The role of dietary factors in chronic disease control in China

Identification of Chinese dietary patterns and their relationships with health outcomes: a systematic review and meta-analysis

OBJECTIVE

China has been undergoing a rapid nutrition transition in the past few decades. This review aims to characterise commonly reported dietary patterns in Chinese populations and their associations with health outcomes.

DESIGN

We searched PubMed, Embase and CNKI from inception to June 2020 to identify observational studies reporting dietary patterns or the associations between dietary patterns and health outcomes. Information regarding dietary patterns, their association with health outcomes and other related items was collected.

SETTING

Chinese population and Chinese immigrants.

PARTICIPANTS

Not applicable.

RESULTS

Results from 130 studies with over 900 000 participants were included. Six dietary patterns were identified: traditional whole-grain diet (Traditional WG), traditional non-whole-grain diet (Traditional NWG), plant-based diet (Plant-based), animal food diet (Animal-food), Western energy-dense diet (Western) and other unclassified diets (Unclassified). The Plant-based diet was associated with a reduced risk of CVD and cancer from prospective studies, reduced risk of diabetes, hypertension, cognitive impairment and depressive symptoms from all study designs. The Traditional WG diet was associated with a reduced risk of diabetes and hypertension. Animal-food diet is associated with a range of metabolic diseases, and Western diet was associated with increased risks of obesity and depressive symptoms.

CONCLUSION

Multiple dietary patterns identified reflect the diversity and transitioning of the Chinese diet. A healthy Chinese diet, comprising both the Traditional WG and Plant-based diets, was associated with reduced risks of specific undesirable health outcomes. Promoting this healthy diet will improve public health among the Chinese populations.

Health shocks and changes in preventive behaviors: Results from the China Health and Retirement Longitudinal Study

Background

China is facing the challenge of rising prevalence and ballooning burden of chronic non-communicable diseases (NCDs); however, the Chinese middle- and older-aged population considerably lack preventive behaviors. Health shocks (HS), widely defined as sudden health deterioration brought on by diseases or accidents, bring a “teachable moment” to motivate changes in preventive behaviors.

Objective

This study aims to examine the effect of HS on changes in preventive behaviors, including personal health practices and preventive care utilization.

Methods

HS was defined as any five chronic disease diagnoses (cancer, heart disease, stroke, diabetes, and hypertension). The impacts of HS on smoking, drinking, and exercise, physical examination were estimated. The panel data of 13,705 respondents were obtained from the latest two waves of the China Health and Retirement Longitudinal Study (CHARLS) in 2015 and 2018. A multilevel propensity score match difference-in-difference (multilevel PSM-DID) model was constructed.

Results

HS significantly decreased smoking (OR = 0.59, p < 0.05) and drinking (OR = 0.62, p < 0.01) and increased the utilization of auxiliary inspection in physical examination (OR = 1.19, p < 0.1). Major HS had significantly considerable and specific effects on reducing smoking and drinking (OR = 0.37 and 0.56, p < 0.01), while minor HS had relatively small effects on reducing smoking (OR = 0.74, p < 0.05) and drinking (OR = 0.69, p < 0.01), but extensive effects on initiating exercise (OR = 1.32, p < 0.05), physical examination (OR = 1.18, p < 0.1), and auxiliary inspection (OR = 1.30, p < 0.05).

Conclusion

After HS, there is a teachable moment to promote positive changes in preventive behaviors. Guided by the 5A's brief intervention model (Ask, Advise, Assess, Assist, Arrange), tailored interventions should be targeted at these populations to reduce the risk of the progression and complications of existing diseases, prevent the related comorbidity, and prolong the expected life-span.

Study on the Use of Cooking Oil in Chinese Dishes

The purpose of this study was to research the amount of cooking oil used in mainstream Chinese cuisine, as well as the features of cooking oil used in different types of dishes. The results provide reference data for the assessment of edible oil intake for eating out. A total of 302 common Chinese dishes were chosen and prepared following standard procedures. The cooking oils used in these dishes were analyzed in terms of the cooking process, food material combination, types of primary food materials, type of cooking oil, and the purpose of the cooking oil. The results showed that the mean amount of cooking oil used per 100 g of food material was 8.1 g. There were no significant differences in the amount of cooking oil used in the eight major styles of Chinese cuisine. The average amount of cooking oil used in hot dishes (10.0 g) was higher than that used in cold dishes. The amount of cooking oil in pure meat, mixed meat-vegetable, and pure vegetable dishes was up to 10.9 g, 9.3 g, and 4.6 g, respectively. The findings of the present study could be used in future dietary surveys to determine the average oil consumption associated with different dishes. In addition, the results provide reference data for oil intake assessments in nutrition surveys or nutritional recipes.

Urban-rural disparity of overweight/obesity distribution and its potential trend with breast cancer among Chinese women

Objective

To evaluate the urban-rural disparity of overweight/obesity and explore its potential trend with breast cancer among Chinese women.

Results

The prevalence of overweight/obesity for Chinese rural women (35.2%, 29.2% for overweight and 6.0% for obesity) was significantly higher than that for Chinese urban women (33.4%, 27.7% for overweight and 5.7% for obesity) (P < 0.001). For either rural or urban women, the prevalence of overweight/obesity was highest in north region, followed by east region for rural women and north-east region for urban women. For rural women, higher prevalence of overweight/obesity was significantly positively associated with elder age, Han nationality, low level of education, no occupation, high family income, less number of family residents, insurance, and elder age at marriage. Similar positive associations were also found for urban women, except negative associations for high family income, less number of family residents, and elder age at marriage. A non-significant positive trend between overweight/obesity and breast cancer was found for rural women [odds ratio (OR): 1.06; 95% confidence interval (CI): 0.87–1.29], but a significant positive trend for urban women (OR: 1.55; 95% CI: 1.19–2.02).

Materials and Methods

A total of 1 210 762 participants were recruited from the Chinese National Breast Cancer Screening Program. Overweight and obesity were defined as body mass index (BMI) ranged 24.0–27.9 kg/m² and BMI ≥ 28.0kg/m², respectively.

Conclusions

There was an obvious urban-rural disparity of overweight/obesity distribution among Chinese women, which could also lead to an obvious disparity of breast cancer distribution.

Dietary Patterns and Obesity among Chinese Adults: Results from a Household-Based Cross-Sectional Study

The key dietary pattern other than dietary factors influencing obesity has been reported by several large epidemiological studies. This study was carried out between 2010 and 2012 including 1613 adult residents in Zhejiang Province. Dietary patterns were extracted by factor analysis based on 24-h dietary recall. Associations with dietary patterns and obesity were examined and adjusted for age and gender by logistic regression. Five dietary patterns were identified by factor analysis with their eigenvalues greater than 1: 'cereal, animal, and plant food', 'high protein food', 'plant food', 'poultry', and 'beverage'. After adjustment for age and gender, the 'cereal, animal, and plant food' and 'beverage' pattern was associated with obesity (OR = 2.924, 3.257; 95% CI = 1.147-7.463, 1.372-7.692). In conclusion, 'cereal, animal, and plant food' and 'beverage' dietary patterns may be associated with increased risk of obesity. 'Cereal, animal, and plant food' dietary patterns may be associated with increased risk of obesity resulting from increased total energy intake by increased protein and fat intake; while a 'beverage' dietary pattern may be associated with increased risk of obesity resulting from increased total energy intake by increased carbohydrate intake. The findings are valuable in targeting future nutrition education.

Waist-to-height ratio is an effective indicator for comprehensive cardiovascular health

The aim of this study was to determine the associations between cardiovascular health and the waist circumference (WC) and waist-to-height ratio (WHtR). A cross-sectional study was performed recruiting 26701 middle-aged Chinese men. Of the seven ideal cardiovascular health metrics, body mass index (BMI), total cholesterol (TC), blood pressure (BP), and fasting blood glucose (FBG) were found to increase with an elevation of the mean WC and WHtR. The mean WC and WHtR were significantly lower in the subjects with intermediate or ideal cardiovascular health than those with poor or intermediate health. After adjustment for age, the mean WC and WHtR decreased by 1.486 cm and 0.009 per 1-point increase in the cardiovascular health score, and 2.242 cm and 0.013 per 1-point increase in the number of ideal cardiovascular health metrics, respectively. The cardiovascular health score was negatively correlated with the WC (r = -0.387) and WHtR (r = -0.400), while the number of ideal cardiovascular health metrics was negatively associated with the WC (r = -0.384) and WHtR (r = -0.395). The cardiovascular health is correlated negatively with the WC and WHtR, and a stronger correlation existed between the cardiovascular health and WHtR than WC.

The relationship between sodium excretion and blood pressure, urine albumin, central retinal arteriolar equivalent

BACKGROUND

Many studies showed an association between dietary salt intake, blood pressure and increased CVD risk. The potential reason may be related to vascular structural and functional changes, through alterations in endothelial function. The central retinal arteriolar equivalent and urinary albumin reflected vascular endothelial dysfunction in different part of the body. The urinary sodium-creatinine ratio of causal urine specimens could represent the 24-h urinary sodium intake to estimate sodium intake.

METHODS

The 24-h sodium excretion was estimated by urinary sodium-creatinine ratio. Urinary albumin-creatinine ratio (UACR), reflecting renal arterial damage, was also determined. The central retinal arteriolar equivalent (CRAE) was detected by fundus photography and was further analyzed by semi-quantitative software.

RESULTS

Participants included 951 hypertensive patients with the average sodium excretion of 11.62 ± 3.01 g. The sodium excretion was significantly higher (P < 0.01) in the hypertensive as compared to that of the non-hypertensive participants. Prevalence of hypertension was increased with increasing sodium excretion. The sodium excretion was positively correlated with systolic blood pressure (SBP) and diastolic blood pressure (DBP), respectively (r = 0.20 and 0.14; P < 0.01). Furthermore, UACR and CRAE were significantly (P < 0.01) different within the sodium excretion quartiles (Q1-Q4). After adjusting the confounding variables, such as age and sex, the binary logistic regression analysis showed that sodium excretion was an independent factor of UACR and CRAE (P < 0.01).

CONCLUSION

Our results suggest that sodium excretion in the hypertensive participants were higher. The high sodium excretion was related with the renal arterial damage as well as retinal arteriolar changes.

Association between ideal cardiovascular health and the atherogenic index of plasma

The American Heart Association aims to improve cardiovascular health by encouraging the general population to meet 7 cardiovascular health behaviors and factors. The atherogenic index of plasma (AIP) is an important index. Our aim is to evaluate the relationship between ideal cardiovascular health and the atherogenic index of plasma (AIP) in middle-aged Chinese men.A cross-sectional study was performed. A total of 27,824 middle-aged Chinese men were enrolled. The association between ideal cardiovascular health behaviors and factors and AIP was determined. The 7 cardiovascular health metrics were scored as follows: 0, poor; 1, general; and 2, ideal. The cardiovascular health status was classified according to the total score, as follows: 0 to 4, inadequate; 5 to 9, average; and 10 to 14, optimum. Analyses assessed the prevalence of 7 cardiovascular health metrics, its association with AIP. Logistic regression models were used to calculate odds ratios (ORs), adjusting for age.All 7 cardiovascular health metrics were shown to correlate with AIP (all P values < 0.05), and the strongest correlation existed between body mass and AIP, followed by total cholesterol and AIP. The mean AIP level increased with the decrease in the score of each of the 7 cardiovascular health metrics (all P values < 0.05). The subjects with poor cardiovascular health status had a 4.982-fold increase in the high risk of developing atherosclerosis, whereas a 1-point increase in the cardiovascular health score resulted a 0.046 reduction in AIP and a 22.3% reduction in the high-risk of developing atherosclerosis (OR = 0.777, 95% CI: 0.768-0.787).The ideal cardiovascular health score correlated significantly with AIP, and a 1-point increase in the cardiovascular health score led to a 0.046 reduction in AIP and a 22.3% reduction in the high risk of developing atherosclerosis. These validated the value of ideal cardiovascular health behaviors and factors in the prediction of high risk of developing cardiovascular diseases. Ideal cardiovascular health metrics are of great realistic significance for the prevention and control of atherosclerosis and cardiovascular diseases.

Prevalence of Hypertension among Adults in Remote Rural Areas of Xinjiang, China

OBJECTIVE

The present study aimed to estimate prevalence of hypertension among adults in rural remote areas of Xinjiang, China and evaluate the associated factors of hypertension.

METHODS

The survey was based on questionnaire interviews and clinical measurements of 11,340 individuals (≥18 years old), and was conducted during 2009-2010 via a stratified cluster random sampling method in the remote rural areas of Xinjiang, about 4407 km away from the capital Beijing. Hypertension was defined according to WHO/ISH criteria.

RESULTS

Systolic blood pressure (SBP) and diastolic blood pressure (DBP) of the population were (126.3 ± 21.4) and (80.9 ± 13.4) mmHg. Compared with Han nationality subjects, SBP and DBP of Kazakh nationality subjects were significantly high (p < 0.05), while the SBP and DBP of Uyghur subjects were significantly low (Kazakh: (128.7 ± 23.9) and (83.0 ± 14.6) mmHg, Uyghur: (123.6 ± 19.3) and (77.4 ± 12.7) mmHg, Han: (126.5 ± 20.5) and (82.6 ± 11.9) mmHg, p < 0.05). Prevalence of hypertension of the population was 32.1%, and was greater among Kazakhs and lower among Uyghur than Han (Kazakh: 36.9%, Uyghur: 26.1%, Han: 33.7%, p < 0.05). The age-standardized prevalence of hypertension was 30.2%, and was greater among Kazakhs while lower among Uyghurs than Han subjects (Kazakh: 37.0%, Uyghur: 26.0%, Han: 33.8%, p < 0.05, p < 0.05). Multivariate logistic regression analyses showed Gender (OR = 1.324), age (OR = 2.098, 3.681, 6.794, 9.473, 14.646), nationality (OR = 1.541), occupation (OR = 1.659, 1.576), education (OR = 1.260), BMI (OR = 1.842), WC (OR = 1.585), WHR (OR = 1.188), WHR (OR = 1.188), diabetes (OR = 1.879), hypertriglyceridemia (OR = 1.361), hypercholesterolemia (OR = 1.131) and high blood low density lipoprotein cholesterol (LDL-C) (OR = 1.956) were all positively correlated with hypertension, while low blood high density lipoprotein cholesterol (HDL-C) (OR = 0.765) was negatively correlated with hypertension.

CONCLUSIONS

Prevalence of hypertension among adults in remote rural areas of Xinjiang was higher than the national average. Prevalence of hypertension was greater among Kazakhs and lower among Uyghurs than Han nationals, thus indicating significant differences between regions and nationalities. Gender, age, nation, occupation, education, overweight or obesity, abdominal obesity, diabetes, hyperlipidemia, hypercholesterolemia, high LDL-C were positively correlated with hypertension, low HDL-C was negatively correlated with hypertension.

Trend of non-communicable disease mortality for three common conditions in the elderly population from 2002 to 2010: A population-based study in China

Objective

There is a lack of data focusing on non-communicable disease (NCD) mortality in the Chinese elderly population over the past decade.

Methods

Using mortality data from the Chinese Health Statistics, we explored the crude and age-standardized mortality trend of three major NCDs in the Chinese population ≥65 years of age from 2002 to 2010, namely, malignant neoplasms, heart diseases, and cerebrovascular diseases. Subpopulations characterized as rural and urban residence, and by gender and age were examined separately.

Results

Mortality increased with age and was higher among males than among females across the three NCDs, with the gender difference being most remarkable for malignant neoplasms and least for heart diseases mortality. Condition-specific crude mortalities increased between 2002 and 2010, overall and in all the pre-specified subpopulations. After age-standardization, rising trends were observed for people ≥65 years old, and condition-specific mortalities generally increased in rural regions and decreased in urban regions, especially for cerebrovascular diseases.

Conclusions

There were increasing trends for mortality due to malignant neoplasms, heart diseases, and cerebrovascular diseases in China between 2002 and 2010, which were largely driven by the population aging. Disparities existed by rural and urban residence, gender, and age.

Associations of lipoprotein lipase gene rs326 with changes of lipid profiles after a high-carbohydrate and low-fat diet in healthy Chinese Han youth

To investigate the effects of a high-carbohydrate and low-fat (HC/LF) diet on plasma lipids and apolipoproteins (Apos) of healthy Chinese Han youth with different genotypes of lipoprotein lipase gene (LPL) rs326, 56 subjects were given a washout diet of 30.1% fat and 54.1% carbohydrate for seven days, followed by the HC/LF diet of 13.8% fat and 70.1% carbohydrate for six days, with no total energy restriction. Plasma glucose, triglyceride (TG), total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), Apo B-100 and Apo A-I were analyzed at baseline and before and after the HC/LF diet. The results show that, when compared with before the HC/LF diet, only the male G carriers experienced increased HDL-C (p = 0.008) and Apo A-I (p = 0.005) after the HC/LF diet. Decreased TC in both males and females and increased TG in females were found regardless of the genotype after the HC/LF diet. LDL-C decreased in all the subjects although the decrease was not significant in the female G carriers. These results demonstrate that the G allele of LPL rs326 associates with the elevated levels of HDL-C and Apo A-I after the HC/LF diet in males of the healthy Chinese Han Youth.

The emergence of cardiometabolic disease risk in Chinese children and adults: consequences of changes in diet, physical activity and obesity

Strong secular declines in physical activity, increased fat and salt intake, and increased obesity, especially abdominal obesity, mark China's recent nutrition transition. The China Health and Nutrition 2009 Survey collected anthropometry, blood pressure and fasting blood samples from more than 9,000 individuals ≥ 7 years of age. We focus on elevated blood pressure and plasma markers of diabetes, inflammation and dyslipidemia. We used international definitions of cardiometabolic risk and estimated age- and sex-specific prevalence ratios for each outcome for high waist circumference or overweight. We used logistic regression to assess each risk factor's association with diet, physical activity, overweight and abdominal obesity. Cardiometabolic risk prevalence was high in all age groups Prevalence ratios for most risk factors were nearly doubled for overweight or high waist circumference groups. Prevalence ratios were higher in younger than older adults. Low physical activity consistently predicted higher cardiometabolic risk across most outcomes and age-sex groups. The co-occurrence of overweight and high waist circumference was highly predictive of dyslipidemia, elevated glycated haemoglobin and diabetes. High prevalence of cardiometabolic risk factors and their strong association with weight status and abdominal obesity in young adults portend increases in cardiometabolic morbidity and mortality. Early interventions will be required to reverse trends.

Human behaviors determine health: strategic thoughts on the prevention of chronic non-communicable diseases in China

BACKGROUND

In the last three decades, people's living standards have significantly increased along with the rapid growth of the national economy of China. However, the prevalence of unhealthy behaviors and unfavorable lifestyles (e.g., smoking, excessive use of alcohol, physical inactivity, and unhealthy diets) also steadily increased, which may contribute to the growing epidemic of chronic non-communicable diseases (CNCDs) such as diabetes, coronary heart disease, stroke, and cancers.

PURPOSE

To briefly summarize the major studies from China concerning epidemic and burden of CNCDs and unhealthy lifestyles, and propose intervention strategies toward unhealthy lifestyles and behaviors aiming for effective control of the growing epidemic of CNCDs in China.

METHODS

We first review the major national studies addressing the epidemic and burden of CNCDs and unhealthy behaviors in China. Then, we aim to develop the preventive strategies against the increasing epidemic of CNCDs by focusing on the intervention campaign toward health unfavorable behaviors and lifestyles.

RESULTS

CNCDs have posed major challenges to public health and the ongoing reform of health care system in China. Unhealthy lifestyles and behaviors (e.g., smoking, excessive alcohol consumpsion, physical inactivity, and imbalanced diets) are responsible for the growing epidemic of CNCDs. Adherence to healthy behaviors and lifestyles is critical for maintaining physical and mental health.

CONCLUSION

Active implementation of the population-wide intervention program of health education and promotion by targeting unhealthy behaviors and lifestyles may help to constrain the growing epidemic of CNCDs in China.

Dietary pattern and weight change in a 5-year follow-up among Chinese adults: results from the Jiangsu Nutrition Study

The aim of the present study was to examine the association between dietary patterns and weight change prospectively. We followed up 1231 adults aged 20 years and older (mean age 49·3 years) from 2002 to 2007. Food intake was assessed at baseline by an FFQ. Factor analysis was used to identify dietary patterns. Nutrient intake was measured by food weighing plus consecutive individual 3 d food records. Body weight and height were measured. The mean 5-year weight gain among all participants was 0·8 (sd 4·7) kg. The mean weight changes across quartiles of the 'traditional' pattern (rice, fresh vegetables, pork and wheat flour) were 2·0, 0·6, 0·6 and 0·0 kg. The corresponding values were 0·4, 0·5, 0·7 and 1·6 kg across quartiles of the 'vegetable-rich' pattern. No significant association between the 'macho' dietary pattern (meat and alcohol), the 'sweet tooth' pattern (drinks and cake) and weight gain was found. In multivariate linear regression, using the first quartile as the reference, participants in the highest quartile of the 'traditional' pattern had a β of - 2·18 (95 % CI - 2·91, - 1·45) for weight gain. However, the β from weight change of the highest quartile of the 'vegetable-rich' pattern was 1·00 (95 % CI 0·25, 1·74). In conclusion, the 'traditional' dietary pattern was negatively and the 'vegetable-rich' pattern was positively associated with weight gain in Chinese adults.

Effects of green tea, black tea and Rooibos tea on angiotensin-converting enzyme and nitric oxide in healthy volunteers

OBJECTIVE

Tea has been reported to reduce cardiovascular mortality, but the underlying mechanisms are largely unknown. The aim of the current project was to investigate the effect of green tea (Japanese Sencha), black tea (Indian Assam B.O.P.) and Rooibos tea (South Africa) on angiotensin-converting enzyme (ACE) and nitric oxide (NO).

DESIGN

Seventeen healthy volunteers received a single oral dose of 400 ml green tea, black tea or Rooibos tea in a randomized, three-phase, crossover study. ACE activity and NO concentration were measured (at 0, 30, 60 and 180 min) in all phases. ACE activity was analysed by means of a commercial radioenzymatic assay. Nitrite was analysed as a marker of NO concentration. In addition, ACE genotype was determined using a PCR method.

RESULTS

Oral intake of a single dose of Rooibos tea significantly inhibited ACE activity after 30 min (P < 0.01) and after 60 min (P < 0.05). A significant inhibition of ACE activity was seen with green tea for the ACE II genotype 30 min after intake of the tea (P < 0.05) and for the ACE ID genotype 60 min after intake (P < 0.05). A significant inhibition of ACE activity was also seen with Rooibos tea for the ACE II genotype 60 min after intake (P < 0.05). No significant effect on NO concentration was seen.

CONCLUSIONS

These results suggest that green tea and Rooibos tea may have cardiovascular effects through inhibition of ACE activity.

Risk factors associated with the dramatic increase in the prevalence of diabetes in the adult Chinese population in Qingdao, China

OBJECTIVE

To investigate the major risk factors and their association with the dramatic increase in the prevalence of diabetes from 2001-2002 to 2006 in Qingdao, China.

METHODS

Population-based cross-sectional studies on diabetes were performed in 4598 men and 7026 women aged 35-74 years. The 2006 World Health Organization diagnostic criteria for diabetes were used.

RESULTS

The crude prevalence of diabetes was 11.3% in both men and women in urban areas and 5.3% and 8.9% in rural areas in 2001-2002. This increased to 19.2% and 16.1% in urban areas and 14.2% and 13.8% in rural areas in 2006 for men and women, respectively. The increase in diabetes prevalence from 2001-2002 to 2006 was paralleled by an increased body mass index in rural areas but not in urban areas. The major risk factors associated with diabetes were age, family history of diabetes, obesity, hypertension and high triglycerides. The multivariate adjusted odds ratio and 95% confidence interval for diabetes corresponding to a one standard deviation increase in waist circumference was 1.81 (1.47, 2.23) in urban men, 1.64 (1.26, 2.13) in rural men, 1.98 (1.66, 2.37) in urban women and 2.02 (1.63, 2.51) in rural women. Low socio-economic classes had a higher risk for diabetes in urban areas but a lower risk in rural areas, both associated with increased waist circumference.

CONCLUSION

Established risk factors are of great importance for the prevalence of diabetes in the urban and rural Chinese populations and changes in these factors could explain the recent dramatic increase in diabetes prevalence, particularly in rural areas. Considering the high prevalence of obesity and physical inactivity, intervention is urgently required in China.

Safety, tolerability and pharmacokinetics of phenoprolamine hydrochloride floating sustained-release tablets in healthy Chinese subjects

The present study was designed to assess the safety, tolerability and pharmacokinetics of phenoprolamine hydrochloride floating sustained tablets (PHFST) in healthy Chinese subjects. 116 volunteers were randomized into single- or multiple-dose groups for oral administration 30-240 mg of PHFST once or 60-120 mg twice daily. Safety and tolerability were appraised by monitoring adverse events and laboratory parameters. Pharmacokinetics was assessed by determining the plasma concentrations of phenoprolamine hydrochloride with a validated HPLC method. In single-dose studies, no severe adverse events were observed in volunteers, and all adverse events were mild; the percentages of treatment-emergent events judged to be possibly related to the drug were 3/6 in the 240 mg dose group, 1/6 in the 180-210 mg dose groups, and none in the 30-150 mg dose groups; system exposure (AUC, C(max)) increased with respect to dose at 30-120 mg, whereas AUC raised disproportionately with dose escalating from 120 to 240 mg; the absorption of phenoprolamine hydrochloride was unaffected by food. In multiple studies, no safety concerns were revealed up to 7 days; steady-state plasma concentration was achieved after approximately 4-5 days of repeated twice-daily dosing. PHFST is safe and well tolerated in healthy Chinese subjects. The mean C(max) of PHFST is proportional to dose, but not the AUC. Oral dosing regimen selected for subsequent Phase II/III clinical trials was 60 mg of PHFST, b.i.d., and dose up to 120 mg, b.i.d. - may be used to achieve better antihypertensive effect.