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Lin H, Pan H, Chen C, Cheng H, Chia Y, Sogunuru GP, Tay JC, Turana Y, Verma N, Kario K, Wang T. Standardized home blood pressure monitoring: Rationale behind the 722 protocol. J Clin Hypertens (Greenwich) 2022; 24:1161-1173. [PMID: 36196472 PMCID: PMC9532917 DOI: 10.1111/jch.14549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 07/02/2022] [Accepted: 07/05/2022] [Indexed: 11/07/2022]
Abstract
Home blood pressure (HBP) has been recognized as a prognostic predictor for cardiovascular events, and integrated into the diagnosis and management of hypertension. With increasing accessibility of oscillometric blood pressure devices, HBP monitoring is easy to perform, more likely to obtain reliable estimation of blood pressures, and feasible to document long-term blood pressure variations, compared to office and ambulatory blood pressures. To obtain reliable HBP estimates, a standardized HBP monitoring protocol is essential. A consensus regarding the optimal duration and frequency of HBP monitoring is yet to be established. Based on the current evidence, the "722" protocol, which stands for two measurements on one occasion, two occasions a day (morning and evening), and over a consecutive of 7 days, is most commonly used in clinical studies and recommended in relevant guidelines and consensus documents. HBP monitoring based on the "722" protocol fulfills the minimal requirement of blood pressure measurements to achieve agreement of blood pressure classifications defined by office blood pressures and to predict cardiovascular risks. In the Taiwan HBP consensus, the frequency of repeating the "722" protocol of HBP monitoring according to different scenarios of hypertension management, from every 2 weeks to 3 months, is recommended. It is reasonable to conclude that the "722" protocol for HBP monitoring is clinically justified and can serve as a basis for standardized HBP monitoring.
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Affiliation(s)
- Hung‐Ju Lin
- CardiovascularCenter and Division of Cardiology, Department of Internal MedicineNational Taiwan University HospitalTaipeiTaiwan
| | - Heng‐Yu Pan
- Department of Internal MedicineNational Taiwan University Hospital Yun‐Lin BranchYun‐Lin CountyTaiwan
| | - Chen‐Huan Chen
- Department of MedicineNational Yang Ming Chiao Tung University College of MedicineTaipeiTaiwan
- Department of Medical EducationTaipei Veterans General HospitalTaipeiTaiwan
| | - Hao‐Min Cheng
- Institute of Public Health and Community Medicine Research CenterNational Yang‐Ming University School of MedicineTaipeiTaiwan
- Department of MedicineDivision of CardiologyTaipei Veterans General HospitalTaipeiTaiwan
- Faculty of MedicineNational Yang‐Ming University School of MedicineTaipeiTaiwan
- Department of Medical EducationCenter for Evidence‐based MedicineTaipei Veterans General HospitalTaipeiTaiwan
| | - Yook‐Chin Chia
- Department of Medical SciencesSchool of Medical and Life SciencesSunway UniversitySelangor Darul EhsanBandar SunwayMalaysia
- Department of Primary Care MedicineFaculty of MedicineUniversity of MalayaKuala LumpurMalaysia
| | - Guru Prasad Sogunuru
- Fortis HospitalsChennaiTamil NaduIndia
- College of Medical SciencesKathmandu UniversityBharatpurNepal
| | - Jam Chin Tay
- Department of General MedicineTan Tock Seng HospitalSingapore CitySingapore
| | - Yuda Turana
- Department of NeurologySchool of Medicine and Health SciencesAtma Jaya Catholic University of IndonesiaJakartaIndonesia
| | - Narsingh Verma
- Asia Pacific Society of HypertensionDepartment of PhysiologyKing George's Medical UniversityLucknowIndia
| | - Kazuomi Kario
- Division of Cardiovascular MedicineDepartment of MedicineJichi Medical University School of MedicineTochigiJapan
| | - Tzung‐Dau Wang
- Cardiovascular Center and Divisions of Cardiology and Hospital Medicine, Department of Internal MedicineNational Taiwan University Hospital and National Taiwan University College of MedicineTaipeiTaiwan
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Miao H, Zou C, Yang S, Chia Y, Van Huynh M, Sogunuru GP, Tay JC, Wang T, Kario K, Zhang Y. Targets and management of hypertension in heart failure: focusing on the stages of heart failure. J Clin Hypertens (Greenwich) 2022; 24:1218-1225. [PMID: 36196463 PMCID: PMC9532909 DOI: 10.1111/jch.14553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 06/30/2022] [Accepted: 07/09/2022] [Indexed: 11/05/2022]
Abstract
Hypertension is highly prevalent worldwide and is the major risk factor for heart failure (HF). More than half of the patients with HF in Asia suffer from hypertension. According to the 2022 American Heart Association/American College of Cardiology/Heart Failure Society of America HF guideline, there are four stages of HF, including at risk for HF (stage A), pre-HF (stage B), symptomatic HF (stage C), and advanced HF (stage D). Given the high prevalence of hypertension as well as HF and the stronger association between hypertension and cardiovascular diseases in Asians compared to the west, measures to prevent and alleviate the progression to clinical HF, especially controlling the blood pressure (BP), are of priority for Asian populations. After reviewing evidence-based studies, we propose a BP target of less than 130/80 mmHg for patients at stages A, B, and C. However, relatively higher BP may represent an opportunity to maximize guideline-directed medical therapy (GDMT), which could potentially result in a better prognosis for patients at stage D. Traditional antihypertensive drugs are the cornerstones for the management of hypertension at stages A and B. Notably, calcium channel blockers (CCBs) are inferior to other drug classes for the preventing of HF, whereas diuretics are superior to others. For patients at stage C, GDMT is essential which also helps the control of BP. In particular, sodium-glucose cotransporter-2 (SGLT2) inhibitors are newer therapies recommended for the treatment of HF and presumably even in hypertension to prevent HF. Regarding patients at stage D, GDMT is also recommended if tolerable and measures should be taken to improve hemodynamics.
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Affiliation(s)
- Huanhuan Miao
- Department of CardiologyFuwai HospitalChinese Academy of Medical Sciences & Peking Union Medical CollegeBeijingChina
| | - Changhong Zou
- Department of CardiologyFuwai HospitalChinese Academy of Medical Sciences & Peking Union Medical CollegeBeijingChina
| | - Shijie Yang
- Department of CardiologyFuwai HospitalChinese Academy of Medical Sciences & Peking Union Medical CollegeBeijingChina
| | - Yook‐Chin Chia
- Department of Medical SciencesSchool of Medical and Life SciencesSunway UniversityBandar SunwayMalaysia
- Department of Primary Care MedicineFaculty of MedicineUniversity of MalayaKuala LumpurMalaysia
| | - Minh Van Huynh
- Department of Internal MedicineUniversity of Medicine and PharmacyHue UniversityVietnam
| | - Guru Prasad Sogunuru
- Advanced Heart Failure & Device Therapies, MEDWAY HEART INSTITUTEChennaiTamil NaduIndia
- College of Medical SciencesKathmandu UniversityBharatpurNepal
| | - Jam Chin Tay
- Department of General MedicineTan Tock Seng HospitalSingaporeSingapore
| | - Tzung‐Dau Wang
- Cardiovascular Center and Divisions of Cardiology and Hospital MedicineDepartment of Internal MedicineNational Taiwan University HospitalTaipei CityTaiwan
| | - Kazuomi Kario
- Division of Cardiovascular MedicineDepartment of MedicineJichi Medical University School of MedicineTochigiJapan
| | - Yuqing Zhang
- Department of CardiologyFuwai HospitalChinese Academy of Medical Sciences & Peking Union Medical CollegeBeijingChina
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103
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Du X, Fang L, Xu J, Chen X, Bai Y, Wu J, Wu L, Zhong J. The association of knowledge, attitudes and behaviors related to salt with 24-h urinary sodium, potassium excretion and hypertensive status. Sci Rep 2022; 12:13901. [PMID: 35974077 PMCID: PMC9381520 DOI: 10.1038/s41598-022-18087-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 08/04/2022] [Indexed: 11/12/2022] Open
Abstract
To understand the association between sodium and potassium consumption levels, hypertension and knowledge, attitudes and behaviors (KAB) toward salt and the commitment to effective sodium reduction and potassium supplementation to achieve the purpose of suppressing hypertension. A stratified multistage random sampling method was used to obtain a representative provincial sample of 7512 residents aged 18-69 years through a cross-sectional survey by the Salt Reduction and Hypertension Prevention Project (SRHPP) in Zhejiang Province of China in 2017-2018. A screening including demographic, anthropometric, salt-related KAB and physical measurements was implemented, and 24-h urine of approximately 1/5 of the participants was collected and tested. The mean age was 44.8 years, 50.1% were women, 44.0% lived in urban areas, and hypertension or prehypertension accounted for approximately 35.0%. The mean 24-h urinary sodium and potassium excretion were 3848.5 (1661.1) mg/d and 1491.1 (710.9) mg/d, respectively. KAB in urban areas was generally more favorable than in rural areas, women were better than men, and the optimal blood pressure group was better than the other two groups (P < 0.05). However, the awareness and correct use rate of salt-restricted spoons, low-sodium salt and nutrition labeling were lower. A multivariable linear regression model indicated that KAB had a smaller effect on sodium (two indicators effective for promoting sodium reduction) and a greater effect on potassium (six indicators effective for promoting potassium supplementation) and mainly focused on knowledge and behavior indicators. A multivariable logistic regression model indicated that mastering more knowledge and taking active measures could effectively reduce the transition to hypertension, even if the individual was already in prehypertension. There is much room for improvement of salt-related KAB in the Chinese population. A clear association indicates that KAB can help to reduce sodium and supplement potassium, especially potassium, and help to suppress the development of hypertension. The role of beliefs in KAB should be fully valued and improved, similar to knowledge and behaviors. This study provides important evidence and insight into China's efforts to meet the targets of salt reduction and hypertension prevention.
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Affiliation(s)
- Xiaofu Du
- Department of Chronic Disease Prevention and Control, Zhejiang Provincial Center for Disease Control and Prevention, No. 3399 Binsheng Road, Hangzhou, 310051, China
| | - Le Fang
- Department of Chronic Disease Prevention and Control, Zhejiang Provincial Center for Disease Control and Prevention, No. 3399 Binsheng Road, Hangzhou, 310051, China
| | - Jianwei Xu
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 27 Nanwei Road, Beijing, 100050, China
| | - Xiangyu Chen
- Department of Chronic Disease Prevention and Control, Zhejiang Provincial Center for Disease Control and Prevention, No. 3399 Binsheng Road, Hangzhou, 310051, China
| | - Yamin Bai
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 27 Nanwei Road, Beijing, 100050, China
| | - Jing Wu
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 27 Nanwei Road, Beijing, 100050, China
| | - Lin Wu
- Department of Medical College, Jinhua Polytechnic, No. 888 Haitang West Road, JinHua, 321017, China
| | - Jieming Zhong
- Department of Chronic Disease Prevention and Control, Zhejiang Provincial Center for Disease Control and Prevention, No. 3399 Binsheng Road, Hangzhou, 310051, China.
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Trajectories of Lipid Profile and Risk of Carotid Atherosclerosis Progression: A Longitudinal Cohort Study. Nutrients 2022; 14:nu14153243. [PMID: 35956420 PMCID: PMC9370402 DOI: 10.3390/nu14153243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 07/31/2022] [Accepted: 08/03/2022] [Indexed: 11/30/2022] Open
Abstract
Background: Early assessment of carotid atherosclerotic plaque characteristics is essential for atherosclerotic cardiovascular disease (ASCVD) risk stratification and prediction. We aimed to identify different trajectories of lipid profiles and investigate the association of lipid trajectories with carotid atherosclerosis (CAS) progression in a large, longitudinal cohort of the Chinese population. Methods: 10,412 participants aged ≥18 years with ≥2 times general health checkups were included in this longitudinally prospective cohort study at Peking University Third Hospital. We used latent class trajectory models to identify trajectories of total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), triglycerides (TG), and high-density lipoprotein cholesterol (HDL-C) over follow-up time (757 days, IQR: 388–844 days). Results: Participants with carotid plaque were more likely to be older, male, have higher body mass index, have a higher prevalence of hypertension and diabetes, and have a higher level of blood pressure, TG, TC, and LDL-C, compared with carotid intima-media thickness (cIMT) and normal group. Subjects were trichotomized according to different trajectory patterns into stable, moderate-stable, and elevated-increasing classes. TC ≥ 5.18 mmol/L and moderate-stable class (hazard ratio (HR): 1.416, 95% confidence interval (CI): 1.285–1.559, p: 0.000), TG ≥ 1.70 mmol/L and moderate-stable class (HR: 1.492, 95% CI: 1.163–1.913, p: 0.002), TG ≥ 1.70 mmol/L and elevated-increasing class (HR: 1.218, 95% CI: 1.094–1.357, p: 0.000), LDL-C ≥ 3.36 mmol/L and stable class (HR: 1.500, 95% CI: 1.361–1.653, p: 0.000) were statistically significant associated with CAS progression compared with the reference group. Conclusions: Borderline elevated baseline lipid (TC, TG, and LDL-C) with stable and elevated-increasing trajectories were associated with CAS progression. Long-term strategies for low-level lipid are beneficial for ASCVD management.
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105
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Chun M, Clarke R, Zhu T, Clifton D, Bennett DA, Chen Y, Guo Y, Pei P, Lv J, Yu C, Yang L, Li L, Chen Z, Cairns BJ. Development, validation and comparison of multivariable risk scores for prediction of total stroke and stroke types in Chinese adults: a prospective study of 0.5 million adults. Stroke Vasc Neurol 2022; 7:328-336. [PMID: 35292536 PMCID: PMC9453839 DOI: 10.1136/svn-2021-001251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 01/11/2022] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND AND PURPOSE Low-income and middle-income countries have the greatest stroke burden, yet remain understudied. This study compared the utility of Framingham versus novel risk scores for prediction of total stroke and stroke types in Chinese adults. METHODS China Kadoorie Biobank (CKB) is a prospective study of 512 726 adults, aged 30-79 years, recruited from 10 areas in China in 2004-2008. By 1 January 2018, 43 234 incident first stroke cases (36 310 ischaemic stroke (IS); 8865 haemorrhagic stroke (HS)) were recorded in 503 842 participants with no history of stroke at baseline. We compared the predictive utility of the Framingham Stroke Risk Profile (FSRP) with novel CKB stroke risk scores and included recalibration, refitting, stratifying by study area and addition of other risk factors. Discrimination was assessed using area under the receiver operating characteristic curve (AUC) and calibration was assessed using Greenwood-Nam-D'Agostino χ2 statistics. RESULTS Incidence of total stroke varied fivefold by area in China. The FSRP had good discrimination for total stroke (AUC (95% CI); men: 0.78 (0.77 to 0.79), women: 0.77 (95% CI 0.76 to 0.78)), but poor calibration (χ2; men: 1,825, women: 3,053), substantially underestimating absolute risks. Recalibration reduced χ2 by >80%, but did not improve discrimination. Refitting the FSRP did not materially improve discrimination, but further improved calibration. Stratification by area improved discrimination (AUC; men: 0.82 (0.82 to 0.83); women: 0.82 (0.82 to 0.83)), but not calibration. Adding other risk factors yielded modest, but statistically significant, improvements in the AUCs. The findings for IS and HS were similar to those for total stroke. CONCLUSIONS The FSRP reliably differentiated Chinese adults with incident stroke, but substantially underestimated the absolute risks of stroke. Novel local risk prediction equations that took account of differences in stroke incidence within China enhanced risk prediction of total stroke and major stroke pathological types.
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Affiliation(s)
- Matthew Chun
- Clinical Trial Service Unit and Epidemiological Studies, Nuffield Department of Population Health, University of Oxford, Oxford, UK
- Department of Engineering Science, University of Oxford, Oxford, UK
| | - Robert Clarke
- Clinical Trial Service Unit and Epidemiological Studies, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Tingting Zhu
- Department of Engineering Science, University of Oxford, Oxford, UK
| | - David Clifton
- Department of Engineering Science, University of Oxford, Oxford, UK
- Department of Biomedical Engineering, Oxford-Suzhou Centre for Advanced Research, Suzhou, China
| | - Derrick A Bennett
- Clinical Trial Service Unit and Epidemiological Studies, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Yiping Chen
- Clinical Trial Service Unit and Epidemiological Studies, Nuffield Department of Population Health, University of Oxford, Oxford, UK
- Medical Research Council Health Research Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Yu Guo
- CKB Project Department, Fuwai Hospital Chinese Academy of Medical Sciences, National Center for Cardiovascular Diseases, Beijing, China
| | - Pei Pei
- CKB Project Department, Chinese Academy of Medical Sciences, Beijing, China
| | - Jun Lv
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
- Department of Epidemiology, Peking University Center for Public Health and Epidemic Preparedness and Response, Beijing, China
| | - Canqing Yu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
- Department of Epidemiology, Peking University Center for Public Health and Epidemic Preparedness and Response, Beijing, China
| | - Ling Yang
- Clinical Trial Service Unit and Epidemiological Studies, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Liming Li
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
- Department of Epidemiology, Peking University Center for Public Health and Epidemic Preparedness and Response, Beijing, China
| | - Zhengming Chen
- Medical Research Council Health Research Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Benjamin J Cairns
- Clinical Trial Service Unit and Epidemiological Studies, Nuffield Department of Population Health, University of Oxford, Oxford, UK
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Sun N, Wang L, Xi Y, Wang H, Yang F, Chen Y, Liu J, Cui Y, Zeng Z. Accuracy Evaluation of Carotid-Femoral Pulse Wave Velocity Estimated by Smart Terminal Watch. Front Cardiovasc Med 2022; 9:893557. [PMID: 35935640 PMCID: PMC9353553 DOI: 10.3389/fcvm.2022.893557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 06/07/2022] [Indexed: 11/13/2022] Open
Abstract
To evaluate the accuracy of the smartwatch in estimating carotid-femoral pulse wave velocity (cfPWV). A cohort of gender-matched volunteers aged 18–80 years were recruited. At the sitting and supine positions, cfPWV was measured alternately by smartwatch and CompliorAnalyse, for each participant, and nine sets of data were collected from each participant with a 60 s interval between measurements. The accuracy of cfPWV measurement for smartwatches was assessed using mean error (ME) and mean absolute error (MAE), while the consistency of the two methods was assessed using the Bland-Altman analysis and concordance class correlation. A total of 347 participants were enrolled. The mean cfPWV was 9.01 ± 2.29 m/s measured by CompliorAnalyse and 9.06 ± 1.94 m/s by smartwatch. The consistency correlation coefficient (CCC) was 0.9045 (95% CI 0.8853–0.9206), the ME was 0.046 ± 0.92, and the MAE was 0.66 (95% CI 0.59–0.73). Bland-Altman analysis showed that the error of 95% samples was in the range between −1.77 m/s and 1.86 m/s. The Kappa value of cfPWV greater than 10 m/s was 0.79, the area under the ROC curve was 0.97 (P < 0.001), sensitivity was 0.90, specificity was 0.93, positive predictive value was 0.83 and negative predictive value was 0.96. Smartwatch can accurately estimate cfPWV to evaluate arterial stiffness. This method is simple and feasible and is suitable for people to actively and early monitor vascular elasticity.
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Affiliation(s)
- Ningling Sun
- Department of Hypertension, Peking University People’s Hospital, Beijing, China
- *Correspondence: Ningling Sun,
| | - Luyan Wang
- Department of Hypertension, Peking University People’s Hospital, Beijing, China
| | - Yang Xi
- Department of Hypertension, Peking University People’s Hospital, Beijing, China
| | - Hongyi Wang
- Department of Hypertension, Peking University People’s Hospital, Beijing, China
| | - Fan Yang
- Department of Hypertension, Peking University People’s Hospital, Beijing, China
| | - Yuanyuan Chen
- Department of Hypertension, Peking University People’s Hospital, Beijing, China
| | - Jing Liu
- Department of Hypertension, Peking University People’s Hospital, Beijing, China
| | - Yuxian Cui
- Department of Hypertension, Peking University People’s Hospital, Beijing, China
| | - Zhechun Zeng
- Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
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Bioequivalence evaluation and food effect assessment of Lisinopril/amlodipine tablets in healthy Chinese subjects under fasting and fed conditions. BMC Pharmacol Toxicol 2022; 23:45. [PMID: 35794660 PMCID: PMC9260974 DOI: 10.1186/s40360-022-00590-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 07/04/2022] [Indexed: 11/10/2022] Open
Abstract
PURPOSE The combination of lisinopril and amlodipine has a marked additional effect on blood pressure and fewer side effects than individual monotherapy. This study was conducted to compare the pharmacokinetic parameters and evaluate the bioequivalence between two Lisinopril/amlodipine tablets in healthy Chinese subjects. METHODS A single center, randomized, open-label, single-dose, two-period crossover bioequivalence study was designed in healthy Chinese subjects under both fasting and fed conditions. Blood samples were collected before drug administration and at 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 24, 36, 48, 72, 96, 144, 168 h after administration. Liquid chromatography-tandem mass spectrometry (LC-MS/MS) was applied to determine the plasma concentration of lisinopril and amlodipine. Maximum concentration (Cmax) and area under the concentration-time curve (AUC) were used to evaluate bioequivalence. Adverse events were recorded. RESULTS Ninety-two healthy subjects were enrolled, and 75 completed the study. The 90% confidence intervals (CIs) of the ratio of geometric means (GMRs) of Cmax, AUC0-t, and AUC0-∞ of lisinopril and amlodipine under both fasting and fed conditions fell within the conventional bioequivalence criteria of 0.80-1.25. A high-fat meal appeared to decrease the Cmax and AUC of lisinopril. No severe adverse events were observed. CONCLUSION The trial demonstrated that the test and the reference lisinopril/amlodipine tablets were bioequivalent and well tolerated in Chinese people under fasting and fed conditions. TRIAL REGISTRATION Clinical Trails.gov identifier, NCT04885660 (retrospectively registered in 13/05/ 2021).
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108
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Cheng W, Zhuang J, Chen S. Dyslipidemia and the Prevalence of Hypertension: A Cross-Sectional Study Based on Chinese Adults Without Type 2 Diabetes Mellitus. Front Cardiovasc Med 2022; 9:938363. [PMID: 35872884 PMCID: PMC9300889 DOI: 10.3389/fcvm.2022.938363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Accepted: 06/03/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundIn clinical practice, it is frequently observed that patients with hypertension often coexist with dyslipidemia. However, studies on atherosclerotic indices and the prevalence of hypertension are still limited. The purpose of this study was to assess the relationship between atherosclerotic indices and the prevalence of hypertension in Chinese adults without type 2 diabetes mellitus.MethodsIn this paper, a cross-sectional study was conducted based on 117,056 adults in 11 Chinese cities (Shanghai, Beijing, Wuhan, Suzhou, Shenzhen, Changzhou, Nantong, Guangzhou, Hefei, Nanjing, and Chengdu) from 2010 to 2016. Besides, the raw data was obtained from the public database (www.Datadryad.org), while eight atherosclerosis indices namely the atherogenic coefficient (AC), Castelli's risk index I (CRI-I) and II (CRI-II), the atherogenic index of plasma (AIP), the cholesterol index, the lipoprotein combined index (LCI), non-high-density lipoprotein cholesterol (non-HDL-C) and triglycerides/high-density lipoprotein cholesterol (TG/HDL-C) were analyzed in this study. Apart from that, two groups of continuous variables were measured using the Mann-Whitney test, and categorical variables were analyzed using the Chi-square test. Differences between multiple groups of continuous variables were investigated using Kruskal-Wallis one-way analysis of variance (ANOVA) and Dunn's test. Furthermore, Spearman correlation analysis and multivariate logistic regression analyses were performed to assess the relationship between atherosclerotic indices and blood pressure levels, and the prevalence of hypertension, respectively. The results of multivariate logistic regression analyses were expressed as the odds ratio (OR) and their corresponding 95% confidence intervals (CIs). Moreover, the receiver operating characteristic (ROC) curve was depicted to further analyze the predictive value of the atherosclerotic indices on the prevalence of hypertension.ResultsThe atherosclerosis indices were higher in the hypertensive population compared to those in the normotensive population. Meanwhile, systolic blood pressure (SBP) and diastolic blood pressure (DBP) were linearly and positively correlated with atherosclerotic indices. In addition, multivariate logistic regression analysis showed that the cholesterol index and non-HDL-C were observed to be positively associated with the prevalence of hypertension (p for trend < 0.05). Moreover, the prevalence of hypertension increased by 3.7% (OR: 1.037; 95% CI: 1.009-1.065; p = 0.009) and 6.1% (OR: 1.06; 95% CI: 1.033–1.091; p < 0.001), respectively, as per 1-standard deviation (SD) increase in the cholesterol index and non-HDL-C. Beyond that, ROC analysis demonstrated that the cholesterol index and non-HDL-C have a good predictive value for the prevalence of hypertension in women, with under the ROC curve (AUC) of 0.659 and 0.684 and cut-off values of 47.94 and 134.34 mg/dl, accordingly.ConclusionsIn Chinese adults without type 2 diabetes mellitus, atherosclerotic indices were significantly higher in hypertensive populations compared with those in normotensive populations, regardless of hypertension levels. Meanwhile, SBP and DBP were linearly and positively related to atherosclerotic indices. Besides, the cholesterol index and non-HDL-C were independent risk factors for the prevalence of hypertension, and they could be adopted for effectively predicting the prevalence of hypertension in women.
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Affiliation(s)
- Wenke Cheng
- Medical Faculty, University of Leipzig, Leipzig, Germany
| | - Jingqi Zhuang
- Department of Admission and Follow-Up, Lintong Rehabilitation and Recuperation Center, Xian, China
| | - Siwei Chen
- Department of Cardiovascular Medicine, The Third Hospital of Nanchang, Nanchang, China
- *Correspondence: Siwei Chen
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Chao H, He Y, Wang Q, Bai Y, Avolio A, Deng X, Zuo J. Comparison of Influence of Blood Pressure and Carotid-Femoral Pulse Wave Velocity on Target Organ Damage in Hypertension. Front Cardiovasc Med 2022; 9:934747. [PMID: 35865385 PMCID: PMC9294321 DOI: 10.3389/fcvm.2022.934747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 06/15/2022] [Indexed: 11/13/2022] Open
Abstract
Objectives Assessment of target organ damage (TOD) is an important part of the diagnosis and evaluation of hypertension. Carotid-femoral pulse wave velocity (cf-PWV) is considered to be the gold-standard for noninvasive arterial stiffness assessment. This study aims to analyze the risk of TOD in people with different phenotypes of peripheral blood pressure and cf-PWV. Methods The study cohort was recruited from December 2017 to September 2021 at Ruijin Hospital in Shanghai. It was divided into 4 groups according to peripheral blood pressure (pBP) and cf-PWV. TOD was assessed as carotid intima-media thickness (CIMT), chronic kidney disease (CKD), urinary albumin-creatinine ratio (ACR), estimated glomerular filtration rate (eGFR) and left ventricular mass index (LVMI). Results A total of 1,257 subjects (mean age 53.13 ± 12.65 years, 64.2% males) was recruited. Age, body mass index (BMI) and fasting blood glucose (FBG), as well as peripheral systolic blood pressure (pSBP), peripheral diastolic blood pressure (pDBP), peripheral pulse pressure (pPP) were significantly different in the four groups (P < 0.01). eGFR, ACR, LVMI and CIMT were significantly different among different groups (P < 0.01). The risk of ACR abnormality was significantly higher in the group with elevated pBP (P = 0.005, OR 2.264, 95%CI 1.277–4.016; and in the group with elevated pBP and cf-PWV (P = 0.003, OR 1.482, 95%CI 1.144–1.920), while left ventricular hypertrophy (LVH) was significantly higher in the group with elevated cf-PWV (P = 0.002, OR 1.868, 95%CI 1.249–2.793). Conclusion Different profiles based on the status of PBP and cf-PWV associated with different TOD. Individuals with higher pBP have an increased risk of ACR abnormality, while individuals with only cf-PWV elevated have a higher risk of LVH.
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Affiliation(s)
- Huijuan Chao
- Department of Geriatrics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yan He
- Department of Cardiovascular Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qian Wang
- Department of Geriatrics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yaya Bai
- Department of Geriatrics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Alberto Avolio
- Macquarie Medical School, Faculty of Medicine Health and Human Sciences, Macquarie University, Sydney, NSW, Australia
| | - Xueqin Deng
- Department of Geriatrics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Xueqin Deng
| | - Junli Zuo
- Department of Geriatrics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Macquarie Medical School, Faculty of Medicine Health and Human Sciences, Macquarie University, Sydney, NSW, Australia
- *Correspondence: Junli Zuo
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Mai H, Li C, Chen K, Wu Z, Liang X, Wang Y, Chen T, Chen F. Hypertension Subtypes, Mortality Risk, and Differential Effects Between Two Hypertension Guidelines. Front Med (Lausanne) 2022; 9:814215. [PMID: 35865177 PMCID: PMC9295617 DOI: 10.3389/fmed.2022.814215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Accepted: 06/15/2022] [Indexed: 11/27/2022] Open
Abstract
Aim: To examine which hypertension subtypes are primarily responsible for the difference in the hypertension prevalence and treatment recommendations, and to assess their mortality risk if 2017 American College of Cardiology (ACC)/American Heart Association (AHA) hypertension guideline were adopted among Chinese adults. Methods We used the nationally representative data of China Health and Retirement Longitudinal Study (CHARLS) to estimate the differences in the prevalence of isolated systolic hypertension (ISH), systolic diastolic hypertension (SDH) and isolated diastolic hypertension (IDH) between the 2017 ACC/AHA and the 2018 China Hypertension League (CHL) guidelines. We further assessed their mortality risk using follow-up data from the China Health and Nutrition Survey (CHNS) by the Cox model. Results The increase from the 2017 ACC/AHA guideline on hypertension prevalence was mostly from SDH (8.64% by CHL to 25.59% by ACC/AHA), followed by IDH (2.42 to 6.93%). However, the difference was minuscule in the proportion of people recommended for antihypertensive treatment among people with IDH (2.42 to 3.34%) or ISH (12.00 to 12.73%). Among 22,184 participants with a median follow-up of 6.14 years from CHNS, attenuated but significant associations were observed between all-cause mortality and SDH (hazard ratio 1.56; 95% CI: 1.36,1.79) and ISH (1.29; 1.03,1.61) by ACC/AHA but null association for IDH (1.15; 0.98,1.35). Conclusion Adoption of the 2017 ACC/AHA may be applicable to improve the unacceptable hypertension control rate among Chinese adults but with cautions for the drug therapy among millions of subjects with IDH.
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Affiliation(s)
- Hui Mai
- Department of Neurology, Central People's Hospital of Zhanjiang, Zhanjiang, China
| | - Chao Li
- Department of Epidemiology and Health Statistics, School of Public Health, Xi'an Jiaotong University Health Science Centre, Xi'an, China
- *Correspondence: Chao Li
| | - Kangyu Chen
- Division of Life Sciences and Medicine, Department of Cardiology, The First Affiliated Hospital of USTC, University of Science and Technology of China, Hefei, China
| | - Zhenqiang Wu
- Department of Geriatric Medicine, The University of Auckland, Auckland, New Zealand
| | - Xuanyi Liang
- Department of Epidemiology and Health Statistics, School of Public Health, Xi'an Jiaotong University Health Science Centre, Xi'an, China
| | - Yongjuan Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Xi'an Jiaotong University Health Science Centre, Xi'an, China
| | - Tao Chen
- Department of Public Health, Policy and Systems, Institute of Population Health, Whelan Building, Quadrangle, The University of Liverpool, Liverpool, United Kingdom
- Tao Chen
| | - Fengjian Chen
- Department of Neurology, Central People's Hospital of Zhanjiang, Zhanjiang, China
- Fengjian Chen
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111
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Zhu H, Zheng H, Liang X, Huang C, Sun L, Liu X, Qiu M, Mai W, Huang Y. Prevalence and Related Factors of White Coat Hypertension and Masked Hypertension in Shunde District, Southern China. Front Physiol 2022; 13:936750. [PMID: 35846000 PMCID: PMC9283833 DOI: 10.3389/fphys.2022.936750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 06/06/2022] [Indexed: 11/15/2022] Open
Abstract
Background: White coat hypertension (WCH) and masked hypertension (MH) can increase the risk of target organ damage. Home blood pressure monitoring is an important method for detecting WCH and MH. However, the prevalence and related factors of WCH and MH in China have been rarely reported. Objective: To explore the prevalence and related factors associated with white coat hypertension (WCH) and masked hypertension (MH) in Shunde District, Southern China. Methods: This study recruited subjects from the Physical Examination Center in Shunde Hospital, Southern Medical University. Office blood pressure and home blood pressure values were collected using the home blood pressure monitor with telemedicine device and office blood pressure monitor, and the prevalence of WCH and MH was calculated by the values. Multivariate logistic regression was used to explore the related factors for WCH and MH. Results: Four-hundred and sixty-one participants (61% male), with an average age of 49 years, were included. The prevalence of WCH and MH was 5.1 and 15.2%, respectively. Multivariate logistic regression analysis showed that smoking (OR = 4.71, 95% CI = 1.05–21.15) and family history of coronary heart disease (OR = 4.51, 95% CI = 1.08–18.93) were associated with higher odds of WCH. The associated factors for higher odds of MH were smoking (OR = 2.83, 95% CI = 1.11–7.23), family history of hypertension (OR = 2.17, 95% CI = 1.11–4.26) and family history of coronary heart disease (OR = 2.82, 95% CI = 1.07–7.45). Conclusion: WCH and MH are highly prevalent in the Physical Examination Center in Shunde Hospital, Southern Medical University. We found smoking and family history of coronary heart disease were related factors for WCH, and smoking, family history of hypertension and coronary heart disease were associated with the odds of MH. Home blood pressure monitoring with a telemedicine device should be recommended to identity abnormal BP phenotype.
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Affiliation(s)
- Hailan Zhu
- Department of Cardiology, Shunde Hospital, Southern Medical University, Foshan, China
| | - Haoxiao Zheng
- Department of Cardiology, Shunde Hospital, Southern Medical University, Foshan, China
| | - Xiaoyan Liang
- Department of Health Check-up Centre, Shunde Hospital, Southern Medical University, Foshan, China
| | - Chunyi Huang
- Department of Health Check-up Centre, Shunde Hospital, Southern Medical University, Foshan, China
| | - Lichang Sun
- Department of Cardiology, Shunde Hospital, Southern Medical University, Foshan, China
| | - Xiong Liu
- Department of Cardiology, Shunde Hospital, Southern Medical University, Foshan, China
| | - Min Qiu
- Department of Cardiology, Shunde Hospital, Southern Medical University, Foshan, China
| | - Weiyi Mai
- Department of Cardiology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Yuli Huang
- Department of Cardiology, Shunde Hospital, Southern Medical University, Foshan, China
- The George Institute for Global Health, newtown, NSW, Australia
- *Correspondence: Yuli Huang,
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112
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Zhu B, Li Y, Shi Y, Song N, Fang Y, Ding X. Long-term drinking behavior change patterns and its association with hyperuricemia in chinese adults: evidence from China Health and Nutrition Survey. BMC Public Health 2022; 22:1230. [PMID: 35725435 PMCID: PMC9210654 DOI: 10.1186/s12889-022-13637-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Accepted: 06/08/2022] [Indexed: 11/27/2022] Open
Abstract
Background We aimed to explore the association between long-term drinking behavior change patterns with hyperuricemia (HUA) in Chinese community adults. Methods This study was designed as a community-based unbalanced cohort study involving 4127 adults aged between 18 ~ 75 years, derived from the China Health and Nutrition Survey (CHNS) in 1997 and 2009. Drinking behavior change patterns were categorized into: never drinking, change to drinking, quitting drinking, and continued drinking. The alcoholism, type, and frequency of drinking were further categorized. We applied logistic regression models to explore the associations between drinking behavior change patterns and HUA. Results The average age of the participants was 54.6 (± 11.3) years and 47.8% were male. The overall prevalence of HUA was 15.5%. Drinking behavior change patterns of quitting (aOR 1.8; 95% CI 1.1 ~ 2.8) and continued drinking (aOR 2.0; 95% CI 1.3 ~ 3.0) were positively associated with high risks of HUA in the male participants. Early drinking behaviors such as liquor intake (aOR 1.8; 95% CI 1.4 ~ 2.5) and high consumption or frequency showed a positive correlation with HUA. Of note, heavy alcoholism (aOR 2.0; 95% CI 1.4 ~ 2.8) and daily drinking (aOR 2.5; 95% CI 1.7 ~ 3.6) had the highest risks of HUA. Furthermore, in the male participants, the association between early total alcohol intake and HUA was more pronounced at 18 standard drinks intake, with a stable increasing trend. In contrast, no statistical correlation was observed between the drinking behaviors and HUA in the female participants. Conclusions Drinking behavior change patterns of quitting and continued drinking are strongly associated with increased risks of HUA in males. The risks emanated from early drinking behaviors such as liquor drinking, high drinking frequency, and alcohol consumption. Although quitting drinking was associated with lower HUA risks compared to continued drinking, it still presented an undeniable risk for HUA. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13637-4.
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Affiliation(s)
- Bowen Zhu
- Department of Nephrology, Zhongshan Hospital, Fudan University, No.180 Fenglin Road, 200032, Shanghai, Shanghai, China.,Shanghai Medical Center of Kidney, Shanghai, China.,Shanghai Key Laboratory of Kidney and Blood Purification, Shanghai, China
| | - Yang Li
- Department of Nephrology, Zhongshan Hospital, Fudan University, No.180 Fenglin Road, 200032, Shanghai, Shanghai, China.,Shanghai Medical Center of Kidney, Shanghai, China.,Shanghai Key Laboratory of Kidney and Blood Purification, Shanghai, China
| | - Yiqin Shi
- Department of Nephrology, Zhongshan Hospital, Fudan University, No.180 Fenglin Road, 200032, Shanghai, Shanghai, China.,Shanghai Medical Center of Kidney, Shanghai, China.,Shanghai Key Laboratory of Kidney and Blood Purification, Shanghai, China
| | - Nana Song
- Department of Nephrology, Zhongshan Hospital, Fudan University, No.180 Fenglin Road, 200032, Shanghai, Shanghai, China.,Shanghai Medical Center of Kidney, Shanghai, China.,Shanghai Key Laboratory of Kidney and Blood Purification, Shanghai, China
| | - Yi Fang
- Department of Nephrology, Zhongshan Hospital, Fudan University, No.180 Fenglin Road, 200032, Shanghai, Shanghai, China.,Shanghai Medical Center of Kidney, Shanghai, China.,Shanghai Key Laboratory of Kidney and Blood Purification, Shanghai, China
| | - Xiaoqiang Ding
- Department of Nephrology, Zhongshan Hospital, Fudan University, No.180 Fenglin Road, 200032, Shanghai, Shanghai, China. .,Shanghai Medical Center of Kidney, Shanghai, China. .,Shanghai Key Laboratory of Kidney and Blood Purification, Shanghai, China.
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113
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Ouyang F, He J, Cheng X, Qiu D, Li L, Bangura JB, Duan Y, Luo D, Xiao S. The Association Between Life Events and Incidence of Hypertension Among Government Employees in China: A Prospective Cohort Study. Front Psychol 2022; 13:822610. [PMID: 35707654 PMCID: PMC9190203 DOI: 10.3389/fpsyg.2022.822610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Accepted: 04/25/2022] [Indexed: 11/13/2022] Open
Abstract
Background Hypertension (HTN) is a global public health concern. However, the association between life events (LEs) and HTN is complex. Thus, we conducted a prospective cohort study to explore this complex association. Methods A total of 8,077 government employees without HTN were recruited through cluster sampling between 2018 and 2019 in Hunan Province, China. At baseline, information regarding sociodemographic characteristics, LEs, and behavioral factors was collected. After the 1-year follow-up, the participants were revisited to obtain the HTN diagnosis. Crude and adjusted Poisson regression models were constructed to calculate the incidence rate ratios (IRRs) and 95% confidence intervals (CIs). Cubic regression spline models were used to visualize the trends between LEs and HTN IRRs. Interactive and subgroup analyses were also performed. Results The 1-year HTN incidence rate among government employees in Hunan province was 4.30% (95% CI: 3.86-4.74%). LEs were associated with a higher HTN risk (IRR, 1.02; 95% CI, 1.00-1.04). When calculating positive and negative LEs scores separately, only the latter was a risk factor for HTN incidence (IRR, 1.04; 95% CI, 1.03-1.06); conversely, positive LEs reduced the risk (IRR, 0.90; 95% CI, 0.85-0.96). Compared with patients in the lowest quartile of LEs score, those in quartiles two (IRR, 1.28; 95% CI, 0.96-1.71), three (IRR, 1.43; 95% CI, 1.04-1.96), and four (IRR, 1.73; 95% CI, 1.26-2.37) were at progressively higher risk. In restricted spline curves, a non-linear association was noted between LEs and HTN risk. Regarding the subcategories of LEs, work-related LEs, personal LEs, and all subcategories of negative LEs were associated with an increased risk of HTN. However, among positive LEs, only the family-related cases were associated with a lower risk of HTN. Conclusion LEs had a non-linear association with an increased risk of HTN. Negative LEs were risk factors for HTN incidence, whereas positive LEs reduced the risk of HTN. Thus, the importance of LEs should be highlighted in the development of HTN prevention strategies and initiatives.
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Affiliation(s)
- Feiyun Ouyang
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China.,Hunan Provincial Key Laboratory of Clinical Epidemiology, Changsha, China
| | - Jun He
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China.,Hunan Provincial Key Laboratory of Clinical Epidemiology, Changsha, China
| | - Xunjie Cheng
- Department of Geriatric Medicine, Xiangya Hospital, Central South University, Changsha, China
| | - Dan Qiu
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China.,Hunan Provincial Key Laboratory of Clinical Epidemiology, Changsha, China
| | - Ling Li
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China.,Hunan Provincial Key Laboratory of Clinical Epidemiology, Changsha, China
| | - Joseph Benjamin Bangura
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China.,Hunan Provincial Key Laboratory of Clinical Epidemiology, Changsha, China
| | - Yanyin Duan
- Hunan Provincial Key Laboratory of Clinical Epidemiology, Changsha, China.,Department of Occupational and Environmental Health, Xiangya School of Public Health, Central South University, Changsha, China
| | - Dan Luo
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China.,Hunan Provincial Key Laboratory of Clinical Epidemiology, Changsha, China
| | - Shuiyuan Xiao
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China.,Hunan Provincial Key Laboratory of Clinical Epidemiology, Changsha, China
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Ba H, Peng H, Xu L, Qin Y, Wang H. Clinical Characteristics of Hospitalized Pediatric Patients With Hypertensive Crisis—A Retrospective, Single-Center Study in China. Front Cardiovasc Med 2022; 9:891804. [PMID: 35711370 PMCID: PMC9193964 DOI: 10.3389/fcvm.2022.891804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 05/10/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundA hypertensive crisis is a medical emergency that causes acute damage to multiple organs. However, the etiology, clinical features, and prognosis of hypertensive crisis in Chinese children remain relatively unknown. The purpose of this study was to analyze the clinical characteristics of pediatric hypertensive crisis patients from a single center in China.MethodsWe analyzed data from 70 children with hypertensive crisis between January, 2000, and January, 2022. The patients were divided into two groups: those diagnosed with a hypertensive emergency (n = 46) and those diagnosed with hypertensive urgency (n = 24). Baseline etiologies and risk factors were compared between the two groups. The following data were collected and analyzed: age, sex, weight, height, family history of hypertension, blood pressure, clinical manifestations of hypertensive crisis, underlying causes, biochemical indicators, and antihypertensive drugs.ResultsThe major symptoms of hypertensive crisis were headache (n = 31, 44.29%), followed by visual symptoms (n = 15, 21.43%), and dizziness (n = 13, 18.57%). Further analysis showed that the incidence of convulsions was significantly higher in patients with hypertensive emergency than those with hypertensive urgency (χ2 = 5.38, p = 0.02). The leading underlying causes were renal disease (n = 34, 48.57%), followed by vascular disease (n = 11, 15.71%), essential hypertension (n = 9, 12.86%), oncological disease (n = 9, 12.86%), central nervous system disease (n = 3, 4.29%), endocrine and metabolic diseases (n = 2, 2.86%), and other (one case with lead poisoning, one case with histiocytosis). End-organ damage occurred in 46 patients with hypertensive crisis, including retinal damage (n = 20, 43.48%), brain damage (n = 19, 41.30%), heart damage (n = 15, 32.61%), and renal damage (n = 3, 6.52%). Hypertensive crisis was most common among children aged 7–12 years. Among children aged 13–18 years, hypertensive urgency was more common than hypertensive emergency. The incidence of dyslipidemia, elevated serum creatinine, and elevated uric acid did not differ significantly between the two groups. Most patients with hypertensive crisis need combined antihypertensive therapy (n = 60, 85.71%). There were no cases of mortality.ConclusionsHypertensive crisis is caused by secondary diseases, especially renal disease and vascular disease, in the majority of pediatric patients. Combination therapy with antihypertensive agents and treatment of secondary etiology results in a good prognosis.
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Affiliation(s)
- Hongjun Ba
- Department of Paediatric Cardiology, Heart Centre, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- Key Laboratory on Assisted Circulation, Ministry of Health, Guangzhou, China
| | - Huimin Peng
- Department of Paediatric Cardiology, Heart Centre, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- Key Laboratory on Assisted Circulation, Ministry of Health, Guangzhou, China
| | - Lingling Xu
- Department of Pediatrics, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Youzhen Qin
- Department of Paediatric Cardiology, Heart Centre, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- *Correspondence: Youzhen Qin
| | - Huisheng Wang
- Department of Paediatric Cardiology, Heart Centre, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- Huisheng Wang
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115
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Chen D, Tang J, Gong T, Mu L, Li J, Yu P, Wang H, Bu X, Mu L, Mei Y. Short-term effects of modest salt reduction combined with DASH diet on changing salt eating habits in hypertensive patients with type II diabetes. Clin Exp Hypertens 2022; 44:514-522. [PMID: 35611762 DOI: 10.1080/10641963.2022.2079666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVE Excessive salt intake is currently the foremost universal risk factor for controllable chronic disease. This study evaluated the short-term effects of a modest salt intake reduction combined with the Chinese Modified Dietary Approaches to Stop Hypertension (CM-DASH) diet on sodium and potassium intake, mean arterial pressure (MAP), and pulse pressure (PP) in hypertensive patients with type II diabetes. METHODS Sixty-one participants were randomized to the intervention group (52% low-sodium salt and DASH) and control group (normal salt and DASH). An 8-week dietary intervention was applied. Daily salt intake, blood pressure (BP), and drug use were recorded every week. Twenty-four-hour urine, casual urine, and blood samples were measured at baseline, the 4th week, and the end of the intervention. RESULTS Fifty-nine patients (25 men) completed the entire study. Sodium intake decreased by 1259.66 (792.76, 1726.56)/705.80 (149.21, 1262.39) mg/day after 4 weeks (intervention: P < .001; control: P = .015). Potassium intake increased by 641.14 (73.31, 1208.96)/43.43 (-259.66, 346.53) mg/day (intervention: P = .028); MAP decreased by 9.06 (6.69, 11.43)/7.16 (4.03, 10.28) mmHg (both: P < .001); PP decreased by 7.97 (3.05, 12.88)/5.74 (2.55,8.94) mmHg (intervention: P = .002; control: P = .001) after 8 weeks. However, the difference between the two groups was not statistically significant. CONCLUSION Modest salt reduction and the CM-DASH diet for hypertensive patients with type II diabetes can achieve short-term salt reduction effects. The effect on changing salt-eating habits needs to be investigated with an extended follow-up.
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Affiliation(s)
- Dan Chen
- Department of Epidemiology, School of Public Health and Management, Research Center for Medicine and Social Development, Innovation Center for Social Risk Governance in Health, Chongqing Medical University, Chongqing, SC, China
| | - Jie Tang
- Department of Epidemiology, School of Public Health and Management, Research Center for Medicine and Social Development, Innovation Center for Social Risk Governance in Health, Chongqing Medical University, Chongqing, SC, China
| | - Tao Gong
- Department of Nutrition and Food Hygiene, School of Public Health and Management, Chongqing Medical University, Chongqing, SC, China
| | - Lisha Mu
- Department of Epidemiology, School of Public Health and Management, Research Center for Medicine and Social Development, Innovation Center for Social Risk Governance in Health, Chongqing Medical University, Chongqing, SC, China
| | - Jing Li
- Department of Humanity and Art, School of Public Health and Management, Chongqing Medical University, Chongqing, SC, China
| | - Pingping Yu
- Health Management Center of the Second Affiliated Hospital, Chongqing Medical University, Chongqing, SC, China
| | - Hao Wang
- Department: Administrative Office, Chongqing Nan'an District People's Hospital, Chongqing, SC, China
| | - Xiaoqing Bu
- Department of Epidemiology, School of Public Health and Management, Research Center for Medicine and Social Development, Innovation Center for Social Risk Governance in Health, Chongqing Medical University, Chongqing, SC, China
| | - Lihong Mu
- Department of Epidemiology, School of Public Health and Management, Research Center for Medicine and Social Development, Innovation Center for Social Risk Governance in Health, Chongqing Medical University, Chongqing, SC, China
| | - Ying Mei
- Health Management Center of the Second Affiliated Hospital, Chongqing Medical University, Chongqing, SC, China
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Bao J, Liu J, Li Z, Zhang Z, Su X, Sun J, Tu J, Wang J, Li J, Song Y, Ning X. Relationship Between Hypertension and Cognitive Function in an Elderly Population: A Population-Based Study in Rural Northern China. Front Neurol 2022; 13:885598. [PMID: 35651343 PMCID: PMC9150797 DOI: 10.3389/fneur.2022.885598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 04/21/2022] [Indexed: 11/13/2022] Open
Abstract
The burden of cognitive impairment and dementia is particularly severe in low- and middle-income countries. Although hypertension is an important risk factor for cognitive impairment, the influence of different hypertension classification on cognitive impairment remains controversial. To explore the impact of hypertension and hypertension classification on cognitive function, this study was based on a low-income population aged over 60 years in northern China. This population-based, cross-sectional study was conducted from April 2014 to January 2015 in rural areas of Tianjin, China. A total of 1,171 participants aged ≥ 60 years were included. Participants were interviewed by professional researchers face-to-face, using the pre-designed questionnaire. Cognitive function was assessed using the Mini-mental State Examination (MMSE). Multivariate regression analysis was used to calculate the odds ratio (OR) value. There was a significant association between hypertension and cognitive impairment (OR, 1.415; 95% CI: 1.005–1.992; P = 0.047) and a significant positive association between stage 3 hypertension (OR, 1.734; 95% CI: 1.131–2.656; P = 0.012) and the prevalence of cognitive impairment. To prevent dementia, clinicians should consider the cognitive function and blood pressure control of low-income individuals aged over 60 years with hypertension in northern China, especially those with stage 3 hypertension. In addition, the inconsistent effects of blood pressure on different cognitive functions should also be considered; special attention should be paid to orientation and concentration.
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Affiliation(s)
- Jie Bao
- Department of Rehabilitation Medicine, Tianjin Medical University General Hospital, Tianjin, China
| | - Jie Liu
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China
- Laboratory of Epidemiology, Tianjin Neurological Institute, Tianjin, China
- Key Laboratory of Post-Neuroinjury Neuro-Repair and Regeneration in Central Nervous System, Tianjin Neurological Institute, Ministry of Education and Tianjin City, Tianjin, China
- Center of Clinical Epidemiology and Evidence-Based Medicine, Tianjin Jizhou People's Hospital, Tianjin, China
| | - Zhiying Li
- Department of Acupuncture, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine & National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
| | - Zhen Zhang
- Department of Cardiology, Tianjin Medical University General Hospital, Tianjin, China
| | - Xiao Su
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China
| | - Jiayi Sun
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China
| | - Jun Tu
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China
- Laboratory of Epidemiology, Tianjin Neurological Institute, Tianjin, China
- Key Laboratory of Post-Neuroinjury Neuro-Repair and Regeneration in Central Nervous System, Tianjin Neurological Institute, Ministry of Education and Tianjin City, Tianjin, China
- Center of Clinical Epidemiology and Evidence-Based Medicine, Tianjin Jizhou People's Hospital, Tianjin, China
| | - Jinghua Wang
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China
- Laboratory of Epidemiology, Tianjin Neurological Institute, Tianjin, China
- Key Laboratory of Post-Neuroinjury Neuro-Repair and Regeneration in Central Nervous System, Tianjin Neurological Institute, Ministry of Education and Tianjin City, Tianjin, China
- Center of Clinical Epidemiology and Evidence-Based Medicine, Tianjin Jizhou People's Hospital, Tianjin, China
| | - Jidong Li
- Center of Clinical Epidemiology and Evidence-Based Medicine, Tianjin Jizhou People's Hospital, Tianjin, China
- Department of Neurosurgery, Tianjin Jizhou People's Hospital, Tianjin, China
- Jidong Li
| | - Yijun Song
- Department of General Medicine, Tianjin Medical University General Hospital, Tianjin, China
- Yijun Song
| | - Xianjia Ning
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China
- Laboratory of Epidemiology, Tianjin Neurological Institute, Tianjin, China
- Key Laboratory of Post-Neuroinjury Neuro-Repair and Regeneration in Central Nervous System, Tianjin Neurological Institute, Ministry of Education and Tianjin City, Tianjin, China
- Center of Clinical Epidemiology and Evidence-Based Medicine, Tianjin Jizhou People's Hospital, Tianjin, China
- *Correspondence: Xianjia Ning
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Li W, Wang Y, Chen S, Zhao J, Su Q, Fan Y, Wu S, Li J, Hong J. Evaluation of Carotid Artery Atherosclerosis and Arterial Stiffness in Cardiovascular Disease Risk: An Ongoing Prospective Study From the Kailuan Cohort. Front Cardiovasc Med 2022; 9:812652. [PMID: 35586658 PMCID: PMC9108697 DOI: 10.3389/fcvm.2022.812652] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 03/21/2022] [Indexed: 11/17/2022] Open
Abstract
Objective To assess whether carotid artery ultrasonography and brachial-ankle pulse wave velocity (baPWV) measurement can accurately predict cardiovascular and cerebrovascular events, and all-cause mortality in patients with cardiovascular diseases (CVD). Methods Patients from the Kailuan Study Stroke Cohort (Tangshan, China) who underwent carotid artery ultrasonography and baPWV measurement between June 2010 and June 2011 were included in this study. The effects of carotid plaque, baPWV, and their combination on cardiovascular events, including myocardial infarction (MI), cerebral ischemic stroke, cerebrovascular events, and all-cause mortality, were evaluated using Kaplan-Meier analysis and Cox proportional hazards regression. Results A total of 4,899 participants (59.7% males; 54.18 ± 11.52 years old) were analyzed. During a mean follow-up of 5.68 ± 0.66 years, the incidence of cardiovascular events and all-cause mortality were 4.94‰ person-years and 7.02‰ person-years, respectively; 32.8% of participants had both carotid artery atherosclerosis and increased arterial stiffness. A high baPWV alone was associated with an increased risk of CVD events [hazard ratio (HR): 2.68; 95% confidence interval (95% CI): 1.20–6.00; P = 0.007] and cerebral infarction (HR: 5.92; 95% CI: 1.76–19.93; P = 0.004), but not with MI or all-cause death. The presence of both carotid plaque and high baPWV was highly associated with an increased risk of CVD events (HR: 4.65; 95% CI: 2.06–10.45; P < 0.001) and cerebral infarction (HR: 9.21; 95% CI: 2.71–31.19; P < 0.001), but not with MI or all-cause death. Similar results were obtained by the Kaplan-Meier analyses. Conclusion The presence of carotid plaque and high baPWV were associated with a high risk of CVD events and ischemic stroke. Moreover, the combination of carotid artery ultrasonography and baPWV measurement could predict the risk for CVD ability more accurately than a single measurement alone.
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Affiliation(s)
- Wen Li
- Department of Ultrasound, Shanghai Jiao Tong University Affiliated 6th People's Hospital, Shanghai Institute of Ultrasound in Medicine, Shanghai, China
| | - Yan Wang
- Department of Ultrasound, Shanghai Jiao Tong University Affiliated 6th People's Hospital, Shanghai Institute of Ultrasound in Medicine, Shanghai, China
| | - Shuohua Chen
- Department of Cardiology, Kailuan General Hospital Affiliated to North China University of Science and Technology, Tangshan, China
| | - Jianqiu Zhao
- Department of Anesthesiology, Anting Hospital, Shanghai, China
| | - Qi Su
- Department of Internal and Emergency Medicine, Shanghai General Hospital, Shanghai, China
| | - Yanfeng Fan
- Department of Ultrasound, Shanghai Jiao Tong University Affiliated 6th People's Hospital, Shanghai Institute of Ultrasound in Medicine, Shanghai, China
| | - Shouling Wu
- Department of Cardiology, Kailuan General Hospital Affiliated to North China University of Science and Technology, Tangshan, China
- *Correspondence: Shouling Wu
| | - Jun Li
- Department of Cardiology, Shanghai General Hospital, Shanghai, China
- Jun Li
| | - Jiang Hong
- Department of Internal and Emergency Medicine, Shanghai General Hospital, Shanghai, China
- Jiang Hong
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Qin Y, Liu R, Wang Y, Tang J, Cong L, Ren J, Tang S, Du Y. Self-Reported Sleep Characteristics Associated with Cardiovascular Disease Among Older Adults Living in Rural Eastern China: A Population-Based Study. Clin Interv Aging 2022; 17:811-824. [PMID: 35611325 PMCID: PMC9124474 DOI: 10.2147/cia.s361876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 05/06/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose To investigate the cross-sectional associations of self-reported sleep characteristics with cardiovascular diseases (CVDs) and cardiovascular multimorbidity in older adults living in rural Eastern China. Patients and Methods This population-based study included 4618 participants (age ≥65 years; 56.5% women) living in rural Eastern China. In March–September 2018, data were collected through interviews, clinical examinations, neuropsychological testing, and laboratory tests. Sleep parameters were assessed using the Pittsburgh Sleep Quality Index, Epworth Sleepiness Score, and Berlin questionnaire. Coronary heart disease (CHD), heart failure (HF), and stroke were defined according to in-person interviews, clinical and neurological examinations, and electrocardiogram examination. Data were analyzed using logistic regression and restricted cubic spline regression. Results CHD was diagnosed in 991 participants, HF in 135 participants, and stroke in 696 participants. The multivariable-adjusted odds ratio (OR) of CHD was 1.27 (95% CI, 1.09–1.49) for sleep duration ≤6 hours/night (vs >6–8 hours/night), 1.40 (1.20–1.62) for poor sleep quality, and 1.22 (1.04–1.43) for high risk for obstructive sleep apnea (OSA). The OR of HF was 2.16 (1.38–3.39) for sleep duration >8 hours/night, and 1.76 (1.22–2.54) for high risk for OSA. In addition, the OR of stroke was 1.23 (1.04–1.46) for poor sleep quality, 1.32 (1.01–1.72) for excessive daytime sleepiness, and 1.42 (1.19–1.70) for high risk for OSA. The associations of poor sleep with cardiovascular multimorbidity (≥2 CVDs) were stronger than that of sleep problems with a single CVD. Conclusion Extreme sleep duration, high risk for OSA, and other sleep problems were associated with CVDs, especially cardiovascular multimorbidity.
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Affiliation(s)
- Yu Qin
- Department of Neurology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, People’s Republic of China
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, People’s Republic of China
| | - Rui Liu
- Department of Neurology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, People’s Republic of China
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, People’s Republic of China
| | - Yongxiang Wang
- Department of Neurology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, People’s Republic of China
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, People’s Republic of China
- Shandong Provincial Clinical Research Center for Neurological Diseases, Jinan, Shandong, People’s Republic of China
| | - Jiyou Tang
- Department of Neurology, The First Affiliated Hospital of Shandong First Medical University, Jinan, Shandong, People’s Republic of China
| | - Lin Cong
- Department of Neurology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, People’s Republic of China
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, People’s Republic of China
- Shandong Provincial Clinical Research Center for Neurological Diseases, Jinan, Shandong, People’s Republic of China
| | - Juan Ren
- Department of Neurology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, People’s Republic of China
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, People’s Republic of China
| | - Shi Tang
- Department of Neurology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, People’s Republic of China
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, People’s Republic of China
- Shandong Provincial Clinical Research Center for Neurological Diseases, Jinan, Shandong, People’s Republic of China
| | - Yifeng Du
- Department of Neurology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, People’s Republic of China
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, People’s Republic of China
- Shandong Provincial Clinical Research Center for Neurological Diseases, Jinan, Shandong, People’s Republic of China
- Correspondence: Yifeng Du; Shi Tang, Department of Neurology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, No. 324 Jingwuweiqi Road, Jinan, Shandong, 250021, People’s Republic of China, Tel +86 531 68776354; +86-18678780912, Fax +86 531 68776354, Email ;
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Sang Z, Zeng X, Yuan X, Wang X, Fu L, Zhuang W. Association of Office and Ambulatory Blood Pressure with Left Ventricular Structure and Function in Hypertensive Patients. Int J Gen Med 2022; 15:4649-4656. [PMID: 35548589 PMCID: PMC9081003 DOI: 10.2147/ijgm.s357508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 04/01/2022] [Indexed: 11/23/2022] Open
Abstract
Objective Methods Results Conclusion
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Affiliation(s)
- Zhuo Sang
- Department of General Practice, Huizhou Municipal Central Hospital, Huizhou, Guangdong, People’s Republic of China
- Correspondence: Zhuo Sang, Department of General Practice, Huizhou Municipal Central Hospital, Huizhou, Guangdong, People’s Republic of China, Tel +86-752-2288288, Email
| | - Xianli Zeng
- Department of General Practice, Huizhou Municipal Central Hospital, Huizhou, Guangdong, People’s Republic of China
| | - Xiaohui Yuan
- Department of General Practice, Huizhou Municipal Central Hospital, Huizhou, Guangdong, People’s Republic of China
| | - Xiaolin Wang
- Department of General Practice, Huizhou Municipal Central Hospital, Huizhou, Guangdong, People’s Republic of China
| | - Liancong Fu
- Department of General Practice, Huizhou Municipal Central Hospital, Huizhou, Guangdong, People’s Republic of China
| | - Wenwen Zhuang
- Department of General Practice, Huizhou Municipal Central Hospital, Huizhou, Guangdong, People’s Republic of China
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Kraut R, Lundby C, Babenko O, Kamal A, Sadowski CA. Antihypertensive medication in frail older adults: A narrative review through a deprescribing lens. AMERICAN HEART JOURNAL PLUS : CARDIOLOGY RESEARCH AND PRACTICE 2022; 17:100166. [PMID: 38559885 PMCID: PMC10978346 DOI: 10.1016/j.ahjo.2022.100166] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 05/25/2022] [Accepted: 05/30/2022] [Indexed: 04/04/2024]
Abstract
Purpose of review The management of hypertension in frail older adults remains controversial, as these patients are underrepresented in clinical trials and practice guidelines. Overtreatment may cause harm while undertreatment may lead to greater risk of cardiovascular events. Our research aims to examine this controversy and provide guidance regarding deprescribing decisions in frail older adults. Results Current evidence suggests that there may be minimal cardiovascular benefit and significant harm of antihypertensive medication in the frail older adult population. A minority of hypertension guidelines provide sufficient recommendations for frail older adults, and there are limited tools available to guide clinical decision-making. Conclusion Randomized controlled trials and well-designed observational studies are needed to confirm the benefit-to-harm relationship of antihypertensive medication in frail older adults. Decision tools that comprehensively address antihypertensive deprescribing would be advantageous to help clinicians with hypertension management in this population. Clinicians should engage in shared decision-making with the patient and family to ensure that decisions regarding antihypertensive deprescribing best meet the needs of all involved.
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Affiliation(s)
- Roni Kraut
- Department of Family Medicine, University of Alberta, Edmonton, Canada
| | - Carina Lundby
- Hospital Pharmacy Funen, Odense University Hospital, Odense C, Denmark
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense C, Denmark
- Clinical Pharmacology, Pharmacy and Environmental Medicine, Department of Public Health, University of Southern Denmark, Odense C, Denmark
| | - Oksana Babenko
- Department of Family Medicine, University of Alberta, Edmonton, Canada
| | - Ahmad Kamal
- Faculty of Science, University of Alberta, Edmonton, Canada
| | - Cheryl A. Sadowski
- Faculty of Pharmacy & Pharmaceutical Sciences, University of Alberta, Edmonton, Canada
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Mei YX, Zhang ZX, Wu H, Hou J, Liu XT, Sang SX, Mao ZX, Zhang WH, Yang DB, Wang CJ. Health-Related Quality of Life and Its Related Factors in Survivors of Stroke in Rural China: A Large-Scale Cross-Sectional Study. Front Public Health 2022; 10:810185. [PMID: 35450122 PMCID: PMC9016152 DOI: 10.3389/fpubh.2022.810185] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Accepted: 02/18/2022] [Indexed: 12/12/2022] Open
Abstract
Background Stroke is a major health threat and the leading cause of mortality and disability in China. The aims of this study were to identify the possible influencing factors of health-related quality of life (HRQoL) and its domain-specific contents in stroke patients in rural areas in China. Methods A total of 1,709 stroke patients aged 36–79 years from the baseline data of Henan Rural Cohort study (n = 39,259) were included in the cross-sectional study. The Chinese version of the European Quality of Life Five Dimension (including mobility, self-care, usual activities, pain/discomfort, and anxiety/depression) Five Level Scale (EQ-5D-5L) and visual analog scale (VAS) were used to evaluate HRQoL in stroke patients. Tobit regression models, generalized linear models and binary logistic regression models were constructed to determine potential influencing factors of the EQ-5D utility index, as well as influencing factors of each domain and VAS score. Results The mean utility index and VAS scores of stroke patients were 0.885 (SD, 0.204), and 68.39 (SD, 17.31), respectively. Pain/discomfort (PD, 35.2%) and mobility (MO, 30.4%) were the most frequently reported issues. Regression models revealed that illiterate; a low monthly income; low physical activity intensity; and diabetes, anxiety, depression, or poor sleep quality were significantly associated with lower utility index and VAS scores among stroke patients. In addition, patients with stroke who were older, female, drinking, smoking, and consuming a high-fat diet, had a higher BMI, and lived with a stroke for a longer time, were also significantly associated with different dimensions of the EQ-5D. Conclusion Patients with stroke in rural areas in China had a low HRQoL. Factors associated with the EQ-5D utility index as well as each domain and VAS score, need to be considered by health providers in rural areas. Patients with stroke in rural areas need to be included in national basic public medical services and managed systematically by medical institutions.
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Affiliation(s)
- Yong-Xia Mei
- School of Nursing and Health, Zhengzhou University, Zhengzhou, China.,Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, China.,The People's Hospital of Hebi, Hebi, China
| | - Zhen-Xiang Zhang
- School of Nursing and Health, Zhengzhou University, Zhengzhou, China
| | - Hui Wu
- School of Public Health, Xinxiang Medical University, Xinxiang, China.,School of Public Health, Tianjin Medical University, Tianjin, China.,Henan Province General Medical Educations and Research Center, Xinxiang, China
| | - Jian Hou
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Xiao-Tian Liu
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Sheng-Xiang Sang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Zhen-Xing Mao
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Wei-Hong Zhang
- School of Nursing and Health, Zhengzhou University, Zhengzhou, China
| | | | - Chong-Jian Wang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, China
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Han Y, Du J, Wang J, Liu B, Yan YL, Deng SB, Zou Y, Jing XD, Du JL, Liu YJ, She Q. Cold Pressor Test in Primary Hypertension: A Cross-Sectional Study. Front Cardiovasc Med 2022; 9:860322. [PMID: 35548443 PMCID: PMC9081644 DOI: 10.3389/fcvm.2022.860322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Accepted: 03/22/2022] [Indexed: 11/13/2022] Open
Abstract
Objectives To investigate the characteristics of patients with primary hypertension who had positive responses to the cold pressor test (CPT). Methods This cross-sectional study was conducted between November 2018 to November 2019, and the CPT was performed in patients with primary hypertension in 48 hospitals. The demographic characteristics and complications were collected through a questionnaire and physical examinations. A 12-month follow-up was conducted to identify the occurrence of the following events: a) all-cause mortality; b) myocardial infarction; c) stroke; d) hospitalized for heart failure. Results The CPT was positive in 30.7% of the patients. Compared with the negative CPT group, the positive CPT group was associated with a lower rate of blood pressure control, and was more likely to have a high salt diet, diabetes, hyperuricemia, left ventricular wall thickening, carotid plaques, coronary heart disease and heart failure. A high-salt diet (OR = 1.228, 95%CI: 1.037–1.456) was found to be correlated with the positive result of CPT. Among patients in the positive CPT group, those using diuretics had a significantly higher rate of blood pressure control than those not using diuretics (54.6 vs.42.6%, x2 = 6.756, P = 0.009). After a 12-month follow-up, the incidence of heart failure in the positive CPT group was significantly higher than that in the negative CPT group (7.35 vs.5.01%, x2 = 3.945, P = 0.047). Conclusions Patients with positive responses to the CPT had lower rates of BP control and a high risk of heart failure, which may be related to their preference for a high-salt diet. The use of diuretics helps to better control blood pressure in those patients.
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Wang MH, Heizhati M, Li NF, Yao XG, Luo Q, Lin MY, Hong J, Ma Y, Wang R, Sun L, Ren YL, Yue N. Development and Validation of a Prognostic Model to Predict High-Risk Patients for Coronary Heart Disease in Snorers With Uncontrolled Hypertension. Front Cardiovasc Med 2022; 9:777946. [PMID: 35528833 PMCID: PMC9069207 DOI: 10.3389/fcvm.2022.777946] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 02/08/2022] [Indexed: 12/23/2022] Open
Abstract
PurposeSnoring or obstructive sleep apnea, with or without uncontrolled hypertension, is common and significantly increases the risk of coronary heart disease (CHD). The aim of this study was to develop and validate a prognostic model to predict and identify high-risk patients for CHD among snorers with uncontrolled hypertension.MethodsRecords from 1,822 snorers with uncontrolled hypertension were randomly divided into a training set (n = 1,275, 70%) and validation set (n = 547, 30%). Predictors for CHD were extracted to construct a nomogram model based on multivariate Cox regression analysis. We performed a single-split verification and 1,000 bootstraps resampling internal validation to assess the discrimination and consistency of the prediction model using area under the receiver operating characteristic curve (AUC) and calibration plots. Based on the linear predictors, a risk classifier for CHD could be set.ResultsAge, waist circumference (WC), and high- and low-density lipoprotein cholesterol (HDL-C and LDL-C) were extracted as the predictors to generate this nomogram model. The C-index was 0.720 (95% confidence interval 0.663–0.777) in the derivation cohort and 0.703 (0.630–0.776) in the validation cohort. The AUC was 0.757 (0.626–0.887), 0.739 (0.647–0.831), and 0.732 (0.665–0.799) in the training set and 0.689 (0.542–0.837), 0.701 (0.606–0.796), and 0.712 (0.615–0.808) in the validation set at 3, 5, and 8 years, respectively. The calibration plots showed acceptable consistency between the probability of CHD-free survival and the observed CHD-free survival in the training and validation sets. A total of more than 134 points in the nomogram can be used in the identification of high-risk patients for CHD among snorers with uncontrolled hypertension.ConclusionWe developed a CHD risk prediction model in snorers with uncontrolled hypertension, which includes age, WC, HDL-C, and LDL-C, and can help clinicians with early and quick identification of patients with a high risk for CHD.
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Affiliation(s)
- Meng-hui Wang
- Hypertension Center of People’s Hospital of Xinjiang Uygur Autonomous Region, Ürümqi, China
- Xinjiang Hypertension Institute, Ürümqi, China
- National Health Committee Key Laboratory of Hypertension Clinical Research, Ürümqi, China
| | - Mulalibieke Heizhati
- Hypertension Center of People’s Hospital of Xinjiang Uygur Autonomous Region, Ürümqi, China
- Xinjiang Hypertension Institute, Ürümqi, China
- National Health Committee Key Laboratory of Hypertension Clinical Research, Ürümqi, China
| | - Nan-fang Li
- Hypertension Center of People’s Hospital of Xinjiang Uygur Autonomous Region, Ürümqi, China
- Xinjiang Hypertension Institute, Ürümqi, China
- National Health Committee Key Laboratory of Hypertension Clinical Research, Ürümqi, China
- *Correspondence: Nan-fang Li,
| | - Xiao-guang Yao
- Hypertension Center of People’s Hospital of Xinjiang Uygur Autonomous Region, Ürümqi, China
- Xinjiang Hypertension Institute, Ürümqi, China
- National Health Committee Key Laboratory of Hypertension Clinical Research, Ürümqi, China
| | - Qin Luo
- Hypertension Center of People’s Hospital of Xinjiang Uygur Autonomous Region, Ürümqi, China
- Xinjiang Hypertension Institute, Ürümqi, China
- National Health Committee Key Laboratory of Hypertension Clinical Research, Ürümqi, China
| | - Meng-yue Lin
- Key Laboratory of Xinjiang Uygur Autonomous Region “Hypertension Research Laboratory”, Ürümqi, China
- Xinjiang Clinical Medical Research Center for Hypertension (Cardio-Cerebrovascular) Diseases, Ürümqi, China
| | - Jing Hong
- Hypertension Center of People’s Hospital of Xinjiang Uygur Autonomous Region, Ürümqi, China
- Xinjiang Hypertension Institute, Ürümqi, China
- National Health Committee Key Laboratory of Hypertension Clinical Research, Ürümqi, China
| | - Yue Ma
- Key Laboratory of Xinjiang Uygur Autonomous Region “Hypertension Research Laboratory”, Ürümqi, China
- Xinjiang Clinical Medical Research Center for Hypertension (Cardio-Cerebrovascular) Diseases, Ürümqi, China
| | - Run Wang
- Key Laboratory of Xinjiang Uygur Autonomous Region “Hypertension Research Laboratory”, Ürümqi, China
- Xinjiang Clinical Medical Research Center for Hypertension (Cardio-Cerebrovascular) Diseases, Ürümqi, China
| | - Le Sun
- Hypertension Center of People’s Hospital of Xinjiang Uygur Autonomous Region, Ürümqi, China
- Xinjiang Hypertension Institute, Ürümqi, China
- National Health Committee Key Laboratory of Hypertension Clinical Research, Ürümqi, China
| | - Ying-li Ren
- Hypertension Center of People’s Hospital of Xinjiang Uygur Autonomous Region, Ürümqi, China
- Xinjiang Hypertension Institute, Ürümqi, China
- National Health Committee Key Laboratory of Hypertension Clinical Research, Ürümqi, China
| | - Na Yue
- Hypertension Center of People’s Hospital of Xinjiang Uygur Autonomous Region, Ürümqi, China
- Xinjiang Hypertension Institute, Ürümqi, China
- National Health Committee Key Laboratory of Hypertension Clinical Research, Ürümqi, China
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Qu L, Dong Z, Ma S, Liu Y, Zhou W, Wang Z, Wu C, Ma R, Jiang X, Zu T, Cheng M, Wu Y. Gut Microbiome Signatures Are Predictive of Cognitive Impairment in Hypertension Patients—A Cohort Study. Front Microbiol 2022; 13:841614. [PMID: 35464979 PMCID: PMC9024414 DOI: 10.3389/fmicb.2022.841614] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 02/26/2022] [Indexed: 12/29/2022] Open
Abstract
Growing evidence has demonstrated that hypertension was associated with dysbiosis of intestinal flora. Since intestinal microbes could critically regulate neurofunction via the intestinal–brain axis, the study aimed to reveal the role and prediction value of intestinal flora alteration in hypertension-associated cognitive impairment. A cohort of 97 participants included 63 hypertension patients and 34 healthy controls. The structure of intestinal flora was analyzed by V3–V4 16S rRNA amplicon sequencing. The cognitive function was assessed using the Montreal Cognitive Assessment (MoCA) scale, and 31 patients were considered to have cognitive impairment (MoCA < 26). Patients with cognitive impairment had considerable alterations in intestinal flora structure, composition, and function compared with normal-cognitive patients. In particular, the abundance of LPS-containing taxa (Proteobacteria, Gammaproteobacteria, Enterobacterales, Enterobacteriaceae, and Escherichia–Shigella) and SCFA-producing taxon (Prevotella) significantly changed in cognition-impaired patients. Tax4Fun predication results showed downregulation of glycan biosynthesis and metabolism in hypertension patients with cognitive impairment. Additionally, the pathway was demonstrated to be significantly correlated with LPS-containing taxa (Proteobacteria, Gammaproteobacteria, Enterobacterales, Enterobacteriaceae, and Escherichia–Shigella) and SCFA-producing taxon Prevotella. Furthermore, the taxa-based multiple joint prediction model (9×) was demonstrated to have excellent diagnostic potential for cognitive impairment of hypertension patients (AUC = 0.944). The current study revealed the involvement of intestinal microbiota dysbiosis in cognition-impaired hypertension patients and provided an objective predictive index for this cognition disorder.
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Affiliation(s)
- Lei Qu
- Department of Pathogenic Biology, Binzhou Medical University, Yantai, China
| | - Zhouyan Dong
- Department of Pathogenic Biology, Binzhou Medical University, Yantai, China
| | - Songcui Ma
- Yantai Yuhuangding Hospital, Yantai, China
| | - Yaping Liu
- Institute of Health and Disease Management, Binzhou Medical University, Yantai, China
| | - Wei Zhou
- Institute of Health and Disease Management, Binzhou Medical University, Yantai, China
| | - Zitong Wang
- Institute of Health and Disease Management, Binzhou Medical University, Yantai, China
| | - Chen Wu
- School of Nursing and Rehabilitation, Shandong University, Jinan, China
| | - Rui Ma
- Institute of Health and Disease Management, Binzhou Medical University, Yantai, China
| | - Xinze Jiang
- Institute of Health and Disease Management, Binzhou Medical University, Yantai, China
| | - Tingting Zu
- Clinical Medicine School, Binzhou Medical University, Yantai, China
| | - Mei Cheng
- Institute of Health and Disease Management, Binzhou Medical University, Yantai, China
- *Correspondence: Mei Cheng,
| | - Yulong Wu
- Department of Pathogenic Biology, Binzhou Medical University, Yantai, China
- Yulong Wu,
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Zhou M, Zhao G, Zeng Y, Zhu J, Cheng F, Liang W. Aging and Cardiovascular Disease: Current Status and Challenges. Rev Cardiovasc Med 2022; 23:135. [PMID: 39076212 PMCID: PMC11274005 DOI: 10.31083/j.rcm2304135] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 03/10/2022] [Accepted: 03/10/2022] [Indexed: 07/31/2024] Open
Abstract
Cardiovascular disease (CVD) is the leading cause of death worldwide. Population aging is becoming the most important driver of the CVD epidemic. With the rapid increase in an aging population, the burden of CVD will continuously increase. Most old people also suffer multimorbidity, which is strongly associated with impaired quality of life, disability, dependence, and mortality. However, few reviews evaluated the CVD burden accompanied by population aging and the challenges of CVD care in elderly individuals with multimorbidity. This review identified and summarized the current status of the CVD epidemic associated with aging and highlighted the challenges and needs of CVD care for the elderly.
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Affiliation(s)
- Mengge Zhou
- Vanke School of Public Health, Tsinghua University, 10084 Beijing, China
- School of Medicine, Tsinghua University, 10084 Beijing, China
| | - Guanqi Zhao
- Center for Coronary Artery Disease, Division of Cardiology, Beijing Anzhen Hospital, Capital Medical University, 100029 Beijing, China
| | - Yuhong Zeng
- Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), 400038 Chongqing, China
| | - Jiming Zhu
- Vanke School of Public Health, Tsinghua University, 10084 Beijing, China
| | - Feng Cheng
- Vanke School of Public Health, Tsinghua University, 10084 Beijing, China
- School of Medicine, Tsinghua University, 10084 Beijing, China
| | - Wannian Liang
- Vanke School of Public Health, Tsinghua University, 10084 Beijing, China
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Association of AGTR1 A1166C and CYP2C9∗3 Gene Polymorphisms with the Antihypertensive Effect of Valsartan. Int J Hypertens 2022; 2022:7677252. [PMID: 35345577 PMCID: PMC8957473 DOI: 10.1155/2022/7677252] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 01/27/2022] [Accepted: 02/12/2022] [Indexed: 11/20/2022] Open
Abstract
Background The differences in the antihypertensive treatment with angiotensin type II receptor blockers (ARBs) may be attributed to polymorphisms in genes involving drug-targeted receptor and drug metabolism. The present study aimed to investigate whether the antihypertensive effect of the ARB drug valsartan was associated with angiotensin II type 1 receptor (AGTR1) gene polymorphism (A1166 C) and cytochrome P450 enzyme 2C9 (CYP2C9) gene polymorphism (CYP2C9∗3). Methods 281 patients with hypertension who received valsartan monotherapy in the past month were included in this retrospective study. Polymerase chain reaction-melting curve analysis was performed to genotype the AGTR1 and CYP2C9 gene polymorphisms. Based on the systolic blood pressure (SBP) and diastolic blood pressure (DBP) at the time of visit, the patients were divided into well-controlled group (n = 144, SBP/DBP <140/90 mmHg) and poorly controlled group (n = 137, SBP/DBP ≥140/90 mmHg). Results Older age, decreased history of drinking, a higher proportion of mild-to-moderate hypertension, lower alanine aminotransferase levels, and higher high-density lipoprotein cholesterol levels were observed in the well-controlled group than the poorly controlled group. Higher frequencies of the C allele and AC + CC genotype of AGTR1 A1166C were detected in the well-controlled than the poorly controlled patients (P = 0.005 and P = 0.006). After adjustment for demographic and environmental factors, the CC + AC genotype of AGTR1 A1166C was markedly linked to better hypertension control with valsartan treatment compared to the AA genotype (odds ratio: 2.836, 95% confidence interval: 1.199–6.705, P = 0.018). No significant difference was observed in the allele or genotype distribution of CYP2C9∗3 polymorphism between well-controlled and poorly controlled patients. Conclusions The current data suggested that the AGTR1 A1166 C polymorphism may be associated with the antihypertensive effect of valsartan, and carriers with AC and CC genotypes may have a better antihypertensive efficacy response to valsartan treatment.
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Li Y, He Y, Yang L, Liu Q, Li C, Wang Y, Yang P, Wang J, Chen Z, Huang X. Body Roundness Index and Waist–Hip Ratio Result in Better Cardiovascular Disease Risk Stratification: Results From a Large Chinese Cross-Sectional Study. Front Nutr 2022; 9:801582. [PMID: 35360688 PMCID: PMC8960742 DOI: 10.3389/fnut.2022.801582] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 02/04/2022] [Indexed: 12/29/2022] Open
Abstract
Background The appropriate optimal anthropometric indices and their thresholds within each BMI category for predicting those at a high risk of cardiovascular disease risk factors (CVDRFs) among the Chinese are still under dispute. Objectives We aimed to identify the best indicators of CVDRFs and the optimal threshold within each BMI category among the Chinese. Methods Between 2012 and 2020, a total of 500,090 participants were surveyed in Hunan, China. Six anthropometric indices including waist circumference (WC), a body shape index (ABSI), body roundness index (BRI), waist–hip ratio (WHR), hip circumference (HC), and waist–height ratio (WHtR) were evaluated in the present study. Considered CVDRFs included dyslipidaemia, hypertension, diabetes mellitus (DM), and chronic kidney disease (CKD). The associations of anthropometrics with CVDRFs within each BMI category were evaluated through logistic regression models. The area under the receiver operating characteristic curve (AUROC) was used to assess the predictive abilities. Results For the presence of at least one CVDRFs, the WHR had the highest AUROC in overweight [0.641 (95%CI:0.638, 0.644)] and obese [0.616 (95%CI:0.609, 0.623)] men. BRI had the highest AUROC in underweight [0.649 (95%CI:0.629, 0.670)] and normal weight [0.686 (95%CI:0.683, 0.690)] men. However, the BRI had the highest discrimination ability among women in all the BMI categories, with AUROC ranging from 0.641 to 0.727. In most cases, the discriminatory ability of WHtR was similar to BRI and was easier to calculate; therefore, thresholds of BRI, WHR, and WHtR for CVDRFs identification were all calculated. In men, BRI thresholds of 1.8, 3.0, 3.9, and 5.0, WHtR thresholds of 0.41, 0.48, 0.53, and 0.58, and WHR thresholds of 0.81, 0.88, 0.92, and 0.95 were identified as optimal thresholds across underweight, normal weight, overweight, and obese populations, respectively. The corresponding BRI values in women were 1.9, 2.9, 4.0, and 5.2, respectively, and WHtR were 0.41, 0.48, 0.54, and 0.59, while the WHR values were 0.77, 0.83, 0.88, and 0.90. The recommended BRI, WHtR, or WHR cut-offs could not statistically differentiate high-risk CKD or hypercholesterolemia populations. Conclusions We found that BRI and WHR were superior to other indices for predicting CVD risk factors, except CKD or hypercholesterolemia, among the Chinese.
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Affiliation(s)
- Ying Li
- Department of Health Management, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Yongmei He
- Department of Health Management, Aerospace Center Hospital, Beijing, China
| | - Lin Yang
- Department of Cancer Epidemiology and Prevention Research, Cancer Care Alberta, Alberta Health Services, Calgary, AB, Canada
- Departments of Oncology and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Qingqi Liu
- Department of Biostatistics, Bioinformatics and Biomathematics, Georgetown University, Washington, DC, United States
| | - Chao Li
- Hunan Key Laboratory for Bioanalysis of Complex Matrix Samples, Changsha, China
| | - Yaqin Wang
- Department of Health Management, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Pingting Yang
- Department of Health Management, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Jiangang Wang
- Department of Health Management, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Zhiheng Chen
- Department of Health Management, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Xin Huang
- Department of Epidemiology, School of Medicine, Hunan Normal University, Changsha, China
- *Correspondence: Xin Huang
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Sun Q, Pan Y, Zhao Y, Liu Y, Jiang Y. Association of Nighttime Systolic Blood Pressure With Left Atrial-Left Ventricular–Arterial Coupling in Hypertension. Front Cardiovasc Med 2022; 9:814756. [PMID: 35282370 PMCID: PMC8907528 DOI: 10.3389/fcvm.2022.814756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 01/24/2022] [Indexed: 11/13/2022] Open
Abstract
Objective Hypertension (HT) induces left atrial (LA) and left ventricular (LV) dysfunction, and an increase in arterial stiffness. In this study, we investigated the association between LA-LV–arterial coupling and nighttime systolic blood pressure (BP) as well as BP circadian rhythm in essential hypertension. Methods We enrolled 290 HT patients. All subjects were evaluated by 2- dimensional speckle tracking echocardiography (2DSTE), ambulatory 24 h BP monitoring (ABPM), and brachial–ankle pulse wave velocity (PWV). According to BP patterns, these patients were divided into two groups, which included dippers (n = 111), patients with a >10% reduction in BP at nighttime; non-dippers (n = 179), patients with a <10% reduction in BP at nighttime. 2D-STE based LA and LV strains were studied and the following parameters were measured, LV global longitudinal strain (GLS), LA reservoir strain (LAS−S), LA conduit strain (LAS−E), and LA booster pump strain (LAS−A). LA stiffness index (LASI) defined as the ratio of E/e′ to LAS−S, and PWV-to-GLS ratio (PWV/GLS) were calculated to reflect LA-LV–arterial coupling. Furthermore, we also explored the correlation between LASI (or PWV/GLS) and ambulatory blood pressure indexes. Results Left atrial stiffness index was significantly higher in non-dippers [0.29 (0.21, 0.41)] than in dippers [0.26 (0.21, 0.33)] (P < 0.05). PWV/GLS was significantly higher in non-dippers [−80.9 (−69.3, −101.5)] than in dippers [−74.2 (−60.2, −90.6)] (P < 0.05). LAS−S, LAS−E, LAS−A,and LV GLS were significantly lower in non-dippers than in dippers (P < 0.05). Multivariate linear regression analysis revealed that nighttime systolic BP was independently correlated with LASI and PWV/GLS, even adjusted for multiple clinical risk factors, LVMI, and LVEF. Conclusions The dipping pattern of BP was related to the abnormalities of myocardial mechanics and LA-LV–arterial coupling. However, absolute nocturnal systolic BP value maybe more important than BP circadian profile in the progression of abnormal LA-LV–arterial coupling.
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Affiliation(s)
- Qiaobing Sun
- Department of Cardiology, First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Yu Pan
- Department of Cardiology, First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Yixiao Zhao
- Department of Geriatric Cerebrovasology, Baoji Central Hospital, Baoji, China
| | - Yan Liu
- Department of Cardiology, First Affiliated Hospital of Dalian Medical University, Dalian, China
- *Correspondence: Yan Liu
| | - Yinong Jiang
- Department of Cardiology, First Affiliated Hospital of Dalian Medical University, Dalian, China
- Yinong Jiang
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Hu Y, Zhao J, Wang Q, Chao H, Tang B, Cheng D, Tan I, Butlin M, Avolio A, Wang W, Zuo J. Disparate Associations of 24-h Central Aortic and Brachial Cuff Blood Pressure With Hypertension-Mediated Organ Damage and Cardiovascular Risk. Front Cardiovasc Med 2022; 9:795509. [PMID: 35274011 PMCID: PMC8902413 DOI: 10.3389/fcvm.2022.795509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Accepted: 01/04/2022] [Indexed: 11/27/2022] Open
Abstract
Objective Aim of this study was to evaluate the associations of non-invasive central aortic and peripheral (brachial) blood pressure (BP) for Hypertension-mediated organ damage (HMOD) and atherosclerotic cardiovascular disease (ASCVD) risk. Methods We evaluated associations of HMOD with 24-h ambulatory blood pressure monitoring (ABPM) of central aortic and peripheral BP indices in patients with primary hypertension and presence of several cardiovascular risk factors. BP measurements were performed by means of a non-invasive automated oscillometric device (Mobil-O-Graph). HMOD was defined as the presence of carotid intima-media thickness (IMT) above normal values and/or carotid plaque, left ventricular hypertrophy (LVH), and/or renal abnormalities as assessed by urine albumin/creatinine ratio above normal values and/or estimated glomerular filtration rate (eGFR) <60 ml/min per 1.73 m2. Results In the study cohort of 273 (age 55.2 ± 13.4 years, 71.8% male) patients with primary hypertension, documented HMOD was present in 180 (65.9%), LVH in 70 (25.6%), increased IMT in 129 (47.3%). Fifty-six patients (20.5%) had kidney organ damage (20.5% albuminuria and 2.6% impaired eGFR). When accounting for confounding factors (age, sex, body-mass-index, antihypertensive treatment, smoking, triacylglycerol, statin treatment, glucose, hypoglycemic therapy, or heart rate) only peripheral 24-h pulse pressure (PP) maintained statistical significance with HMOD indices (OR: 1.126, 95% CI: 1.012~1.253; p = 0.029). Using ASCVD risk score as the independent continuous variable in multiple linear regression, 24-h central systolic pressure (SBP) (β = 0.179; 95% CI:0.019~0.387; p = 0.031), daytime central PP (β = 0.114; 95% CI:0.070~0.375; p = 0.005, night-time central SBP (β = 0.411; 95% CI:0.112~0.691; p = 0.007) and night-time PP (β = 0.257; 95% CI:0.165~0.780; p = 0.003) were all positively associated with ASCVD risk. Conclusions Blood pressure obtained by 24-h ABPM was better correlated with HMOD than office BP. Whilst 24-h peripheral BP showed a stronger association with HMOD than 24-h central BP, the prognostic value of 24-h central BP for the 10-year ASCVD risk was superior to 24-h peripheral BP.
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Affiliation(s)
- Yueliang Hu
- Department of Geriatrics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jiehui Zhao
- Daning Community Health Service Center, Shanghai, China
| | - Qian Wang
- Department of Geriatrics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Huijuan Chao
- Department of Geriatrics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Biwen Tang
- Department of Geriatrics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Di Cheng
- Department of Geriatrics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Isabella Tan
- Macquarie Medical School, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW, Australia
| | - Mark Butlin
- Macquarie Medical School, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW, Australia
| | - Alberto Avolio
- Macquarie Medical School, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW, Australia
| | | | - Junli Zuo
- Department of Geriatrics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Macquarie Medical School, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW, Australia
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Chen K, Su H, Wang Q, Wu Z, Shi R, Yu F, Yan J, Yuan X, Qin R, Zhou Z, Hou Z, Li C, Chen T. Similarities in Hypertension Status but Differences in Mortality Risk: A Comparison of 2017 ACC/AHA and 2018 Chinese Hypertension Guidelines. Front Cardiovasc Med 2022; 9:784433. [PMID: 35265676 PMCID: PMC8898956 DOI: 10.3389/fcvm.2022.784433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 01/20/2022] [Indexed: 11/13/2022] Open
Abstract
Background Few studies investigated the concordance in hypertension status and antihypertensive treatment recommendations between the 2018 Chinese Hypertension League (CHL) guidelines and the 2017 American College of Cardiology (ACC)/American Heart Association (AHA) guidelines and assessed the change of premature mortality risk with hypertension defined by the ACC/AHA guidelines. Methods We used the baseline data of the China Health and Retirement Longitudinal Study (CHARLS) to estimate the population impact on hypertension management between CHL and ACC/AHA guidelines. Mortality risk from hypertension was estimated using the data from China Health and Nutrition Survey (CHNS). Cox proportional hazards model was used to estimate the hazard ratios (HRs) and their 95% confidence intervals(CIs). Results Among 13,704 participants analyzed from the nationally representative data of CHARLS, 42.64% (95% CI: 40.35, 44.96) of Chinese adults were diagnosed by both CHL and ACC/AHA guidelines. 41.25% (39.17, 43.36) did not have hypertension according to either guideline. Overall, the concordance in hypertension status was 83.89% (81.69, 85.57). A high percentage of agreement was also found for recommendation to initiate treatment among untreated subjects (87.62% [86.67, 88.51]) and blood pressure (BP) above the goal among treated subjects (71.68% [68.16, 74.95]). Among 23,063 adults from CHNS, subjects with hypertension by CHL had a higher risk of premature mortality (1.75 [1.50, 2.04]) compared with those without hypertension. The association diminished for hypertension by ACC/AHA (1.46 [1.07, 1.30]). Moreover, the excess risk was not significant for the newly defined Grade 1 hypertension by ACC/AHA (1.15 [0.95, 1.38]) when compared with BP <120/80 mmHg. This contrasted with the estimate from CHL (1.54 [1.25, 1.89]). The same pattern was observed for total mortality. Conclusions If ACC/AHA guidelines were adopted, a high degree of concordance in hypertension status and initiation of antihypertensive treatment was found with CHL guidelines. However, the mortality risk with hypertension was reduced with a non-significant risk for Grade 1 hypertension defined by the ACC/AHA.
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Affiliation(s)
- Kangyu Chen
- Department of Cardiology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Hao Su
- Department of Cardiology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Qi Wang
- Department of Cardiology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Zhenqiang Wu
- Department of Geriatric Medicine, The University of Auckland, Auckland, New Zealand
| | - Rui Shi
- Heart Rhythm Centre, The Royal Brompton and Harefield National Health Service Foundation Trust, National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - Fei Yu
- Department of Cardiology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Ji Yan
- Department of Cardiology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Xiaodan Yuan
- Department of Health Education, Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Jiangsu Province Academy of Traditional Chinese Medicine, Nanjing University of Chinese Medicine, Nanjing, China
| | - Rui Qin
- Department of Health Education, Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Jiangsu Province Academy of Traditional Chinese Medicine, Nanjing University of Chinese Medicine, Nanjing, China
| | - Ziai Zhou
- Department of Epidemiology and Health Statistics, School of Public Health, Xi'an Jiaotong University Health Science Centre, Xi'an, China
| | - Zeyi Hou
- Department of Epidemiology and Health Statistics, School of Public Health, Xi'an Jiaotong University Health Science Centre, Xi'an, China
| | - Chao Li
- Department of Epidemiology and Health Statistics, School of Public Health, Xi'an Jiaotong University Health Science Centre, Xi'an, China
- *Correspondence: Chao Li
| | - Tao Chen
- Department of Public Health, Policy and Systems, Institute of Population Health, The University of Liverpool, Liverpool, United Kingdom
- Tao Chen
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Zeng D, Yang C, Chien WT. Testing the psychometric properties of a Chinese version of Dyadic Relationship Scale for families of people with hypertension in China. BMC Psychol 2022; 10:34. [PMID: 35189971 PMCID: PMC8862279 DOI: 10.1186/s40359-022-00747-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 02/04/2022] [Indexed: 11/29/2022] Open
Abstract
Background Interventions for people with chronic illness have increasingly got involvement and partnership with family members in China and worldwide. The patient-family interactions in chronic illness care can greatly influence not only family dyadic relationship or collaboration in caregiving but also both patient’s and caregiver’s health and well-being. To date, very few instruments have been developed to measure the family dyadic relationship; and none has been found in Chinese language. This study aimed to translate the original English Dyadic Relationship Scales (DRS), including DRS-patient and DRS-caregiver, into simplified Chinese language (DRS-C) and examine their psychometric properties in Chinese people with hypertension in a rural community. Methods The Brislin’s model of translation was adopted for translation. Face and content validity and semantic equivalence of the translated Chinese version of the two DRS-patient and DRS-caregiver scales were examined. A sample of 132 adults with hypertension and their family caregivers were recruited to test the psychometric properties of the DRS-C scales. Results The DRS-C scales indicated very satisfactory face validity with 10 family dyads in hypertension care, content validity rated by five experts (Item CVI = 0.8–1.0; Scale CVI = 0.98) and semantic equivalence rated by 22 panel members (i.e., all items were rated as 3 = relevant or 4 = very relevant by > 18 members). A well-fitting model of DRS-C-patient was identified with χ2/df = 1.47, p = 0.04, RMSEA = 0.06, GFI = 0.941, CFI = 0.961, TLI = 0.947, and SRMR = 0.019. A well-fitting model of DRS-C-caregiver was identified with χ2/df = 1.340, p = 0.092, RMSEA = 0.039, GFI = 0.940, CFI = 0.975, TLI = 0.965, and SRMR = 0.014. The Chinese DRS-patient and DRS-caregiver had satisfactory internal consistency with Cronbach’s α coefficients of 0.82 and 0.83, respectively, and test–retest reliabilities with intra-correlation coefficients of 0.97 and 0.96, respectively. The convergent validities of the Chinese versions of the DRS-patient and DRS-caregiver were very satisfactory with the self-efficacy subscale of Hypertension Self-Care Profile, and Zarit Burden Interview, respectively (Pearson’s r = − 0.70 and 0.79; both p < 0.001). Significant differences on mean scores of the Chinese versions of the DRS-patient (t = − 8.10, p < 0.001) and the DRS-caregiver (t = − 9.15, p < 0.001), between the groups of adults with hypertension and normal blood pressure counterparts. Conclusion Both Chinese versions of the DRS-patient and DRS-caregiver have sound psychometric properties and similar factor structure to the original English version. The Chinese versions can be valid measures of family dyadic relationship among Chinese adults with hypertension. Supplementary Information The online version contains supplementary material available at 10.1186/s40359-022-00747-2.
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Lin W, Shi S, Huang H, Wang N, Wen J, Chen G. Development of a Risk Model for Predicting Microalbuminuria in the Chinese Population Using Machine Learning Algorithms. Front Med (Lausanne) 2022; 9:775275. [PMID: 35198573 PMCID: PMC8858816 DOI: 10.3389/fmed.2022.775275] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 01/03/2022] [Indexed: 11/16/2022] Open
Abstract
Objective Microalbuminuria (MAU) occurs due to universal endothelial damage, which is strongly associated with kidney disease, stroke, myocardial infarction, and coronary artery disease. Screening patients at high risk for MAU may aid in the early identification of individuals with an increased risk of cardiovascular events and mortality. Hence, the present study aimed to establish a risk model for MAU by applying machine learning algorithms. Methods This cross-sectional study included 3,294 participants ranging in age from 16 to 93 years. R software was used to analyze missing values and to perform multiple imputation. The observed population was divided into a training set and a validation set according to a ratio of 7:3. The first risk model was constructed using the prepared data, following which variables with P <0.1 were extracted to build the second risk model. The second-stage model was then analyzed using a chi-square test, in which a P ≥ 0.05 was considered to indicate no difference in the fit of the models. Variables with P <0.05 in the second-stage model were considered important features related to the prevalence of MAU. A confusion matrix and calibration curve were used to evaluate the validity and reliability of the model. A series of risk prediction scores were established based on machine learning algorithms. Results Systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting blood glucose (FBG), triglyceride (TG) levels, sex, age, and smoking were identified as predictors of MAU prevalence. Verification using a chi-square test, confusion matrix, and calibration curve indicated that the risk of MAU could be predicted based on the risk score. Conclusion Based on the ability of our machine learning algorithm to establish an effective risk score, we propose that comprehensive assessments of SBP, DBP, FBG, TG, gender, age, and smoking should be included in the screening process for MAU.
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Affiliation(s)
- Wei Lin
- Department of Endocrinology, Shengli Clinical Medical College of Fujian Medical University, Fujian Provincial Hospital, Fuzhou, China
| | - Songchang Shi
- Department of Critical Care Medicine, Shengli Clinical Medical College of Fujian Medical University, Fujian Provincial Hospital South Brance, Fujian Provincial Hospital Jinshan Branch, Fuzhou, China
| | - Huibin Huang
- Department of Endocrinology, Shengli Clinical Medical College of Fujian Medical University, Fujian Provincial Hospital, Fuzhou, China
| | - Nengying Wang
- Department of Endocrinology, Shengli Clinical Medical College of Fujian Medical University, Fujian Provincial Hospital, Fuzhou, China
| | - Junping Wen
- Department of Endocrinology, Shengli Clinical Medical College of Fujian Medical University, Fujian Provincial Hospital, Fuzhou, China
- *Correspondence: Junping Wen
| | - Gang Chen
- Department of Endocrinology, Shengli Clinical Medical College of Fujian Medical University, Fujian Provincial Hospital, Fuzhou, China
- Gang Chen
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Canoy D, Copland E, Nazarzadeh M, Ramakrishnan R, Pinho-Gomes AC, Salam A, Dwyer JP, Farzadfar F, Sundström J, Woodward M, Davis BR, Rahimi K. Antihypertensive drug effects on long-term blood pressure: an individual-level data meta-analysis of randomised clinical trials. BRITISH HEART JOURNAL 2022; 108:1281-1289. [PMID: 35058294 PMCID: PMC9340038 DOI: 10.1136/heartjnl-2021-320171] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Accepted: 11/30/2021] [Indexed: 12/12/2022]
Abstract
ObjectiveEvidence from randomised trials of pharmacological treatments on long-term blood pressure (BP) reduction is limited. We investigated the antihypertensive drug effects on BP over time and across different participant characteristics.MethodsWe conducted an individual patient-level data meta-analysis of 52 large-scale randomised clinical trials in the Blood Pressure Lowering Treatment Trialists’ Collaboration using mixed models to examine treatment effects on BP over 4 years of mean follow-up.ResultsThere were 363 684 participants (42% women), with baseline mean age=65 years and mean systolic/diastolic BP=152/87 mm Hg, and among whom 19% were current smokers, 49% had cardiovascular disease, 28% had diabetes and 69% were taking antihypertensive treatment at baseline. Drugs were effective in lowering BP showing maximal effect after 12 months and gradually attenuating towards later years. Based on measures taken ≥12 months postrandomisation, mean systolic/diastolic BP difference (95% CI) between more and less intense BP-lowering treatment was −11.1 (−11.3 to −10.8)/−5.6 (−5.7 to −5.4) mm Hg; between active treatment and placebo was −5.1 (−5.3 to −5.0)/−2.3 (−2.4 to −2.2) mm Hg; and between active and control arms for drug comparison trials was −1.4 (−1.5 to −1.3)/−0.6 (−0.7 to −0.6) mm Hg. BP reductions were observed across different baseline BP values and ages, and by sex, history of cardiovascular disease and diabetes and prior antihypertensive treatment use.ConclusionThese findings suggest that BP-lowering pharmacotherapy is effective in lowering BP, up to 4 years on average, in people with different characteristics. Appropriate treatment strategies are needed to sustain substantive long-term BP reductions.
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Affiliation(s)
- Dexter Canoy
- Deep Medicine, Nuffield Department of Women's and Reproductive Health, University of Oxford, Oxford, UK
- NIHR Oxford Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, Oxfordshire, UK
| | - Emma Copland
- Deep Medicine, Nuffield Department of Women's and Reproductive Health, University of Oxford, Oxford, UK
| | - Milad Nazarzadeh
- Deep Medicine, Nuffield Department of Women's and Reproductive Health, University of Oxford, Oxford, UK
| | - Rema Ramakrishnan
- National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Ana-Catarina Pinho-Gomes
- School of Population Health and Environmental Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK
- Department of Community Medicine, Centre for Health Technology and Services Research, University of Porto, Porto, Portugal
| | - Abdul Salam
- The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
- The George Institute for Global Health India, Hyderabad, India
| | - Jamie P Dwyer
- Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Farshad Farzadfar
- Endocrinology and Metabolism Institute, Tehran University of Medical Sciences, Tehran, Iran (the Islamic Republic of)
| | - Johan Sundström
- Department of Medical Sciences, Uppsala Universitet, Uppsala, Sweden
| | - Mark Woodward
- The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
- The George Institute for Global Health UK, Imperial College London, London, UK
| | - Barry R Davis
- Department of Biostatistics, University of Texas School of Public Health, Houston, Texas, USA
| | - Kazem Rahimi
- Deep Medicine, Nuffield Department of Women's and Reproductive Health, University of Oxford, Oxford, UK
- NIHR Oxford Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, Oxfordshire, UK
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134
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Tang N, Ma J, Tao R, Chen Z, Yang Y, He Q, Lv Y, Lan Z, Zhou J. The effects of the interaction between BMI and dyslipidemia on hypertension in adults. Sci Rep 2022; 12:927. [PMID: 35042940 PMCID: PMC8766602 DOI: 10.1038/s41598-022-04968-8] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Accepted: 01/05/2022] [Indexed: 12/04/2022] Open
Abstract
Body mass index (BMI) and dyslipidemia are indicators of human health and are often associated with high blood pressure. In this study,we explored the relationship between BMI or dyslipidemia and the risk of hypertension and further verified the possible interacting influences of BMI with dyslipidemia on the risk of hypertension. The aim is to explore the possible risk factors of hypertension and to provide scientific basis for the prevention and treatment of hypertension. Eligible subjects were selected from a cross-sectional survey in Changsha City, and we collected relevant data and clinical indicators for each participant. Body mass index (BMI) was calculated as weight (kg)/height2 (m2), and divided into four categories according to the Chinese standard. Dyslipidemia is defined according to Chinese guideline. Unconditional logistic regression models were used for dichotomous variables to determine the risk or protective factors of dependent variables. Multivariate Logistic model was used to study the influence of BMI and dyslipidemia on hypertension. The following indicators were used to assess the interaction effects: (1) Relative excess risk due to interaction (RERI); (2) Attributable proportion due to interaction(AP); (3) Synergy index (SI). SPSS software was used for statistical analysis. A total of 2740 eligible participants were enrolled in the cross-sectional study, of which 765 subjects (27.9%) were diagnosed with hypertension. Multivariate Logistic model showed that overweight (OR: 1.70, 95%CI: 1.39–2.09) or obese (OR: 2.60, 95%CI: 1.84–3.66) subjects had a significantly higher risk of hypertension than normal weight people, and underweight was a protective factor for hypertension(OR: 0.52, 95%CI: 0.29–0.93). People with dyslipidemia have a higher risk of hypertension than those with normal lipids (OR: 3.05, 95%CI: 2.36–3.90). In addition,there was a significant potentiating interaction effect between overweight or obesity and dyslipidemia(overweight: RERI (1.91, 95%CI: 0.17–3.66), AP (0.40, 95%CI:0.14–0.66), SI (2.03, 95%CI:1.11–3.74) and obesity: RERI (2.20, 95%CI:1.01–3.40), AP (0.38, 95%CI:0.18–0.58), SI (1.84, 95%CI:1.18–2.89), while no interaction was found between underweight and dyslipidemia. Low body weight is an independent protective factor for hypertension, but overweight, obesity and dyslipidemia are risk factors for hypertension, and dyslipidemia significantly shared interactions with overweight and obesity that influenced the risk of hypertension.
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Affiliation(s)
- Na Tang
- Key Laboratory of Molecular Epidemiology of Hunan Province, School of Medicine, Hunan Normal University, Changsha, 410013, Hunan, China
| | - Jian Ma
- Key Laboratory of Molecular Epidemiology of Hunan Province, School of Medicine, Hunan Normal University, Changsha, 410013, Hunan, China
| | - Rongqin Tao
- Tianxin District Center for Disease Control and Prevention, Changsha, 410009, Hunan, China
| | - Zhijun Chen
- Key Laboratory of Molecular Epidemiology of Hunan Province, School of Medicine, Hunan Normal University, Changsha, 410013, Hunan, China
| | - Yide Yang
- Key Laboratory of Molecular Epidemiology of Hunan Province, School of Medicine, Hunan Normal University, Changsha, 410013, Hunan, China
| | - Quanyuan He
- Key Laboratory of Molecular Epidemiology of Hunan Province, School of Medicine, Hunan Normal University, Changsha, 410013, Hunan, China
| | - Yuan Lv
- Key Laboratory of Molecular Epidemiology of Hunan Province, School of Medicine, Hunan Normal University, Changsha, 410013, Hunan, China
| | - Zelong Lan
- Tianxin District Center for Disease Control and Prevention, Changsha, 410009, Hunan, China.
| | - Junhua Zhou
- Key Laboratory of Molecular Epidemiology of Hunan Province, School of Medicine, Hunan Normal University, Changsha, 410013, Hunan, China.
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135
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Wang L, Li S, Mo Y, Hu M, Zhang J, Zeng M, Li H, Zhao H. Gender-Disparities in the in-Hospital Clinical Outcome Among Patients with Chronic Kidney Disease Undergoing Percutaneous Coronary Intervention. Int J Gen Med 2022; 15:593-602. [PMID: 35058710 PMCID: PMC8765440 DOI: 10.2147/ijgm.s343129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 12/21/2021] [Indexed: 11/23/2022] Open
Abstract
PURPOSE The current study was to evaluate the gender-disparities in the in-hospital thrombotic and bleeding events among patients with chronic kidney disease (CKD) undergoing percutaneous coronary intervention (PCI). PATIENTS AND METHODS Patients with CKD undergoing PCI were retrospectively enrolled. Baseline characteristics, and thrombotic and bleeding events occurred during hospitalization were collected and compared by gender. RESULTS Compared to males (n = 558), females (n = 402) were older and more likely to have diabetes mellitus (37.1% vs 29.7%). Females had a lower estimated glomerular filtration rate (eGFR; 51.2 ± 7.9 vs 54.6 ± 5.1 mL/min/1.73m2) and were more likely to undergo urgent PCI (66.7% vs 60.2%) and use glycoprotein IIb/IIIa inhibitor (15.4% vs 7.5%) at peri-PCI period. Compared to males, females had a higher rate of in-hospital mortality which was due to thrombotic events (9.0% vs 3.4%). Females also had a higher rate of moderate-to-severe hemorrhage (8.0% vs 3.2%). After multivariable adjustment, diabetes mellitus (odds ratio [OR] 1.15 and 95% confidence interval [CI] 1.07-1.29) and acute coronary syndrome (ACS) presentation (OR 1.53 and 95% CI 1.34-1.93) were associated with gender-disparities in composite thrombotic events. Ageing (OR 1.10 and 95% CI 1.02-1.33), diabetes mellitus (OR 1.21 and 95% CI 1.07-1.40) and glycoprotein IIb/IIIa inhibitor use (OR 1.13 and 95% CI 1.02-1.28) were associated with composite bleeding events. CONCLUSION Females with CKD undergoing PCI had a higher risk of experiencing in-hospital thrombotic and bleeding events than males.
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Affiliation(s)
- Li Wang
- Department of Nephrology, People’s Hospital of Longhua District, Shenzhen, Guangdong, People’s Republic of China
| | - Sha Li
- Department of Nephrology, People’s Hospital of Longhua District, Shenzhen, Guangdong, People’s Republic of China
| | - Yihao Mo
- Department of Nephrology, People’s Hospital of Longhua District, Shenzhen, Guangdong, People’s Republic of China
| | - Mingliang Hu
- Department of Nephrology, People’s Hospital of Longhua District, Shenzhen, Guangdong, People’s Republic of China
| | - Junwei Zhang
- Department of Nephrology, People’s Hospital of Longhua District, Shenzhen, Guangdong, People’s Republic of China
| | - Min Zeng
- Department of Nephrology, People’s Hospital of Longhua District, Shenzhen, Guangdong, People’s Republic of China
| | - Huafeng Li
- Department of Nephrology, People’s Hospital of Longhua District, Shenzhen, Guangdong, People’s Republic of China
| | - Honglei Zhao
- Department of Cardiology, Fuwai Hospital Chinese Academy of Medical Science, Shenzhen, Guangdong, People’s Republic of China
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136
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Qi SF, Cao YJ, Wang HJ, Zhang B, Yan J, Tian QB. Associations of Carbohydrate Intake With New-Onset Hypertension Subtypes: Results From the China Health and Nutrition Survey (2000-2011). Front Nutr 2022; 8:728774. [PMID: 35071289 PMCID: PMC8770856 DOI: 10.3389/fnut.2021.728774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 12/06/2021] [Indexed: 11/29/2022] Open
Abstract
Background: The effects of carbohydrate intake on hypertension (HTN) subtypes are scarce. We examined the association of carbohydrate intake with new-onset HTN subtypes in Chinese adults. Methods: Chinese Health and Nutrition Survey (CHNS) 2000-2011, 22,418 individuals were recorded using a 24-h recall method over three consecutive days. We excluded those who were pregnant women, lactating mothers, age <18 years, baseline age, blood pressure, and energy intake deficiency, extreme energy intake (male > 6,000 kcal or < 800 kcal; female > 4,000 kcal or < 600 kcal), and pulse pressure difference (Systolic Blood Pressure [SBP] - Diastolic Blood Pressure [DBP]) <10 mm Hg, HTN at baseline and data from only one survey. The total number of subjects who participated in at least two surveys was 7,930. The main outcome was new-onset HTN subtypes over 6.9 person years of follow-up. Results: 2,521 participants were found to be HTN, which included 1,318 males (52.3%), 1,203 females (47.7%), 721 had systolic-diastolic hypertension (SDH, 28.6%), 655 had isolated systolic hypertension (ISH, 26.0%), and 993 had isolated diastolic hypertension (IDH, 39.4%). Compared with extreme quintiles of carbohydrate, multivariable-adjusted hazard ratios (HR) and 95% confidence intervals (CI) for new-onset HTN, SDH, ISH and IDH associated with carbohydrate intake were 1.12 (0.97-1.30), 1.54 (1.18-2.00), 0.89 (0.67-1.19) and 1.15 (0.91-1.45), respectively. The HR of SDH compared with extreme quintiles of carbohydrates was 1.56 (95% CI, 1.08-2.25; P trend = 0.04) in men and 1.52 (95% CI, 1.02-2.26; P trend = 0.02) in women. Conclusion: Carbohydrates were related to a higher risk of SDH, which were not observed with HTN, ISH, and IDH.
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Affiliation(s)
- Su-Fen Qi
- Hebei Key Laboratory of Environment and Human Health, Department of Epidemiology and Statistics, School of Public Health, Hebei Medical University, Shijiazhuang, China
| | - Ya-Jing Cao
- Hebei Key Laboratory of Environment and Human Health, Department of Epidemiology and Statistics, School of Public Health, Hebei Medical University, Shijiazhuang, China
| | - Hui-Jun Wang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Bing Zhang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jing Yan
- Research Center of Electron Microscope, Hebei Medical University, Shijiazhuang, China
| | - Qing-Bao Tian
- Hebei Key Laboratory of Environment and Human Health, Department of Epidemiology and Statistics, School of Public Health, Hebei Medical University, Shijiazhuang, China
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137
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Chen R, Ye X, Sun M, Yang J, Zhang J, Gao X, Liu C, Ke J, He C, Yuan F, Lv H, Yang Y, Cheng R, Tan H, Huang L. Blood Pressure Load: An Effective Indicator of Systemic Circulation Status in Individuals With Acute Altitude Sickness. Front Cardiovasc Med 2022; 8:765422. [PMID: 35047574 PMCID: PMC8761955 DOI: 10.3389/fcvm.2021.765422] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Accepted: 12/13/2021] [Indexed: 12/23/2022] Open
Abstract
Background: Acute high altitude (HA) exposure results in blood pressure (BP) variations in most subjects. Previous studies have demonstrated that higher BP is potentially correlated with acute mountain sickness (AMS). The BP load may be of clinical significance regarding systemic circulation status. Objectives: This study aimed to examine HA-induced BP changes in patients with AMS compared to those in healthy subjects. Further, we provided clinical information about the relationship between variations in 24-h ambulatory parameters (BP level, BP variability, and BP load) and AMS. Methods: Sixty-nine subjects were enrolled and all participants ascended Litang (4,100 m above sea level). They were monitored using a 24-h ambulatory blood pressure device and underwent echocardiography within 24 h of altitude exposure. The 2018 Lake Louise questionnaire was used to evaluate AMS. Results: The AMS group comprised more women than men [15 (65.2%) vs. 13 (28.3%), P < 0.001] and fewer smokers [4 (17.4%) vs. 23 (50.0%), P = 0.009]. The AMS group exhibited significant increases in 24-h BP compared to the non-AMS group (24-h SBP variation: 10.52 ± 6.48 vs. 6.03 ± 9.27 mmHg, P = 0.041; 24-h DBP variation: 8.70 ± 4.57 vs. 5.03 ± 4.98 mmHg, P = 0.004). The variation of mean 24-h cBPL (cumulative BP load) (mean 24-h cSBPL: 10.58 ± 10.99 vs. 4.02 ± 10.58, P = 0.016; 24-h mean cDBPL: 6.03 ± 5.87 vs. 2.89 ± 4.99, P = 0.034) was also obviously higher in AMS subjects than in non-AMS subjects after HA exposure. 24-h mean cSBPL variation (OR = 1.07, P = 0.024) and 24-h mean cDBPL variation (OR = 1.14, P = 0.034) were independent risk factors of AMS. Moreover, variation of 24-h mean cSBPL showed a good correlation with AMS score (R = 0.504, P < 0.001). Conclusions: Our study demonstrated that patients with AMS had higher BP and BP load changes after altitude exposure than healthy subjects. Excessive BP load variations were associated with AMS. Thus, BP load could be an effective indicator regarding systemic circulation status of AMS.
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Affiliation(s)
- Renzheng Chen
- Institute of Cardiovascular Diseases of Chinese People's Liberation Army (PLA), The Second Affiliated Hospital, Third Military Medical University (Army Medical University), Chongqing, China
- Department of Cardiology, The Second Affiliated Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Xiaowei Ye
- Institute of Cardiovascular Diseases of Chinese People's Liberation Army (PLA), The Second Affiliated Hospital, Third Military Medical University (Army Medical University), Chongqing, China
- Department of Cardiology, The Second Affiliated Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Mengjia Sun
- Institute of Cardiovascular Diseases of Chinese People's Liberation Army (PLA), The Second Affiliated Hospital, Third Military Medical University (Army Medical University), Chongqing, China
- Department of Cardiology, The Second Affiliated Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Jie Yang
- Institute of Cardiovascular Diseases of Chinese People's Liberation Army (PLA), The Second Affiliated Hospital, Third Military Medical University (Army Medical University), Chongqing, China
- Department of Cardiology, The Second Affiliated Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Jihang Zhang
- Institute of Cardiovascular Diseases of Chinese People's Liberation Army (PLA), The Second Affiliated Hospital, Third Military Medical University (Army Medical University), Chongqing, China
- Department of Cardiology, The Second Affiliated Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Xubin Gao
- Institute of Cardiovascular Diseases of Chinese People's Liberation Army (PLA), The Second Affiliated Hospital, Third Military Medical University (Army Medical University), Chongqing, China
- Department of Cardiology, The Second Affiliated Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Chuan Liu
- Institute of Cardiovascular Diseases of Chinese People's Liberation Army (PLA), The Second Affiliated Hospital, Third Military Medical University (Army Medical University), Chongqing, China
- Department of Cardiology, The Second Affiliated Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Jingbin Ke
- Institute of Cardiovascular Diseases of Chinese People's Liberation Army (PLA), The Second Affiliated Hospital, Third Military Medical University (Army Medical University), Chongqing, China
- Department of Cardiology, The Second Affiliated Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Chunyan He
- Institute of Cardiovascular Diseases of Chinese People's Liberation Army (PLA), The Second Affiliated Hospital, Third Military Medical University (Army Medical University), Chongqing, China
- Department of Cardiology, The Second Affiliated Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Fangzhengyuan Yuan
- Institute of Cardiovascular Diseases of Chinese People's Liberation Army (PLA), The Second Affiliated Hospital, Third Military Medical University (Army Medical University), Chongqing, China
- Department of Cardiology, The Second Affiliated Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Hailin Lv
- Institute of Cardiovascular Diseases of Chinese People's Liberation Army (PLA), The Second Affiliated Hospital, Third Military Medical University (Army Medical University), Chongqing, China
- Department of Cardiology, The Second Affiliated Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Yuanqi Yang
- Institute of Cardiovascular Diseases of Chinese People's Liberation Army (PLA), The Second Affiliated Hospital, Third Military Medical University (Army Medical University), Chongqing, China
- Department of Cardiology, The Second Affiliated Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Ran Cheng
- Institute of Cardiovascular Diseases of Chinese People's Liberation Army (PLA), The Second Affiliated Hospital, Third Military Medical University (Army Medical University), Chongqing, China
- Department of Cardiology, The Second Affiliated Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Hu Tan
- Institute of Cardiovascular Diseases of Chinese People's Liberation Army (PLA), The Second Affiliated Hospital, Third Military Medical University (Army Medical University), Chongqing, China
- Department of Cardiology, The Second Affiliated Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Lan Huang
- Institute of Cardiovascular Diseases of Chinese People's Liberation Army (PLA), The Second Affiliated Hospital, Third Military Medical University (Army Medical University), Chongqing, China
- Department of Cardiology, The Second Affiliated Hospital, Third Military Medical University (Army Medical University), Chongqing, China
- *Correspondence: Lan Huang
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138
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Wang Z, Heizhati M, Wang L, Li M, Yang Z, Lin M, Abudereyimu R, Hong J, Yang W, Yao L, Liu S, Hu J, Li N. Poor sleep quality is negatively associated with low cognitive performance in general population independent of self-reported sleep disordered breathing. BMC Public Health 2022; 22:3. [PMID: 34980052 PMCID: PMC8725333 DOI: 10.1186/s12889-021-12417-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 12/09/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Sleep disordered breathing (SDB) plays a significant role in both sleep quality and cognition and whether it has an impact on the relationship between above two factors remains to be clear. The study aimed to explore the association between sleep quality and cognitive performance in general population by considering influence of sleep disordered breathing (SDB). METHODS In this cross-sectional study, we enrolled subjects aged ≥ 18 years using a multi-stage random sampling method. Cognitive status was assessed using Mini Mental State Examination (MMSE) questionnaire, sleep quality using Pittsburgh Sleep Quality Index (PSQI) and SDB was assessed using No-SAS scale, respectively. Multi-variable logistic regression was applied to examine the association of sleep quality and cognitive performance. Subgroup analyses were performed in different age groups, and in those with and without SDB. RESULTS Finally, 30,872 participants aged 47.5 ± 13.8 years with 53.5% women were enrolled, of whom 32.4% had poor sleep quality and 18.6% had low cognitive performance. Compared with good sleepers, subjects with poor sleep quality exhibited significantly higher presence of low cognitive performance (23.7% vs 16.2%, P < 0.001). Poor sleepers revealed 1.26 (95%CI: 1.16,1.36), 1.26 (1.08,1.46) and 1.25 (1.14,1.37) fold odds for low cognitive performance in general population and in subjects with and without self-reported SDB respectively. Stratified by age and SDB, the association was observed in young and middle-aged group without SDB (OR = 1.44, 95%CI: 1.30,1.59) and in the elderly group with SDB (OR = 1.30, 95%CI: 1.07,1.58). CONCLUSIONS Sleep quality is in a negative association with cognitive performance in general population independent of SDB, implying improvement of sleep disturbances is a potential objective of intervention strategies for cognitive protection at population level.
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Affiliation(s)
- Zhongrong Wang
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute National Health Committee Key Laboratory of Hypertension Clinical Research, No. 91, Tianchi Road Urumqi, Xinjiang, 830001, China.,Xinjiang Hypertension Institute, Xinjiang, China.,National Health Committee Key Laboratory of Hypertension Clinical Research, Xinjiang, China.,Key Laboratory of Xinjiang Uygur Autonomous Region "Hypertension Research Laboratory, Xinjiang, China.,Xinjiang Clinical Medical Research Center for Hypertension (Cardio-Cerebrovascular) Diseases, Xinjiang, China
| | - Mulalibieke Heizhati
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute National Health Committee Key Laboratory of Hypertension Clinical Research, No. 91, Tianchi Road Urumqi, Xinjiang, 830001, China.,Xinjiang Hypertension Institute, Xinjiang, China.,National Health Committee Key Laboratory of Hypertension Clinical Research, Xinjiang, China.,Key Laboratory of Xinjiang Uygur Autonomous Region "Hypertension Research Laboratory, Xinjiang, China.,Xinjiang Clinical Medical Research Center for Hypertension (Cardio-Cerebrovascular) Diseases, Xinjiang, China
| | - Lin Wang
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute National Health Committee Key Laboratory of Hypertension Clinical Research, No. 91, Tianchi Road Urumqi, Xinjiang, 830001, China.,Xinjiang Hypertension Institute, Xinjiang, China.,National Health Committee Key Laboratory of Hypertension Clinical Research, Xinjiang, China.,Key Laboratory of Xinjiang Uygur Autonomous Region "Hypertension Research Laboratory, Xinjiang, China.,Xinjiang Clinical Medical Research Center for Hypertension (Cardio-Cerebrovascular) Diseases, Xinjiang, China
| | - Mei Li
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute National Health Committee Key Laboratory of Hypertension Clinical Research, No. 91, Tianchi Road Urumqi, Xinjiang, 830001, China.,Xinjiang Hypertension Institute, Xinjiang, China.,National Health Committee Key Laboratory of Hypertension Clinical Research, Xinjiang, China.,Key Laboratory of Xinjiang Uygur Autonomous Region "Hypertension Research Laboratory, Xinjiang, China.,Xinjiang Clinical Medical Research Center for Hypertension (Cardio-Cerebrovascular) Diseases, Xinjiang, China
| | - Zhikang Yang
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute National Health Committee Key Laboratory of Hypertension Clinical Research, No. 91, Tianchi Road Urumqi, Xinjiang, 830001, China.,Xinjiang Hypertension Institute, Xinjiang, China.,National Health Committee Key Laboratory of Hypertension Clinical Research, Xinjiang, China.,Key Laboratory of Xinjiang Uygur Autonomous Region "Hypertension Research Laboratory, Xinjiang, China.,Xinjiang Clinical Medical Research Center for Hypertension (Cardio-Cerebrovascular) Diseases, Xinjiang, China
| | - Mengyue Lin
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute National Health Committee Key Laboratory of Hypertension Clinical Research, No. 91, Tianchi Road Urumqi, Xinjiang, 830001, China.,Xinjiang Hypertension Institute, Xinjiang, China.,National Health Committee Key Laboratory of Hypertension Clinical Research, Xinjiang, China.,Key Laboratory of Xinjiang Uygur Autonomous Region "Hypertension Research Laboratory, Xinjiang, China.,Xinjiang Clinical Medical Research Center for Hypertension (Cardio-Cerebrovascular) Diseases, Xinjiang, China
| | - Reyila Abudereyimu
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute National Health Committee Key Laboratory of Hypertension Clinical Research, No. 91, Tianchi Road Urumqi, Xinjiang, 830001, China.,Xinjiang Hypertension Institute, Xinjiang, China.,National Health Committee Key Laboratory of Hypertension Clinical Research, Xinjiang, China.,Key Laboratory of Xinjiang Uygur Autonomous Region "Hypertension Research Laboratory, Xinjiang, China.,Xinjiang Clinical Medical Research Center for Hypertension (Cardio-Cerebrovascular) Diseases, Xinjiang, China
| | - Jing Hong
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute National Health Committee Key Laboratory of Hypertension Clinical Research, No. 91, Tianchi Road Urumqi, Xinjiang, 830001, China.,Xinjiang Hypertension Institute, Xinjiang, China.,National Health Committee Key Laboratory of Hypertension Clinical Research, Xinjiang, China.,Key Laboratory of Xinjiang Uygur Autonomous Region "Hypertension Research Laboratory, Xinjiang, China.,Xinjiang Clinical Medical Research Center for Hypertension (Cardio-Cerebrovascular) Diseases, Xinjiang, China
| | - Wenbo Yang
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute National Health Committee Key Laboratory of Hypertension Clinical Research, No. 91, Tianchi Road Urumqi, Xinjiang, 830001, China.,Xinjiang Hypertension Institute, Xinjiang, China.,National Health Committee Key Laboratory of Hypertension Clinical Research, Xinjiang, China.,Key Laboratory of Xinjiang Uygur Autonomous Region "Hypertension Research Laboratory, Xinjiang, China.,Xinjiang Clinical Medical Research Center for Hypertension (Cardio-Cerebrovascular) Diseases, Xinjiang, China
| | - Ling Yao
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute National Health Committee Key Laboratory of Hypertension Clinical Research, No. 91, Tianchi Road Urumqi, Xinjiang, 830001, China.,Xinjiang Hypertension Institute, Xinjiang, China.,National Health Committee Key Laboratory of Hypertension Clinical Research, Xinjiang, China.,Key Laboratory of Xinjiang Uygur Autonomous Region "Hypertension Research Laboratory, Xinjiang, China.,Xinjiang Clinical Medical Research Center for Hypertension (Cardio-Cerebrovascular) Diseases, Xinjiang, China
| | - Shasha Liu
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute National Health Committee Key Laboratory of Hypertension Clinical Research, No. 91, Tianchi Road Urumqi, Xinjiang, 830001, China.,Xinjiang Hypertension Institute, Xinjiang, China.,National Health Committee Key Laboratory of Hypertension Clinical Research, Xinjiang, China.,Key Laboratory of Xinjiang Uygur Autonomous Region "Hypertension Research Laboratory, Xinjiang, China.,Xinjiang Clinical Medical Research Center for Hypertension (Cardio-Cerebrovascular) Diseases, Xinjiang, China
| | - Junli Hu
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute National Health Committee Key Laboratory of Hypertension Clinical Research, No. 91, Tianchi Road Urumqi, Xinjiang, 830001, China.,Xinjiang Hypertension Institute, Xinjiang, China.,National Health Committee Key Laboratory of Hypertension Clinical Research, Xinjiang, China.,Key Laboratory of Xinjiang Uygur Autonomous Region "Hypertension Research Laboratory, Xinjiang, China.,Xinjiang Clinical Medical Research Center for Hypertension (Cardio-Cerebrovascular) Diseases, Xinjiang, China
| | - Nanfang Li
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute National Health Committee Key Laboratory of Hypertension Clinical Research, No. 91, Tianchi Road Urumqi, Xinjiang, 830001, China. .,Xinjiang Hypertension Institute, Xinjiang, China. .,National Health Committee Key Laboratory of Hypertension Clinical Research, Xinjiang, China. .,Key Laboratory of Xinjiang Uygur Autonomous Region "Hypertension Research Laboratory, Xinjiang, China. .,Xinjiang Clinical Medical Research Center for Hypertension (Cardio-Cerebrovascular) Diseases, Xinjiang, China.
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Baffour-Awuah B, Pearson MJ, Smart NA, Dieberg G. Safety, efficacy and delivery of isometric resistance training as an adjunct therapy for blood pressure control: a modified Delphi study. Hypertens Res 2022; 45:483-495. [PMID: 35017680 PMCID: PMC8752388 DOI: 10.1038/s41440-021-00839-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 10/18/2021] [Accepted: 11/05/2021] [Indexed: 01/21/2023]
Abstract
Uncontrolled hypertension remains the major risk factor for cardiovascular disease. Isometric resistance training (IRT) has been shown to be a useful nonpharmacological therapy for reducing blood pressure (BP); however, some exercise physiologists and other health professionals are uncertain of the efficacy and safety of IRT. Experts' consensus was sought in light of the current variability of IRT use as an adjunct treatment for hypertension. An expert consensus-building analysis (Delphi study) was conducted on items relevant to the safety, efficacy and delivery of IRT. The study consisted of 3 phases: (1) identification of items and expert participants for inclusion; (2) a two-round modified Delphi exercise involving expert panelists to build consensus; and (3) a study team consensus meeting for a final item review. A list of 50 items was generated, and 42 international experts were invited to join the Delphi panel. Thirteen and 10 experts completed Delphi Rounds 1 and 2, respectively, reaching consensus on 26 items in Round 1 and 10 items in Round 2. The study team consensus meeting conducted a final item review and considered the remaining 14 items for the content list. A final list of 43 items regarding IRT reached expert consensus: 7/10 items on safety, 11/11 items on efficacy, 10/12 items on programming, 8/10 items on delivery, and 7/7 on the mechanism of action. This study highlights that while experts reached a consensus that IRT is efficacious as an antihypertensive therapy, some still have safety concerns, and there is also ongoing conjecture regarding optimal delivery.
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Affiliation(s)
- Biggie Baffour-Awuah
- Clinical Exercise Physiology, School of Science and Technology, Faculty of Science, Agriculture, Business and Law, University of New England, Armidale, NSW, 2351, Australia.
| | - Melissa J. Pearson
- grid.1020.30000 0004 1936 7371Clinical Exercise Physiology, School of Science and Technology, Faculty of Science, Agriculture, Business and Law, University of New England, Armidale, NSW 2351 Australia
| | - Neil A. Smart
- grid.1020.30000 0004 1936 7371Clinical Exercise Physiology, School of Science and Technology, Faculty of Science, Agriculture, Business and Law, University of New England, Armidale, NSW 2351 Australia
| | - Gudrun Dieberg
- grid.1020.30000 0004 1936 7371Biomedical Sciences, School of Science and Technology, Faculty of Science, Agriculture, Business and Law, University of New England, Armidale, NSW 2351 Australia
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140
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Koracevic G, Perisic Z, Stanojkovic M, Stojanovic M, Zdravkovic M, Tomasevic M, Djordjevic D, Mladenovic K, Koracevic M, Trkulja J. A Discrepancy: Calcium Channel Blockers Are Effective for the Treatment of Hypertensive Left Ventricular Hypertrophy but Not as Effective for Prevention of Heart Failure. Med Princ Pract 2022; 31:454-462. [PMID: 36044874 PMCID: PMC9801368 DOI: 10.1159/000526792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Accepted: 08/25/2022] [Indexed: 01/03/2023] Open
Abstract
Arterial hypertension (HTN) is important due to its high prevalence, morbidity, and mortality rates. Calcium channel blockers (CCBs) are the first-line antihypertensive drugs. HTN can lead to heart failure (HF) by causing hypertensive left ventricular hypertrophy (HTN LVH). CCBs are recommended for the treatment of HTN LVH. The aim of this study was to analyze the status of CCBs regarding (1) HTN LVH treatment and (2) capability to prevent HTN-induced HF in the guidelines. For this narrative review, the following databases were searched: Medline, Scopus, Science Direct, Springer, SAGE, Wiley, Oxford Journals, Cambridge, and Google Scholar. CCBs are effective antihypertensive drugs and a very good therapeutic option for HTN LVH as they can cause reverse LVH remodeling. Consequently, we may expect that CCBs would prevent HF. However, evidence suggests that CCBs confer less protection from HF than other first-line antihypertensive drugs. A negative inotropic action of nondihydropyridine CCBs may contribute to suboptimal protection against HF. This discrepancy is clinically relevant because CCBs are in one of the two recommended (single pill) combinations for the initial treatment of HTN. LVH is a strong risk factor for HF in HTN patients. When LVH arises, the risk of HF increases dramatically. CCBs are inferior to renin-angiotensin-aldosterone system blockers but still very effective in bringing about regression of HTN LVH; consequently, CCBs are expected to protect from HF. On the contrary, CCBs protect from HF less effectively than other first-line antihypertensive drugs. This discrepancy needs to be investigated further to improve clinical practice.
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Affiliation(s)
- Goran Koracevic
- Faculty of Medicine, University of Nis, Nis, Serbia
- Department for Cardiovascular Diseases, University Clinical Center Nis, Nis, Serbia
| | - Zoran Perisic
- Faculty of Medicine, University of Nis, Nis, Serbia
- Department for Cardiovascular Diseases, University Clinical Center Nis, Nis, Serbia
| | | | - Milovan Stojanovic
- Faculty of Medicine, University of Nis, Nis, Serbia
- Institute for Treatment and Rehabilitation Niska Banja, Nis, Serbia
- *Milovan Stojanovic,
| | | | - Miloje Tomasevic
- Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
- Clinic for Cardiology, Clinical Center of Serbia, Belgrade, Serbia
| | - Dragan Djordjevic
- Faculty of Medicine, University of Nis, Nis, Serbia
- Institute for Treatment and Rehabilitation Niska Banja, Nis, Serbia
| | - Katarina Mladenovic
- Faculty of Science, Department of Biology and Ecology, University of Kragujevac, Kragujevac, Serbia
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141
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Yang C, He Q, Chen Z, Qin JJ, Lei F, Liu YM, Liu W, Chen MM, Sun T, Zhu Q, Wu Y, Zhuo M, Cai J, Mao W, Li H. A Bidirectional Relationship Between Hyperuricemia and Metabolic Dysfunction-Associated Fatty Liver Disease. Front Endocrinol (Lausanne) 2022; 13:821689. [PMID: 35250880 PMCID: PMC8889101 DOI: 10.3389/fendo.2022.821689] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 01/21/2022] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND AND AIMS Metabolic dysfunction-associated fatty liver disease (MAFLD) is a newly emerged term that is suggested to better reflect the pathogenesis of nonalcoholic fatty liver disease (NAFLD); however, the association between hyperuricemia and MAFLD has not been explored in the Chinese population. Meantime, this study also examined the temporal relationship between the two entities in a longitudinal cohort. METHODS We conducted a retrospective cross-sectional study including 1,587,962 individuals from 19 health check-up centers in China from 2009-2017 and a longitudinal study with 16,112 individuals. A logistic regression model was applied to determine the association between hyperuricemia and MAFLD in a cross-sectional study. The Cox regression model was used to explore the association between hyperuricemia at baseline and subsequent onset of MAFLD or the association between the presence of MAFLD at baseline and the subsequent incidence of hyperuricemia. The cross-lagged analysis was applied to exam the temporal relationship between hyperuricemia and MAFLD. RESULTS In the cross-sectional study, hyperuricemia showed a strong positive association with MAFLD after controlled potential confounders. In the longitudinal cohorts, hyperuricemia at baseline was associated with the new-onset of MAFLD, with a hazard ratio (HR) of 1.765 (95% CI: 1.512, 2.060). Interestingly, baseline MAFLD was also associated with the subsequent incidence of hyperuricemia, with an HR of 1.245 (95% CI: 1.106, 1.400). The cross-lagged path analysis revealed a bidirectional relationship between hyperuricemia and MAFLD. CONCLUSIONS The results suggested that hyperuricemia and MAFLD form a vicious cycle, resulting in more deterioration of metabolic status.
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Affiliation(s)
- Chengzhang Yang
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China
- Institute of Model Animal, Wuhan University, Wuhan, China
| | - Qianjin He
- Department of Hepatobiliary Surgery, Huanggang Central Hospital, Huanggang, China
- Huanggang Institute of Translational Medicine, Huanggang Central Hospital, Huanggang, China
| | - Ze Chen
- Institute of Model Animal, Wuhan University, Wuhan, China
- Department of Cardiology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Juan-Juan Qin
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China
- Institute of Model Animal, Wuhan University, Wuhan, China
| | - Fang Lei
- Institute of Model Animal, Wuhan University, Wuhan, China
- School of Basic Medical Science, Wuhan University, Wuhan, China
| | - Ye-Mao Liu
- Institute of Model Animal, Wuhan University, Wuhan, China
- Department of Cardiology, Huanggang Central Hospital, Huanggang, China
| | - Weifang Liu
- Institute of Model Animal, Wuhan University, Wuhan, China
- School of Basic Medical Science, Wuhan University, Wuhan, China
| | - Ming-Ming Chen
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China
- Institute of Model Animal, Wuhan University, Wuhan, China
| | - Tao Sun
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China
- Institute of Model Animal, Wuhan University, Wuhan, China
| | - Qian Zhu
- Department of Pharmacy, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Yonglin Wu
- Department of Pharmacy, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Ming Zhuo
- Department of Anesthesiology, The First Affiliated Hospital of Gannan Medical College, Ganzhou, China
- First Clinical College, Medical College of Soochow University, Suzhou, China
| | - Jingjing Cai
- Institute of Model Animal, Wuhan University, Wuhan, China
- Department of Cardiology, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Weiming Mao
- Huanggang Institute of Translational Medicine, Huanggang Central Hospital, Huanggang, China
- Department of General Surgery, Huanggang Central Hospital, Huanggang, China
- *Correspondence: Hongliang Li, ; Weiming Mao,
| | - Hongliang Li
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China
- Institute of Model Animal, Wuhan University, Wuhan, China
- *Correspondence: Hongliang Li, ; Weiming Mao,
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142
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Wu H, Shi L, Lin Y, Zheng T. The Correlation Between ABPM Parameters and Left Ventricular Hypertrophy in Pediatric Essential Hypertension. Front Pediatr 2022; 10:896054. [PMID: 35722487 PMCID: PMC9201109 DOI: 10.3389/fped.2022.896054] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 05/02/2022] [Indexed: 01/19/2023] Open
Abstract
OBJECTIVE To explore the association of dipping pattern and blood pressure load with left ventricular hypertrophy (LVH) in pediatric essential hypertension. MATERIALS AND METHODS Through an echocardiography monitor and an ambulatory blood pressure monitor of 425 children and adolescents diagnosed with essential hypertension with no treatment received, we identified 140 cases of LVH. Grouping patients according to LVH (LVH, N = 140; n-LVH, N = 285), we further evaluated their ambulatory blood pressure monitoring (ABPM) parameters by comparing dipping patterns between groups. A multivariable logistic regression analysis was used to determine the effect of blood pressure load on LVH. RESULTS No significant difference was found in systolic or diastolic blood pressure dipping patterns between groups (P = 0.161, P = 0.139). However, compared to the n-LVH group, the LVH group presented significant elevated nighttime systolic blood pressure (SBP) (P < 0.05), while nighttime DBP remained stable (P = 0.391), resulting in higher daytime and nighttime SBP loads, higher nighttime DBP load, and higher 24-h SBP load (P < 0.05). Notably, our multivariable logistic regression has shown that this trend of 24-h SBP load acts independently as a critical risk factor for LVH. CONCLUSION Collectively, we observed a correlation between BP load and LVH in pediatric hypertension. Our data demonstrated that SBP load has a more significant weight in LVH progression, and 24-h SBP load, in particular, acts as a critical early prognostic parameter for LVH in pediatric hypertension.
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Affiliation(s)
- Haojie Wu
- Capital Institute of Pediatrics, Beijing, China.,Department of Cardiology, Children's Hospital, Capital Institute of Pediatrics, Beijing, China
| | - Lin Shi
- Capital Institute of Pediatrics, Beijing, China.,Department of Cardiology, Children's Hospital, Capital Institute of Pediatrics, Beijing, China
| | - Yao Lin
- Department of Cardiology, Children's Hospital, Capital Institute of Pediatrics, Beijing, China
| | - Tong Zheng
- Department of Cardiology, Children's Hospital, Capital Institute of Pediatrics, Beijing, China
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143
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Xie Y, Qi H, Li B, Wen F, Zhang F, Guo C, Zhang L. Serum lipoprotein (a) associates with the risk of renal function damage in the CHCN-BTH Study: Cross-sectional and Mendelian randomization analyses. Front Endocrinol (Lausanne) 2022; 13:1023919. [PMID: 36506069 PMCID: PMC9727385 DOI: 10.3389/fendo.2022.1023919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Accepted: 10/28/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Evidence regarding the effects of lipoprotein (a) [lp(a)] and renal function remains unclear. The present study aimed to explore the causal association of serum lp(a) with renal function damage in Chinese general adults. METHODS A total of 25343 individuals with available lp(a) data were selected from the baseline survey of the Cohort Study on Chronic Disease of Communities Natural Population in Beijing, Tianjin, and Hebei (CHCN-BTH). Five renal function indexes [estimated glomerular filtration rate (eGFR), serum creatinine (Scr), blood urea nitrogen (BUN), uric acid (UA), high-sensitivity C-reactive protein(CRPHS)] were analyzed. The restricted cubic spline (RCS) method, logistic regression, and linear regression were used to test the dose-response association between lp(a) and renal function. Stratified analyses related to demographic characteristics and disease status were performed. Two-sample Mendelian randomization (MR) analysis was used to obtain the causal association of lp(a) and renal function indexes. Genotyping was accomplished by MassARRAY System. RESULTS Lp(a) levels were independently associated with four renal function indexes (eGFR, Scr, BUN, CRPHS). Individuals with a higher lp(a) level had a lower eGFR level, and the association with Scr estimated GFR was stronger in individuals with a lower lp(a) level (under 14 mg/dL). . The association was similar in individuals regardless of diabetes or hypertension. MR analysis confirmed the causal association of two renal function indexes (Scr and BUN). For MR analysis, each one unit higher lp(a) was associated with 7.4% higher Scr (P=0.031) in the inverse-variance weighted method. But a causal effect of genetically increased lp(a) level with increased eGFR level which contrasted with our observational results was observed. CONCLUSION The observational and causal effect of lp(a) on Scr and BUN were founded, suggesting the role of lp(a) on the risk of renal function damage in general Chinese adults.
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144
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Chen S, Song X, Shi H, Li J, Ma S, Chen L, Lu Y, Hong C, Zhu H, Sun H, Zhang M. Association Between Sleep Quality and Hypertension in Chinese Adults: A Cross-Sectional Analysis in the Tianning Cohort. Nat Sci Sleep 2022; 14:2097-2105. [PMID: 36466133 PMCID: PMC9717590 DOI: 10.2147/nss.s388535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 11/15/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Poor sleep quality is becoming very common in a developed society and relates to many health disorders. However, the association between sleep quality and hypertension has not been well studied in Chinese adults. METHODS Blood pressure was measured and sleep quality was assessed by the Pittsburgh Sleep Quality Index (PSQI) for 5167 participants (mean aged 51±15 years, 41.5% males) in the Tianning Cohort. A logistic regression model was constructed to examine the association between sleep quality, as well as its components, and hypertension, adjusting for age, sex, education level, current smoking, current drinking, physical activity, obesity, glucose, and blood lipids. RESULTS After multivariate adjustment, a higher score Of the PSQI was significantly associated with an increased risk of prevalent hypertension (OR=1.03, P=0.018). Compared to participants with normal sleep (the PSQI score <5), those with a poor sleep quality (the PSQI score ≥5) had a 17% increased risk of prevalent hypertension (OR=1.17, P=0.042). Three of the seven components of sleep quality, such as subjective sleep quality (OR=1.17, P=0.001), sleep latency (OR=1.11, P=0.010), and sleep disturbances (OR=1.19, P=0.004), were also significantly associated with prevalent hypertension. CONCLUSION Poor sleep quality is increasingly prevalent in developed societies and may be related to an increased risk of hypertension in Chinese adults. The underlying causality is waiting to be studied.
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Affiliation(s)
- Shi Chen
- Department of Nursing, School of Nursing, Suzhou Vocational Health College, Suzhou, People's Republic of China
| | - Xugui Song
- Shishan Community Health Service Center, Suzhou, People's Republic of China
| | - Hongfei Shi
- Center for Disease Prevention and Control of Tianning District, Changzhou, People's Republic of China
| | - Jing Li
- Department of Epidemiology, School of Public Health, Medical College of Soochow University, Suzhou, People's Republic of China
| | - Shengqi Ma
- Department of Epidemiology, School of Public Health, Medical College of Soochow University, Suzhou, People's Republic of China
| | - Linan Chen
- Department of Epidemiology, School of Public Health, Medical College of Soochow University, Suzhou, People's Republic of China
| | - Ying Lu
- Department of Epidemiology, School of Public Health, Medical College of Soochow University, Suzhou, People's Republic of China
| | - Conglin Hong
- Department of Epidemiology, School of Public Health, Medical College of Soochow University, Suzhou, People's Republic of China
| | - Hanyun Zhu
- Department of Epidemiology, School of Public Health, Medical College of Soochow University, Suzhou, People's Republic of China
| | - Hongyan Sun
- Center for Disease Prevention and Control of Tianning District, Changzhou, People's Republic of China
| | - Mingzhi Zhang
- Department of Biostatistics, School of Public Health, Medical College of Soochow University, Suzhou, People's Republic of China
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Chen MM, Huang X, Xu C, Song XH, Liu YM, Yao D, Lu H, Wang G, Zhang GL, Chen Z, Sun T, Yang C, Lei F, Qin JJ, Ji YX, Zhang P, Zhang XJ, Zhu L, Cai J, Wan F, She ZG, Li H. High Remnant Cholesterol Level Potentiates the Development of Hypertension. Front Endocrinol (Lausanne) 2022; 13:830347. [PMID: 35222285 PMCID: PMC8863865 DOI: 10.3389/fendo.2022.830347] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 01/11/2022] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND Emerging evidence suggests an association between remnant cholesterol (RC) and vascular damage and hypertension. However, this association has not been explored in a large-scale population in China, and a temporal relationship between RC and hypertension also needs to be investigated. METHODS We conducted a retrospective cross-sectional study in 2,199,366 individuals and a longitudinal study in 24,252 individuals with repeated measurements of lipid profile and blood pressure in at least a 3-year follow-up. The logistic model was used to explore the association between lipid components and hypertension in the cross-sectional analysis. The Cox model was used to analyze the association between high RC (HRC) at baseline and the subsequent incidence of hypertension or the association between hypertension at baseline and incidence of HRC. The cross-lagged panel model was applied to analyze the temporal relationship between RC and hypertension. RESULTS RC level as a continuous variable had the highest correlation with hypertension among lipid profiles, including RC, low-density lipoprotein cholesterol, total cholesterol, non-high-density lipoprotein cholesterol, and triglycerides, with an odds ratio of 1.59 (95% confidence interval: 1.58-1.59). In the longitudinal cohort, HRC at baseline was associated with incident hypertension. We further explored the temporal relationship between RC and hypertension using the cross-lagged analysis, and the results showed that RC increase preceded the development of hypertension, rather than vice versa. CONCLUSIONS RC had an unexpected high correlation with the prevalence and incidence of hypertension. Moreover, RC increase might precede the development of hypertension, suggesting the potential role of RC in the development of hypertension.
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Affiliation(s)
- Ming-Ming Chen
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Xuewei Huang
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Chengsheng Xu
- Department of Cardiology, Huanggang Central Hospital, Huanggang, China
| | - Xiao-Hui Song
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China
- Institute of Model Animal, Wuhan University, Wuhan, China
| | - Ye-Mao Liu
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China
- Institute of Model Animal, Wuhan University, Wuhan, China
| | - Dongai Yao
- Physical Examination Center, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Huiming Lu
- General Medical Department, China Resource and WireCo Wire Rope Co (CR & WISCO) General Hospital, Wuhan, China
| | - Gang Wang
- Basic Medical Laboratory, General Hospital of Central Theater Command, Wuhan, China
| | - Gui-Lan Zhang
- Physical Examination Center, Xiaogan Central Hospital, Xiaogan, China
| | - Ze Chen
- Institute of Model Animal, Wuhan University, Wuhan, China
- Department of Cardiology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Tao Sun
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China
- Institute of Model Animal, Wuhan University, Wuhan, China
| | - Chengzhang Yang
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China
- Institute of Model Animal, Wuhan University, Wuhan, China
| | - Fang Lei
- Institute of Model Animal, Wuhan University, Wuhan, China
| | - Juan-Juan Qin
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China
- Institute of Model Animal, Wuhan University, Wuhan, China
| | - Yan-Xiao Ji
- Institute of Model Animal, Wuhan University, Wuhan, China
- Medical Science Research Center, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Peng Zhang
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China
- Institute of Model Animal, Wuhan University, Wuhan, China
- School of Basic Medical Science, Wuhan University, Wuhan, China
| | - Xiao-Jing Zhang
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China
- Institute of Model Animal, Wuhan University, Wuhan, China
- School of Basic Medical Science, Wuhan University, Wuhan, China
| | - Lihua Zhu
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China
- Institute of Model Animal, Wuhan University, Wuhan, China
| | - Jingjing Cai
- Institute of Model Animal, Wuhan University, Wuhan, China
- Department of Cardiology, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Feng Wan
- Department of Neurology, Huanggang Central Hospital, Huanggang, China
- Huanggang Institute of Translational Medicine, Huanggang, China
- *Correspondence: Feng Wan, ; Zhi-Gang She, ; Hongliang Li,
| | - Zhi-Gang She
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China
- Institute of Model Animal, Wuhan University, Wuhan, China
- *Correspondence: Feng Wan, ; Zhi-Gang She, ; Hongliang Li,
| | - Hongliang Li
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China
- Institute of Model Animal, Wuhan University, Wuhan, China
- Medical Science Research Center, Zhongnan Hospital of Wuhan University, Wuhan, China
- Huanggang Institute of Translational Medicine, Huanggang, China
- *Correspondence: Feng Wan, ; Zhi-Gang She, ; Hongliang Li,
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146
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Hu J, Ding Z, Han D, Hai B, Lv H, Yin J, Shen H, Gu A, Yang H. Prevalence of hypertension and related risk factors among children and adolescents at three separate visits: A large school-based study in China. Front Pediatr 2022; 10:976317. [PMID: 36210942 PMCID: PMC9537608 DOI: 10.3389/fped.2022.976317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 08/29/2022] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE We aimed to demonstrate characteristics of hypertension at three separate visits and its risk factors among children and adolescents based on a large school-based study in China. MATERIALS AND METHODS Based on a large-scale ongoing monitoring program conducted in Suzhou, China, 59,679 children and adolescents aged 7-17 years from 60 public schools were enrolled during 2020 to 2021. Height, weight, and blood pressure (BP) were measured. Additional BP would be measured for hypertensive students at least 2 weeks later. Confirmed hypertension was defined as simultaneously BP meeting above or equal to 95th percentile for age, sex, and height at three separate visits. Odds ratio (ORs), and 95% CIs were calculated by logistic regression to identify risk factors for hypertension. RESULTS Prevalence of hypertension at three separate visits were 20.4, 6.3, and 3.1%, respectively. Prevalence of confirmed isolated systolic hypertension, isolated diastolic hypertension, and systolic and diastolic hypertension were 1.9, 0.3, and 0.9%, respectively. Hypertension prevalence for stages 1 and 2 were 2.6 and 0.6%. Different hypertension prevalence were found among various age and gender groups. Boys [OR, 1.137 (95% CI, 1.033-1.251)], high age [OR, 3.326 (95% CI, 2.950-3.751)], urban residents [OR, 1.579 (95% CI, 1.417-1.760)], high-socioeconomic status [OR, 1.156 (95% CI, 1.039-1.286)] and body mass index category including overweight [1.883 (95% CI, 1.665-2.129)], obesity [4.049 (95% CI, 3.625-4.523)], and thinness [OR, 0.457 (95% CI, 0.306-0.683)] were associated with confirmed hypertension. CONCLUSION A single BP measurement would overestimate hypertension prevalence, about 3% Chinese children were hypertensive, early, and effective intervention around risk factors for hypertension should be taken.
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Affiliation(s)
- Jia Hu
- State Key Laboratory of Reproductive Medicine, School of Public Health, Nanjing Medical University, Nanjing, China.,Suzhou Institute of Advanced Study in Public Health, Gusu School, Nanjing Medical University, Suzhou, China.,Suzhou Center for Disease Prevention and Control, Suzhou, China
| | - Ziyao Ding
- Suzhou Center for Disease Prevention and Control, Suzhou, China.,Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China
| | - Di Han
- Suzhou Center for Disease Prevention and Control, Suzhou, China
| | - Bo Hai
- Suzhou Center for Disease Prevention and Control, Suzhou, China
| | - Huiling Lv
- State Key Laboratory of Reproductive Medicine, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Jieyun Yin
- Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Hui Shen
- Suzhou Institute of Advanced Study in Public Health, Gusu School, Nanjing Medical University, Suzhou, China.,Suzhou Center for Disease Prevention and Control, Suzhou, China
| | - Aihua Gu
- State Key Laboratory of Reproductive Medicine, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Haibing Yang
- State Key Laboratory of Reproductive Medicine, School of Public Health, Nanjing Medical University, Nanjing, China.,Suzhou Institute of Advanced Study in Public Health, Gusu School, Nanjing Medical University, Suzhou, China.,Suzhou Center for Disease Prevention and Control, Suzhou, China
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147
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Zhang H, Chen Y, Zheng T, Zhang M, Li X, Shi L. Factors Affecting the Exercise Capacity in Pediatric Primary Hypertension. Front Pediatr 2022; 10:882223. [PMID: 35692974 PMCID: PMC9174901 DOI: 10.3389/fped.2022.882223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 04/28/2022] [Indexed: 11/18/2022] Open
Abstract
PURPOSE Exercise training is crucial to the early intervention of pediatric primary hypertension (PHT). However, much less is known about exercise capacity in this disease. This work investigated the exercise capacity in pediatric PHT and analyzed the factors affecting exercise capacity. METHODS The study enrolled children with PHT at the Children's Hospital Capital Institute of Pediatrics between July 2017 and July 2020. The Bruce protocol of the treadmill exercise test (TET) was used to assess exercise capacity. Multivariate ordinal logistic regression and generalized linear models were used to analyze factors affecting exercise capacity. RESULTS Of 190 patients, 146 (76.8%) were male, and the median age was 13 (11, 14). Most children accomplished TET and achieved the submaximal heart rates (189 [99.5%]). Children with lower resting diastolic blood pressure (DBP) and 24 h average diastolic blood pressure (ADBP) could achieve a TET stage of 6 or more, whereas children with higher DBP and ADBP could only achieve a TET stage of 3 (P all < 0.05). Children with lower DBP and 24 h ADBP were also associated with greater metabolic equivalents (METs; r = -0.237, r = -0.179, P all < 0.05). The completion of TET stages was negatively associated with female (OR = 0.163), younger age (OR = 1.198), greater body mass index (BMI, OR = 0.921), and higher 24 h ADBP (OR = 0.952, P all < 0.05). In addition, METs were negatively associated with female (β = -1.909), younger age (β = 0.282), greater BMI (β = -0.134), and higher 24 h ADBP (β = -0.063, P all < 0.05). CONCLUSIONS Exercise capacity was impaired among pediatric PHT patients. Female gender, younger age, greater BMI, and higher 24 h ADBP are independently associated with the exercise capacity in pediatric PHT. These findings may help developing scientific exercise prescriptions for pediatric PHT.
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Affiliation(s)
- Hui Zhang
- Department of Cardiovascular Medicine, Children's Hospital Capital Institute of Pediatrics, Peking Union Medical College Graduate School, Beijing, China
| | - Yeshi Chen
- Capital Institute of Pediatrics-Peking University Teaching Hospital, Beijing, China
| | - Tong Zheng
- Department of Cardiovascular Medicine, Children's Hospital Capital Institute of Pediatrics, Beijing, China
| | - Mingming Zhang
- Department of Cardiovascular Medicine, Children's Hospital Capital Institute of Pediatrics, Beijing, China
| | - Xiaohui Li
- Department of Cardiovascular Medicine, Children's Hospital Capital Institute of Pediatrics, Peking Union Medical College Graduate School, Beijing, China.,Capital Institute of Pediatrics-Peking University Teaching Hospital, Beijing, China.,Department of Cardiovascular Medicine, Children's Hospital Capital Institute of Pediatrics, Beijing, China
| | - Lin Shi
- Department of Cardiovascular Medicine, Children's Hospital Capital Institute of Pediatrics, Beijing, China
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Song Q, Liu S, Ling QH, Gao QN, Yang RX, Chen SH, Wu S, Chen ML, Cai J. Severity of Nonalcoholic Fatty Liver Disease is Associated With Cardiovascular Outcomes in Patients With Prehypertension or Hypertension: A Community-Based Cohort Study. Front Endocrinol (Lausanne) 2022; 13:942647. [PMID: 36093080 PMCID: PMC9453754 DOI: 10.3389/fendo.2022.942647] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 06/15/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND It is unclear whether more severe non-alcoholic fatty liver disease (NAFLD) combined with prehypertension or hypertension is associated with a higher risk of cardiovascular events (CVEs). To evaluate the relationship between the severity of NAFLD and CVEs among patients with prehypertension or hypertension. METHODS In this prospective community-based Kailuan cohort, participants without cardiovascular disease and alcohol abuse, or other liver diseases were enrolled. NAFLD was diagnosed by abdominal ultrasonography. Prehypertension was defined as systolic blood pressure (BP) of 120-139 mmHg or diastolic BP of 80-89 mmHg. Participants with NAFLD were divided into mild, moderate, and severe subgroups. Follow-up for CVEs including myocardial infarction, hemorrhagic stroke, and ischemic stroke. The Cox proportional hazards model was used to estimate hazard ratios and 95% CIs of CVEs according to the severity of NAFLD and hypertensive statutes. The C-statistic was used to evaluate the efficiency of models. RESULTS A total of 71926 participants (mean [SD] age, 51.83 [12.72] years, 53794 [74.79%] men, and 18132 [25.21%] women) were enrolled in this study, 6,045 CVEs occurred during a median of 13.02 (0.65) years of follow-up. Compared with participants without NAFLD, the hazard ratios of CVEs for patients with mild, moderate, and severe NAFLD were 1.143 (95% CI 1.071-1.221, P < 0.001), 1.218 (95% CI 1.071-1.221, P < 0.001), and 1.367 (95% CI 1.172-1.595, P < 0.001), respectively. Moreover, participants with prehypertension plus moderate/severe NAFLD and those with hypertension plus moderate/severe NAFLD had 1.558-fold (95% CI 1.293-1.877, P < 0.001) and 2.357-fold (95% CI 2.063-2.691, P < 0.001) higher risks of CVEs, respectively, compared with those with normal BP and no NAFLD. Adding a combination of NAFLD and BP status to the crude Cox model increased the C-statistic by 0.0130 (0.0115-0.0158, P < 0.001). CONCLUSIONS Our findings indicated that the increased cardiovascular risk with elevated BP is largely driven by the coexistence of moderate/severe NAFLD, suggesting that the severity of NAFLD may help further stratify patients with prehypertension and hypertension.
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Affiliation(s)
- Qi–Rui Song
- State Key Laboratory of Cardiovascular Disease of China, Hypertension Center, Fuwai Hospital, National Center for Cardiovascular Diseases of China, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Shuo–Lin Liu
- Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai, China
| | - Qian-Hui Ling
- State Key Laboratory of Cardiovascular Disease of China, Hypertension Center, Fuwai Hospital, National Center for Cardiovascular Diseases of China, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Qian-Nan Gao
- State Key Laboratory of Cardiovascular Disease of China, Hypertension Center, Fuwai Hospital, National Center for Cardiovascular Diseases of China, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Rui-Xue Yang
- State Key Laboratory of Cardiovascular Disease of China, Hypertension Center, Fuwai Hospital, National Center for Cardiovascular Diseases of China, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Shuo-Hua Chen
- Department of Cardiology, Kailuan General Hospital, Tangshan, China
| | - Shou–Ling Wu
- Department of Cardiology, Kailuan General Hospital, Tangshan, China
- *Correspondence: Shou–Ling Wu, ; Mu-Lei Chen, ; Jun Cai,
| | - Mu-Lei Chen
- Heart Center and Beijing Key Laboratory of Hypertension, Department of Cardiology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
- *Correspondence: Shou–Ling Wu, ; Mu-Lei Chen, ; Jun Cai,
| | - Jun Cai
- State Key Laboratory of Cardiovascular Disease of China, Hypertension Center, Fuwai Hospital, National Center for Cardiovascular Diseases of China, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- *Correspondence: Shou–Ling Wu, ; Mu-Lei Chen, ; Jun Cai,
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149
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Yao T, Lu W, Ke J, Zhang H, Zhao X, Song B, Liu T, Ke Q, Liu C. Residual Risk of Coronary Atherosclerotic Heart Disease and Severity of Coronary Atherosclerosis Assessed by ApoB and LDL-C in Participants With Statin Treatment: A Retrospective Cohort Study. Front Endocrinol (Lausanne) 2022; 13:865863. [PMID: 35573992 PMCID: PMC9097510 DOI: 10.3389/fendo.2022.865863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Accepted: 03/08/2022] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Low-density lipoprotein cholesterol (LDL-C) is the primary target of lipid-lowering therapy on the management of hypercholesterolemia in the United States and European guidelines, while apolipoprotein B (apoB) is the secondary target. The objective was to determine if elevated levels of apoB is superior to LDL-C in assessing residual risk of coronary atherosclerotic heart disease and severity of coronary atherosclerosis in participants with statin treatment. METHODS This study included 131 participants with statin treatment. The generalized linear model and relative risk regression (generalized linear Poisson model with robust error variance) were used to analyze the association of the levels of apoB and LDL-C with the severity of coronary atherosclerosis and residual risk of coronary atherosclerotic heart disease. RESULTS Categorizing apoB and LDL-C based on tertiles, higher levels of apoB were significantly associated with the severity of coronary atherosclerosis (Ptrend = 0.012), whereas no such associations were found for elevated levels of LDL-C (Ptrend = 0.585). After multivariate adjustment, higher levels of apoB were significantly associated with residual risk of coronary atherosclerotic heart disease. When compared with low-level apoB (≤0.66 g/L), the multivariate adjusted RR and 95% CI of intermediate-level apoB (0.67-0.89 g/L) and high-level apoB (≥0.90 g/L) were 1.16 (1.01, 1.33) and 1.31 (1.08, 1.60), respectively (Ptrend = 0.011). There was a 45% increased residual risk of coronary atherosclerotic heart disease per unit increment in natural log-transformed apoB (Ptrend <0.05). However, higher levels of LDL-C were not significantly associated with residual risk of coronary atherosclerotic heart disease. When compared with low-level LDL-C (≤1.56 mmol/L), the multivariate adjusted RR and 95% CI of intermediate-level LDL-C (1.57-2.30 mmol/L) and high-level LDL-C (≥2.31 mmol/L) were 0.99 (0.84, 1.15) and 1.10 (0.86, 1.42), respectively (Ptrend = 0.437). Similar results were observed in the stratified analyses and sensitivity analyses. No significant interactions were detected for both apoB and LDL-C (all Pinteraction>0.05). CONCLUSIONS Elevated apoB are superior in assessing the residual risk of coronary atherosclerotic heart disease and severity of coronary atherosclerosis in participants with statin treatment.
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Affiliation(s)
- Tianci Yao
- Department of Geriatrics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Weilin Lu
- Department of Geriatrics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jinshan Ke
- Department of Clinical Laboratory, Shanghai Hudong Hospital, Shanghai, China
| | - Hao Zhang
- Department of Geriatrics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiaofang Zhao
- Department of Geriatrics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Bei Song
- Department of Geriatrics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ting Liu
- Department of Geriatrics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Qinmei Ke
- Department of Geriatrics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- *Correspondence: Qinmei Ke, ; Chengyun Liu,
| | - Chengyun Liu
- Department of Geriatrics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- *Correspondence: Qinmei Ke, ; Chengyun Liu,
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150
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Zhang R, Guan Q, Zhang M, Ding Y, Tang Z, Wang H, Zhang W, Chen Y, Jiang R, Cui Y, Wang J. Association Between Triglyceride-Glucose Index and Risk of Metabolic Dysfunction-Associated Fatty Liver Disease: A Cohort Study. Diabetes Metab Syndr Obes 2022; 15:3167-3179. [PMID: 36268197 PMCID: PMC9578360 DOI: 10.2147/dmso.s383907] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 10/07/2022] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE Insulin resistance (IR) is a major factor involved in the pathogenesis of metabolic dysfunction-associated fatty liver disease (MAFLD). Triglyceride-glucose (TyG) index, an easily detected surrogate marker of IR, has not been explored sufficiently on its relationship with incident MAFLD risk. This study sought to investigate the association of baseline TyG index with the risk of MAFLD in a Chinese cohort. METHODS This health check-up cohort was constructed with eligible 2056 Chinese from a community. The TyG index was calculated as ln (fasting triglyceride [mg/dL]×fasting glucose [mg/dL]/2). Cox proportion hazard models were used to evaluate the longitudinal association between baseline TyG index and the risk of MAFLD. RESULTS During an average follow-up of 2.5 ± 0.5 years, about 12.8% of the subjects developed MAFLD, and the incidence of MAFLD trended to increase with the quartile TyG index (P trend < 0.05). After adjusting for all confounders, TyG index was independently correlated with the risk of incident MAFLD (HR = 1.784, 95% CI = 1.383-2.302, P < 0.001), and the risk of MAFLD in the highest quartile of TyG index was two times higher than that in the lowest quartile (95% CI = 1.377-2.992, P = 0.001). The restricted cubic spline analysis showed that the relationship between TyG index and the risk of MAFLD was linear in males (P for total < 0.001; P for non-linearity = 0.746), but nonlinear in females (P for non-linearity = 0.040). CONCLUSION A high baseline TyG index was independently associated with a high risk of incident MAFLD, and we might develop the strategy of MAFLD prevention based on the TyG index.
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Affiliation(s)
- Ru Zhang
- School of Nursing, Nanjing Medical University, Nanjing, People’s Republic of China
| | - Qing Guan
- School of Nursing, Nanjing Medical University, Nanjing, People’s Republic of China
| | - Mengting Zhang
- School of Nursing, Nanjing Medical University, Nanjing, People’s Republic of China
| | - Yajie Ding
- School of Nursing, Nanjing Medical University, Nanjing, People’s Republic of China
| | - Zongzhe Tang
- School of Nursing, Nanjing Medical University, Nanjing, People’s Republic of China
| | - Hongliang Wang
- Department of General Practice, Community Health Service Center, Nanjing, People’s Republic of China
| | - Wei Zhang
- Department of Epidemiology, Shanghai Cancer Institute, Shanghai, People’s Republic of China
| | - Yue Chen
- School of Nursing, Nanjing Medical University, Nanjing, People’s Republic of China
| | - Rong Jiang
- School of Nursing, Nanjing Medical University, Nanjing, People’s Republic of China
| | - Yan Cui
- School of Nursing, Nanjing Medical University, Nanjing, People’s Republic of China
| | - Jie Wang
- School of Nursing, Nanjing Medical University, Nanjing, People’s Republic of China
- Correspondence: Jie Wang; Yan Cui, School of Nursing, Nanjing Medical University, 101 Longmian Avenue, Jiangning District, Nanjing, Jiangsu, 211166, People’s Republic of China, Tel +86-25-86869557, Email ;
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