1
|
Koh S, Kim D, Kim M, Kim T. Aerobic exercise effects on systolic blood pressure and endothelial inflammation in obese and non-obese elderly women with isolated systolic hypertension. J Hypertens 2024; 42:1743-1749. [PMID: 39091233 DOI: 10.1097/hjh.0000000000003794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/04/2024]
Abstract
OBJECTIVES This study aimed to investigate the effects of a 16-week aerobic exercise program on systolic blood pressure, intracellular cell adhesion molecule-1, vascular cell adhesion molecule-1, and oxidized low-density lipoprotein of obese and nonobese elderly women with isolated systolic hypertension. METHODS Elderly women aged 70-85 years were recruited and grouped into the normal isolated systolic hypertension ( n = 12) and obese isolated systolic hypertension groups ( n = 13). The participants followed an aerobic exercise program, using a wireless heart rate monitor to maintain an appropriate heart rate reserve based on the American College of Sports Medicine exercise guidelines. The two-way repeated measures analysis of variance tested group × time interaction. Pearson's correlation and simple regression assessed the influence of each variable, which showed significant differences. RESULTS An interaction effect for systolic blood pressure, intracellular cell adhesion molecule-1, and vascular cell adhesion molecule-1 ( P < 0.05) and a main time effect for oxidized low-density lipoprotein ( P < 0.05) were observed. A correlation between the rates of change in systolic blood pressure and vascular cell adhesion molecule-1 ( P < 0.05) with a 42.8% influence ( P < 0.001) and in intracellular cell adhesion molecule-1 and vascular cell adhesion molecule-1 ( P < 0.05) with a 21.6% influence ( P < 0.05) was observed. CONCLUSIONS These findings collectively showed that the 16-week aerobic exercise program effectively lowered blood pressure in patients with isolated systolic hypertension, particularly in the normal group compared to the obese group. Thus, regular aerobic exercise for 16 weeks or more enhances vascular health, potentially improving the healthy life expectancy of elderly women.
Collapse
Affiliation(s)
- Suhan Koh
- Physical Education, Pusan National University, Busan, Republic of Korea
| | | | | | | |
Collapse
|
2
|
Huang X, Qiu L, Wang TD, Yao Q, Liu J, Xu R, Zheng Q, Zhang X, Wu J. Prevalence and risk factors for isolated systolic hypertension among the oldest-old population in southwestern China: A community-based cross-sectional study. J Clin Hypertens (Greenwich) 2024; 26:757-764. [PMID: 38687184 PMCID: PMC11232445 DOI: 10.1111/jch.14826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Revised: 03/19/2024] [Accepted: 04/01/2024] [Indexed: 05/02/2024]
Abstract
The prevalence of isolated systolic hypertension (ISH) has doubled between 2002-2005 and 2014 among the oldest-old population in China. However, the prevalence and characteristics of ISH among the oldest-old population in southwestern China remain less known. This study aimed to investigate the prevalence of ISH among the oldest-old population in Chengdu and identify associated factors to provide valuable information for disease etiology and prevention. We recruited 1,312 participants aged over 80 years by using a stratified cluster sampling method between September 2015 and June 2016, from three districts (Jinjiang, Qingyang, and Longquanyi) of Chengdu, the largest city of southwest China. A structured questionnaire, anthropometric data, and blood pressure were collected according to the standard method. Blood pressure was measured three times by using a standardized mercury sphygmomanometer after a 10-minute seated rest. Of 1312 participants, 53.0% (n = 695) had ISH. The prevalence of ISH in men and women was 54.7% and 51.3%, respectively, with no significant sex difference (P = .222). The prevalence of ISH increased with advanced age in men (P for trend = 0.029), 52.5% for the 80-84 years group, 55.2% for the 85-89 years group, and 70.4% for the 90-98 years group, respectively. Multivariable logistic regression analyses found that drinking (OR = 1.85, 95%CI = 1.26-2.71), being overweight (OR = 1.88, 95%CI = 1.19-2.96), and having a higher heart rate (OR = 0.66, 95%CI = 0.51-0.86) were associated with ISH. Stratified by sex, these three factors remained significant in men. Our work highlights that the burden of ISH is substantial among the oldest-old population in southwestern China.
Collapse
Affiliation(s)
- Xiaobo Huang
- Center of Gerontology and Geriatrics, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
- Department of Cardiology, Second People's Hospital of Chengdu, Chengdu, China
| | - Lingli Qiu
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Tzung-Dau Wang
- Department of Internal Medicine, Cardiovascular Center and Division of Cardiology, National Taiwan University Hospital, Taipei City, Taiwan, China
| | - Qian Yao
- Department of Nursing, Second People's Hospital of Chengdu, Chengdu, China
| | - Jianxiong Liu
- Department of Cardiology, Second People's Hospital of Chengdu, Chengdu, China
| | - Ronghua Xu
- Stroke Center, Second People's Hospital of Chengdu, Chengdu, China
| | - Qingkun Zheng
- Department of Cardiology, Second People's Hospital of Chengdu, Chengdu, China
| | - Xingping Zhang
- Department of General Medicine, Second People's Hospital of Chengdu, Chengdu, China
| | - Jinhui Wu
- Center of Gerontology and Geriatrics, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| |
Collapse
|
3
|
Zheng X, Lu J, Xiang S, Zou P, Chen H, Liu J, Zeng C, He Y. Elevated serum levels of leukocyte cell-derived chemotaxin 2 are associated with the prevalence of metabolic syndrome. Acta Diabetol 2024; 61:643-655. [PMID: 38383671 DOI: 10.1007/s00592-024-02242-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 01/18/2024] [Indexed: 02/23/2024]
Abstract
AIMS Inflammation is central to the pathogenesis of metabolic syndrome (MetS). Leukocyte cell-derived chemotaxin 2 (LECT2) is constitutively secreted in response to inflammatory stimuli and oxidative stress contributing to tissue or systemic inflammation. We explored the relationship between LECT2 levels and MetS severity in humans and mice. METHODS Serum LECT2 levels were measured in 210 participants with MetS and 114 without MetS (non-MetS). LECT2 expression in the liver and adipose tissue was also examined in mice fed a high-fat diet (HFD) and genetically obese (ob/ob) mice. RESULTS Serum LECT2 levels were significantly higher in MetS participants than in non-MetS participants (7.47[3.36-17.14] vs. 3.74[2.61-5.82], P < 0.001). Particularly, serum LECT2 levels were significantly elevated in participants with hypertension, central obesity, diabetes mellitus (DM), hyperglycaemia, elevated triglyceride (TG) levels, and reduced high-density lipoprotein cholesterol (HDL-C) levels compared to those in participants without these conditions. Pearson's correlation analysis showed that serum LECT2 levels were positively associated with conventional risk factors in all patients. Moreover, LECT2 was positively associated with the number of MetS components (r = 0.355, P < 0.001), indicating that higher serum LECT2 levels reflected MetS severity. Multivariate regression analysis revealed that a one standard deviation increase in LECT2 was associated with an odds ratio of 1.52 (1.01-2.29, P = 0.044) for MetS prevalence after adjusting for age, sex, body mass index, waist circumference, smoking status, white blood cell count, fasting blood glucose, TG, total cholesterol, HDL-C, blood urea nitrogen, and alanine aminotransferase. Receiver operating characteristic curve analysis confirmed the strong predictive ability of serum LECT2 levels for MetS. The optimum serum LECT2 cut-off value was 9.05. The area under the curve was 0.73 (95% confidence interval 0.68-0.78, P < 0.001), with a sensitivity and specificity of 45.71% and 95.61%, respectively. Additionally, LECT2 expression levels were higher at baseline and dramatically enhanced in metabolic organs (e.g. the liver) and adipose tissue in HFD-induced obese mice and ob/ob mice. CONCLUSIONS Increased LECT2 levels were significantly and independently associated with the presence and severity of MetS, indicating that LECT2 could be used as a novel biomarker and clinical predictor of MetS.
Collapse
Affiliation(s)
- Xialei Zheng
- Department of Cardiology, The Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China
| | - Junmi Lu
- Department of Pathology, The Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China
| | - Shaojun Xiang
- Department of Cardiology, Hong Jiang Hospital of Traditional Chinese Medicine, Huaihua, 418200, Hunan, China
| | - Pu Zou
- Department of Cardiology, The Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China
| | - Hao Chen
- Department of Cardiology, The Second Affiliated Hospital of University of South China, Hengyang, 421200, Hunan, China
| | - Jing Liu
- Department of Cardiology, The Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China
| | - Cheng Zeng
- Department of Cardiology, The Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China
| | - Yuhu He
- Department of Cardiology, The Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China.
| |
Collapse
|
4
|
Huang Y, Meng L, Liu C, Liu S, Tao L, Zhang S, Gao J, Sun L, Qin Q, Zhao Y, Wang C, Chen Z, Guo X, Sun Y, Li G. Global burden of disease attributable to high systolic blood pressure in older adults, 1990-2019: an analysis for the Global Burden of Disease Study 2019. Eur J Prev Cardiol 2023; 30:917-927. [PMID: 36416196 DOI: 10.1093/eurjpc/zwac273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 10/18/2022] [Accepted: 11/14/2022] [Indexed: 08/02/2023]
Abstract
AIMS High systolic blood pressure (HSBP), a significant public health challenge, has not been systematically studied in the elderly population in the context of global aging. Understanding the temporal trends of the disease burden associated with HSBP in the elderly population is essential to control and mitigate the harm caused by HSBP. METHODS AND RESULTS We used the estimated data derived from the Global Burden of Disease Study to analyse the disease burden of HSBP among the elderly population by region, sex, and temporal changes from 1990 to 2019. We found that the number of deaths due to HSBP increased to 7.86 (95% UI: 6.89-8.82) million, with an increase of 54.1%, and the number of disability-adjusted life years (DALYs) increased to 146 (95% UI: 130-162) million, with an increase of 52.4%. Conversely, the death and DALY rates of HSBP decreased by -27.0 and -27.8%, respectively. At the national and regional levels, Australasia and other high socio-demographic index regions have made significant improvements in the burden of HSBP, while it remains high in other regions of the world. Additionally, the burden of HSBP in older men is greater than that in older women. CONCLUSION Our findings indicate that the current prevention and control of HSBP in older adults is poor, with the total burden increasing significantly. There is an urgent need to implement feasible measures to resist HSBP and lessen the disparity of the global HSBP burden for older adults.
Collapse
Affiliation(s)
- Yuxian Huang
- Department of Cardiology, The First Hospital of China Medical University, 155 Nanjing North Street, Heping District, Shenyang 110001, Liaoning Province, China
- School of Public Health, China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang 110122, Liaoning Province, China
| | - Lingrui Meng
- Department of Cardiology, The First Hospital of China Medical University, 155 Nanjing North Street, Heping District, Shenyang 110001, Liaoning Province, China
- School of Public Health, China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang 110122, Liaoning Province, China
| | - Canru Liu
- Department of Cardiology, The First Hospital of China Medical University, 155 Nanjing North Street, Heping District, Shenyang 110001, Liaoning Province, China
- School of Public Health, China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang 110122, Liaoning Province, China
| | - Songyue Liu
- Department of Cardiology, The First Hospital of China Medical University, 155 Nanjing North Street, Heping District, Shenyang 110001, Liaoning Province, China
| | - Luqiu Tao
- School of Public Health, Nanjing Medical University, No. 101 Longmian Avenue, Jiangning District, Nanjing, 211166 Jiangsu Province, China
| | - Sijia Zhang
- School of Public Health, China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang 110122, Liaoning Province, China
- Chronic Noncommunicable Diseases Prevention and Control Center, Chinese Center for Disease Control and Prevention, No. 27 Nanwei Road, Xicheng District, 100050 Beijing, China
| | - Jiaying Gao
- School of Public Health, Fudan University, No. 130 Dongan Road, Xuhui District, 200032 Shanghai, China
| | - Lingmin Sun
- Department of Cardiology, The First Hospital of China Medical University, 155 Nanjing North Street, Heping District, Shenyang 110001, Liaoning Province, China
- School of Public Health, China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang 110122, Liaoning Province, China
| | - Qiying Qin
- Department of Cardiology, The First Hospital of China Medical University, 155 Nanjing North Street, Heping District, Shenyang 110001, Liaoning Province, China
- School of Public Health, China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang 110122, Liaoning Province, China
| | - Yingchen Zhao
- School of Public Health, China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang 110122, Liaoning Province, China
| | - Chang Wang
- Department of Cardiology, The First Hospital of China Medical University, 155 Nanjing North Street, Heping District, Shenyang 110001, Liaoning Province, China
| | - Zihan Chen
- Department of Cardiology, The First Hospital of China Medical University, 155 Nanjing North Street, Heping District, Shenyang 110001, Liaoning Province, China
| | - Xiaofan Guo
- Department of Cardiology, The First Hospital of China Medical University, 155 Nanjing North Street, Heping District, Shenyang 110001, Liaoning Province, China
| | - Yinxian Sun
- Department of Cardiology, The First Hospital of China Medical University, 155 Nanjing North Street, Heping District, Shenyang 110001, Liaoning Province, China
| | - Guangxiao Li
- Department of Cardiology, The First Hospital of China Medical University, 155 Nanjing North Street, Heping District, Shenyang 110001, Liaoning Province, China
- Department of Medical Record Management Center, The First Hospital of China Medical University, 155 Nanjing North Street, Heping District, Shenyang, 110001 Liaoning Province, China
| |
Collapse
|
5
|
Li L, Xiong YL, Tu B, Liu SY, Zhang ZH, Hu Z, Yao Y. Effect of renal denervation for patients with isolated systolic hypertension: a systematic review and meta-analysis. J Geriatr Cardiol 2023; 20:121-129. [PMID: 36910242 PMCID: PMC9992953 DOI: 10.26599/1671-5411.2023.02.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/14/2023] Open
Abstract
BACKGROUND Renal denervation (RDN) is a promising treatment based on catheter intervention for patients with refractory hypertension. However, the effect in patients with isolated systolic hypertension (ISH) remains controversial. The aim of this meta-analysis was to determine the blood pressure lowing effect of RDN in patients with ISH compared with combined systolic/diastolic hypertension (CH) patients. METHODS PubMed, Embase, Cochrane and ClinicalTrials.gov were searched for prospective clinical studies that included RDN. The outcomes of interest were the change of 24-hour ambulatory systolic blood pressure (SBP) from baseline. We used the fixed effects model to calculate weighted mean difference (WMD) with 95% confidence interval (CI). RESULTS Six trials were included, with 1405 participants, including 597 patients with ISH and 808 patients with CH. Mean follow-up was five months. The reduction of 24-hour ambulatory SBP was significantly greater for the CH patients than the ISH patients (WMD = 3.89, 95% CI: 2.32-5.45, P < 0.0001). RDN also showed a greater reduction in office SBP in the CH patients compared to the ISH patients (WMD = 10.24, 95% CI: 4.24-15.74, P = 0.0003). And the effect was independent of age, length of follow-up, and ablation device. CONCLUSIONS RDN provides superior blood pressure control in the CH patients compared with the ISH patients, and the CH patients may be the best suitable population for which RDN is indicated.
Collapse
Affiliation(s)
- Le Li
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yu-Long Xiong
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Bin Tu
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Shang-Yu Liu
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Zhen-Hao Zhang
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Zhao Hu
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yan Yao
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| |
Collapse
|
6
|
Sun M, Gao L, Bai H, Hu W, Zhang X, Xiao J, Deng X, Tao H, Ge P, Qin Y, Zhang D. Association Between Visceral Fat, Blood Pressure and Arterial Stiffness in Patients with HFpEF: A Mediation Analysis. Diabetes Metab Syndr Obes 2023; 16:653-662. [PMID: 36923684 PMCID: PMC10008911 DOI: 10.2147/dmso.s399928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 02/21/2023] [Indexed: 03/10/2023] Open
Abstract
PURPOSE To investigate the association of visceral fat with arterial stiffness of heart failure patients with preserved ejection fraction (HFpEF) and to evaluate the extent to which this association is mediated by blood pressure (BP). PATIENTS AND METHODS This cross-sectional descriptive study (clinicaltrials.gov identifier: NCT04535726) recruited 94 patients with HFpEF totally from October to December 2020. The obesity-related measurements included visceral fat area (VFA), body mass index (BMI), waist circumference (WC), hip circumference (HC), waist-hip ratio (WC/HC), abdominal circumference (AC), body fat mass and fat percentage. Brachial-ankle pulse wave velocity (baPWV) was used to estimate the degree of arterial stiffness. Mediation analysis was performed to reveal whether the effect of visceral fat area on arterial stiffness can be mediated by BP in patients with HFpEF and the extent to which this association was mediated by BP. RESULTS About 93.6% of HFpEF patients were accompanied with abdominal obesity. Patients in baPWV ≥1800cm/s group were older, with a higher incidence of type 2 diabetes mellitus (T2DM), hypertension and abdominal obesity. VFA, systolic BP (SBP), diastolic BP (DBP) and pulse pressure (PP) were correlated with baPWV in total group. Adjusted for age ≥75 years old, gender, smoking, T2DM, calcium channel blocker and statins, the mediation effect of systolic SBP and PP on the VFA-baPWV association were 53.3% (indirect effect was 2.28, 95% CI 0.62-4.73) and 48.4% (indirect effect was 2.07, 95% CI 0.51-4.38), respectively. DBP failed to mediate the association between VFA and baPWV (indirect effect was 0.50, 95% CI -0.41-2.14). CONCLUSION The association of visceral fat with baPWV in HFpEF patients may be partly accounted for SBP or PP. Elevated SBP and PP might be important potential targets for preventing arterial stiffness in HFpEF patients.
Collapse
Affiliation(s)
- Min Sun
- Department of Cardiovascular Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
- Health Management Center, The First Branch of the Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
| | - Lei Gao
- Department of Cardiovascular Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
| | - Hongmei Bai
- Department of Cardiovascular Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
| | - Weiwei Hu
- Department of Cardiovascular Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
| | - Xiaofang Zhang
- Department of Cardiovascular Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
| | - Jin Xiao
- Department of Cardiovascular Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
| | - Xiangliang Deng
- Department of Cardiovascular Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
| | - Hongmei Tao
- Department of Cardiovascular Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
| | - Ping Ge
- Health Management Center, The First Branch of the Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
| | - Yuhong Qin
- Department of Cardiovascular Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
| | - Dongying Zhang
- Department of Cardiovascular Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
- Correspondence: Dongying Zhang; Yuhong Qin, Tel +86-23-13608398395; +86-23-13068357151, Email ;
| |
Collapse
|
7
|
Gao M, Lin W, Ma T, Luo Y, Xie H, Cheng X, Bai Y. The Impact of Different Antihypertensive Drugs on Cardiovascular Risk in Isolated Systolic Hypertension with Type 2 Diabetes Patients. J Clin Med 2022; 11:6486. [PMID: 36362714 PMCID: PMC9655533 DOI: 10.3390/jcm11216486] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 10/20/2022] [Accepted: 10/24/2022] [Indexed: 09/01/2023] Open
Abstract
BACKGROUNDS Angiotensin receptor blockers (ARB), angiotensin converting enzyme inhibitor (ACEI), calcium channel blocker (CCB) and thiazide diuretics (TD) are common antihypertensive drugs for diabetes patients with hypertension. The purpose of this study was to compare the cardiovascular risks of these drugs in patients with isolated systolic hypertension (ISH) and type 2 diabetes mellitus (T2DM). METHODS We used Action to Control Cardiovascular Risk in Diabetes trial data to explore the relationship between antihypertensive drugs and cardiovascular risks in ISH with T2DM patients by performing propensity score matching, Kaplan-Meier survival analyses and Cox proportional regression. RESULTS The cumulative incidence rates of primary outcomes (PO, including cardiovascular mortality, non-fatal myocardial infarction and non-fatal stroke) in the ARB use group were significantly lower than those without (hazard ratio (HR) 0.53; 95% confidence interval (CI) 0.34-0.83; p = 0.006). However, for ACEI, CCB and TD, they were negligible (ACEI: p = 0.209; CCB: p = 0.245; TD: p = 0.438). ARB decreased cardiovascular mortality (CM) in PO rather than non-fatal myocardial infarction (NMI) and non-fatal stroke (NST) (CM: HR 0.32; 95%CI 0.18-0.90; p = 0.004; NMI: p = 0.692; NST: p = 0.933). CONCLUSION ARB may alleviate the cardiovascular risks in ISH with T2DM patients, but ACEI, CCB, and TD did not.
Collapse
Affiliation(s)
- Ming Gao
- Department of Geriatric Medicine, Center of Coronary Circulation, Xiangya Hospital, Central South University, Changsha 410008, China
| | - Wenrui Lin
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha 410008, China
| | - Tianqi Ma
- Department of Geriatric Medicine, Center of Coronary Circulation, Xiangya Hospital, Central South University, Changsha 410008, China
| | - Yi Luo
- Department of Geriatric Medicine, Center of Coronary Circulation, Xiangya Hospital, Central South University, Changsha 410008, China
| | - Hejian Xie
- Department of Geriatric Medicine, Center of Coronary Circulation, Xiangya Hospital, Central South University, Changsha 410008, China
| | - Xunjie Cheng
- Department of Geriatric Medicine, Center of Coronary Circulation, Xiangya Hospital, Central South University, Changsha 410008, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha 410008, China
| | - Yongping Bai
- Department of Geriatric Medicine, Center of Coronary Circulation, Xiangya Hospital, Central South University, Changsha 410008, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha 410008, China
| |
Collapse
|
8
|
Yang D, Chen J, Zhang T, Lin Y, Yao X, Meng L, Guo F, Chen K, Dai H, Tang M. Influencing factors of wide pulse pressure in an elderly Chinese population: A cross-sectional study. J Clin Hypertens (Greenwich) 2022; 24:1482-1490. [PMID: 36259250 DOI: 10.1111/jch.14582] [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: 07/15/2022] [Revised: 09/01/2022] [Accepted: 09/06/2022] [Indexed: 11/30/2022]
Abstract
Blood pressure and pulse pressure (PP) had their own characteristics in the elderly population. This cross-sectional study including 5030 elderly participants was conducted to describe the distribution of blood pressure and wide PP in the elderly population and find influencing factors of wide PP. Wide PP was defined as PP equal to or more than 65 mmHg, and was classified three types as low systolic blood pressure (SBP) and low diastolic blood pressure (DBP) (LSLD), high SBP and low DBP (HSLD), and high SBP and high DBP (HSHD). Using multivariate logistic regression models to analyze the associations of demographic factors, health-related factors and lifestyle factors with different wide PP types. The associations of lifestyles with wide PP by gender were estimated by subgroup analyses. Among 5030 elderly participants, 2727 (54.2%) participants had wide PP. Logistic regression models showed older age (OR = 2.48, 95%CI: 2.14-2.88), female (OR = 1.31, 95%CI: 1.07-1.60), not married (OR = 1.26, 95%CI: 1.07-1.49), having chronic diseases (OR = 1.28, 95%CI: 1.09-1.50), current alcohol drinker (OR = 1.29, 95%CI: 1.11-1.50) were positively associated, and higher body height (OR = .78, 95%CI: .62-.99), higher education level (OR = .60, 95%CI: .43-.82), current smoker (OR = .79, 95%CI: .64-.97) were negatively associated with wide PP. Among three different types of wide PP including LSLD, HSLD, HSHD, these factors had different effects. Subgroup analyses found that only among male, current smoker was negatively associated and current alcohol drinker was positively associated with wide PP.
Collapse
Affiliation(s)
- Dandan Yang
- Department of Public Health, Fourth Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Jie Chen
- Fourth Affiliated Hospital, Zhejiang University School of Medicine, Jinhua, China
| | - Tingting Zhang
- Fourth Affiliated Hospital, Zhejiang University School of Medicine, Jinhua, China
| | - Yaoyao Lin
- Department of Public Health, Fourth Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Xuecheng Yao
- Department of Public Health, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Lin Meng
- Department of Public Health, Fourth Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Fanjia Guo
- Department of Public Health, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Kun Chen
- Department of Public Health, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Honglei Dai
- Fourth Affiliated Hospital, Zhejiang University School of Medicine, Jinhua, China
| | - Mengling Tang
- Department of Public Health, Fourth Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| |
Collapse
|
9
|
Hosseinzadeh A, Ebrahimi H, Khosravi A, Emamian MH, Hashemi H, Fotouhi A. Isolated systolic hypertension and its associated risk factors in Iranian middle age and older population: a population-based study. BMC Cardiovasc Disord 2022; 22:425. [PMID: 36167527 PMCID: PMC9516785 DOI: 10.1186/s12872-022-02856-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Accepted: 09/12/2022] [Indexed: 11/29/2022] Open
Abstract
Background Isolated systolic hypertension (ISH), is the most common form of hypertension in older adults. However, the ISH prevalence is not well known in many developing countries such as Iran. This study was conducted to determine the ISH prevalence and its related risk factors in an Iranian population. Methods Data were obtained from the second phase of the Shahroud eye cohort study (ShECS) in 2014. ShECS is a longitudinal population-based study which the first phase had been conducted in 2009 using the stratified multistage cluster sampling design on 5190 people aged 40 to 70 years. The ISH prevalence was determined based on the eighth Joint National Commission guidelines for different demographic variables. The associated risk factors were estimated by multiple logistic regression and a two-tailed p-value less than 0.05 was considered significant. Results The ISH prevalence was 15.89% (95% CI: 14.88–16.96). It was 15.68% (14.12–17.39) and 15.87% (14.54–17.29) for men and women, respectively. The prevalence of ISH increased significantly with increasing age. The 65–70 compared to 45–69 year age group (OR = 4.21), body mass index (OR = 1.03), diabetes (OR = 1.64), retirement, compared to practitioner job (OR = 1.53), and waist to hip ratio (WHR) (OR = 9.81) were significantly associated with ISH prevalence. Conclusions ISH is highly prevalent among the older adult population in Iran. Given the risk of cardiovascular disease associated with ISH, it is recommended to conduct education and public health interventions to improve the detection, prevention, and treatment of ISH.
Collapse
Affiliation(s)
- Ali Hosseinzadeh
- Department of Epidemiology, School of Public Health, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Hossein Ebrahimi
- Randomized Controlled Trial Research Center, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Ahmad Khosravi
- Department of Epidemiology, School of Public Health, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Mohammad Hassan Emamian
- Ophthalmic Epidemiology Research Center, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Hassan Hashemi
- Noor Ophthalmology Research Center, Noor Eye Hospital, Tehran, Iran
| | - Akbar Fotouhi
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, PO Box: 14155-6446, Tehran, Iran.
| |
Collapse
|
10
|
Hearing Problems in Indonesia: Attention to Hypertensive Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159222. [PMID: 35954575 PMCID: PMC9367905 DOI: 10.3390/ijerph19159222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 07/22/2022] [Accepted: 07/26/2022] [Indexed: 02/01/2023]
Abstract
Known as a silent disability, hearing loss is one of the major health burdens worldwide. Evidence implies that those suffering from hypertension can experience hearing disturbances. Self-reporting of hearing problems and self-reporting of hypertension may be useful in providing an alarm for detecting hearing problems. However, in the Indonesian population, this matter has not been properly reported. The aim of this study was to explore the prevalence of hearing problems and their relationships with other demographic factors. In total, 28,297 respondents of productive age from the Indonesian Family Life Survey 5th wave were assessed. A questionnaire and physical examination data were included in this survey. Self-reported hearing problems and their predictors were analyzed using univariate and multivariate logistic regressions. Hypertension awareness was a significant predictor of having a hearing problem (odds ratio (OR) [95% confidence interval (CI)], p value: 2.715 [1.948~3.785], <0.001). Having a general check-up was also crucial for detecting hearing problems (2.192 [1.54~3.121], <0.001). There was a significant link between hearing problems and early adults who have isolated systolic hypertension. Hypertension awareness and having a general check-up had predictive value for detecting hearing problems in adults in the age range of 26~35 years. Therefore, public health strategies for hearing loss prevention might target this group by detecting and treating hypertension.
Collapse
|
11
|
Zhidkova EA, Shlipakov SV, Gutor EM, Gurevich MV, Pankova VB, Vilk MF, Gurevich KG, Drapkina OM. Prevalence of elevated blood pressure among locomotive workers according to the long-term assessment of pre-trip health screening. КАРДИОВАСКУЛЯРНАЯ ТЕРАПИЯ И ПРОФИЛАКТИКА 2022. [DOI: 10.15829/1728-8800-2022-3189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Hypertension is considered as one of the leading cardiovascular diseases in transport workers.Aim. In the context of epidemiological prospective study, to assess the prevalence of elevated blood pressure (BP) detected at pre-trip health screening (PTHS).Material and methods. We analyzed records of the database of PTHS automatic system for 15 years (2006-2020) to reveal elevated systolic (140 mm Hg) and/or diastolic (90 mm Hg) BP.Results. For 15 years, the detection rate of systolic BP >140 mm Hg has decreased by 4 times. For diastolic BP, the detection rate of values >90 mm Hg decreased by 8 times. The detection rate of non-normal systolic BP among railway staff correlates with the detection rate of non-normal diastolic BP (r=0,92; p<0,05) on different railways. Over the 15-year period, the number of suspensions from the trip due to PTHS has decreased by 2 times, while the number of suspensions due to hypertension decreased by 2,5 times.Conclusion. The conducted study may indicate the effectiveness of primary and secondary prevention of hypertension among Russian Railways staff.
Collapse
Affiliation(s)
- E. A. Zhidkova
- Central Healthcare Directorate — branch of the Russian Railways; A.I. Evdokimov Moscow State University of Medicine and Dentistry
| | | | - E. M. Gutor
- Central Healthcare Directorate — branch of the Russian Railways
| | - M. V. Gurevich
- Ambulatory clinic Central Clinical Hospital RZD-Medicine
| | | | - M. F. Vilk
- All-Russian Research Institute of Railway Hygiene
| | - K. G. Gurevich
- A.I. Evdokimov Moscow State University of Medicine and Dentistry; Research Institute for Healthcare and Medical Management
| | - O. M. Drapkina
- National Medical Research Center for Therapy and Preventive Medicine
| |
Collapse
|
12
|
Yi Q, Zha M, Yang Q, Zhang Y, Hou L, Ye X, Chen G, Shao J, Xia W, Song P. Trends in the prevalence of hypertension according to severity and phenotype in Chinese adults over two decades (1991-2015). J Clin Hypertens (Greenwich) 2021; 23:1302-1315. [PMID: 34128308 PMCID: PMC8678778 DOI: 10.1111/jch.14306] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 05/22/2021] [Accepted: 05/23/2021] [Indexed: 11/28/2022]
Abstract
Until recently, few studies have reported the secular trend and associated factors of hypertension severities and phenotypes in China. In this study, the authors aimed to assess the trend in the prevalence of hypertension according to severity and phenotype in Chinese adults from 1991 to 2015 and to explore potential cardiometabolic factors. From the China Health and Nutrition Survey (CHNS), the authors included 164 682 records of adults (≥18 years). The prevalence of hypertension by severity (stage 1 and stage 2 hypertension) and by phenotype (isolated systolic hypertension [ISH], isolated diastolic hypertension [IDH], and systolic-diastolic hypertension [SDH]), during 1991-2015 was explored. The potential effects of demographic, socioeconomic, geographic, and cardiometabolic factors on hypertension severities and phenotypes were assessed by multivariable logistic regression. During 1991-2015, the overall prevalence of hypertension increased dramatically from 15.7% to 23.3%. For stage 1 and stage 2 hypertension, the age-standardized prevalence increased from 10.1% to 15.6% and from 5.5% to 7.4%, respectively. For ISH and SDH, the age-standardized prevalence rates rose from 3.6% to 6.4% and from 6.9% to 10.4%, respectively. Advanced age and medium/high urbanization were positively associated factors, whereas females, higher educational attainments, and residing in Southern China were negatively associated factors. Additionally, general obesity, central obesity, diabetes, and elevated triglyceride levels were linked to ISH, IDH, and SDH. The present study documents an increasing trend in the prevalence of hypertension, including different severities and phenotypes, among Chinese adults over more than two decades. Efforts for the prevention and management of hypertension are in urgent need in China.
Collapse
Affiliation(s)
- Qian Yi
- School of Public HealthZhejiang University School of MedicineHangzhouChina
| | - Mingming Zha
- Department of Neurology, Jinling HospitalMedical School of Southeast UniversityNanjingChina
| | - Qingwen Yang
- Department of Neurology, Jinling HospitalMedical School of Southeast UniversityNanjingChina
| | - Yan Zhang
- Faculty of Life Science and MedicineKings College LondonLondonUK
| | - Leying Hou
- School of Public HealthZhejiang University School of MedicineHangzhouChina
| | - Xinxin Ye
- School of Public HealthZhejiang University School of MedicineHangzhouChina
| | - Ge Chen
- Medical Research and Biometrics CenterNational Center for Cardiovascular DiseasesBeijingChina
| | - Jing Shao
- School of NursingZhejiang University School of MedicineHangzhouChina
| | - Wei Xia
- School of NursingSun Yat‐Sen UniversityGuangzhouChina
| | - Peige Song
- School of Public HealthZhejiang University School of MedicineHangzhouChina
- Women’s HospitalZhejiang University School of MedicineHangzhouChina
| |
Collapse
|