Microalbuminuria in treated hypertensives: only a mirror image of cardiovascular risk? The HUNT Study, Norway.

OBJECTIVES: Microalbuminuria as an independent marker of cardiovascular morbidity and mortality in hypertensive individuals is under debate. The aim of this study was to study the possible associations between microalbuminuria on one hand and known cardiovascular risk factors and cardiovascular disease on the other hand, in a large, unselected population of treated hypertensives without diabetes. DESIGN: Cross-sectional study. SETTING: Participants of the HUNT Study, Norway (n = 65,258). SUBJECTS: 5,369 individuals (> or =20 years) with treated hypertension delivered three morning urine samples for microalbuminuria analysis. MAIN OUTCOME MEASURES: Microalbuminuria expressed as albumin-to-creatinine ratio, cardiovascular risk factors and cardiovascular disease. RESULTS: Increasing age, pulse pressure (systolic blood pressure-diastolic blood pressure), s-creatinine, cigarette pack years, cardiovascular disease, antihypertensive medication group, and years with antihypertensive medication were significantly associated with microalbuminuria in men. Increasing pulse pressure, cigarette pack years, and antihypertensive medication group were associated with microalbuminuria in women, adjusted for other cardiovascular risk factors. When excluding individuals of both sexes with self-reported cardiovascular disease and blood pressure > 160/90 mm Hg, no variable associated with cardiovascular risk factors registered was statistically associated with microalbuminuria. CONCLUSION: The present study indicates that microalbuminuria mainly represents a mirror image of hypertension (BP > 160/90) and prior or present cardiovascular disease. We therefore question whether the treatment quality would improve if yet another risk factor, microalbuminuria, were introduced as a routine test in treated hypertensives.

Leisure time physical activity and change in body mass index: an 11-year follow-up study of 9357 normal weight health women 20-49 years old.

OBJECTIVE: To study the association between self-reported leisure time physical activity at baseline (1984-1986) and change in body mass index (BMI) during an 11-year follow-up period (1995-1997). The study population was 9357 healthy women, aged 20-49 years, who had a normal body weight (BMI 18.5-24.9 kg/m2) at baseline. METHODS: A general population-based health survey was performed both in 1984-1986 (HUNT 1) and 1995-1997 (HUNT 2). Leisure time physical activity at HUNT 1 was categorized into high, moderate, and low levels based on self-reported intensity, duration, and frequency. Women who at baseline reported diabetes, stroke, angina, myocardial infarction, or long-term illnesses impairing their activities of living were excluded. RESULTS: Physical activity was a significant predictor of BMI at HUNT 2 adjusted for BMI,age, and education at HUNT 1. Low level of leisure time physical activity compared with high level at baseline was significantly associated with a higher BMI 11 years later. Those with high level of activity gained 0.18 kg/m2 (95% CI 0.05, 0.32) less than those with low level of physical activity over 11 years. CONCLUSIONS: This study has demonstrated that leisure time physical activity has a moderate effect on BMI. However, not even a high level of leisure time physical activity was sufficient to prevent weight gain and BMI increase in all subgroups of the study population.

[Prevalence of hypothyroidism and hyperthyroidism in Nord-Trondelag]. / Prevalens av hypotyreose og hypertyreose i Nord-Trøndelag.

BACKGROUND: The objective of this survey was to examine the prevalence of thyroid disease including autoimmunity in Norway. MATERIALS AND METHODS: All 94,009 inhabitants aged 20 and above in Nord-Trøndelag county, Norway were invited to participate in a health survey. RESULTS: The prevalence of formerly diagnosed hyperthyroidism was 2.5% in women and 0.6% in men, hypothyroidism 4.8% and 0.9% respectively, increasing with age. In individuals without a history of thyroid disease the median, 2.5 and 97.5 percentiles for TSH (mU/l) were 1.8 and 0.49-5.7 for women and 1.5 and 0.56-4.6 for men. When excluding individuals with positive thyroid peroxidase antibodies (TPOAb), the 97.5 percentiles were 3.6 mU/l for women and 3.4 mU/l for men. The prevalence of pathological TSH values in women and men were TSH > or = 10 mu/l 0.9% and 0.4%; TSH 4.1-9.9 mU/l 5.1% and 3.7%; TSH < or = 0.05 mU/l 0.5% and 0.2%. The prevalence of positive TPOAb was 13.9% in women and 2.8% in men, the lowest percentage was seen with TSH 0.2-2.0 mU/l and increased both with higher and lower TSH values and was higher in women except for those with TSH > or = 10 mU/l (85% TPOAb positive). CONCLUSION: In spite of a high prevalence of recognised thyroid disease in the population a considerable number have undiagnosed thyroid dysfunction and positive TPOAb.