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Xiao W, Wumaer A, Maimaitiwusiman Z, Liu J, Xuekelati S, Wang H. Heat maps of cardiovascular disease risk factor clustering among community-dwelling older people in Xinjiang: a cross-sectional study. BMJ Open 2022; 12:e058400. [PMID: 35981774 PMCID: PMC9394193 DOI: 10.1136/bmjopen-2021-058400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVE The clustering of multiple cardiovascular disease (CVD) risk factors (CRFs) increases the risk of CVD prevalence and mortality. Little is known about CRF clustering among community-dwelling older people in Xinjiang. The objective of this study was to explore the prevalence of CRF clustering in this population. DESIGN Cross-sectional study. SETTING Xinjiang, China. PARTICIPANTS Multilevel random sampling was used to survey individuals aged ≥60 in six regions of Xinjiang. In total, 87 000 participants volunteered, with a response rate of 96.67%; 702 participants with incomplete data were excluded and data from 86 298 participants were analysed. OUTCOME MEASURES The prevalence of smoking, hypertension, diabetes, dyslipidaemia and overweight/obesity was 9.4%, 52.1%, 16.8%, 28.6% and 62.7%, respectively. The prevalence of CRF clusters among people of different ages, regions and ethnic groups differed significantly. The 85.7% of the participants presented at least one CRFs and 55.9% of the participants presented clustering of CRFs. The proportion of CRF clusters tended to be higher in men, 60-69-year-old group, northern Xinjiang and the Kazakh population. After adjusting for age and sex, logistic regression analysis revealed that men, 60-69-year-old group, northern Xinjiang and the Kazakh population were more likely to have clustering of CRFs, compared with their counterparts. CONCLUSIONS The prevalence of CRFs in the older Xinjiang population is high and their clustering differs by sex, age, region and ethnicity. CRF prevention and management should be active in this population, and strategies to reduce CVD risk based on sex, age, ethnic group and region are warranted.
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Affiliation(s)
- Wenwen Xiao
- Second Department of Cadre Health Care Center, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, China
| | - Aishanjiang Wumaer
- Second Department of Cadre Health Care Center, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, China
| | - Zhuoya Maimaitiwusiman
- Second Department of Cadre Health Care Center, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, China
| | - Jinling Liu
- Second Department of Cadre Health Care Center, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, China
| | - Saiyare Xuekelati
- Second Department of Cadre Health Care Center, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, China
| | - Hongmei Wang
- Second Department of Cadre Health Care Center, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, China
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2
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Wang Z, Heizhati M, Wang L, Li M, Yang Z, Lin M, Abudereyimu R, Hong J, Yang W, Yao L, Liu S, Hu J, Li N. Poor sleep quality is negatively associated with low cognitive performance in general population independent of self-reported sleep disordered breathing. BMC Public Health 2022; 22:3. [PMID: 34980052 PMCID: PMC8725333 DOI: 10.1186/s12889-021-12417-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 12/09/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Sleep disordered breathing (SDB) plays a significant role in both sleep quality and cognition and whether it has an impact on the relationship between above two factors remains to be clear. The study aimed to explore the association between sleep quality and cognitive performance in general population by considering influence of sleep disordered breathing (SDB). METHODS In this cross-sectional study, we enrolled subjects aged ≥ 18 years using a multi-stage random sampling method. Cognitive status was assessed using Mini Mental State Examination (MMSE) questionnaire, sleep quality using Pittsburgh Sleep Quality Index (PSQI) and SDB was assessed using No-SAS scale, respectively. Multi-variable logistic regression was applied to examine the association of sleep quality and cognitive performance. Subgroup analyses were performed in different age groups, and in those with and without SDB. RESULTS Finally, 30,872 participants aged 47.5 ± 13.8 years with 53.5% women were enrolled, of whom 32.4% had poor sleep quality and 18.6% had low cognitive performance. Compared with good sleepers, subjects with poor sleep quality exhibited significantly higher presence of low cognitive performance (23.7% vs 16.2%, P < 0.001). Poor sleepers revealed 1.26 (95%CI: 1.16,1.36), 1.26 (1.08,1.46) and 1.25 (1.14,1.37) fold odds for low cognitive performance in general population and in subjects with and without self-reported SDB respectively. Stratified by age and SDB, the association was observed in young and middle-aged group without SDB (OR = 1.44, 95%CI: 1.30,1.59) and in the elderly group with SDB (OR = 1.30, 95%CI: 1.07,1.58). CONCLUSIONS Sleep quality is in a negative association with cognitive performance in general population independent of SDB, implying improvement of sleep disturbances is a potential objective of intervention strategies for cognitive protection at population level.
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Affiliation(s)
- Zhongrong Wang
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute National Health Committee Key Laboratory of Hypertension Clinical Research, No. 91, Tianchi Road Urumqi, Xinjiang, 830001, China.,Xinjiang Hypertension Institute, Xinjiang, China.,National Health Committee Key Laboratory of Hypertension Clinical Research, Xinjiang, China.,Key Laboratory of Xinjiang Uygur Autonomous Region "Hypertension Research Laboratory, Xinjiang, China.,Xinjiang Clinical Medical Research Center for Hypertension (Cardio-Cerebrovascular) Diseases, Xinjiang, China
| | - Mulalibieke Heizhati
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute National Health Committee Key Laboratory of Hypertension Clinical Research, No. 91, Tianchi Road Urumqi, Xinjiang, 830001, China.,Xinjiang Hypertension Institute, Xinjiang, China.,National Health Committee Key Laboratory of Hypertension Clinical Research, Xinjiang, China.,Key Laboratory of Xinjiang Uygur Autonomous Region "Hypertension Research Laboratory, Xinjiang, China.,Xinjiang Clinical Medical Research Center for Hypertension (Cardio-Cerebrovascular) Diseases, Xinjiang, China
| | - Lin Wang
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute National Health Committee Key Laboratory of Hypertension Clinical Research, No. 91, Tianchi Road Urumqi, Xinjiang, 830001, China.,Xinjiang Hypertension Institute, Xinjiang, China.,National Health Committee Key Laboratory of Hypertension Clinical Research, Xinjiang, China.,Key Laboratory of Xinjiang Uygur Autonomous Region "Hypertension Research Laboratory, Xinjiang, China.,Xinjiang Clinical Medical Research Center for Hypertension (Cardio-Cerebrovascular) Diseases, Xinjiang, China
| | - Mei Li
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute National Health Committee Key Laboratory of Hypertension Clinical Research, No. 91, Tianchi Road Urumqi, Xinjiang, 830001, China.,Xinjiang Hypertension Institute, Xinjiang, China.,National Health Committee Key Laboratory of Hypertension Clinical Research, Xinjiang, China.,Key Laboratory of Xinjiang Uygur Autonomous Region "Hypertension Research Laboratory, Xinjiang, China.,Xinjiang Clinical Medical Research Center for Hypertension (Cardio-Cerebrovascular) Diseases, Xinjiang, China
| | - Zhikang Yang
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute National Health Committee Key Laboratory of Hypertension Clinical Research, No. 91, Tianchi Road Urumqi, Xinjiang, 830001, China.,Xinjiang Hypertension Institute, Xinjiang, China.,National Health Committee Key Laboratory of Hypertension Clinical Research, Xinjiang, China.,Key Laboratory of Xinjiang Uygur Autonomous Region "Hypertension Research Laboratory, Xinjiang, China.,Xinjiang Clinical Medical Research Center for Hypertension (Cardio-Cerebrovascular) Diseases, Xinjiang, China
| | - Mengyue Lin
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute National Health Committee Key Laboratory of Hypertension Clinical Research, No. 91, Tianchi Road Urumqi, Xinjiang, 830001, China.,Xinjiang Hypertension Institute, Xinjiang, China.,National Health Committee Key Laboratory of Hypertension Clinical Research, Xinjiang, China.,Key Laboratory of Xinjiang Uygur Autonomous Region "Hypertension Research Laboratory, Xinjiang, China.,Xinjiang Clinical Medical Research Center for Hypertension (Cardio-Cerebrovascular) Diseases, Xinjiang, China
| | - Reyila Abudereyimu
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute National Health Committee Key Laboratory of Hypertension Clinical Research, No. 91, Tianchi Road Urumqi, Xinjiang, 830001, China.,Xinjiang Hypertension Institute, Xinjiang, China.,National Health Committee Key Laboratory of Hypertension Clinical Research, Xinjiang, China.,Key Laboratory of Xinjiang Uygur Autonomous Region "Hypertension Research Laboratory, Xinjiang, China.,Xinjiang Clinical Medical Research Center for Hypertension (Cardio-Cerebrovascular) Diseases, Xinjiang, China
| | - Jing Hong
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute National Health Committee Key Laboratory of Hypertension Clinical Research, No. 91, Tianchi Road Urumqi, Xinjiang, 830001, China.,Xinjiang Hypertension Institute, Xinjiang, China.,National Health Committee Key Laboratory of Hypertension Clinical Research, Xinjiang, China.,Key Laboratory of Xinjiang Uygur Autonomous Region "Hypertension Research Laboratory, Xinjiang, China.,Xinjiang Clinical Medical Research Center for Hypertension (Cardio-Cerebrovascular) Diseases, Xinjiang, China
| | - Wenbo Yang
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute National Health Committee Key Laboratory of Hypertension Clinical Research, No. 91, Tianchi Road Urumqi, Xinjiang, 830001, China.,Xinjiang Hypertension Institute, Xinjiang, China.,National Health Committee Key Laboratory of Hypertension Clinical Research, Xinjiang, China.,Key Laboratory of Xinjiang Uygur Autonomous Region "Hypertension Research Laboratory, Xinjiang, China.,Xinjiang Clinical Medical Research Center for Hypertension (Cardio-Cerebrovascular) Diseases, Xinjiang, China
| | - Ling Yao
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute National Health Committee Key Laboratory of Hypertension Clinical Research, No. 91, Tianchi Road Urumqi, Xinjiang, 830001, China.,Xinjiang Hypertension Institute, Xinjiang, China.,National Health Committee Key Laboratory of Hypertension Clinical Research, Xinjiang, China.,Key Laboratory of Xinjiang Uygur Autonomous Region "Hypertension Research Laboratory, Xinjiang, China.,Xinjiang Clinical Medical Research Center for Hypertension (Cardio-Cerebrovascular) Diseases, Xinjiang, China
| | - Shasha Liu
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute National Health Committee Key Laboratory of Hypertension Clinical Research, No. 91, Tianchi Road Urumqi, Xinjiang, 830001, China.,Xinjiang Hypertension Institute, Xinjiang, China.,National Health Committee Key Laboratory of Hypertension Clinical Research, Xinjiang, China.,Key Laboratory of Xinjiang Uygur Autonomous Region "Hypertension Research Laboratory, Xinjiang, China.,Xinjiang Clinical Medical Research Center for Hypertension (Cardio-Cerebrovascular) Diseases, Xinjiang, China
| | - Junli Hu
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute National Health Committee Key Laboratory of Hypertension Clinical Research, No. 91, Tianchi Road Urumqi, Xinjiang, 830001, China.,Xinjiang Hypertension Institute, Xinjiang, China.,National Health Committee Key Laboratory of Hypertension Clinical Research, Xinjiang, China.,Key Laboratory of Xinjiang Uygur Autonomous Region "Hypertension Research Laboratory, Xinjiang, China.,Xinjiang Clinical Medical Research Center for Hypertension (Cardio-Cerebrovascular) Diseases, Xinjiang, China
| | - Nanfang Li
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute National Health Committee Key Laboratory of Hypertension Clinical Research, No. 91, Tianchi Road Urumqi, Xinjiang, 830001, China. .,Xinjiang Hypertension Institute, Xinjiang, China. .,National Health Committee Key Laboratory of Hypertension Clinical Research, Xinjiang, China. .,Key Laboratory of Xinjiang Uygur Autonomous Region "Hypertension Research Laboratory, Xinjiang, China. .,Xinjiang Clinical Medical Research Center for Hypertension (Cardio-Cerebrovascular) Diseases, Xinjiang, China.
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3
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Heizhati M, Li N, Wang L, Hong J, Li M, Yang W, Yao L, Lin M, Pan F, Yang Z, Wang Z, Abudereyimu R. Association of Hypertension with Mild Cognitive Impairment in Population from Less-Developed Areas of Multiethnic Northwest China. Neuroepidemiology 2021; 55:407-415. [PMID: 34515156 DOI: 10.1159/000517956] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Accepted: 06/10/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Relationship between hypertension and mild cognitive impairment (MCI) remains undetermined in population from less-developed regions. We aimed to explore whether hypertension is associated with MCI in this specific population. METHODS In this cross-sectional study, we enrolled subjects aged ≥18 years using multistage random sampling from Emin, China, in 2019. Participants underwent questionnaires and data collection including mini-mental state examination (MMSE) and blood pressure measurement. RESULTS Finally, 31,329 subjects were included, with 11,270 hypertensives. Compared with normotensive subjects, hypertensives were characterized by significantly older age (55.19 ± 12.25 vs. 43.26 ± 12.71), more men (52.5% vs. 42.9%), low education attainment (≤primary education: 42.4% vs. 26.3%), more abdominal obesity (39.7% vs. 19.1%), poor sleep quality (39.1% vs. 28.7%), and chronic kidney disease (6.6% vs. 3.4%, p for all <0.001). Prevalence of MCI in hypertensives was significantly higher than that of normotensive subjects (24.3% vs. 15.6%, p < 0.001). Multivariate logistic regression analysis showed in a fully adjusted model that the odds for MCI were significantly increased in hypertensives than in normotensive population (OR = 1.19, 95% CI: 1.09, 1.30, p < 0.001) and independent of all the parameters studied including age, education level, and stroke. In the age-stratified regression model, presence of hypertension significantly increased the odds of MCI by 1.17-fold (95% CI: 1.03, 1.33, p = 0.020) and by 1.22-fold (95% CI: 1.04, 1.44, p = 0.016) in middle-aged and elderly population. Sensitivity analysis of excluding those with stroke history showed that hypertension was still a risk factor for MCI in total, middle-aged, and elderly population. CONCLUSION Hypertension is in independent negative association with MCI in middle-aged and elderly population from underdeveloped regions.
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Affiliation(s)
- Mulalibieke Heizhati
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, National Health Committee Key Laboratory of Hypertension Clinical Research, Urumqi, China.,Key Laboratory of Xinjiang Uygur Autonomous Region "Hypertension Research Laboratory Xinjiang Clinical Medical Research Center for Hypertension (Cardio-Cerebrovascular Diseases)", Urumqi, China
| | - Nanfang Li
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, National Health Committee Key Laboratory of Hypertension Clinical Research, Urumqi, China.,Key Laboratory of Xinjiang Uygur Autonomous Region "Hypertension Research Laboratory Xinjiang Clinical Medical Research Center for Hypertension (Cardio-Cerebrovascular Diseases)", Urumqi, China
| | - Lin Wang
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, National Health Committee Key Laboratory of Hypertension Clinical Research, Urumqi, China.,Key Laboratory of Xinjiang Uygur Autonomous Region "Hypertension Research Laboratory Xinjiang Clinical Medical Research Center for Hypertension (Cardio-Cerebrovascular Diseases)", Urumqi, China
| | - Jing Hong
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, National Health Committee Key Laboratory of Hypertension Clinical Research, Urumqi, China.,Key Laboratory of Xinjiang Uygur Autonomous Region "Hypertension Research Laboratory Xinjiang Clinical Medical Research Center for Hypertension (Cardio-Cerebrovascular Diseases)", Urumqi, China
| | - Mei Li
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, National Health Committee Key Laboratory of Hypertension Clinical Research, Urumqi, China.,Key Laboratory of Xinjiang Uygur Autonomous Region "Hypertension Research Laboratory Xinjiang Clinical Medical Research Center for Hypertension (Cardio-Cerebrovascular Diseases)", Urumqi, China
| | - Wenbo Yang
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, National Health Committee Key Laboratory of Hypertension Clinical Research, Urumqi, China.,Key Laboratory of Xinjiang Uygur Autonomous Region "Hypertension Research Laboratory Xinjiang Clinical Medical Research Center for Hypertension (Cardio-Cerebrovascular Diseases)", Urumqi, China
| | - Ling Yao
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, National Health Committee Key Laboratory of Hypertension Clinical Research, Urumqi, China.,Key Laboratory of Xinjiang Uygur Autonomous Region "Hypertension Research Laboratory Xinjiang Clinical Medical Research Center for Hypertension (Cardio-Cerebrovascular Diseases)", Urumqi, China
| | - Mengyue Lin
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, National Health Committee Key Laboratory of Hypertension Clinical Research, Urumqi, China.,Key Laboratory of Xinjiang Uygur Autonomous Region "Hypertension Research Laboratory Xinjiang Clinical Medical Research Center for Hypertension (Cardio-Cerebrovascular Diseases)", Urumqi, China
| | - Fengyu Pan
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, National Health Committee Key Laboratory of Hypertension Clinical Research, Urumqi, China.,Key Laboratory of Xinjiang Uygur Autonomous Region "Hypertension Research Laboratory Xinjiang Clinical Medical Research Center for Hypertension (Cardio-Cerebrovascular Diseases)", Urumqi, China
| | - Zhikang Yang
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, National Health Committee Key Laboratory of Hypertension Clinical Research, Urumqi, China.,Key Laboratory of Xinjiang Uygur Autonomous Region "Hypertension Research Laboratory Xinjiang Clinical Medical Research Center for Hypertension (Cardio-Cerebrovascular Diseases)", Urumqi, China
| | - Zhongrong Wang
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, National Health Committee Key Laboratory of Hypertension Clinical Research, Urumqi, China.,Key Laboratory of Xinjiang Uygur Autonomous Region "Hypertension Research Laboratory Xinjiang Clinical Medical Research Center for Hypertension (Cardio-Cerebrovascular Diseases)", Urumqi, China
| | - Reyila Abudereyimu
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, National Health Committee Key Laboratory of Hypertension Clinical Research, Urumqi, China.,Key Laboratory of Xinjiang Uygur Autonomous Region "Hypertension Research Laboratory Xinjiang Clinical Medical Research Center for Hypertension (Cardio-Cerebrovascular Diseases)", Urumqi, China
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4
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Meng X, Song M, Vilaj M, Štambuk J, Dolikun M, Zhang J, Liu D, Wang H, Zhang X, Zhang J, Cao W, Momčilović A, Trbojević-Akmačić I, Li X, Zheng D, Wu L, Guo X, Wang Y, Lauc G, Wang W. Glycosylation of IgG Associates with Hypertension and Type 2 Diabetes Mellitus Comorbidity in the Chinese Muslim Ethnic Minorities and the Han Chinese. J Pers Med 2021; 11:jpm11070614. [PMID: 34209622 PMCID: PMC8307283 DOI: 10.3390/jpm11070614] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 06/18/2021] [Accepted: 06/21/2021] [Indexed: 01/07/2023] Open
Abstract
Objectives: Hypertension and type 2 diabetes mellitus comorbidity (HDC) is common, which confers a higher risk of cardiovascular disease than the presence of either condition alone. Describing the underlying glycomic changes of immunoglobulin G (IgG) that predispose individuals to HDC may help develop novel protective immune-targeted and anti-inflammatory therapies. Therefore, we investigated glycosylation changes of IgG associated with HDC. Methods: The IgG N-glycan profiles of 883 plasma samples from the three northwestern Chinese Muslim ethnic minorities and the Han Chinese were analyzed by ultra-performance liquid chromatography instrument. Results: We found that 12 and six IgG N-glycan traits showed significant associations with HDC in the Chinese Muslim ethnic minorities and the Han Chinese, respectively, after adjustment for potential confounders and false discovery rate. Adding the IgG N-glycan traits to the baseline models, the area under the receiver operating characteristic curves (AUCs) of the combined models differentiating HDC from hypertension (HTN), type 2 diabetes mellitus (T2DM), and healthy individuals were 0.717, 0.747, and 0.786 in the pooled samples of Chinese Muslim ethnic minorities, and 0.828, 0.689, and 0.901 in the Han Chinese, respectively, showing improved discriminating performance than both the baseline models and the glycan-based models. Conclusion: Altered IgG N-glycan profiles were shown to associate with HDC, suggesting the involvement of inflammatory processes of IgG glycosylation. The alterations of IgG N-glycome, illustrated here for the first time in HDC, demonstrate a biomarker potential, which may shed light on future studies investigating their potential for monitoring or preventing the progression from HTN or T2DM towards HDC.
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Affiliation(s)
- Xiaoni Meng
- Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing 100069, China; (X.M.); (J.Z.); (D.L.); (X.Z.); (J.Z.); (W.C.); (D.Z.); (L.W.); (X.G.); (Y.W.); (W.W.)
| | - Manshu Song
- Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing 100069, China; (X.M.); (J.Z.); (D.L.); (X.Z.); (J.Z.); (W.C.); (D.Z.); (L.W.); (X.G.); (Y.W.); (W.W.)
- School of Medical and Health Sciences, Edith Cowan University, Perth, WA 6027, Australia;
- Correspondence:
| | - Marija Vilaj
- Genos Glycoscience Research Laboratory, 10000 Zagreb, Croatia; (M.V.); (J.Š.); (A.M.); (I.T.-A.); (G.L.)
| | - Jerko Štambuk
- Genos Glycoscience Research Laboratory, 10000 Zagreb, Croatia; (M.V.); (J.Š.); (A.M.); (I.T.-A.); (G.L.)
| | - Mamatyusupu Dolikun
- College of the Life Sciences and Technology, Xinjiang University, Urumqi 830046, China;
| | - Jie Zhang
- Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing 100069, China; (X.M.); (J.Z.); (D.L.); (X.Z.); (J.Z.); (W.C.); (D.Z.); (L.W.); (X.G.); (Y.W.); (W.W.)
| | - Di Liu
- Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing 100069, China; (X.M.); (J.Z.); (D.L.); (X.Z.); (J.Z.); (W.C.); (D.Z.); (L.W.); (X.G.); (Y.W.); (W.W.)
| | - Hao Wang
- Department of Clinical Epidemiology and Evidence-Based Medicine, National Clinical Research Center for Digestive Disease, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China;
| | - Xiaoyu Zhang
- Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing 100069, China; (X.M.); (J.Z.); (D.L.); (X.Z.); (J.Z.); (W.C.); (D.Z.); (L.W.); (X.G.); (Y.W.); (W.W.)
| | - Jinxia Zhang
- Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing 100069, China; (X.M.); (J.Z.); (D.L.); (X.Z.); (J.Z.); (W.C.); (D.Z.); (L.W.); (X.G.); (Y.W.); (W.W.)
| | - Weijie Cao
- Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing 100069, China; (X.M.); (J.Z.); (D.L.); (X.Z.); (J.Z.); (W.C.); (D.Z.); (L.W.); (X.G.); (Y.W.); (W.W.)
| | - Ana Momčilović
- Genos Glycoscience Research Laboratory, 10000 Zagreb, Croatia; (M.V.); (J.Š.); (A.M.); (I.T.-A.); (G.L.)
| | - Irena Trbojević-Akmačić
- Genos Glycoscience Research Laboratory, 10000 Zagreb, Croatia; (M.V.); (J.Š.); (A.M.); (I.T.-A.); (G.L.)
| | - Xingang Li
- School of Medical and Health Sciences, Edith Cowan University, Perth, WA 6027, Australia;
- Centre for Precision Health, Edith Cowan University, Perth, WA 6027, Australia
| | - Deqiang Zheng
- Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing 100069, China; (X.M.); (J.Z.); (D.L.); (X.Z.); (J.Z.); (W.C.); (D.Z.); (L.W.); (X.G.); (Y.W.); (W.W.)
| | - Lijuan Wu
- Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing 100069, China; (X.M.); (J.Z.); (D.L.); (X.Z.); (J.Z.); (W.C.); (D.Z.); (L.W.); (X.G.); (Y.W.); (W.W.)
| | - Xiuhua Guo
- Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing 100069, China; (X.M.); (J.Z.); (D.L.); (X.Z.); (J.Z.); (W.C.); (D.Z.); (L.W.); (X.G.); (Y.W.); (W.W.)
| | - Youxin Wang
- Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing 100069, China; (X.M.); (J.Z.); (D.L.); (X.Z.); (J.Z.); (W.C.); (D.Z.); (L.W.); (X.G.); (Y.W.); (W.W.)
- School of Medical and Health Sciences, Edith Cowan University, Perth, WA 6027, Australia;
| | - Gordan Lauc
- Genos Glycoscience Research Laboratory, 10000 Zagreb, Croatia; (M.V.); (J.Š.); (A.M.); (I.T.-A.); (G.L.)
- Faculty of Pharmacy and Biochemistry, University of Zagreb, 10000 Zagreb, Croatia
| | - Wei Wang
- Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing 100069, China; (X.M.); (J.Z.); (D.L.); (X.Z.); (J.Z.); (W.C.); (D.Z.); (L.W.); (X.G.); (Y.W.); (W.W.)
- School of Medical and Health Sciences, Edith Cowan University, Perth, WA 6027, Australia;
- Centre for Precision Health, Edith Cowan University, Perth, WA 6027, Australia
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5
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Zhang Q, Huang F, Zhang L, Li S, Zhang J. The effect of high blood pressure-health literacy, self-management behavior, self-efficacy and social support on the health-related quality of life of Kazakh hypertension patients in a low-income rural area of China: a structural equation model. BMC Public Health 2021; 21:1114. [PMID: 34112122 PMCID: PMC8194055 DOI: 10.1186/s12889-021-11129-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 05/19/2021] [Indexed: 11/19/2022] Open
Abstract
Background Health-Related Quality of Life (HRQoL) of hypertensive patients is not only affected by the disease itself but also by some subjective factors. Low health literacy is prevalent among ethnic minorities. Considering the Kazakh-Chinese people have the highest prevalence of hypertension in Xinjiang, and the High Blood Pressure-Health Literacy (HBP-HL) has not been included in the study of HRQoL. The synergistic effects and the potential mechanism HBP-HL, self-management behavior, therapeutic adherence, self-efficacy, social support on HRQoL remain unclear. This study aimed to introduce the HBP-HL, and develop a structural equation model (SEM) to identify the factors influencing of the HRQoL among Kazakh hypertensive patients. Methods The data was obtained by questionnaire survey and physical examination in 2015. Patients with hypertension were recruited through random cluster sampling in Kazakh settlements in Xinjiang. Firstly, the blood pressure was measured. Then the one-for-one household interviews were conducted by Kazakh investigators. The questionnaires regarding HBP-HL, HRQoL, self-management behavior, therapeutic adherence, self-efficacy, and social support were used to collect data. Finally, SEM was constructed, and p ≤ 0.05 was taken as significant. Results The data was analysed by SPSS18.0 and AMOS18.0 software. 516 Kazakh hypertension patients were recruited, and 94.4% of them had a relatively low HBP-HL score. The mean standardized scores of HRQoL, self-management, therapeutic adherence were poor; they were 63.5, 66.2, and 64.4, respectively. But 96.1% and 98.3% of the participants had high levels of self-efficacy and social support. The SEM of the HRQoL had a good overall fit (χ2/df = 2.078, AGFI = 0.944, GFI = 0.968, CFI = 0.947, IFI = 0.949, RMSEA = 0.046). The model indicated that the HBP-HL has the highest correlation with HRQoL, following with self-management behavior, social support, and self-efficacy. Conclusions Low HBP-HL is a major influenced factor of HRQoL among Kazakh hypertensive patients. Future programs should consider HBP-HL as the breakthrough point when designing targeting intervention strategies.
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Affiliation(s)
- Qinghua Zhang
- School of Medicine, Hu Zhou University, 759-Second Ring East Road, Huzhou, 313000, Zhejiang, China.
| | - Feifei Huang
- School of Nursing, Fu Jian Medical University, Fu Zhou, Fujian, China
| | - Lei Zhang
- First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Shasha Li
- School of Medicine, Hu Zhou University, 759-Second Ring East Road, Huzhou, 313000, Zhejiang, China
| | - Jingping Zhang
- Nursing Psychology Research Center of Xiangya Nursing School, Central South University, 172 Tong Zi Po Road, Changsha, 410000, Hunan, China.
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Barriers to Access to Treatment for Hypertensive Patients in Primary Health Care of Less Developed Northwest China: A Predictive Nomogram. Int J Hypertens 2021; 2021:6613231. [PMID: 33953970 PMCID: PMC8062209 DOI: 10.1155/2021/6613231] [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: 12/07/2020] [Accepted: 04/03/2021] [Indexed: 11/17/2022] Open
Abstract
Background This study aims to evaluate the risk factors associated with untreated hypertension and develop and internally validate untreated risk nomograms in patients with hypertension among primary health care of less developed Northwest China. Methods A total of 895 eligible patients with hypertension in primary health care of less developed Northwest China were divided into a training set (n = 626) and a validation set (n = 269). Untreated hypertension was defined as not taking antihypertensive medication during the past two weeks. Using least absolute shrinkage and selection operator (LASSO) regression model, we identified the optimized risk factors of nontreatment, followed by establishment of a prediction nomogram. The discriminative ability, calibration, and clinical usefulness were determined using the area under the receiver operating characteristic curve (AUC), calibration curve, and decision analysis. The results were assessed by internal validation in the validation set. Results Five independent risk factors were derived from LASSO regression model and entered into the nomogram: age, herdsman, family income per member, altitude of habitation, and comorbidity. The nomogram displayed a robust discrimination with an AUC of 0.859 (95% confidence interval: 0.812–0.906) and good calibration. The nomogram was clinically useful when the intervention was decided at the untreated possibility threshold of 7% to 91% in the decision curve analysis. Results were confirmed by internal validation. Conclusions Our nomogram showed favorable predictive accuracy for untreated hypertension in primary health care of less developed Northwest China and might help primary health care assess the risk of nontreatment in patients with hypertension.
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Association of Depression with Uncontrolled Hypertension in Primary Care Setting: A Cross-Sectional Study in Less-Developed Northwest China. Int J Hypertens 2021; 2021:6652228. [PMID: 33854797 PMCID: PMC8019649 DOI: 10.1155/2021/6652228] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 03/03/2021] [Accepted: 03/18/2021] [Indexed: 12/14/2022] Open
Abstract
Background Hypertensive patients commonly experience comorbid depression, which is closely associated with adverse health outcomes. This study aimed to examine the association between depression and uncontrolled hypertension in primary care setting of Northwest China. Methods We used a stratified multistage random sampling method to obtain 1856 hypertensives subjects aged ≥18 years among primary care setting in Xinjiang, Northwest China, between April and October 2019. Depression was evaluated by Hospital Anxiety and Depression Scale (HADS), with a cut-off score ≥8. We related depression to uncontrolled hypertension, using multiple logistic regression, adjusting for minimally sufficient adjustment set of variables retrieved from a literature-based directed acyclic graphs (DAGs) and optimal adjustment set of variables derived from the least absolute shrinkage and selection operator (LASSO) regression. Results A total of 1,653 (89.1%) patients had uncontrolled hypertension. The prevalence of depression was 14.5% and 7.4% among patients with uncontrolled and controlled hypertension. Depression was associated with 1.12-fold increased odds of uncontrolled hypertension [odds ratio (OR) 2.12, 95% confidence interval (CI): 1.23-3.65]. The association remained significant even after adjusting for the minimal sufficient adjustment sets and the optimal adjustment set of variables. Conclusion Depression is significantly associated with uncontrolled hypertension in primary care setting of northwest China. The integrated management of depression and hypertension in the setting might be warranted.
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Wang L, Li N, Heizhati M, Li M, Pan F, Yang Z, Wang Z, Abudereyimu R. Prevalence and predictive nomogram of depression among hypertensive patients in primary care: A cross-sectional study in less developed Northwest China. Medicine (Baltimore) 2021; 100:e24422. [PMID: 33530241 PMCID: PMC7850745 DOI: 10.1097/md.0000000000024422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 01/01/2021] [Indexed: 01/05/2023] Open
Abstract
Hypertensive patients commonly co-exist persistent depressive symptoms. However, these issues are not always identified, especially in primary health care, which may worsen the prognosis of hypertension. Therefore, the aim of this study was to determine the prevalence and risk factor of depression, and to develop risk nomogram of depression in hypertensive patients from primary health care Northwest China.We used a stratified multistage random sampling method to obtain 1856 hypertensives subjects aged ≥18 years in Xinjiang between April and October 2019. The subjects were randomly divided into a training set (n = 1299) and a validation set (n = 557). Depression was evaluated by Hospital Anxiety and Depression Scale (HADS), with a cut-off score ≥8. Using the least absolute shrinkage and selection operator (LASSO) regression model, we identified optimized risk factors of depression in the training set, followed by the establishment of prediction nomogram. The discriminative ability, calibration, and clinical usefulness of nomogram were assessed. The results were verified by internal validation in validation set.13.7% hypertensive subjects displayed depression. Seven independent risk factors of depression were identified and entered into the nomogram including age, region, ethnicity, marital status, physical activity, sleep quality, and control of hypertension. The nomogram displayed robust discrimination with an AUC of 0.760 [95% confidence interval (CI): 0.724-0.797)] and 0.761 (95%CI: 0.702-0.819), and good calibration in training set and validation set, respectively. The decision curve analysis and clinical impact curve demonstrated clinical usefulness of predictive nomogram.There is a considerable prevalence of depression in patients with hypertension from primary care of Xinjiang, Northwest China. Our nomogram may help primary care providers assess the risk of depression in patients with hypertension.
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Affiliation(s)
- Lin Wang
- Xinjiang Medical University, Urumqi, Xinjiang Uygur Autonomous Region
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region; Xinjiang Hypertension Institute; National Health Committee Key Laboratory of Hypertension Clinical Research Urumqi, Xinjiang, China
| | - Nanfang Li
- Xinjiang Medical University, Urumqi, Xinjiang Uygur Autonomous Region
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region; Xinjiang Hypertension Institute; National Health Committee Key Laboratory of Hypertension Clinical Research Urumqi, Xinjiang, China
| | - Mulalibieke Heizhati
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region; Xinjiang Hypertension Institute; National Health Committee Key Laboratory of Hypertension Clinical Research Urumqi, Xinjiang, China
| | - Mei Li
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region; Xinjiang Hypertension Institute; National Health Committee Key Laboratory of Hypertension Clinical Research Urumqi, Xinjiang, China
| | - Fengyu Pan
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region; Xinjiang Hypertension Institute; National Health Committee Key Laboratory of Hypertension Clinical Research Urumqi, Xinjiang, China
| | - Zhikang Yang
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region; Xinjiang Hypertension Institute; National Health Committee Key Laboratory of Hypertension Clinical Research Urumqi, Xinjiang, China
| | - Zhongrong Wang
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region; Xinjiang Hypertension Institute; National Health Committee Key Laboratory of Hypertension Clinical Research Urumqi, Xinjiang, China
| | - Reyila Abudereyimu
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region; Xinjiang Hypertension Institute; National Health Committee Key Laboratory of Hypertension Clinical Research Urumqi, Xinjiang, China
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Yang Z, Heizhati M, Wang L, Li M, Pan F, Wang Z, Abudureyimu R, Hong J, Yao L, Yang W, Liu S, Li N. Subjective Poor Sleep Quality is Associated with Higher Blood Pressure and Prevalent Hypertension in General Population Independent of Sleep Disordered Breathing. Nat Sci Sleep 2021; 13:1759-1770. [PMID: 34675724 PMCID: PMC8517633 DOI: 10.2147/nss.s329024] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 09/04/2021] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVE To explore the relationship of subjective sleep quality with blood pressure (BP) and hypertension by considering the influence of sleep disordered breathing (SDB) and age in the general population. METHODS We evaluated sleep quality using the Pittsburgh sleep quality index (PSQI) and SDB using NoSAS score and measured BP in randomly selected adults in China in 2019. Sleep quality is categorized into four groups as very good, fairly good, fairly bad and very bad. SDB is defined as NoSAS score ≥8. Hypertension is defined as systolic BP ≥140 mmHg and/or diastolic BP ≥90 mmHg, and/or use of antihypertensive medicine within previous 2 weeks. Multi-variable linear and logistic regression analyses were used to assess the association of global PSQI score and sleep quality with BP and prevalent hypertension. RESULTS In the 33,341 participants (53.4% women, median age: 48 years), prevalence of hypertension significantly increased from very good to very bad sleepers in total (34.3 vs 42.6 vs 50.3 vs 58.5%), SDB (61.2 vs 68.3 vs 73.3 vs 75.5%) and non-SDB participants (26.8 vs 33.1 vs 40.1 vs 50.9%). In multiple linear regression, PSQI global score showed significant positive association with BP levels in total, SDB and non-SDB participants, consistent in sensitivity analysis by excluding participants who were taking antihypertensives, and in participants aged <60 years in age-stratified analysis. In multivariable logistic regression, odds ratio for presence of hypertension significantly increased from very good to very bad sleepers in total (1 vs 1.08 vs 1.22 vs 1.48), SDB (1 vs 1.17 vs 1.35 vs 1.28) and non-SDB participants (1 vs 1.05 vs 1.14 vs 1.53), consistent in participants aged <60 years. CONCLUSION Poor subjective sleep quality is significantly associated with higher BP and prevalent hypertension, independent of SDB in the young- and middle-aged general population, indicating potential of improving sleep quality to lower BP and optimize hypertension management at population level.
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Affiliation(s)
- Zhikang Yang
- Hypertension Center, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, People's Republic of China.,Xinjiang Hypertension Institute, Urumqi, Xinjiang, People's Republic of China.,National Health Committee Key Laboratory of Hypertension Clinical Research, Urumqi, Xinjiang, People's Republic of China
| | - Mulalibieke Heizhati
- Hypertension Center, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, People's Republic of China.,Xinjiang Hypertension Institute, Urumqi, Xinjiang, People's Republic of China.,National Health Committee Key Laboratory of Hypertension Clinical Research, Urumqi, Xinjiang, People's Republic of China
| | - Lin Wang
- Hypertension Center, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, People's Republic of China.,Xinjiang Hypertension Institute, Urumqi, Xinjiang, People's Republic of China.,National Health Committee Key Laboratory of Hypertension Clinical Research, Urumqi, Xinjiang, People's Republic of China
| | - Mei Li
- Hypertension Center, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, People's Republic of China.,Xinjiang Hypertension Institute, Urumqi, Xinjiang, People's Republic of China.,National Health Committee Key Laboratory of Hypertension Clinical Research, Urumqi, Xinjiang, People's Republic of China
| | - Fengyu Pan
- Hypertension Center, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, People's Republic of China.,Xinjiang Hypertension Institute, Urumqi, Xinjiang, People's Republic of China.,National Health Committee Key Laboratory of Hypertension Clinical Research, Urumqi, Xinjiang, People's Republic of China
| | - Zhongrong Wang
- Hypertension Center, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, People's Republic of China.,Xinjiang Hypertension Institute, Urumqi, Xinjiang, People's Republic of China.,National Health Committee Key Laboratory of Hypertension Clinical Research, Urumqi, Xinjiang, People's Republic of China
| | - Reyila Abudureyimu
- Hypertension Center, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, People's Republic of China.,Xinjiang Hypertension Institute, Urumqi, Xinjiang, People's Republic of China.,National Health Committee Key Laboratory of Hypertension Clinical Research, Urumqi, Xinjiang, People's Republic of China
| | - Jing Hong
- Hypertension Center, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, People's Republic of China.,Xinjiang Hypertension Institute, Urumqi, Xinjiang, People's Republic of China.,National Health Committee Key Laboratory of Hypertension Clinical Research, Urumqi, Xinjiang, People's Republic of China
| | - Ling Yao
- Hypertension Center, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, People's Republic of China.,Xinjiang Hypertension Institute, Urumqi, Xinjiang, People's Republic of China.,National Health Committee Key Laboratory of Hypertension Clinical Research, Urumqi, Xinjiang, People's Republic of China
| | - Wenbo Yang
- Hypertension Center, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, People's Republic of China.,Xinjiang Hypertension Institute, Urumqi, Xinjiang, People's Republic of China.,National Health Committee Key Laboratory of Hypertension Clinical Research, Urumqi, Xinjiang, People's Republic of China
| | - Shasha Liu
- Hypertension Center, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, People's Republic of China.,Xinjiang Hypertension Institute, Urumqi, Xinjiang, People's Republic of China.,National Health Committee Key Laboratory of Hypertension Clinical Research, Urumqi, Xinjiang, People's Republic of China
| | - Nanfang Li
- Hypertension Center, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, People's Republic of China.,Xinjiang Hypertension Institute, Urumqi, Xinjiang, People's Republic of China.,National Health Committee Key Laboratory of Hypertension Clinical Research, Urumqi, Xinjiang, People's Republic of China
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Prevalence, Awareness, Treatment, Control, and Related Factors of Hypertension among Tajik Nomads Living in Pamirs at High Altitude. Int J Hypertens 2020; 2020:5406485. [PMID: 32733702 PMCID: PMC7376436 DOI: 10.1155/2020/5406485] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Revised: 05/27/2020] [Accepted: 06/09/2020] [Indexed: 12/15/2022] Open
Abstract
Background Hypertension is a global problem, for which high-altitude residents exhibit higher burden. Hypertension in Tajik nomads from Pamirs with an average altitude above 4000 m remains less studied. We aimed to determine the prevalence, awareness, treatment, control, and risk factors associated with hypertension among Tajik population in Pamirs. Methods A cross-sectional survey was conducted between August and September 2015 using stratified three-stage random sampling in Taxkorgan county, Pamirs, China. Hypertension is defined as mean systolic and/or diastolic blood pressure (SBP, DBP) ≥140/90 mmHg and/or taking antihypertensive medication within the past two weeks. The prevalence (SBP ≥130 or DBP ≥80 mmHg) was also estimated using the 2017 American College of Cardiology (ACC)/American Heart Association (AHA) High Blood Pressure Guideline. The awareness, treatment, and control of hypertension and associated factors were evaluated. Results Totally, 797 subjects aged ≥18 years were enrolled with 46.3% men and 88.8% nomads with the mean age of 42.3 ± 15.2 years. The prevalence of hypertension was 24.2% (140/90 mmHg), and the prevalence was as high as 40.3%, based on the 2017 ACC/AHA guideline. Overall awareness, treatment, and control of hypertension were 52.8%, 40.9%, and 9.3%, respectively. In multivariate logistic regression, BMI ≥24.0 kg/m2 (OR: 2.41, 95% CI: 1.44–4.04) was a risk factor for prehypertension, and age ≥60 years (OR: 2.04, 95% CI: 1.15–3.61), BMI ≥24.0 kg/m2 (OR: 2.04, 95% CI: 1.15–3.61), and abdominal obesity (OR: 1.87, 95% CI: 1.09–3.22) were risk factors for hypertension. Angiotensin-converting enzyme inhibitors/angiotensin receptor blockers were the most commonly used antihypertensive medication (45.4%) as monotherapy, and 13.6% of treated hypertensive patients used two drugs. Conclusions There is a considerable prevalence of hypertension with low awareness, treatment, and control rates among Tajik nomads in Pamirs, where health programs improving the hypertension status are urgently needed, with the excess weight loss as a strategy.
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Heizhati M, Wang L, Li N, Li M, Pan F, Yang Z, Wang Z, Abudereyimu R. Prevalence of mild cognitive impairment is higher in hypertensive population: a cross-sectional study in less developed northwest China. Medicine (Baltimore) 2020; 99:e19891. [PMID: 32384432 PMCID: PMC7220181 DOI: 10.1097/md.0000000000019891] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Revised: 03/07/2020] [Accepted: 03/11/2020] [Indexed: 12/13/2022] Open
Abstract
Uncertainty remains about the association of hypertension with mild cognitive impairment (MCI) in less-developed areas.This is a cross-sectional survey conducted in Xinjiang, a less-developed region in China between April and October 2019. We used multi-stage stratified sampling method to obtain study population aged ≥45 years, and we analyzed complete data for 3282 subjects. The Mini-Mental State Examination (MMSE) was used to assess cognitive function. MCI is defined as an MMSE score < 17 for illiterate subjects, <20 for subjects with 1 to 6 years of education, and <24 for subjects with ≥7 years of education.The prevalence of MCI was significantly higher in hypertensive subjects than in non-hypertensive subjects (22.1% vs 16.1%, P < .001) and higher in hypertensives with uncontrolled blood pressure (BP) than in those with controlled BP (27.5% vs 20.7%, P = .01). Hypertensive subjects had significantly lower each item score and total score of MMSE, compared to non-hypertensive subjects. Significant negative correlations were observed between systolic and diastolic BP with MMSE scores (P for all <.001). Multivariate logistic regression analysis showed that hypertension was the significant risk factor for the presence of MCI (OR = 1.62, 95%CI: 1.34, 2.35, P < .001), independent of such factors as gender, age, education attainment, and dyslipidemia.The prevalence of MCI is higher in hypertensive population, and hypertension is an independent risk factor for MCI in less-developed region, suggesting that hypertensives should be screened for MCI to provide improved diagnoses and optimal therapeutics for cognitive decline prevention, specially in settings with approximate conditions.
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Affiliation(s)
- Mulalibieke Heizhati
- Xinjiang Medical University, Urumqi, Xinjiang Uygur Autonomous Region, People's Republic of China
- National Health Committee Key Laboratory of Hypertension Clinical Research, Hypertension Institute of Xinjiang, Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang, China
| | - Lin Wang
- Xinjiang Medical University, Urumqi, Xinjiang Uygur Autonomous Region, People's Republic of China
- National Health Committee Key Laboratory of Hypertension Clinical Research, Hypertension Institute of Xinjiang, Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang, China
| | - Nanfang Li
- Xinjiang Medical University, Urumqi, Xinjiang Uygur Autonomous Region, People's Republic of China
- National Health Committee Key Laboratory of Hypertension Clinical Research, Hypertension Institute of Xinjiang, Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang, China
| | - Mei Li
- National Health Committee Key Laboratory of Hypertension Clinical Research, Hypertension Institute of Xinjiang, Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang, China
| | - Fengyu Pan
- National Health Committee Key Laboratory of Hypertension Clinical Research, Hypertension Institute of Xinjiang, Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang, China
| | - Zhikang Yang
- National Health Committee Key Laboratory of Hypertension Clinical Research, Hypertension Institute of Xinjiang, Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang, China
| | - Zhongrong Wang
- National Health Committee Key Laboratory of Hypertension Clinical Research, Hypertension Institute of Xinjiang, Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang, China
| | - Reyila Abudereyimu
- National Health Committee Key Laboratory of Hypertension Clinical Research, Hypertension Institute of Xinjiang, Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang, China
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