***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Microalbuminuria ( MA ) is associated with increased  cardiovascular and all-cause mortality .  It has been proposed that MA reflects generalized atherosclerosis and may thus predict mortality . To investigate this hypothesis , we studied the associations between , on the one h and , MA and peripheral arterial disease ( PAD ) , a generally accepted marker of generalized atherosclerosis , and , on the other h and , cardiovascular and all-cause mortality in an age- , sex- , and glucose tolerance-stratified sample ( n=631 ) of a population -based cohort aged 50 to 75 years followed prospect ively for 5 years . At baseline , the  albumin-to-creatinine ratio ( ACR ) was measured in an overnight spot urine sample ; MA was defined as ACR > 2.0 mg/mmol . PAD was defined as an ankle-brachial pressure index below 0.90 and /or a history of a peripheral arterial bypass or amputation . After 5 years of follow-up , 58 subjects had died ( 24 of cardiovascular causes ) . Both MA and PAD were associated with a 4-fold increase in cardiovascular mortality . After adjusting for age , sex , diabetes mellitus , hypertension , levels of total and HDL-cholesterol and triglyceride , body mass index , smoking habits , and preexistent ischemic heart disease , the relative risks ( RR ) ( 95 % confidence intervals ) were 3.2 ( 1.3 to 8.1 ) for MA and 2.4 ( 0.9 to 6.1 ) for PAD . When both MA and PAD were included in the multivariate analysis , the RRs were 2.9 ( 1.1 to 7.3 ) for MA and 2.0 ( 0.7 to 5.7 ) for PAD . MA and PAD were both associated with an about 2-fold increase in all-cause mortality . The RRs of all-cause mortality associated with MA and PAD were about 4 times higher among hypertensive than among normotensive subjects . We conclude that both MA and PAD are associated with an increased risk of cardiovascular mortality . MA and PAD are mutually independent risk indicators . The associations of MA and PAD with all-cause mortality are somewhat weaker . They are more pronounced in the presence of hypertension than in its absence . These data suggest that MA affects mortality risk through a mechanism different from generalized atherosclerosis A community based case-control study was conducted to determine the risk factors for hypertension among a rural population in Nakhon Ratchasima Province , Thail and . Seventy-two subjects diagnosed with hypertension ( BP > or = 140/ 90 mmHg ) were r and omly selected . Seventy-two controls with normal blood pressure ( BP < 120 - 80 mmHg ) were also r and omly selected from the same or nearest house to the subjects . Data collection was carried out in February 2010 using a structured question naire . Statistics used were percentages , arithmetic means , st and ard deviations , odds ratios ( OR ) , adjusted odds ratios ( aOR ) , confidence interval ( 95 % CI ) for the OR and logistic regression . After adjusting for the effect of other variables in the study , significant risk factors for hypertension were age > or = 50 years old ( aOR 5.67 , 95 % CI 1.98 - 16.24 ) , education level of primary school or lower ( aOR 8.09 , 95 % CI 2.17 - 30.20 ) , occupation of farmer or unemployed ( aOR 2.88 , 95 % CI 1.14 - 7.30 ) , body mass index 230.0 kg/m2 ( aOR 7.43 , 95 % CI 1.68 - 32.87 ) , presence of high cholesterol ( aOR 11.26 , 95 % CI 2.55 - 49.75 ) , and having mild stress to high stress ( aOR 5.33 , 95 % CI 1.45 - 19.61 ) . Forty percent of the variation in the presence of hypertension is explained by the developed model for the above risk factors . These findings are useful for health education and health promotion program development in order to prevent hypertension among rural Thai population OBJECTIVE Blood pressure ranges associated with cardiovascular disease ( CVD ) events in advanced type 2 diabetes are not clear . Our objective was to determine whether baseline and follow-up ( On- Study ) systolic blood pressure ( SBP ) , diastolic blood pressure ( DBP ) , and SBP combined with DBP predict CVD events in the Veterans Affairs Diabetes Trial ( VADT ) . RESEARCH DESIGN AND METHODS Participants in the VADT ( n = 1,791 ) with hypertension received stepped treatment to maintain blood pressure below the target of 130/80 mmHg in st and ard and intensive glycemic treatment groups .  Blood pressure levels of all subjects at baseline and On- Study were analyzed to detect associations with CVD risk . The primary outcome was the time from r and omization to the first occurrence of myocardial infa rct ion , stroke , congestive heart failure , surgery for vascular disease , inoperable coronary disease , amputation for ischemic gangrene , or CVD death . RESULTS Separated SBP ≥140 mmHg had significant risk at baseline ( hazards ratio [ HR ] 1.508 , P < 0.001 ) and On- Study ( HR 1.469 , P = 0.002 ) . DBP < 70 mmHg increased CVD events at baseline ( HR 1.482 , P < 0.001 ) and On- Study ( HR 1.491 , P < 0.001 ) . Combined blood pressure categories indicated high risk for CVD events for SBP ≥140 with DBP < 70 mmHg at baseline ( HR 1.785 , P = 0.03 ) and On- Study ( HR 2.042 , P = 0.003 ) and nearly all SBP with DBP < 70 mmHg . CONCLUSIONS Increased risk of CVD events with SBP ≥140 mmHg emphasizes the urgency for treatment of systolic hypertension . Increased risk with DBP < 70 mmHg , even when combined with SBP in guideline -recommended target ranges , supports a new finding in patients with type 2 diabetes . The results emphasize that DBP < 70 mmHg in these patients was associated with elevated CVD risk and may best be avoided Objectives To assess trends in average blood pressure levels and prevalence , awareness , treatment , and control of hypertension among adults in a rural area of Northwest China , and to determine associated risk factors . Methods Four cross-sectional population -based surveys were conducted between 1982 and 2010 among r and omly selected adults in rural areas of Hanzhong , in Northwest China . Data on blood pressure , body mass index , family history of hypertension , and socio-demographic and lifestyle characteristics were collected in similar way by trained investigators in four surveys . Data of 8575 participants aged 35–64 years was analyzed . Averages and proportions were adjusted for age and sex . Results Average blood pressure in the population has increased since 1982 from 76.9 mm Hg to 79.6 mm Hg in 2010 ( diastolic ) and from 120.9 to 129.7 mm Hg ( systolic ) . Prevalence of hypertension increased from 18.4 % in 1982 to 30.5 % in 2010 , and awareness of hypertension increased from 16.8 % to 38.4 % in 2010 . Treatment of hypertension increased from 1.0 % in 1982 to 17.4 % in 2010 , and control of hypertension increased from 0.1 % in 1982 to 3.5 % in 2010 . All these gradients were statistically significant ( P<0.01 for trend ) . Population blood pressure and prevalence , awareness and treatment of hypertension were positively associated with increasing age , body mass index and having family history of hypertension . Conclusions Average blood pressure levels and the prevalence , awareness , treatment and control of hypertension among adults in rural areas of Hanzhong have increased since 1982 . However , awareness , treatment and control rates remain low . Public health programs and practical strategies are required to improve prevention and control of hypertension in rural Northwest China . In particular , attention should be given to the elderly and obese , and to those with a family history of hypertension , while raising awareness and treatment among younger adults Liaoning Province is located in northeast China , which has distinct weather conditions , geographic characteristics and lifestyles compared with other regions of the country ; the lifestyle differences are especially pronounced in the rural parts of this region , where there is a dearth of financial and other re sources . However , information on the prevalence , awareness , treatment , and control of hypertension in these impoverished areas is very scarce . We therefore performed multistage cluster r and om sampling of a group of 29,970 adult residents ( ≥5 years of residency ; ≥35 years of age ) of the rural portions of Liaoning Province from 2005 to 2006 . The sampling included a survey on blood pressure and associated risk factors . The overall prevalence of hypertension in the community was 36.2 % , and 73.0 % of hypertensives were unaware of their condition . Among the total group of hypertensives , only 19.8 % were taking prescribed medication to lower their BP , and 0.9 % had controlled hypertension . Of all subjects , 46.4 % did not think that high blood pressure would endanger their lives . As to the reasons given by hypertensives who were aware of their hypertension for not taking antihypertensive medication , 47.4 % reported that they lacked knowledge about the mortality of hypertension . The average salt intake in hypertensives was 16.6±9.9 g/day , and the percentages of smoking ( 44.3 % ) , drinking ( 31.7 % ) and salt intake > 6 g/day ( 86.8 % ) in hypertensives were high . Logistic regression analysis indicated that the relative risks ( 95 % confidence interval [ CI ] ) of overweight , obesity , smoking , drinking , increased salt intake and family history of hypertension for hypertension were 1.95 ( range , 1.82–2.08 ) , 2.92 ( 2.40–3.55 ) , 1.19 ( 1.12–1.27 ) , 1.16 ( 1.08–1.25 ) , 1.26 ( 1.20–1.33 ) and 2.85 ( 2.66–3.05 ) , respectively . A higher education level was found to be a protective factor . In conclusion , the prevalence of hypertension in adults living in the rural parts of Liaoning Province was high , and the rates of awareness , treatment , and control were unacceptably low , which may have been due to unique geographical characteristics , unwholesome lifestyles , greater sodium intake , lower education levels , and genetic risk factors To determine the association of socio-economic status ( SES ) and prevalence of hypertension  and its risk factors in a rural population , a cross sectional survey was conducted in two r and omly selected villages in the Moradabad district in North India . There were 1935 residents aged over 25 ( 984 men and 951 women ) who were r and omly selected and categorised into social classes 1–4 depending upon SES based on occupation , housing conditions , l and holding , total per capita income , ownership of consumer durables and education . The prevalence of hypertension diagnosed by JNC V criteria ( > 140/90 mm Hg ) was significantly higher among social class 1 and 2 and showed positive relation with SES in both sexes . Among social class 1 and 2 subjects , there was a higher prevalence of overweight and obesity and sedentary lifestyle . Logistic regression analysis with adjustment of age showed that SES had a positive relation with hypertension ( odds ratio : men 1.09 , 95 % CI 1.05–1.14 ; women 1.08 , 95 % CI 1.05–1.13 ) , body mass index ( odds ratio : men 1.12 , 1.08–1.18 ; women 1.11 , 1.06–1.16 ) and sedentary lifestyle ( odds ratio : men 1.45 , 1.32–1.58 ; women 1.38 , 1.26–1.49 ) . Only weak but significant associations were observed with smoking , alcohol and salt intake . The association of hypertension with social class was reduced after adjustment of body mass index , sedentary lifestyle , smoking and salt intake ( odds ratio : men 0.96 , 0.81–1.14 ; women 0.73 , 0.54–1.04 ) . There was an increase in the prevalence of hypertension and age-specific blood pressure ( BP ) with increasing age in both sexes . The overall prevalence of hypertension by WHO criteria ( > 160/95 ) was 4.6 % and by JNC V criteria 20.8 % , and the rates were comparable in both sexes . Social class 1 and 2 subjects in rural North India have a higher prevalence of hypertension and its risk factors of overweight and sedentary lifestyle Purpose This study aim ed 
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RESULTS Overall , no association was detected between educational status and hypertension , whereas a positive association was observed with income .
Higher income , household assets or social class were positively associated with hypertension in South Asia whereas no association was detected in East Asia and Africa .
Compared with other occupations , farmers or manual labourers were associated with a lower risk for hypertension .
We provide evidence that the association between hypertension and SES in rural population s of LMICs in Asia varies according to geographical region .