Hypertension Clinical Trial
Originally from 1991 to 1991, to test the hypothesis that differences in hypertension prevalence in Nigerian workers were primarily related to differences in socioeconomic status (SES). At renewal in 1996, to determine the importance of weight gain and weight-related factors in blood pressure.
BACKGROUND:
This dynamic population provided a valuable opportunity to gain important information about
the etiology of hypertension which would be much more difficult to gain from a United States
Black population because higher weight and blood pressure are already entrenched and static
in the United States population.
DESIGN NARRATIVE:
From 1991 to 1996, a cross-sectional study was conducted to test the hypothesis that
differences in hypertension prevalence were primarily related to differences in SES. The
higher prevalence of hypertension among the high SES Nigerian professionals was thought to
be related to higher weight, caloric intake, Westernization of diet, alcohol intake, sodium
intake, cardiovascular reactivity, and stress due to job, migration, and change in SES, and
to reduced potassium intake and physical activity. Civil servants were systematically
sampled from civil service employee lists. Data were collected on blood pressure; urinary
sodium, potassium, and protein; diet; anthropometry; electrocardiogram; serum insulin;
stress in the work environment, migration history, and cardiovascular reactivity.
In FY 1992, the Office of Research on Women's Health provided supplemental funds to enlarge
the study and to perform gender analyses. The supplemental funds were used to determine
whether fatty acid distributions, and their relationships to cardiovascular risk factors
differed between Nigerian women and United States Black women; United States Black women and
United States white women; and Nigerian women and Nigerian men. Forty men and forty women,
ages 18 to 30, were chosen randomly from the Nigerian civil servant population. Subjects
with hypertension, those using oral contraceptives, or any medication affecting the
sympathetic nervous system, were excluded. The Nigerian subjects were compared with 40 Black
and 40 white healthy female volunteers at the University of Pittsburgh.
The grant was renewed in 1996 through August 2001 to conduct a longitudinal study of 726
members of the original cohort. The purpose was to determine the importance of weight gain
and weight-related factors, and the possible interaction of other factors, e.g.
psychosocial, electrolytes, reactivity, macronutrient intake, to change in blood pressure.
Factors related to weight gain were identified. The high prevalence of the electrocardiogram
left ventricular hypertrophy (ECG-LVH) was validated against echocardiographic measures
(ECHO-LVH). Predictors of change in ECG-LVH, and the correlates of microalbuminuria were
identified. In Year 2 (Cohort Year 4) half of the population was restudied with
echocardiography, cardiovascular reactivity, and new psychosocial measures. In Year 4
(Cohort Year 6), with the exception of cardiovascular reactivity, the full cohort was
re-examined for baseline measures, including multiple blood pressure readings, height,
weight, waist, hips, ECG, physical activity, two 24 hour dietary recalls, alcohol intake,
menopausal status, psychosocial measures, 24 hour urine for sodium, potassium, creatinine,
micro-albuminuria, and fasting serum for lipids, insulin, glucose, and creatinine.
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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