Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
BMC Cardiovascular Disorders
Published in: BMC Cardiovascular Disorders 1/2021

Open Access 01-12-2021 | Hypertension | Research

Individual and combined association analysis of famine exposure and serum uric acid with hypertension in the mid-aged and older adult: a population-based cross-sectional study

Authors: Lin Zhang, Liu Yang, Congzhi Wang, Ting Yuan, Dongmei Zhang, Huanhuan Wei, Jing Li, Yunxiao Lei, Lu Sun, Xiaoping Li, Ying Hua, Hengying Che, Yuanzhen Li

Published in: BMC Cardiovascular Disorders | Issue 1/2021

Login to get access

Abstract

Background

Malnutrition in early life may affect health in later life. The associations between malnutrition and serum uric acid (SUA) and hypertension were inconsistent. The present study aimed to investigate the individual and combined association between famine exposure and serum uric acid and hypertension in middle-aged and older Chinese.

Methods

Data were selected from the China Health and Retirement Longitudinal Study (CHARLS) Wave2011. The analytic sample included 9368 individuals aged 45 to 90. Differences between baseline characteristics and famine exposure/SUA level were evaluated using the Chi-square test, t-test, and F-test. Then, the differences in the prevalence of hypertension between characteristic groups was also estimated by the Chi-square and t-test. Finally, multivariable-adjusted logistic regression models examined association of famine exposure and serum uric acid with odds of prevalence of hypertension.

Results

A total of 9368 individuals were enrolled in the study, 4366 (46.61%) and 5002 (53.39%) were male and female, respectively. Among males, 459 (10.51%) had been exposed to the Chinese famine during the fetal stage, whereas 1760 (40.31%) and 1645 (37.68%) had been exposed to the famine during childhood and adolescence/adult stage, respectively. Among females, 635 (12.69%) had been exposed to the Chinese famine during the fetal stage, whereas 1988 (39.74%) and 1569 (31.37%) had been exposed to the famine during childhood and adolescence/adult stage, respectively. Regarding the participants with SUA level measurements, 290 (6.64%) reported having Hyperuricemia (HUA) in males and 234 (4.68%) in the females. Furthermore, 1357 (31.08%) reported having hypertension in male and 1619 (32.37%) in the female. In multivariable-adjusted model, famine exposure and serum uric acid were associated with prevalence of hypertension independently in total populations [(1) Model fourd, fatal exposed group vs non-exposed group: 1.25 (95% CI 1.03, 1.52); childhood-exposed group vs non-exposed group:1.60 (95% CI 1.37, 1.87); adolescence/adult exposed group vs non-exposed group: 2.87 (95% CI 2.44, 3.37), P for trend < 0.001; (2) Model four e, high vs normal:1.73 (95% CI 1.44, 2.08)]. When stratified by sex, the results in both males and females were similar to those in the total population. In general, interaction analysis in the multivariable-adjusted model, compared with the combination of normal SUA level and no-exposed famine stage, all groups trended towards higher odds of prevalence of hypertension [the greatest increase in odds, adolescence/adult exposed stage and high SUA level in total participants: OR4.34; 95%CI 3.24, 5.81; P for interaction < 0.001]. When stratified by sex, the results in both males and females were also similar to those in the total population.

Conclusion

Our data support a strongly positive individual and combined association of famine exposure and serum uric acid with hypertension in middle-aged and elderly Chinese.
Literature
1.
de Kouchkovsky I, Mayfield J, Kohlwes J. Hypertension in young adults and subsequent cardiovascular disease. JAMA. 2019;321(13):1310.PubMedCrossRef
2.
Gutierrez J, Alloubani A, Mari M, Alzaatreh M. Cardiovascular disease risk factors: hypertension, diabetes mellitus and obesity among Tabuk citizens in Saudi Arabia. Open Cardiovasc Med J. 2018;12:41–9.PubMedPubMedCentralCrossRef
3.
4.
Abdulsalam S, Olugbenga-Bello A, Olarewaju O, Abdus-Salam I. Sociodemographic correlates of modifiable risk factors for hypertension in a rural local government area of oyo state South west Nigeria. Int J Hypertens. 2014;2014:842028.PubMedPubMedCentralCrossRef
5.
Ke L, Ho J, Feng J, Mpofu E, Dibley MJ, Feng X, Van F, Leong S, Lau W, Lueng P, et al. Modifiable risk factors including sunlight exposure and fish consumption are associated with risk of hypertension in a large representative population from Macau. J Steroid Biochem Mol Biol. 2014;144(Pt A):152–5.PubMedCrossRef
6.
Ibekwe R. Modifiable risk factors of hypertension and socio-demographic profile in Oghara, Delta State; prevalence and correlates. Ann Med Health Sci Res. 2015;5(1):71–7.PubMedPubMedCentralCrossRef
7.
Pilakkadavath Z, Shaffi M. Modifiable risk factors of hypertension: a hospital-based case-control study from Kerala, India. J Family Med Prim Care. 2016;5(1):114–9.PubMedPubMedCentralCrossRef
8.
Mamudu HM, Paul TK, Wang L, Veeranki SP, Panchal HB, Alamian A, Budoff M. Association between multiple modifiable risk factors of cardiovascular disease and hypertension among asymptomatic patients in central appalachia. South Med J. 2017;110(2):90–6.PubMedCrossRef
9.
10.
Wang PX, Wang JJ, Lei YX, Xiao L, Luo ZC. Impact of fetal and infant exposure to the Chinese Great Famine on the risk of hypertension in adulthood. PLoS ONE. 2012;7(11):e49720.PubMedPubMedCentralCrossRef
11.
Gluckman PD, Hanson MA, Cooper C, Thornburg KL. Effect of in utero and early-life conditions on adult health and disease. N Engl J Med. 2008;359(1):61–73.PubMedPubMedCentralCrossRef
12.
Alexander BT. Fetal programming of hypertension. Am J Physiol Regul Integr Comp Physiol. 2006;290(1):R1–10.PubMedCrossRef
13.
Li Y, Jaddoe VW, Qi L, He Y, Lai J, Wang J, Zhang J, Hu Y, Ding EL, Yang X, et al. Exposure to the Chinese famine in early life and the risk of hypertension in adulthood. J Hypertens. 2011;29(6):1085–92.PubMedCrossRef
14.
van Abeelen AFM, de Rooij SR, Osmond C, Painter RC, Veenendaal MVE, Bossuyt PMM, Elias SG, Grobbee DE, van der Schouw YT, Barker DJP, et al. The sex-specific effects of famine on the association between placental size and later hypertension. Placenta. 2011;32(9):694–8.PubMedCrossRef
15.
Carroll D, Ginty AT, Painter RC, Roseboom TJ, Phillips AC, de Rooij SR. Systolic blood pressure reactions to acute stress are associated with future hypertension status in the Dutch Famine Birth Cohort Study. Int J Psychophysiol. 2012;85(2):270–3.PubMedCrossRef
16.
Chen H, Nembhard WN, Stockwell HG. Sex-specific effects of fetal exposure to the 1959–1961 Chinese famine on risk of adult hypertension. Matern Child Health J. 2014;18(3):527–33.PubMedCrossRef
17.
Wang Z, Li C, Yang Z, Zou Z, Ma J. Infant exposure to Chinese famine increased the risk of hypertension in adulthood: results from the China Health and Retirement Longitudinal Study. BMC Public Health. 2016;16:435.PubMedPubMedCentralCrossRef
18.
Liu L, Xu X, Zeng H, Zhang Y, Shi Z, Zhang F, Cao X, Xie YJ, Reis C, Zhao Y. Increase in the prevalence of hypertension among adults exposed to the Great Chinese Famine during early life. Environ Health Prev Med. 2017;22(1):64.PubMedPubMedCentralCrossRef
19.
20.
Yu C, Wang J, Li Y, Han X, Hu H, Wang F, Yuan J, Yao P, Miao X, Wei S, et al. Exposure to the Chinese famine in early life and hypertension prevalence risk in adults. PLoS ONE. 2017;35(1):63–8.
21.
Liu L, Xu X, Zeng H, Zhang Y, Shi Z, Zhang F, Cao X, Xie YJ, Reis C, Zhao Y. Correction to: Increase in the prevalence of hypertension among adults exposed to the great Chinese famine during early life. Environ Health Prev Med. 2018;23(1):11.PubMedPubMedCentralCrossRef
22.
Shi Z, Nicholls SJ, Taylor AW, Magliano DJ, Appleton S, Zimmet P. Early life exposure to Chinese famine modifies the association between hypertension and cardiovascular disease. J Hypertens. 2018;36(1):54–60.PubMedCrossRef
23.
Xin X, Yao J, Yang F, Zhang D. Famine exposure during early life and risk of hypertension in adulthood: a meta-analysis. Crit Rev Food Sci Nutr. 2018;58(14):2306–13.PubMedCrossRef
24.
Zhao R, Duan X, Wu Y, Zhang Q, Chen Y. Association of exposure to Chinese famine in early life with the incidence of hypertension in adulthood: a 22-year cohort study. Nutr Metab Cardiovasc Dis. 2019;29(11):1237–44.PubMedCrossRef
25.
Chen JP, Peng B, Tang L, Sun R, Hu S, Wen XY, Que P, Wang YH. Fetal and infant exposure to the Chinese famine increases the risk of fatty liver disease in Chongqing, China. J Gastroenterol Hepatol. 2016;31(1):200–5.PubMedCrossRef
26.
Zhou J, Sheng J, Fan Y, Zhu X, Tao Q, Liu K, Hu C, Ruan L, Yang L, Tao F, et al. The effect of Chinese famine exposure in early life on dietary patterns and chronic diseases of adults. Public Health Nutr 2018;1–11
27.
Wang Y, Weng P, Wan H, Zhang W, Chen C, Chen Y, Cai Y, Guo M, Xia F, Wang N, et al. Economic status moderates the association between early-life famine exposure and hyperuricemia in adulthood. J Clin Endocrinol Metab. 2020;105(11):dgaa523.PubMedCrossRef
28.
Zhang W, Luan R. Early-life exposure to the Chinese famine of 1959–61 and risk of Hyperuricemia: results from the China health and retirement longitudinal study. BMC Public Health. 2020;20(1):15.PubMedPubMedCentralCrossRef
29.
Li C, Liu T, Sun W, Wu L, Zou ZY. Prevalence and risk factors of arthritis in a middle-aged and older Chinese population: the China health and retirement longitudinal study. Rheumatology. 2015;54(4):697–706.PubMedCrossRef
30.
Zhang L, Liu K, Li H, Li D, Chen Z, Zhang LL, Guo LL. Relationship between body mass index and depressive symptoms: the “fat and jolly” hypothesis for the middle-aged and elderly in China. BMC Public Health. 2016;16(1):1201.PubMedPubMedCentralCrossRef
31.
Zhang L, Li JL, Zhang LL, Guo LL, Li H, Li D. No association between C-reactive protein and depressive symptoms among the middle-aged and elderly in China Evidence from the China Health and Retirement Longitudinal Study. Medicine. 2018;97(38):e12352.PubMedPubMedCentralCrossRef
32.
Zhang L, Li JL, Zhang LL, Guo LL, Li H, Li D. Association and interaction analysis of body mass index and triglycerides level with blood pressure in elderly individuals in China. Biomed Res Int. 2018;2018:8934534.PubMedPubMedCentralCrossRef
33.
Zhang L, Li JL, Zhang LL, Guo LL, Li H, Yan WZ, Li D. Relationship between adiposity parameters and cognition: the “fat and jolly” hypothesis in middle-aged and elderly people in China. Medicine. 2019;98(10):e14747.PubMedPubMedCentralCrossRef
34.
Zhang L, Li JL, Zhang LL, Guo LL, Li H, Li D. Body mass index and serum uric acid level: Individual and combined effects on blood pressure in middle-aged and older individuals in China. Medicine. 2020;99(9):e19418.PubMedPubMedCentralCrossRef
35.
Zhang L, Li JL, Guo LL, Li H, Li D, Xu G. The interaction between serum uric acid and triglycerides level on blood pressure in middle-aged and elderly individuals in China: result from a large national cohort study. BMC Cardiovasc Disord. 2020;20(1):174.PubMedPubMedCentralCrossRef
36.
Teng F, Zhu R, Zou C, Xue Y, Yang M, Song H, Liang J. Interaction between serum uric acid and triglycerides in relation to blood pressure. J Hum Hypertens. 2011;25(11):686–91.PubMedCrossRef
37.
Wang N, Wang X, Li Q, Han B, Chen Y, Zhu C, Chen Y, Lin D, Wang B, Jensen MD, et al. The famine exposure in early life and metabolic syndrome in adulthood. Clin Nutr. 2017;36(1):253–9.PubMedCrossRef
38.
Li Y, Zhao L, Yu D, Ding G. Exposure to the Chinese famine in early life and depression in adulthood. Psychol Health Med. 2018;23(8):952–7.PubMedCrossRef
39.
Song S. Does famine have a long-term effect on cohort mortality? Evidence from the 1959–1961 great leap forward famine in China. J Biosoc Sci. 2009;41(4):469–91.PubMedCrossRef
40.
de Rooij SR, Painter RC, Holleman F, Bossuyt PM, Roseboom TJ. The metabolic syndrome in adults prenatally exposed to the Dutch famine. Am J Clin Nutr. 2007;86(4):1219–24.PubMedCrossRef
41.
Stein AD, Zybert PA, van der Pal-de BK, Lumey LH. Exposure to famine during gestation, size at birth, and blood pressure at age 59 y: evidence from the Dutch Famine. Eur J Epidemiol. 2006;21(10):759–65.PubMedCrossRef
42.
Stanner SA, Bulmer K, Andrès C, Lantseva OE, Borodina V, Poteen VV, Yudkin JS. Does malnutrition in utero determine diabetes and coronary heart disease in adulthood? Results from the Leningrad siege study, a cross sectional study. BMJ (Clinical research ed). 1997;315(7119):1342–8.CrossRef
43.
Khanal P, Johnsen L, Axel AM, Hansen PW, Kongsted AH, Lyckegaard NB, Nielsen MO. Long-term impacts of foetal malnutrition followed by early postnatal obesity on fat distribution pattern and metabolic adaptability in adult sheep. PLoS ONE. 2016;11(6):e0156700.PubMedPubMedCentralCrossRef
44.
Bol V, Desjardins F, Reusens B, Balligand JL, Remacle C. Does early mismatched nutrition predispose to hypertension and atherosclerosis, in male mice? PLoS ONE. 2010;5(9):e12656.PubMedPubMedCentralCrossRef
45.
Bai SY, Briggs DI, Vickers MH. Increased systolic blood pressure in rat offspring following a maternal low-protein diet is normalized by maternal dietary choline supplementation. J Dev Orig Health Dis. 2012;3(5):342–9.PubMedCrossRef
46.
Kubaszek A, Markkanen A, Eriksson JG, Forsen T, Osmond C, Barker DJ, Laakso M. The association of the K121Q polymorphism of the plasma cell glycoprotein-1 gene with type 2 diabetes and hypertension depends on size at birth. J Clin Endocrinol Metab. 2004;89(5):2044–7.PubMedCrossRef
47.
Aagaard-Tillery KM, Grove K, Bishop J, Ke X, Fu Q, McKnight R, Lane RH. Developmental origins of disease and determinants of chromatin structure: maternal diet modifies the primate fetal epigenome. J Mol Endocrinol. 2008;41(2):91–102.PubMedPubMedCentralCrossRef
48.
Kansui Y, Ohtsubo T, Goto K, Sakata S, Ichishima K, Fukuhara M, Ohta Y, Matsumura K. Association of serum uric acid with blood pressure in Japanese men Cross-sectional study in work-site group. Circ J. 2011;75(12):2827–32.PubMedCrossRef
49.
Lyngdoh T, Viswanathan B, Myers GJ, Bochud M, Bovet P. Impact of different adiposity measures on the relation between serum uric acid and blood pressure in young adults. J Hum Hypertens. 2012;26(11):677–83.PubMedCrossRef
50.
Kawamoto R, Tabara Y, Kohara K, Kusunoki T, Abe M, Miki T. Synergistic influence of age and serum uric acid on blood pressure among community-dwelling Japanese women. J Clin Hypertens (Greenwich). 2013;36(7):634–8.
51.
Kawamoto R, Ninomiya D, Senzaki K, Kumagi T. Interaction between body mass index and serum uric acid in relation to blood pressure in community-dwelling Japanese men. Clin Hypertens. 2018;24:1.PubMedPubMedCentralCrossRef
52.
Ninomiya D, Senzaki K, Kumagi T, Kawada T. Relationship between serum uric acid and blood pressure by adjusting dietary factors. Clin Hypertens. 2018;20(2):418.CrossRef
53.
Irijanto F, Zulaela Z, Widiatmoko A, Kholiq A, Tomino Y, Kawamoto R. Interaction between body mass index and serum uric acid in relation to blood pressure in community-dwelling Japanese men. BMJ Open. 2018;24:1.
54.
Yang CC, Bawazier LA, Sjabani M. Association of serum uric acid, morning home blood pressure and cardiovascular risk factors in a population with previous prehypertension: a cross-sectional study. Blood Press. 2020;10(9):e038046.
55.
Lin KH, Yen FS, Chen HS, Hwu CM. Serum uric acid and blood pressure among adolescents: data from the Nutrition and Health Survey in Taiwan (NAHSIT) 2010–2011. Blood Press. 2021;30(2):118–25.PubMedCrossRef
56.
Khanum FA, Lee SW, Kim HC, Nam C, Lee HY, Ahn SV, Oh YA, Suh I. Age-differential association between serum uric acid and incident hypertension. Sci Rep. 2019;42(3):428–37.
57.
Cao Z, Cheng Y, Li S, Yang H, Sun L, Gao Y, Yu P, Li W, Wang Y. Mediation of the effect of serum uric acid on the risk of developing hypertension: a population-based cohort study. J Transl Med. 2019;17(1):202.PubMedPubMedCentralCrossRef
58.
Kansui Y, Matsumura K, Morinaga Y, Inoue M, Kiyohara K, Ohta Y, Goto K, Ohtsubo T, Ooboshi H, Kitazono T. Impact of serum uric acid on incident hypertension in a worksite population of Japanese men. J Transl Med. 2018;36(7):1499–505.
59.
Zheng R, Yang T, Chen Q, Chen C, Mao Y. Serum uric acid concentrations can predict hypertension: a longitudinal population-based epidemiological study. Horm Metab Res. 2017;49(11):873–9.PubMedCrossRef
60.
Cui LF, Shi HJ, Wu SL, Shu R, Liu N, Wang GY, Zhou B, Sun K, Yu P, Wang J, et al. Association of serum uric acid and risk of hypertension in adults: a prospective study of Kailuan Corporation cohort. Clin Rheumatol. 2017;36(5):1103–10.PubMedCrossRef
61.
Yokoi Y, Kondo T, Okumura N, Shimokata K, Osugi S, Maeda K, Murohara T. Serum uric acid as a predictor of future hypertension: Stratified analysis based on body mass index and age. Prev Med. 2016;90:201–6.PubMedCrossRef
62.
Ali N, Mahmood S, Islam F. Relationship between serum uric acid and hypertension: a cross-sectional study in Bangladeshi adults. Sci Rep. 2019;9(1):9061.PubMedPubMedCentralCrossRef
63.
Yu FN, Shi YX, Cheng HY, Huang XL, Liu SS. An observational study on the relationship between serum uric acid and hypertension in a Northern Chinese population aged 45 to 59 years. Medicine. 2017;96(17):e6773.PubMedPubMedCentralCrossRef
64.
Wu L, He Y, Jiang B, Liu M, Wang J, Zhang D, Wang Y, Zeng J. Association between serum uric acid level and hypertension in a Chinese elderly rural population. Clin Exp Hypertens. 2017;39(6):505–12.PubMedCrossRef
65.
Oyabambi AO, Areola ED, Olatunji LA, Soladoye AO. Uric acid is a key player in salt-induced endothelial dysfunction: the therapeutic role of Stigma maydis (corn silk) extract. Appl Physiol Nutr Metab. 2020;45(1):67–71.PubMedCrossRef
66.
Li P, Zhang L, Zhang M, Zhou C, Lin N. Uric acid enhances PKC-dependent eNOS phosphorylation and mediates cellular ER stress: a mechanism for uric acid-induced endothelial dysfunction. Int J Mol Med. 2016;37(4):989–97.PubMedPubMedCentralCrossRef
Metadata
Title
Individual and combined association analysis of famine exposure and serum uric acid with hypertension in the mid-aged and older adult: a population-based cross-sectional study
Authors
Lin Zhang
Liu Yang
Congzhi Wang
Ting Yuan
Dongmei Zhang
Huanhuan Wei
Jing Li
Yunxiao Lei
Lu Sun
Xiaoping Li
Ying Hua
Hengying Che
Yuanzhen Li
Publication date
01-12-2021
Publisher
BioMed Central
Published in
BMC Cardiovascular Disorders / Issue 1/2021
Electronic ISSN: 1471-2261
DOI
https://doi.org/10.1186/s12872-021-02230-z

Other articles of this Issue 1/2021

BMC Cardiovascular Disorders 1/2021 Go to the issue

Research

A retrospective analysis of high sensitivity cardiac troponin-T ranges in non-myocardial infarction emergency department visits

Research

Macro-reentrant atrial tachycardia after tricuspid or mitral valve surgery: is there difference in electrophysiological characteristics and effectiveness of catheter ablation?

Research article

Chronic polytherapy after myocardial infarction: the trade-off between hospital and community-based providers in determining adherence to medication

Research

Severe, but not mild to moderate, non-alcoholic fatty liver disease associated with increased risk of subclinical coronary atherosclerosis

Research article

Analysis for interaction between interleukin-35 genes polymorphisms and risk factors on susceptibility to coronary heart disease in the Chinese Han population

Research

Inverse correlation between serum irisin and cardiovascular risk factors among Chinese overweight/obese population

ACC 2024 Congress Coverage

Heart Failure Video

Year in Review: Heart failure and cardiomyopathies

Watch now

Watch this official video from ACC.24. Dr. Biykem Bozkurt discuss last year's major advances in heart failure and cardiomyopathies.

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

16-04-2024 Type 2 Diabetes News

Incentivised to exercise

11-04-2024 Lifestyle Modifications News

New intervention for STEMI-related cardiogenic shock

10-04-2024 Myocardial Infarction News

» View more highlights on the ACC 2024 congress hub page

Image Credits