.
authors.forename: Beata
authors.initials: B
authors.lastname: Tobiasz-Adamczyk
authors.affiliation: National Institute for Health and Welfare, Helsinki, Finland.
authors.forename: Seppo
authors.initials: S
authors.lastname: Koskinen
authors.affiliation: Neurology, Public Health and Disability Unit, Neurological Institute "Carlo Besta" Foundation IRCCS (Istituto di ricovero e cura a carattere scientifico), Milan, Italy.
authors.forename: Matilde
authors.initials: M
authors.lastname: Leonardi
authors.affiliation: Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Dr Antoni Pujades, 42, 08830 Sant Boi de Llobregat, Barcelona, Spain; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Monforte de Lemos 3-5. Pabellón 11, 28029 Madrid, Spain. Electronic address: jmharo@pssjd.org.
authors.forename: Josep Maria
authors.initials: JM
authors.lastname: Haro
mesh_terms: D000328:Adult; D000349:Africa / Q000453:epidemiology; D000367:Age Factors; D000368:Aged; D000886:Anthropometry; D062186:Arterial Pressure; D001208:Asia / Q000453:epidemiology; D015992:Body Mass Index; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000175:diagnosis / Q000453:epidemiology; D005060:Europe / Q000453:epidemiology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D008297:Male; D008800:Mexico / Q000453:epidemiology; D008875:Middle Aged; D009765:Obesity / Q000175:diagnosis / Q000453:epidemiology; D015995:Prevalence; D012307:Risk Factors; D020521:Stroke / Q000175:diagnosis / Q000453:epidemiology; D013997:Time Factors; D014655:Vascular Resistance; D059289:Vascular Stiffness
keywords: Developing countries; Hypertension; Mean arterial pressure; Obesity; Pulse pressure