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Wang Z, Chen D, Peng L, Wang X, Ding Q, Li L, Xu T. Serum γ-glutamyltransferase levels and obesity status changes the risk of prehypertension in Chinese adults. Prev Med Rep 2024; 43:102792. [PMID: 38975280 PMCID: PMC11225693 DOI: 10.1016/j.pmedr.2024.102792] [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: 12/07/2023] [Revised: 06/05/2024] [Accepted: 06/06/2024] [Indexed: 07/09/2024] Open
Abstract
Objective It's well known that γ-Glutamyltransferase (γ-GGT) and obesity plays an important role in the development of preHT. However, the effect of γ-GGT on preHT in populations with different obesity status remains unclear. Methods From February 2014 to January 2018, a total of 20,368 participants were enrolled in this study after excluding those with hypertension and liver diseases. Fasting blood samples were collected to measure γ-GGT and blood lipid levels and glucose indices. Demographic and clinical parameters such as sex, age, height, weight, neck circumference (NC), waist circumference (WC), hip circumference (HC), and body fat ratio (BFR); and information on smoking and alcohol consumption were collected by trained medical professionals. Results Participants were divided into three groups based on obesity status. The prevalence of preHT was 83.5 % in the obesity group was higher than that in the overweight group (58.9 %) and the normal group (47.1 %). γ-GGT in different categories of obesity indices were significantly different, and higher obesity indices were found with higher γ-GGT levels. The interaction of γ-GGT and obesity indices such as NC, WC, HC, and BFR on the prevalence of preHT was significant (P = 0.028, 0.002, 0.007, and 0.034, respectively). Serum γ-GGT was found to be positively associated with preHT in participants with normal and overweight body mass indices. Conclusion Our results indicate that γ-GGT is a risk factor for preHT in participants who are nonobese, and that the obesity indices NC, WC, HC, BFR, and γ-GGT were contributing factors in increasing the risk of preHT.
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Affiliation(s)
- Zhi Wang
- Department of Endocrinology, The Second People’s Hospital of Lianyungang, Jiangsu, China
| | - Dongjun Chen
- Department of Cardiac Function Examine, The Second People’s Hospital of Lianyungang, Jiangsu, China
| | - Lingling Peng
- Department of Endocrinology, The Second People’s Hospital of Lianyungang, Jiangsu, China
| | - Xian Wang
- Department of Ultrasonography, The Second People’s Hospital of Lianyungang, Jiangsu, China
| | - Qun Ding
- Department of Endocrinology, The Second People’s Hospital of Lianyungang, Jiangsu, China
| | - Liang Li
- Department of Ultrasonography, The Second People’s Hospital of Lianyungang, Jiangsu, China
| | - Tongdao Xu
- Department of Endocrinology, The Second People’s Hospital of Lianyungang, Jiangsu, China
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Jia X, Zhang B, Yu Y, Xia W, Lu Z, Guo X, Xue F. Greenness mitigate cause-specific mortality associated with air pollutants in ischemic and hemorrhagic stroke patients: An ecological health cohort study. ENVIRONMENTAL RESEARCH 2024; 251:118512. [PMID: 38458591 DOI: 10.1016/j.envres.2024.118512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 01/24/2024] [Accepted: 02/15/2024] [Indexed: 03/10/2024]
Abstract
BACKGROUND Air pollution is one of the most serious environmental risks to mortality of stroke. However, there exists a noteworthy knowledge gap concerning the different stroke subtypes, causes of death, the susceptibility of stroke patient, and the role of greenness in this context. METHODS We analyzed data from an ecological health cohort, which included 334,261 patients aged ≥40 years with stroke (comprising 288,490 ischemic stroke and 45,771 hemorrhagic stroke) during the period 2013-2019. We used Cox proportional hazards models with time-varying exposure to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) to assess the associations of annual average fine particulate matter (PM2.5), nitrogen dioxide (NO2), and ozone (O3) with both all-cause and cause-specific mortality. Additionally, we conducted analyses to examine the effect modification by greenness and identify potential susceptibility factors through subgroup analyses. RESULT In multivariable-adjusted models, long-term exposure to PM2.5 and NO2 was associated with increased risk of all-cause mortality (HR: 1.038, 95% CI: 1.029-1.047 for PM2.5; HR: 1.055, 95% CI: 1.026-1.085 for NO2, per 10 μg/m3, for ischemic stroke patients; similar for hemorrhagic stroke patients). Gradually increasing effect sizes were shown for CVD mortality and stroke mortality. The HRs of mortality were slightly weaker with high versus low vegetation exposure. Cumulative exposures increased the HRs of pollutant-related mortality, and greater greenness decreased this risk. Two subtypes of stroke patients exhibited diverse patterns of benefit. CONCLUSION Increasing residential greenness attenuates the increased risk of mortality with different patterns due to chronic air pollutants for ischemic and hemorrhagic stroke, offering valuable insights for precise tertiary stroke prevention strategies.
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Affiliation(s)
- Xianjie Jia
- Department of Biostatistics, School of Public Health, Healthcare Big Data Research Institute, Cheeloo College of Medicine, Shandong University, Jinan, China; Department of Epidemiology and Statistics, Bengbu Medical College, Bengbu, China
| | - Bingyin Zhang
- Shandong Center for Disease Control and Prevention, Jinan, China
| | - Ying Yu
- Department of Physiology, Bengbu Medical College, Bengbu, China
| | - Wanning Xia
- Department of Epidemiology and Statistics, Bengbu Medical College, Bengbu, China
| | - Zilong Lu
- Department of Physiology, Bengbu Medical College, Bengbu, China
| | - Xiaolei Guo
- Shandong Center for Disease Control and Prevention, Jinan, China.
| | - Fuzhong Xue
- Department of Biostatistics, School of Public Health, Healthcare Big Data Research Institute, Cheeloo College of Medicine, Shandong University, Jinan, China.
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3
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Feng X, Zhu J, Hua Z, Shi Q, Zhou J, Luo P. The prevalence and determinant of overweight and obesity among residents aged 40-69 years in high-risk regions for upper gastrointestinal cancer in southeast China. Sci Rep 2023; 13:8172. [PMID: 37210438 DOI: 10.1038/s41598-023-35477-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 05/18/2023] [Indexed: 05/22/2023] Open
Abstract
Being overweight or obese is one of the public health concerns worldwide, and its prevalence is gradually increasing. Obesity has been proven to be associated with some cancers, including upper gastrointestinal cancer (UGC). However, studies on the prevalence of obesity among residents of areas at high risk of UGC in China are minimal. The aim of this study is to assess the prevalence of obesity and its influencing factors among people aged 40-69 years (high-risk population) in high-risk areas for UGC in Jiangsu Province, southeast China. This cross-sectional study involved 45,036 subjects aged 40-69 years identified in the Rural Early Diagnosis and Treatment of UGC Project database in Jiangsu Province from 2017 to 2021. Differences in prevalence across gender and age were assessed using the Chi-square test. Using a multinomial logistic regression model, we examined independent risk factors for overweight/obesity and their gender and age differences. The prevalence of overweight, obesity, and overweight/obesity varied based on the standards used: Chinese standard (42.1%, 11.9%, and 54.0%) and WHO standard (34.7%, 4.7%, and 39.4%), respectively. Being overweight was more common in men than women, while obesity was more common in women than men. Age of 50-59 years, married, household size of 7-9, drinking, soy products, pickled food, and hot food intake were positively associated with overweight/obesity. Females, 60-69 years, higher education level, household size of 4-6, annual family income of more than 60,000 CNY, smoking, and fresh fruit intake were negatively associated with overweight/obesity. Stratified analysis showed that the effects of age, education and meat, egg and dairy products on overweight/obesity were different across gender. The impact of fresh fruit and vegetables on overweight/obesity was also heterogeneous between the younger (40-59 years) and older (60-69 years) groups. In conclusion, the prevalence of overweight and obesity is high among adults aged 40-69 years from high-risk areas for UGC of Jiangsu Province, southeast China. Independent influencing factors of being overweight/obese included gender, age, marital status, education, household size, annual family income, smoking, drinking, fresh fruit, soy products, pickled food and hot food intake, and may vary by gender and age. Screening-based interventions should be considered to control obesity levels among screened participants. Besides, heterogeneity of influencing factors across subgroups could be focused on to improve intervention effectiveness.
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Affiliation(s)
- Xiang Feng
- Institute of Tumour Prevention and Control, Yangzhong People's Hospital, Yangzhong, 212200, China
| | - Jinhua Zhu
- Institute of Tumour Prevention and Control, Yangzhong People's Hospital, Yangzhong, 212200, China.
- Department of Gastroenterology, Zhongda Hospital, Southeast University, Nanjing, 210000, China.
| | - Zhaolai Hua
- Institute of Tumour Prevention and Control, Yangzhong People's Hospital, Yangzhong, 212200, China
| | - Qiuping Shi
- Institute of Tumour Prevention and Control, Yangzhong People's Hospital, Yangzhong, 212200, China
| | - Jinyi Zhou
- Department of Non-communicable Disease Prevention and Control, Jiangsu Provincial Centre for Disease Control and Prevention, Nanjing, 210009, China.
| | - Pengfei Luo
- Department of Non-communicable Disease Prevention and Control, Jiangsu Provincial Centre for Disease Control and Prevention, Nanjing, 210009, China
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4
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Moftakhar L, Rezaianzadeh A, Seif M, Ghoddusi Johari M, Hosseini SV, Dehghani SS. The effect of prehypertension and hypertension on the incidence of cardiovascular disease: A population-based cohort study in Kharameh, a city in the South of Iran. Health Sci Rep 2023; 6:e1264. [PMID: 37251525 PMCID: PMC10210051 DOI: 10.1002/hsr2.1264] [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: 12/28/2022] [Revised: 04/25/2023] [Accepted: 04/27/2023] [Indexed: 05/31/2023] Open
Abstract
Background and Aim Prehypertension and hypertension are important risk factors for cardiovascular diseases. This study was carried out to evaluate the effect of prehypertension and hypertension on the development of cardiovascular diseases. Methods This prospective cohort study was performed on 9442 people aged 40-70 in Kharameh, southern Iran. Individuals were divided into three groups: normal blood pressure (N = 5009), prehypertension (N = 2166), and hypertension (N = 2267). In this study, demographic data, disease histories, behavioral habits, and biological parameters were studied. At first, the incidence density was calculated. Then Firth's Cox regression models were used to investigate the association between prehypertension and hypertension with the incidence of cardiovascular diseases. Results The incidence density in the three groups of individuals with normal blood pressure, prehypertension, and hypertension was 1.33, 2.02, and 3.29 cases per 100,000 person-days, respectively. The results of multiple Firth's Cox regression by controlling all factors showed that the risk of occurrence of cardiovascular disease in people with prehypertension was 1.33 times (hazard ratio [HR] = 1.32, 95% confidence interval [CI]: 1.01-1.73, p = 0.03) and those with hypertension were 1.85 times higher (HR = 1.77, 95% CI: 1.38-2.29, p < 0.0001) than the individuals with normal blood. Conclusion Prehypertension and hypertension have played an independent role in the risk for developing cardiovascular diseases. Therefore, early detection of individuals with these factors and control of other risk factors in them can contribute to reducing the occurrence of cardiovascular diseases.
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Affiliation(s)
- Leila Moftakhar
- Student Research CommitteeShiraz University of Medical SciencesShirazIran
| | - Abbas Rezaianzadeh
- Colorectal Research CenterShiraz University of Medical ScienceShirazIran
| | - Mozhgan Seif
- Department of Epidemiology, School of Health, Faculty of BiostatisticsShiraz University of Medical SciencesShirazIran
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Li D, Luo M, Liu Y, Dong J, Geng W, Li X, Yang L, Wang J, Cao P. Increased Rates of Health Management and Health Education on Hypertension and Diabetes in Inner Mongolia, China: 10-Year Population Level Trends (2009-2018). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13048. [PMID: 36293621 PMCID: PMC9603444 DOI: 10.3390/ijerph192013048] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 10/01/2022] [Indexed: 06/16/2023]
Abstract
Health management and health education are two important tasks in the national basic public health service project with a wide audience, large service volume, and high accessibility. From 2009 to 2018, the Inner Mongolia Autonomous Region of China launched the basic public health service (BPHS) project comprehensively. The implementation of health management and health education was supported and instructed actively. This study aimed to document population-level trends in health management and health education on chronic diseases such as hypertension and diabetes in Inner Mongolia, China. We collected monthly and annual reports on the implementation progress of the BPHS project in Inner Mongolia, China. A two-stage random sampling method was used to investigate health management and health education for hypertension and diabetes patients. The rate of standard health management for both hypertension and diabetes has significantly increased. The blood pressure control rate and glycemic control rate have also improved. This work provides the most comprehensive evidence to date regarding the upward trends in health management and health education on chronic diseases such as hypertension and diabetes in Inner Mongolia, China.
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Affiliation(s)
- Daxu Li
- Department of Medicine, Ordos Institute of Technology, Ordos 017000, China
- Prevention and Health Section, Pudong New Area People’s Hospital, Shanghai 201200, China
| | - Meixuan Luo
- Clinical Research Center, Zhujiang Hospital, Southern Medical University, Guangzhou 510280, China
- Department of Biostatistics, School of Public Health, Southern Medical University, Guangzhou 510515, China
| | - Yu Liu
- Clinical Research Center, Zhujiang Hospital, Southern Medical University, Guangzhou 510280, China
| | - Jing Dong
- Medical Center of Diagnosis and Treatment for Cervical and Intrauterine Diseases, Obstetrics and Gynecology Hospital of Fudan University, Shanghai 200032, China
| | - Wei Geng
- Department of Liver Surgery, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200127, China
| | - Xiaoliu Li
- Department of Rehabilitation Medicine, Minhang Hospital, Fudan University, Shanghai 200032, China
| | - Lijun Yang
- SUMHS-SHUANG JIA Institute of Emergency Medical Rescue Technology, Shanghai University of Medicine and Health Sciences, Shanghai 201318, China
| | - Jin Wang
- Department of Medicine, Ordos Institute of Technology, Ordos 017000, China
| | - Peihua Cao
- Clinical Research Center, Zhujiang Hospital, Southern Medical University, Guangzhou 510280, China
- Department of Biostatistics, School of Public Health, Southern Medical University, Guangzhou 510515, China
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6
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Huang H, Chen J, Fang S, Chen X, Pan X, Lei H, Zhang Y, Lin H, Yuan Q, Xia P, Liu N, Du H. Association Between Previous Stroke and Severe COVID-19: A Retrospective Cohort Study and an Overall Review of Meta-Analysis. Front Neurol 2022; 13:922936. [PMID: 35911884 PMCID: PMC9327441 DOI: 10.3389/fneur.2022.922936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Accepted: 06/14/2022] [Indexed: 01/08/2023] Open
Abstract
Objective The objective of this study was to investigate the association between previous stroke and the risk of severe coronavirus disease 2019 (COVID-19). Methods We included 164 (61.8 ± 13.6 years) patients with COVID-19 in a retrospective study. We evaluated the unadjusted and adjusted associations between previous stroke and severe COVID-19, using a Cox regression model. We conducted an overall review of systematic review and meta-analysis to investigate the relationship of previous stroke with the unfavorable COVID-19 outcomes. Results The rate of severe COVID-19 in patients with previous stroke was 28.37 per 1,000 patient days (95% confidence interval [CI]: 10.65–75.59), compared to 3.94 per 1,000 patient days (95% CI: 2.66–5.82) in those without previous stroke (p < 0.001). Previous stroke was significantly associated with severe COVID-19 using a Cox regression model (unadjusted [hazard ratio, HR]: 6.98, 95% CI: 2.42–20.16, p < 0.001; adjusted HR [per additional 10 years]: 4.62, 95% CI: 1.52–14.04, p = 0.007). An overall review of systematic review and meta-analysis showed that previous stroke was significantly associated with severe COVID-19, mortality, need for intensive care unit admission, use of mechanical ventilation, and an unfavorable composite outcome. Conclusion Previous stroke seems to influence the course of COVID-19 infection; such patients are at high risk of severe COVID-19 and might benefit from early hospital treatment measures and preventive strategies.
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Affiliation(s)
- Huayao Huang
- Department of Rehabilitation, Fujian Medical University Union Hospital, Fuzhou, China
| | - Junnian Chen
- Department of Critical Care Medicine, Fujian Medical University Union Hospital, Fuzhou, China
| | - Shuangfang Fang
- Department of Neurology, Stroke Research Center, Fujian Medical University Union Hospital, Fuzhou, China
| | - Xiaoling Chen
- Department of Infectious Disease, Fujian Medical University Union Hospital, Fuzhou, China
| | - Xiaobin Pan
- Department of Critical Care Medicine, Fujian Provincial Hospital South Branch, Fuzhou, China
| | - Hanhan Lei
- Department of Neurology, Stroke Research Center, Fujian Medical University Union Hospital, Fuzhou, China
| | - Yixian Zhang
- Department of Rehabilitation, Fujian Medical University Union Hospital, Fuzhou, China
| | - Hailong Lin
- Department of Radiology, Fujian Medical University Union Hospital, Fuzhou, China
| | - Qilin Yuan
- Department of Neurology, Stroke Research Center, Fujian Medical University Union Hospital, Fuzhou, China
| | - Pincang Xia
- Fujian Center for Disease Control and Prevention, Fuzhou, China
| | - Nan Liu
- Department of Rehabilitation, Fujian Medical University Union Hospital, Fuzhou, China
- Department of Neurology, Stroke Research Center, Fujian Medical University Union Hospital, Fuzhou, China
| | - Houwei Du
- Department of Neurology, Stroke Research Center, Fujian Medical University Union Hospital, Fuzhou, China
- *Correspondence: Houwei Du
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Hernández-Vásquez A, Vargas-Fernández R. Prevalence of Prehypertension and Associated Cardiovascular Risk Profiles among Adults in Peru: Findings from a Nationwide Population-Based Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19137867. [PMID: 35805525 PMCID: PMC9265298 DOI: 10.3390/ijerph19137867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 06/22/2022] [Accepted: 06/24/2022] [Indexed: 12/04/2022]
Abstract
Prehypertension is a clinical condition that increases the risk of hypertension and cardiovascular disease. In South American countries, prehypertension affects almost one-third of the population. The aim of the present study was to determine the association between prehypertension and the main cardiometabolic risk factors according to the US National Cholesterol Education Program Adult Treatment Panel III by sex in the Peruvian population. A total of 863 participants surveyed were included in the study. A total of 21.1% had prehypertension, 14.4% of whom were female, and 30.5% were male. Women belonging to the age group 50–59 years, having abdominal obesity and being a current smoker, were more likely to have prehypertension, while the likelihood of having prehypertension increased in men with abdominal obesity. Three out of 10 men and one out of 10 women in Peru have prehypertension. In women, being 50 to 59 years of age, having abdominal obesity, and being a current smoker, increased the probability of having prehypertension, whereas, in men, only abdominal obesity was found to be associated with prehypertension. Our findings will allow the development of prevention strategies focused on the appropriate diagnosis of prehypertension and cardiometabolic risk factors according to sex.
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Affiliation(s)
- Akram Hernández-Vásquez
- Centro de Excelencia en Investigaciones Económicas y Sociales en Salud, Vicerrectorado de Investigación, Universidad San Ignacio de Loyola, Lima 15024, Peru
- Correspondence:
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The predictive value of serum level of cystatin C for COVID-19 severity. Sci Rep 2021; 11:21964. [PMID: 34754069 PMCID: PMC8578213 DOI: 10.1038/s41598-021-01570-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 10/29/2021] [Indexed: 02/07/2023] Open
Abstract
To investigate the potential prognostic value of Serum cystatin C (sCys C) in patients with COVID-19 and determine the association of sCys C with severe COVID-19 illness. We performed a retrospective review of medical records of 162 (61.7 ± 13.5 years) patients with COVID-19. We assessed the predictive accuracy of sCys C for COVID-19 severity by the receiver operating characteristic (ROC) curve analysis. The participants were divided into two groups based on the sCys C cut-off value. We evaluated the association between high sCys C level and the development of severe COVID-19 disease, using a COX proportional hazards regression model. The area under the ROC curve was 0.708 (95% CI 0.594–0.822), the cut-off value was 1.245 (mg/L), and the sensitivity and specificity was 79.1% and 60.7%, respectively. A multivariable Cox analysis showed that a higher level of sCys C (adjusted HR 2.78 95% CI 1.25–6.18, p = 0.012) was significantly associated with an increased risk of developing a severe COVID-19 illness. Patients with a higher sCys C level have an increased risk of severe COVID-19 disease. Our findings suggest that early assessing sCys C could help to identify potential severe COVID-19 patients.
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Zhang Y, Feng Y, Chen S, Liang S, Wang S, Xu K, Ning D, Yuan X, Zhu H, Pan H, Shan G. Relationship between the duration of smoking and blood pressure in Han and ethnic minority populations: a cross-sectional study in China. BMC Public Health 2021; 21:135. [PMID: 33446177 PMCID: PMC7807505 DOI: 10.1186/s12889-020-09975-w] [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: 05/29/2020] [Accepted: 11/25/2020] [Indexed: 11/10/2022] Open
Abstract
Background Evidence for correlation between the cigarette use and blood pressure change remains ambiguous. This study modelled relationship between the duration of smoking and systolic blood pressure in a large national multi-ethnic cross-sectional survey in China. Methods Participants were selected through a multi-stage probability sampling procedure from 2012 to 2017. Former or current smokers were included in this study, whose smoking behaviour, blood pressure, and other demographic information were collected and measured through a face-to-face interview. Linear and non-linear relationships between the duration of smoking and systolic blood pressure were analysed and differences of the association between Han and minority populations were specially checked. Results A total of 8801 participants were enrolled in this study. Prevalence of hypertension was 41.3 and 77.8% were current smokers. For every additional year of smoking duration, systolic blood pressure raised by 0.325 mmHg (95% CI 0.296 to 0.354 mmHg, P < 0.001). The Chinese minority populations may suffer more from the elevated blood pressure in long-term smoking than Han populations (0.283 mmHg (95% CI 0.252 to 0.314 mmHg, P < 0.001) versus 0.450 mmHg (95% CI 0.380 to 0.520 mmHg, P < 0.001) raise in systolic blood pressure with each additional year of smoking in minority and Han populations). Conclusions Smoking is associated with raised systolic blood pressure in Chinese population. This association is notedly stronger in Chinese minority populations.
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Affiliation(s)
- Yuelun Zhang
- Medical Research Center, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yunying Feng
- Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Shi Chen
- Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Siyu Liang
- Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Shirui Wang
- Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Ke Xu
- Department of Endocrinology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Dongping Ning
- Department of Pediatrics, Linfen Central Hospital, Linfen, China
| | - Xianxian Yuan
- Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Huijuan Zhu
- Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Hui Pan
- Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
| | - Guangliang Shan
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, School of Basic Medicine, Peking Union Medical College, Beijing, China
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10
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Du H, Pan X, Liu N, Chen J, Chen X, Werring DJ, Ambler G, Li X, Chen R, Zhang Y, Huang H, Lin F, Xia P, Chen C, Zheng Z, Wu S, Lei H, Gao L, Huang M, Lin K, Xu X, Luo Y, Zhao Z, Li C, Lin H, Lin Y, Huang Z, Cao R, Chen L. The effect of vascular risk factor burden on the severity of COVID-19 illness, a retrospective cohort study. Respir Res 2020; 21:241. [PMID: 32957997 PMCID: PMC7503438 DOI: 10.1186/s12931-020-01510-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Accepted: 09/14/2020] [Indexed: 01/08/2023] Open
Abstract
Background Patients with cardiovascular comorbidities are at high risk of poor outcome from COVID-19. However, how the burden (number) of vascular risk factors influences the risk of severe COVID-19 disease remains unresolved. Our aim was to investigate the association of severe COVID-19 illness with vascular risk factor burden. Methods We included 164 (61.8 ± 13.6 years) patients with COVID-19 in this retrospective study. We compared the difference in clinical characteristics, laboratory findings and chest computed tomography (CT) findings between patients with severe and non-severe COVID-19 illness. We evaluated the association between the number of vascular risk factors and the development of severe COVID-19 disease, using a Cox regression model. Results Sixteen (9.8%) patients had no vascular risk factors; 38 (23.2%) had 1; 58 (35.4%) had 2; 34 (20.7%) had 3; and 18 (10.9%) had ≥4 risk factors. Twenty-nine patients (17.7%) experienced severe COVID-19 disease with a median (14 [7–27] days) duration between onset to developing severe COVID-19 disease, an event rate of 4.47 per 1000-patient days (95%CI 3.10–6.43). Kaplan-Meier curves showed a gradual increase in the risk of severe COVID-19 illness (log-rank P < 0.001) stratified by the number of vascular risk factors. After adjustment for age, sex, and comorbidities as potential confounders, vascular risk factor burden remained associated with an increasing risk of severe COVID-19 illness. Conclusions Patients with increasing vascular risk factor burden have an increasing risk of severe COVID-19 disease, and this population might benefit from specific COVID-19 prevention (e.g., self-isolation) and early hospital treatment measures.
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Affiliation(s)
- Houwei Du
- Stroke Research Center, Department of Neurology, Fujian Medical University Union Hospital, 29 Xinquan Road, Gulou District, Fuzhou, 350001, China. .,Institute of Clinical Neurology, Fujian Medical University, Fuzhou, China.
| | - Xiaobin Pan
- Department of Critical Care Medicine, Fujian Provincial Hospital South Branch, Fuzhou, China
| | - Nan Liu
- Stroke Research Center, Department of Neurology, Fujian Medical University Union Hospital, 29 Xinquan Road, Gulou District, Fuzhou, 350001, China.,Department of Rehabilitation, Fujian Medical University Union Hospital, Fuzhou, China
| | - Junnian Chen
- Department of Critical Care Medicine, Fujian Medical University Union Hospital, Fuzhou, China
| | - Xiaoling Chen
- Department of Infectious Disease, Fujian Medical University Union Hospital, Fuzhou, China
| | | | - Gareth Ambler
- Statistical Science, University College London, London, UK
| | - Xiaoqing Li
- Fujian Center for Disease Control and Prevention, Fuzhou, China
| | - Ronghua Chen
- Stroke Research Center, Department of Neurology, Fujian Medical University Union Hospital, 29 Xinquan Road, Gulou District, Fuzhou, 350001, China.,Institute of Clinical Neurology, Fujian Medical University, Fuzhou, China
| | - Yixian Zhang
- Department of Rehabilitation, Fujian Medical University Union Hospital, Fuzhou, China
| | - Huayao Huang
- Department of Rehabilitation, Fujian Medical University Union Hospital, Fuzhou, China
| | - Feifei Lin
- Stroke Research Center, Department of Neurology, Fujian Medical University Union Hospital, 29 Xinquan Road, Gulou District, Fuzhou, 350001, China
| | - Pincang Xia
- Fujian Center for Disease Control and Prevention, Fuzhou, China
| | - Chao Chen
- Department of Neurology, Fuzhou Second Hospital Affiliated to Xiamen University, Fuzhou, China
| | - Zhenyang Zheng
- Stroke Research Center, Department of Neurology, Fujian Medical University Union Hospital, 29 Xinquan Road, Gulou District, Fuzhou, 350001, China.,Institute of Clinical Neurology, Fujian Medical University, Fuzhou, China
| | - Sangru Wu
- Stroke Research Center, Department of Neurology, Fujian Medical University Union Hospital, 29 Xinquan Road, Gulou District, Fuzhou, 350001, China
| | - Hanhan Lei
- Stroke Research Center, Department of Neurology, Fujian Medical University Union Hospital, 29 Xinquan Road, Gulou District, Fuzhou, 350001, China
| | - Lei Gao
- Department of Thoracic Surgery, Fujian Medical University Union Hospital, Fuzhou, China
| | - Mingxu Huang
- Department of Emergency Medicine, Fujian Medical University Union Hospital, Fuzhou, China
| | - Kexu Lin
- Department of Emergency Medicine, Fujian Medical University Union Hospital, Fuzhou, China
| | - Xiaoping Xu
- Department of Anesthesiology, Fujian Medical University Union Hospital, Fuzhou, China
| | - Yukun Luo
- Department of Cardiology, Fujian Medical University Union Hospital, Fuzhou, China
| | - Ziwen Zhao
- Department of Cardiology, Fujian Medical University Union Hospital, Fuzhou, China
| | - Chen Li
- Department of Otolaryngology, Fujian Medical University Union Hospital, Fuzhou, China
| | - Hailong Lin
- Department of Radiology, Fujian Medical University Union Hospital, Fuzhou, China
| | - Yu Lin
- Department of Colorectal Surgery, Fujian Medical University Union Hospital, Fuzhou, China
| | - Zhenghui Huang
- Department of Respiratory Medicine, Fujian Medical University Union Hospital, Fuzhou, China
| | - Rongxiang Cao
- Department of Respiratory Medicine, Fujian Medical University Union Hospital, Fuzhou, China
| | - Limin Chen
- Department of Respiratory Medicine, Fujian Medical University Union Hospital, Fuzhou, China
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11
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Akinbodewa AA, Adejumo AO, Lamidi OA, Adeyemi O. Clustering of Cardiometabolic Risk Factors among Children and Adolescents in a Rural Community in Ondo, Southwest Nigeria. J Trop Pediatr 2020; 66:366-376. [PMID: 31665517 DOI: 10.1093/tropej/fmz075] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Clustering of cardiometabolic risk factors is rapidly becoming prevalent among children and adolescents with grave implications for their cardiovascular health. We set out to determine prevalence and pattern of clustering of risk factors and, identify factors (if any) that determine their clustering. METHODS A cross-sectional study of children (3-9 years) and adolescents (10-17 years) in a rural, agrarian community. Their blood pressure, body mass index and lipids were measured. Data was analyzed with SPSS 20. RESULTS A total of 114 (M : F, 1 : 1.1) subjects were studied. The mean age of children and adolescents were 5.6 ± 2.1 and 12.9 ± 2.2 years respectively. The most prevalent cardiometabolic risk factors were elevated non-high density lipoprotein-cholesterol (HDL-c; 39.5%), low HDL-c (33.3%), prehypertension (12.3%) and overweight (9.6%). The prevalence of hypertension was higher among females (11.9% vs. 1.8%, p = 0.024) and adolescents (13.2% vs. 1.6%, p = 0.037). Serum levels of non-HDL-c was higher among adolescents than children (50.9% vs. 29.5%, p = 0.013). At least one risk factor was present in 68.4% of the subjects. Clustering of two and three risk factors were present in 18.4% and 6.1%. The presence of prehypertension (χ2 23.93, p < .001), hypertension (χ2 12.19, p = 0.002), high serum non-HDL-c (χ2 6.336, p = 0.011) and high serum total cholesterol (TC; χ2 8.810, p < 0.001) were associated with clustering of cardiometabolic risk factors. CONCLUSION The burden of cardiometabolic risk factors among children and adolescents is high. Identified determinants of risk factor clustering were prehypertension, hypertension, non-HDL-c and TC.
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Affiliation(s)
- Akinwumi Ayodeji Akinbodewa
- Department of Medicine, Kidney Care Centre, University of Medical Sciences Teaching Hospital, PMB 542, Ondo City, Nigeria
| | - Ademola Oluseyi Adejumo
- Department of Medicine, Kidney Care Centre, University of Medical Sciences Teaching Hospital, PMB 542, Ondo City, Nigeria
| | - Oluwakemi Abiola Lamidi
- Department of Dietetics and Nutrition, University of Medical Sciences Teaching Hospital, PMB 542, Ondo City, Nigeria
| | - Ogunleye Adeyemi
- Chemical Pathology Major, Medical Laboratory Science Department, University of Medical Sciences Teaching Hospital, PMB 542, Ondo City, Nigeria
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12
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Xi Y, Niu L, Cao N, Bao H, Xu X, Zhu H, Yan T, Zhang N, Qiao L, Han K, Hang G, Wang W, Zhang X. Prevalence of dyslipidemia and associated risk factors among adults aged ≥35 years in northern China: a cross-sectional study. BMC Public Health 2020; 20:1068. [PMID: 32631296 PMCID: PMC7339536 DOI: 10.1186/s12889-020-09172-9] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Accepted: 06/26/2020] [Indexed: 12/30/2022] Open
Abstract
Background Cardiovascular disease (CVD) prevalence has increased continuously over the last 30 years in China. Dyslipidemia is an important modifiable risk factor in CVD. We aimed to collect current data on the prevalence of dyslipidemia in northern China and explore potential influencing factors. Methods In this cross-sectional study, we selected a representative sample of 65,128 participants aged ≥35 years in Inner Mongolia during 2015–2017. All participants completed a questionnaire and were examined for risk factors. Dyslipidemia was defined according to 2016 Chinese guidelines for adults. The associated factors for dyslipidemia were estimated by multivariate logistic regression analysis. Results The age-standardized prevalence of dyslipidemia was 31.2% overall, with 4.3, 2.4, 14.7, and 17.4% for high total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), triglycerides (TG), and low high-density lipoprotein cholesterol (HDL-C), respectively. The dyslipidemia prevalence was significantly higher in men than women (37.9% vs. 27.5%, P < 0.001), but postmenopausal women had a higher prevalence of dyslipidemia components (except low HDL-C). Compared with Han participants, Mongol participants had a lower prevalence of dyslipidemia (29.1% vs. 31.4%, P < 0.001). Male sex, living in urban areas, Han ethnicity, smoking, obesity, central obesity, hypertension, and diabetes were all positively correlated with dyslipidemia; alcohol consumption was linked to lower risk of dyslipidemia. Conclusions Our study revealed that dyslipidemia is a health problem in northern China. Greater efforts to prevent and manage dyslipidemia, especially in men under age 55 years, postmenopausal women, and people with unhealthy lifestyles or chronic diseases.
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Affiliation(s)
- Yunfeng Xi
- The Inner Mongolia Autonomous Region Comprehensive Center or Disease Control and Prevention, 50 Ordos street, Hohhot, Inner Mongolia Province, 010000, P.R. China
| | - Liwei Niu
- Public Health College, Inner Mongolia Medical University, Hohhot, Inner Mongolia Province, PR China
| | - Ning Cao
- Public Health College, Inner Mongolia Medical University, Hohhot, Inner Mongolia Province, PR China
| | - Han Bao
- Public Health College, Inner Mongolia Medical University, Hohhot, Inner Mongolia Province, PR China
| | - Xiaoqian Xu
- Public Health College, Inner Mongolia Medical University, Hohhot, Inner Mongolia Province, PR China
| | - Hao Zhu
- Public Health College, Inner Mongolia Medical University, Hohhot, Inner Mongolia Province, PR China
| | - Tao Yan
- Public Health College, Inner Mongolia Medical University, Hohhot, Inner Mongolia Province, PR China
| | - Nan Zhang
- Public Health College, Inner Mongolia Medical University, Hohhot, Inner Mongolia Province, PR China
| | - Liying Qiao
- The Inner Mongolia Autonomous Region Comprehensive Center or Disease Control and Prevention, 50 Ordos street, Hohhot, Inner Mongolia Province, 010000, P.R. China
| | - Ke Han
- The Inner Mongolia Autonomous Region Comprehensive Center or Disease Control and Prevention, 50 Ordos street, Hohhot, Inner Mongolia Province, 010000, P.R. China
| | - Gai Hang
- The Inner Mongolia Autonomous Region Comprehensive Center or Disease Control and Prevention, 50 Ordos street, Hohhot, Inner Mongolia Province, 010000, P.R. China
| | - Wenrui Wang
- The Inner Mongolia Autonomous Region Comprehensive Center or Disease Control and Prevention, 50 Ordos street, Hohhot, Inner Mongolia Province, 010000, P.R. China
| | - Xingguang Zhang
- Public Health College, Inner Mongolia Medical University, Hohhot, Inner Mongolia Province, PR China.
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Zhu H, Xi Y, Bao H, Xu X, Niu L, Tao Y, Cao N, Wang W, Zhang X. Assessment of cardiovascular disease risk in Northern China: a cross-sectional study. Ann Hum Biol 2020; 47:498-503. [PMID: 32618477 DOI: 10.1080/03014460.2020.1779814] [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: 10/23/2022]
Abstract
Cardiovascular disease (CVD) is a life-threatening chronic illness. CVD risk may be influenced by environment and lifestyle. People in northern China usually consume high-fat, high-salt diets and alcohol and live in a cold climate over long periods. However, there are limited studies on CVD risk among people in northern China. In the present study, we sought to estimate the CVD risk profile among residents of northern China. Using the Programme of Screening and Intervention Subjects with High Risk Cardiovascular Diseases, we collected data from residents in six cities from September 2015 to June 2017. In total, 56,716 participants aged 40 years and above were finally included in the CVD risk assessment. To assess the 10-year risk of CVD among participants, we used World Health Organisation/International Society of Hypertension risk prediction charts. Among the study participants, 22.7% had a high 10-year risk of CVD. We identified differences in the 10-year CVD risk according to sex, socioeconomic status, and marital status. We conclude that individuals with high socioeconomic status should be encouraged to change their lifestyle habits, and greater medical resources should be invested for individuals residing in rural areas and those with low education levels.
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Affiliation(s)
- Hao Zhu
- Public Health College, Inner Mongolia Medical University, Hohhot, China
| | - Yunfeng Xi
- The Inner Mongolia Autonomous Region Comprehensive Center of Disease Control and Prevention, Hohhot, China
| | - Han Bao
- Public Health College, Inner Mongolia Medical University, Hohhot, China
| | - Xiaoqian Xu
- Public Health College, Inner Mongolia Medical University, Hohhot, China
| | - Liwei Niu
- Public Health College, Inner Mongolia Medical University, Hohhot, China
| | - Yan Tao
- Public Health College, Inner Mongolia Medical University, Hohhot, China
| | - Ning Cao
- Public Health College, Inner Mongolia Medical University, Hohhot, China
| | - Wenrui Wang
- The Inner Mongolia Autonomous Region Comprehensive Center of Disease Control and Prevention, Hohhot, China
| | - Xingguang Zhang
- Public Health College, Inner Mongolia Medical University, Hohhot, China
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14
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Tang L, Zhao Q, Han W, Li K, Li J. Association of cardiovascular risk factor clustering and prehypertension among adults:Results from the China health and retirement longitudinal study baseline. Clin Exp Hypertens 2020; 42:315-321. [PMID: 31394956 DOI: 10.1080/10641963.2019.1652633] [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: 10/26/2022]
Abstract
Background: Prehypertension is common in China, but its causes and associated factors have not been well studied. This study aimed to examine the age and gender-specific associations between CVD risk factor clustering and prehypertension among adults in China.Methods: This cross-sectional study used data from participants (n = 8735) aged over 45 in the China Health and Retirement Longitudinal Study (CHARLS) Baseline conducted from 2011-2012. The participants' data were collected using standard questionnaires, anthropometric, and biochemical tests. Logistic regression analyses were used to examine the associations between cardiovascular risk factors, their clustering and prehypertension.Results: Overall, 21.1%, 39.5%, 27.6% and 11.8% participants had 0, 1, 2, ≥ 3 CVD risk factors in prehypertension group, respectively. Diabetes and overweight/obesity were significantly associated with prehypertension (OR, 1.24; 95% confidence interval [CI], 1.06-1.44; OR, 1.55; 95% CI, 1.38-1.75) in the overall population, and diabetes was associated with prehypertension only in men (OR, 1.26; 95% CI, 1.00-1.58) and older adults (OR, 1.32; 95% CI, 1.03-1.69). Moreover, participants with 1, 2 and ≥3 risk factors had increased odds of having prehypertension (OR, 1.29; 95% CI, 1.12-1.49; OR, 1.59; 95% CI, 1.31-1.78; OR, 2.05; 95% CI, 1.66-2.53, respectively) and existed dose-response relationship, regardless of age and gender.Conclusions: This study indicated that CVD risk factor clustering was significantly associated with prehypertension and hypertension. These results provide valuable information for health professionals to better understand the impact of CVD risk factor clustering on prehypertension and hypertension.
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Affiliation(s)
- Liya Tang
- School of Nursing, Jilin University, Changchun, China
| | - Qiheng Zhao
- Department of orthopedics, China-Japan Union Hospital, Jilin University, Changchun, China
| | - Wenwen Han
- School of Nursing, Jilin University, Changchun, China
| | - Kun Li
- School of Nursing, Jilin University, Changchun, China
| | - Junxin Li
- School of Nursing, Johns Hopkins University, Baltimore, MD, USA
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Huang Y, Deng Z, Se Z, Bai Y, Yan C, Zhan Q, Zeng Q, Ouyang P, Dai M, Xu D. Combined impact of risk factors on the subsequent development of hypertension. J Hypertens 2019; 37:696-701. [PMID: 30817449 DOI: 10.1097/hjh.0000000000001956] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES This study aimed to develop a cumulative score composed of seven risk factors: age, resting heart rate, overweight or obesity, dyslipidemia, hyperuricemia, impaired glucose regulation, and impaired estimated glomerular filtration rate (eGFR), to evaluate the risk of new-onset hypertension. METHODS We retrospectively conducted a cohort study in 23 665 participants free from hypertension at baseline, who attended at least two annual health examinations between 2011 and 2016. We defined hypertension as SBP of 140 mmHg or less and/or DBP of at least 90 mmHg, according to the 2010 Chinese guidelines for the management of hypertension. We computed a composite, individual-level cumulative score incorporating all seven risk factors (no = 0 point; yes = 1 point; total range 0-7 points). Cox regression was used to analyze the association between cumulative score and risk of hypertension. RESULTS A total of 2305 participants developed hypertension during a median follow-up period of 3.6 years. Compared with participants with 0 points, the adjusted hazard ratios (95% confidence intervals) for the development of hypertension for those with 2, 3, and at least 4 points were 1.61 (1.29-2.02), 2.05 (1.64-2.57) and 2.77 (2.22-3.46), respectively (P trend < 0.001). This association was present after adjustment for sex and baseline blood pressure. CONCLUSION Age, resting heart rate, overweight or obesity, dyslipidemia, hyperuricemia, impaired glucose regulation, and impaired eGFR were associated with significant risk of new-onset hypertension and when combined there was an accumulation of risk.
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Affiliation(s)
- Yuli Huang
- State Key Laboratory of Organ Failure Research, Department of Cardiology, Nanfang Hospital, Southern Medical University, Guangzhou
- Department of Cardiology, Shunde Hospital, Southern Medical University, Foshan
| | - Zhihui Deng
- State Key Laboratory of Organ Failure Research, Department of Cardiology, Nanfang Hospital, Southern Medical University, Guangzhou
| | - Zhen Se
- State Key Laboratory of Organ Failure Research, Department of Cardiology, Nanfang Hospital, Southern Medical University, Guangzhou
| | - Yujia Bai
- State Key Laboratory of Organ Failure Research, Department of Cardiology, Nanfang Hospital, Southern Medical University, Guangzhou
| | - Chuanjie Yan
- Department of Health Management, Nanfang Hospital, Southern Medical University, Guangzhou, PR China
| | - Qiong Zhan
- State Key Laboratory of Organ Failure Research, Department of Cardiology, Nanfang Hospital, Southern Medical University, Guangzhou
| | - Qingchun Zeng
- State Key Laboratory of Organ Failure Research, Department of Cardiology, Nanfang Hospital, Southern Medical University, Guangzhou
| | - Ping Ouyang
- Department of Health Management, Nanfang Hospital, Southern Medical University, Guangzhou, PR China
| | - Meng Dai
- Department of Health Management, Nanfang Hospital, Southern Medical University, Guangzhou, PR China
| | - Dingli Xu
- State Key Laboratory of Organ Failure Research, Department of Cardiology, Nanfang Hospital, Southern Medical University, Guangzhou
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Effect of BMI and Its Optimal Cut-Off Value in Identifying Hypertension in Uyghur and Han Chinese: A Biethnic Study from the China National Health Survey (CNHS). Int J Hypertens 2018; 2018:1508083. [PMID: 30643642 PMCID: PMC6311287 DOI: 10.1155/2018/1508083] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Accepted: 11/19/2018] [Indexed: 01/13/2023] Open
Abstract
Objective The effect of adiposity on hypertension among Uyghur Chinese is not clear. This study aimed to compare the effect of BMI and its optimal cut-off value in identifying hypertension in Uyghur and Han adults in China. Methods By using a multistage stratified sampling method, 3072 Uyghur and 3195 Han adults underwent questionnaire interview, physical examination, and biochemical tests. Age- and sex-standardized prevalence of hypertension was calculated. Adjusted odds ratios for adiposity associated with hypertension were estimated. ROC analyses were used for assessing the ethnic and sex specific optimal BMI cut-off values in identifying hypertension. Results Both in Uyghur and Han, increased BMI was consistent with the elevated systolic and diastolic blood pressure. Although more Uyghur were overweight/obese, their standardized prevalence of hypertension (17.87%) was lower than that of Han (20.28%). Han adults had 1.42 times odds than Uyghur of hypertension. The adjusted ORs of overweight and obesity were 2.67 and 6.04 in Uyghur and 2.74 and 7.58 in Han. In male, the optimal cut-off values of BMI identifying hypertension in Uyghur and Han were 24.6 kg/m2 and 24.9 kg/m2 , respectively, but the correspond values in Uyghur and Han females were 27.2 kg/m2 and 25.0 kg/m2. Conclusions Adiposity had strong effect on hypertension, but this effect was less strong in Uyghur female than in Han female.
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Song J, Chen X, Zhao Y, Mi J, Wu X, Gao H. Risk factors for prehypertension and their interactive effect: a cross- sectional survey in China. BMC Cardiovasc Disord 2018; 18:182. [PMID: 30219041 PMCID: PMC6139180 DOI: 10.1186/s12872-018-0917-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Accepted: 09/06/2018] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Individuals with prehypertension are at higher risk of developing hypertension and cardiovascular diseases, while the interaction between factors may aggravate prehypertension risk. Therefore, this study aimed to evaluate the risk factors for prehypertension in Chinese middle-aged and elderly adults, and explore the potentially interactive effect of evaluated factors. METHODS All the participants that came from a community based cross-sectional survey were investigated in Bengbu, China, by being interviewed with a questionnaire. Body mass index (BMI), Waist circumference (WC) and lipid accumulation product (LAP) that reflect participants' obesity were also calculated. In addition, logistic regression model was applied to explore the risk factors of prehypertension, followed by the assessment of the interactive effects between risk factors on prehypertension by the relative excess risk due to interaction (RERI), attributable proportion due to interaction (AP) and synergy index (SI). RESULTS A total of 1777 participants were enrolled in this study, among which the prevalence of normtension, prehypertension and hypertension were 41.70%, 33.93% and 24.37% respectively. According to the multivariate logistic regression analysis, age (OR: 1.01, 95%CI: 1.00-1.02), smoking (OR: 1.67, 95%CI: 1.22-2.29), family history of cardiovascular diseases (OR: 1.52, 95%CI: 1.14-2.02), general obesity (OR: 1.51, 95%CI: 1.15-1.97) and LAP (OR: 2.58, 95%CI: 1.76-3.80) were all defined as the major factors that significantly related with the risk of prehypertension. When identifying prehypertension risk, the receiver-operating characteristics (ROC) curves (AUC) analysis indicated that LAP performed better than BMI in males (Z = 2.05, P = 0.03) and females (Z = 2.12, P = 0.03), but was superior to WC only in females (Z = 2.43, P = 0.01). What is more, there were significant interactive effects of LAP with family history of cardiovascular diseases (RERI: 1.88, 95%CI: 0.25-3.51; AP: 0.44, 95%CI: 0.20-0.69; SI: 2.37, 95%CI: 1.22-4.60) and smoking (RERI: 1.99, 95%CI: 0.04-3.93; AP: 0.42, 95%CI: 0.17-0.67; SI: 2.16, 95%CI: 1.68-4.00) on prehypertension risk. The value of AP (0.40, 95%CI: 0.03-0.77) also indicated a significant interaction between family history of cardiovascular diseases and smoking on prehypertension. CONCLUSION Prehypertension is currently prevalent in Chinese adults. This study indicated that age, family history of cardiovascular diseases, smoking, general obesity and LAP were significantly related with prehypertension risk. Furthermore, interactive effects on risk of prehypertension had been demonstrated in this study as well, which would help researchers to build strategy against prehypertension more comprehensively and scientifically.
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Affiliation(s)
- Jian Song
- School of public health, Bengbu medical college, 2600 Donghai Road, Bengbu, 233000 Anhui Province China
| | - Xue Chen
- School of public health, Bengbu medical college, 2600 Donghai Road, Bengbu, 233000 Anhui Province China
| | - Yingying Zhao
- Bengbu health board, 568 Nanhu Road, Bengbu, 233000 Anhui Province China
| | - Jing Mi
- School of public health, Bengbu medical college, 2600 Donghai Road, Bengbu, 233000 Anhui Province China
| | - Xuesen Wu
- School of public health, Bengbu medical college, 2600 Donghai Road, Bengbu, 233000 Anhui Province China
| | - Huaiquan Gao
- School of public health, Bengbu medical college, 2600 Donghai Road, Bengbu, 233000 Anhui Province China
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Determination of the Best Anthropometric Index of Obesity for Prediction of Prehypertension and Hypertension in a Large Population - Based - Study; the Azar- Cohort. IRANIAN RED CRESCENT MEDICAL JOURNAL 2018. [DOI: 10.5812/ircmj.59911] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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