Breastfeeding and maternal hypertension and diabetes: a population-based cross-sectional study.

OBJECTIVE: This study aimed to assess the association of breastfeeding and maternal hypertension and diabetes in Beijing, China. SUBJECTS AND METHODS: A cross-sectional study was conducted in four urban communities of Beijing, China, with 9,128 parous women 40-81 years of age who had had only one lifetime birth. Each participant completed a detailed survey and accepted blood pressure measurement and blood glucose testing. Moreover, self-reported hypertension and diabetes were confirmed by review of medical records. RESULTS: After the analysis was adjusted for the potential confounders, including age, body mass index (BMI), waist to hip ratio (WHR), working status, educational level, drinking, smoking, family history of hypertension, age of menarche, menopause, oral contraceptive use, age of child-bearing, and postpartum BMI, the odd ratio (OR) of hypertension was 1.18 (95% confidence interval [CI], 1.05-1.32) for women who did not breastfeed, compared with women who did. In addition, the ORs for >0 to 6 months, >6 to 12 months, and >12 months of breastfeeding were 0.87 (95% CI, 0.76-0.99), 0.83 (95% CI, 0.68-1.00), and 0.79 (95% CI, 0.65-0.97), respectively, compared with women who did not breastfeed. With adjustment for age, WHR, working status, educational level, family history of diabetes, and postpartum BMI, women who did not breastfeed increased the risk of diabetes (OR=1.30; 95% CI, 1.11-1.53) compared with women who did. Moreover, women who breastfed for >0 to 6 months (OR=0.81; 95% CI, 0.67-0.98) and >6 to 12 months (OR=0.46; 95% CI, 0.26-0.84) had a lower risk of diabetes, compared with women who did not breastfeed. CONCLUSIONS: Chinese mothers who did not breastfeed were more likely to develop hypertension and diabetes in later life.

C-reactive protein predicts the severity of coronary artery disease beyond low-density lipoprotein cholesterol.

Prospective studies and clinical trials have shown that C-reactive protein (CRP) independently predicts the occurrence of cardiovascular events, even in individuals without hypercholesterolemia. We evaluated whether CRP can predict the severity of coronary artery stenosis in patients with lower low-density lipoprotein cholesterol (LDL-C) levels. A total of 418 patients with lower LDL-C (<3.37 mmol/L) who underwent coronary angiography were recruited. The median levels of CRP increased according to the number of stenotic vessels. Multivariable adjustment model indicated that CRP was associated with the severity of coronary artery disease (CAD) in the top to the bottom third comparison of CRP levels, yielding an odds ratio of 1.72 (95% confidence interval: 1.08-2.74); this trend was preserved after excluding the confounding effect of statin treatment. C-reactive protein may serve as a useful biomarker for improving the risk assessment and secondary prevention of CAD patients without hypercholesterolemia.

Dietary factors associated with hypertension.

Hypertension is one of the major risk factors for cardiovascular disease, with an impact on global health. Multiple studies have suggested that various dietary factors are associated with blood pressure (BP) and hypertension. The purpose of this Review is to provide up-to-date knowledge on the impact of dietary factors on BP and hypertension, to compare types and recommended intakes of dietary factors in hypertension management and prevention guidelines from different countries and organizations, and to outline global population-based healthy-diet strategies for hypertension control. Of the 27 dietary factors we evaluated on the basis of specified review criteria, 17 have been proposed to have protective effects against hypertension, six were proposed to be risk factors for hypertension, and the association between BP and the remaining factors was considered inconclusive. Excessive sodium intake is a causal risk factor for hypertension, whereas a diet rich in fruit, vegetables, and low-fat dairy products, and low in sodium and saturated fat has been recommended to prevent and reduce hypertension on the basis of strong evidence. Notable differences exist in the recommended types and intakes of dietary factors among available hypertension management and prevention guidelines. Available evidence supports the vigorous implementation of dietary strategies against hypertension through population-based, national action plans.

[Association between high sensitivity C-reactive protein levels in serum and the 5-year-accumulative-risk of diabetes].

OBJECTIVE: To analyze the association between hs-CRP (high-sensitivity C-reactive protein) levels in serum and the 5-year-accumulative-risk of diabetes in a general population. METHODS: Participants were from the cohort of Peking University residential community in the Chinese Multi-provincial Cohort Study (CMCS). Two surveys on cardiovascular risk factors and the measurements of serum hs-CRP levels were conducted in 2002 and 2007, respectively. Individuals with incomplete information and those having infectious diseases at baseline were excluded. A total of 1045 participants aged 45 to 74 years and free of diabetes at baseline were included in this analysis. RESULTS: The age-standardized 5-year accumulative incidence rate of diabetes was 8.8% (male: 9.8%, female: 8.2%) and increased significantly with the level of hs-CRP in both women and men (P<0.01). After adjustment for age, hypertension, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol, triglycerides, fasting glucose, smoking status and central obesity, people with hs-CRP≥3 mg/L had a 3.30 times higher risk of developing diabetes in men and 2.58 times for women when compared to those with hs-CRP<1 mg/L. The areas under the receiver operating characteristic curves of baseline hs-CRP level in predicting the incidence of diabetes were 0.619 (95%CI: 0.536-0.701) in men and 0.667 (95%CI: 0.585-0.749) in women. CONCLUSION: Serum hs-CRP levels could predict the incidence of diabetes, indicating that inflammation might have great importance in the onset of diabetes.