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Li Y, Zhong D, Dong C, Shi L, Zheng Y, Liu Y, Li Q, Zheng H, Li J, Liu T, Jin R. The effectiveness and safety of Tai Chi for patients with essential hypertension: study protocol for an open-label single-center randomized controlled trial. BMC Complement Med Ther 2021; 21:23. [PMID: 33413354 PMCID: PMC7792191 DOI: 10.1186/s12906-020-03192-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Accepted: 12/15/2020] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Evidence showed that Tai Chi may have beneficial effects among hypertensive individuals, although the results are not convincing. We aim to conduct a high-quality clinical trial with 24-h BP measurement to provide robust evidence of Tai Chi for essential hypertension. METHODS This is an open-label single-center randomized controlled trial with 3 parallel arms. We will compare Tai Chi with walking and waiting-list control. We will recruit 234 hypertensive patients with mild to moderate essential hypertension and randomly assign them to 3 different groups. Participants in Tai Chi group will receive a group-format Yang style 24-form Tai Chi exercise program, 3 sessions per week for 12 weeks. The walking group will be asked to walk, 3 sessions per week for 12 weeks. The waiting-list group will not receive any interventions and/or exercise training. The primary outcome is the change in average 24-h systolic blood pressure (SBP) between baseline and 12 weeks after randomization. The secondary outcomes include 24-h Diastolic Blood Pressure (DBP), average SBP and average DBP during the daytime and night-time, blood pressure (BP) variability, SBP load and DBP load, circadian rhythm of BP, and morning BP surge, endothelial functional indicators, home measured BP, quality of life, adverse events and so on. DISCUSSION We expect findings of this trial will provide important insight into application of Tai Chi as an effective and acceptable method for hypertensive patients. Successful completion of this proposed study will also contribute to promotion of Tai Chi in the community in the future. TRIAL REGISTRATION Clinicaltrials.gov registry: https://clinicaltrials.gov/ct2/show/NCT04267471 , date: February 12, 2020.
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Affiliation(s)
- Yuxi Li
- School of Acupuncture-Moxibustion and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Dongling Zhong
- School of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Chao Dong
- The General Hospital of Western Theater Command, Chengdu, China
| | - Lihong Shi
- School of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Yaling Zheng
- School of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Yongguo Liu
- Knowledge and Data Engineering Laboratory of Chinese Medicine, School of Information and Software Engineering, University of Electronic Science and Technology of China, Chengdu, China
| | - Qiaoqin Li
- Knowledge and Data Engineering Laboratory of Chinese Medicine, School of Information and Software Engineering, University of Electronic Science and Technology of China, Chengdu, China
| | - Hui Zheng
- School of Acupuncture-Moxibustion and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Juan Li
- School of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, China.
| | - Tianyu Liu
- School of Sports, Chengdu University of Traditional Chinese Medicine, Chengdu, China.
| | - Rongjiang Jin
- School of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, China.
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The changing epidemiology of Ebstein's anomaly and its relationship with maternal mental health conditions: a European registry-based study. Cardiol Young 2017; 27:677-685. [PMID: 27572669 DOI: 10.1017/s1047951116001025] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVES The aim of this study was to describe the epidemiology of Ebstein's anomaly in Europe and its association with maternal health and medication exposure during pregnancy. DESIGN We carried out a descriptive epidemiological analysis of population-based data. SETTING We included data from 15 European Surveillance of Congenital Anomalies Congenital Anomaly Registries in 12 European countries, with a population of 5.6 million births during 1982-2011. Participants Cases included live births, fetal deaths from 20 weeks gestation, and terminations of pregnancy for fetal anomaly. Main outcome measures We estimated total prevalence per 10,000 births. Odds ratios for exposure to maternal illnesses/medications in the first trimester of pregnancy were calculated by comparing Ebstein's anomaly cases with cardiac and non-cardiac malformed controls, excluding cases with genetic syndromes and adjusting for time period and country. RESULTS In total, 264 Ebstein's anomaly cases were recorded; 81% were live births, 2% of which were diagnosed after the 1st year of life; 54% of cases with Ebstein's anomaly or a co-existing congenital anomaly were prenatally diagnosed. Total prevalence rose over time from 0.29 (95% confidence interval (CI) 0.20-0.41) to 0.48 (95% CI 0.40-0.57) (p<0.01). In all, nine cases were exposed to maternal mental health conditions/medications (adjusted odds ratio (adjOR) 2.64, 95% CI 1.33-5.21) compared with cardiac controls. Cases were more likely to be exposed to maternal β-thalassemia (adjOR 10.5, 95% CI 3.13-35.3, n=3) and haemorrhage in early pregnancy (adjOR 1.77, 95% CI 0.93-3.38, n=11) compared with cardiac controls. CONCLUSIONS The increasing prevalence of Ebstein's anomaly may be related to better and earlier diagnosis. Our data suggest that Ebstein's anomaly is associated with maternal mental health problems generally rather than lithium or benzodiazepines specifically; therefore, changing or stopping medications may not be preventative. We found new associations requiring confirmation.
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Chen CC, Liu K, Hsu CC, Chang HY, Chung HC, Liu JS, Liu YH, Tsai TL, Liaw WJ, Lin IC, Wu HW, Juan CC, Chiu HC, Lee MM, Hsiung CA. Healthy lifestyle and normal waist circumference are associated with a lower 5-year risk of type 2 diabetes in middle-aged and elderly individuals: Results from the healthy aging longitudinal study in Taiwan (HALST). Medicine (Baltimore) 2017; 96:e6025. [PMID: 28178143 PMCID: PMC5313000 DOI: 10.1097/md.0000000000006025] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Type 2 diabetes mellitus (DM) is known to be closely associated with lifestyle and obesity and has a prevalence that increases with age. This study aimed to assess the short-term composite effect of diet, physical activity, psychosocial health, and waist circumference (WC) on the incidence of DM in the elderly and to provide a lifestyle-based predictive index.We used baseline measurements (2009-2013) of 5349 community-dwelling participants (aged 55 years and older, 52% female) of the Healthy Aging Longitudinal Study in Taiwan (HALST) for fasting plasma glucose, HbA1C, serum cholesterol, triglycerides, blood pressures, WC, and outcomes of home-visit questionnaire. Principal component analysis (PCA) was used to identify participants with a healthy lifestyle (HLF: higher diet, physical activity, and psychosocial scores) and a lower WC, with cutoffs determined by the receiver-operating characteristics. A Cox regression model was applied to 3424 participants without DM at baseline by linking to their National Health Insurance records (median follow-up of 3.1 years).In total, 247 new DM cases (7.2%) were identified. The HLF and lower WC group had a relative risk (RR) of DM of 0.54 (95% CI 0.35-0.82) compared to the non-HLF and higher WC group. When stratified by the presence of impaired glucose tolerance (IGT) or metabolic syndrome (MS), only participants with IGT/MS showed significant risks (RR 0.55; 95% CI 0.33-0.92). However, except for WC, the individual lifestyle factors were nonsignificant in the overall model without PCA.A composite protective effect of HLF and normal WC on DM within 5 years was observed, especially in those with IGT or MS. Psychosocial health constituted an important lifestyle factor in the elderly. The cutoffs identified could be used as a lifestyle-based risk index for DM. Maintaining an HLF to prevent DM is especially important for the elderly.
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Affiliation(s)
- Chu-Chih Chen
- Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Taiwan
| | - Kiang Liu
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Chih-Chen Hsu
- Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Taiwan
| | - Hsing-Yi Chang
- Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Taiwan
| | - Hsiao-Chun Chung
- Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Taiwan
| | - Jih-Shin Liu
- Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Taiwan
| | | | | | | | - I-Ching Lin
- Department of Family Medicine, Changhua Christian Hospital, Changhua
| | - Hsi-Wen Wu
- Family Medicine, Community Health Department, Mennonite Christian Hospital, Hualien
| | | | - Hou-Chang Chiu
- Department of Neurology, Shin Kong Wu Ho Su Memorial Hospital, Taipei
- College of Medicine, Fu-Jen Catholic University, New Taipei City, Taiwan
| | - Marion M. Lee
- Division of Cancer Epidemiology, Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
| | - Chao A. Hsiung
- Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Taiwan
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Li P, Chen K, Nie Y, Guo LL, Wang HB, Wang SS, Wang AP, Hu DY, Mu YM, Li JH. Association of obesity with glucose, blood pressure, and lipid goals attainment in patients with concomitant diabetes and hypertension. Curr Med Res Opin 2015; 31:1623-31. [PMID: 26051230 DOI: 10.1185/03007995.2015.1058770] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To investigate the associations between obesity and any significant improvements in glycemic control, blood pressure, and lipid targets in Chinese patients with concomitant type 2 diabetes mellitus (T2DM) and hypertension. METHODS AND RESULTS A total of 3041 dyslipidemia patients with an average age of 65.7 ± 10.53 years and comorbid conditions of T2DM and hypertension from the DYSlipidemia International Study (DYSIS) - China were included in the present subgroup analysis. Patients' demographic data, medication use, blood glucose, and lipid parameters were analyzed retrospectively. Body mass index (BMI), waist circumference (WC), and waist-to-height ratio (WtHR) differed significantly among participants according to the attainment of treatment targets. Among female patients, significant differences in the rate of target attainment were observed among different WC, WtHR, and BMI quartile groups, whereas no significant differences in goal attainment were found according to WC and WtHR quartiles in male patients. Among the female patients, the results of logistic regression supported a significant association of anthropometric indices and the achievement of targets. CONCLUSION A considerable proportion of dyslipidemia patients failed to achieve guideline-recommended targets in China, and this apparent treatment gap was more pronounced among women with central adiposity and patients with an elevated BMI. Based on the limitations of this cross-sectional study, further investigation of the mechanism at the molecular level is necessary.
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Affiliation(s)
- Ping Li
- a a Department of Endocrinology , Chinese PLA General Hospital , Beijing , China
- b b Department of Endocrinology , Hebei General Hospital , Shijiazhuang , China
| | - Kang Chen
- a a Department of Endocrinology , Chinese PLA General Hospital , Beijing , China
| | - Yi Nie
- a a Department of Endocrinology , Chinese PLA General Hospital , Beijing , China
| | - Ling-Ling Guo
- a a Department of Endocrinology , Chinese PLA General Hospital , Beijing , China
- c c Department of Endocrinology , Beijing Electric Power Hospital , Beijing , China
| | - Hai-Bin Wang
- a a Department of Endocrinology , Chinese PLA General Hospital , Beijing , China
| | - Shuang-Shuang Wang
- a a Department of Endocrinology , Chinese PLA General Hospital , Beijing , China
| | - An-Ping Wang
- a a Department of Endocrinology , Chinese PLA General Hospital , Beijing , China
| | - Da-Yi Hu
- d d Department of Cardiology , Peking University People's Hospital , Beijing , China
| | - Yi-Ming Mu
- a a Department of Endocrinology , Chinese PLA General Hospital , Beijing , China
| | - Ji-Hu Li
- e e MSD China Holding Co. Ltd , Shanghai , China
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