High-normal blood pressure in midlife is a stronger risk factor for incident hypertension 26 years later in women than men: the Hordaland Health Study

Purpose To identify modifiable risk factors in early midlife associated with incident hypertension 26 years later in women and men. Materials and methods We used data from 1025 women and 703 men in the community-based Hordaland Health Study examined at the mean age of 42 years (baseline) and after a 26-year follow-up. Patients with hypertension at baseline were excluded. Blood pressure (BP) was classified according to European guidelines. Factors associated with incident hypertension were identified in logistic regression analyses. Results At baseline, women had a lower average BP and a lower prevalence of high-normal BP (19% vs 37%, p < .05). Overall, 39% of women and 45% of men developed hypertension during follow-up (p < .05). Among those with high-normal BP at baseline, 72% of women and 58% of men developed hypertension (p < .01). In multivariable logistic regression analyses, high-normal BP at baseline was a stronger predictor of incident hypertension in women (odds ratio, OR 4.8, [95% confidence interval, CI 3.4–6.9]) than in men (OR 2.1, [95% CI 1.5–2.8]), p < .01 for sex interaction. A higher baseline body mass index (BMI) was associated with incident hypertension in both sexes. Conclusions High-normal BP in midlife is a stronger risk factor for developing hypertension 26 years later in women than in men, independent of BMI.publishedVersio

Clinical Pharmacy: Looking 20 Years Back… Looking 20 Years Forward

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/90209/1/phco.20.16.235S.35021.pd

Mental health as perceived by Norwegian adolescents living with parental somatic illness: Living in an earthquake zone

Purpose: Severe parental somatic illnesses can influence the entire family, including adolescents’ everyday life, psychosocial functioning and health. Within salutogenesis, it is highlighted that stressor life events, such as parental somatic illness, might lead to a chain of events that can produce tension. There is a lack of in-depth understanding regarding how adolescents living in a situation with a severely somatically ill parent (SIP) perceive their own mental health. The aim of this study was therefore to explore the lived experience of Norwegian adolescents living with an SIP, and their perception of the parental illness’ influence on their mental health. Methods: Interpretative phenomenological analysis was used. In-depth interviews were conducted with 11 adolescents (aged 13–18 years) who had an SIP. Two adolescents with an SIP participated in study preparation and data analysis. Results: Adolescents perceived parental somatic illness as a multifaceted influence on their mental health as it represented both personal and relational strain and growth. Their perceptions can be conceptualized by the super-ordinate theme “living in an earthquake zone”, and by two themes, “inner shakes—but not falling apart” and “relational aftershocks— gains and losses”. Conclusion: For adolescents, parental somatic illness means personal and relational strain and growth

Mental health promotion as perceived by Norwegian adolescents with somatically ill parents – an interpretative phenomenological analysis

ABSTRACTObjective Having a somatically ill parent can influence adolescents’ daily lives and mental health. This study aimed to explore the lived experiences of mental health promotion among adolescents with a somatically ill parent, based on a salutogenic orientation.Methods Individual interviews with 11 adolescents (13–18 years of age) with a somatically ill parent were conducted. The data were analysed according to interpretative phenomenological analysis.Results A superordinate theme, feeling at home in a house of mental health–promoting conversations, frames the participants’ perceptions of a prominent mental health promotion experience, including decisive characteristics of the significant conversation partners and different important conversation contexts. The metaphor of feeling at home expresses that the participants ascribe the conversations taking place there as promoting mental health. The themes elucidate the superordinate theme: (a) significant conversation partners characterised by the three subthemes: (i) being available, (ii) being competent and (iii) being caring and (b) rooms reflecting conversation contexts containing four subthemes: (i) room of increased knowledge, (ii) room of disclosure, (iii) room for meeting points and (iv) room for breaks.Conclusion Adolescents with a somatically ill parent perceived that conversations about important topics with significant others with special characteristics in distinct contexts promoted mental health

Mental health as perceived by Norwegian adolescents living with parental somatic illness: Living in an earthquake zone

Purpose - Severe parental somatic illnesses can influence the entire family, including adolescents’ everyday life, psychosocial functioning and health. Within salutogenesis, it is highlighted that stressor life events, such as parental somatic illness, might lead to a chain of events that can produce tension. There is a lack of in-depth understanding regarding how adolescents living in a situation with a severely somatically ill parent (SIP) perceive their own mental health. The aim of this study was therefore to explore the lived experience of Norwegian adolescents living with an SIP, and their perception of the parental illness’ influence on their mental health. Methods - Interpretative phenomenological analysis was used. In-depth interviews were conducted with 11 adolescents (aged 13–18 years) who had an SIP. Two adolescents with an SIP participated in study preparation and data analysis. Results - Adolescents perceived parental somatic illness as a multifaceted influence on their mental health as it represented both personal and relational strain and growth. Their perceptions can be conceptualized by the super-ordinate theme “living in an earthquake zone”, and by two themes, “inner shakes—but not falling apart” and “relational aftershocks—gains and losses”. Conclusion - For adolescents, parental somatic illness means personal and relational strain and growth

Interferon gamma (IFN-γ)-mediated inflammation and the kynurenine pathway in relation to risk of hip fractures: The Hordaland Health Study

Summary The cytokine interferon gamma (IFN-γ) stimulates neopterin release and tryptophan degradation into kynurenines through the kynurenine pathway. High levels of neopterin were associated with increased hip fracture risk, as were some of the kynurenines, suggesting a role of IFN-γ-mediated inflammation in the processes leading to hip fracture. Introduction Low-grade systemic inflammation has been associated with bone loss and risk of fractures. Interferon gamma (IFN-γ) initiates macrophage release of neopterin and also stimulates degradation of tryptophan along the kynurenine pathway as part of cell-mediated immune activation. Plasma neopterin and the kynurenine/tryptophan ratio (KTR) are thus markers of IFN-γ-mediated inflammation. Risk of hip fracture was investigated in relation to markers of inflammation and metabolites in the kynurenine pathway (kynurenines). Methods Participants (71 to74 years, N = 3,311) in the community-based Hordaland Health Study (HUSK) were followed for hip fractures from enrolment (1998–2000) until 31 December 2009. Plasma C-reactive protein (CRP), neopterin, KTR, and six kynurenines were investigated as predictors of hip fracture, using Cox proportional hazards regression analyses. Results A hazard ratio (HR) of 1.9 (95 % confidence interval (CI) 1.3–2.7) for hip fracture was found in the highest compared to the lowest quartile of neopterin (p trend across quartiles <0.001). CRP and KTR were not related to hip fracture risk. Among the kynurenines, a higher risk of fracture was found in the highest compared to the lowest quartiles of anthranilic acid and 3-hydroxykynurenine. For subjects in the highest quartiles of neopterin, CRP, and KTR compared to those in no top quartiles, HR was 2.5 (95 % CI 1.6–4.0). Conclusions This may indicate a role for low-grade immune activation in the pathogenic processes leading to hip fracture

Airflow limitation as a risk factor for low bone mineral density and hip fracture

Aim: To investigate whether airflow limitation is associated with bone mineral density (BMD) and risk of hip fractures. Methods: A community sample of 5,100 subjects 47–48 and 71–73 years old and living in Bergen was invited. Participants filled in questionnaires and performed a post-bronchodilator spirometry measuring forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC). All attendants were invited to have a BMD measurement of the hip. During 10 years of follow-up, information on death was collected from the Norwegian Cause of Death Registry, and incident hip fractures were registered from regional hospital records of discharge diagnoses and surgical procedure codes. Results: The attendance rate was 69% (n=3,506). The prevalence of chronic obstructive pulmonary disease (COPD) (FEV1/FVC<0.7) was 9%. In multiple logistic regression, the lowest quartile of BMD versus the three upper was significantly predicted by FEV1/FVC<0.7 and FEV1% predicted (odds ratio [OR]: 1.58, 95% confidence interval [CI]: 1.11 to 2.25, and OR per increase of 10%: 0.92, 95% CI: 0.86 to 0.99, respectively). Hip fracture occurred in 126 (4%) participants. In a Cox regression analysis, FEV1% predicted was associated with a lowered risk of hip fracture (hazard ratio per increase of 10%: 0.89, 95% CI: 0.79 to 0.997). Conclusion: Airflow limitation is positively associated with low BMD and risk of hip fracture in middle-aged and elderly