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Liu X, Ding X, Zhang F, Chen L, Luo Q, Xiao M, Liu X, Wu Y, Tang W, Qiu J, Tang X. Association between alcohol consumption and risk of stroke among adults: results from a prospective cohort study in Chongqing, China. BMC Public Health 2023; 23:1593. [PMID: 37608319 PMCID: PMC10464090 DOI: 10.1186/s12889-023-16361-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Accepted: 07/20/2023] [Indexed: 08/24/2023] Open
Abstract
BACKGROUND The incidence of stroke in China is increasing, along with a clear trend in the prevalence of risk factors. Alcohol consumption is also a risk factor for stroke. Many cohort studies have explored the relationship between alcohol consumption and stroke risk. However, findings have been inconsistent. METHODS We used cluster sampling to select 13 districts and counties (at the same level) in Chongqing, China. Then, we used stratified random sampling to distribute the number of people in each district and county. 23,308 adults aged 30-79 were recruited between October 2018 and February 2019. Follow-up was conducted through a monitoring system and questionnaires until September 2022. Information on alcohol consumption and other covariates was collected using a standardized questionnaire. Participants were asked to report their weekly frequency of drinking over the past year and weekly intake of various alcoholic beverages in general. The frequency of drinking was divided into three categories: 1-2 d/week, 3-5 d/week, and 6-7 d/week. The average daily alcohol consumption is calculated based on the amount of alcohol contained in different alcoholic beverages. It is classified as nondrinker (0 g/day), light (0 to 12 g/day), moderate (13 to 36 g/day), and high (> 36 g/day). Cox proportional hazard regression models were used to estimate the association between alcohol consumption and stroke risk. Results are shown as multivariate-adjusted hazard ratios (HRs) and 95% confidence intervals (95% CIs). RESULTS With an average follow-up of 3.80 years, there were 310 new stroke events. The incidence of total stroke was 368.69 per 100,000 person-years. Overall, after adjusting for covariates, moderate alcohol consumption (average daily alcohol consumption 13-36 g/d) was associated with a lower risk of total stroke (HR: 0.48; 95% CI: 0.25-0.92) compared with nondrinkers. The adjusted HR and 95% CI for total stroke and ischemic stroke for those who drank alcohol 6-7 days per week were 0.60(0.37, 0.96) and 0.53(0.30, 0.94), respectively. The risk of total stroke (HR: 0.39; 95% CI: 0.17-0.89) was reduced in a pattern of drinking 6-7 days per week but with a mean alcohol consumption of less than 36 g/d. There was no significant association between alcohol consumption and hemorrhagic stroke. CONCLUSION This study suggests moderate alcohol consumption is associated with a lower risk of total stroke. And healthy drinking patterns should be of more significant concern.
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Affiliation(s)
- Xin Liu
- School of Public Health, Research Center for Medical and Social Development, Chongqing Medical University, Chongqing, China
| | - Xianbin Ding
- Institute of Chronic Non-Communicable Disease Control and Prevention, Chongqing Center for Disease Control and Prevention, Chongqing, China
| | - Fan Zhang
- School of Public Health, Research Center for Medical and Social Development, Chongqing Medical University, Chongqing, China
| | - Liling Chen
- Institute of Chronic Non-Communicable Disease Control and Prevention, Chongqing Center for Disease Control and Prevention, Chongqing, China
| | - Qinwen Luo
- School of Public Health, Research Center for Medical and Social Development, Chongqing Medical University, Chongqing, China
| | - Meng Xiao
- School of Public Health, Research Center for Medical and Social Development, Chongqing Medical University, Chongqing, China
| | - Xiang Liu
- Department of Epidemiology and Health Statistics, West China School of Public Health, Sichuan University, Chengdu, China
| | - Yunyun Wu
- Institute of Chronic Non-Communicable Disease Control and Prevention, Chongqing Center for Disease Control and Prevention, Chongqing, China
| | - Wenge Tang
- Institute of Chronic Non-Communicable Disease Control and Prevention, Chongqing Center for Disease Control and Prevention, Chongqing, China
| | - Jingfu Qiu
- School of Public Health, Research Center for Medical and Social Development, Chongqing Medical University, Chongqing, China
| | - Xiaojun Tang
- School of Public Health, Research Center for Medical and Social Development, Chongqing Medical University, Chongqing, China.
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Tian DS, Liu CC, Wang CL, Qin C, Wang MH, Liu WH, Liu J, Zhang HW, Zhang RG, Wang SK, Zhang XX, Wang L, Pan DJ, Hu JP, Luo X, Xu SB, Wang W. Prevalence and risk factors of stroke in China: a national serial cross-sectional study from 2003 to 2018. Stroke Vasc Neurol 2023; 8:238-248. [PMID: 36418056 PMCID: PMC10359805 DOI: 10.1136/svn-2022-001598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 11/02/2022] [Indexed: 11/24/2022] Open
Abstract
Stroke imposes a substantial burden worldwide. With the rapid economic and lifestyle transition in China, trends of the prevalence of stroke across different geographic regions in China remain largely unknown. Capitalizing on the data in the National Health Services Surveys (NHSS), we assessed the prevalence and risk factors of stroke in China from 2003 to 2018. In this study, data from 2003, 2008, 2013, and 2018 NHSS were collected. Stroke cases were based on participants' self-report of a previous diagnosis by clinicians. We estimated the trends of stroke prevalence for the overall population and subgroups by age, sex, and socioeconomic factors, then compared across different geographic regions. We applied multivariable logistic regression to assess associations between stroke and risk factors. The number of participants aged 15 years or older were 154,077, 146,231, 230,067, and 212,318 in 2003, 2008, 2013, and 2018, respectively, among whom, 1435, 1996, 3781, and 6069 were stroke patients. The age and sex standardized prevalence per 100,000 individuals was 879 in 2003, 1100 in 2008, 1098 in 2013, and 1613 in 2018. Prevalence per 100,000 individuals in rural areas increased from 669 in 2003 to 1898 in 2018, while urban areas had a stable trend from 1261 in 2003 to 1365 in 2018. Across geographic regions, the central region consistently had the highest prevalence, but the western region has an alarmingly increasing trend from 623/100,000 in 2003 to 1898/100,000 in 2018 (P trend<0.001), surpassing the eastern region in 2013. Advanced age, male sex, rural area, central region, hypertension, diabetes, depression, low education and income level, retirement or unemployment, excessive physical activity, and unimproved sanitation facilities were significantly associated with stroke. In conclusion, the increasing prevalence of stroke in China was primarily driven by economically underdeveloped regions. It is important to develop targeted prevention programs in underdeveloped regions. Besides traditional risk factors, more attention should be paid to nontraditional risk factors to improve the prevention of stroke.
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Affiliation(s)
- Dai-Shi Tian
- Department of Neurology, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Chen-Chen Liu
- Department of Neurology, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Chao-Long Wang
- Department of Epidemiology and Biostatistics, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Chuan Qin
- Department of Neurology, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Ming-Huan Wang
- Department of Neurology, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Wen-Hua Liu
- Department of Scientific Research Management, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Jian Liu
- Department of Scientific Research Management, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Han-Wen Zhang
- Infervision Medical Technology Co., Ltd, Beijing, China
| | | | | | - Xiao-Xiang Zhang
- Department of Computer Center, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Liang Wang
- Department of Computer Center, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Deng-Ji Pan
- Department of Neurology, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Jian-Ping Hu
- Centre for Health Statistics Information, National Health Commission of the People's Republic of China, Beijing, China
| | - Xiang Luo
- Department of Neurology, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Sha-Bei Xu
- Department of Neurology, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Wei Wang
- Department of Neurology, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei, China
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Xiong S, Yin S, Deng W, Zhao Y, Li W, Wang P, Li Z, Yang H, Zhou Y, Yu S, Guo X, Sun Y. Predictive value of liver fibrosis scores in cardiovascular diseases among hypertensive population. J Hypertens 2023; 41:741-750. [PMID: 36883472 PMCID: PMC10090336 DOI: 10.1097/hjh.0000000000003394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 12/27/2022] [Accepted: 01/21/2023] [Indexed: 03/09/2023]
Abstract
PURPOSE To explore the predictive value of liver fibrosis scores [fibrosis-4, AST/platelet ratio index, BAAT score (BMI Age ALT TG), and BARD score (BMI AST/ALT Ratio Diabetes)] for the risk of cardiovascular disease (CVD) in a hypertensive population. METHODS A total of 4164 hypertensive participants without history of CVD were enrolled in the follow-up. Four liver fibrosis scores (LFSs) were used, including the fibrosis-4 (FIB-4), APRI, BAAT score, and BARD score. The endpoint was CVD incidence which was defined as stroke or coronary heart disease (CHD) during the follow-up period. Cox regression analyses were used to calculate hazard ratios between LFSs and CVD. Kaplan-Meier curve was used to show the probability of CVD in different levels of LFSs. Restricted cubic spline further explored whether the relationship between LFSs and CVD was linear. Finally, we assessed the discriminatory ability of each LFS for CVD was assessed using C -statistics, net reclassification index (NRI), and integrated discrimination improvement (IDI). RESULTS During a median follow-up time of 4.66 years, 282 hypertensive participants had CVD. Kaplan-Meier curve showed that four LFSs were associated with CVD and high levels of LFSs significantly increase the probability of CVD in hypertensive population. In the multivariate Cox regression analysis, the adjusted hazard ratios for four LFSs were 3.13 in FIB-4, 1.66 in APRI, 1.47 in BAAT score, and 1.36 in BARD score. Moreover, after adding LFSs to original risk prediction model, we find that all four new models have higher C -statistics of CVD than the traditional model. Furthermore, the results of both NRI and IDI were positive, indicating that LFSs enhanced the effect on the prediction of CVD. CONCLUSIONS Our study showed that LFSs were associated with CVD in hypertensive populations in northeastern China. Furthermore, it suggested that LFSs could be a new tool for identifying patients at high risk of primary CVD in a hypertensive population.
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Affiliation(s)
- Shengjun Xiong
- Department of Cardiology, The First Hospital of China Medical University, Heping District, Shenyang, Liaoning Province, People Republic of China
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Xiaojie N, Bicheng C, Yongling L, Tingting H, Yi Z, Chen Z. Metabolic-Related Index to Predict Post-Transplantation Diabetes Mellitus After Kidney Transplantation. Horm Metab Res 2023; 55:343-354. [PMID: 37130537 DOI: 10.1055/a-2053-2688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Metabolic-related markers are novel tools for assessing insulin resistance. Early identification of post-transplantation diabetes mellitus (PTDM) before hyperglycemia can be helpful to attenuate the rapid development of diabetic complications. This article aims to explore the convenient and inexpensive values of metabolic-related markers, including TyG, TyG-BMI, TG/HDL-C, and non-HDL-C/HDL-C for predicting PTDM. The data of 191 kidney transplant recipients in our center were collected retrospectively. The association between TyG, TyG-BMI, TG/HDL-C, non-HDL-C/HDL-C and the risk of PTDM was examined by the area under the curve and logistic regression analyses. During 6 months follow-up, 12.04% of KT recipients developed PTDM, and significantly higher values of TyG-BMI, TyG, and non-HDL-C/HDL-C was found in patients with PTDM than in nondiabetic patients, especially among the recipients taking tacrolimus, regardless of gender. The incidence of PTDM increased along with the values of TyG or TyG-BMI. After adjusting for multiple potential factors, recipients with the highest trisector of TyG or TyG-BMI still had a higher risk of PTDM morbidity. In conclusion, TyG, TyG-BMI, TG/HDL-C and non-HDL-C/HDL-C can be used as cost-effective and promising monitors to identify individuals at high risk of PTDM, and TyG-BMI was the best alternative marker among the four markers.
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Affiliation(s)
- Ni Xiaojie
- Department of Urology (Renal Transplantation), Wenzhou Medical University First Affiliated Hospital, Wenzhou, China
| | - Chen Bicheng
- Key Laboratory of Diagnosis and Treatment of Severe Hepato-Pancreatic Diseases of Zhejiang Province, Wenzhou Medical University First Affiliated Hospital, Wenzhou, China
| | - Li Yongling
- Key Laboratory of Diagnosis and Treatment of Severe Hepato-Pancreatic Diseases of Zhejiang Province, Wenzhou Medical University First Affiliated Hospital, Wenzhou, China
| | - Huang Tingting
- Key Laboratory of Diagnosis and Treatment of Severe Hepato-Pancreatic Diseases of Zhejiang Province, Wenzhou Medical University First Affiliated Hospital, Wenzhou, China
| | - Zhou Yi
- Key Laboratory of Diagnosis and Treatment of Severe Hepato-Pancreatic Diseases of Zhejiang Province, Wenzhou Medical University First Affiliated Hospital, Wenzhou, China
| | - Zimiao Chen
- Department of Endocrine and Metabolic Diseases, Wenzhou Medical University First Affiliated Hospital, Wenzhou, China
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Kuczyńska J, Nieradko-Iwanicka B. Comparison of the effects of ketoprofen and ketoprofen lysine salt on the Wistar rats' nervous system, kidneys and liver after ethyl alcohol intoxication. Biomed Pharmacother 2023; 161:114456. [PMID: 36870283 DOI: 10.1016/j.biopha.2023.114456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 02/24/2023] [Accepted: 02/26/2023] [Indexed: 03/06/2023] Open
Abstract
Side effects of Ketoprofen and ketoprofen lysine salt (KLS) may be inter alia from the central nervous system, kidneys and liver. After binge drinking people often use ketoprofen, which increases the risk for the occurrence of side effects. The aim of the study was to compere effects of ketoprofen and KLS on the nervous system, kidneys and liver after ethyl alcohol intoxication. There were 6 groups of 6 male rats which received: ethanol; 0.9%NaCl; 0.9%NaCl and ketoprofen; ethanol and ketoprofen; 0.9%NaCl and KLS; ethanol and KLS. On day 2, the motor coordination test on a rotary rod and memory and motor activity test in the Y-maze were performed. Hot plate test was performed on day 6. After euthanasia brains, livers and kidneys were taken to histopathological tests. Motor coordination was significant worse in group 5 vs 1,3, p 0.05. Spontaneous motor activity of group 6 was significant better than that of groups 1,5. Pain tolerance of group 6 was significant worse than that of groups 1,4,5. Liver and kidney mass were significantly lower in group 6 vs group 3,5 and vs group 1,3, respectively. The histopathologic examination of the brains and kidneys revealed normal picture in all groups, without signs of inflammation. In the histopathologic examination of the livers in one animal in group 3 some of the specimens showed perivascular inflammation. After alcohol ketoprofen is a better painkiller than KLS. Spontaneous motor activity is better after KLS after alcohol. Both drugs have a similar effect on the kidneys and liver.
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Affiliation(s)
- Joanna Kuczyńska
- Department of Hygiene and Epidemiology, Medical University of Lublin, Chodźki 7 Street, 20-093 Lublin, Poland; Doctoral School, Medical University of Lublin, Poland.
| | - Barbara Nieradko-Iwanicka
- Department of Hygiene and Epidemiology, Medical University of Lublin, Chodźki 7 Street, 20-093 Lublin, Poland.
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Xiong S, Wang P, Yin S, Deng W, Zhao Y, Li W, Li Z, Zhou Y, Yu S, Yang H, Guo X, Sun Y. The association between liver fibrosis scores and chronic kidney disease. Front Med (Lausanne) 2023; 10:1046825. [PMID: 36793875 PMCID: PMC9922852 DOI: 10.3389/fmed.2023.1046825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Accepted: 01/03/2023] [Indexed: 01/31/2023] Open
Abstract
Purpose This study aimed to clarify the relationship between liver fibrosis scores (Fibrosis-4, BARD score, and BAAT score) and chronic kidney disease (CKD). Methods We collected a range of data from 11,503 subjects (5,326 men and 6,177 women) from the rural regions of Northeastern China. Three liver fibrosis scores (LFSs) including fibrosis-4 (FIB-4), BARD score, and BAAT score were adopted. A logistic regression analysis was used to calculate odds ratios and the 95% confidence interval. A subgroup analysis showed the association between LFSs and CKD under different stratifications. Restricted cubic spline could further explore whether there is a linear relationship between LFSs and CKD. Finally, we used C-statistics, Net Reclassification Index (NRI), and Integrated Discrimination Improvement (IDI) to assess the effect of each LFS on CKD. Results Through the baseline characteristics, we observed that LFSs were higher in the CKD population than in non-CKD. The proportion of participants with CKD also increased with LFSs. In a multivariate logistic regression analysis, the ORs of CKD were 6.71 (4.45-10.13) in FIB-4, 1.88 (1.29-2.75) in the BAAT score, and 1.72 (1.28-2.31) in the BARD score by comparing the high level with the low level in each LFSs. Moreover, after adding LFSs to the original risk prediction model, which consisted of age, sex, drinking, smoking, diabetes, low-density lipoprotein cholesterol, total cholesterol, triglycerides, and mean waist circumference, we found the new models have higher C-statistics. Furthermore, NRI and IDI both indicate LFSs had a positive effect on the model. Conclusions Our study showed that LFSs are associated with CKD among middle-aged populations in rural areas of northeastern China.
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Use of the Vascular Overload Index to Predict Cardiovascular Disease in a Rural Population of China. BIOMED RESEARCH INTERNATIONAL 2022; 2022:5289122. [PMID: 36567914 PMCID: PMC9771649 DOI: 10.1155/2022/5289122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 11/23/2022] [Accepted: 11/28/2022] [Indexed: 12/23/2022]
Abstract
Objective To explore the relationship between vascular overload index (VOI) and cardiovascular disease (CVD) in rural population and find effective ways to prevent cardiovascular disease in rural low-income populations. Methods The data for this study was obtained from a large cohort study called the Northeast China Rural Cardiovascular Health Study (NCRCHS) conducted in 2013 and followed up during 2015-2018. 10,174 subjects completed at least one follow-up visit. Cox regression equation was used to explore whether VOI and cardiovascular disease were independently related. The Kaplan-Meier curves were used to calculate the cumulative incidence of any adverse outcome, and the log-rank test and restrict mean survival analysis were used to compare group differences. Reclassification and discrimination statistics were used to determine whether VOI could strengthen the ability of the model to predict CVD events. Results The prevalence of CVD in the VOI quartiles was 1.92%, 3.96%, 5.42%, and 11.34% for Q1-Q4, respectively (P for trend <0.001). After adjusting for multiple confounders, there was a 2.466-fold increased risk of CVD when comparing the highest and lowest groups. Besides, this study found that for every standard deviation increase, the results still exist. The risk of cardiovascular disease increased by 1.358-fold in this model. The restrict mean survival analysis results show that with the increase of VOI, the restrict mean survival time (RMST) within 5 years gradually became shorter. Reclassification and discrimination statistics indicated that VOI significantly enhanced the ability to estimate CVD events within 4 years. Conclusion Analyses showed that VOI was significantly associated with CVD. VOI is a simple and accurate prognostic marker of CVD risk, which has the potential ability to improve the risk stratification of CVD.
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Predictive Value of the Age, Creatinine, and Ejection Fraction (ACEF) Score in Cardiovascular Disease among Middle-Aged Population. J Clin Med 2022; 11:jcm11226609. [PMID: 36431085 PMCID: PMC9692582 DOI: 10.3390/jcm11226609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 11/04/2022] [Accepted: 11/07/2022] [Indexed: 11/09/2022] Open
Abstract
PURPOSE To explore the predictive value of ACEF scores for identifying the risk of cardiovascular disease (CVD) in the general population. METHODS A total of 8613 participants without a history of CVD were enrolled in the follow-up. The endpoint was CVD incidence, defined as stroke or coronary heart disease (CHD) diagnosed during the follow-up period. Cox regression analyses were used to calculate hazard ratios (HRs) with respect to the age, creatinine, and ejection fraction (ACEF) scores and CVD. A Kaplan-Meier curve was used to analyze the probability of CVD in different quartiles of ACEF. Restricted cubic spline was used to further explore whether the relationship between ACEF and CVD was linear. Finally, we assessed the discriminatory ability of ACEF for CVD using C-statistics, net reclassification index, and integrated discrimination improvement (IDI). RESULTS During a median follow-up period of 4.66 years, 388 participants were diagnosed with CVD. The Kaplan-Meier curve showed that ACEF was associated with CVD, and participants with high ACEF scores were significantly more likely to be diagnosed with CVD compared to participants with low ACEF scores in the general population. In the multivariate Cox regression analysis, the adjusted HRs for four quartiles of ACEF were as follows: the first quartile was used as a reference; the second quartile: HR = 2.33; the third quartile: HR = 4.81; the fourth quartile: HR = 8.00. Moreover, after adding ACEF to the original risk prediction model, we observed that new models had higher C-statistic values of CVD than the traditional model. Furthermore, the results of both NRI and IDI were positive, indicating that ACEF enhanced the prediction of CVD. CONCLUSIONS Our study showed that the ACEF score was associated with CVD in the general population in northeastern China. Furthermore, ACEF could be a new tool for identifying patients at high risk of primary CVD in the general population.
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Abdu H, Seyoum G. Sex Differences in Stroke Risk Factors, Clinical Profiles, and In-Hospital Outcomes Among Stroke Patients Admitted to the Medical Ward of Dessie Comprehensive Specialized Hospital, Northeast Ethiopia. Degener Neurol Neuromuscul Dis 2022; 12:133-144. [PMID: 36304698 PMCID: PMC9595065 DOI: 10.2147/dnnd.s383564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 10/17/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND A stroke is a vascular accident that affects both men and women. The threat of stroke and outcome status differ between the sexes. Such data are lacking in Ethiopia. Therefore, this study assessed sex differences in stroke risk factors, clinical profiles, and outcomes in the medical ward of Dessie comprehensive specialized hospital. METHODS A retrospective cross-sectional study was employed among stroke patients. Medical records with complete information and a confirmed diagnosis of stroke using imaging techniques were included in the study. Using simple random sampling, 344 medical records were selected, 312 of which fulfilled the inclusion criteria. Bivariate and multivariate logistic regression analyses and a chi-square test were employed. The frequency, percentage, and mean and standard deviation of the variables were described using descriptive statistics. Findings with a P-value <0.05 were considered statistically significant. RESULTS Most of the patients were above or equal to 45 years old in both sexes. A significantly higher number of male than female patients were aged less than 45 years (p-value-0.001). Younger age (AOR: 2.998, p = 0.000), cigarette smoking (AOR: 2.911, p = 0.009), and Khat chewing (AOR: 3.650, p = 0.001) were risk factors for stroke in males. A higher number of males presented with hemiplegia/hemiparesis 89 (28.5%), aphasia 45 (14.4%), and facial palsy 19 (6.1%). However, more females were unconscious (15.1%). Significant differences were not seen in the stroke outcomes. Furthermore, there were no apparent differences in risk factors for stroke-related mortality. CONCLUSION Males developed stroke at a younger age. Women were older at the time of stroke onset and presented unconscious. More males experienced hemiplegia/hemiparesis, aphasia, and facial palsy. Smoking, drinking, and khat chewing were risk factors for stroke in men. There were no gender differences in the stroke death rate. Therefore, educating the public about stroke risk factors, lifestyle modification, and conducting prospective research is required.
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Affiliation(s)
- Hussen Abdu
- Department of Anatomy, School of Medicine, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia,Correspondence: Hussen Abdu, Department of Anatomy, School of Medicine, College of Medicine and Health Sciences, Wollo University, P.O. Box 1145, Dessie, Ethiopia, Tel +251-910916321, Email
| | - Girma Seyoum
- Department of Anatomy, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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Xing XY, Wang ZX, Cao YW, Wang XY, Zhang L, Chen YJ, Wang HD, Xu JQ, Niu MX, Liu ZR, Tao SS. The detection rate and influencing factors of high-risk groups of cardiovascular disease in Anhui, China: A cross-sectional study of 99,821 residents. Front Public Health 2022; 10:921038. [PMID: 36091546 PMCID: PMC9454339 DOI: 10.3389/fpubh.2022.921038] [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] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 08/11/2022] [Indexed: 01/22/2023] Open
Abstract
Objective To investigate the detection rate and influencing factors of high-risk population of cardiovascular disease in Anhui province. Methods From March 2017 to August 2019, the residents aged 35-75 years old were selected using the multi-stage stratified cluster sampling method in 8 counties and districts of Anhui Province, and questionnaire survey, anthropometric measurement, and collection of biological samples were carried out among them. Results A total of 99,821 residents in Anhui Province were finally investigated, and among them 21,426 residents were detected to be high-risk groups of cardiovascular disease. The detection rate of high-risk groups was 21.46%. According to the high-risk types, the high-risk groups can be clustered. 74.57% of them had only one high-risk type, 22.57% of them had two high-risk types, and 2.86% had three or more high-risk types. The results of Generalized Linear Mixed Model (GLMM) showed that male, age ≥45 years old, not married, occupation as a farmer, annual family income <25,000 yuan, drinking, overweight and obesity, pre-central obesity and central obesity, snoring, feeling fatigued, sleepiness, and self-reported history of diabetes were more likely to be risk factors of cardiovascular disease (all P value < 0.05). Conclusion The detection rate of high-risk groups of cardiovascular disease in Anhui Province is relatively high. Individualized intervention measures as well as comprehensive prevention and control strategies should be adopted focusing on the distribution characteristics of risk factors of high-risk groups.
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Affiliation(s)
- Xiu-Ya Xing
- Anhui Provincial Center for Disease Control and Prevention, Department of Chronic Non-communicable Disease Prevention and Control, Hefei, China
| | - Zhi-Xin Wang
- Department of Rheumatology and Immunology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Ya-Wen Cao
- Major of Preventive Medicine, School of Public Health, Anhui Medical University, Hefei, China
| | - Xin-Yi Wang
- Department of Radiation Oncology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
- First Clinical Medical College, Anhui Medical University, Hefei, China
| | - Luan Zhang
- Anhui Provincial Center for Disease Control and Prevention, Department of Chronic Non-communicable Disease Prevention and Control, Hefei, China
| | - Ye-Ji Chen
- Anhui Provincial Center for Disease Control and Prevention, Department of Chronic Non-communicable Disease Prevention and Control, Hefei, China
| | - Hua-Dong Wang
- Anhui Provincial Center for Disease Control and Prevention, Department of Chronic Non-communicable Disease Prevention and Control, Hefei, China
| | - Jing-Qiao Xu
- Anhui Provincial Center for Disease Control and Prevention, Department of Chronic Non-communicable Disease Prevention and Control, Hefei, China
| | - Mi-Xue Niu
- Anhui Provincial Center for Disease Control and Prevention, Department of Chronic Non-communicable Disease Prevention and Control, Hefei, China
| | - Zhi-Rong Liu
- Anhui Provincial Center for Disease Control and Prevention, Department of Chronic Non-communicable Disease Prevention and Control, Hefei, China
| | - Sha-Sha Tao
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, China
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11
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Han X, Liu F, Hidru TH, Yang X, Wang C, Xia Y. Postmenopausal Women with Breast, Endometrial, and Ovarian Cancers Have an Increased Risk for Cardiovascular Conditions prior to Active Endocrine Therapy. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2022; 2022:5104351. [PMID: 36046689 PMCID: PMC9423972 DOI: 10.1155/2022/5104351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 08/03/2022] [Indexed: 11/17/2022]
Abstract
Background Patients with active cancer have an increased risk of cardiovascular diseases (CVDs) among cancer patients receiving endocrine therapy. However, little research has explored the distribution of CVD comorbidities and cardiovascular risk factors (CVRFs) among postmenopause women with breast, endometrial, or ovarian cancer prior to active treatment with endocrine therapy. We aimed to explore the distribution of CVD comorbidities and associated CVRF in patients suffering from breast, endometrial, or ovarian cancer prior to the use of endocrine therapy and to assess whether there was compliance with existing hospital recommendations, particularly on the use of lipid-lowering agents to prevent the development of CVD comorbidities in postmenopause women. Methods A total of 10,731 postmenopause women with primary breast, endometrial, or ovarian cancer were enrolled between 30th May 2008 and 31st July 2021 from an electronic health record database at the first affiliated hospital of Dalian Medical University. Dyslipidemia was defined according to 2016 Chinese guidelines for adults. Multivariate logistic regression analysis was used to identify the independent predictors of CVD comorbidities in breast, endometrial, and ovarian cancers separately. Results Overall, 18.9% of the included women had at least one CVD record before endocrine therapy. The highest prevalence of CVD was identified for hypertension (16.5%), followed by coronary heart disease (4.5%), stroke (2.1%), heart failure (1.2%), and atrial fibrillation (1.1%). The most common CVRF among total cancer patients was dyslipidemia, with a remarkable prevalence of 62.8%, followed by diabetes mellitus (8.6%). Notably, only 11.1% of cancer patients were receiving lipid-lowering agents. Conclusion Cancer patients with potential eligibility for endocrine therapy use had an increased risk for CVD comorbidities. Dyslipidemia was the common CVRF. Compliance with recommendations for preventing and managing these comorbidities requires serious attention.
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Affiliation(s)
- Xu Han
- Health Management Center, First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China
| | - Fei Liu
- Department of Cardiology, Institute of Cardiovascular Diseases, First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China
| | - Tesfaldet H. Hidru
- Department of Cardiology, Institute of Cardiovascular Diseases, First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China
| | - Xiaolei Yang
- Department of Cardiology, Institute of Cardiovascular Diseases, First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China
| | - Chengfang Wang
- Health Management Center, First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China
| | - Yunlong Xia
- Department of Cardiology, Institute of Cardiovascular Diseases, First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China
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12
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Han AL, Lee HK. Association of the Metabolic Dysfunction-Associated Fatty Liver Disease with Serum Uric Acid-to-Creatinine Ratio. Metab Syndr Relat Disord 2022; 20:370-376. [PMID: 35796698 DOI: 10.1089/met.2022.0013] [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: 11/12/2022] Open
Abstract
Background: No study has examined whether serum uric acid/creatinine (sUA/Cr) is associated with the newly defined metabolic-associated fatty liver disease (MAFLDs). Furthermore, studies on other factors influencing their relationship have not been conducted. Aim: To investigate the relationship between sUA/Cr and newly defined MAFLD, and to identify any factors that affect this relationship. Methods: We retrospectively reviewed the data of patients who underwent abdominal computed tomography (CT) at the Hospital Health Promotion Center. Participants were divided into the healthy (no evidence of liver disease; n = 707), MAFLD+non-heavy drinking (steatosis diagnosed by CT and drinking <140 and 70 grams/week for men and women, respectively; n = 291), and MAFLD+heavy drinking (fatty liver diagnosed by CT and drinking >140 and 70 grams/week for men and women, respectively; n = 61) groups. The relationship between sUA/Cr and MAFLD among the three groups were compared using multivariate logistic regression. Results: After adjusting for age, it was observed that when the sUA/Cr ratio increased by 1, the risk of MAFLD increased by 1.205 times the risk in the normal group. After adjusting for age, an increase by 1 in the sUA/Cr ratio increased the probability of non-heavy drinking+MAFLD and heavy drinking+MAFLD by 1.302 and 1.556 times, respectively, compared with healthy individuals. For those who smoked, the probability of heavy drinking+MAFLD was 9.901 times higher compared with healthy individuals. Conclusion: The newly defined MAFLD is related to sUA/Cr. The amount of alcohol consumption and smoking influenced the association between sUA/Cr and MAFLD.
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Affiliation(s)
- A Lum Han
- Department of Family Medicine, Wonkwang University Hospital, Iksan, Republic of Korea
| | - Hee Kyung Lee
- Department of Family Medicine, Wonkwang University Hospital, Iksan, Republic of Korea
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13
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Liu M, Du Z, Sun Y. Prognostic significance of first-degree atrioventricular block in a large Asian population: a prospective cohort study. BMJ Open 2022; 12:e062005. [PMID: 35379649 PMCID: PMC8981319 DOI: 10.1136/bmjopen-2022-062005] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
OBJECTIVE To investigate the prognostic significance of first-degree atrioventricular block (AVB) in Asian populations. DESIGN AND SETTING Participants (N=9634) from the Northeast China Rural Cardiovascular Health Study were included. The first-degree AVB was defined as PR (from the beginning of the P wave to the beginning of the QRS complex on an electrocardiogram) interval >200 ms, and primary composite outcome (all events) included new onset cardiovascular disease (CVD) and mortality. Cox regression and restricted cubic spline were used to identify the associations of PR interval or first-degree AVB with end points. Furthermore, the relationship between new-onset CVD and mortality and first-degree AVB was separately evaluated. The value of first-degree AVB for predicting adverse events was evaluated by reclassification and discrimination analyses. RESULTS During a median of 4.65 years follow-up, 524 participants developed CVD and 371 died. Compared with participants with PR ≤200 ms, those with first-degree AVB had an increased risk of all events (HR: 1.84; 95% CI 1.18 to 2.88). Furthermore, first-degree AVB was predictive of incident CVD (1.96, 1.18 to 3.23) and stroke (2.22, 1.27 to 3.90) after adjusting for conventional risk. These statistically significant associations remained unchanged after further stratification by potential confounding factors. Discrimination and reclassification analyses suggested that first-degree AVB addition could improve the conventional model for predicting adverse outcomes within 4 years. CONCLUSIONS Our results indicated that first-degree AVB was an independent risk factor for adverse events, suggesting that it should not be considered as inconsequential factor in general population. These results have potential clinical value for identifying individuals at high risk for adverse outcomes.
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Affiliation(s)
- Moujie Liu
- Department of Cardiovascular Medicine, The First Hospital of China Medical University, Shenyang, China
| | - Zhi Du
- Department of Cardiovascular Medicine, The First Hospital of China Medical University, Shenyang, China
| | - Yingxian Sun
- Department of Cardiovascular Medicine, The First Hospital of China Medical University, Shenyang, China
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14
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Wang C, Du Z, Ye N, Shi C, Liu S, Geng D, Sun Y. Hyperlipidemia and hypertension have synergistic interaction on ischemic stroke: insights from a general population survey in China. BMC Cardiovasc Disord 2022; 22:47. [PMID: 35152896 PMCID: PMC8842864 DOI: 10.1186/s12872-022-02491-2] [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: 11/22/2021] [Accepted: 01/18/2022] [Indexed: 02/07/2023] Open
Abstract
Background Hyperlipidemia (HLP) and hypertension (HTN) are both independent risk factors for ischemic stroke. This study aimed to assess whether HTN and HLP have a synergistic effect on the risk of ischemic stroke. Methods Between January and August 2013, 11,695 subjects in rural areas of northeastern China were enrolled. The additive and multiplicative scales were used to evaluate the interaction. Results The prevalence of ischemic stroke was 5.7%. Using the healthy group (without HTN or HLP) as the reference group, subjects with both HTN and HLP had a higher risk of ischemic stroke (odds ratio [OR]: 3.369, 95% confidence interval [CI]: 2.579–4.402), and this OR was greater than that of subjects with only HTN (OR: 1.995, 95% CI 1.526–2.610) or HLP (OR: 1.321, 95% CI 0.937–1.862) (adjusting for age, sex, race, education level, family income, current smoking and drinking status, physical activity, body mass index, diabetes, family history of stroke, and atrial fibrillation). Regarding the additive scale, the relative excess risk due to interaction (OR: 1.053, 95% CI 0.458–1.648) was positive after adjusting for confounders. Moreover, the attributable proportion was 31.3%, which means that 31.3% of the total risk of ischemic stroke was due to the synergistic interaction between HTN and HLP. Furthermore, the synergistic index (S) of ischemic stroke was 1.8 (95% CI 1.157–2.801), which also indicates a synergistic interaction between HTN and HLP. Regarding the multiplicative scale, the interaction effect was also significant after adjusting for confounders (OR: 2.163, 95% CI 1.817–2.575). Conclusion The results suggest that the synergistic effect of HTN and HLP on ischemic stroke is significantly higher than the sum of their independent effects. The quantification of the combined effect should help to promote healthy blood pressure and blood lipid levels among the general population.
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Zhang S, Liu S, Jiao Y, Zheng L, Sun Y, Sun Z. Association of isolated diastolic hypertension based on different guideline definitions with incident cardiovascular risk in a Chinese rural cohort. J Clin Hypertens (Greenwich) 2021; 24:18-25. [PMID: 34913260 PMCID: PMC8783363 DOI: 10.1111/jch.14349] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 07/19/2021] [Accepted: 07/28/2021] [Indexed: 11/28/2022]
Abstract
The 2017 American College of Cardiology/American Heart Association (ACC/AHA) guideline lowered the threshold (systolic blood pressure [SBP] <130 mm Hg and diastolic blood pressure [DBP] ≥80 mm Hg) for isolated diastolic hypertension (IDH), whereas the 2018 Chinese guideline still recommends the old threshold (SBP <140 mm Hg and DBP ≥90 mm Hg). This study aimed to investigate the association between IDH, as defined by both guidelines, and the risk of incident cardiovascular disease (CVD) in rural areas of northeast China. This prospective study included participants whose baseline data were collected between 2004 and 2006. The exclusion criteria were baseline CVD, incomplete data, and systolic hypertension. The primary end point was incident CVD, a composite end point including nonfatal myocardial infarction (MI), nonfatal stroke, and CVD death. Multivariate Cox models were used to evaluate the association of IDH with CVD risk. The authors analyzed 19 688 participants (7140 participants with IDH) according to the ACC/AHA guideline. Compared with normotensive participants, individuals with ACC/AHA‐defined IDH were at a high risk of CVD (HR = 1.177, 95% CI: 1.035–1.339). A similar difference in CVD risk was noted when normotensive participants were compared with those with IDH, determined based on the 2018 Chinese guideline (HR = 1.218, 95% CI: 1.050–1.413). Similar results were found in participants who did not take antihypertensives at baseline. Moreover, IDH defined by either guideline was significantly associated with nonfatal MI. ACC/AHA‐defined IDH was associated with a risk of CVD, implying that blood pressure management should be improved in rural areas of China.
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Affiliation(s)
- Shiru Zhang
- Department of Cardiology, Shengjing Hospital of China Medical University, Shenyang, Liaoning Province, P. R. China
| | - Sitong Liu
- Department of Cardiology, Department of Library and Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, Liaoning Province, P. R. China
| | - Yundi Jiao
- Department of Cardiology, Shengjing Hospital of China Medical University, Shenyang, Liaoning Province, P. R. China
| | - Liqiang Zheng
- Department of Cardiology, Department of Library and Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, Liaoning Province, P. R. China
| | - Yingxian Sun
- Department of Cardiology, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning Province, P. R. China
| | - Zhaoqing Sun
- Department of Cardiology, Shengjing Hospital of China Medical University, Shenyang, Liaoning Province, P. R. China
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Gan Y, Feng J, Zhu Y, Li L, Shen X, Lou Y, Room R, Lei Z, Yue W, Jiang H, Lu Z. Association between alcohol consumption and the risk of stroke in middle-aged and older adults in China. Drug Alcohol Depend 2021; 229:109134. [PMID: 34847483 DOI: 10.1016/j.drugalcdep.2021.109134] [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: 04/18/2021] [Revised: 09/07/2021] [Accepted: 09/29/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVE This study aimed to investigate the association between alcohol consumption and the prevalence of stroke in Chinese adults aged 40 years and over. METHOD We conducted a cross-sectional analysis among 113,573 Chinese adults aged ≥ 40 years in the China National Stroke Prevention Project (2014-2015) to examine correlations of alcohol consumption with the prevalence of stroke. Logistic regression models were used to calculate odds ratios (ORs) and 95% confidence intervals (CIs), controlling for various confounders, e.g., gender, age, smoking, physical activity and other health conditions. RESULTS Within the study population, a total of 12,753 stroke survivors were identified. The prevalence of light to moderate and of heavy alcohol consumption was 10.1% and 5.7% respectively. The multivariate logistic regression results show that light to moderate alcohol consumption was associated with reduced risk of stroke of all types [0.91 (95%CI: 0.85-0.97)] and of ischemic stroke [0.90 (0.84-0.97)]. No association was found between alcohol consumption and hemorrhagic stroke. Compared with abstainers, the adjusted ORs of all stroke were 0.83 (0.75-0.92) for those who drank 11-20 years, and no association was found between 1 and 10 years or over 20 years of drinking and risk of stroke. CONCLUSIONS These results indicate that light to moderate alcohol consumption may be protective against all and ischemic stroke, and heavy drinking was not significantly associated with risk of all stroke in China. No association between alcohol consumption and hemorrhagic stroke was found.
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Affiliation(s)
- Yong Gan
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Jing Feng
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Yi Zhu
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Liqing Li
- Department of Management Science and Engineering, School of Economics and Management, Jiangxi Science and Technology Normal University, Nanchang, Jiangxi, China
| | - Xin Shen
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Yiling Lou
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Robin Room
- Centre for Alcohol Policy Research, School of Psychology and Public Health, La Trobe University, Melbourne, Vic, Australia; Centre for Social Research on Alcohol and Drugs, Department of Public Health Sciences, Stockholm University, Stockholm, Sweden
| | - Zihui Lei
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Wei Yue
- Neurology Department, Tianjin Huanhu Hospital, Tianjin, China
| | - Heng Jiang
- Centre for Alcohol Policy Research, School of Psychology and Public Health, La Trobe University, Melbourne, Vic, Australia; Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Vic, Australia.
| | - Zuxun Lu
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
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Li Z, Yang Y, Zheng L, Sun G, Guo X, Sun Y. It's Time to Add Electrocardiography and Echocardiography to CVD Risk Prediction Models: Results from a Prospective Cohort Study. Risk Manag Healthc Policy 2021; 14:4657-4671. [PMID: 34815727 PMCID: PMC8604639 DOI: 10.2147/rmhp.s337466] [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: 09/09/2021] [Accepted: 10/31/2021] [Indexed: 11/23/2022] Open
Abstract
Objective To develop and validate a new prediction model for the general population based on a large panel of both traditional and novel factors in cardiovascular disease (CVD). Design and Setting We used a prospective cohort in the Northeast China Rural Cardiovascular Health Study (NCRCHS). Participants A total of 11,956 participants aged ≥35 years were recruited between 2012 and 2013, using a multistage, randomly stratified, cluster-sampling scheme. In 2015 and 2017, the participants were invited to join the follow-up study for incident cardiovascular events. The loss to follow-up number was 351. At the study’s end, we obtained the CVD outcome events for 10,349 participants. Primary and Secondary Outcome Measures The prediction model was developed using demographic factors, blood biochemical indicators, electrocardiographic (ECG) characteristics, and echocardiography indicators collected at baseline (Model 1). Framingham-related variables, namely age, sex, smoking, total and high-density lipoprotein cholesterol and diabetes status were used to construct the traditional model (Model 2). Results For the observed population (n = 10,349), the median follow-up time was 4.66 years. The total incidence of CVD was 1.1%/year, including stroke (n = 342) and coronary heart disease (n = 175). The results of Model 1 indicated that in addition to the traditional risk factors, QT interval (p < 0.001), aortic root diameter (p < 0.001), and ventricular septal thickness (p < 0.001) were predictive factors for CVD. Decision curve analysis (DCA) showed that the net benefit with Model 1 was higher than that of Model 2. Conclusion QT interval from electrocardiography and aortic root diameter and ventricular septal thickness from echocardiography should be included in the CVD risk prediction models.
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Affiliation(s)
- Zhao Li
- Department of Cardiology, The First Hospital of China Medical University, Shenyang, 110001, People's Republic of China
| | - Yiqing Yang
- Department of Cardiology, The First Hospital of China Medical University, Shenyang, 110001, People's Republic of China
| | - Liqiang Zheng
- Department of Clinical Epidemiology, Library, Department of Health Policy and Hospital Management, Shengjing Hospital of China Medical University, Shenyang, 110004, People's Republic of China
| | - Guozhe Sun
- Department of Cardiology, The First Hospital of China Medical University, Shenyang, 110001, People's Republic of China
| | - Xiaofan Guo
- Department of Cardiology, The First Hospital of China Medical University, Shenyang, 110001, People's Republic of China
| | - Yingxian Sun
- Department of Cardiology, The First Hospital of China Medical University, Shenyang, 110001, People's Republic of China
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18
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Li R, Cheng X, Schwebel DC, Yang Y, Ning P, Cheng P, Hu G. Disability-adjusted life years associated with population ageing in China, 1990-2017. BMC Geriatr 2021; 21:369. [PMID: 34134664 PMCID: PMC8207592 DOI: 10.1186/s12877-021-02322-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 06/01/2021] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND The Chinese population has aged significantly in the last few decades. Comprehensive health losses including both fatal and non-fatal health outcomes associated with ageing in China have not been detailed. METHODS Based on freely accessible disability adjusted life years (DALYs) estimated by the Global Burden of Diseases (GBD) 2017, we adopted a robust decomposition method that ascribes changes in DALYs in any given country across two time points to changes resulting from three sources: population size, age structure, and age-specific DALYs rate per 100,000 population. Using the method, we calculated DALYs associated with population ageing in China from 1990 to 2017 and examined the counteraction between the effects of DALYs rate change and population ageing. This method extends previous work through attributing the change in DALYs to the three sources. RESULTS Population ageing was associated with 92.8 million DALYs between 1990 and 2017 in China, of which 65.8% (61.1 million) were years of life lost (YLLs). Males had comparatively more DALYs associated with population ageing than females in the study period. The five leading causes of DALYs associated with population ageing between 1990 and 2017 were stroke (23.6 million), chronic obstructive pulmonary disease (COPD) (18.3 million), ischemic heart disease (13.0 million), tracheal, bronchus, and lung cancer (6.1 million) and liver cancer (5.0 million). Between 1990 and 2017, changes in DALYs associated with age-specific DALY rate reductions far exceeded those related to population ageing (- 196.2 million versus 92.8 million); 57.5% (- 112.8 million) of DALYs were caused by decreases in rates attributed to 84 modifiable risk factors. CONCLUSION Population ageing was associated with growing health loss in China from 1990 to 2017. Despite the recent progress in alleviating health loss associated with population ageing, the government should encourage scientific research on effective and affordable prevention and control strategies and should consider investment in resources to implement strategies nationwide to address the future challenge of population ageing.
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Affiliation(s)
- Ruotong Li
- Department of Epidemiology and Health Statistics, Hunan Provincial Key Laboratory of Clinical Epidemiology, Xiangya School of Public Health, Central South University, Changsha, 410078, China
| | - Xunjie Cheng
- Department of Geriatric Medicine, Xiangya Hospital, Central South University, Changsha, China
| | - David C Schwebel
- Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Yang Yang
- Department of Biostatistics, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA.,Emerging Pathogens Institute, University of Florida, Gainesville, FL, USA
| | - Peishan Ning
- Department of Epidemiology and Health Statistics, Hunan Provincial Key Laboratory of Clinical Epidemiology, Xiangya School of Public Health, Central South University, Changsha, 410078, China
| | - Peixia Cheng
- Department of Epidemiology and Health Statistics, Hunan Provincial Key Laboratory of Clinical Epidemiology, Xiangya School of Public Health, Central South University, Changsha, 410078, China
| | - Guoqing Hu
- Department of Epidemiology and Health Statistics, Hunan Provincial Key Laboratory of Clinical Epidemiology, Xiangya School of Public Health, Central South University, Changsha, 410078, China. .,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China.
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Xu J, Zhang R, Guo R, Wang Y, Dai Y, Xie Y, Zheng J, Sun Z, Xing L, Sun Y, Zheng L. Trajectories of body mass index and risk of incident hypertension among a normal body mass index population: A prospective cohort study. J Clin Hypertens (Greenwich) 2021; 23:1212-1220. [PMID: 33743180 PMCID: PMC8678668 DOI: 10.1111/jch.14241] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2020] [Revised: 03/02/2021] [Accepted: 03/07/2021] [Indexed: 11/30/2022]
Abstract
It is unclear whether there are different body mass index (BMI) trajectories among a population with normal BMI levels, and the association between BMI patterns and incident hypertension is not well characterized. This prospective cohort study includes surveys conducted at baseline and three follow‐ups. 3939 participants who are free of hypertension at baseline or first two follow‐ups were enrolled. At baseline, the age of participants ranged from 35 to 82 years and the mean age was 45.9 years. The BMI trajectories were identified using latent mixture modeling with data from the baseline and first two follow‐ups. The effects of different BMI trajectories on the development of hypertension were analyzed using a Cox proportional hazard model. Four distinct BMI trajectories were identified over the study period (2004‐2010): normal‐stable (n = 1456), normal‐increasing (n = 2159), normal‐fluctuated (n = 166), and normal‐sharp‐increasing (n = 158). Relative to the normal‐stable BMI group, the hazard ratios (HRs) and 95% confidence intervals (CIs) after adjustment for confounding factors of the normal‐increasing, normal‐fluctuated, and normal‐sharp‐increasing groups were 1.244 (1.103‐1.402), 1.331 (1.008‐1.756), and 1.641 (1.257‐2.142), respectively. Additionally, subgroup analysis showed that the normal‐fluctuated BMI trajectory was associated with a significantly higher risk of hypertension only in women (HR = 1.362; 95% CI = 1.151‐1.611). The BMI trajectories were significant predictors of hypertension incidence, and increasing BMI trajectories within the currently designated normal range were associated with an increased hypertension risk, especially in women.
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Affiliation(s)
- Jiahui Xu
- Department of Cardiology, Department of Library and Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China.,School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Rui Zhang
- College of Public Health, Shanghai University of Medicine and Health Sciences, Shanghai, China
| | - Rongrong Guo
- Department of Cardiology, Department of Library and Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yali Wang
- Department of Cardiology, Department of Library and Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yue Dai
- Department of Cardiology, Department of Library and Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yanxia Xie
- Department of Cardiology, Department of Library and Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Jia Zheng
- Department of Cardiology, Department of Library and Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Zhaoqing Sun
- Department of Cardiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Liying Xing
- Institute of Chronic Disease, Liaoning Provincial Center for Disease Control and Prevention, Shenyang, China
| | - Yingxian Sun
- Department of Cardiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Liqiang Zheng
- Department of Cardiology, Department of Library and Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China.,School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Using the Atherogenic Index of Plasma to Estimate the Prevalence of Ischemic Stroke within a General Population in a Rural Area of China. BIOMED RESEARCH INTERNATIONAL 2020; 2020:7197054. [PMID: 33490253 PMCID: PMC7787721 DOI: 10.1155/2020/7197054] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 11/16/2020] [Accepted: 11/26/2020] [Indexed: 02/06/2023]
Abstract
Objective To investigate the relationship between the atherogenic index of plasma (AIP) and ischemic stroke. Design We collected a range of data from 11,495 residents (aged ≥35 years; 54.28% female) residing in rural areas of northeast China between January and August 2013, including fasting lipid profile and anthropometric parameters. Logistic regression models were used to evaluate the correlation between AIP and ischemic stroke. Category-free analysis was used to determine whether AIP enhanced our capacity to estimate ischemic stroke. Results Irrespective of gender, AIP was independently associated with the occurrence of ischemic stroke. The prevalence of ischemic stroke increased significantly from the lowest quartile to the highest quartile (females: 10.5%-48.7%, P < 0.001; males: 22.0%-36.5%, P = 0.08). After adjusting for age, gender, income, education, smoking, drinking, exercise, hypertension, body mass index (BMI), diabetes, atrial fibrillation, and a family history of stroke, we found that for every 1 standard deviation (SD) increase in AIP, there was a 34.8% and 20.9% increase in the prevalence of stroke for females and males, respectively. Curve fitting was also used to evaluate the linear relationship between AIP and the occurrence of ischemic stroke. Category-free analysis indicated that AIP significantly enhanced our ability to estimate ischemic stroke in both females (NRI (95% confidence interval (CI)): 0.188 (0.105-0.270)) and males (NRI (95% CI): 0.175 (0.017-0.333)). Conclusion Analyses detected a significant and positive linear relationship between AIP and the prevalence of ischemic stroke. This relationship was independent of a range of conventional risk factors.
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Sun Y, Lin J, Huang S, Xu X, Cai Y, Yang L, Li H, Wu S. Preliminary verification of lncRNA ENST00000609755.1 potential ceRNA regulatory network in coronary heart disease. Int J Cardiol 2020; 328:165-175. [PMID: 33279591 DOI: 10.1016/j.ijcard.2020.11.064] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 09/29/2020] [Accepted: 11/25/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND This study aims to explore the possible ceRNA regulatory network of lncRNA ENST00000609755.1 in CHD patients based on the population; reveal the possible regulatory mechanism of lncRNA ENST00000609755.1. METHOD Microarray analysis were used to identify differentially expressed miRNA, and mRNA profiles between 5 CHD and 5 healthy controls. The lncRNA ENST00000609755.1-miRNA-mRNA ceRNA regulatory network was constructed with lncRNA ENST00000609755.1 as the core based on microarray data and related prediction software (RNAhybird, miRanda, miRWalk 2.0). Furthermore, qRT-PCR was used to verify the expression levels of miRNA and mRNA. t-test and pearson correlation analysis were used to compare the expression differences and correlations of lncRNA, miRNA and mRNA. The receiver operating characteristic (ROC) curve was used to determine the discriminative ability of lncRNA ENST00000609755.1 and its downstream targets. RESULTS Totally 25 miRNAs and 953 mRNAs were differentially expressed between CHD and healthy control. The lncRNA ENST00000609755.1- miRNA- mRNA ceRNA regulatory network was constructed (5 miRNA and 58 mRNA). qRT-PCR results suggest that the expression of lncRNA ENST00000609755.1 and ELK1 were up-regulated in CHD group and positively correlated, the expression of miR-150 was down-regulated in CHD, which was negatively correlated with lncRNA ENST00000609755.1 and ELK1. The AUC was 0.777(95%CI, 0.659-0.895) when miRNA-150 and ELK1 was added, which was higher than that of lncRNA ENST00000609755.1 single indicator. CONCLUSION LncRNA ENST00000609755.1, miR-150 and ELK1 may have a potential ceRNA regulatory network relationship which could be considered to have a good combined diagnostic value for CHD. Also, preliminarily reveal the possible mechanism of lncRNA ENST00000609755.1 involved in CHD.
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Affiliation(s)
- Yi Sun
- Fujian Key Lab of Environmental Factors and Cancer, School of Public Health, Fujian Medical University, China; School of Public Health, Fujian Medical University, Minhou County, Fuzhou, China
| | - Jie Lin
- The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China
| | - Shuna Huang
- Department of Clinical research and translation center office, the First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Xingyan Xu
- School of Public Health, Fujian Medical University, Minhou County, Fuzhou, China
| | - Yingying Cai
- School of Public Health, Fujian Medical University, Minhou County, Fuzhou, China
| | - Le Yang
- School of Public Health, Fujian Medical University, Minhou County, Fuzhou, China
| | - Huangyuan Li
- Fujian Key Lab of Environmental Factors and Cancer, School of Public Health, Fujian Medical University, China; School of Public Health, Fujian Medical University, Minhou County, Fuzhou, China.
| | - Siying Wu
- Fujian Key Lab of Environmental Factors and Cancer, School of Public Health, Fujian Medical University, China; Key Lab of Environment and Health, School of Public Health, Fujian Medical University, China.
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Duan W, Wu J, Liu S, Jiao Y, Zheng L, Sun Y, Sun Z. Impact of Prehypertension on the Risk of Major Adverse Cardiovascular Events in a Chinese Rural Cohort. Am J Hypertens 2020; 33:465-470. [PMID: 32030405 DOI: 10.1093/ajh/hpaa019] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Revised: 12/09/2019] [Accepted: 02/04/2020] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND The study was performed to investigate the impact of prehypertension defined by the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC7) on the risk of major adverse cardiovascular events (MACE) in a Chinese rural cohort. METHODS The epidemiological prospective cohort study included 38,765 participants aged ≥35 years followed for a median of 12.5 years-divided into normal BP (n = 7,366), prehypertension (n = 18,095), and hypertension groups (n = 13,304)-were enrolled for the final analysis. Follow-up for MACE including cardiovascular disease (CVD) death, stroke and myocardial infarction (MI) was conducted. Adjusted Cox proportional hazards models were used to estimate hazard ratios (HR) and 95% confidence intervals (CI). RESULTS The age and sex-adjusted incidence of MACE and its subtypes rose progressively with elevation of BP levels (P < 0.001). After adjusting multivariable Cox proportional hazards, significant increases were observed from the prehypertensive group for incident MACE (HR = 1.337, 95% CI: 1.186-1.508, P < 0.001), CVD mortality (HR = 1.331, 95% CI: 1.109-1.597, P = 0.002), and stroke (HR = 1.424, 95% CI:1.237-1.639, P < 0.001) but not MI (P > 0.05) compared with normal BP. CONCLUSION Prehypertensive individuals had a greater risk of incident MACE, CVD mortality, and stroke, implying that improvements in BP monitoring and early intervention in individuals with prehypertension in rural China are urgently needed.
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Affiliation(s)
- Weili Duan
- Department of Cardiology, Shengjing Hospital of China Medical University, Shenyang, P. R. China
| | - Jiake Wu
- Department of Cardiology, Shengjing Hospital of China Medical University, Shenyang, P. R. China
| | - Sitong Liu
- Department of Clinical Epidemiology, Library, Shengjing Hospital of China Medical University, Shenyang, P. R. China
| | - Yundi Jiao
- Department of Cardiology, Shengjing Hospital of China Medical University, Shenyang, P. R. China
| | - Liqiang Zheng
- Department of Clinical Epidemiology, Library, Shengjing Hospital of China Medical University, Shenyang, P. R. China
| | - Yingxian Sun
- Department of Cardiology, the First Affiliated Hospital of China Medical University, Shenyang, P. R. China
| | - Zhaoqing Sun
- Department of Cardiology, Shengjing Hospital of China Medical University, Shenyang, P. R. China
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Effects of long- and short-term body mass index changes on incident hypertension are different. Nutrition 2020; 74:110755. [PMID: 32240929 DOI: 10.1016/j.nut.2020.110755] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Revised: 01/20/2020] [Accepted: 01/22/2020] [Indexed: 02/08/2023]
Abstract
OBJECTIVES The aim of this study was to evaluate hypertension risk associated with long- and short-term body mass index (BMI) changes. METHODS This prospective cohort study included four examinations: 2004 to 2006, 2008, 2010, and 2017. Adjusted Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) of BMI changes on incident hypertension. The difference of β coefficients between long- and short-term BMI changes were examined using Fisher Z-test. RESULTS Relative to stable, normal BMI, both long- and short-term elevated BMI conferred an increased risk for hypertension, with HRs of 1.507 (95% CI, 1.286-1.767) and 1.197(95% CI, 1.019-1.405), respectively. In contrast, relative to stable overweight, both long- and short-term decreased BMI conferred a reduced risk for hypertension, with HRs of 0.651(95% CI, 0.536-0.789) and 0.775 (0.625-0.962), respectively. Additionally, for BMI changing from normal to overweight, long-term changes were relatively more strongly associated with increased risk for incident hypertension than short-term based on regression coefficients (β = 0.410 versus β = 0.179, P < 0.001). For BMI changing from overweight to normal, long-term changes were relatively more strongly associated with lower risk than short-term based on regression coefficients (β = -0.430 versus β = -0.254, P = 0.007). Additionally, there was no correlation between absolute changes in BMI and systolic blood pressure for long- (P = 0.744) and short-term (P = 0.097). CONCLUSION For participants with normal BMI, risk tended to be higher in adults whose elevated BMI occurred during the long-term. For those who are overweight, long-term decreased BMI can reduce the risk for incident hypertension to a greater extent. No correlation was found between absolute changes in BMI and systolic blood pressure.
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Associations between ideal blood pressure based on different BMI categories and stroke incidence. J Hypertens 2020; 38:1271-1277. [PMID: 32195818 DOI: 10.1097/hjh.0000000000002404] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
OBJECTIVES The 2017 American College of Cardiology/American Heart Association (ACC/AHA) Guideline for high blood pressure (BP) in adults redefined hypertension as SBP at least 130 mmHg or DBP at least 80 mmHg. However, the optimal BP for different BMI population to reduce stroke incidence is uncertain. METHODS A prospective cohort study was designed by four examinations: baseline (2004-2006), 2008, 2010 and 2017 follow-up. The study group composed of 36 352 individuals, to determine the ideal BP range to reduce stroke incidence of two BMI level, adjusted Cox proportional hazards models were utilized to establish the associations between SBP/DBP and the risk of stroke incident. Then, the restricted cubic spline regression was applied to find the ideal range of SBP/DBP values for two kinds of BMI categories definitions. RESULTS During a median follow-up period of 12.5 years, 2548 (7.0%) nonstroke individuals at baseline developed incident stroke. After fully adjusting confounding factors, SBP (per 20 mmHg increase) and DBP (per 10 mmHg increase) are independently associated with the risk of stroke incidence [SBP, hazard ratio = 1.277, 95% confidence interval (95% CI), 1.217-1.340, P < 0.001; DBP, hazard ratio = 1.138, 95% CI, 1.090-1.189, P < 0.001]. CONCLUSION Our study revealed that the ideal BP for a population with BMI less than 24 kg/m was less than 130/80 mmHg, whereas the ideal BP for BMI at least 24 kg/m was less than 120/80 mmHg. The sensitivity analyses between BMI less than 25 kg/m and BMI at least 25 kg/m showed similar findings. This finding provides more accurate primary prevention strategies based on various BMI populations.
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Chen MQ, Shi WR, Shi CN, Zhou YP, Sun YX. Impact of monocyte to high-density lipoprotein ratio on prevalent hyperuricemia: findings from a rural Chinese population. Lipids Health Dis 2020; 19:48. [PMID: 32178680 PMCID: PMC7077021 DOI: 10.1186/s12944-020-01226-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Accepted: 03/09/2020] [Indexed: 02/21/2023] Open
Abstract
BACKGROUND Monocyte to high-density lipoprotein cholesterol ratio (MHR) is a novel inflammatory marker that has been used to predict various inflammation-related diseases. This study aims to explore the association between MHR and prevalent hyperuricemia in a rural Chinese population. METHODS 8163 eligible participants (mean age: 54.13 years, males: 45.71%) from northeast China were enrolled in this cross-sectional study between 2012 to 2013. MHR was determined as blood monocyte count ratio to high-density lipoprotein cholesterol concentration. RESULTS The prevalence of hyperuricemia was 12.86%. After adjusting for potential confounding factors, per SD increase of MHR caused a 25.2% additional risk for hyperuricemia, and the top quartile of MHR had an 82.9% increased risk for hyperuricemia compared with the bottom quartile. Additionally, smooth curve fitting and subgroup analyses showed a linear and robust association between MHR and prevalent hyperuricemia respectively. Finally, after introducing MHR into the established model of risk factors, the AUC displayed a significant improvement (0.718 vs 0.724, p = 0.008). Furthermore, Category-free net reclassification improvement (0.160, 95% CI: 0.096-0.224, P < 0.001) and integrated discrimination improvement (0.003, 95% CI: 0.002-0.005, P < 0.001) also demonstrated significant improvements. CONCLUSIONS The present study suggests that MHR was positively and independently correlated with prevalent hyperuricemia among rural Chinese adults. Our results also implicate an important value for MHR in optimizing the risk stratification of hyperuricemia.
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Affiliation(s)
- Meng-Qi Chen
- Department of Cardiology, The First Hospital of China Medical University, 155 Nanjing North Street, Heping District, Shenyang, 110001, China
| | - Wen-Rui Shi
- Department of Cardiology, The First Hospital of China Medical University, 155 Nanjing North Street, Heping District, Shenyang, 110001, China
| | - Chu-Ning Shi
- Department of Cardiology, The First Hospital of China Medical University, 155 Nanjing North Street, Heping District, Shenyang, 110001, China
| | - Ya-Ping Zhou
- Department of Neurology, The First Hospital of China Medical University, 155 Nanjing North Street, Heping District, Shenyang, 110001, China
| | - Ying-Xian Sun
- Department of Cardiology, The First Hospital of China Medical University, 155 Nanjing North Street, Heping District, Shenyang, 110001, China.
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Chen R, Gao Q, Sun J, Yang H, Li Y, Kang F, Wu W. Short-term effects of particulate matter exposure on emergency room visits for cardiovascular disease in Lanzhou, China: a time series analysis. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2020; 27:9327-9335. [PMID: 31916161 DOI: 10.1007/s11356-020-07606-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Accepted: 01/01/2020] [Indexed: 06/10/2023]
Abstract
Cardiovascular disease (CVD) has been the leading cause of death in China. Identifying the relationship between particulate matter (PM) and CVD in China is a significant challenge. In this study, daily CVD emergency room visit, environmental monitoring, and weather data from January 1, 2017, to December 31, 2018, in Lanzhou were collected. Generalized additive models (GAMs) were constructed to estimate the short-term effects of daily PM2.5, PMC, and PM10 concentrations on CVD emergency room visits with different lag structures after controlling for the influence of meteorological elements and gaseous pollutants. Stratified analyses were conducted according to age (≥ 65 years and < 65 years), sex (male and female), cold season (from November to April), and warm season (from May to October). The results showed that each 10 μg/m3 increase in PM2.5 was associated with a 1.93% (95% CI 0.12-3.78%) increase in CVD emergency room visits at lag03, and no single lag model was statistically significant. The excess relative risks (ERRs) of PM10 and PMC were not statistically significant at any lag pattern. The exposure-response curves demonstrated a nonlinear upward trend for these three PM pollutants. When adjusting for other gaseous pollutants, such as NO2, SO2, CO, and O3, in the two-pollutant models, the associations between PM10 and PMC and CVD emergency room visits did not change compared with the single-pollutant models. The ERRs of PM2.5 were 1.67% (95% CI 0.03-3.34%) at lag02 after adjustment for NO2 and 1.65% (95% CI 0.02-3.30%) at lag02 after adjustment for SO2. The ERRs of PM2.5 were still statistically significant at lag03 when we adjusted for any one of the gaseous pollutants. Susceptibility to PM2.5 was increased in people aged < 65 years, in males, and in the warm season. The findings are very important for local governments to develop environmental policies and strategies to reduce ambient PM2.5 levels.
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Affiliation(s)
- Rui Chen
- Environment and School Health Branch, Gansu Province Centre for Disease Control and Prevention, No.230 Donggang West Road, Chengguan Area, Lanzhou, 730000, Gansu, China
| | - Qian Gao
- Department of Environmental Health, School of Public Health, China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang, 110122, Liaoning, China
| | - Jianyun Sun
- Environment and School Health Branch, Gansu Province Centre for Disease Control and Prevention, No.230 Donggang West Road, Chengguan Area, Lanzhou, 730000, Gansu, China
| | - Haixia Yang
- Environment and School Health Branch, Gansu Province Centre for Disease Control and Prevention, No.230 Donggang West Road, Chengguan Area, Lanzhou, 730000, Gansu, China
| | - Yongjun Li
- Physical and Chemical Examination Centre, Gansu Province Centre for Disease Control and Prevention, No.335 Duan Jia Tan Road, Chengguan Area, Lanzhou, 730000, Gansu, China
| | - Fenyan Kang
- Environment and School Health Branch, Gansu Province Centre for Disease Control and Prevention, No.230 Donggang West Road, Chengguan Area, Lanzhou, 730000, Gansu, China
| | - Wei Wu
- Department of Epidemiology, School of Public Health, China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang, 110122, Liaoning, China.
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Could fasting blood glucose predict hypertension: findings from a low-resource community. J Hypertens 2020; 38:369-371. [PMID: 31913952 DOI: 10.1097/hjh.0000000000002305] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Shi W, Zhou Y, Chen Y. Does baseline LDL-cholesterol predict cardiovascular outcomes in high cardiovascular risk hypertensive patients? Insights from an Asian population. Int J Cardiol 2019; 297:141. [PMID: 31422878 DOI: 10.1016/j.ijcard.2019.08.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Accepted: 08/05/2019] [Indexed: 11/26/2022]
Affiliation(s)
- Wenrui Shi
- Department of Cardiology, The First Hospital of China Medical University, 155 Nanjing North Street, Heping District, Shenyang 110001, China
| | - Yaping Zhou
- Department of Neurology, The First Hospital of China Medical University, 155 Nanjing North Street, Heping District, Shenyang 110001, China
| | - Yihan Chen
- Department of Cardiology, The First Hospital of China Medical University, 155 Nanjing North Street, Heping District, Shenyang 110001, China; Department of Cardiology, East Hospital, Tongji University School of Medicine, 150 Jimo Road, Pudong District, Shanghai 200120, China.
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29
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Xie Y, Ma M, Li Z, Guo X, Sun G, Sun Z, Zheng J, Sun Y, Zheng L. Elevated blood pressure level based on 2017 ACC/AHA guideline in relation to stroke risk in rural areas of Liaoning province. BMC Cardiovasc Disord 2019; 19:258. [PMID: 31747878 PMCID: PMC6868830 DOI: 10.1186/s12872-019-1197-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Accepted: 09/13/2019] [Indexed: 02/07/2023] Open
Abstract
Background The new ACC/AHA hypertension guideline lower the definition of hypertension from 140/90 mmHg to 130/80 mmHg and eliminate the category of prehypertension thus increasing the prevalence of hypertension. A purpose of this study is to explore the applicability of the new guidelines in rural China. Methods In total, 3229 participants aged ≥35 years and free of stroke at baseline were followed for up to 4.8 years during 2012 to 2017 in a rural community-based prospective cohort study of Xifeng County. The hazard ratio (HR) and 95% Confidence interval (CI) of different blood pressure (BP) levels for risk of incident stroke were analyzed by multivariable Cox proportional hazard models. Results During the follow-up, 81 new strokes occurred among the 3229 participants. Compared with normal BP (Systolic BP (SBP)<120 mmHg and Diastolic BP (DBP)<80 mmHg), stage 2 hypertension (SBP ≥ 140 mmHg or DBP ≥ 90 mmHg) had approximately 2.1 greater risks for stroke (HR: 2.10, 95% CI: 1.13 to 3.91, P = 0.020). However, there was no significant association between elevated (SBP:120-129 mmHg and DBP<80 mmHg), stage1 hypertension (SBP:130-139 mmHg or DBP:80-89 mmHg) and stroke incidence (HR: 0.93, 95% CI: 0.33 to 2.61, P = 0.888; HR: 0.96, 95% CI: 0.46 to 2.02, P = 0.920, respectively). An increase of the SBP by 1-SD increases the risk for stroke by 56% (HR: 1.56, 95%CI: 1.29 to 1.88, P < 0.001). An increase of the SBP by 20 mmHg increases the risk for stroke by 51% (HR: 1.51, 95%CI: 1.27 to 1.80, P < 0.001). Conclusions Compared with normal BP, the stage 2 hypertension based on 2017 ACC/AHA guideline significantly increases the risk of stroke incidence, but this association was not observed between elevated, stage1 hypertension and stroke incidence in Chinese rural adults.
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Affiliation(s)
- Yanxia Xie
- Department of Clinical Epidemiology, Library, Department of Health Policy and Hospital Management, Shengjing Hospital of China Medical University, Shenyang, 110004, People's Republic of China
| | - Mingfeng Ma
- Department of Cardiology, Zhuhai People's Hospital, Zhuhai Hospital Affiliated with Jinan University, Zhuhai, 519000, People's Republic of China
| | - Zhao Li
- Department of Cardiology, the First Affiliated Hospital of China Medical University, Shenyang, 110001, People's Republic of China
| | - Xiaofan Guo
- Department of Cardiology, the First Affiliated Hospital of China Medical University, Shenyang, 110001, People's Republic of China
| | - Guozhe Sun
- Department of Cardiology, the First Affiliated Hospital of China Medical University, Shenyang, 110001, People's Republic of China
| | - Zhaoqing Sun
- Department of Cardiology, Shengjing Hospital of China Medical University, Shenyang, 110004, People's Republic of China
| | - Jia Zheng
- Department of Clinical Epidemiology, Library, Department of Health Policy and Hospital Management, Shengjing Hospital of China Medical University, Shenyang, 110004, People's Republic of China
| | - Yingxian Sun
- Department of Cardiology, Shengjing Hospital of China Medical University, Shenyang, 110004, People's Republic of China.
| | - Liqiang Zheng
- Department of Clinical Epidemiology, Library, Department of Health Policy and Hospital Management, Shengjing Hospital of China Medical University, Shenyang, 110004, People's Republic of China.
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Vallée A, Lelong H, Lopez-Sublet M, Topouchian J, Safar ME, Blacher J. Reply. J Hypertens 2019; 37:2499-2500. [PMID: 31688294 DOI: 10.1097/hjh.0000000000002215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Alexandre Vallée
- Hypertension and Cardiovascular Prevention Unit, Diagnosis and Therapeutic Center, Hôtel-Dieu Hospital, AP-HP, Paris-Descartes University
| | - Hélène Lelong
- Hypertension and Cardiovascular Prevention Unit, Diagnosis and Therapeutic Center, Hôtel-Dieu Hospital, AP-HP, Paris-Descartes University
| | - Marilucy Lopez-Sublet
- Department of Internal Medicine, AP-HP Hôpital Avicenne, European Society of Hypertension Excellence Center, Paris, France
| | - Jirar Topouchian
- Hypertension and Cardiovascular Prevention Unit, Diagnosis and Therapeutic Center, Hôtel-Dieu Hospital, AP-HP, Paris-Descartes University
| | - Michel E Safar
- Hypertension and Cardiovascular Prevention Unit, Diagnosis and Therapeutic Center, Hôtel-Dieu Hospital, AP-HP, Paris-Descartes University
| | - Jacques Blacher
- Hypertension and Cardiovascular Prevention Unit, Diagnosis and Therapeutic Center, Hôtel-Dieu Hospital, AP-HP, Paris-Descartes University
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Estimate of the impact of serum lipid parameters on aortic stiffness: insights from an Asian population. J Hypertens 2019; 37:2498-2499. [PMID: 31688293 DOI: 10.1097/hjh.0000000000002214] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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Qiu H, Chen Z, Lv L, Tang W, Hu R. Associations Between microRNA Polymorphisms and Development of Coronary Artery Disease: A Case-Control Study. DNA Cell Biol 2019; 39:25-36. [PMID: 31692368 DOI: 10.1089/dna.2019.4963] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Coronary artery disease (CAD), a common cardiovascular disease, has become a vital cause of mortality worldwide. Genetic microRNA (miR) polymorphisms might contribute to CAD susceptibility. In this study, we selected miR-146a, miR-196a2, and miR-499 single nucleotide polymorphisms and conducted a case-control study. In total, 505 CAD cases and 1109 controls were recruited. We used SNPscan™ genotyping assay to obtain genotyping of miR rs2910164, rs11614913, and rs3746444 variants. We found that miR-196a2 rs11614913 T > C decreased the susceptibility of myocardial infarction (MI) (TC vs. TT: adjusted p = 0.007 and CC/TC vs. TT: adjusted p = 0.012). In female subgroup, our results indicated that miR-196a2 rs11614913 T > C variants might also decrease the susceptibility of CAD (TC vs. TT: adjusted p = 0.017 and TC/CC vs. TT: adjusted p = 0.015). In summary, these results suggest that miR-196a2 rs11614913 T > C locus decreases the susceptibility of CAD in female and MI subgroups. However, further studies are needed to validate the potential associations of miR-196a2 rs11614913 locus with CAD.
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Affiliation(s)
- Hao Qiu
- Department of Immunology, School of Medicine, Jiangsu University, Zhenjiang, China
| | - Zheng Chen
- Department of Anesthesiology, Zhenjiang No. 1 People's Hospital, Zhenjiang, China
| | - Lu Lv
- Department of Cardiothoracic Surgery, Zhenjiang No. 1 People's Hospital, Zhenjiang, China
| | - Weifeng Tang
- Department of Cardiothoracic Surgery, Zhenjiang No. 1 People's Hospital, Zhenjiang, China
| | - Rong Hu
- Department of Cardiology, Fujian Medical University Union Hospital, Fuzhou, China
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Xie Y, Guo R, Li Z, Guo X, Sun G, Sun Z, Zheng J, Sun Y, Zheng L. Temporal relationship between body mass index and triglyceride-glucose index and its impact on the incident of hypertension. Nutr Metab Cardiovasc Dis 2019; 29:1220-1229. [PMID: 31383505 DOI: 10.1016/j.numecd.2019.07.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2019] [Revised: 05/22/2019] [Accepted: 07/02/2019] [Indexed: 01/03/2023]
Abstract
BACKGROUND AND AIMS Obesity and insulin levels can influence each other by metabolism. However, their temporal sequences and influence on hypertension are generally unknown, especially in Chinese adults. Recently, some scholars have proposed that triglycerides-glucose index (TyG) is an important indicator of insulin resistance. The study aims to describe the relationship between body mass index (BMI) and TyG index and its impact on hypertension. METHODS AND RESULTS A total of 4081 adults (56.33% women) without antihypertensive, hypoglycemic or lipid-lowering medications were selected for the present study. Measurements of BMI and TyG index were obtained twice from 2012 to 2017. Cross-lagged panel analysis was used to describe the temporal sequences between BMI and TyG index, and the effect of their temporal relationship patterns on hypertension was explored through mediation analysis. After adjusting for confounding factors (age, sex, ethnicity et al.), the cross-lagged path coefficient from baseline BMI to follow-up TyG (ρ2 = 0.135, P < 0.001) was significantly greater than the path coefficient from baseline TyG to follow-up BMI (ρ1 = 0.043, P < 0.001), and P < 0.001 for the difference between ρ1 and ρ2. Furthermore, the sensitivity analyses between women and men revealed identical findings. In addition, TyG index mediation effect on BMI-hypertension was estimated to be 38.45% (P < 0.001) in total population, 25.24% in women and 57.35% in men. CONCLUSION These results provided evidence that the temporal relationship between BMI and insulin resistance is reciprocal and a higher BMI precedes hyperinsulinemia in Chinese adults. This relationship plays an essential role in the development of hypertension, while there is a difference between women and men.
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Affiliation(s)
- Yanxia Xie
- Department of Clinical Epidemiology, Library, Department of Health Policy and Hospital Management, Shengjing Hospital of China Medical University, 36 Sanhao Street, Heping District, Shenyang, 110004, PR China
| | - Rongrong Guo
- Department of Clinical Epidemiology, Library, Department of Health Policy and Hospital Management, Shengjing Hospital of China Medical University, 36 Sanhao Street, Heping District, Shenyang, 110004, PR China
| | - Zhao Li
- Department of Cardiology, The First Affiliated Hospital of China Medical University, 155 Nanjing Street, Heping District, Shenyang, 110001, PR China
| | - Xiaofan Guo
- Department of Cardiology, The First Affiliated Hospital of China Medical University, 155 Nanjing Street, Heping District, Shenyang, 110001, PR China
| | - Guozhe Sun
- Department of Cardiology, The First Affiliated Hospital of China Medical University, 155 Nanjing Street, Heping District, Shenyang, 110001, PR China
| | - Zhaoqing Sun
- Department of Cardiology, Shengjing Hospital of China Medical University, 36 Sanhao Street, Heping District, Shenyang, 110004, PR China
| | - Jia Zheng
- Department of Clinical Epidemiology, Library, Department of Health Policy and Hospital Management, Shengjing Hospital of China Medical University, 36 Sanhao Street, Heping District, Shenyang, 110004, PR China
| | - Yingxian Sun
- Department of Cardiology, Shengjing Hospital of China Medical University, 36 Sanhao Street, Heping District, Shenyang, 110004, PR China.
| | - Liqiang Zheng
- Department of Clinical Epidemiology, Library, Department of Health Policy and Hospital Management, Shengjing Hospital of China Medical University, 36 Sanhao Street, Heping District, Shenyang, 110004, PR China.
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Sun Y, Chen R, Lin S, Xie X, Ye H, Zheng F, Lin J, Huang Q, Huang S, Ruan Q, Zhang T, Li H, Wu S. Association of circular RNAs and environmental risk factors with coronary heart disease. BMC Cardiovasc Disord 2019; 19:223. [PMID: 31619168 PMCID: PMC6796436 DOI: 10.1186/s12872-019-1191-3] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2018] [Accepted: 08/25/2019] [Indexed: 11/30/2022] Open
Abstract
Background Coronary heart disease (CHD) is a complex disease caused by multi-factors and a major threat to human health. Circular RNAs (circRNAs) have critical roles in various biological processes and diseases. This study explores the independent role of circRNAs and their interaction with environmental factors in CHD. Methods A case–control study was conducted from March 2015 to September 2017 in Fuzhou, China. A total of 585 CHD patients and 585 gender- and age-matched healthy controls were enrolled. Questionnaire survey, health examination and molecular biology laboratory testing were conducted. Microarray technology and quantitative real-time polymerase chain reaction (PCR) were used to profile the expression levels of circRNAs. The area under the curve (AUC) of the receiver operating characteristic (ROC) was used to determine the diagnostic cut-offs. Multivariate logistic regression and multiplicative analysis were used to analyse the effects of environmental factors and hsa_circ_0008507, hsa_circ_0001946, hsa_circ_0000284 and hsa_circ_0125589 on CHD. Results The expression profile of circRNAs showed that 3423 circRNAs were differentially expressed at P < 0.05, but none pass multiple testing correction. qRT-PCR further confirmed the expression levels of hsa_circ_0008507, hsa_circ_0001946 and hsa_circ_0000284 in peripheral blood leukocytes in CHD cases were higher than those in non-CHD subjects (All p < 0.05). Hsa_circ_0008507 (OR = 1.29; 95% CI: 1.11–1.50), hsa_circ_0001946 (OR = 1.20; 95% CI: 1.01–1.42) and hsa_circ_0000284 (OR = 2.05; 95% CI: 1.32–3.19) were independent risk factors for CHD after controlling other common environmental risk factors. The AUC for hsa_circ_0008507, hsa_circ_0001946 and hsa_circ_0000284 was 0.75, 0.71 and 0.68, respectively. Compared with non-smoking individuals with low hsa_circ_0008507 expression, the smokers with high hsa_circ_0008507 expression showed the highest magnitude of OR in CHD risk. Additionally, a statistically significant multiplicative interaction was found between hsa_circ_0008507 and smoking for CHD. Conclusions Hsa_circ_0008507, hsa_circ_0001946 and hsa_circ_0000284 were closely related to the occurrence and development of CHD. The combination of smoking and high hsa_circ_0008507 expression causes the occurrence and development of CHD. Electronic supplementary material The online version of this article (10.1186/s12872-019-1191-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Yi Sun
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Minhou County, Fuzhou, Fujian, China
| | - Rong Chen
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Minhou County, Fuzhou, Fujian, China
| | - Shaowei Lin
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Minhou County, Fuzhou, Fujian, China
| | - Xiaoxu Xie
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Minhou County, Fuzhou, Fujian, China.,National Research Institute for Health and Family Planning, Beijing, China
| | - Hailing Ye
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Minhou County, Fuzhou, Fujian, China
| | - Fuli Zheng
- Department of Preventive Medicine, School of Public Health, Fujian Medical University, Minhou County, Fuzhou, Fujian, China
| | - Jie Lin
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Minhou County, Fuzhou, Fujian, China
| | - Qing Huang
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Minhou County, Fuzhou, Fujian, China
| | - Shuna Huang
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Minhou County, Fuzhou, Fujian, China
| | - Qishuang Ruan
- Department of Orthopedics, Fujian Medical University Union Hospital, Fuzhou, Fujian, China
| | - Tingxing Zhang
- Department of Cardiology, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China.
| | - Huangyuan Li
- Department of Preventive Medicine, School of Public Health, Fujian Medical University, Minhou County, Fuzhou, Fujian, China.
| | - Siying Wu
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Minhou County, Fuzhou, Fujian, China.
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Xie Y, Gao J, Guo R, Zheng J, Wang Y, Dai Y, Sun Z, Xing L, Zhang X, Sun YX, Zheng L. Stage 1 hypertension defined by the 2017 ACC/AHA guideline predicts future cardiovascular events in elderly Chinese individuals. J Clin Hypertens (Greenwich) 2019; 21:1637-1644. [PMID: 31556480 PMCID: PMC6900035 DOI: 10.1111/jch.13706] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Revised: 07/06/2019] [Accepted: 07/16/2019] [Indexed: 12/02/2022]
Abstract
The 2017 American College of Cardiology and American Heart Association (ACC/AHA) hypertension guideline updated stage 1 hypertension defined as systolic blood pressure (SBP) of 130‐139 mm Hg or diastolic blood pressure (DBP) of 80‐89 mm Hg. However, the impact of 1 hypertension that affects future cardiovascular risk remains unclear among older adults in rural China. The prospective cohort study included 7503 adults aged ≥60 years with complete data and no cardiovascular disease (CVD) at baseline. Follow‐up for the new adverse events was conducted from the end of the baseline survey to the end of the third follow‐up survey (2007.01‐2017.12). Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (95% CIs) for blood pressure (BP) classifications and adverse events with normal BP as reference (< 120/80 mm Hg). During the 57 290 person‐years follow‐up period, 2261 all‐cause mortality, 1271 CVD mortality, 1159 stroke, and 347 myocardial infarctions (MI) occurred. Patients with stage 1 hypertension versus normal BP had HRs (95% CI) of 1.068 (0.904‐1.261) for all‐cause mortality, 1.304 (1.015‐1.675) for CVD mortality, 1.449 (1.107‐1.899) for stroke, and 1.735 (1.051‐2.863) for MI, respectively. In conclusion, among adults aged ≥60 years, stage 1 hypertension revealed an increased hazard of CVD mortality, stroke, and MI, which is complementary evidence for the application of 2017 ACC/AHA hypertension guidelines in an older Chinese population. Therefore, BP control in patients with stage 1 hypertension may be beneficial to reduce the hazard of CVD in elderly Chinese individuals.
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Affiliation(s)
- Yanxia Xie
- Department of Clinical Epidemiology, Library, Shengjing Hospital of China Medical University, Shenyang, China
| | - Jinyue Gao
- Department of Clinical Epidemiology, Library, Shengjing Hospital of China Medical University, Shenyang, China
| | - Rongrong Guo
- Department of Clinical Epidemiology, Library, Shengjing Hospital of China Medical University, Shenyang, China
| | - Jia Zheng
- Department of Clinical Epidemiology, Library, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yali Wang
- Department of Clinical Epidemiology, Library, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yue Dai
- Department of Clinical Epidemiology, Library, Shengjing Hospital of China Medical University, Shenyang, China
| | - Zhaoqing Sun
- Department of Cardiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Liying Xing
- Institute of Chronic Disease, Liaoning Provincial Center for Disease Control and Prevention, Shenyang, China
| | - Xingang Zhang
- Department of Cardiology, the First Affiliated Hospital of China Medical University, Shenyang, China
| | - Ying Xian Sun
- Department of Cardiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Liqiang Zheng
- Department of Clinical Epidemiology, Library, Shengjing Hospital of China Medical University, Shenyang, China
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Shi W, Zhou Y, Sun Y. Could Serum Sodium Predict Cardiovascular Death in the General Population? A Focus on the Chinese Population. Can J Cardiol 2019; 35:1605.e11-1605.e12. [PMID: 31537393 DOI: 10.1016/j.cjca.2019.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Accepted: 07/03/2019] [Indexed: 11/27/2022] Open
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Zheng J, Sun Z, Guo X, Xie Y, Sun Y, Zheng L. Blood pressure predictors of stroke in rural Chinese dwellers with hypertension: a large-scale prospective cohort study. BMC Cardiovasc Disord 2019; 19:206. [PMID: 31464591 PMCID: PMC6716914 DOI: 10.1186/s12872-019-1186-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Accepted: 08/16/2019] [Indexed: 01/07/2023] Open
Abstract
Background Little was known about the different predictive power of blood pressure (BP) parameters (SBP, systolic BP; mean arterial pressure, MAP; pulse pressure, PP; and diastolic BP, DBP) and stroke incidence. This study’s aim was to compare power of BP parameters predict stroke events among rural dwelling Chinese individuals with hypertension. Method A total of 5097 hypertension patients (56.2% women; mean age, 56.3 ± 11.2 years) were included in the prospective cohort study with a median follow-up of 8.4 years. Results Until the end of the last follow-up, there were 501 onset strokes (310 ischemic, 186 hemorrhagic, and 5 unclassified strokes) among the 5097 participants. The results showed that hazard ratio (HR) (95% confidence interval, 95% CI) with an increment of 5 mmHg were 1.095 (1.070–1.121) for PP, 1.173 (1.139–1.208) for MAP, 1.109(1.089–1.130) for SBP, 1.143(1.104–1.185) for DBP. The SBP indicated the largest β coefficient in the Cox proportional hazard model for all stroke except PP or MAP, and the SBP revealed slightly higher value than MAP (βSBP = 0.435, βMAP = 0.430, P = 0.756). Conclusions Both PP and MAP were predictive factors for stroke. The MAP showed a stronger ability to predict stroke events than PP, and slightly inferior to SBP for hypertension patients.
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Affiliation(s)
- Jia Zheng
- Department of Clinical Epidemiology, Library, Department of Health Policy and Hospital Management, Shengjing Hospital of China Medical University, Shenyang, 110004, People's Republic of China
| | - Zhaoqing Sun
- Department of Cardiology, Shengjing Hospital of China Medical University, Shenyang, 110004, People's Republic of China
| | - Xiaofan Guo
- Department of Cardiology, the First Affiliated Hospital of China Medical University, Shenyang, 110001, People's Republic of China
| | - Yanxia Xie
- Department of Clinical Epidemiology, Library, Department of Health Policy and Hospital Management, Shengjing Hospital of China Medical University, Shenyang, 110004, People's Republic of China
| | - Yingxian Sun
- Department of Cardiology, Shengjing Hospital of China Medical University, Shenyang, 110004, People's Republic of China.
| | - Liqiang Zheng
- Department of Clinical Epidemiology, Library, Department of Health Policy and Hospital Management, Shengjing Hospital of China Medical University, Shenyang, 110004, People's Republic of China.
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Short-Term and Long-Term Blood Pressure Changes and the Risk of All-Cause and Cardiovascular Mortality. BIOMED RESEARCH INTERNATIONAL 2019; 2019:5274097. [PMID: 31467896 PMCID: PMC6699331 DOI: 10.1155/2019/5274097] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Revised: 07/02/2019] [Accepted: 07/07/2019] [Indexed: 11/24/2022]
Abstract
Background Few studies compared the effects of BP changes in short- and long-terms on all-cause mortality and CVD mortality. Methods We performed a 12.5-year follow-up study to examine the association between short- (2008 to 2010) and long-term [baseline (2004-2006) to 2010] BP changes and the risk of mortality (2010 to 2017) in the Fuxin prospective cohort study. The Cox proportional hazards model was used for this study, and the average BP was stratified according to the Seven Joint National Committee (JNC7). Results We identified 1496 (805 CVD deaths) and 2138 deaths (1222 CVD deaths) in short- and long-term study. Compared with BP maintainer, in short-term BP changes, for participants from normotension or prehypertension to hypertension, the hazards ratios (HRs) and 95% confidence intervals (CIs) of all-cause mortality were 1.948 (1.118-3.392) and 1.439 (1.218-1.700), respectively, while for participants from hypertension to prehypertension, the HRs (95% CIs) were 0.766 (0.638-0.899) for all-cause mortality and 0.729 (0.585-0.908) for CVD mortality, respectively. In long-term BP changes, for participants from normotension or prehypertension to hypertension, the HRs (95% CIs) of all-cause mortality were 1.738 (1.099-2.749) and 1.203 (1.023-1.414), and they were 2.351 (1.049-5.269) and 1.323 (1.047-1.672) for CVD mortality, respectively. In addition, the effects of short-term BP changes on all-cause and CVD mortality, measured as regression coefficients (β), were significantly greater than those in long-term change (all P<0.05). Conclusions Our study emphasizes that short-term changes in BP have a greater impact on all-cause and CVD mortality than long-term changes and assess the cut-off value of the changes in blood pressure elevation.
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The Use of Alcohol and Knowledge of Cardiovascular Diseases among Ellisras Rural Children Aged 14-22 Years: Ellisras Longitudinal Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16152650. [PMID: 31344981 PMCID: PMC6695915 DOI: 10.3390/ijerph16152650] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Revised: 07/22/2019] [Accepted: 07/22/2019] [Indexed: 01/07/2023]
Abstract
The harm alcohol abuse does to physical and mental health is well established. The perception of cardiovascular disease risk factors and alcohol use requires attention. This study aims to investigate the association between alcohol usage and knowledge of cardiovascular diseases (CVDs) risk factors among Ellisras rural adolescents and young adults aged 14–22 years. In this cross-sectional study a total of 1409 subjects (736 boys and 673 girls), aged 14–22 years, from the Ellisras Longitudinal Study, South Africa completed a validated alcohol use and CVDs knowledge questionnaire. Logistic regression was used to estimate the association. The prevalence of alcohol intake increased with increasing age among girls (13.6% to 17.7%) and boys (10.3% to 16.9%) and reached a statistically significant difference (p < 0.024) at an older age category (20–22 years). There was a significant (p < 0.05) association between alcohol use and a positive response on the following knowledge statements: The fact that cardiovascular disease attacked all age groups and mostly elderly people (the odds ratio (OR) ranged between 0.5 95% confidence interval (CI) = 0.33–0.74 and OR = 2.86 95% CI = 1.27–6.42). Medical doctors can help to diagnose somebody with cardiovascular diseases (OR ranged between 2.25 95% CI = 1.49–3.39 and OR = 0.75 95% CI = 0.65–0.87). The condition for cardiovascular diseases developed over a long period (OR ranged between 1.75 95% CI = 1.16–2.64 and OR = 2.23 95% CI = 1.34–4.07). The prevalence of alcohol use in Ellisras rural adolescents and young adults begins between the ages of 14 and 16 years and increases with age. Binge drinking was more evident on Fridays and Saturdays among the Ellisras rural adolescents and young adults with girls showing a significantly higher prevalence of binge drinking compared to boys on a Friday.
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Guo Q, Xie W, Peng R, Ma Y, Chong F, Wang Y, Song M, Ye H, Wang P, Wang K, Song C. A Dose-Response Relationship Between Sleep Duration and Stroke According to Nonhealth Status in Central China: A Population-based Epidemiology Survey. J Stroke Cerebrovasc Dis 2019; 28:1841-1852. [PMID: 31076320 DOI: 10.1016/j.jstrokecerebrovasdis.2019.04.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Revised: 04/05/2019] [Accepted: 04/09/2019] [Indexed: 11/27/2022] Open
Abstract
PURPOSE The aim was to investigate the relationship between sleep duration and stroke according to nonhealth status among adults in Central China. METHODS A total of 18,670 participants were selected by stratified multistage random sampling method in Henan province during 2013-2015. Restricted cubic splines and logistic regression were used to calculate the association between sleep duration and stroke. RESULTS Sleep duration showing a J-shaped dose-response association with risk of stroke among the Chinese adults in the study. The respective percentages of stroke were 6.2%, 5.6%, 3.5%, 4.5%, 5.6%, and 9.2% for those whose sleep duration less than 6 h/day, 6∼7 h/day, 7∼8 h/day, 8∼9 h/day, 9∼10 h/day, and more than or equal to 10 h/day. Compared with sleep duration of 7∼8 h/day, the risk of stroke increased by 37% (95% confidence interval [CI]: 8%, 73%) and 63% (95% CI: 30%, 104%) for those whose sleep duration were 9∼10 h/day and more than or equal to 10 h/day. The correlations between sleep durations and stroke seemed to be stronger in men than women. Stroke was associated with shorter sleep duration in ageing 60-88 years, instead of 18-59 years. The correlation between sleep duration and stroke was statistically significant at lower education level. Furthermore, the risk of stroke was slightly higher in urban residents than rural residents. CONCLUSIONS In summary, a J-shaped dose-response association between sleep duration and stroke was found among the adults in Central China. Furthermore, people who were male, older, less educated and living in urban areas had a higher risk of stroke.
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Affiliation(s)
- Qiaoyun Guo
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China; Henan Key Laboratory of Tumor Epidemiology, Zhengzhou, Henan, China
| | - Weihong Xie
- Department of Oral and Maxillofacial Surgery, the First Affiliated Hospital, Zhengzhou University, Zhengzhou, Henan, China
| | - Rui Peng
- The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yan Ma
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China; Henan Key Laboratory of Tumor Epidemiology, Zhengzhou, Henan, China
| | - Feifei Chong
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China; Henan Key Laboratory of Tumor Epidemiology, Zhengzhou, Henan, China
| | - Yanli Wang
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China; Henan Key Laboratory of Tumor Epidemiology, Zhengzhou, Henan, China
| | - Mengmeng Song
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China; Henan Key Laboratory of Tumor Epidemiology, Zhengzhou, Henan, China
| | - Hua Ye
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China; Henan Key Laboratory of Tumor Epidemiology, Zhengzhou, Henan, China
| | - Peng Wang
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China; Henan Key Laboratory of Tumor Epidemiology, Zhengzhou, Henan, China
| | - Kaijuan Wang
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China; Henan Key Laboratory of Tumor Epidemiology, Zhengzhou, Henan, China
| | - Chunhua Song
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China; Henan Key Laboratory of Tumor Epidemiology, Zhengzhou, Henan, China.
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Wang Y, Dai Y, Zheng J, Xie Y, Guo R, Guo X, Sun G, Sun Z, Sun Y, Zheng L. Sex difference in the incidence of stroke and its corresponding influence factors: results from a follow-up 8.4 years of rural China hypertensive prospective cohort study. Lipids Health Dis 2019; 18:72. [PMID: 30909919 PMCID: PMC6434616 DOI: 10.1186/s12944-019-1010-y] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Accepted: 03/08/2019] [Indexed: 02/08/2023] Open
Abstract
Background Few studies investigate sex difference in stroke incidence in rural China hypertensive population. Methods A total of 5097 hypertensive patients aged ≥35 years (mean age, 56.3 ± 11.2 years; 43.8% men) were included in our analysis with a median follow-up 8.4 years in Fuxin county of Liaoning province in China. Cox proportional hazard models were used to analyze the association between the potential factors and incident stroke. Results We observed 501 new strokes (310 ischemic, 186 hemorrhagic, and 5 unclassified stroke) during the follow-up. The overall incidence of stroke was 1235.21 per 100,000 person-years; for men, the rates were 1652.51 and 920.80 for women. This sex difference in all stroke can be explained by approximately 25% through age, systolic blood pressure, body mass index, low-density lipoprotein-cholesterol, current smoking, current drinking, antihypertensive drugs, education and physical activity. Subgroup analysis indicated that in hemorrhagic stroke this sex difference was more remarkable (63.89% can be explained). Conclusions The incidence of stroke was higher in men than that in women and this difference was partly explained by several traditional cardiovascular risk factors.
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Affiliation(s)
- Yali Wang
- Department of Clinical Epidemiology, Library, Department of Health Policy and Hospital Management, Shengjing Hospital of China Medical University, Shenyang, 110004, People's Republic of China
| | - Yue Dai
- Department of Clinical Epidemiology, Library, Department of Health Policy and Hospital Management, Shengjing Hospital of China Medical University, Shenyang, 110004, People's Republic of China
| | - Jia Zheng
- Department of Clinical Epidemiology, Library, Department of Health Policy and Hospital Management, Shengjing Hospital of China Medical University, Shenyang, 110004, People's Republic of China
| | - Yanxia Xie
- Department of Clinical Epidemiology, Library, Department of Health Policy and Hospital Management, Shengjing Hospital of China Medical University, Shenyang, 110004, People's Republic of China
| | - Rongrong Guo
- Department of Clinical Epidemiology, Library, Department of Health Policy and Hospital Management, Shengjing Hospital of China Medical University, Shenyang, 110004, People's Republic of China
| | - Xiaofan Guo
- Department of Cardiology, the First Affiliated Hospital of China Medical University, Shenyang, 110001, People's Republic of China
| | - Guozhe Sun
- Department of Cardiology, the First Affiliated Hospital of China Medical University, Shenyang, 110001, People's Republic of China
| | - Zhaoqing Sun
- Department of Cardiology, Shengjing Hospital of China Medical University, 36 Sanhao Street, Heping District, Shenyang, 110004, People's Republic of China
| | - Yingxian Sun
- Department of Cardiology, Shengjing Hospital of China Medical University, 36 Sanhao Street, Heping District, Shenyang, 110004, People's Republic of China.
| | - Liqiang Zheng
- Department of Clinical Epidemiology, Library, Department of Health Policy and Hospital Management, Shengjing Hospital of China Medical University, Shenyang, 110004, People's Republic of China.
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Zheng J, Sun Z, Zhang X, Li Z, Guo X, Xie Y, Sun Y, Zheng L. Non-traditional lipid profiles associated with ischemic stroke not hemorrhagic stroke in hypertensive patients: results from an 8.4 years follow-up study. Lipids Health Dis 2019; 18:9. [PMID: 30621696 PMCID: PMC6325839 DOI: 10.1186/s12944-019-0958-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Accepted: 01/01/2019] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Studies have shown that non-traditional lipid profiles have a better association with stroke than traditional blood lipids in clinical applications, other studies have drawn different conclusions. METHODS This study was a large-scale study with a median follow-up of 8.4 years. The hazard ratio (HR) and 95% Confidence interval (CI) of lipid variables for risk of incident stroke were analyzed by multivariable Cox proportional hazard models. RESULTS During the follow-up, 502 new strokes (310 ischemic, 187 hemorrhagic, and 5 unclassified strokes) occurred among the 5099 hypertensive patients. Comparing with the lowest quarter, the HR of future ischemic stroke (IS) in the highest were 1.41(95%CI, 1.03-1.92) for TC, 1.60 (95%CI, 1.15-2.22) for TG, 1.03 (95%CI, 0.75-1.42) for HDL-C, 1.77 (95%CI, 1.29-2.44) for LDL-C, 1.42 (95%CI, 1.03-1.94) for non-HDL, 2.09 (95%CI, 1.45-3.00) for TC/HDL, 2.08 (95%CI, 1.46-2.96) for LDL/HDL, 1.86 (95%CI 1.33-2.60) for TG/HDL, respectively. No significant association was observed between lipid-related indicators and hemorrhagic stroke. The results of statistical differences showed that the correlation between LDL/HDL and the risk of ischemic stroke in non-traditional lipids was higher than that of other traditional lipids (P < 0.001), except for LDL (P = 0.056). CONCLUSIONS We didn't find that HDL was associated with the risk of stroke and all the lipid parameters were not associated with the risk of hemorrhagic stroke. LDL/HDL was associated with a higher risk of ischemic stroke than other lipids and should be considered for clinical diagnosis and future disease prevention.
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Affiliation(s)
- Jia Zheng
- Department of Clinical Epidemiology, Library, Department of Health Policy and Hospital Management, Shengjing Hospital of China Medical University, Shenyang, 110004, People's Republic of China
| | - Zhaoqing Sun
- Department of Cardiology, Shengjing Hospital of China Medical University, Shenyang, 110004, People's Republic of China
| | - Xingang Zhang
- Department of Cardiology, First Affiliated Hospital of China Medical University, Shenyang, 110001, People's Republic of China
| | - Zhao Li
- Department of Cardiology, First Affiliated Hospital of China Medical University, Shenyang, 110001, People's Republic of China
| | - Xiaofan Guo
- Department of Cardiology, First Affiliated Hospital of China Medical University, Shenyang, 110001, People's Republic of China
| | - Yanxia Xie
- Department of Clinical Epidemiology, Library, Department of Health Policy and Hospital Management, Shengjing Hospital of China Medical University, Shenyang, 110004, People's Republic of China
| | - Yingxian Sun
- Department of Cardiology, Shengjing Hospital of China Medical University, Shenyang, 110004, People's Republic of China.
| | - Liqiang Zheng
- Department of Clinical Epidemiology, Library, Department of Health Policy and Hospital Management, Shengjing Hospital of China Medical University, Shenyang, 110004, People's Republic of China.
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Zheng L, Zheng J, Xie Y, Li Z, Guo X, Sun G, Sun Z, Xing F, Sun Y. Serum gut microbe-dependent trimethylamine N-oxide improves the prediction of future cardiovascular disease in a community-based general population. Atherosclerosis 2019; 280:126-131. [DOI: 10.1016/j.atherosclerosis.2018.11.010] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Revised: 09/29/2018] [Accepted: 11/07/2018] [Indexed: 12/12/2022]
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Guo Y, Hu H, Liu Y, Leng Y, Gao X, Cui Q, Chen J, Geng B, Zhou Y. Gender differences in the relationship between alcohol consumption and insomnia in the northern Chinese population. PLoS One 2018; 13:e0207392. [PMID: 30521547 PMCID: PMC6283629 DOI: 10.1371/journal.pone.0207392] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Accepted: 10/30/2018] [Indexed: 01/01/2023] Open
Abstract
Background Insomnia is one of the main symptoms of sleep disorders. Previous studies have suggested that alcohol intake is associated with several adverse health outcomes. The association between alcohol consumption and insomnia has been addressed in several studies with different results. However, whether gender may modify the association between alcohol consumption and insomnia is not clear. This study will focus on gender differences in the relationship between alcohol consumption and insomnia. Methods The final study includes 8081 subjects aged between 18 and 65 years from the Jidong cohort. The data on alcohol consumption is collected by questionnaires, and insomnia problems are assessed using the entire 8-item Athens Insomnia Scale (AIS-8). Logistic analysis is used to evaluate the association between alcohol consumption and insomnia. Results Among the 8081 participants in this study, 2618 (32.4%) are alcohol drinkers, including 2424 males and 194 females. The prevalence of insomnia is 9.6% in the male and 10.6% in the female. The adjusted odds ratios (ORs) with 95% confidence interval (CI) of mild-to-moderate drinkers and heavy drinkers for insomnia are 1.27 (1.02–1.58) and 1.02 (0.79–1.32), respectively. Heavy alcohol consumption is significantly correlated with insomnia in the female, after controlling for potential confounding factors (OR: 2.11, 95% CI: 1.28–3.49, p for interaction = 0.002). Conclusion A significant association between alcohol consumption and insomnia is found in females, but not in males from the northern Chinese population.
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Affiliation(s)
- Yuchen Guo
- Department of Health Information Management, Institute of Medical Information, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Hongpu Hu
- Department of Health Information Management, Institute of Medical Information, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Yingping Liu
- Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
| | - Yue Leng
- Department of Psychiatry, University of California, San Francisco, California, United States of America
| | - Xing Gao
- Department of Health Information Management, Institute of Medical Information, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Qinghua Cui
- Department of Biomedical Informatics, School of Basic Medical Sciences, Key Laboratory of Molecular Cardiovascular Science of the Ministry of Education Center for Non-coding RNA Medicine, Peking University Health Science Center, Beijing, China
| | - Jianxin Chen
- Beijing University of Chinese Medicine, Beijing, China
| | - Bin Geng
- Hypertension Center, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, State Key Laboratory of Cardiovascular Disease, Beijing, China
| | - Yong Zhou
- Sanbo Brain Institute, Sanbo Brain Hospital, Capital Medical University, Beijing, China
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Yan Y, Zhang Y, Yang Q, Dong K, Duan F, Liang S, Ma N, Nie W, Song C, Wang K. Association between resting heart rate and hypertension in Chinese with different waist-to-height ratio: a population-based cross-sectional study. JOURNAL OF THE AMERICAN SOCIETY OF HYPERTENSION : JASH 2018; 12:e93-e101. [PMID: 30268408 DOI: 10.1016/j.jash.2018.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Revised: 08/13/2018] [Accepted: 08/26/2018] [Indexed: 06/08/2023]
Abstract
Elevated resting heart rate (RHR) and obesity are important risk factors for hypertension. However, studies are rare on the combined impact of RHR and obesity on prehypertension and hypertension. This study aimed to investigate the association between RHR and hypertension with different waist-to-height ratio (WHtR) in Chinese. The population-based cross-sectional study was conducted during 2013-2015 in Henan province, China, and 15,536 participants aged ≥15 years were included. RHR was classified according to sex-specific quartiles. The cutoff value of WHtR was 0.5 in both sexes. Multilinear and multilogistic regression models were used to evaluate the association of RHR and WHtR with prehypertension and hypertension. In both sexes, higher RHR was associated with higher blood pressure and lower pulse pressure. Compared with the lowest RHR quartile, participants in the highest RHR quartile had an increased risk of prehypertension (odds ratio [OR]: 1.40, 95% confidence interval [CI]: 1.18-1.65; OR: 1.27, 95% CI: 1.09-1.48) and hypertension (OR: 1.75, 95% CI: 1.43-2.15; OR: 1.36, 95% CI: 1.13-1.63) for male and female, respectively, after fully adjusting the data. In addition, adjusted ORs for prehypertension and hypertension of participants with high WHtR and high RHR were 2.91 (95% CI: 2.38-3.55) and 6.28 (4.96-7.97) for male and 2.45 (2.05-2.93) and 4.63 (3.66-5.85) for female, respectively, compared with the normal WHtR and normal RHR. In conclusion, elevated RHR was significantly associated with the risk of prehypertension and hypertension in Chinese and WHtR as a measure of abdominal obesity further increased this association.
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Affiliation(s)
- Yali Yan
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China; Key Laboratory of Tumor Epidemiology of Henan Province, Zhengzhou, China
| | - Ye Zhang
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China; Key Laboratory of Tumor Epidemiology of Henan Province, Zhengzhou, China
| | - Qian Yang
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China; Key Laboratory of Tumor Epidemiology of Henan Province, Zhengzhou, China
| | - Kaiyan Dong
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China; Key Laboratory of Tumor Epidemiology of Henan Province, Zhengzhou, China
| | - Fujiao Duan
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China; Key Laboratory of Tumor Epidemiology of Henan Province, Zhengzhou, China
| | - Shuying Liang
- The Henan Academy of Medical Sciences, Zhengzhou, China
| | - Nan Ma
- The Henan Academy of Medical Sciences, Zhengzhou, China
| | - Wei Nie
- The Henan Academy of Medical Sciences, Zhengzhou, China
| | - Chunhua Song
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China; Key Laboratory of Tumor Epidemiology of Henan Province, Zhengzhou, China
| | - Kaijuan Wang
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China; Key Laboratory of Tumor Epidemiology of Henan Province, Zhengzhou, China.
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Wang H, Wang S, Sun Y. Could red blood cell distribution width predict high CHADS 2 and CHADS 2-VAS C score in adults with atrial fibrillation? A focus on the general population. Int J Cardiol 2018; 271:345. [PMID: 30223368 DOI: 10.1016/j.ijcard.2018.04.097] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Accepted: 04/20/2018] [Indexed: 12/01/2022]
Affiliation(s)
- Haoyu Wang
- Department of Cardiology, The First Hospital of China Medical University, 155 Nanjing North Street, Heping District, Shenyang 110001, China
| | - Shuze Wang
- Department of Computational Medicine and Bioinformatics, University of Michigan, 100 Washtenaw Avenue, Ann Arbor, MI 48109, USA
| | - Yingxian Sun
- Department of Cardiology, The First Hospital of China Medical University, 155 Nanjing North Street, Heping District, Shenyang 110001, China.
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Wang H, Wang S, Tao Y, Sun Y. Further insight into 10-year CVD risk evaluation and recommended eligibility for statin therapy in Chinese population: Comparison of cardiovascular risk prediction models and their guidelines. Int J Cardiol 2018; 271:343. [DOI: 10.1016/j.ijcard.2018.04.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Accepted: 04/05/2018] [Indexed: 11/29/2022]
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Reply. J Hypertens 2018; 36:1946-1947. [PMID: 30192311 DOI: 10.1097/hjh.0000000000001833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Evaluation of the impact of aortic root dimension on arterial stiffness in the general population: insights from a large Asian population. J Hypertens 2018; 36:1944-1945. [PMID: 30192310 DOI: 10.1097/hjh.0000000000001831] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Wang H, Wang S, Yi X, Tao Y, Qian H, Jia P, Chen Y, Sun Y. Estimate of ischemic stroke prevalence according to a novel 4-tiered classification of left ventricular hypertrophy: insights from the general Chinese population. Ann Med 2018; 50:519-528. [PMID: 30001637 DOI: 10.1080/07853890.2018.1500702] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Recently, a novel 4-tiered classification of left ventricular hypertrophy (LVH) based on ventricular dilatation (indexed LV end-diastolic volume [EDV]) and concentricity (mass/EDV0.67) has improved all-cause and cardiovascular mortality risk stratification. However, their possible association with ischemic stroke has not been extensively evaluated in the general population. METHODS We evaluated a cross-sectional study of 11,037 subjects from the general population of China in whom echocardiographic and ischemic stroke data were available to subdivide patients with LVH into four geometric patterns: indeterminate, dilated, thick and both thick and dilated hypertrophy. RESULTS Compared with normal LV geometry, indeterminate and thick hypertrophy showed a higher prevalence of ischemic stroke (p < .05). Ischemic stroke was significantly greater in participants with indeterminate (adjusted odd ratio [OR]:1.635, 95% confidence interval [CI]: 1.115-2.398) and thick (2.143 [1.329-3.456]) hypertrophy but not significantly in those with dilated (1.251 [0.803-1.950]) and both thick and dilated hypertrophy (0.926 [0.435-1.971]) compared with normal geometry in multivariable analysis. CONCLUSIONS Indeterminate and thick hypertrophy were significantly associated with the presence of ischemic stroke in the general Chinese population. The new 4-tiered categorization of LVH can permit a better understanding of which subjects are at high enough risk for ischemic stroke to warrant early targeted therapy. Key messages This was the first study to investigate whether a 4-tiered classification of LVH defines subgroups in the general population that are at variable risks of ischemic stroke. We identified that thick hypertrophy carried the greatest odd for ischemic stroke, independently of traditional risk factors, followed by indeterminate hypertrophy. The new 4-tiered categorization of LVH emerged as a valuable operational approach, a potential alternative to LVM, to refine ischemic stroke stratification in general population.
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Affiliation(s)
- Haoyu Wang
- a Department of Cardiology , The First Hospital of China Medical University , Shenyang , Liaoning , China
| | - Shuze Wang
- b Department of Computational Medicine and Bioinformatics , University of Michigan , Ann Arbor , MI , USA
| | - Xin Yi
- c Department of Cardiovascular Medicine , Beijing Moslem Hospital , Beijing , China
| | - Yining Tao
- d Department of Radiology , Shanghai Jiao Tong University Affiliated Sixth People's Hospital , Shanghai , China
| | - Hao Qian
- a Department of Cardiology , The First Hospital of China Medical University , Shenyang , Liaoning , China
| | - Pengyu Jia
- a Department of Cardiology , The First Hospital of China Medical University , Shenyang , Liaoning , China
| | - Yintao Chen
- e Department of Cardiovascular Medicine , The First Affiliated Hospital of Chongqing Medical University , Chongqing , China
| | - Yingxian Sun
- a Department of Cardiology , The First Hospital of China Medical University , Shenyang , Liaoning , China
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