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Socioeconomic, Cultural, Political & Environmental Factors

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Socioeconomic, Cultural, Political & Environmental Factors

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Socioeconomic, Cultural, Political & Environmental Factors

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Socioeconomic, Cultural, Political & Environmental Factors

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Socioeconomic, Cultural, Political & Environmental Factors

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Socioeconomic, Cultural, Political & Environmental Factors

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(1) Pinto, I. C., & Martins, D. (2017). Prevalence and risk factors of arterial hypertension: A literature review. Journal of Cardiovascular Medicine and Therapeutics, 1(2), 1-7.

Chicago

(2) Kotsis, V., Stabouli, S., Papakatsika, S., Rizos, Z., & Parati, G. (2010). Mechanisms of obesity-induced hypertension. Hypertension research, 33(5), 386-393.

(3) Petrie, J. R., Guzik, T. J., & Touyz, R. M. (2018). Diabetes, hypertension, and cardiovascular disease: clinical insights and vascular mechanisms. Canadian Journal of Cardiology, 34(5), 575-584.

(4) Husain, K., Ansari, R. A., & Ferder, L. (2014). Alcohol-induced hypertension: Mechanism and prevention. World journal of cardiology, 6(5), 245.

(5) Grillo, A., Salvi, L., Coruzzi, P., Salvi, P., & Parati, G. (2019). Sodium intake and hypertension. Nutrients, 11(9), 1970.

(6) Grassi, G., Seravalle, G., Calhoun, D. A., Bolla, G. B., Giannattasio, C., Marabini, M., ... & Mancia, G. (1994). Mechanisms responsible for sympathetic activation by cigarette smoking in humans. Circulation, 90(1), 248-253.

(7) Wu, L., Yang, S., He, Y., Liu, M., Wang, Y., Wang, J., & Jiang, B. (2017). Association between passive smoking and hypertension in Chinese non-smoking elderly women. Hypertension Research, 40(4), 399-404.

(8) Hegde, S. M., & Solomon, S. D. (2015). Influence of physical activity on hypertension and cardiac structure and function. Current hypertension reports, 17, 1-8.

(9) Coylewright, M., Reckelhoff, J. F., & Ouyang, P. (2008). Menopause and hypertension: an age-old debate. Hypertension, 51(4), 952-959.

Chicago

(10) McEniery, C. M., Wilkinson, I. B., & Avolio, A. P. (2007). Age, hypertension and arterial function. Clinical and Experimental Pharmacology and Physiology, 34(7), 665-671.

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¹

>5 g sodium per day⁵

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Increased Sympathetic Nervous System (SNS) activity

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Increased Sympathetic Nervous System (SNS) activity

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Diet-induced, in obese study subjects²

Insulin-stimulated, in obesity & diabetes ²

Stimulated by cigarette smoking ⁶

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Renal excretion of water & sodium (diuresis & natriuresis) altered in obesity: increased sodium retention causes extracellular-fluid volume increase -> increased pressure²

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9, 10

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Increased risk: Black, Hispanic, Asian¹²

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Inflammatory cytokines (TNF-α, interferon-γ, IL-1β, and IL-12) increased in T2DM ³

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Alcohol impairs baroreceptor reflex by interacting with receptors in the brain stem -> increased SNS activity⁴

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High salt intake increases circulating volume -> increases mechanic load & tension in blood vessels

Activates arterial extracellular matrix metalloproteinases, inducing thinning & breakage of elastin fibers -> arterial stiffening⁵

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⁷

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¹³

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Prolonged high blood pressure -> ventricular hypertrophy; wall thickening (to reduce stress). Aerobic exercise reduces ventricular mass in hypertensive patients⁸

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Male = increased risk9, 11

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⁹

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Estrogen may increase production/activity of NO -> controls vasoconstriction/dilation.

Men & post-menopausal women have less circulating estrogen -> endothelial dysfunction⁹

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Black study subjects: higher salt sensitivity, decreased ability to excrete a sodium load¹²

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Food Desert: Lack of access to healthy food options reduce blood pressure management. Disproportionately impact minority communities¹²

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¹⁴

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¹⁵

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Increased risk: Excess energy, low intake of cereal fiber & polyunsaturated fat, high intake of saturated, trans fats¹⁶

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Obesity: increased adipose tissue & altered biology (adipose tissue fibrosis, inflammation, production of exosomes) that can induce insulin resistance¹⁴

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(11) Sandberg, K., & Ji, H. (2012). Sex differences in primary hypertension. Biology of sex differences, 3, 1-21.

(12) Abrahamowicz, A. A., Ebinger, J., Whelton, S. P., Commodore-Mensah, Y., & Yang, E. (2023). Racial and ethnic disparities in hypertension: barriers and opportunities to improve blood pressure control. Current cardiology reports, 25(1), 17-27.

(13) Zhao, W., Mo, L., & Pang, Y. (2021). Hypertension in adolescents: The role of obesity and family history. The Journal of Clinical Hypertension, 23(12), 2065-2070.

(14) Klein, S., Gastaldelli, A., Yki-Järvinen, H., & Scherer, P. E. (2022). Why does obesity cause diabetes?. Cell metabolism, 34(1), 11-20.

(15) Yaribeygi, H., Maleki, M., Sathyapalan, T., Jamialahmadi, T., & Sahebkar, A. (2021). Pathophysiology of physical inactivity‐dependent insulin resistance: a theoretical mechanistic review emphasizing clinical evidence. Journal of diabetes research, 2021(1), 7796727.

(16) Hu, F. B., Manson, J. E., Stampfer, M. J., Colditz, G., Liu, S., Solomon, C. G., & Willett, W. C. (2001). Diet, lifestyle, and the risk of type 2 diabetes mellitus in women. New England journal of medicine, 345(11), 790-797.

(17) Manson, J. E., Ajani, U. A., Liu, S., Nathan, D. M., & Hennekens, C. H. (2000). A prospective study of cigarette smoking and the incidence of diabetes mellitus among US male physicians. The American journal of medicine, 109(7), 538-542.

(18) Fletcher, B., Gulanick, M., & Lamendola, C. (2002). Risk factors for type 2 diabetes mellitus. Journal of Cardiovascular Nursing, 16(2), 17-23.

(19) Lysy, Z., Booth, G. L., Shah, B. R., Austin, P. C., Luo, J., & Lipscombe, L. L. (2013). The impact of income on the incidence of diabetes: a population-based study. Diabetes research and clinical practice, 99(3), 372-379.

(20) Tramunt, B., Smati, S., Grandgeorge, N., Lenfant, F., Arnal, J. F., Montagner, A., & Gourdy, P. (2020). Sex differences in metabolic regulation and diabetes susceptibility. Diabetologia, 63, 453-461.

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Aerobic exercise stimulates expression & function of insulin-sensitive genes involved in glucose homeostasis¹⁵

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Induced by excess energy consumption

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¹⁷

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¹⁸

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Low income = increased risk¹⁹

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Lower income -> more likely to buy inexpensive foods (calorie dense, high in saturated fat). More likely to live in a food desert.

Lower income -> less likely to exercise due to cost, time constraint, fear of injury¹⁹

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Male = increased risk²⁰

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Premenopausal women more likely to store subcutaneous adipose tissue, men more likely to store visceral & ectopic adipose tissue²⁰

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Endogenous estrogen promotes insulin sensitivity in skeletal muscle & adipose tissue²⁰

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Open space preservation in cities, compact building design, diverse housing choices, mixed land use -> increased walking (exercise)²¹

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(21) Durand, C. P., Andalib, M., Dunton, G. F., Wolch, J., & Pentz, M. A. (2011). A systematic review of built environment factors related to physical activity and obesity risk: implications for smart growth urban planning. Obesity reviews, 12(5), e173-e182.

(22) Marmot, M. G., Smith, G. D., Stansfeld, S., Patel, C., North, F., Head, J., ... & Feeney, A. (2013). Health inequalities among British civil servants: the Whitehall II study. In Stress and the Brain (pp. 61-67). Routledge.

(23) In a recent study conducted with older adults in central Spain, type 2 diabetes incidence was lower among professionals, semiskilled professionals, and administrators compared with farmers and unskilled workers

(24) Bartz, S., & Freemark, M. (2012). Pathogenesis and prevention of type 2 diabetes: parental determinants, breastfeeding, and early childhood nutrition. Current diabetes reports, 12, 82-87.

(25) Chin, S. H., Kahathuduwa, C. N., & Binks, M. (2016). Physical activity and obesity: what we know and what we need to know. Obesity Reviews, 17(12), 1226-1244.

(26) Swinburn, B. A., Caterson, I., Seidell, J. C., & James, W. P. T. (2004). Diet, nutrition and the prevention of excess weight gain and obesity. Public health nutrition, 7(1a), 123-146.

(27) Knutson, K. L., Spiegel, K., Penev, P., & Van Cauter, E. (2007). The metabolic consequences of sleep deprivation. Sleep medicine reviews, 11(3), 163-178.

(28) Razzoli, M., & Bartolomucci, A. (2016). The dichotomous effect of chronic stress on obesity. Trends in Endocrinology & Metabolism, 27(7), 504-515.

(29) Sun, M., Feng, W., Wang, F., Li, P., Li, Z., Li, M., ... & Tse, L. A. (2018). Meta‐analysis on shift work and risks of specific obesity types. Obesity reviews, 19(1), 28-40.

(30) Gibson, L. Y., Byrne, S. M., Davis, E. A., Blair, E., Jacoby, P., & Zubrick, S. R. (2007). The role of family and maternal factors in childhood obesity. Medical journal of Australia, 186(11), 591-595.

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Open space preservation in cities, compact building design, diverse housing choices, mixed land use -> increased walking (exercise)²¹

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Lower occupational rank = higher likelihood of dying from cardiovascular disease²²

Unstable jobs

long work hours

Hazardous

No health insurance

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Farmers & unskilled workers = higher likelihood of diabetes²³

Unstable jobs

long work hours

Hazardous

No health insurance

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Mother obese during pregnancy = increased risk of childhood T2DM²⁴

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BMI between 25 and 29.9

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Low circulating high-density lipoprotein cholesterol (HDL-C)

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Increased risk: Energy dense, micronutrient-poor foods, low intake of non-starch fibre, sugar-sweetened soft drinks & fruit juices²⁶

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Aerobic exercise increases energy expenditure & fat oxidation²⁵

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Causes increased ghrelin, reduced leptin, increased perceived hunger²⁷

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Chronic mild & social stress -> Increased appetite, cravings for palatable food²⁸

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Increased risk: areas with heavy marketing of energy-dense food & fast food²⁶

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Open space preservation in cities, compact building design, diverse housing choices, mixed land use -> increased walking (exercise)²¹

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Night shift work = increased risk of overweight & obesity²⁹

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Single-parent household = increased risk of childhood overweight & obesity³⁰

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Hereditary genetic factors affect body weight and response to diet & exercise³¹

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(31) Farooqi, I. S. (2005). Genetic and hereditary aspects of childhood obesity. Best Practice & Research Clinical Endocrinology & Metabolism, 19(3), 359-374.

(32) Lee, A., Cardel, M., & Donahoo, W. T. (2019). Social and environmental factors influencing obesity. Endotext [Internet].

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Non-Hispanic black, non-Hispanic Asian, Hispanic women: Increased obesity vs men with same ethnicity

non-Hispanic Asians: lower prevalence of obesity

Non-Hispanic blacks, Hispanics: Increased obesity³²

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Rural areas: further distance between residences and supermarkets, healthcare, recreational opportunities. Prevents active transport -> reduced physical activity³²

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Food Desert: Lack of access to healthy food options increases obesity prevalence. Disproportionately impact minority communities³²