Estimating the effects of overweight duration, sodium intake and genetic variants on hypertension risk among Filipino women in Cebu, Philippines Public Deposited

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  • March 21, 2019
  • Lee, Nanette R.
    • Affiliation: Gillings School of Global Public Health, Department of Nutrition
  • Hypertension makes the largest contribution to the worldwide burden of cardiovascular diseases. It is a multi-factorial disease that develops from the complex interplay of environmental and genetic factors. Asians are a special concern because they tend to develop hypertension at a lower body mass index (BMI) compared to Caucasian populations and have been reported to consume high amounts of sodium. This research examined the roles of overweight duration, variants of the angiotensinogen (AGT Met235Thr), angiotensin converting enzyme (ACE insertion/deletion (I/D) in intron 16) and alpha adducin (ADD1 Gly460Trp) genes, and high sodium consumption on hypertension risk among adult Filipino women in Cebu, Philippines. Additionally, this research explored potential heterogeneity of effects according to different genetic and environmental characteristics. We used data gathered by the Cebu Longitudinal Health and Nutrition Survey (CLHNS). Aside from detailed individual, household and community level socio-demographic characteristics, this data contained genetic information, repeated anthropometric measures that span over two decades, dietary measures including sodium intake, and repeated blood pressure measurements. Using poisson regression with robust error variance, we found that overweight duration influenced the 5-year cumulative incidence (2002-2007) of hypertension independent of 2002 BMI. Results of logistic regression analyses showed that AGT Met235Thr appeared to influence hypertension risk regardless of age, BMI and presence of the other variants. We found possible age-dependent effects for the ACE and ADD1 variants. Our findings also suggest that the effect of high sodium intake on hypertension is: (1) enhanced in women with the ADD1 TrpTrp genotype but not evident in women with the GlyGly or GlyTrp genotypes; (2) increased with increasing age, in women who had never been overweight and those who were smokers; and (3) decreased with increasing BMI. Overall, this research found that the duration of being overweight, selected genetic variants and sodium intake may influence hypertension risk in adult Filipino women. We observed potential heterogeneity of effects and support the importance of conducting context-dependent analyses. Results of this research may be used to design a more comprehensive hypertension prevention program in the Philippines and possibly in other Asian and developing countries.
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  • Adair, Linda
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