Cardiovascular diseases (CVD) are the leading causes of morbidity and mortality in the world (1- 3). Hypertension and diabetes, two of the major CVD risk factors, are complex diseases caused by the combined actions of genetic and environmental factors (4-8). Few studies have examined the interaction of these factors and fewer, if any, have looked at their effects in populations of developing Asian countries that are plagued with increasing levels of obesity and rapidly changing food environments (9, 10). The information gap may be due to the lack of population-based studies with adequate depth and detail. There is a paucity of information on dietary and adiposity trends derived from longitudinal studies and there are inadequate genetic data, especially among Asians who tend to develop CVD risk factors at lower body mass index thresholds (11, 12).
Aims and Methods: The proposed study aims to understand how weight history, dietary patterns, and genetic variants independently and jointly affect blood pressure and fasting glucose among adult Filipino women (ages 38 to 71 yr in 2007) using the Cebu Longitudinal Health and Nutrition Survey (CLHNS), an ongoing community-based study of over 2000 women (and their infants) which began in 1983. This is a unique dataset that contains not only rich genetic information on these women but also dietary and anthropometric measurements obtained since baseline, recent blood pressure (1998-2007) and fasting glucose (2005) measurements, and other individual-, household-, and community-level data collected over a span of 24 years of rapid country-wide socio-economic changes. Specifically, using multivariate regression methods we will determine the: (a) effect of weight history (i.e. duration of overweight) on the risk of having hypertension and/or diabetes;(b) association between dietary patterns (identified through cluster analysis) and hypertension and/or diabetes;(c) independence and co-occurrence of hypertension and diabetes and how these relate to weight and dietary patterns;and (d) effects of genetic variants on hypertension and diabetes, focusing on gene variants that have been associated with hypertension or diabetes by previous association studies. Further, the study will explore significant interaction of effects among genetic variants, overweight history and dietary patterns in affecting hypertension or diabetes.
This study will examine the independent and combined effects of genetic predisposition and modifiable factors such as weight and dietary patterns on the risks of having hypertension and diabetes, two major cardiovascular disease (CVD) risk factors. The demographic and health trends in the Philippines exemplify those of other developing Asian countries where CVD-related morbidities and deaths are prevalent and increasing. Thus, studying the mechanisms that can lead to the development of hypertension and diabetes among Filipinos can provide critical information that may guide more tailored prevention efforts for these populations, potentially narrowing global health disparities.
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