The Interdependence of Blood Pressure and Glucose in Vietnam

• Published in: High blood pressure & cardiovascular prevention Vol. 28; no. 2; pp. 141 - 150
• Main Authors: Nga, Tran Thi Thu, Blizzard, Christopher Leigh, Khue, Luong Ngoc, Le Van Ngoc, Truong, Bao, Tran Quoc, Otahal, Petr, Nelson, Mark R., Magnussen, Costan G., Van Tan, Bui, Srikanth, Velandai, Thuy, Au Bich, Son, Ha Thai, Hai, Phung Ngoc, Mai, Tran Hoang, Callisaya, Michele, Gall, Seana
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01-03-2021; Springer Nature B.V
• Subjects: Adiposity; Adult; Alcohol use; Biomarkers - blood; Blood Glucose - metabolism; Blood Pressure; Body Mass Index; Cardiology; Diabetes; Exercise; Female; Fruits; Glucose; Glucose Metabolism Disorders - blood; Glucose Metabolism Disorders - diagnosis; Glucose Metabolism Disorders - epidemiology; Health risks; Humans; Hypertension; Hypertension - diagnosis; Hypertension - epidemiology; Hypertension - physiopathology; Male; Medicine; Medicine & Public Health; Middle Aged; Obesity; Obesity - diagnosis; Obesity - epidemiology; Obesity - physiopathology; Original Article; Pharmacotherapy; Prognosis; Questionnaires; Risk Assessment; Risk Factors; Vietnam - epidemiology; Waist Circumference; Womens health; Vietnam; Blood glucose; Inter-relationship; Blood pressure
• ISSN: 1120-9879; 1179-1985
• DOI: 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.