Obesity Clinical Trial
To evaluate the relation between blood pressure and socioeconomic status, electrolyte intake, obesity and psychosocial factors in Black and white students. Also, to compare blood pressure, cardiovascular risk factors, sodium and potassium excretion in United States Blacks with West African Blacks.
BACKGROUND:
Hypertension related diseases are major causes of morbidity and mortality among United
States Blacks. Among Blacks and whites, lower levels of education are associated with higher
levels of blood pressure, stroke, and coronary heart disease mortality. High levels of blood
pressure in United States Blacks compared to United States whites persist even after
controlling for education. Furthermore, it has been demonstrated that individuals living in
the southeastern part of the United States continue to have higher stroke and coronary heart
disease mortality rates than those living in most other areas of the United States. The
number of upwardly mobile Blacks, based on education and occupation, has been increasing in
the United States yet relatively little is known about the relationships of improvements in
socioeconomic status and cardiovascular risk factors, particularly blood pressure. In
Africa, for over four decades, hypertension has been regarded as a rare disease among the
Black Africans. However, recent evidence from hospital and community based populations
suggests that hypertension is the most prevalent cardiovascular disease among Africans and
constitutes a major public health problem, particularly in West Africa. Furthermore, stroke
is an increasing health problem.
DESIGN NARRATIVE:
In this longitudinal study, the United States students were recruited and followed annually
for three years. The African students were followed for two years. At the initial clinic
visit blood pressure, heart rate and anthropometric measurements were obtained and
questionnaires completed concerning socioeconomic status, family and medical history,
dietary practices, and smoking and drinking habits. One out of every four students had blood
pressure measurements reassessed. Each participant collected an overnight urine sample for
analysis of sodium and potassium. Fifty percent of the population wore a physical activity
monitor for two days. Approximately ten percent of the students' families were studied to
validate the hypertensive status and medical history of the parent as reported by the
students and to assess known cardiovascular risk factors including obesity, smoking, alcohol
intake, physical activity, and behavioral factors. Univariate analyses were conducted to
assess the association between the dependent variable of blood pressure and each of the
independent variables including age, body mass index, height, sodium and potassium. T-tests
were used to analyze the dichotomous variables such as sex, race, and geographic location.
Stratification was used to examine blood pressure levels for Blacks and whites by
socioeconomic status. Multiple regression models were used to determine whether
physiological or psychosocial variables were more predictive of cardiovascular risk.
The study completion date listed in this record was obtained from the "End Date" entered in
the Protocol Registration and Results System (PRS) record.
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