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Zhang H, Sun J, Zhang Y, Xiao K, Wang Y, Si J, Li Y, Sun L, Zhao T, Yi M, Chu X, Li J. Association between exposure to air pollution and arterial stiffness in participants with and without atherosclerotic cardiovascular disease. Clin Res Cardiol 2024:10.1007/s00392-024-02506-2. [PMID: 39105787 DOI: 10.1007/s00392-024-02506-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Accepted: 07/23/2024] [Indexed: 08/07/2024]
Abstract
AIMS To assess the association of air pollution exposure at different time scales with arterial stiffness in participants with and without atherosclerotic cardiovascular disease (ASCVD). METHODS We measured participants' arterial stiffness with brachial-ankle pulse wave velocity (baPWV) from October 2016 to January 2020. Concentrations of air pollutants including fine particles < 2.5 μm aerodynamic diameter (PM2.5), inhalable particles < 10 μm aerodynamic diameter (PM10), sulfur dioxide (SO2), nitrogen dioxide (NO2), carbon monoxide (CO), and ozone (O3) measured by fixed ambient air monitoring stations were collected for short- (7-day) and long-term (365-day) exposure assessment. We used generalized estimating equations (GEEs) to analyze and further explored the modification effects between ASCVD and air pollutants. RESULTS Seven hundred sixty-five participants were finally included and four hunderd sixty (60.1%) participants had a history of ASCVD. Based on the partial regression coefficients (β) and 95% confidence intervals (95% CI) calculated from GEEs using linear regression, each 10 μg/m3 increase in long-term exposure to PM2.5 and PM10 was associated with 31.85 cm/s (95% CI, 17.97 to 45.73) and 35.93 cm/s (95% CI, 21.01 to 50.84) increase in baPWV. There was no association between short-term exposure to air pollution and arterial stiffness. Although no significant interaction effect was observed between air pollution and ASCVD, baPWV showed a greater increment in the subgroup without ASCVD. CONCLUSION Long-term exposure to air pollution is closely associated with higher arterial stiffness in participants with and without ASCVD. Reducing air pollution exposure is essential in the primary and secondary prevention of ASCVD.
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Affiliation(s)
- Haoyu Zhang
- Department of Geriatrics, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing, 100053, China
| | - Jinghao Sun
- Department of Geriatrics, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing, 100053, China
| | - Yinghua Zhang
- Department of Cardiology, Chuiyangliu Hospital Affiliated to Tsinghua University, Beijing, 100021, China
| | - Keling Xiao
- Department of Geriatrics, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing, 100053, China
| | - Yang Wang
- Medical Research and Biometrics Center, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, China
| | - Jin Si
- Department of Geriatrics, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing, 100053, China
| | - Yan Li
- Department of Geriatrics, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing, 100053, China
| | - Lijie Sun
- Department of Geriatrics, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing, 100053, China
| | - Ting Zhao
- Department of Geriatrics, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing, 100053, China
| | - Ming Yi
- Department of Geriatrics, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing, 100053, China
| | - Xi Chu
- Health Management Center, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China.
| | - Jing Li
- Department of Geriatrics, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing, 100053, China.
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Meng Y, Liu L, Chen X, Zhao L, She H, Zhang W, Zhang J, Qin X, Li J, Xu X, Wang B, Hou F, Tang G, Liao R, Huo Y, Li J, Yang L. Associations between brachial-ankle pulse wave velocity and hypertensive retinopathy in treated hypertensive adults: Results from the China Stroke Primary Prevention Trial (CSPPT). J Clin Hypertens (Greenwich) 2024; 26:724-734. [PMID: 38683601 PMCID: PMC11180693 DOI: 10.1111/jch.14820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Revised: 03/28/2024] [Accepted: 03/31/2024] [Indexed: 05/01/2024]
Abstract
Although the association between persistent hypertension and the compromise of both micro- and macro-circulatory functions is well recognized, a significant gap in quantitative investigations exploring the interplay between microvascular and macrovascular injuries still exists. In this study, the authors looked into the relationship between brachial-ankle pulse wave velocity (baPWV) and hypertensive retinopathy in treated hypertensive adults. The authors conducted a cross-sectional study of treated hypertensive patients with the last follow-up data from the China Stoke Primary Prevention Trial (CSPPT) in 2013. With the use of PWV/ABI instruments, baPWV was automatically measured. The Keith-Wagener-Barker classification was used to determine the diagnosis of hypertensive retinopathy. The odds ratio (OR) and 95% confidence interval (CI) for the connection between baPWV and hypertensive retinopathy were determined using multivariable logistic regression models. The OR curves were created using a multivariable-adjusted restricted cubic spline model to investigate any potential non-linear dose-response relationships between baPWV and hypertensive retinopathy. A total of 8514 (75.5%) of 11,279 participants were diagnosed with hypertensive retinopathy. The prevalence of hypertensive retinopathy increased from the bottom quartile of baPWV to the top quartile: quartile 1: 70.7%, quartile 2: 76.1%, quartile 3: 76.7%, quartile 4: 78.4%. After adjusting for potential confounders, baPWV was positively associated with hypertensive retinopathy (OR = 1.05, 95% CI, 1.03-1.07, p < .001). Compared to those in the lowest baPWV quartile, those in the highest baPWV quartile had an odds ratio for hypertensive retinopathy of 1.61 (OR = 1.61, 95% CI: 1.37-1.89, p < .001). Two-piece-wise logistic regression model demonstrated a nonlinear relationship between baPWV and hypertensive retinopathy with an inflection point of 17.1 m/s above which the effect was saturated .
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Affiliation(s)
- Ying Meng
- Department of OphthalmologyPeking University First HospitalBeijingChina
- Department of OphthalmologyPeking University International HospitalBeijingChina
| | - Lishun Liu
- Graduate School at ShenzhenTsinghua UniversityBeijingChina
| | - Xuling Chen
- Department of Ophthalmologythe First Affiliated Hospital of Fujian Medical UniversityFuzhouChina
| | - Liang Zhao
- Department of OphthalmologyPeking University First HospitalBeijingChina
| | - Haicheng She
- Beijing Tongren Eye Center, Beijing Tongren HospitalCapital Medical UniversityBeijingChina
- Beijing Ophthalmology and Visual Science Key LaboratoryBeijingChina
| | - Wenbo Zhang
- Department of OphthalmologyPeking University First HospitalBeijingChina
| | - Jing Zhang
- Department of OphthalmologyPeking University First HospitalBeijingChina
| | - Xianhui Qin
- National Clinical Research Center for Kidney Disease, State Key Laboratory for Organ Failure Research, Division of Nephrology, Nanfang HospitalSouthern Medical UniversityGuangzhouChina
| | - Jianping Li
- Department of CardiologyPeking University First HospitalBeijingChina
| | - Xiping Xu
- National Clinical Research Center for Kidney Disease, State Key Laboratory for Organ Failure Research, Division of Nephrology, Nanfang HospitalSouthern Medical UniversityGuangzhouChina
| | - Binyan Wang
- School of Health AdministrationAnhui UniversityHefeiChina
| | - Fanfan Hou
- National Clinical Research Center for Kidney Disease, State Key Laboratory for Organ Failure Research, Division of Nephrology, Nanfang HospitalSouthern Medical UniversityGuangzhouChina
| | - Genfu Tang
- School of Health AdministrationAnhui UniversityHefeiChina
| | - Rongfeng Liao
- Department of Ophthalmologythe First Affiliated Hospital of Anhui Medical UniversityHefeiChina
| | - Yong Huo
- Department of CardiologyPeking University First HospitalBeijingChina
| | - Jun Li
- Department of OphthalmologyPeking University First HospitalBeijingChina
| | - Liu Yang
- Department of OphthalmologyPeking University First HospitalBeijingChina
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Zhang S, Zhong Y, Wu S, Wu H, Cai J, Zhang W. Intensive blood pressure control on arterial stiffness among older patients with hypertension. Chin Med J (Engl) 2024; 137:1078-1087. [PMID: 37968125 PMCID: PMC11062691 DOI: 10.1097/cm9.0000000000002868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Indexed: 11/17/2023] Open
Abstract
BACKGROUND Arterial stiffening increases with age and blood pressure and is associated with cardiovascular disease (CVD), but the relationship between blood pressure lowering and arterial stiffening is still uncertain, especially in older people. This study aimed to evaluate the effect of intensive blood pressure treatment on the progression of arterial stiffness and risk of CVD in older patients with hypertension. METHODS The Strategy of Blood Pressure Intervention in the Elderly Hypertensive Patients (STEP) trial was a multicenter, randomized, controlled trial performed at 42 clinical centers throughout China, and 8511 patients aged 60-80 years with essential hypertension were enrolled and randomly assigned to systolic blood pressure (SBP) target of 110 mmHg to <130 mmHg (intensive treatment) or 130 mmHg to <150 mmHg (standard treatment). Patients underwent repeated examinations of the brachial-ankle pulse wave velocity (baPWV) and ankle-brachial index (ABI) at baseline, and the arterial stiffness was evaluated at the 3-year follow-up. A total of 5339 patients who had twice repeated measurements were included in this study. Changes in arterial stiffness between the intensive and standard treatment groups were analyzed using a multivariate linear regression model. The Cox proportional hazard regression model was used to evaluate the effect of intensive treatment on primary CVD outcomes. RESULTS The changes in baPWV were 61.5 cm/s (95% confidence interval [CI]: 49.8-73.2 cm/s) in the intensive treatment group and 98.4 cm/s (95% CI: 86.7-110.1 cm/s) in the standard treatment group ( P <0.001). Intensive treatment significantly delayed the progression of arterial stiffness, with an annual change of 23.1 cm·s -1 ·year -1vs. 36.7 cm·s -1 ·year -1 of baPWV in the intensive and standard treatment groups, respectively. During a median follow-up period of 3.36 years, primary CVD outcomes occurred in 77 (2.9%) patients in the intensive treatment group compared with 93 (3.5%) in the standard treatment group. Intensive treatment resulted in a significantly lower CVD risk in patients aged 70-80 years or with SBP <140 mmHg. CONCLUSION Intensive blood pressure control with an SBP target of 110 mmHg to <130 mmHg could delay the progression of arterial stiffness and reduce the risk of CVD in older patients with hypertension. CLINICAL TRIAL REGISTRATION http://www.clinicaltrials.gov ; No. NCT03015311.
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Affiliation(s)
- Shuyuan Zhang
- National Clinical Research Center of Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing 100037, China
- Department of Cardiology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - Yixuan Zhong
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing 100037, China
| | - Shouling Wu
- Department of Cardiology, Kailuan General Hospital, Tangshan, Hebei 063000, China
| | - Hailei Wu
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing 100037, China
| | - Jun Cai
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing 100037, China
| | - Weili Zhang
- National Clinical Research Center of Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing 100037, China
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing 100037, China
- Central China Subcenter of National Center for Cardiovascular Diseases, Henan Cardiovascular Disease Center , Fuwai Central-China Cardiovascular Hospital, Central China Fuwai Hospital of Zhengzhou University, Zhengzhou, Henan 450046, China
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Zhou Z, Liu X, Xian W, Wang Y, Tao J, Xia W. Estimated pulse wave velocity added additional prognostic information in general population: Evidence from National Health and Nutrition Examination Survey (NHANES) 1999-2018. INTERNATIONAL JOURNAL OF CARDIOLOGY. CARDIOVASCULAR RISK AND PREVENTION 2024; 20:200233. [PMID: 38229680 PMCID: PMC10789630 DOI: 10.1016/j.ijcrp.2023.200233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 12/04/2023] [Accepted: 12/21/2023] [Indexed: 01/18/2024]
Abstract
Background As an indicator of arterial stiffness, there is controversy over whether estimated pulse wave velocity (ePWV) add additional prognostic information other than cardiovascular risk factors or traditional risk estimation model in general population. Methods Data from National Health and Nutrition Examination Survey in 1999-2018 was analyzed. Cardiovascular risk factors were collected and Framingham Risk Score (FRS) was calculated. Using all-cause and cardiovascular mortality as outcomes, Cox and restricted cubic spline (RCS) analysis was performed. Receiver operator characteristic (ROC) curves, Harrell's C-statistic and net reclassification index (NRI) analysis were used to assess whether ePWV adds additional predictive value. Results The association between ePWV and outcomes was independent of cardiovascular risk factors (HR = 1.23 [95%CI 1.23-1.50] per m/s for all-cause mortality, and 1.52 [1.30-1.78] for cardiovascular mortality) and FRS (1.22 [1.12-1.32] for all-cause mortality, and 1.32 [1.10-1.59] for cardiovascular mortality). Except for ePWV and all-cause mortality adjusted by FRS, a liner association was found between ePWV and outcomes. For predictive value, the area under ROC and C-index of the model added with ePWV was higher than the one with FRS or risk factors alone (P < 0.01). The elevated ePWV upgraded 1338456 subjects from high-intermediate to high FRS category, and NRI was 3.61 % and 2.62 % for all-cause and cardiovascular deaths, respectively (all P < 0.001). Conclusions In general population, the present study demonstrated the association between ePWV and all-cause, cardiovascular mortality is independent of cardiovascular risk factors and traditional risk estimated model. ePWV also added additional information to them in predicting clinical outcomes.
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Affiliation(s)
- Zhe Zhou
- Department of Hypertension and Vascular Disease, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
- NHC Key Laboratory of Assisted Circulation, Sun Yat-Sen University, Guangzhou, China
- National-Guangdong Joint Engineering Laboratory for Diagnosis and Treatment of Vascular Diseases, Guangzhou, China
| | - Xiaoling Liu
- Department of Cardiology, Shantou Central Hospital, China
- Department of Critical Care Medicine, Shantou Central Hospital, China
| | - Wanyong Xian
- The Fourth People's Hospital of Nanhai District of Foshan City, Foshan, China
| | - Yan Wang
- Health Management Center of the First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Jun Tao
- Department of Hypertension and Vascular Disease, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
- NHC Key Laboratory of Assisted Circulation, Sun Yat-Sen University, Guangzhou, China
- National-Guangdong Joint Engineering Laboratory for Diagnosis and Treatment of Vascular Diseases, Guangzhou, China
| | - Wenhao Xia
- Department of Hypertension and Vascular Disease, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
- NHC Key Laboratory of Assisted Circulation, Sun Yat-Sen University, Guangzhou, China
- National-Guangdong Joint Engineering Laboratory for Diagnosis and Treatment of Vascular Diseases, Guangzhou, China
- Guangxi Hospital Division of the First Affiliated Hospital, Sun Yat-sen University, China
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Li X, Du H, Li X, Gao Q, Chen J, Chen X. Brachial-ankle pulse wave velocity is associated with intracranial artery calcification in acute stroke patients. Clin Neurol Neurosurg 2023; 233:107918. [PMID: 37541159 DOI: 10.1016/j.clineuro.2023.107918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Revised: 07/17/2023] [Accepted: 07/29/2023] [Indexed: 08/06/2023]
Abstract
BACKGROUND Intracranial artery calcification (IAC) is closely associated with cerebrovascular disease. Brachial-ankle pulse wave velocity (baPWV) is a noninvasive method for estimating arterial stiffness, which reflects the stiffness of peripheral arteries. This study aimed to examine the association of baPWV with the presence and degree of IAC in patients with acute ischemic stroke. METHODS A total of 143 ischemic stroke subjects were recruited. A head computed tomography (CT) scan was used to assess the presence and severity of IAC. The oscillometric method was used to simultaneously measure bilateral brachial and posterior tibial arterial pulse waveforms and arterial BP. Multiple logistic regression analysis was used to identify the independent relationship between baPWV and IAC. RESULTS 143 subjects were included in this study. The demographic and clinical characteristics of the study population were classified according to the baPWV quartile. A higher prevalence of IAC was noted across increasing baPWV quartiles (Q1: 53 %, Q2: 69 %, Q3: 86 %, Q4: 94 %, P < 0.001). IAC scores were also increased with elevated ccPWV values (1.60 ± 1.71; 2.56 ± 1.99; 3.44 ± 1.91; 4.64 ± 1.58. P < 0.001). After an additional adjustment for age and hypertension, the odds ratio (95 % confidence interval) for the IAC scores was 1.61 (1.06-2.45; P = 0.025) in the top quartile of baPWV compared with those in the lowest quartile. CONCLUSIONS Arterial stiffness as defined by baPWV was positively associated with the degree of IAC in patients with acute ischemic stroke, suggesting the severity of IAC may also be a marker of peripheral or systemic arterial stiffness.
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Affiliation(s)
- Xuelong Li
- Department of Health Technology and Informatics, The Hong Kong Polytechnic University, Kowloon, Hong Kong.
| | - Heng Du
- Department of Health Technology and Informatics, The Hong Kong Polytechnic University, Kowloon, Hong Kong.
| | - Xianliang Li
- Department of Neurology, The Second Affiliated Hospital, Guangzhou Medical University, Guangzhou 510260 China.
| | - Qingchun Gao
- Department of Neurology, The Second Affiliated Hospital, Guangzhou Medical University, Guangzhou 510260 China.
| | - Junru Chen
- Department of Neurology, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
| | - Xiangyan Chen
- Department of Health Technology and Informatics, The Hong Kong Polytechnic University, Kowloon, Hong Kong.
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He P, Li H, Zhang Z, Zhang Y, Lin T, Song Y, Liu L, Liang M, Nie J, Wang B, Huo Y, Hou FF, Xu X, Qin X. Change in the Estimated Glomerular Filtration Rate Over Time and Risk of First Stroke in Hypertensive Patients. J Epidemiol 2023; 33:142-149. [PMID: 35400712 PMCID: PMC9909174 DOI: 10.2188/jea.je20210242] [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] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The association between changes in estimated glomerular filtration rate (eGFR) over time and the risk of stroke remains inconclusive. We aimed to evaluate the relation of eGFR change during the China Stroke Primary Prevention Trial (CSPPT) with the risk of first stroke during the subsequent post-trial follow-up. METHODS A total of 11,742 hypertensive participants with two eGFR measurements (median measure interval, 4.4; interquartile range, 4.2-4.6 years) and without a history of stroke from the CSPPT were included in this analysis. RESULTS Over a median post-trial follow-up of 4.4 years, 729 first strokes were identified, of which 635 were ischemic, 88 were hemorrhagic, and 6 were uncertain types of strokes. Compared with those with 1 to <2% per year increase in eGFR (with the lowest stroke risk), those with an increase in eGFR of ≥4% per year had significantly increased risks of first stroke (adjusted hazard ratio [HR] 1.96; 95% confidence interval [CI], 1.10-3.50) and first ischemic stroke (adjusted HR 2.14; 95% CI, 1.17-3.90). Similarly, those with a decline in eGFR of ≥5% per year also had significantly increased first stroke (adjusted HR 2.13; 95% CI, 1.37-3.31) and first ischemic stroke (adjusted HR 1.89; 95% CI, 1.19-3.02) risk. However, there was no significant association between eGFR change and first hemorrhagic stroke. A similar result was found when the change in eGFR was quantified as an absolute annual change. CONCLUSION In Chinese hypertensive patients, both the decline and increase of eGFR levels were independently associated with the risks of first stroke or first ischemic stroke.
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Affiliation(s)
- Panpan He
- Division of Nephrology, Nanfang Hospital, Southern Medical University; National Clinical Research Center for Kidney Disease; State Key Laboratory of Organ Failure Research; Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory
| | - Huan Li
- Division of Nephrology, Nanfang Hospital, Southern Medical University; National Clinical Research Center for Kidney Disease; State Key Laboratory of Organ Failure Research; Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory
| | - Zhuxian Zhang
- Division of Nephrology, Nanfang Hospital, Southern Medical University; National Clinical Research Center for Kidney Disease; State Key Laboratory of Organ Failure Research; Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory
| | - Yuanyuan Zhang
- Division of Nephrology, Nanfang Hospital, Southern Medical University; National Clinical Research Center for Kidney Disease; State Key Laboratory of Organ Failure Research; Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory
| | - Tengfei Lin
- Beijing Advanced Innovation Center for Food Nutrition and Human Health, College of Food Science and Nutritional Engineering, China Agricultural University
| | - Yun Song
- Beijing Advanced Innovation Center for Food Nutrition and Human Health, College of Food Science and Nutritional Engineering, China Agricultural University.,Institute of Biomedicine, Anhui Medical University
| | - Lishun Liu
- Beijing Advanced Innovation Center for Food Nutrition and Human Health, College of Food Science and Nutritional Engineering, China Agricultural University
| | - Min Liang
- Division of Nephrology, Nanfang Hospital, Southern Medical University; National Clinical Research Center for Kidney Disease; State Key Laboratory of Organ Failure Research; Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory
| | - Jing Nie
- Division of Nephrology, Nanfang Hospital, Southern Medical University; National Clinical Research Center for Kidney Disease; State Key Laboratory of Organ Failure Research; Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory
| | - Binyan Wang
- Institute of Biomedicine, Anhui Medical University.,Shenzhen Evergreen Medical Institute
| | - Yong Huo
- Department of Cardiology, Peking University First Hospital
| | - Fan Fan Hou
- Division of Nephrology, Nanfang Hospital, Southern Medical University; National Clinical Research Center for Kidney Disease; State Key Laboratory of Organ Failure Research; Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory
| | - Xiping Xu
- Division of Nephrology, Nanfang Hospital, Southern Medical University; National Clinical Research Center for Kidney Disease; State Key Laboratory of Organ Failure Research; Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory.,Beijing Advanced Innovation Center for Food Nutrition and Human Health, College of Food Science and Nutritional Engineering, China Agricultural University
| | - Xianhui Qin
- Division of Nephrology, Nanfang Hospital, Southern Medical University; National Clinical Research Center for Kidney Disease; State Key Laboratory of Organ Failure Research; Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory
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Yi T, Gao L, Fan F, Jiang Y, Jia J, Zhang Y, Li J, Huo Y. Association between pulse wave velocity and the 10-year risk of atherosclerotic cardiovascular disease in the Chinese population: A community-based study. J Clin Hypertens (Greenwich) 2023; 25:278-285. [PMID: 36794419 PMCID: PMC9994158 DOI: 10.1111/jch.14642] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Revised: 01/04/2023] [Accepted: 01/19/2023] [Indexed: 02/17/2023]
Abstract
Accumulated evidence has shown that carotid-femoral and brachial-ankle PWV well predict cardiovascular events but it is still unclear if the predictability is same or not. In this cross-sectional study based on a community atherosclerosis cohort in Beijing, China, a total of 5282 participants without previous coronary heart disease and stroke were enrolled from a community atherosclerosis cohort in Beijing, China. The 10-year atherosclerotic cardiovascular disease (ASCVD) risk were calculated by the China-PAR model, and < 5%, 5%-10% and > 10% were defined as low, intermediate, and high risk, respectively. The average baPWV and cfPWV values were 16.63 ± 3.35 m/s and 8.45 ± 1.78 m/s, respectively. The mean 10-year ASCVD risk was 6.98% (interquartile range: 3.90%-12.01%). The patients with low, intermediate, and high 10-year ASCVD risk accounted for 34.84% (1840), 31.94% (1687),, and 33.23% (1755) respectively. Multivariate analysis showed that for every 1 m/s increase in baPWV and cfPWV, the 10-year ASCVD risk increased by 0.60% (95% confidence interval: 0.56%-0.65%, p < .001) and 1.17% (95% confidence interval: 1.09%-1.25%, p < .001), respectively. The diagnostic ability of the baPWV was comparable to the cfPWV (area under the curve: 0.870 [0.860-0.879] vs. 0.871 [0.861-0.881], p = .497). In conclusion, baPWV and cfPWV are positively associated with the 10-year risk of ASCVD in the Chinese community-based population, with a nearly identical association with a high 10-year risk of ASCVD.
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Affiliation(s)
- Tieci Yi
- Department of Cardiovascular Disease, Peking University First Hospital, Beijing, China.,Institute of Cardiovascular Disease, Peking University First Hospital, Beijing, China.,Hypertension Precision Diagnosis and Treatment Research Center, Peking University First Hospital, Beijing, China
| | - Lan Gao
- Department of Cardiovascular Disease, Peking University First Hospital, Beijing, China.,Institute of Cardiovascular Disease, Peking University First Hospital, Beijing, China.,Hypertension Precision Diagnosis and Treatment Research Center, Peking University First Hospital, Beijing, China
| | - Fangfang Fan
- Department of Cardiovascular Disease, Peking University First Hospital, Beijing, China.,Institute of Cardiovascular Disease, Peking University First Hospital, Beijing, China.,Hypertension Precision Diagnosis and Treatment Research Center, Peking University First Hospital, Beijing, China
| | - Yimeng Jiang
- Department of Cardiovascular Disease, Peking University First Hospital, Beijing, China.,Institute of Cardiovascular Disease, Peking University First Hospital, Beijing, China.,Hypertension Precision Diagnosis and Treatment Research Center, Peking University First Hospital, Beijing, China
| | - Jia Jia
- Institute of Cardiovascular Disease, Peking University First Hospital, Beijing, China.,Hypertension Precision Diagnosis and Treatment Research Center, Peking University First Hospital, Beijing, China
| | - Yan Zhang
- Department of Cardiovascular Disease, Peking University First Hospital, Beijing, China.,Institute of Cardiovascular Disease, Peking University First Hospital, Beijing, China.,Hypertension Precision Diagnosis and Treatment Research Center, Peking University First Hospital, Beijing, China
| | - Jianping Li
- Department of Cardiovascular Disease, Peking University First Hospital, Beijing, China.,Institute of Cardiovascular Disease, Peking University First Hospital, Beijing, China.,Hypertension Precision Diagnosis and Treatment Research Center, Peking University First Hospital, Beijing, China
| | - Yong Huo
- Department of Cardiovascular Disease, Peking University First Hospital, Beijing, China.,Institute of Cardiovascular Disease, Peking University First Hospital, Beijing, China.,Hypertension Precision Diagnosis and Treatment Research Center, Peking University First Hospital, Beijing, China
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Association between baseline brachial-ankle pulse wave velocity and short-term risk of first stroke among Chinese hypertensive adults. J Hum Hypertens 2022; 36:1085-1091. [PMID: 34782738 DOI: 10.1038/s41371-021-00611-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Revised: 09/07/2021] [Accepted: 09/13/2021] [Indexed: 12/14/2022]
Abstract
Little information is available on the association between brachial-ankle pulse wave velocity (baPWV) and the risk of stroke in Chinese H-type hypertension patients. Therefore, our study aimed to assess this association between baseline baPWV and short-term risk of first stroke and to propose a cutoff value of baPWV that could predict near cerebrovascular events. A total of 9787 hypertension patients without preexisting stroke who underwent baPWV measurement were included. The primary end points were first symptomatic stroke. Secondary end points were first ischemic stroke and first hemorrhagic stroke. During a median follow-up of 20.8 months, there was a total of 138 first strokes including 123 first ischemic strokes and 15 first hemorrhagic strokes. When baPWV was categorized in quartiles, the higher risks of first stroke (HR = 1.52; 95% CI: 1.05-2.21) and first ischemic stroke (HR = 1.53; 95% CI: 1.03-2.26) were found in participants in quartile 4 (≥21.31 m/s), compared with those in quartile 1-3 (<21.31 m/s). In receiver operating characteristic curve analysis, the best cutoff value of baPWV that could predict first stroke was 21.43 m/s. Higher baPWV (≥21.43 m/s) was significantly associated with increased risk of first stroke (HR = 1.60; 95% CI: 1.10-2.32) and first ischemic stroke (HR = 1.60; 95% CI: 1.08-2.37). In conclusion, higher baPWV levels were associated with an increased risk of first stroke among Chinese H-type hypertensive patients. In addition, a cutoff value of 21.43 m/s of baPWV was proposed that could predict the next two years' cerebrovascular events.
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Song Q, Ling Q, Bai J, Zhang H, Bu P, Chen F, Wu S, Zhang W, Chen M, Cai J. Influence of baseline arterial stiffness on effects of intensive compared with standard blood pressure control: a post hoc analysis of the STEP trial. BMC Med 2022; 20:358. [PMID: 36261812 PMCID: PMC9583479 DOI: 10.1186/s12916-022-02556-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 09/08/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND The benefits and risks of intensive versus standard systolic blood pressure (SBP) treatment in older patients with arterial stiffness (AS) remains unclear. This study aims to investigate the interaction between the baseline AS and SBP treatments on cardiovascular outcomes. METHODS In this post hoc analysis of the Strategy of Blood Pressure Intervention in the Elderly Hypertensive Patients (STEP) trial, we involved 6865 participants with complete data regarding baseline brachial-ankle pulse wave velocity (baPWV). Patients were categorized by baseline AS status (AS, baPWV ≥ 1800 cm/s; non-AS, baPWV < 1800 cm/s). The primary outcome was a composite of cardiovascular events. The secondary outcomes were stroke, acute coronary syndrome (ACS), major cardiovascular events (MACE), and all-cause death. Cox regression was used to calculate hazard ratios for the outcomes. RESULTS During a mean follow-up of 2.69 years, a total of 248 primary outcome events and 81 all-cause deaths occurred. The hazard ratios for the primary outcome were 0.76 (95% confidence interval (CI), 0.54-1.09) and 0.63 (95% CI, 0.43-0.92) in the AS and non-AS groups, respectively (P for interaction = 0.43), and that for stroke was 0.58 (95% CI, 0.33-1.02) and 0.48 (95% CI, 0.23-0.99) in the AS and non-AS groups, respectively (P for interaction = 0.68). Effects of intensive SBP treatment on safety outcomes and all-cause death were also similar in the two groups (P for interaction > 0.05 for all). CONCLUSIONS In the STEP trial, the beneficial effects of intensive SBP treatment were similar among those in the AS group and the non-AS group at baseline. TRIAL REGISTRATION STEP ClinicalTrials.gov number, NCT03015311. Registered 2 January 2017.
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Affiliation(s)
- Qirui Song
- Hypertension Center, Fuwai Hospital, State Key Laboratory of Cardiovascular Disease of China, National Center for Cardiovascular Diseases of China, Chinese Academy of Medical Sciences and Peking Union Medical College, Beilishi Rd. 167, Xicheng District, Beijing, 100037, China
| | - Qianhui Ling
- Hypertension Center, Fuwai Hospital, State Key Laboratory of Cardiovascular Disease of China, National Center for Cardiovascular Diseases of China, Chinese Academy of Medical Sciences and Peking Union Medical College, Beilishi Rd. 167, Xicheng District, Beijing, 100037, China
| | - Jingjing Bai
- Hypertension Center, Fuwai Hospital, State Key Laboratory of Cardiovascular Disease of China, National Center for Cardiovascular Diseases of China, Chinese Academy of Medical Sciences and Peking Union Medical College, Beilishi Rd. 167, Xicheng District, Beijing, 100037, China
| | - Hongwei Zhang
- The Hospital of Shunyi District Beijing, Beijing, 101300, China
| | - Peili Bu
- Qilu Hospital of Shandong University, Jinan, 250012, Shandong, China
| | - Fang Chen
- The First People's Hospital of Yinchuan, Yinchuan, 750000, Ningxia, China
| | - Shouling Wu
- Kailuan General Hospital, Tangshan, 063000, Hebei, China
| | - Weili Zhang
- Hypertension Center, Fuwai Hospital, State Key Laboratory of Cardiovascular Disease of China, National Center for Cardiovascular Diseases of China, Chinese Academy of Medical Sciences and Peking Union Medical College, Beilishi Rd. 167, Xicheng District, Beijing, 100037, China
| | - Mulei Chen
- Heart Center and Beijing Key Laboratory of Hypertension, Department of Cardiology, Beijing Chaoyang Hospital, Capital Medical University, Gongtinanlu Rd. 8, Chaoyang District, Beijing, 100020, China.
| | - Jun Cai
- Hypertension Center, Fuwai Hospital, State Key Laboratory of Cardiovascular Disease of China, National Center for Cardiovascular Diseases of China, Chinese Academy of Medical Sciences and Peking Union Medical College, Beilishi Rd. 167, Xicheng District, Beijing, 100037, China.
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10
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Zhou Y, Dan H, Bai L, Jia L, Lu B, Cui W. Nonlinear relationship with saturation effect observed between neutrophil to high-density lipoprotein cholesterol ratio and atherosclerosis in a health examination population: a cross-sectional study. BMC Cardiovasc Disord 2022; 22:424. [PMID: 36162980 PMCID: PMC9513987 DOI: 10.1186/s12872-022-02869-2] [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: 05/17/2022] [Accepted: 09/22/2022] [Indexed: 11/10/2022] Open
Abstract
Background The relationships between inflammatory indexes and atherosclerosis as well as those between blood lipid indexes and atherosclerosis have been widely studied, but the relationship between the neutrophil to high-density lipoprotein cholesterol ratio (NHR) and atherosclerosis had not been investigated until the present study. Methods For this cross‐sectional study, we continuously collected data from a health examination population in the Second Hospital of Hebei Medical University from January 2012 to December 2017 (N = 1978). The collected data included clinical data, hematological indexes, and brachial-ankle pulse wave velocity (Ba-PWV). Atherosclerosis was defined as Ba-PWV ≥ 1400 cm/s. The relationship between the NHR and atherosclerosis was explored via univariate regression analysis, multivariate regression analysis, smoothing function analysis, and analysis of a threshold saturation effect. Results Among 1978 participants, the mean age was 54 years, 1189 participants (60.11%) were male, and 1103 (55.76%) had a history of atherosclerosis. Univariate analysis showed a positive association between the NHR and atherosclerosis [odds ratio (OR) = 1.19, 95% confidence interval (CI): 1.11–1.27, P < 0.01], and this positive association remained significant on multivariate analyses with adjustments for confounding factors (OR = 1.14, 95% CI: 1.06–1.24, P < 0.01). Generalized additive model results revealed a non-linear relationship with a saturation effect between the NHR and atherosclerosis, with a threshold at 3.32. At values ≤ 3.32, the NHR was positively associated with atherosclerosis, but the association was not statistically significant for values > 3.32. Conclusion A nonlinear relationship with a certain saturation effect was observed between the NHR and atherosclerosis in a health examination population.
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Affiliation(s)
- Yaqing Zhou
- Department of Cardiology, The Second Hospital of Hebei Medical University and Institute of Cardiocerebrovascular Disease of Hebei Province, No. 215, He Ping West Road, Shijiazhuang, 050000, China
| | - Haijun Dan
- Department of Physical Examination Center, The Second Hospital of Hebei Medical University, Shijiazhuang, 050000, China
| | - Long Bai
- Department of Cardiology, The Second Hospital of Hebei Medical University and Institute of Cardiocerebrovascular Disease of Hebei Province, No. 215, He Ping West Road, Shijiazhuang, 050000, China
| | - Limei Jia
- Department of Physical Examination Center, The Second Hospital of Hebei Medical University, Shijiazhuang, 050000, China
| | - Baojin Lu
- Department of Physical Examination Center, The Second Hospital of Hebei Medical University, Shijiazhuang, 050000, China
| | - Wei Cui
- Department of Cardiology, The Second Hospital of Hebei Medical University and Institute of Cardiocerebrovascular Disease of Hebei Province, No. 215, He Ping West Road, Shijiazhuang, 050000, China.
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11
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Song Y, Li J, Liu L, Xu R, Zhou Z, Xu B, Lin T, Chen P, Li H, Li Y, Liu C, Huang X, Wang B, Zhang Y, Li J, Huo Y, Ren F, Xu X, Zhang H, Qin X. Plasma Vitamin E and the Risk of First Stroke in Hypertensive Patients: A Nested Case-Control Study. Front Nutr 2021; 8:734580. [PMID: 34805240 PMCID: PMC8595403 DOI: 10.3389/fnut.2021.734580] [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: 07/01/2021] [Accepted: 10/11/2021] [Indexed: 11/13/2022] Open
Abstract
Background: The association between plasma vitamin E levels and first stroke risk in men and women remains unclear. Objective: We aimed to examine the prospective association between plasma vitamin E and first stroke, and evaluate the effect modifiers for the association, among hypertensive patients. Design: The study sample was drawn from the China Stroke Primary Prevention Trial (CSPPT), which randomized a total of 20,702 hypertensive patients to a double-blind, daily treatment with either 10 mg enalapril and 0.8 mg folic acid or 10 mg enalapril alone. This nested case-control study, including 618 first stroke cases and 618 controls matched for age, sex, treatment group, and study site, was conducted after the completion of the CSPPT. Results: The median follow-up duration was 4.5 years. Among men, a significantly higher risk of first stroke (adjusted OR, 1.67; 95%CI: 1.01, 2.77) was found for those with plasma vitamin E ≥7.1 μg/mL (≥quartile 1) compared with those with plasma vitamin E < 7.1 μg/mL. Subgroup analyses further showed that the association between vitamin E (≥7.1 vs. <7.1 μg/mL) and first stroke in men was significantly stronger in non-drinkers (adjusted OR, 2.64; 95%CI: 1.41, 4.96), compared to current drinkers (adjusted OR, 0.84; 95% CI: 0.43, 1.66, P-interaction = 0.008). However, there was no significant association between plasma vitamin E and first stroke in women (P-interaction between sex and plasma vitamin E = 0.048). Conclusions: Among Chinese hypertensive patients, there was a statistically significant positive association between baseline plasma vitamin E and the risk of first stroke in men, but not in women. Clinical Trial Registration: https://clinicaltrials.gov/ct2/show/NCT00794885, Identifier: NCT00794885.
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Affiliation(s)
- Yun Song
- Key Laboratory of Precision Nutrition and Food Quality, Department of Nutrition and Health, College of Food Sciences and Nutritional Engineering, China Agricultural University, Beijing, China.,Institute of Biomedicine, Anhui Medical University, Hefei, China
| | - Jingyi Li
- State Key Laboratory of Natural Medicines, Research Center of Biostatistics and Computational Pharmacy, China Pharmaceutical University, Nanjing, China
| | - Lishun Liu
- Tsinghua Shenzhen International Graduate School, Tsinghua University, Shenzhen, China
| | - Richard Xu
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Ziyi Zhou
- Tsinghua Shenzhen International Graduate School, Tsinghua University, Shenzhen, China
| | - Benjamin Xu
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, United States
| | - Tengfei Lin
- Key Laboratory of Precision Nutrition and Food Quality, Department of Nutrition and Health, College of Food Sciences and Nutritional Engineering, China Agricultural University, Beijing, China.,College of Pharmacy, Jinan University, Guangzhou, China
| | - Ping Chen
- College of Pharmacy, Jinan University, Guangzhou, China
| | - Huan Li
- National Clinical Research Study Center for Kidney Disease, Southern Medical University, Guangzhou, China.,The State Key Laboratory for Organ Failure Research, Southern Medical University, Guangzhou, China.,Renal Division, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Youbao Li
- National Clinical Research Study Center for Kidney Disease, Southern Medical University, Guangzhou, China.,The State Key Laboratory for Organ Failure Research, Southern Medical University, Guangzhou, China.,Renal Division, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Chengzhang Liu
- Institute of Biomedicine, Anhui Medical University, Hefei, China.,Department of Scientific Research, Shenzhen Evergreen Medical Institute, Shenzhen, China
| | - Xiao Huang
- Department of Cardiology, Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Binyan Wang
- Institute of Biomedicine, Anhui Medical University, Hefei, China.,Department of Scientific Research, Shenzhen Evergreen Medical Institute, Shenzhen, China
| | - Yan Zhang
- Department of Cardiology, Peking University First Hospital, Beijing, China
| | - Jianping Li
- Department of Cardiology, Peking University First Hospital, Beijing, China
| | - Yong Huo
- Department of Cardiology, Peking University First Hospital, Beijing, China
| | - Fazheng Ren
- Key Laboratory of Precision Nutrition and Food Quality, Department of Nutrition and Health, College of Food Sciences and Nutritional Engineering, China Agricultural University, Beijing, China
| | - Xiping Xu
- Key Laboratory of Precision Nutrition and Food Quality, Department of Nutrition and Health, College of Food Sciences and Nutritional Engineering, China Agricultural University, Beijing, China.,National Clinical Research Study Center for Kidney Disease, Southern Medical University, Guangzhou, China.,The State Key Laboratory for Organ Failure Research, Southern Medical University, Guangzhou, China.,Renal Division, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Hao Zhang
- Key Laboratory of Precision Nutrition and Food Quality, Department of Nutrition and Health, College of Food Sciences and Nutritional Engineering, China Agricultural University, Beijing, China
| | - Xianhui Qin
- National Clinical Research Study Center for Kidney Disease, Southern Medical University, Guangzhou, China.,The State Key Laboratory for Organ Failure Research, Southern Medical University, Guangzhou, China.,Renal Division, Nanfang Hospital, Southern Medical University, Guangzhou, China
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12
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Wang Z, Li M, Xie J, Gong J, Liu N. Association between remnant cholesterol and arterial stiffness: A secondary analysis based on a cross-sectional study. J Clin Hypertens (Greenwich) 2021; 24:26-37. [PMID: 34750951 PMCID: PMC8783357 DOI: 10.1111/jch.14384] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 10/15/2021] [Accepted: 10/18/2021] [Indexed: 12/15/2022]
Abstract
The relationship between conventional lipid parameters and arterial stiffness (AS) has been verified by previous studies. However, it remains unknown whether non‐conventional lipid parameters have certain predictive effect on AS represented by brachial‐ankle pulse wave velocity (baPWV). Therefore, the study was to explore the relationship between remnant cholesterol (RC) and other non‐conventional lipid parameters and AS in the general population free from cardiovascular disease. The study included 912 participants aged 24–84 years from a medical health checkup center of Murakami Memorial Hospital. Logistic regression analysis and receiver operating characteristic (ROC) curves were used to examine the association between non‐conventional lipid parameters and AS. The results showed that compared with non‐AS group, the AS group had higher RC, non‐high‐density lipoprotein cholesterol (Non‐HDL‐C), atherogenic index of plasma (AIP), lipoprotein combine index (LCI), atherosclerosis index (AI), triglycerides/HDL‐C (TG/HDL‐C), Castelli's risk index I (CRI‐I) and Castelli's risk index II (CRI‐II). Then, the authors divided participants into two groups by the optimal cutoff point of 23.6 of RC determined by Youden index. The baPWV was significantly higher in higher RC group compared with lower RC group, and RC was positively correlated with baPWV. Multivariate Logistic regression analysis showed that, regarding lower RC as reference, higher RC was independently associated with higher risk of AS, independent of other risk factors (OR = 1.794, 95% CI: 1.267‐2.539, p = .001). The area under the curve of AS predicted by RC was higher than that of other non‐conventional lipid parameters (almost all p < .05). The findings indicated that increased RC was a significant predictor of AS.
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Affiliation(s)
- Zhenwei Wang
- Department of Cardiology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Min Li
- Department of Cardiology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Jing Xie
- College of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University, Nanjing, China
| | - Jing Gong
- Department of Cardiology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Naifeng Liu
- Department of Cardiology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
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13
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Wang A, Tian X, Zuo Y, Chen S, Wu S, Wang Y. Mediation effect of arterial stiffness on ideal cardiovascular health and stroke. Nutr Metab Cardiovasc Dis 2021; 31:2382-2390. [PMID: 34162503 DOI: 10.1016/j.numecd.2021.05.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Revised: 03/30/2021] [Accepted: 05/03/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND AIMS Ideal cardiovascular health (CVH) metrics was associated with stroke, but the causal pathway was poorly investigated. Arterial stiffness was a major factor associated with both ideal CVH metrics and stroke. This study aimed to investigate whether the effect of ideal CVH metrics on stroke was mediated and enhanced by arterial stiffness. METHODS AND RESULTS A total of 15,297 participants were included in current study. Arterial stiffness was measured by brachial-ankle pulse wave velocity (baPWV). Causal mediation analyses were used to separate the overall effects of ideal CVH metrics on stroke into indirect effects (mediated by arterial stiffness) and direct effects (mediated through pathways other than arterial stiffness). After a median follow-up of 5.88 years, 324 total stroke events (292 ischemic stroke and 31 hemorrhagic stroke) occurred. Mediation analysis showed 23.94% of the relation between ideal CVH and total stroke was mediated by baPWV (95% confidence interval [CI] of the indirect effect: 0.93-0.95). Further analysis showed the ideal CVH < median combined with baPWV ≥1400 cm/s was associated with the highest risk of total stroke (hazard ratio: 5.62; 95% CI, 3.53-8.96), compared with CVH ≥ median combined with baPWV < 1400 cm/s. Similar results were observed for ischemic stroke, but not for hemorrhagic stroke. CONCLUSIONS Arterial stiffness played a mediating role in the associations between ideal CVH metrics and risk of total and ischemic stroke. Combined ideal CVH metrics and baPWV is a reasonable and useful tool for the assessment and prevention of stroke.
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Affiliation(s)
- Anxin Wang
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Xue Tian
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Yingting Zuo
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Shuohua Chen
- Department of Cardiology, Kailuan Hospital, North China University of Science and Technology, Tangshan, China
| | - Shouling Wu
- Department of Cardiology, Kailuan Hospital, North China University of Science and Technology, Tangshan, China.
| | - Yongjun Wang
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
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14
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Jia B, Jiang C, Song Y, Duan C, Liu L, Liu C, Xu X, Qin X, Chen G. Association Between White Blood Cell Counts and Brachial-Ankle Pulse Wave Velocity in Chinese Hypertensive Adults: A Cross-Sectional Study. Angiology 2021; 73:42-50. [PMID: 34164997 DOI: 10.1177/00033197211021199] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Increased arterial stiffness is highly prevalent in patients with hypertension and is associated with cardiovascular (CV) risk. Increased white blood cell (WBC) counts may also be an independent risk factor for arterial stiffness and CV events. The aim of the study was to investigate the relationship between differential WBC counts and brachial-ankle pulse wave velocity (baPWV) in hypertensive adults. A total of 14 390 participants were included in the final analysis. A multivariate linear regression model was applied for the correlation analysis of WBC count and baPWV. Higher WBC counts were associated with a greater baPWV: adjusted β = 10 (95% CI, 8-13, P < .001). The same significant association was also found when WBC count was assessed as categories or quartiles. In addition, the effect of differential WBC subtypes, including neutrophil count and lymphocyte count on baPWV, showed the similar results. These findings showed that baPWV has positive associations with differential WBC counts in hypertensive adults.
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Affiliation(s)
- Buyun Jia
- College of Integrative Medicine, Anhui University of Chinese Medicine, Hefei, People's Republic of China
| | - Chongfei Jiang
- National Clinical Research Center for Kidney Disease, Southern Medical University, Guangzhou, People's Republic of China
| | - Yun Song
- National Clinical Research Center for Kidney Disease, Southern Medical University, Guangzhou, People's Republic of China
| | | | - Lishun Liu
- College of Food Science and Nutritional Engineering, China Agricultural University, Beijing, People's Republic of China
| | - Chengzhang Liu
- Shenzhen Evergreen Medical Institute, Shenzhen, People's Republic of China
| | - Xiping Xu
- National Clinical Research Center for Kidney Disease, Southern Medical University, Guangzhou, People's Republic of China
| | - Xianhui Qin
- National Clinical Research Center for Kidney Disease, Southern Medical University, Guangzhou, People's Republic of China
| | - Guangliang Chen
- College of Integrative Medicine, Anhui University of Chinese Medicine, Hefei, People's Republic of China
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15
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Zhou Z, Xing AJ, Zhang JN, Xia WH, Su C, Xu SY, Zhang XY, Chen SH, Huang Z, Qian XX, Wu SL, Tao J. Hypertension, Arterial Stiffness, and Clinical Outcomes: A Cohort Study of Chinese Community-Based Population. Hypertension 2021; 78:333-341. [PMID: 34120451 DOI: 10.1161/hypertensionaha.121.17131] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
[Figure: see text].
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Affiliation(s)
- Zhe Zhou
- Department of Hypertension and Vascular Disease, The First Affiliated Hospital, Sun Yat-Sen University (Z.Z., J.-N.Z., W.-H.X., C.S., S.-Y.X., X.-Y.Z., J.T.), Sun Yat-Sen University, Guangzhou, China.,NHC Key Laboratory of Assisted Circulation, Sun Yat-Sen University (Z.Z., J.-N.Z., W.-H.X., C.S., S.-Y.X., X.-Y.Z., J.T.), Sun Yat-Sen University, Guangzhou, China.,National-Guangdong Joint Engineering Laboratory for Diagnosis and Treatment of Vascular Diseases, Guangzhou, China (Z.Z., J.-N.Z., W.-H.X., C.S., S.-Y.X., X.-Y.Z., J.T.)
| | - Ai-Jun Xing
- Cardiology Department, Kailuan General Hospital, Tangshan, China (A.-J.X., Z.H., S.-L.W.)
| | - Jian-Ning Zhang
- Department of Hypertension and Vascular Disease, The First Affiliated Hospital, Sun Yat-Sen University (Z.Z., J.-N.Z., W.-H.X., C.S., S.-Y.X., X.-Y.Z., J.T.), Sun Yat-Sen University, Guangzhou, China.,NHC Key Laboratory of Assisted Circulation, Sun Yat-Sen University (Z.Z., J.-N.Z., W.-H.X., C.S., S.-Y.X., X.-Y.Z., J.T.), Sun Yat-Sen University, Guangzhou, China.,National-Guangdong Joint Engineering Laboratory for Diagnosis and Treatment of Vascular Diseases, Guangzhou, China (Z.Z., J.-N.Z., W.-H.X., C.S., S.-Y.X., X.-Y.Z., J.T.)
| | - Wen-Hao Xia
- Department of Hypertension and Vascular Disease, The First Affiliated Hospital, Sun Yat-Sen University (Z.Z., J.-N.Z., W.-H.X., C.S., S.-Y.X., X.-Y.Z., J.T.), Sun Yat-Sen University, Guangzhou, China.,NHC Key Laboratory of Assisted Circulation, Sun Yat-Sen University (Z.Z., J.-N.Z., W.-H.X., C.S., S.-Y.X., X.-Y.Z., J.T.), Sun Yat-Sen University, Guangzhou, China.,National-Guangdong Joint Engineering Laboratory for Diagnosis and Treatment of Vascular Diseases, Guangzhou, China (Z.Z., J.-N.Z., W.-H.X., C.S., S.-Y.X., X.-Y.Z., J.T.)
| | - Chen Su
- Department of Hypertension and Vascular Disease, The First Affiliated Hospital, Sun Yat-Sen University (Z.Z., J.-N.Z., W.-H.X., C.S., S.-Y.X., X.-Y.Z., J.T.), Sun Yat-Sen University, Guangzhou, China.,NHC Key Laboratory of Assisted Circulation, Sun Yat-Sen University (Z.Z., J.-N.Z., W.-H.X., C.S., S.-Y.X., X.-Y.Z., J.T.), Sun Yat-Sen University, Guangzhou, China.,National-Guangdong Joint Engineering Laboratory for Diagnosis and Treatment of Vascular Diseases, Guangzhou, China (Z.Z., J.-N.Z., W.-H.X., C.S., S.-Y.X., X.-Y.Z., J.T.)
| | - Shi-Yue Xu
- Department of Hypertension and Vascular Disease, The First Affiliated Hospital, Sun Yat-Sen University (Z.Z., J.-N.Z., W.-H.X., C.S., S.-Y.X., X.-Y.Z., J.T.), Sun Yat-Sen University, Guangzhou, China.,NHC Key Laboratory of Assisted Circulation, Sun Yat-Sen University (Z.Z., J.-N.Z., W.-H.X., C.S., S.-Y.X., X.-Y.Z., J.T.), Sun Yat-Sen University, Guangzhou, China.,National-Guangdong Joint Engineering Laboratory for Diagnosis and Treatment of Vascular Diseases, Guangzhou, China (Z.Z., J.-N.Z., W.-H.X., C.S., S.-Y.X., X.-Y.Z., J.T.)
| | - Xiao-Yu Zhang
- Department of Hypertension and Vascular Disease, The First Affiliated Hospital, Sun Yat-Sen University (Z.Z., J.-N.Z., W.-H.X., C.S., S.-Y.X., X.-Y.Z., J.T.), Sun Yat-Sen University, Guangzhou, China.,NHC Key Laboratory of Assisted Circulation, Sun Yat-Sen University (Z.Z., J.-N.Z., W.-H.X., C.S., S.-Y.X., X.-Y.Z., J.T.), Sun Yat-Sen University, Guangzhou, China.,National-Guangdong Joint Engineering Laboratory for Diagnosis and Treatment of Vascular Diseases, Guangzhou, China (Z.Z., J.-N.Z., W.-H.X., C.S., S.-Y.X., X.-Y.Z., J.T.)
| | - Shuo-Hua Chen
- Health Care Center, Kailuan Group, Tangshan, China (S.-H.C.)
| | - Zhe Huang
- Cardiology Department, Kailuan General Hospital, Tangshan, China (A.-J.X., Z.H., S.-L.W.)
| | - Xiao-Xian Qian
- Department of Cardiology, Third Affiliated Hospital (X.-X.Q.), Sun Yat-Sen University, Guangzhou, China
| | - Shou-Ling Wu
- Cardiology Department, Kailuan General Hospital, Tangshan, China (A.-J.X., Z.H., S.-L.W.)
| | - Jun Tao
- Department of Hypertension and Vascular Disease, The First Affiliated Hospital, Sun Yat-Sen University (Z.Z., J.-N.Z., W.-H.X., C.S., S.-Y.X., X.-Y.Z., J.T.), Sun Yat-Sen University, Guangzhou, China.,NHC Key Laboratory of Assisted Circulation, Sun Yat-Sen University (Z.Z., J.-N.Z., W.-H.X., C.S., S.-Y.X., X.-Y.Z., J.T.), Sun Yat-Sen University, Guangzhou, China.,National-Guangdong Joint Engineering Laboratory for Diagnosis and Treatment of Vascular Diseases, Guangzhou, China (Z.Z., J.-N.Z., W.-H.X., C.S., S.-Y.X., X.-Y.Z., J.T.)
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Wu Y, Han X, Gao J, Wang Y, Zhu C, Huang Z, Xing A, Chen S, Ma Y, Zheng M, Liu Q, Tian Y, Wu S. Individual and combined contributions of age-specific and sex-specific pulse pressure and brachial-ankle pulse wave velocity to the risk of new-onset diabetes mellitus. BMJ Open Diabetes Res Care 2021; 9:9/1/e001942. [PMID: 34155045 PMCID: PMC8217932 DOI: 10.1136/bmjdrc-2020-001942] [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: 10/09/2020] [Revised: 04/19/2021] [Accepted: 04/25/2021] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION We aimed to investigate the individual and combined effects of age-specific and sex-specific pulse pressure (PP) and brachial-ankle pulse wave velocity (baPWV) on the incidence of new-onset diabetes mellitus. RESEARCH DESIGN AND METHODS Participants in the Kailuan study cohort who were ≥20 years old, participated in follow-up assessments and underwent baPWV measurements in 2010-2011, 2012-2013, and 2014-2015 were studied. The participants were allocated to four groups according to their PP and baPWV status, each categorized as high or normal, according to age-specific and sex-specific median values. Cox proportional hazards models were used to explore the individual and combined effects of PP and baPWV on the incidence of diabetes mellitus. RESULTS There were 18 619 participants who were followed for 4.27±1.91 years. A total of 877 new cases of diabetes were identified, and the incidence density was 11.03/1000 per year. Using the normal PP and normal baPWV group as the reference group, the multivariable-adjusted HRs and 95% CIs for diabetes mellitus in the high PP and high baPWV groups were 1.08 (0.93 to 1.25) and 1.64 (1.41 to 1.90), respectively. Compared with the normal PP/baPWV group, the HR and 95% CI for diabetes in the normal PP/high baPWV, the high PP/normal baPWV, and high PP/baPWV groups were 1.66 (1.35 to 2.05), 1.09 (0.86 to 1.37), and 1.74 (1.43 to 2.13), respectively. CONCLUSIONS High baPWV was independently associated with a higher risk of diabetes mellitus, and individuals with both high baPWV and high PP were at a still higher risk of diabetes mellitus.
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Affiliation(s)
- Yuntao Wu
- Department of Cardiology, Kailuan General Hospital, North China University of Science and Technology, Tangshan, China
| | - Xu Han
- Graduate School, North China University of Science and Technology, Tangshan, China
| | - Jingli Gao
- Department of Cardiology, Kailuan General Hospital, North China University of Science and Technology, Tangshan, China
| | - Yanxiu Wang
- Department of Cardiology, Kailuan General Hospital, North China University of Science and Technology, Tangshan, China
| | - Chenrui Zhu
- Department of Cardiology, Kailuan General Hospital, North China University of Science and Technology, Tangshan, China
| | - Zhe Huang
- Department of Cardiology, Kailuan General Hospital, North China University of Science and Technology, Tangshan, China
| | - Aijun Xing
- Department of Cardiology, Kailuan General Hospital, North China University of Science and Technology, Tangshan, China
| | - Shuohua Chen
- Department of Cardiology, Kailuan General Hospital, North China University of Science and Technology, Tangshan, China
| | - Yihan Ma
- Department of Cardiology, Kailuan General Hospital, North China University of Science and Technology, Tangshan, China
| | - Mengyi Zheng
- Graduate School, North China University of Science and Technology, Tangshan, China
| | - Qian Liu
- Department of Cardiology, Kailuan General Hospital, North China University of Science and Technology, Tangshan, China
| | - Yaohua Tian
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Shouling Wu
- Department of Cardiology, Kailuan General Hospital, North China University of Science and Technology, Tangshan, China
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17
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Yasuharu T, Setoh K, Kawaguchi T, Nakayama T, Matsuda F. Brachial-ankle pulse wave velocity and cardio-ankle vascular index are associated with future cardiovascular events in a general population: The Nagahama Study. J Clin Hypertens (Greenwich) 2021; 23:1390-1398. [PMID: 34041835 PMCID: PMC8678776 DOI: 10.1111/jch.14294] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 04/24/2021] [Accepted: 05/07/2021] [Indexed: 11/27/2022]
Abstract
Faster pulse wave velocity (PWV) is known to be associated with the incidence of cardiovascular diseases (CVD). The aim of this study was to clarify the hypothesis that PWV may be associated with future CVD events even when its time-dependent changes were adjusted. We also investigated a prognostic significance of cardio-ankle vascular index, another index of arterial stiffness. Study participants included 8850 community residents. The repeated measures of the clinical parameters at 5.0 years after the baseline were available for 7249 of the participants. PWV was calculated using the arterial waveforms measured at the brachia and ankles (baPWV). The cardio-ankle vascular index was calculated by estimated pulse transit time from aortic valve to tibial artery. During the 8.53 years follow-up period, we observed 215 cases of CVD. The incidence rate increased linearly with baPWV quartiles (per 10 000 person-years: Q1, 2.7; Q2, 12.6; Q3, 22.5; Q4, 76.2), and the highest quartile was identified as an independent determinant of incident CVD by conventional Cox proportional hazard analysis adjusted for known risk factors [hazard ratio (HR), 4.00; p = .007]. Per unit HR of baPWV (HR, 1.15; p < .001) remained significant in the time-dependent Cox regression analysis including baPWV and other clinical values measured at 5-year after the baseline as time-varying variables (HR, 1.14; p < .001). The cardio-ankle vascular index was also associated with CVD with similar manner though the associations were less clear than that of baPWV. baPWV is a good risk marker for the incidence of CVD.
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Affiliation(s)
- Tabara Yasuharu
- Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan.,Graduate School of Public Health, Shizuoka Graduate University of Public Health, Shizuoka, Japan
| | - Kazuya Setoh
- Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Takahisa Kawaguchi
- Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Takeo Nakayama
- Graduate School of Public Health, Shizuoka Graduate University of Public Health, Shizuoka, Japan.,Department of Health Informatics, Kyoto University School of Public Health, Kyoto, Japan
| | - Fumihiko Matsuda
- Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan.,Graduate School of Public Health, Shizuoka Graduate University of Public Health, Shizuoka, Japan
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18
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Wang S, Shi J, Peng Y, Fang Q, Mu Q, Gu W, Hong J, Zhang Y, Wang W. Stronger association of triglyceride glucose index than the HOMA-IR with arterial stiffness in patients with type 2 diabetes: a real-world single-centre study. Cardiovasc Diabetol 2021; 20:82. [PMID: 33888131 PMCID: PMC8063289 DOI: 10.1186/s12933-021-01274-x] [Citation(s) in RCA: 93] [Impact Index Per Article: 31.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 04/15/2021] [Indexed: 12/17/2022] Open
Abstract
Background The triglyceride-glucose index (TyG index) has been proposed as a simple and reliable alternative insulin resistance (IR) marker, while the homeostasis model assessment for IR (HOMA-IR) is the most frequently used index. Few studies have evaluated the role of IR assessed by the TyG index and HOMA-IR on arterial stiffness in a type 2 diabetes (T2D) population with a high risk of increased arterial stiffness. We aimed to investigate the association of the TyG index and HOMA-IR with arterial stiffness in patients with T2D. Methods We recruited 3185 patients with T2D, who underwent brachial-ankle pulse wave velocity (baPWV), an indicator of arterial stiffness, but without previous cardiovascular disease. Increased arterial stiffness was defined as a baPWV value greater than the 75th percentile (18.15 m/s) in the present study. The TyG index was determined as ln(fasting triglycerides [mg/dL] × fasting glucose [mg/dL]/2), and the HOMA-IR was calculated as (fasting insulin [μIU/mL] × fasting glucose [mmol/L])/22.5. Results The mean age of the study participants was 54.6 ± 12.0 years, and 1954 (61.4%) were men. Seemingly unrelated regression estimation analysis demonstrated that the TyG index had stronger associations with baPWV than the HOMA-IR (all P < 0.001). In the multivariable logistic analyses, each one-unit increase in the TyG index was associated with a 1.40-fold (95% CI 1.16–1.70, P < 0.001) higher prevalence of increased arterial stiffness, but the prominent association of the HOMA-IR with the prevalence of increased arterial stiffness was not observed. Subgroup analyses showed that a more significant association between the TyG index and the prevalence of increased arterial stiffness was detected in older patients with a longer duration of diabetes and poor glycaemic control (all P < 0.05). Conclusions Compared with the HOMA-IR, the TyG index is independently and more strongly associated with arterial stiffness in patients with T2D. Supplementary Information The online version contains supplementary material available at 10.1186/s12933-021-01274-x.
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Affiliation(s)
- Shujie Wang
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Juan Shi
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ying Peng
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qianhua Fang
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qian Mu
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Weiqiong Gu
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jie Hong
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yifei Zhang
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China. .,Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| | - Weiqing Wang
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China. .,Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
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19
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Effect of Brachial-Ankle Pulse Wave Velocity Combined with Waist-to-Hip Ratio on Cardiac and Cerebrovascular Events. Am J Med Sci 2021; 362:135-142. [PMID: 33621529 DOI: 10.1016/j.amjms.2021.02.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 09/05/2020] [Accepted: 02/17/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND Abdominal obesity and brachial-ankle pulse wave velocity (baPWV) are indicators of atherosclerosis. But few studies have shown the relationship between baPWV combined with waist-hip ratio (WHR) and cardiac-cerebrovascular events (CCVEs). METHODS A total of 18944 subjects from Kailuan study were enrolled in this study. Follow-up was conducted three times over 4.82±1.92 years. All the participants were divided into 4 groups according to baPWV and WHR status on baseline: Q1 (normal baPWV, normal WHR), Q2 (normal baPWV, increased WHR), Q3 (increased baPWV, normal WHR) and Q4 (increased baPWV, increased WHR). The incidence and risk factors and further analysis of hypertension subgroups were analyzed. RESULTS During follow-up, 88 myocardial infarctions (MI), 278 cerebral ischemic strokes (CI), 285 strokes and 371 CCVEs occurred, with the cumulative incidence of 0.46%, 1.47%, 1.50%, and 1.96%, respectively. Multivariate Cox regression analysis revealed the risk of CI, stroke and CCVEs was higher in patients with increased baPWV and increased WHR than in the other three groups, followed by the Q3 group (increased baPWV, normal WHR) and Q2 group (normal baPWV, increased WHR) group (all adjusted P<0.01). Further hypertension subgroups analysis showed similar results, but differences were more significant among hypertensive patients. Accordingly, the combination of baPWV and WHR increased the risk of total CCVEs, especially in hypertensive patients. CONCLUSIONS BaPWV and WHR were important risk factors for CCVEs and had synergistic effects. When baPWV increased, WHR may contribute more to the risk of CCVEs in hypertensive patients.
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20
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Abstract
OBJECTIVE Using the brachial--ankle pulse wave velocity (baPWV) as a biomarker for arteriosclerosis, we studied the effect of blood pressure (BP) and BP control on arteriosclerosis progression. METHODS AND RESULTS The community-based longitudinal Kailuan study included 6552 participants [4938 (75.37%) men] with a mean follow-up of 4.62 ± 2.21 years. Hypertension was defined based on the Joint National Committee (JNC7) criteria and the 2017 American College of Cardiology (ACC)/American Heart Association (AHA) guidelines. All study participants had hypertension and were stratified as follows according to BP at baseline and follow-up: the normal--normal [normal BP (under therapy) at baseline and final follow-up], normal--hypertensive, hypertensive--normal, and hypertensive--hypertensive groups. Using the JNC7-based hypertension definition, the annual baPWV increase was the highest (P < 0.001) in the hypertensive--hypertensive group [17.32 cm/s; 95% confidence interval [CI]:9.7--24.9], followed by the normal--hypertensive group (14.44 cm/s; 95% CI:5.5--23.4), and the hypertensive--normal group (0.88 cm/s; 95% CI: -7.84 to 9.60), with the normal--normal group as the reference group in a multivariable model. The model additionally included parameters, such as age, baseline baPWV, heart rate, BMI, serum glucose concentration, prevalence of antihypertensive treatment and alcohol consumption, heart rate, and estimated glomerular filtration rate. Applying the ACC/AHA guidelines and the same multivariable model, the annual baPWV increase was the highest (P < 0.001) in the hypertensive--hypertensive group (43.54 cm/s; 95% CI: 22.54--64.55), followed by the normal--hypertensive group (34.01 cm/s; 95% CI: 10.39--57.62) and the hypertensive--normal group (24.12 cm/s; 95% CI: 1.24--47.00). CONCLUSION Lower BP and medical reduction in increased BP were associated with a reduction in the baPWV increase and may delay the progression of arteriosclerosis in hypertensive patients.
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21
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Li C, Wang Z, Liu S, Guo S, Song Y, Liu L, Zhou Z, Wang B, Huang M, Wang R, Zhai L, Gao Y, Qin X, Wang X, Zheng H, Zhao Z. Association of Brachial Ankle Pulse Wave Velocity With New Onset Stroke in Hypertensive Patients Aged Less Than 65 With Normal Fasting Glucose Among Chinese Community-Based Population. Front Endocrinol (Lausanne) 2021; 12:828286. [PMID: 35145484 PMCID: PMC8822600 DOI: 10.3389/fendo.2021.828286] [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: 12/03/2021] [Accepted: 12/30/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Previous studies have shown an association of stroke and brachial ankle pulse wave velocity (baPWV). However, due to limitations on total population size and small numbers of stroke cases, lack of power has prevented further detection among subgroups such as age and laboratory testing. METHODS A total of 19217 participants including 660 incident stroke patients were pooled in the present study. Participants were divided to 2 groups, aged less than 65 years [56.0 (50.0, 61.0)] and aged 65 years or more [70.0 (67.0, 74.0)]. RESULTS After adjustment for demographic, anthropometric, and laboratory parameters, the incident stroke was positively associated to baPWV in the group aged less than 65 years (OR, 1.16; 95% CI, 1.05-1.28), but not in the older group aged 65 or more. When baPWV was assigned as quartiles, a significant, increased risk of new-onset stroke was found in quartiles 3-4 compared with quartile 1. In addition, the predictive value of baPWV for incident stroke was modified by fasting glucose in participants aged less than 65 years (P-interaction = 0.010). An increase in baPWV was strongly, positively associated to new-onset stroke in the subgroup of normal fasting glucose (< 5.6 mmol/L) (OR, 1.34; 95% CI, 1.15 - 1.57), but no effect was seen in the impaired fasting glucose (5.6-7.0 mmol/L) or diabetic fasting glucose (> 7.0 mmol/L) subgroups. CONCLUSIONS Increased baPWV was significantly associated with new-onset stroke in a hypertensive population aged less than 65 years. Particularly, it is of great importance to monitor baPWV for predicting incident stroke in "relatively healthy" hypertensive patients, i.e. aged less than 65 years with normal fasting glucose.
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Affiliation(s)
- Cao Li
- Department of Pharmacy, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Zhuo Wang
- Key Laboratory of Precision Nutrition and Food Quality, Ministry of Education, Department of Nutrition and Health, College of Food Sciences and nutritional engineering, China Agricultural University, Beijing, China
| | - Shuai Liu
- State Key Laboratory of Natural Medicines, Research Center of Biostatistics and Computational Pharmacy, China Pharmaceutical University, Nanjing, China
| | - Shanshan Guo
- Department of Pharmacy, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Yun Song
- Institute of Biomedicine, Anhui Medical University, Hefei, China
- Department of Scientific Research, Shenzhen Evergreen Medical Institute, Shenzhen, China
| | - Lishun Liu
- Department of Scientific Research, Shenzhen Evergreen Medical Institute, Shenzhen, China
- Graduate School at Shenzhen, Tsinghua University, Shenzhen, China
| | - Ziyi Zhou
- Department of Scientific Research, Shenzhen Evergreen Medical Institute, Shenzhen, China
- Graduate School at Shenzhen, Tsinghua University, Shenzhen, China
| | - Binyan Wang
- Institute of Biomedicine, Anhui Medical University, Hefei, China
| | - Meiqing Huang
- Department of Scientific Research, Shenzhen Evergreen Medical Institute, Shenzhen, China
| | - Ruiqing Wang
- Health Management Center, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Lijie Zhai
- Department of Pharmacy, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Yiming Gao
- Department of Pharmacy, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Xianhui Qin
- Institute of Biomedicine, Anhui Medical University, Hefei, China
- National Clinical Research Center for Kidney Disease, State Key Laboratory for Organ Failure Research, Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Xiaobin Wang
- Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, United States
| | - Huaguang Zheng
- Health Management Center, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- *Correspondence: Huaguang Zheng, ; Zhigang Zhao,
| | - Zhigang Zhao
- Department of Pharmacy, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- *Correspondence: Huaguang Zheng, ; Zhigang Zhao,
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Fan Y, Gao W, Li J, Fan F, Qin X, Liu L, Cheng X, Xu X, Wang X, Wang B, Huo Y. Effect of the baseline pulse wave velocity on short term and long term blood pressure control in primary hypertension. Int J Cardiol 2020; 317:193-199. [PMID: 32505371 DOI: 10.1016/j.ijcard.2020.02.059] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Revised: 01/30/2020] [Accepted: 02/23/2020] [Indexed: 11/27/2022]
Abstract
OBJECTIVES Arterial stiffness may affect antihypertensive response to antihypertensive treatment. However, sufficient clinical evidence is lacking. This longitudinal study aimed to evaluate the effect of baseline arterial stiffness measured by the brachial-ankle pulse wave velocity (baPWV) on response to short-term and long-term enalapril-based treatment in 3310 hypertensive adults from the China Stroke Primary Prevention Trial (CSPPT). METHODS AND RESULTS Blood pressure (BP) measured at three months (short-term) in 2780 subjects, and the time-average on-treatment BP in 3310 subjects during a median of 4.5-year follow-ups (long-term) were analyzed in the study. After short-term antihypertensive treatment, every 1 m/s increase in baPWV denoted a 7% and 6% decreased chance of achieving systolic BP (SBP) control (odds ratio (OR), 0.93; 95% CI 0.90, 0.96; P < 0.001) and BP control (OR, 0.94; 95% CI 0.91, 0.97; P < 0.001), respectively, after adjustment for age, gender and other variables. After long-term treatment, every 1 m/s increase in baPWV posed an 7% and 6% greater risk of failing to attain SBP control (OR, 0.93; 95% CI 0.90, 0.95; P < 0.001) and BP control (OR, 0.94; 95% CI, 0.92, 0.96; P < 0.001), respectively, not regarding for DBP control after both short- and long-term treatment. Higher baseline baPWV significantly decreased SBP reduction both after three months and the median 4.5-year treatment, while increased DBP reduction after the median 4.5-year treatment. CONCLUSIONS Elevated baseline baPWV significantly decreased BP response to short-and long-term treatment in adults with primary hypertensive. Arterial stiffness improvement may be an essential target to achieve adequate BP control.
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Affiliation(s)
- Y Fan
- Department of Cardiology and Institute of Vascular Medicine, Peking University Third Hospital, Beijing, China
| | - W Gao
- Department of Cardiology and Institute of Vascular Medicine, Peking University Third Hospital, Beijing, China
| | - J Li
- Cardiology Department, Peking University First Hospital, Beijing, China
| | - F Fan
- Cardiology Department, Peking University First Hospital, Beijing, China
| | - X Qin
- National Center for Clinical Research in Kidney Disease, Guangdong Institute of Nephrology, Southern Medical University, Guangzhou, China
| | - L Liu
- Beijing Advanced Innovation Center for Food Nutrition and Human Health, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing, China
| | - X Cheng
- Department of Cardiology, The Second Affiliated Hospital of Nanchang University, Jiangxi, China
| | - X Xu
- National Center for Clinical Research in Kidney Disease, Guangdong Institute of Nephrology, Southern Medical University, Guangzhou, China
| | - X Wang
- Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - B Wang
- Institute of Biomedicine, Anhui Medical University, Hefei, China
| | - Y Huo
- Cardiology Department, Peking University First Hospital, Beijing, China.
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Li M, Zhan A, Huang X, Hu L, Zhou W, Wang T, Zhu L, Bao H, Cheng X. Positive association between triglyceride glucose index and arterial stiffness in hypertensive patients: the China H-type Hypertension Registry Study. Cardiovasc Diabetol 2020; 19:139. [PMID: 32948181 PMCID: PMC7501677 DOI: 10.1186/s12933-020-01124-2] [Citation(s) in RCA: 92] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 09/12/2020] [Indexed: 01/18/2023] Open
Abstract
Background Data are limited on whether TyG index is an independent predictor of arterial stiffness in hypertensive patients. The purpose of this study was to assess the association between the TyG index and arterial stiffness, and examined whether there were effect modifiers, in hypertensive patients. Methods This study included 4718 hypertensive adults, a subset of the China H-type Hypertension Registry Study. The TyG index was calculated as ln[fasting triglycerides (mg/dL) × fasting glucose (mg/dL)/2]. Arterial stiffness was determined by measuring brachial-ankle pulse wave velocity (baPWV). Results The overall mean TyG index was 8.84. Multivariate linear regression analyses showed that TyG index was independently and positively associated with baPWV (β, 1.02; 95% confidence interval [CI] 0.83, 1.20). Consistently, Multiple logistic analyses showed a positive association between TyG index risk of elevated baPWV (> 75th percentile) (odds ratio [OR], 2.12; 95% CI 1.80, 2.50). Analyses using restricted cubic spline confirmed that the associations of TyG index with baPWV and elevated baPWV were linear. Subgroup analyses showed that stronger associations between TyG index and baPWV were detected in men (all P for interaction < 0.05). Conclusion TyG index was independently and positively associated with baPWV and elevated baPWV among hypertensive patients, especially in men. The data suggest that TyG index may serve as a simple and effective tool for arterial stiffness risk assessment in daily clinical practice.
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Affiliation(s)
- Minghui Li
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, No. 1 Minde Road, Nanchang, 330006, Jiangxi, China
| | - Aihua Zhan
- Zheyuan township hospital, Wuyuan, Jiangxi, China
| | - Xiao Huang
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, No. 1 Minde Road, Nanchang, 330006, Jiangxi, China
| | - Lihua Hu
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, No. 1 Minde Road, Nanchang, 330006, Jiangxi, China
| | - Wei Zhou
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, No. 1 Minde Road, Nanchang, 330006, Jiangxi, China.,Center for Prevention and Treatment of Cardiovascular Diseases, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Tao Wang
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, No. 1 Minde Road, Nanchang, 330006, Jiangxi, China.,Center for Prevention and Treatment of Cardiovascular Diseases, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Lingjuan Zhu
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, No. 1 Minde Road, Nanchang, 330006, Jiangxi, China.,Center for Prevention and Treatment of Cardiovascular Diseases, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Huihui Bao
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, No. 1 Minde Road, Nanchang, 330006, Jiangxi, China. .,Center for Prevention and Treatment of Cardiovascular Diseases, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China.
| | - Xiaoshu Cheng
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, No. 1 Minde Road, Nanchang, 330006, Jiangxi, China. .,Center for Prevention and Treatment of Cardiovascular Diseases, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China.
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Hu H, Li H, Huang X, Bao H, Song Y, Wang B, Liu C, Xu R, Liu L, Wang X, Huo Y, Xu X, Cheng X, Qin X, Li P. Association of self-reported sleep duration and quality with BaPWV levels in hypertensive patients. Hypertens Res 2020; 43:1392-1402. [PMID: 32678321 PMCID: PMC7671938 DOI: 10.1038/s41440-020-0509-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2019] [Revised: 05/02/2020] [Accepted: 06/03/2020] [Indexed: 11/09/2022]
Abstract
The association between sleep conditions and arterial stiffness remains inconclusive. We aimed to investigate the relationship of sleep duration and quality with brachial-ankle pulse-wave velocity (baPWV) in hypertensive patients. A total of 14,485 hypertensive adults were included in this cross-sectional analysis. Information about sleep duration and quality was obtained via questionnaire. A baPWV level ≥1800 cm/s was defined as indicative of arterial stiffness. Compared with participants with a sleep duration <8 h per day, participants with a sleep duration ≥8 h per day had a significantly higher baPWV level (β = 13.7 cm/s; 95% CI: 3.9, 23.5) and a nonsignificantly higher prevalence of arterial stiffness (39.7% vs. 33.0%; OR, 1.08; 95% CI: 0.99-1.19). Similarly, compared with participants with good or medium sleep quality, participants with poor sleep quality had a significantly higher baPWV level (β = 16.3 cm/s; 95% CI: 0.1, 32.6) and a nonsignificantly greater prevalence of arterial stiffness (36.6% vs. 35.3%; OR, 1.13; 95% CI: 0.97-1.32). When sleep duration and quality were examined jointly, participants with a sleep duration ≥8 h and/or poor sleep quality had a significantly higher baPWV level (β = 14.4 cm/s; 95% CI: 5.3, 23.4) and a greater prevalence of arterial stiffness (38.8% vs. 32.7%; OR, 1.10; 95% CI: 1.01-1.20) than those with a sleep duration <8 h and good/medium sleep quality. In summary, among hypertensive patients, a longer sleep duration (≥8 h per day) and poor sleep quality were associated with higher baPWV levels and a higher prevalence of arterial stiffness.
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Affiliation(s)
- Huan Hu
- Department of Cardiology, the Second Affiliated Hospital of Nanchang University, Nanchang, China.,Center for Prevention and Treatment of Cardiovascular Diseases, the Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Huan Li
- National Clinical Research Study Center for Kidney Disease; State Key Laboratory for Organ Failure Research; Renal Division, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Xiao Huang
- Department of Cardiology, the Second Affiliated Hospital of Nanchang University, Nanchang, China.,Center for Prevention and Treatment of Cardiovascular Diseases, the Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Huihui Bao
- Department of Cardiology, the Second Affiliated Hospital of Nanchang University, Nanchang, China.,Center for Prevention and Treatment of Cardiovascular Diseases, the Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Yun Song
- Beijing Advanced Innovation Center for Food Nutrition and Human Health, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing, China.,Institute of Biomedicine, Anhui Medical University, Hefei, China
| | - Binyan Wang
- Institute of Biomedicine, Anhui Medical University, Hefei, China.,Shenzhen Evergreen Medical Institute, Shenzhen, China
| | | | - Richard Xu
- Krieger School of Arts and Sciences, Johns Hopkins University, Baltimore, USA
| | - Lishun Liu
- Beijing Advanced Innovation Center for Food Nutrition and Human Health, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing, China
| | - Xiaobin Wang
- Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, USA
| | - Yong Huo
- Department of Cardiology, Peking University First Hospital, Beijing, China
| | - Xiping Xu
- National Clinical Research Study Center for Kidney Disease; State Key Laboratory for Organ Failure Research; Renal Division, Nanfang Hospital, Southern Medical University, Guangzhou, China.,Beijing Advanced Innovation Center for Food Nutrition and Human Health, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing, China
| | - Xiaoshu Cheng
- Department of Cardiology, the Second Affiliated Hospital of Nanchang University, Nanchang, China.,Center for Prevention and Treatment of Cardiovascular Diseases, the Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Xianhui Qin
- National Clinical Research Study Center for Kidney Disease; State Key Laboratory for Organ Failure Research; Renal Division, Nanfang Hospital, Southern Medical University, Guangzhou, China. .,Institute of Biomedicine, Anhui Medical University, Hefei, China.
| | - Ping Li
- Department of Cardiology, the Second Affiliated Hospital of Nanchang University, Nanchang, China. .,Center for Prevention and Treatment of Cardiovascular Diseases, the Second Affiliated Hospital of Nanchang University, Nanchang, China.
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25
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Tomiyama H, Shiina K. State of the Art Review: Brachial-Ankle PWV. J Atheroscler Thromb 2020; 27:621-636. [PMID: 32448827 PMCID: PMC7406407 DOI: 10.5551/jat.rv17041] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Accepted: 04/22/2020] [Indexed: 12/11/2022] Open
Abstract
The brachial-ankle pulse wave velocity (brachial-ankle PWV), which is measured simply by wrapping pressure cuffs around the four extremities, is a simple marker to assess the stiffness of the medium- to large- sized arteries. The accuracy and reproducibility of its measurement have been confirmed to be acceptable. Risk factors for cardiovascular disease, especially advanced age and high blood pressure, are reported to be associated with an increase of the arterial stiffness. Furthermore, arterial stiffness might be involved in a vicious cycle with the development/progression of hypertension, diabetes mellitus and chronic kidney disease. Increase in the arterial stiffness is thought to contribute to the development of cardiovascular disease via pathophysiological abnormalities induced in the heart, brain, kidney, and also the arteries themselves. A recent independent participant data meta-analysis conducted in Japan demonstrated that the brachial-ankle PWV is a useful marker to predict future cardiovascular events in Japanese subjects without a previous history of cardiovascular disease, independent of the conventional model for the risk assessment. The cutoff point may be 16.0 m/s in individuals with a low risk of cardiovascular disease (CVD), and 18.0 m/s in individuals with a high risk of CVD and subjects with hypertension. In addition, the method of measurement of the brachial-ankle PWV can also be used to calculate the inter-arm systolic blood pressure difference and ankle-brachial pressure index, which are also useful markers for cardiovascular risk assessment.
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Affiliation(s)
| | - Kazuki Shiina
- Department of Cardiology, Tokyo Medical University, Tokyo, Japan
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26
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Association of brachial-ankle pulse wave velocity and carotid plaque in Chinese hypertensive adults: effect modification by age. Hypertens Res 2020; 43:808-816. [PMID: 32303686 PMCID: PMC7363666 DOI: 10.1038/s41440-020-0432-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2019] [Revised: 02/02/2020] [Accepted: 02/10/2020] [Indexed: 02/06/2023]
Abstract
We aimed to investigate the association of brachial–ankle pulse wave velocity (baPWV) with carotid plaque presence and carotid plaque number in a Chinese hypertensive population. A total of 13,554 hypertensive subjects from the China Stroke Primary Prevention Trial (CSPPT) were recruited. Arterial stiffness and carotid plaque were evaluated by baPWV and B-mode ultrasonography, respectively. Multivariate logistic regression analysis was used to determine the correlation of baPWV and carotid plaque presence. Multinomial logistic regression analysis was used to determine the correlation of baPWV and carotid plaque number. Further interactions between baPWV and carotid plaque presence were examined using subgroup analysis. Continuous baPWV was positively correlated with carotid plaque presence (OR = 1.05, 95% CI: 1.04–1.07) and carotid plaque number (one- to two-plaque group: OR = 1.04, 95% CI: 1.02–1.06; three-or-more-plaque group: OR = 1.09, 95% CI: 1.07–1.12). When baPWV was classified into quartiles, with the lowest quartile as reference, the ORs for having one, two, or three or more plaques increased in parallel with the quartiles of baPWV, indicating a dose-dependent effect. In a subgroup analysis, the association of baPWV and carotid plaque presence was more pronounced among younger participants (OR: 1.14 vs. 1.06 and 1.03 for the age groups <60 years, 60 ≤ 70 years, and ≥70 years, respectively, P for interaction <0.001). In a Chinese hypertensive population, baPWV was positively associated with carotid plaque presence and carotid plaque number. A more pronounced positive association between baPWV and carotid plaque presence was observed in younger participants.
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27
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Maruhashi T, Soga J, Fujimura N, Idei N, Mikami S, Iwamoto Y, Iwamoto A, Kajikawa M, Matsumoto T, Oda N, Kishimoto S, Matsui S, Hashimoto H, Takaeko Y, Yamaji T, Harada T, Han Y, Aibara Y, Mohamad Yusoff F, Hidaka T, Kihara Y, Chayama K, Noma K, Nakashima A, Goto C, Tomiyama H, Takase B, Kohro T, Suzuki T, Ishizu T, Ueda S, Yamazaki T, Furumoto T, Kario K, Inoue T, Koba S, Watanabe K, Takemoto Y, Hano T, Sata M, Ishibashi Y, Node K, Maemura K, Ohya Y, Furukawa T, Ito H, Ikeda H, Yamashina A, Higashi Y. Increased arterial stiffness and cardiovascular risk prediction in controlled hypertensive patients with coronary artery disease: post hoc analysis of FMD-J (Flow-mediated Dilation Japan) Study A. Hypertens Res 2020; 43:781-790. [DOI: 10.1038/s41440-020-0420-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2019] [Revised: 02/10/2020] [Accepted: 02/10/2020] [Indexed: 12/12/2022]
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28
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Qin X, Spence JD, Li J, Zhang Y, Li Y, Sun N, Liang M, Song Y, Zhang Y, Wang B, Cheng X, Zhao L, Wang X, Xu X, Huo Y. Interaction of serum vitamin B 12 and folate with MTHFR genotypes on risk of ischemic stroke. Neurology 2020; 94:e1126-e1136. [PMID: 31932513 DOI: 10.1212/wnl.0000000000008932] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 09/19/2020] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVE We evaluated the interaction of serum folate and vitamin B12 with methylenetetrahydrofolate reductase (MTHFR) C677T genotypes on the risk of first ischemic stroke and on the efficacy of folic acid treatment in prevention of first ischemic stroke. METHODS A total of 20,702 hypertensive adults were randomized to a double-blind treatment of daily enalapril 10 mg and folic acid 0.8 mg or enalapril 10 mg alone. Participants were followed up every 3 months. RESULTS Median values of folate and B12 concentrations at baseline were 8.1 ng/mL and 280.2 pmol/L, respectively. Over a median of 4.5 years, among those not receiving folic acid, participants with baseline serum B12 or serum folate above the median had a significantly lower risk of first ischemic stroke (hazard ratio [HR], 0.74; 95% confidence interval [CI], 0.57-0.96), especially in those with MTHFR 677 CC genotype (wild-type) (HR, 0.49; 95% CI, 0.31-0.78). Folic acid treatment significantly reduced the risk of first ischemic stroke in participants with both folate and B12 below the median (2.3% in enalapril-folic acid group vs 3.6% in enalapril-only group; HR, 0.62; 95% CI, 0.46-0.86), particularly in MTHFR 677 CC carriers (1.6% vs 4.9%; HR, 0.24; 95% CI, 0.11-0.55). However, TT homozygotes responded better with both folate and B12 levels above the median (HR, 0.28; 95% CI, 0.10-0.75). CONCLUSIONS The risk of first ischemic stroke was significantly higher in hypertensive patients with low levels of both folate and B12. Effect of folic acid treatment was greatest in patients with low folate and B12 with the CC genotype, and with high folate and B12 with the TT genotype.
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Affiliation(s)
- Xianhui Qin
- From Renal Division (X.Q., Y.L., M.L., Y.Z., X.X.), Nanfang Hospital, Southern Medical University; National Clinical Research Center for Kidney Disease (X.Q., Y.L., M.L., Y.Z., X.X.); State Key Laboratory for Organ Failure Research (X.Q., Y.L., M.L., Y.Z., X.X.), Guangzhou, China; Stroke Prevention and Atherosclerosis Research Centre (J.D.S.), Robarts Research Institute, University of Western Ontario, London, Canada; Department of Cardiology (J.L., Y.Z., Y.H.), Peking University First Hospital; Department of Cardiology (N.S.), Peking University People's Hospital; Beijing Advanced Innovation Center for Food Nutrition and Human Health (Y.S.), Key Laboratory of Functional Dairy, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing; Institute for Biomedicine (B.W.), Anhui Medical University, Hefei; Department of Cardiology (X.C.), Second Affiliated Hospital, Nanchang University; Department of Cardiology (L.Z.), Tangdu Hospital, the Fourth Military Medical University, Xi'an, China; and Department of Population, Family and Reproductive Health (X.W.), Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD
| | - J David Spence
- From Renal Division (X.Q., Y.L., M.L., Y.Z., X.X.), Nanfang Hospital, Southern Medical University; National Clinical Research Center for Kidney Disease (X.Q., Y.L., M.L., Y.Z., X.X.); State Key Laboratory for Organ Failure Research (X.Q., Y.L., M.L., Y.Z., X.X.), Guangzhou, China; Stroke Prevention and Atherosclerosis Research Centre (J.D.S.), Robarts Research Institute, University of Western Ontario, London, Canada; Department of Cardiology (J.L., Y.Z., Y.H.), Peking University First Hospital; Department of Cardiology (N.S.), Peking University People's Hospital; Beijing Advanced Innovation Center for Food Nutrition and Human Health (Y.S.), Key Laboratory of Functional Dairy, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing; Institute for Biomedicine (B.W.), Anhui Medical University, Hefei; Department of Cardiology (X.C.), Second Affiliated Hospital, Nanchang University; Department of Cardiology (L.Z.), Tangdu Hospital, the Fourth Military Medical University, Xi'an, China; and Department of Population, Family and Reproductive Health (X.W.), Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD
| | - Jianping Li
- From Renal Division (X.Q., Y.L., M.L., Y.Z., X.X.), Nanfang Hospital, Southern Medical University; National Clinical Research Center for Kidney Disease (X.Q., Y.L., M.L., Y.Z., X.X.); State Key Laboratory for Organ Failure Research (X.Q., Y.L., M.L., Y.Z., X.X.), Guangzhou, China; Stroke Prevention and Atherosclerosis Research Centre (J.D.S.), Robarts Research Institute, University of Western Ontario, London, Canada; Department of Cardiology (J.L., Y.Z., Y.H.), Peking University First Hospital; Department of Cardiology (N.S.), Peking University People's Hospital; Beijing Advanced Innovation Center for Food Nutrition and Human Health (Y.S.), Key Laboratory of Functional Dairy, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing; Institute for Biomedicine (B.W.), Anhui Medical University, Hefei; Department of Cardiology (X.C.), Second Affiliated Hospital, Nanchang University; Department of Cardiology (L.Z.), Tangdu Hospital, the Fourth Military Medical University, Xi'an, China; and Department of Population, Family and Reproductive Health (X.W.), Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD
| | - Yan Zhang
- From Renal Division (X.Q., Y.L., M.L., Y.Z., X.X.), Nanfang Hospital, Southern Medical University; National Clinical Research Center for Kidney Disease (X.Q., Y.L., M.L., Y.Z., X.X.); State Key Laboratory for Organ Failure Research (X.Q., Y.L., M.L., Y.Z., X.X.), Guangzhou, China; Stroke Prevention and Atherosclerosis Research Centre (J.D.S.), Robarts Research Institute, University of Western Ontario, London, Canada; Department of Cardiology (J.L., Y.Z., Y.H.), Peking University First Hospital; Department of Cardiology (N.S.), Peking University People's Hospital; Beijing Advanced Innovation Center for Food Nutrition and Human Health (Y.S.), Key Laboratory of Functional Dairy, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing; Institute for Biomedicine (B.W.), Anhui Medical University, Hefei; Department of Cardiology (X.C.), Second Affiliated Hospital, Nanchang University; Department of Cardiology (L.Z.), Tangdu Hospital, the Fourth Military Medical University, Xi'an, China; and Department of Population, Family and Reproductive Health (X.W.), Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD
| | - Youbao Li
- From Renal Division (X.Q., Y.L., M.L., Y.Z., X.X.), Nanfang Hospital, Southern Medical University; National Clinical Research Center for Kidney Disease (X.Q., Y.L., M.L., Y.Z., X.X.); State Key Laboratory for Organ Failure Research (X.Q., Y.L., M.L., Y.Z., X.X.), Guangzhou, China; Stroke Prevention and Atherosclerosis Research Centre (J.D.S.), Robarts Research Institute, University of Western Ontario, London, Canada; Department of Cardiology (J.L., Y.Z., Y.H.), Peking University First Hospital; Department of Cardiology (N.S.), Peking University People's Hospital; Beijing Advanced Innovation Center for Food Nutrition and Human Health (Y.S.), Key Laboratory of Functional Dairy, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing; Institute for Biomedicine (B.W.), Anhui Medical University, Hefei; Department of Cardiology (X.C.), Second Affiliated Hospital, Nanchang University; Department of Cardiology (L.Z.), Tangdu Hospital, the Fourth Military Medical University, Xi'an, China; and Department of Population, Family and Reproductive Health (X.W.), Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD
| | - Ningling Sun
- From Renal Division (X.Q., Y.L., M.L., Y.Z., X.X.), Nanfang Hospital, Southern Medical University; National Clinical Research Center for Kidney Disease (X.Q., Y.L., M.L., Y.Z., X.X.); State Key Laboratory for Organ Failure Research (X.Q., Y.L., M.L., Y.Z., X.X.), Guangzhou, China; Stroke Prevention and Atherosclerosis Research Centre (J.D.S.), Robarts Research Institute, University of Western Ontario, London, Canada; Department of Cardiology (J.L., Y.Z., Y.H.), Peking University First Hospital; Department of Cardiology (N.S.), Peking University People's Hospital; Beijing Advanced Innovation Center for Food Nutrition and Human Health (Y.S.), Key Laboratory of Functional Dairy, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing; Institute for Biomedicine (B.W.), Anhui Medical University, Hefei; Department of Cardiology (X.C.), Second Affiliated Hospital, Nanchang University; Department of Cardiology (L.Z.), Tangdu Hospital, the Fourth Military Medical University, Xi'an, China; and Department of Population, Family and Reproductive Health (X.W.), Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD
| | - Min Liang
- From Renal Division (X.Q., Y.L., M.L., Y.Z., X.X.), Nanfang Hospital, Southern Medical University; National Clinical Research Center for Kidney Disease (X.Q., Y.L., M.L., Y.Z., X.X.); State Key Laboratory for Organ Failure Research (X.Q., Y.L., M.L., Y.Z., X.X.), Guangzhou, China; Stroke Prevention and Atherosclerosis Research Centre (J.D.S.), Robarts Research Institute, University of Western Ontario, London, Canada; Department of Cardiology (J.L., Y.Z., Y.H.), Peking University First Hospital; Department of Cardiology (N.S.), Peking University People's Hospital; Beijing Advanced Innovation Center for Food Nutrition and Human Health (Y.S.), Key Laboratory of Functional Dairy, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing; Institute for Biomedicine (B.W.), Anhui Medical University, Hefei; Department of Cardiology (X.C.), Second Affiliated Hospital, Nanchang University; Department of Cardiology (L.Z.), Tangdu Hospital, the Fourth Military Medical University, Xi'an, China; and Department of Population, Family and Reproductive Health (X.W.), Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD
| | - Yun Song
- From Renal Division (X.Q., Y.L., M.L., Y.Z., X.X.), Nanfang Hospital, Southern Medical University; National Clinical Research Center for Kidney Disease (X.Q., Y.L., M.L., Y.Z., X.X.); State Key Laboratory for Organ Failure Research (X.Q., Y.L., M.L., Y.Z., X.X.), Guangzhou, China; Stroke Prevention and Atherosclerosis Research Centre (J.D.S.), Robarts Research Institute, University of Western Ontario, London, Canada; Department of Cardiology (J.L., Y.Z., Y.H.), Peking University First Hospital; Department of Cardiology (N.S.), Peking University People's Hospital; Beijing Advanced Innovation Center for Food Nutrition and Human Health (Y.S.), Key Laboratory of Functional Dairy, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing; Institute for Biomedicine (B.W.), Anhui Medical University, Hefei; Department of Cardiology (X.C.), Second Affiliated Hospital, Nanchang University; Department of Cardiology (L.Z.), Tangdu Hospital, the Fourth Military Medical University, Xi'an, China; and Department of Population, Family and Reproductive Health (X.W.), Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD
| | - Yuanyuan Zhang
- From Renal Division (X.Q., Y.L., M.L., Y.Z., X.X.), Nanfang Hospital, Southern Medical University; National Clinical Research Center for Kidney Disease (X.Q., Y.L., M.L., Y.Z., X.X.); State Key Laboratory for Organ Failure Research (X.Q., Y.L., M.L., Y.Z., X.X.), Guangzhou, China; Stroke Prevention and Atherosclerosis Research Centre (J.D.S.), Robarts Research Institute, University of Western Ontario, London, Canada; Department of Cardiology (J.L., Y.Z., Y.H.), Peking University First Hospital; Department of Cardiology (N.S.), Peking University People's Hospital; Beijing Advanced Innovation Center for Food Nutrition and Human Health (Y.S.), Key Laboratory of Functional Dairy, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing; Institute for Biomedicine (B.W.), Anhui Medical University, Hefei; Department of Cardiology (X.C.), Second Affiliated Hospital, Nanchang University; Department of Cardiology (L.Z.), Tangdu Hospital, the Fourth Military Medical University, Xi'an, China; and Department of Population, Family and Reproductive Health (X.W.), Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD
| | - Binyan Wang
- From Renal Division (X.Q., Y.L., M.L., Y.Z., X.X.), Nanfang Hospital, Southern Medical University; National Clinical Research Center for Kidney Disease (X.Q., Y.L., M.L., Y.Z., X.X.); State Key Laboratory for Organ Failure Research (X.Q., Y.L., M.L., Y.Z., X.X.), Guangzhou, China; Stroke Prevention and Atherosclerosis Research Centre (J.D.S.), Robarts Research Institute, University of Western Ontario, London, Canada; Department of Cardiology (J.L., Y.Z., Y.H.), Peking University First Hospital; Department of Cardiology (N.S.), Peking University People's Hospital; Beijing Advanced Innovation Center for Food Nutrition and Human Health (Y.S.), Key Laboratory of Functional Dairy, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing; Institute for Biomedicine (B.W.), Anhui Medical University, Hefei; Department of Cardiology (X.C.), Second Affiliated Hospital, Nanchang University; Department of Cardiology (L.Z.), Tangdu Hospital, the Fourth Military Medical University, Xi'an, China; and Department of Population, Family and Reproductive Health (X.W.), Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD
| | - Xiaoshu Cheng
- From Renal Division (X.Q., Y.L., M.L., Y.Z., X.X.), Nanfang Hospital, Southern Medical University; National Clinical Research Center for Kidney Disease (X.Q., Y.L., M.L., Y.Z., X.X.); State Key Laboratory for Organ Failure Research (X.Q., Y.L., M.L., Y.Z., X.X.), Guangzhou, China; Stroke Prevention and Atherosclerosis Research Centre (J.D.S.), Robarts Research Institute, University of Western Ontario, London, Canada; Department of Cardiology (J.L., Y.Z., Y.H.), Peking University First Hospital; Department of Cardiology (N.S.), Peking University People's Hospital; Beijing Advanced Innovation Center for Food Nutrition and Human Health (Y.S.), Key Laboratory of Functional Dairy, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing; Institute for Biomedicine (B.W.), Anhui Medical University, Hefei; Department of Cardiology (X.C.), Second Affiliated Hospital, Nanchang University; Department of Cardiology (L.Z.), Tangdu Hospital, the Fourth Military Medical University, Xi'an, China; and Department of Population, Family and Reproductive Health (X.W.), Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD
| | - Lianyou Zhao
- From Renal Division (X.Q., Y.L., M.L., Y.Z., X.X.), Nanfang Hospital, Southern Medical University; National Clinical Research Center for Kidney Disease (X.Q., Y.L., M.L., Y.Z., X.X.); State Key Laboratory for Organ Failure Research (X.Q., Y.L., M.L., Y.Z., X.X.), Guangzhou, China; Stroke Prevention and Atherosclerosis Research Centre (J.D.S.), Robarts Research Institute, University of Western Ontario, London, Canada; Department of Cardiology (J.L., Y.Z., Y.H.), Peking University First Hospital; Department of Cardiology (N.S.), Peking University People's Hospital; Beijing Advanced Innovation Center for Food Nutrition and Human Health (Y.S.), Key Laboratory of Functional Dairy, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing; Institute for Biomedicine (B.W.), Anhui Medical University, Hefei; Department of Cardiology (X.C.), Second Affiliated Hospital, Nanchang University; Department of Cardiology (L.Z.), Tangdu Hospital, the Fourth Military Medical University, Xi'an, China; and Department of Population, Family and Reproductive Health (X.W.), Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD
| | - Xiaobin Wang
- From Renal Division (X.Q., Y.L., M.L., Y.Z., X.X.), Nanfang Hospital, Southern Medical University; National Clinical Research Center for Kidney Disease (X.Q., Y.L., M.L., Y.Z., X.X.); State Key Laboratory for Organ Failure Research (X.Q., Y.L., M.L., Y.Z., X.X.), Guangzhou, China; Stroke Prevention and Atherosclerosis Research Centre (J.D.S.), Robarts Research Institute, University of Western Ontario, London, Canada; Department of Cardiology (J.L., Y.Z., Y.H.), Peking University First Hospital; Department of Cardiology (N.S.), Peking University People's Hospital; Beijing Advanced Innovation Center for Food Nutrition and Human Health (Y.S.), Key Laboratory of Functional Dairy, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing; Institute for Biomedicine (B.W.), Anhui Medical University, Hefei; Department of Cardiology (X.C.), Second Affiliated Hospital, Nanchang University; Department of Cardiology (L.Z.), Tangdu Hospital, the Fourth Military Medical University, Xi'an, China; and Department of Population, Family and Reproductive Health (X.W.), Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD
| | - Xiping Xu
- From Renal Division (X.Q., Y.L., M.L., Y.Z., X.X.), Nanfang Hospital, Southern Medical University; National Clinical Research Center for Kidney Disease (X.Q., Y.L., M.L., Y.Z., X.X.); State Key Laboratory for Organ Failure Research (X.Q., Y.L., M.L., Y.Z., X.X.), Guangzhou, China; Stroke Prevention and Atherosclerosis Research Centre (J.D.S.), Robarts Research Institute, University of Western Ontario, London, Canada; Department of Cardiology (J.L., Y.Z., Y.H.), Peking University First Hospital; Department of Cardiology (N.S.), Peking University People's Hospital; Beijing Advanced Innovation Center for Food Nutrition and Human Health (Y.S.), Key Laboratory of Functional Dairy, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing; Institute for Biomedicine (B.W.), Anhui Medical University, Hefei; Department of Cardiology (X.C.), Second Affiliated Hospital, Nanchang University; Department of Cardiology (L.Z.), Tangdu Hospital, the Fourth Military Medical University, Xi'an, China; and Department of Population, Family and Reproductive Health (X.W.), Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD.
| | - Yong Huo
- From Renal Division (X.Q., Y.L., M.L., Y.Z., X.X.), Nanfang Hospital, Southern Medical University; National Clinical Research Center for Kidney Disease (X.Q., Y.L., M.L., Y.Z., X.X.); State Key Laboratory for Organ Failure Research (X.Q., Y.L., M.L., Y.Z., X.X.), Guangzhou, China; Stroke Prevention and Atherosclerosis Research Centre (J.D.S.), Robarts Research Institute, University of Western Ontario, London, Canada; Department of Cardiology (J.L., Y.Z., Y.H.), Peking University First Hospital; Department of Cardiology (N.S.), Peking University People's Hospital; Beijing Advanced Innovation Center for Food Nutrition and Human Health (Y.S.), Key Laboratory of Functional Dairy, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing; Institute for Biomedicine (B.W.), Anhui Medical University, Hefei; Department of Cardiology (X.C.), Second Affiliated Hospital, Nanchang University; Department of Cardiology (L.Z.), Tangdu Hospital, the Fourth Military Medical University, Xi'an, China; and Department of Population, Family and Reproductive Health (X.W.), Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD.
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Wu Y, Zhang Y, Gao J, Man S, Xing J, Cao Z, Song S, Wu S, Gao W. Effect of brachial-ankle pulse wave velocity combined with blood pressure on cardio-cerebrovascular events. Exp Ther Med 2019; 18:4555-4566. [PMID: 31807146 PMCID: PMC6878894 DOI: 10.3892/etm.2019.8149] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Accepted: 07/19/2019] [Indexed: 01/19/2023] Open
Abstract
The aim of the present study was to evaluate the effect of brachial-ankle pulse wave velocity (baPWV) combined with blood pressure (BP) on cardio-cerebrovascular events. Participants who received health examinations during the periods 2010-2011, 2012-2013 and 2014-2015 were recruited. The participants were divided into four groups according to their BP and baPWV levels as follows: Normotension + low baPWV, normotension + high baPWV, hypertension + low baPWV, and hypertension + high baPWV. The cumulative incidence of cardio-cerebrovascular events was calculated using life-table analysis, and the associations of BP and baPWV with cardio-cerebrovascular events were analyzed using a multivariate Cox proportional hazards regression model. Receiver operating characteristic curves were used to calculate the predictive values of baPWV combined with BP, baPWV alone or BP alone for cardio-cerebrovascular events by comparing their area under the curve (AUC) using the normal approximation method. There were 20,310 participants with a mean age of 50.13±0.09 years in the present study, including 13,240 males. A total of 278 participants developed a cardio-cerebrovascular event after a mean follow-up period of 3.34±1.82 years. The cumulative incidence of cardio-cerebrovascular events in the normotension + low baPWV, normotension + high baPWV, hypertension + low baPWV and hypertension + high baPWV groups was 0.2, 0.9, 0.8 and 3.1%. Multivariate Cox proportional hazards regression analysis showed that compared with the normotension + low baPWV group, the risks of cardio-cerebrovascular events in the normotension + high baPWV, hypertension + low baPWV and hypertension + high baPWV groups were increased after adjusting for confounding factors, and their hazard ratios (95% CI) were 4.18 (2.23-7.83), 3.00 (1.39-6.47) and 9.34 (5.14-16.96), respectively. The AUC values for the predictive values of baPWV combined with BP, baPWV alone and BP alone on cardio-cerebrovascular events were calculated to be 0.744, 0.677 and 0.698, respectively. In conclusion, high baPWV accompanied by hypertension could increase the risk of cardio-cerebrovascular events. The predictive value of baPWV combined with BP on cardio-cerebrovascular events is superior compared with that of either baPWV or BP alone.
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Affiliation(s)
- Yuntao Wu
- School of Pharmaceutical Science and Technology, Tianjin University, Tianjin 300072, P.R. China.,Department of Cardiology, Kailuan Hospital, North China University of Science and Technology, Tangshan, Hebei 063000, P.R. China
| | - Yajing Zhang
- Department of Cardiology, Kailuan Hospital, North China University of Science and Technology, Tangshan, Hebei 063000, P.R. China.,Graduate School, North China University of Science and Technology, Tangshan, Hebei 063000, P.R. China
| | - Jingsheng Gao
- Department of Cardiology, Kailuan Hospital, North China University of Science and Technology, Tangshan, Hebei 063000, P.R. China
| | - Shuli Man
- School of Pharmaceutical Science and Technology, Tianjin University, Tianjin 300072, P.R. China
| | - Jianong Xing
- Department of Cardiology, The Third People's Hospital, Tangshan, Hebei 063000, P.R. China
| | - Zhiwei Cao
- Department of Cardiology, The People's Hospital of Luanxian, Tangshan, Hebei 063000, P.R. China
| | - Shaomin Song
- Department of Cardiology, Linxi Hospital of Kailuan, Tangshan, Hebei 063000, P.R. China
| | - Shouling Wu
- Department of Cardiology, Kailuan Hospital, North China University of Science and Technology, Tangshan, Hebei 063000, P.R. China
| | - Wenyuan Gao
- School of Pharmaceutical Science and Technology, Tianjin University, Tianjin 300072, P.R. China
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30
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Zhang Y, He P, Li Y, Zhang Y, Li J, Liang M, Wang G, Tang G, Song Y, Wang B, Liu C, Liu L, Cui Y, Wang X, Huo Y, Xu X, Qin X. Positive association between baseline brachial-ankle pulse wave velocity and the risk of new-onset diabetes in hypertensive patients. Cardiovasc Diabetol 2019; 18:111. [PMID: 31462258 PMCID: PMC6714437 DOI: 10.1186/s12933-019-0915-0] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Accepted: 08/19/2019] [Indexed: 12/14/2022] Open
Abstract
Background There is no clearly defined temporal relationship between arterial stiffness and diabetes. We aimed to investigate the prospective association between baseline brachial–ankle pulse wave velocity (baPWV) and the risk of new-onset diabetes during follow-up, and examined whether there were effect modifiers, in hypertensive patients. Methods We included 2429 hypertensive patients with all the pertinent data but without diabetes at the baseline, who were part of the China Stroke Primary Prevention Trial (CSPPT), a randomized, double-blind, actively controlled trial conducted in 32 communities in Anhui and Jiangsu provinces in China. The primary outcome was new-onset diabetes, defined as physician-diagnosed diabetes or use of glucose-lowering drugs during follow-up, or fasting glucose (FG) ≥ 126.0 mg/dL at the exit visit. Results During a median follow-up duration of 4.5 years, 287 (11.8%) participants developed diabetes. There was a significant positive association between baseline baPWV and the risk of new-onset diabetes (per SD increment; OR, 1.33; 95% CI 1.13, 1.56). Consistently, when baPWV was assessed as quartiles, a significantly higher risk of new-onset diabetes was found in participants in quartiles 2–4 (≥ 15.9 m/s; OR, 1.80; 95% CI 1.22, 2.65) compared with those in quartile 1 (< 15.9 m/s). The positive association was consistent in participants with (per SD increment; OR, 1.29; 95% CI 1.06, 1.56) or without (per SD increment; OR, 1.40; 95% CI 1.15, 1.71) impaired fasting glucose (IFG, FG ≥ 100.8 and < 126.0 mg/dL, P-interaction = 0.486). Conclusions In this sample of hypertensive patients, we found a significant positive association between baseline baPWV and the risk of new-onset diabetes. Clinical trial registration Trial registration: NCT00794885 (clinicaltrials.gov). Retrospectively registered November 20, 2008
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Affiliation(s)
- Yuanyuan Zhang
- National Clinical Research Center for Kidney Disease; The State Key Laboratory for Organ Failure Research; Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China
| | - Panpan He
- National Clinical Research Center for Kidney Disease; The State Key Laboratory for Organ Failure Research; Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China
| | - Youbao Li
- National Clinical Research Center for Kidney Disease; The State Key Laboratory for Organ Failure Research; Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China
| | - Yan Zhang
- Department of Cardiology, Peking University First Hospital, Beijing, 100034, China
| | - Jianping Li
- Department of Cardiology, Peking University First Hospital, Beijing, 100034, China
| | - Min Liang
- National Clinical Research Center for Kidney Disease; The State Key Laboratory for Organ Failure Research; Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China
| | - Guobao Wang
- National Clinical Research Center for Kidney Disease; The State Key Laboratory for Organ Failure Research; Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China
| | - Genfu Tang
- Health Management College, Anhui Medical University, Hefei, 230032, China
| | - Yun Song
- Beijing Advanced Innovation Center for Food Nutrition and Human Health, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing, 100083, China.,Institute of Biomedicine, Anhui Medical University, Hefei, 230032, China
| | - Binyan Wang
- Institute of Biomedicine, Anhui Medical University, Hefei, 230032, China
| | - Chengzhang Liu
- Institute of Biomedicine, Anhui Medical University, Hefei, 230032, China
| | - Lishun Liu
- Beijing Advanced Innovation Center for Food Nutrition and Human Health, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing, 100083, China
| | - Yimin Cui
- Department of Pharmacy, Peking University First Hospital, Beijing, 100034, China
| | - Xiaobin Wang
- Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, 615 N. Wolfe Street, E4132, Baltimore, MD, 21205-2179, USA
| | - Yong Huo
- Department of Cardiology, Peking University First Hospital, Beijing, 100034, China
| | - Xiping Xu
- National Clinical Research Center for Kidney Disease; The State Key Laboratory for Organ Failure Research; Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China. .,Beijing Advanced Innovation Center for Food Nutrition and Human Health, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing, 100083, China.
| | - Xianhui Qin
- National Clinical Research Center for Kidney Disease; The State Key Laboratory for Organ Failure Research; Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China.
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31
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Hu L, Zhang Y, Huang X, Song Y, Qin X, Wang B, Zhang Y, Tang G, Li J, Li P, Bao H, Huo Y, Cheng X. Associations between Blood Pressure Indices and Brachial-ankle Pulse Wave Velocity in Treated Hypertensive Adults: results from the China Stroke Primary Prevention Trial (CSPPT). Sci Rep 2019; 9:8178. [PMID: 31160658 PMCID: PMC6547652 DOI: 10.1038/s41598-019-44740-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Accepted: 05/22/2019] [Indexed: 01/27/2023] Open
Abstract
Brachial–ankle pulse wave velocity (baPWV), as a marker of arterial stiffness, has been demonstrated to be associated with blood pressure (BP) and onset of hypertension. However, little information is available on the associations between baPWV and BP indices [systolic BP (SBP), diastolic BP (DBP), pulse pressure (PP), mean arterial pressure (MAP)] in treated hypertensive patients. We aimed to assess the associations between BP indices and baPWV. In this cross-sectional study, 14,598 hypertensive patients from China Stroke Primary Prevention Trial (CSPPT) at the exit visit of the trial were analyzed. Elevated baPWV was defined as ≥18.3 m/s. Multivariate linear and logistic regression analyses were performed to evaluate the associations of BP indices with baPWV and elevated baPWV. Moreover, the smooth curve fitting (penalized spline method) was conducted. Multivariate linear regression analyses showed that continuous SBP, DBP, PP and MAP were independently and positively associated with baPWV (β = 0.081, 0.084, 0.078 and 0.115, respectively, all P < 0.001). Compared with controlled SBP group (<140 mm Hg), uncontrolled SBP (≥140 mm Hg) was significantly associated with higher baPWV [β = 2.234, 95% confidence interval (CI): 2.137–2.332]. Similarly, compared with controlled DBP group (<90 mm Hg), uncontrolled DBP (≥90 mm Hg) was significantly associated with higher baPWV (β = 1.466, 95%CI: 1.341–1.590). Multiple logistic analyses also showed that SBP, DBP, PP and MAP were significantly and positively associated with elevated baPWV (OR = 1.056, 1.049, 1.052, and 1.075, respectively, all P < 0.001). The fully-adjusted smooth curve fitting presented a linear association between BP indices with baPWV. In conclusion, among treated hypertensive patients, SBP, DBP, PP and MAP levels were independently and positively associated with baPWV and elevated baPWV, suggesting that baPWV might be a way to predict uncontrolled BP.
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Affiliation(s)
- Lihua Hu
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang of Jiangxi, China
| | - Yuanyuan Zhang
- National Clinical Research Study Center for Kidney Disease, State Key Laboratory for Organ Failure Research, Renal Division, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Xiao Huang
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang of Jiangxi, China
| | - Yun Song
- National Clinical Research Study Center for Kidney Disease, State Key Laboratory for Organ Failure Research, Renal Division, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Xianhui Qin
- National Clinical Research Study Center for Kidney Disease, State Key Laboratory for Organ Failure Research, Renal Division, Nanfang Hospital, Southern Medical University, Guangzhou, China.,Institute of Biomedicine, Anhui Medical University, Hefei, China
| | - Binyan Wang
- National Clinical Research Study Center for Kidney Disease, State Key Laboratory for Organ Failure Research, Renal Division, Nanfang Hospital, Southern Medical University, Guangzhou, China.,Institute of Biomedicine, Anhui Medical University, Hefei, China
| | - Yan Zhang
- Department of Cardiology and Heart Center, Peking University First Hospital, Beijing, China
| | - Genfu Tang
- School of Health Administration, Anhui University, Hefei, China
| | - Jianping Li
- Department of Cardiology and Heart Center, Peking University First Hospital, Beijing, China
| | - Ping Li
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang of Jiangxi, China
| | - Huihui Bao
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang of Jiangxi, China.
| | - Yong Huo
- Department of Cardiology and Heart Center, Peking University First Hospital, Beijing, China
| | - Xiaoshu Cheng
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang of Jiangxi, China.
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32
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Tanaka A, Tomiyama H, Maruhashi T, Matsuzawa Y, Miyoshi T, Kabutoya T, Kario K, Sugiyama S, Munakata M, Ito H, Ueda S, Vlachopoulos C, Higashi Y, Inoue T, Node K. Physiological Diagnostic Criteria for Vascular Failure. Hypertension 2019; 72:1060-1071. [PMID: 30354826 DOI: 10.1161/hypertensionaha.118.11554] [Citation(s) in RCA: 170] [Impact Index Per Article: 34.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- Atsushi Tanaka
- From the Department of Cardiovascular Medicine, Saga University, Japan (A.T., K.N.)
| | - Hirofumi Tomiyama
- Department of Cardiology and Division of Preemptive Medicine for Vascular Damage, Tokyo Medical University, Japan (H.T.)
| | - Tatsuya Maruhashi
- Department of Cardiovascular Medicine, Graduate School of Biomedical and Health Sciences (T.M.), Hiroshima University, Japan
| | - Yasushi Matsuzawa
- Division of Cardiology, Yokohama City University Medical Center, Japan (Y.M.)
| | - Toru Miyoshi
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Japan (T.M., H.I.)
| | - Tomoyuki Kabutoya
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan (T.K., K.K.)
| | - Kazuomi Kario
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan (T.K., K.K.)
| | - Seigo Sugiyama
- Division of Cardiovascular Medicine, Diabetes Care Center, Jinnouchi Hospital, Kumamoto, Japan (S.S.)
| | - Masanori Munakata
- Research Center for Lifestyle-Related Disease, Tohoku Rosai Hospital, Sendai, Japan (M.M.)
| | - Hiroshi Ito
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Japan (T.M., H.I.)
| | - Shinichiro Ueda
- Department of Clinical Pharmacology and Therapeutics, University of the Ryukyu School of Medicine, Okinawa, Japan (S.U.)
| | - Charalambos Vlachopoulos
- 1st Cardiology Department, Athens Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, Greece (C.V.)
| | - Yukihito Higashi
- Department of Regeneration and Medicine, Research Center for Radiation Genome Medicine, Research Institute for Radiation Biology and Medicine (Y.H.), Hiroshima University, Japan
| | - Teruo Inoue
- Department of Cardiovascular Medicine, Dokkyo Medical University, Tochigi, Japan (T.I.)
| | - Koichi Node
- From the Department of Cardiovascular Medicine, Saga University, Japan (A.T., K.N.)
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33
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Abstract
Background Brachial–ankle pulse wave velocity (baPWV) and cardio-ankle vascular index (CAVI) are indices of arterial stiffness, and several studies have used these indices. However, there is no comprehensive review of these parameters in the prognostic significance. Methods The aim of this study was to review the articles exploring the prognostic significance of these parameters. Articles demonstrating independent significance after multivariate analysis on the Cox proportional hazards model were defined as “successful.” The success rate was compared using Fisher’s exact test. In addition, multivariate logistic regression analysis was performed to explore the independent determinants of the success of prognostic prediction. Results The success rate of the baPWV articles (65.7% [46/70]) tended to be higher than that of the CAVI articles (40.0% [6/15]; P=0.083). Multivariate analysis demonstrated that log (number of patients) (OR 11.20, 95% CI 2.45–51.70, P=0.002) and dialysis population (OR 0.28, 95% CI 0.08–0.94, P=0.039) were positive and negative independent determinants of the success of prognostic prediction, respectively. In addition, after redefining two studies as the absence of arteriosclerosis obliterans (ASO) exclusion, baPWV (OR 3.36, 95% CI 0.86–13.20, P=0.083) and the existence of exclusion criteria of ASO (OR 3.08, 95% CI 0.96–9.93, P=0.060) exhibited statistical tendency in the multivariate analysis. Conclusion This study demonstrated that the number of study participants and dialysis population were the independent determinants of the success of prognostic prediction. This study also showed the importance of exclusion criteria of ASO when using these indices. In addition, a prospective large-scale study to confirm the superiority in the prognostic prediction of these indices is warranted.
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Affiliation(s)
- Dai Ato
- Gakujutsu Shien Co., Ltd, Tokyo, Japan,
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34
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Brachial-Ankle Pulse Wave Velocity is Associated with the Risk of New Carotid Plaque Formation: Data from a Chinese Community-based Cohort. Sci Rep 2018; 8:7037. [PMID: 29728607 PMCID: PMC5935681 DOI: 10.1038/s41598-018-25579-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Accepted: 04/24/2018] [Indexed: 01/15/2023] Open
Abstract
Artery stiffness is an independent marker for atherosclerotic cardiovascular diseases. However, whether the brachial-ankle pulse wave velocity (ba-PWV) is related to new carotid plaque formation is unresolved. This study aimed to investigate the association between baseline ba-PWV and new carotid plaque formation in a Chinese community-based population without carotid plaques at baseline. This study population consisted of a total of 738 participants from an atherosclerosis cohort in Beijing, China. After a mean 2.3-year follow-up, the incidence of carotid plaques were 21.2% and 36.5% in the groups with ba-PWV < 1,400 cm/s and ≥1,400 cm/s, respectively. Compared with baseline ba-PWV < 1,400 cm/s group, ba-PWV ≥ 1,400 cm/s group was significantly associated with the incidence of new carotid plaque formation (odds ratio [OR] = 2.14, 95% CI: 1.50–3.03, P < 0.01), even after adjusting for common risk factors (OR = 1.52, 95% CI: 1.02–2.25, P = 0.04). Furthermore, there was a strong relationship between baseline ba-PWV and carotid plaque formation in subjects with ba-PWV < 1,400 cm/s, but no such relationship was found in subjects with baseline ba-PWV ≥ 1,400 cm/s. In conclusion, this study suggests that baseline ba-PWV is independently associated with the risk of carotid plaque formation in a Chinese community-based population.
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35
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Chen L, Wang B, Wang J, Ban Q, Wu H, Song Y, Zhang J, Cao J, Zhou Z, Liu L, Cao T, Gao L, Guo H, Zhang T, Tang G, Huang X, Zhang Y, Li J, Huo Y, Cheng X, Zang T, Xu X, Zhang H, Qin X. Association between serum total homocysteine and arterial stiffness in adults: a community-based study. J Clin Hypertens (Greenwich) 2018; 20:686-693. [PMID: 29481715 DOI: 10.1111/jch.13246] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Revised: 01/17/2018] [Accepted: 01/28/2018] [Indexed: 02/03/2023]
Abstract
Both increased arterial stiffness and higher total homocysteine (tHcy) are associated with an elevated risk for cardiovascular disease. However, the relationship between tHcy and arterial stiffness is still inconclusive. The authors aimed to test the relationship of tHcy with carotid-femoral pulse wave velocity (cfPWV) and examine the possible effect modifiers in adults. A study was conducted from July to September 2016 in Jiangsu Province, China. A total of 16 644 participants were enrolled in the final analysis. Increased arterial stiffness is defined as a cfPWV ≥10 m/s. Overall, there was a positive association between tHcy and cfPWV levels (per 5-μmol/L tHcy increase: β = 0.10; 95% confidence interval [CI], 0.08-0.13) and increased arterial stiffness (per 5-μmol/L tHcy increase: odds ratio, 1.11; 95% CI, 1.07-1.14). Compared with participants with tHcy <10 μmol/L, the significantly higher cfPWV levels were observed in those with tHcy ≥15 μmol/L (β = 0.37; 95% CI, 0.28-0.47). Accordingly, a higher prevalence of increased arterial stiffness was found in patients with tHcy10 to <15 μmol/L (odds ratio, 1.18; 95% CI, 1.05-1.33) and tHcy ≥15 μmol/L (odds ratio, 1.50; 95% CI, 1.32-1.71) as compared with participants with tHcy <10 μmol/L. Furthermore, the stronger positive association was found in participants who were older (≥60 years, P for interaction = .008), had low body mass index (<25 kg/m2 , P for interaction = .026), high systolic blood pressure levels (≥145 mm Hg [median], P for interaction = .048), or diabetes mellitus (P for interaction = .045). The present study demonstrated that serum tHcy concentrations were positively associated with cfPWV and the prevalence of increased arterial stiffness. These results suggest that the cardiovascular effects of tHcy may partly be mediated through arterial stiffness.
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Affiliation(s)
- Lulu Chen
- Institute of Biomedicine, Anhui Medical University, Hefei, China
| | - Binyan Wang
- Institute of Biomedicine, Anhui Medical University, Hefei, China
| | - Jiancheng Wang
- National Clinical Research Study Center for Kidney Disease, State Key Laboratory for Organ Failure Research, Renal Division, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Qianyun Ban
- Institute of Biomedicine, Anhui Medical University, Hefei, China
| | - Hongxu Wu
- Institute of Biomedicine, Anhui Medical University, Hefei, China
| | - Yun Song
- Beijing Advanced Innovation Center for Food Nutrition and Human Health, the Key Laboratory for Functional Dairy, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing, China
| | - Jingping Zhang
- Institute of Biomedicine, Anhui Medical University, Hefei, China
| | - Jingjing Cao
- Institute of Biomedicine, Anhui Medical University, Hefei, China
| | - Ziyi Zhou
- Beijing Advanced Innovation Center for Food Nutrition and Human Health, the Key Laboratory for Functional Dairy, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing, China
| | - Lishun Liu
- Beijing Advanced Innovation Center for Food Nutrition and Human Health, the Key Laboratory for Functional Dairy, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing, China
| | - Tianyu Cao
- University of California, Santa Barbara, CA, USA
| | - Lan Gao
- Department of Cardiology, Peking University First Hospital, Beijing, China
| | - Huiyuan Guo
- Beijing Advanced Innovation Center for Food Nutrition and Human Health, the Key Laboratory for Functional Dairy, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing, China
| | - Tao Zhang
- Nanshan Center for Chronic Disease Control, Shenzhen, China
| | - Genfu Tang
- Institute of Biomedicine, Anhui Medical University, Hefei, China
| | - Xiao Huang
- Department of Cardiology, Second Affiliated Hospital, Nanchang University, Nanchang, China
| | - Yan Zhang
- Department of Cardiology, Peking University First Hospital, Beijing, China
| | - Jianping Li
- Department of Cardiology, Peking University First Hospital, Beijing, China
| | - Yong Huo
- Department of Cardiology, Peking University First Hospital, Beijing, China
| | - Xiaoshu Cheng
- Department of Cardiology, Second Affiliated Hospital, Nanchang University, Nanchang, China
| | - Tonghua Zang
- Institute of Biomedicine, Anhui Medical University, Hefei, China
| | - Xiping Xu
- Institute of Biomedicine, Anhui Medical University, Hefei, China.,National Clinical Research Study Center for Kidney Disease, State Key Laboratory for Organ Failure Research, Renal Division, Nanfang Hospital, Southern Medical University, Guangzhou, China.,Beijing Advanced Innovation Center for Food Nutrition and Human Health, the Key Laboratory for Functional Dairy, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing, China
| | - Hao Zhang
- Beijing Advanced Innovation Center for Food Nutrition and Human Health, the Key Laboratory for Functional Dairy, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing, China
| | - Xianhui Qin
- Institute of Biomedicine, Anhui Medical University, Hefei, China.,National Clinical Research Study Center for Kidney Disease, State Key Laboratory for Organ Failure Research, Renal Division, Nanfang Hospital, Southern Medical University, Guangzhou, China
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36
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Doumas M, Imprialos KP, Stavropoulos K, Athyros VG. Peripheral arterial stiffness as a surrogate of central hemodynamics: A new era for cardiovascular risk estimation? J Clin Hypertens (Greenwich) 2018; 20:469-471. [PMID: 29370478 DOI: 10.1111/jch.13204] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- Michael Doumas
- Veterans Affairs Medical Center, George Washington University, Washington, DC, USA
| | - Konstantinos P Imprialos
- Second Propedeutic Department of Internal Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Konstantinos Stavropoulos
- Second Propedeutic Department of Internal Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Vasilios G Athyros
- Second Propedeutic Department of Internal Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Huang X, Qin X, Yang W, Liu L, Jiang C, Zhang X, Jiang S, Bao H, Su H, Li P, He M, Song Y, Zhao M, Yin D, Wang Y, Zhang Y, Li J, Yang R, Wu Y, Hong K, Wu Q, Chen Y, Sun N, Li X, Tang G, Wang B, Cai Y, Hou FF, Huo Y, Wang H, Wang X, Cheng X. MTHFR Gene and Serum Folate Interaction on Serum Homocysteine Lowering: Prospect for Precision Folic Acid Treatment. Arterioscler Thromb Vasc Biol 2018; 38:679-685. [PMID: 29371246 DOI: 10.1161/atvbaha.117.310211] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Accepted: 01/11/2018] [Indexed: 12/17/2022]
Abstract
OBJECTIVE This post hoc analysis of the CSPPT (China Stroke Primary Prevention Trial) assessed the individual variation in total homocysteine (tHcy)-lowering response after an average 4.5 years of 0.8 mg daily folic acid therapy in Chinese hypertensive adults and evaluated effect modification by methylenetetrahydrofolate reductase (MTHFR) C677T genotypes and serum folate levels. APPROACH AND RESULTS This analysis included 16 413 participants from the CSPPT, who were randomly assigned to 2 double-blind treatment groups: either 10-mg enalapril+0.8-mg folic acid or 10-mg enalapril, daily and had individual measurements of serum folate and tHcy levels at baseline and exit visits and MTHFR C677T genotypes. Mean baseline tHcy levels were comparable between the 2 treatment groups (14.5±8.5 versus 14.4±8.1 μmol/L; P=0.561). After 4.5 years of treatment, mean tHcy levels were reduced to 12.7±6.1 μmol/L in the enalapril+folic acid group, but almost stayed the same in the enalapril group (14.4±7.9 μmol/L, group difference: 1.61 μmol/L; 11% reduction). More importantly, tHcy lowering varied by MTHFR genotypes and serum folate levels. Compared with CC and CT genotypes, participants with the TT genotype had a more prominent L-shaped curve between tHcy and serum folate levels and required higher folate levels (at least 15 ng/mL) to eliminate the differences in tHcy by genotypes. CONCLUSIONS Compared with CC or CT, tHcy in the TT group manifested a heightened L-shaped curve from low to high folate levels, but this difference in tHcy by genotype was eliminated when plasma folate levels reach ≈15 ng/mL or higher. Our data raised the prospect to tailor folic acid therapy according to individual MTHFR C677T genotype and folate status. CLINICAL TRIAL REGISTRATION URL: http://www.clinicaltrials.gov. Unique identifier: NCT00794885.
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Affiliation(s)
- Xiao Huang
- From the Department of Cardiology, The Second Affiliated Hospital of Nanchang University, China (X.H., H.B., H.S., P.L., R.Y., Y. Wu, K.H., Q.W., X.C.); National Clinical Research Study Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Renal Division, Nanfang Hospital, Southern Medical University, Guangzhou, China (X.Q., C.J., X.Z., Y.S., Y. Wang, B.W., F.F.H.); Institute of Biomedicine, Anhui Medical University, Hefei, China (W.Y., S.J.); China Agricultural University, Beijing (L.L.); School of Life Sciences, Anhui University, Hefei, China (S.J., G.T.); Department of Neurology, First People's Hospital, Lianyungang, China (M.H.); Department of Neurology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China (M.Z., Y. Cai); Department of Cardiology, The First Affiliated Hospital of Soochow University, Suzhou, China (D.Y.); Department of Cardiology, Peking University First Hospital, Beijing, China (Y.Z., J.L., Y.H.); Department of Cardiology, General Hospital of PLA, Beijing, China (Y. Chen); Department of Cardiology, Peking University People's Hospital, Beijing, China (N.S.); Department of Geriatric Cardiology, the General Hospital of the People's Liberation Army, Beijing, China (X.L.); Centers for Metabolic Disease Research, Temple University School of Medicine, Philadelphia, PA (H.W.); and Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD (X.W.)
| | - Xianhui Qin
- From the Department of Cardiology, The Second Affiliated Hospital of Nanchang University, China (X.H., H.B., H.S., P.L., R.Y., Y. Wu, K.H., Q.W., X.C.); National Clinical Research Study Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Renal Division, Nanfang Hospital, Southern Medical University, Guangzhou, China (X.Q., C.J., X.Z., Y.S., Y. Wang, B.W., F.F.H.); Institute of Biomedicine, Anhui Medical University, Hefei, China (W.Y., S.J.); China Agricultural University, Beijing (L.L.); School of Life Sciences, Anhui University, Hefei, China (S.J., G.T.); Department of Neurology, First People's Hospital, Lianyungang, China (M.H.); Department of Neurology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China (M.Z., Y. Cai); Department of Cardiology, The First Affiliated Hospital of Soochow University, Suzhou, China (D.Y.); Department of Cardiology, Peking University First Hospital, Beijing, China (Y.Z., J.L., Y.H.); Department of Cardiology, General Hospital of PLA, Beijing, China (Y. Chen); Department of Cardiology, Peking University People's Hospital, Beijing, China (N.S.); Department of Geriatric Cardiology, the General Hospital of the People's Liberation Army, Beijing, China (X.L.); Centers for Metabolic Disease Research, Temple University School of Medicine, Philadelphia, PA (H.W.); and Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD (X.W.)
| | - Wenbin Yang
- From the Department of Cardiology, The Second Affiliated Hospital of Nanchang University, China (X.H., H.B., H.S., P.L., R.Y., Y. Wu, K.H., Q.W., X.C.); National Clinical Research Study Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Renal Division, Nanfang Hospital, Southern Medical University, Guangzhou, China (X.Q., C.J., X.Z., Y.S., Y. Wang, B.W., F.F.H.); Institute of Biomedicine, Anhui Medical University, Hefei, China (W.Y., S.J.); China Agricultural University, Beijing (L.L.); School of Life Sciences, Anhui University, Hefei, China (S.J., G.T.); Department of Neurology, First People's Hospital, Lianyungang, China (M.H.); Department of Neurology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China (M.Z., Y. Cai); Department of Cardiology, The First Affiliated Hospital of Soochow University, Suzhou, China (D.Y.); Department of Cardiology, Peking University First Hospital, Beijing, China (Y.Z., J.L., Y.H.); Department of Cardiology, General Hospital of PLA, Beijing, China (Y. Chen); Department of Cardiology, Peking University People's Hospital, Beijing, China (N.S.); Department of Geriatric Cardiology, the General Hospital of the People's Liberation Army, Beijing, China (X.L.); Centers for Metabolic Disease Research, Temple University School of Medicine, Philadelphia, PA (H.W.); and Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD (X.W.)
| | - Lishun Liu
- From the Department of Cardiology, The Second Affiliated Hospital of Nanchang University, China (X.H., H.B., H.S., P.L., R.Y., Y. Wu, K.H., Q.W., X.C.); National Clinical Research Study Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Renal Division, Nanfang Hospital, Southern Medical University, Guangzhou, China (X.Q., C.J., X.Z., Y.S., Y. Wang, B.W., F.F.H.); Institute of Biomedicine, Anhui Medical University, Hefei, China (W.Y., S.J.); China Agricultural University, Beijing (L.L.); School of Life Sciences, Anhui University, Hefei, China (S.J., G.T.); Department of Neurology, First People's Hospital, Lianyungang, China (M.H.); Department of Neurology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China (M.Z., Y. Cai); Department of Cardiology, The First Affiliated Hospital of Soochow University, Suzhou, China (D.Y.); Department of Cardiology, Peking University First Hospital, Beijing, China (Y.Z., J.L., Y.H.); Department of Cardiology, General Hospital of PLA, Beijing, China (Y. Chen); Department of Cardiology, Peking University People's Hospital, Beijing, China (N.S.); Department of Geriatric Cardiology, the General Hospital of the People's Liberation Army, Beijing, China (X.L.); Centers for Metabolic Disease Research, Temple University School of Medicine, Philadelphia, PA (H.W.); and Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD (X.W.)
| | - Chongfei Jiang
- From the Department of Cardiology, The Second Affiliated Hospital of Nanchang University, China (X.H., H.B., H.S., P.L., R.Y., Y. Wu, K.H., Q.W., X.C.); National Clinical Research Study Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Renal Division, Nanfang Hospital, Southern Medical University, Guangzhou, China (X.Q., C.J., X.Z., Y.S., Y. Wang, B.W., F.F.H.); Institute of Biomedicine, Anhui Medical University, Hefei, China (W.Y., S.J.); China Agricultural University, Beijing (L.L.); School of Life Sciences, Anhui University, Hefei, China (S.J., G.T.); Department of Neurology, First People's Hospital, Lianyungang, China (M.H.); Department of Neurology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China (M.Z., Y. Cai); Department of Cardiology, The First Affiliated Hospital of Soochow University, Suzhou, China (D.Y.); Department of Cardiology, Peking University First Hospital, Beijing, China (Y.Z., J.L., Y.H.); Department of Cardiology, General Hospital of PLA, Beijing, China (Y. Chen); Department of Cardiology, Peking University People's Hospital, Beijing, China (N.S.); Department of Geriatric Cardiology, the General Hospital of the People's Liberation Army, Beijing, China (X.L.); Centers for Metabolic Disease Research, Temple University School of Medicine, Philadelphia, PA (H.W.); and Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD (X.W.)
| | - Xianglin Zhang
- From the Department of Cardiology, The Second Affiliated Hospital of Nanchang University, China (X.H., H.B., H.S., P.L., R.Y., Y. Wu, K.H., Q.W., X.C.); National Clinical Research Study Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Renal Division, Nanfang Hospital, Southern Medical University, Guangzhou, China (X.Q., C.J., X.Z., Y.S., Y. Wang, B.W., F.F.H.); Institute of Biomedicine, Anhui Medical University, Hefei, China (W.Y., S.J.); China Agricultural University, Beijing (L.L.); School of Life Sciences, Anhui University, Hefei, China (S.J., G.T.); Department of Neurology, First People's Hospital, Lianyungang, China (M.H.); Department of Neurology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China (M.Z., Y. Cai); Department of Cardiology, The First Affiliated Hospital of Soochow University, Suzhou, China (D.Y.); Department of Cardiology, Peking University First Hospital, Beijing, China (Y.Z., J.L., Y.H.); Department of Cardiology, General Hospital of PLA, Beijing, China (Y. Chen); Department of Cardiology, Peking University People's Hospital, Beijing, China (N.S.); Department of Geriatric Cardiology, the General Hospital of the People's Liberation Army, Beijing, China (X.L.); Centers for Metabolic Disease Research, Temple University School of Medicine, Philadelphia, PA (H.W.); and Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD (X.W.)
| | - Shanqun Jiang
- From the Department of Cardiology, The Second Affiliated Hospital of Nanchang University, China (X.H., H.B., H.S., P.L., R.Y., Y. Wu, K.H., Q.W., X.C.); National Clinical Research Study Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Renal Division, Nanfang Hospital, Southern Medical University, Guangzhou, China (X.Q., C.J., X.Z., Y.S., Y. Wang, B.W., F.F.H.); Institute of Biomedicine, Anhui Medical University, Hefei, China (W.Y., S.J.); China Agricultural University, Beijing (L.L.); School of Life Sciences, Anhui University, Hefei, China (S.J., G.T.); Department of Neurology, First People's Hospital, Lianyungang, China (M.H.); Department of Neurology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China (M.Z., Y. Cai); Department of Cardiology, The First Affiliated Hospital of Soochow University, Suzhou, China (D.Y.); Department of Cardiology, Peking University First Hospital, Beijing, China (Y.Z., J.L., Y.H.); Department of Cardiology, General Hospital of PLA, Beijing, China (Y. Chen); Department of Cardiology, Peking University People's Hospital, Beijing, China (N.S.); Department of Geriatric Cardiology, the General Hospital of the People's Liberation Army, Beijing, China (X.L.); Centers for Metabolic Disease Research, Temple University School of Medicine, Philadelphia, PA (H.W.); and Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD (X.W.)
| | - Huihui Bao
- From the Department of Cardiology, The Second Affiliated Hospital of Nanchang University, China (X.H., H.B., H.S., P.L., R.Y., Y. Wu, K.H., Q.W., X.C.); National Clinical Research Study Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Renal Division, Nanfang Hospital, Southern Medical University, Guangzhou, China (X.Q., C.J., X.Z., Y.S., Y. Wang, B.W., F.F.H.); Institute of Biomedicine, Anhui Medical University, Hefei, China (W.Y., S.J.); China Agricultural University, Beijing (L.L.); School of Life Sciences, Anhui University, Hefei, China (S.J., G.T.); Department of Neurology, First People's Hospital, Lianyungang, China (M.H.); Department of Neurology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China (M.Z., Y. Cai); Department of Cardiology, The First Affiliated Hospital of Soochow University, Suzhou, China (D.Y.); Department of Cardiology, Peking University First Hospital, Beijing, China (Y.Z., J.L., Y.H.); Department of Cardiology, General Hospital of PLA, Beijing, China (Y. Chen); Department of Cardiology, Peking University People's Hospital, Beijing, China (N.S.); Department of Geriatric Cardiology, the General Hospital of the People's Liberation Army, Beijing, China (X.L.); Centers for Metabolic Disease Research, Temple University School of Medicine, Philadelphia, PA (H.W.); and Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD (X.W.)
| | - Hai Su
- From the Department of Cardiology, The Second Affiliated Hospital of Nanchang University, China (X.H., H.B., H.S., P.L., R.Y., Y. Wu, K.H., Q.W., X.C.); National Clinical Research Study Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Renal Division, Nanfang Hospital, Southern Medical University, Guangzhou, China (X.Q., C.J., X.Z., Y.S., Y. Wang, B.W., F.F.H.); Institute of Biomedicine, Anhui Medical University, Hefei, China (W.Y., S.J.); China Agricultural University, Beijing (L.L.); School of Life Sciences, Anhui University, Hefei, China (S.J., G.T.); Department of Neurology, First People's Hospital, Lianyungang, China (M.H.); Department of Neurology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China (M.Z., Y. Cai); Department of Cardiology, The First Affiliated Hospital of Soochow University, Suzhou, China (D.Y.); Department of Cardiology, Peking University First Hospital, Beijing, China (Y.Z., J.L., Y.H.); Department of Cardiology, General Hospital of PLA, Beijing, China (Y. Chen); Department of Cardiology, Peking University People's Hospital, Beijing, China (N.S.); Department of Geriatric Cardiology, the General Hospital of the People's Liberation Army, Beijing, China (X.L.); Centers for Metabolic Disease Research, Temple University School of Medicine, Philadelphia, PA (H.W.); and Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD (X.W.)
| | - Ping Li
- From the Department of Cardiology, The Second Affiliated Hospital of Nanchang University, China (X.H., H.B., H.S., P.L., R.Y., Y. Wu, K.H., Q.W., X.C.); National Clinical Research Study Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Renal Division, Nanfang Hospital, Southern Medical University, Guangzhou, China (X.Q., C.J., X.Z., Y.S., Y. Wang, B.W., F.F.H.); Institute of Biomedicine, Anhui Medical University, Hefei, China (W.Y., S.J.); China Agricultural University, Beijing (L.L.); School of Life Sciences, Anhui University, Hefei, China (S.J., G.T.); Department of Neurology, First People's Hospital, Lianyungang, China (M.H.); Department of Neurology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China (M.Z., Y. Cai); Department of Cardiology, The First Affiliated Hospital of Soochow University, Suzhou, China (D.Y.); Department of Cardiology, Peking University First Hospital, Beijing, China (Y.Z., J.L., Y.H.); Department of Cardiology, General Hospital of PLA, Beijing, China (Y. Chen); Department of Cardiology, Peking University People's Hospital, Beijing, China (N.S.); Department of Geriatric Cardiology, the General Hospital of the People's Liberation Army, Beijing, China (X.L.); Centers for Metabolic Disease Research, Temple University School of Medicine, Philadelphia, PA (H.W.); and Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD (X.W.)
| | - Mingli He
- From the Department of Cardiology, The Second Affiliated Hospital of Nanchang University, China (X.H., H.B., H.S., P.L., R.Y., Y. Wu, K.H., Q.W., X.C.); National Clinical Research Study Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Renal Division, Nanfang Hospital, Southern Medical University, Guangzhou, China (X.Q., C.J., X.Z., Y.S., Y. Wang, B.W., F.F.H.); Institute of Biomedicine, Anhui Medical University, Hefei, China (W.Y., S.J.); China Agricultural University, Beijing (L.L.); School of Life Sciences, Anhui University, Hefei, China (S.J., G.T.); Department of Neurology, First People's Hospital, Lianyungang, China (M.H.); Department of Neurology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China (M.Z., Y. Cai); Department of Cardiology, The First Affiliated Hospital of Soochow University, Suzhou, China (D.Y.); Department of Cardiology, Peking University First Hospital, Beijing, China (Y.Z., J.L., Y.H.); Department of Cardiology, General Hospital of PLA, Beijing, China (Y. Chen); Department of Cardiology, Peking University People's Hospital, Beijing, China (N.S.); Department of Geriatric Cardiology, the General Hospital of the People's Liberation Army, Beijing, China (X.L.); Centers for Metabolic Disease Research, Temple University School of Medicine, Philadelphia, PA (H.W.); and Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD (X.W.)
| | - Yun Song
- From the Department of Cardiology, The Second Affiliated Hospital of Nanchang University, China (X.H., H.B., H.S., P.L., R.Y., Y. Wu, K.H., Q.W., X.C.); National Clinical Research Study Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Renal Division, Nanfang Hospital, Southern Medical University, Guangzhou, China (X.Q., C.J., X.Z., Y.S., Y. Wang, B.W., F.F.H.); Institute of Biomedicine, Anhui Medical University, Hefei, China (W.Y., S.J.); China Agricultural University, Beijing (L.L.); School of Life Sciences, Anhui University, Hefei, China (S.J., G.T.); Department of Neurology, First People's Hospital, Lianyungang, China (M.H.); Department of Neurology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China (M.Z., Y. Cai); Department of Cardiology, The First Affiliated Hospital of Soochow University, Suzhou, China (D.Y.); Department of Cardiology, Peking University First Hospital, Beijing, China (Y.Z., J.L., Y.H.); Department of Cardiology, General Hospital of PLA, Beijing, China (Y. Chen); Department of Cardiology, Peking University People's Hospital, Beijing, China (N.S.); Department of Geriatric Cardiology, the General Hospital of the People's Liberation Army, Beijing, China (X.L.); Centers for Metabolic Disease Research, Temple University School of Medicine, Philadelphia, PA (H.W.); and Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD (X.W.)
| | - Min Zhao
- From the Department of Cardiology, The Second Affiliated Hospital of Nanchang University, China (X.H., H.B., H.S., P.L., R.Y., Y. Wu, K.H., Q.W., X.C.); National Clinical Research Study Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Renal Division, Nanfang Hospital, Southern Medical University, Guangzhou, China (X.Q., C.J., X.Z., Y.S., Y. Wang, B.W., F.F.H.); Institute of Biomedicine, Anhui Medical University, Hefei, China (W.Y., S.J.); China Agricultural University, Beijing (L.L.); School of Life Sciences, Anhui University, Hefei, China (S.J., G.T.); Department of Neurology, First People's Hospital, Lianyungang, China (M.H.); Department of Neurology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China (M.Z., Y. Cai); Department of Cardiology, The First Affiliated Hospital of Soochow University, Suzhou, China (D.Y.); Department of Cardiology, Peking University First Hospital, Beijing, China (Y.Z., J.L., Y.H.); Department of Cardiology, General Hospital of PLA, Beijing, China (Y. Chen); Department of Cardiology, Peking University People's Hospital, Beijing, China (N.S.); Department of Geriatric Cardiology, the General Hospital of the People's Liberation Army, Beijing, China (X.L.); Centers for Metabolic Disease Research, Temple University School of Medicine, Philadelphia, PA (H.W.); and Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD (X.W.)
| | - Delu Yin
- From the Department of Cardiology, The Second Affiliated Hospital of Nanchang University, China (X.H., H.B., H.S., P.L., R.Y., Y. Wu, K.H., Q.W., X.C.); National Clinical Research Study Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Renal Division, Nanfang Hospital, Southern Medical University, Guangzhou, China (X.Q., C.J., X.Z., Y.S., Y. Wang, B.W., F.F.H.); Institute of Biomedicine, Anhui Medical University, Hefei, China (W.Y., S.J.); China Agricultural University, Beijing (L.L.); School of Life Sciences, Anhui University, Hefei, China (S.J., G.T.); Department of Neurology, First People's Hospital, Lianyungang, China (M.H.); Department of Neurology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China (M.Z., Y. Cai); Department of Cardiology, The First Affiliated Hospital of Soochow University, Suzhou, China (D.Y.); Department of Cardiology, Peking University First Hospital, Beijing, China (Y.Z., J.L., Y.H.); Department of Cardiology, General Hospital of PLA, Beijing, China (Y. Chen); Department of Cardiology, Peking University People's Hospital, Beijing, China (N.S.); Department of Geriatric Cardiology, the General Hospital of the People's Liberation Army, Beijing, China (X.L.); Centers for Metabolic Disease Research, Temple University School of Medicine, Philadelphia, PA (H.W.); and Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD (X.W.)
| | - Yu Wang
- From the Department of Cardiology, The Second Affiliated Hospital of Nanchang University, China (X.H., H.B., H.S., P.L., R.Y., Y. Wu, K.H., Q.W., X.C.); National Clinical Research Study Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Renal Division, Nanfang Hospital, Southern Medical University, Guangzhou, China (X.Q., C.J., X.Z., Y.S., Y. Wang, B.W., F.F.H.); Institute of Biomedicine, Anhui Medical University, Hefei, China (W.Y., S.J.); China Agricultural University, Beijing (L.L.); School of Life Sciences, Anhui University, Hefei, China (S.J., G.T.); Department of Neurology, First People's Hospital, Lianyungang, China (M.H.); Department of Neurology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China (M.Z., Y. Cai); Department of Cardiology, The First Affiliated Hospital of Soochow University, Suzhou, China (D.Y.); Department of Cardiology, Peking University First Hospital, Beijing, China (Y.Z., J.L., Y.H.); Department of Cardiology, General Hospital of PLA, Beijing, China (Y. Chen); Department of Cardiology, Peking University People's Hospital, Beijing, China (N.S.); Department of Geriatric Cardiology, the General Hospital of the People's Liberation Army, Beijing, China (X.L.); Centers for Metabolic Disease Research, Temple University School of Medicine, Philadelphia, PA (H.W.); and Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD (X.W.)
| | - Yan Zhang
- From the Department of Cardiology, The Second Affiliated Hospital of Nanchang University, China (X.H., H.B., H.S., P.L., R.Y., Y. Wu, K.H., Q.W., X.C.); National Clinical Research Study Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Renal Division, Nanfang Hospital, Southern Medical University, Guangzhou, China (X.Q., C.J., X.Z., Y.S., Y. Wang, B.W., F.F.H.); Institute of Biomedicine, Anhui Medical University, Hefei, China (W.Y., S.J.); China Agricultural University, Beijing (L.L.); School of Life Sciences, Anhui University, Hefei, China (S.J., G.T.); Department of Neurology, First People's Hospital, Lianyungang, China (M.H.); Department of Neurology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China (M.Z., Y. Cai); Department of Cardiology, The First Affiliated Hospital of Soochow University, Suzhou, China (D.Y.); Department of Cardiology, Peking University First Hospital, Beijing, China (Y.Z., J.L., Y.H.); Department of Cardiology, General Hospital of PLA, Beijing, China (Y. Chen); Department of Cardiology, Peking University People's Hospital, Beijing, China (N.S.); Department of Geriatric Cardiology, the General Hospital of the People's Liberation Army, Beijing, China (X.L.); Centers for Metabolic Disease Research, Temple University School of Medicine, Philadelphia, PA (H.W.); and Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD (X.W.)
| | - Jianping Li
- From the Department of Cardiology, The Second Affiliated Hospital of Nanchang University, China (X.H., H.B., H.S., P.L., R.Y., Y. Wu, K.H., Q.W., X.C.); National Clinical Research Study Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Renal Division, Nanfang Hospital, Southern Medical University, Guangzhou, China (X.Q., C.J., X.Z., Y.S., Y. Wang, B.W., F.F.H.); Institute of Biomedicine, Anhui Medical University, Hefei, China (W.Y., S.J.); China Agricultural University, Beijing (L.L.); School of Life Sciences, Anhui University, Hefei, China (S.J., G.T.); Department of Neurology, First People's Hospital, Lianyungang, China (M.H.); Department of Neurology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China (M.Z., Y. Cai); Department of Cardiology, The First Affiliated Hospital of Soochow University, Suzhou, China (D.Y.); Department of Cardiology, Peking University First Hospital, Beijing, China (Y.Z., J.L., Y.H.); Department of Cardiology, General Hospital of PLA, Beijing, China (Y. Chen); Department of Cardiology, Peking University People's Hospital, Beijing, China (N.S.); Department of Geriatric Cardiology, the General Hospital of the People's Liberation Army, Beijing, China (X.L.); Centers for Metabolic Disease Research, Temple University School of Medicine, Philadelphia, PA (H.W.); and Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD (X.W.)
| | - Renqang Yang
- From the Department of Cardiology, The Second Affiliated Hospital of Nanchang University, China (X.H., H.B., H.S., P.L., R.Y., Y. Wu, K.H., Q.W., X.C.); National Clinical Research Study Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Renal Division, Nanfang Hospital, Southern Medical University, Guangzhou, China (X.Q., C.J., X.Z., Y.S., Y. Wang, B.W., F.F.H.); Institute of Biomedicine, Anhui Medical University, Hefei, China (W.Y., S.J.); China Agricultural University, Beijing (L.L.); School of Life Sciences, Anhui University, Hefei, China (S.J., G.T.); Department of Neurology, First People's Hospital, Lianyungang, China (M.H.); Department of Neurology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China (M.Z., Y. Cai); Department of Cardiology, The First Affiliated Hospital of Soochow University, Suzhou, China (D.Y.); Department of Cardiology, Peking University First Hospital, Beijing, China (Y.Z., J.L., Y.H.); Department of Cardiology, General Hospital of PLA, Beijing, China (Y. Chen); Department of Cardiology, Peking University People's Hospital, Beijing, China (N.S.); Department of Geriatric Cardiology, the General Hospital of the People's Liberation Army, Beijing, China (X.L.); Centers for Metabolic Disease Research, Temple University School of Medicine, Philadelphia, PA (H.W.); and Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD (X.W.)
| | - Yanqing Wu
- From the Department of Cardiology, The Second Affiliated Hospital of Nanchang University, China (X.H., H.B., H.S., P.L., R.Y., Y. Wu, K.H., Q.W., X.C.); National Clinical Research Study Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Renal Division, Nanfang Hospital, Southern Medical University, Guangzhou, China (X.Q., C.J., X.Z., Y.S., Y. Wang, B.W., F.F.H.); Institute of Biomedicine, Anhui Medical University, Hefei, China (W.Y., S.J.); China Agricultural University, Beijing (L.L.); School of Life Sciences, Anhui University, Hefei, China (S.J., G.T.); Department of Neurology, First People's Hospital, Lianyungang, China (M.H.); Department of Neurology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China (M.Z., Y. Cai); Department of Cardiology, The First Affiliated Hospital of Soochow University, Suzhou, China (D.Y.); Department of Cardiology, Peking University First Hospital, Beijing, China (Y.Z., J.L., Y.H.); Department of Cardiology, General Hospital of PLA, Beijing, China (Y. Chen); Department of Cardiology, Peking University People's Hospital, Beijing, China (N.S.); Department of Geriatric Cardiology, the General Hospital of the People's Liberation Army, Beijing, China (X.L.); Centers for Metabolic Disease Research, Temple University School of Medicine, Philadelphia, PA (H.W.); and Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD (X.W.)
| | - Kui Hong
- From the Department of Cardiology, The Second Affiliated Hospital of Nanchang University, China (X.H., H.B., H.S., P.L., R.Y., Y. Wu, K.H., Q.W., X.C.); National Clinical Research Study Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Renal Division, Nanfang Hospital, Southern Medical University, Guangzhou, China (X.Q., C.J., X.Z., Y.S., Y. Wang, B.W., F.F.H.); Institute of Biomedicine, Anhui Medical University, Hefei, China (W.Y., S.J.); China Agricultural University, Beijing (L.L.); School of Life Sciences, Anhui University, Hefei, China (S.J., G.T.); Department of Neurology, First People's Hospital, Lianyungang, China (M.H.); Department of Neurology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China (M.Z., Y. Cai); Department of Cardiology, The First Affiliated Hospital of Soochow University, Suzhou, China (D.Y.); Department of Cardiology, Peking University First Hospital, Beijing, China (Y.Z., J.L., Y.H.); Department of Cardiology, General Hospital of PLA, Beijing, China (Y. Chen); Department of Cardiology, Peking University People's Hospital, Beijing, China (N.S.); Department of Geriatric Cardiology, the General Hospital of the People's Liberation Army, Beijing, China (X.L.); Centers for Metabolic Disease Research, Temple University School of Medicine, Philadelphia, PA (H.W.); and Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD (X.W.)
| | - Qinhua Wu
- From the Department of Cardiology, The Second Affiliated Hospital of Nanchang University, China (X.H., H.B., H.S., P.L., R.Y., Y. Wu, K.H., Q.W., X.C.); National Clinical Research Study Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Renal Division, Nanfang Hospital, Southern Medical University, Guangzhou, China (X.Q., C.J., X.Z., Y.S., Y. Wang, B.W., F.F.H.); Institute of Biomedicine, Anhui Medical University, Hefei, China (W.Y., S.J.); China Agricultural University, Beijing (L.L.); School of Life Sciences, Anhui University, Hefei, China (S.J., G.T.); Department of Neurology, First People's Hospital, Lianyungang, China (M.H.); Department of Neurology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China (M.Z., Y. Cai); Department of Cardiology, The First Affiliated Hospital of Soochow University, Suzhou, China (D.Y.); Department of Cardiology, Peking University First Hospital, Beijing, China (Y.Z., J.L., Y.H.); Department of Cardiology, General Hospital of PLA, Beijing, China (Y. Chen); Department of Cardiology, Peking University People's Hospital, Beijing, China (N.S.); Department of Geriatric Cardiology, the General Hospital of the People's Liberation Army, Beijing, China (X.L.); Centers for Metabolic Disease Research, Temple University School of Medicine, Philadelphia, PA (H.W.); and Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD (X.W.)
| | - Yundai Chen
- From the Department of Cardiology, The Second Affiliated Hospital of Nanchang University, China (X.H., H.B., H.S., P.L., R.Y., Y. Wu, K.H., Q.W., X.C.); National Clinical Research Study Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Renal Division, Nanfang Hospital, Southern Medical University, Guangzhou, China (X.Q., C.J., X.Z., Y.S., Y. Wang, B.W., F.F.H.); Institute of Biomedicine, Anhui Medical University, Hefei, China (W.Y., S.J.); China Agricultural University, Beijing (L.L.); School of Life Sciences, Anhui University, Hefei, China (S.J., G.T.); Department of Neurology, First People's Hospital, Lianyungang, China (M.H.); Department of Neurology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China (M.Z., Y. Cai); Department of Cardiology, The First Affiliated Hospital of Soochow University, Suzhou, China (D.Y.); Department of Cardiology, Peking University First Hospital, Beijing, China (Y.Z., J.L., Y.H.); Department of Cardiology, General Hospital of PLA, Beijing, China (Y. Chen); Department of Cardiology, Peking University People's Hospital, Beijing, China (N.S.); Department of Geriatric Cardiology, the General Hospital of the People's Liberation Army, Beijing, China (X.L.); Centers for Metabolic Disease Research, Temple University School of Medicine, Philadelphia, PA (H.W.); and Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD (X.W.)
| | - Ningling Sun
- From the Department of Cardiology, The Second Affiliated Hospital of Nanchang University, China (X.H., H.B., H.S., P.L., R.Y., Y. Wu, K.H., Q.W., X.C.); National Clinical Research Study Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Renal Division, Nanfang Hospital, Southern Medical University, Guangzhou, China (X.Q., C.J., X.Z., Y.S., Y. Wang, B.W., F.F.H.); Institute of Biomedicine, Anhui Medical University, Hefei, China (W.Y., S.J.); China Agricultural University, Beijing (L.L.); School of Life Sciences, Anhui University, Hefei, China (S.J., G.T.); Department of Neurology, First People's Hospital, Lianyungang, China (M.H.); Department of Neurology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China (M.Z., Y. Cai); Department of Cardiology, The First Affiliated Hospital of Soochow University, Suzhou, China (D.Y.); Department of Cardiology, Peking University First Hospital, Beijing, China (Y.Z., J.L., Y.H.); Department of Cardiology, General Hospital of PLA, Beijing, China (Y. Chen); Department of Cardiology, Peking University People's Hospital, Beijing, China (N.S.); Department of Geriatric Cardiology, the General Hospital of the People's Liberation Army, Beijing, China (X.L.); Centers for Metabolic Disease Research, Temple University School of Medicine, Philadelphia, PA (H.W.); and Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD (X.W.)
| | - Xiaoying Li
- From the Department of Cardiology, The Second Affiliated Hospital of Nanchang University, China (X.H., H.B., H.S., P.L., R.Y., Y. Wu, K.H., Q.W., X.C.); National Clinical Research Study Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Renal Division, Nanfang Hospital, Southern Medical University, Guangzhou, China (X.Q., C.J., X.Z., Y.S., Y. Wang, B.W., F.F.H.); Institute of Biomedicine, Anhui Medical University, Hefei, China (W.Y., S.J.); China Agricultural University, Beijing (L.L.); School of Life Sciences, Anhui University, Hefei, China (S.J., G.T.); Department of Neurology, First People's Hospital, Lianyungang, China (M.H.); Department of Neurology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China (M.Z., Y. Cai); Department of Cardiology, The First Affiliated Hospital of Soochow University, Suzhou, China (D.Y.); Department of Cardiology, Peking University First Hospital, Beijing, China (Y.Z., J.L., Y.H.); Department of Cardiology, General Hospital of PLA, Beijing, China (Y. Chen); Department of Cardiology, Peking University People's Hospital, Beijing, China (N.S.); Department of Geriatric Cardiology, the General Hospital of the People's Liberation Army, Beijing, China (X.L.); Centers for Metabolic Disease Research, Temple University School of Medicine, Philadelphia, PA (H.W.); and Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD (X.W.)
| | - Genfu Tang
- From the Department of Cardiology, The Second Affiliated Hospital of Nanchang University, China (X.H., H.B., H.S., P.L., R.Y., Y. Wu, K.H., Q.W., X.C.); National Clinical Research Study Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Renal Division, Nanfang Hospital, Southern Medical University, Guangzhou, China (X.Q., C.J., X.Z., Y.S., Y. Wang, B.W., F.F.H.); Institute of Biomedicine, Anhui Medical University, Hefei, China (W.Y., S.J.); China Agricultural University, Beijing (L.L.); School of Life Sciences, Anhui University, Hefei, China (S.J., G.T.); Department of Neurology, First People's Hospital, Lianyungang, China (M.H.); Department of Neurology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China (M.Z., Y. Cai); Department of Cardiology, The First Affiliated Hospital of Soochow University, Suzhou, China (D.Y.); Department of Cardiology, Peking University First Hospital, Beijing, China (Y.Z., J.L., Y.H.); Department of Cardiology, General Hospital of PLA, Beijing, China (Y. Chen); Department of Cardiology, Peking University People's Hospital, Beijing, China (N.S.); Department of Geriatric Cardiology, the General Hospital of the People's Liberation Army, Beijing, China (X.L.); Centers for Metabolic Disease Research, Temple University School of Medicine, Philadelphia, PA (H.W.); and Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD (X.W.)
| | - Binyan Wang
- From the Department of Cardiology, The Second Affiliated Hospital of Nanchang University, China (X.H., H.B., H.S., P.L., R.Y., Y. Wu, K.H., Q.W., X.C.); National Clinical Research Study Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Renal Division, Nanfang Hospital, Southern Medical University, Guangzhou, China (X.Q., C.J., X.Z., Y.S., Y. Wang, B.W., F.F.H.); Institute of Biomedicine, Anhui Medical University, Hefei, China (W.Y., S.J.); China Agricultural University, Beijing (L.L.); School of Life Sciences, Anhui University, Hefei, China (S.J., G.T.); Department of Neurology, First People's Hospital, Lianyungang, China (M.H.); Department of Neurology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China (M.Z., Y. Cai); Department of Cardiology, The First Affiliated Hospital of Soochow University, Suzhou, China (D.Y.); Department of Cardiology, Peking University First Hospital, Beijing, China (Y.Z., J.L., Y.H.); Department of Cardiology, General Hospital of PLA, Beijing, China (Y. Chen); Department of Cardiology, Peking University People's Hospital, Beijing, China (N.S.); Department of Geriatric Cardiology, the General Hospital of the People's Liberation Army, Beijing, China (X.L.); Centers for Metabolic Disease Research, Temple University School of Medicine, Philadelphia, PA (H.W.); and Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD (X.W.)
| | - Yefeng Cai
- From the Department of Cardiology, The Second Affiliated Hospital of Nanchang University, China (X.H., H.B., H.S., P.L., R.Y., Y. Wu, K.H., Q.W., X.C.); National Clinical Research Study Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Renal Division, Nanfang Hospital, Southern Medical University, Guangzhou, China (X.Q., C.J., X.Z., Y.S., Y. Wang, B.W., F.F.H.); Institute of Biomedicine, Anhui Medical University, Hefei, China (W.Y., S.J.); China Agricultural University, Beijing (L.L.); School of Life Sciences, Anhui University, Hefei, China (S.J., G.T.); Department of Neurology, First People's Hospital, Lianyungang, China (M.H.); Department of Neurology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China (M.Z., Y. Cai); Department of Cardiology, The First Affiliated Hospital of Soochow University, Suzhou, China (D.Y.); Department of Cardiology, Peking University First Hospital, Beijing, China (Y.Z., J.L., Y.H.); Department of Cardiology, General Hospital of PLA, Beijing, China (Y. Chen); Department of Cardiology, Peking University People's Hospital, Beijing, China (N.S.); Department of Geriatric Cardiology, the General Hospital of the People's Liberation Army, Beijing, China (X.L.); Centers for Metabolic Disease Research, Temple University School of Medicine, Philadelphia, PA (H.W.); and Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD (X.W.)
| | - Fan Fan Hou
- From the Department of Cardiology, The Second Affiliated Hospital of Nanchang University, China (X.H., H.B., H.S., P.L., R.Y., Y. Wu, K.H., Q.W., X.C.); National Clinical Research Study Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Renal Division, Nanfang Hospital, Southern Medical University, Guangzhou, China (X.Q., C.J., X.Z., Y.S., Y. Wang, B.W., F.F.H.); Institute of Biomedicine, Anhui Medical University, Hefei, China (W.Y., S.J.); China Agricultural University, Beijing (L.L.); School of Life Sciences, Anhui University, Hefei, China (S.J., G.T.); Department of Neurology, First People's Hospital, Lianyungang, China (M.H.); Department of Neurology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China (M.Z., Y. Cai); Department of Cardiology, The First Affiliated Hospital of Soochow University, Suzhou, China (D.Y.); Department of Cardiology, Peking University First Hospital, Beijing, China (Y.Z., J.L., Y.H.); Department of Cardiology, General Hospital of PLA, Beijing, China (Y. Chen); Department of Cardiology, Peking University People's Hospital, Beijing, China (N.S.); Department of Geriatric Cardiology, the General Hospital of the People's Liberation Army, Beijing, China (X.L.); Centers for Metabolic Disease Research, Temple University School of Medicine, Philadelphia, PA (H.W.); and Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD (X.W.)
| | - Yong Huo
- From the Department of Cardiology, The Second Affiliated Hospital of Nanchang University, China (X.H., H.B., H.S., P.L., R.Y., Y. Wu, K.H., Q.W., X.C.); National Clinical Research Study Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Renal Division, Nanfang Hospital, Southern Medical University, Guangzhou, China (X.Q., C.J., X.Z., Y.S., Y. Wang, B.W., F.F.H.); Institute of Biomedicine, Anhui Medical University, Hefei, China (W.Y., S.J.); China Agricultural University, Beijing (L.L.); School of Life Sciences, Anhui University, Hefei, China (S.J., G.T.); Department of Neurology, First People's Hospital, Lianyungang, China (M.H.); Department of Neurology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China (M.Z., Y. Cai); Department of Cardiology, The First Affiliated Hospital of Soochow University, Suzhou, China (D.Y.); Department of Cardiology, Peking University First Hospital, Beijing, China (Y.Z., J.L., Y.H.); Department of Cardiology, General Hospital of PLA, Beijing, China (Y. Chen); Department of Cardiology, Peking University People's Hospital, Beijing, China (N.S.); Department of Geriatric Cardiology, the General Hospital of the People's Liberation Army, Beijing, China (X.L.); Centers for Metabolic Disease Research, Temple University School of Medicine, Philadelphia, PA (H.W.); and Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD (X.W.)
| | - Hong Wang
- From the Department of Cardiology, The Second Affiliated Hospital of Nanchang University, China (X.H., H.B., H.S., P.L., R.Y., Y. Wu, K.H., Q.W., X.C.); National Clinical Research Study Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Renal Division, Nanfang Hospital, Southern Medical University, Guangzhou, China (X.Q., C.J., X.Z., Y.S., Y. Wang, B.W., F.F.H.); Institute of Biomedicine, Anhui Medical University, Hefei, China (W.Y., S.J.); China Agricultural University, Beijing (L.L.); School of Life Sciences, Anhui University, Hefei, China (S.J., G.T.); Department of Neurology, First People's Hospital, Lianyungang, China (M.H.); Department of Neurology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China (M.Z., Y. Cai); Department of Cardiology, The First Affiliated Hospital of Soochow University, Suzhou, China (D.Y.); Department of Cardiology, Peking University First Hospital, Beijing, China (Y.Z., J.L., Y.H.); Department of Cardiology, General Hospital of PLA, Beijing, China (Y. Chen); Department of Cardiology, Peking University People's Hospital, Beijing, China (N.S.); Department of Geriatric Cardiology, the General Hospital of the People's Liberation Army, Beijing, China (X.L.); Centers for Metabolic Disease Research, Temple University School of Medicine, Philadelphia, PA (H.W.); and Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD (X.W.).
| | - Xiaobin Wang
- From the Department of Cardiology, The Second Affiliated Hospital of Nanchang University, China (X.H., H.B., H.S., P.L., R.Y., Y. Wu, K.H., Q.W., X.C.); National Clinical Research Study Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Renal Division, Nanfang Hospital, Southern Medical University, Guangzhou, China (X.Q., C.J., X.Z., Y.S., Y. Wang, B.W., F.F.H.); Institute of Biomedicine, Anhui Medical University, Hefei, China (W.Y., S.J.); China Agricultural University, Beijing (L.L.); School of Life Sciences, Anhui University, Hefei, China (S.J., G.T.); Department of Neurology, First People's Hospital, Lianyungang, China (M.H.); Department of Neurology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China (M.Z., Y. Cai); Department of Cardiology, The First Affiliated Hospital of Soochow University, Suzhou, China (D.Y.); Department of Cardiology, Peking University First Hospital, Beijing, China (Y.Z., J.L., Y.H.); Department of Cardiology, General Hospital of PLA, Beijing, China (Y. Chen); Department of Cardiology, Peking University People's Hospital, Beijing, China (N.S.); Department of Geriatric Cardiology, the General Hospital of the People's Liberation Army, Beijing, China (X.L.); Centers for Metabolic Disease Research, Temple University School of Medicine, Philadelphia, PA (H.W.); and Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD (X.W.).
| | - Xiaoshu Cheng
- From the Department of Cardiology, The Second Affiliated Hospital of Nanchang University, China (X.H., H.B., H.S., P.L., R.Y., Y. Wu, K.H., Q.W., X.C.); National Clinical Research Study Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Renal Division, Nanfang Hospital, Southern Medical University, Guangzhou, China (X.Q., C.J., X.Z., Y.S., Y. Wang, B.W., F.F.H.); Institute of Biomedicine, Anhui Medical University, Hefei, China (W.Y., S.J.); China Agricultural University, Beijing (L.L.); School of Life Sciences, Anhui University, Hefei, China (S.J., G.T.); Department of Neurology, First People's Hospital, Lianyungang, China (M.H.); Department of Neurology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China (M.Z., Y. Cai); Department of Cardiology, The First Affiliated Hospital of Soochow University, Suzhou, China (D.Y.); Department of Cardiology, Peking University First Hospital, Beijing, China (Y.Z., J.L., Y.H.); Department of Cardiology, General Hospital of PLA, Beijing, China (Y. Chen); Department of Cardiology, Peking University People's Hospital, Beijing, China (N.S.); Department of Geriatric Cardiology, the General Hospital of the People's Liberation Army, Beijing, China (X.L.); Centers for Metabolic Disease Research, Temple University School of Medicine, Philadelphia, PA (H.W.); and Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD (X.W.).
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Gender-specific associations of skeletal muscle mass and arterial stiffness among peritoneal dialysis patients. Sci Rep 2018; 8:1351. [PMID: 29358587 PMCID: PMC5778131 DOI: 10.1038/s41598-018-19710-6] [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: 10/04/2017] [Accepted: 01/08/2018] [Indexed: 11/20/2022] Open
Abstract
Decreased skeletal muscle has been identified as a relevant factor for arterial stiffness but has not been thoroughly investigated in peritoneal dialysis (PD) patients. The aim of this study was to investigate the relationship between skeletal muscle and arterial stiffness in PD patients. A cross-sectional study of 658 prevalent PD patients with a mean brachial-ankle pulse wave velocity (baPWV) of 1714 (±501) cm/s and mean skeletal muscle mass of 26.6 (±5.4) kg was performed. Skeletal muscle mass level was significantly higher in males than in females. When examining skeletal muscle mass as a continuous variable, skeletal muscle mass was significantly associated with baPWV in fully adjusted linear regression models in total patients [standardized coefficients (β), −0.181; 95% confidence interval (95% CI), −0.276 to −0.056; P = 0.003] or female patients (β, −0.119; 95% CI, −0.350 to −0.015; P = 0.03) but not in male patients (β, −0.117; 95% CI, −0.300 to 0.011; P = 0.07). Furthermore, in females, a significant association between the middle or highest tertile of skeletal muscle mass and baPWV was found in fully adjusted models (β, −0.123; 95% CI, −0.204 to −0.008; P = 0.03; β, −0.140; 95% CI, −0.228 to −0.016; P = 0.02, respectively). In conclusion, decreased skeletal muscle mass was independently associated with increased baPWV in PD patients, and this association was significant in females but not in males.
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Small infrarenal aortic diameter associated with lower-extremity peripheral artery disease in Chinese hypertensive adults. Sci Rep 2017; 7:14547. [PMID: 29109408 PMCID: PMC5674057 DOI: 10.1038/s41598-017-12587-x] [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: 03/23/2017] [Accepted: 09/07/2017] [Indexed: 11/18/2022] Open
Abstract
Several studies suggest that infrarenal aortic diameter is associated with lower-extremity peripheral artery disease (LE-PAD). However, data regarding the associations between infrarenal aortic diameter and LE-PAD are limited, especially in large sample populations and Asian or Chinese populations. Our analysis included 17279 Chinese hypertensive adults comprising 6590 men and 10689 women with a mean age of 64.74 ± 7.41 years. Participants were selected from 22693 candidates from two large population-based cohort-studies. The primary noninvasive test for diagnosis of LE-PAD is the ankle–brachial index (ABI) at rest and typically an ABI ≤ 0.90 is used to define LE-PAD. The prevalence of LE-PAD was found to significantly decrease as the aortic diameter increased according to the tertile of the aortic diameter. LE-PAD was significantly more prevalent in the lowest tertile (OR = 1.58, 95% CI = 1.29–1.94, p < 0.001) and similarly prevalent in the highest tertile (OR = 0.92, 95% CI = 0.73–1.16, p = 0.49) when compared with the median tertile. No significant interactions between the aortic diameter and any of the stratified variables were found (all p > 0.05). In conclusion, Small aortic diameter (as opposed to large aortic diameter) is significantly associated with LE-PAD in Chinese hypertensive adults.
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Xu B, Kong X, Xu R, Song Y, Liu L, Zhou Z, Gu R, Shi X, Zhao M, Huang X, He M, Fu J, Cai Y, Li P, Cheng X, Wu C, Chen F, Zhang Y, Tang G, Qin X, Wang B, Xue H, Chen Y, Tian Y, Sun N, Cui Y, Hou FF, Li J, Huo Y. Homocysteine and all-cause mortality in hypertensive adults without pre-existing cardiovascular conditions: Effect modification by MTHFR C677T polymorphism. Medicine (Baltimore) 2017; 96:e5862. [PMID: 28225483 PMCID: PMC5569412 DOI: 10.1097/md.0000000000005862] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Previous studies support an association between elevated total homocysteine (tHcy) levels and increased all-cause mortality. However, few prospective studies have examined this association in hypertensive patients, and/or tested any effect modification by the methylene tetrahydrofolate reductase (MTHFR) C677T genotype. METHODS This was a post hoc analysis of the China Stroke Primary Prevention Trial. Serum tHcy and folate were measured at baseline. Individual MTHFR C677T genotype (CC, CT, and TT) was determined. Evidence for death included death certificates or home visits. Cumulative hazards of all-cause mortality by tHcy quartiles were estimated using the Kaplan-Meier method, and group differences were compared by log-rank tests. Hazard ratios (HRs) and 95% confidence intervals were estimated by Cox proportional-hazard regression models, adjusting for age, sex, baseline folate, vitamin B12, blood pressure, body mass index, smoking and alcohol drinking status, study center, total cholesterol, triglycerides, high-density lipoprotein cholesterol, fasting glucose, creatinine, and treatment group. Potential effect modification by the MTHFR genotype on the relationship between tHcy and all-cause mortality was tested. RESULTS The analyses included 20,424 hypertensive patients (41% males) without a history of myocardial infarction or stroke. Baseline mean age (SD) was 60 ± 7.5 years and mean (SD) serum tHcy was 14.5 ± 8.4 μmol/L. After a mean follow-up period of 4.5 years, there were 612 (3%) all-cause deaths. Kaplan-Meier survival curves revealed a graded relationship between tHcy quartiles and all-cause mortality. The HRs, using the lowest quartile as the reference, were 1.2, 1.2, and 1.5 in Q2, Q3, and Q4, respectively. A linear trend test, using natural log-transformed tHcy, resulted in an HR of 1.5 (95% confidence interval 1.2-1.9, P < .001) after adjustment for lifestyle and health-related variables. Whereas the MTHFR genotype alone had little effect on mortality, it significantly modified the tHcy-mortality association, which was much stronger in the CC/CT genotype than in the TT genotype (P for interaction < 0.05). CONCLUSIONS Among Chinese hypertensive patients without cardiovascular comorbidities, elevated tHcy was a significant risk marker for death from all causes, and the association was subject to effect modification by MTHFR genotypes. If confirmed that tHcy and MTHFR genotypes may serve as useful biomarkers for mortality risk assessment and targeted intervention.
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Affiliation(s)
- Benjamin Xu
- Department of Cardiology, Peking University First Hospital, Beijing
| | - Xiangyi Kong
- Department of Cardiology, Peking University First Hospital, Beijing
| | - Richard Xu
- Department of Cardiology, Peking University First Hospital, Beijing
| | - Yun Song
- National Clinical Research Study Center for Kidney Disease; State Key Laboratory for Organ Failure Research; Renal Division, Nanfang Hospital, Southern Medical University, Guangzhou
| | - Lishun Liu
- Institute for Biomedicine, Anhui Medical University
| | - Ziyi Zhou
- Institute for Biomedicine, Anhui Medical University
| | - Rui Gu
- Institute for Biomedicine, Anhui Medical University
| | - Xiuli Shi
- Department of Neurology, First Affiliated Hospital of Anhui Medical University, Hefei
| | - Min Zhao
- National Clinical Research Study Center for Kidney Disease; State Key Laboratory for Organ Failure Research; Renal Division, Nanfang Hospital, Southern Medical University, Guangzhou
| | - Xiao Huang
- Department of Cardiology, the Second Affiliated Hospital of Nanchang University, Jiangxi
| | - Mingli He
- Department of Neurology, First People's Hospital, Lianyungang
| | - Jia Fu
- Department of Neurology, First Affiliated Hospital of Anhui Medical University, Hefei
| | - Yefeng Cai
- Department of Neurology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou
| | - Ping Li
- Department of Cardiology, the Second Affiliated Hospital of Nanchang University, Jiangxi
| | - Xiaoshu Cheng
- Department of Cardiology, the Second Affiliated Hospital of Nanchang University, Jiangxi
| | - Changyan Wu
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing
| | - Fang Chen
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing
| | - Yan Zhang
- Department of Cardiology, Peking University First Hospital, Beijing
| | - Genfu Tang
- School of Health Administration, Anhui Medical University, Hefei
| | - Xianhui Qin
- National Clinical Research Study Center for Kidney Disease; State Key Laboratory for Organ Failure Research; Renal Division, Nanfang Hospital, Southern Medical University, Guangzhou
| | - Binyan Wang
- National Clinical Research Study Center for Kidney Disease; State Key Laboratory for Organ Failure Research; Renal Division, Nanfang Hospital, Southern Medical University, Guangzhou
| | - Hao Xue
- Department of Cardiology, Chinese People's Liberation Army General Hospital, Beijing
| | - Yundai Chen
- Department of Cardiology, Chinese People's Liberation Army General Hospital, Beijing
| | - Ye Tian
- Department of Cardiology, The First Affiliated Hospital of Harbin Medical University, Harbin
| | - Ningling Sun
- Department of Cardiology, Peking University People's Hospital
| | - Yimin Cui
- Department of Pharmacy, Peking University First Hospital, Beijing, China
| | - Fan Fan Hou
- National Clinical Research Study Center for Kidney Disease; State Key Laboratory for Organ Failure Research; Renal Division, Nanfang Hospital, Southern Medical University, Guangzhou
| | - Jianping Li
- Department of Cardiology, Peking University First Hospital, Beijing
| | - Yong Huo
- Department of Cardiology, Peking University First Hospital, Beijing
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41
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Guo J, Fujiyoshi A, Willcox B, Choo J, Vishnu A, Hisamatsu T, Ahuja V, Takashima N, Barinas-Mitchell E, Kadota A, Evans RW, Miura K, Edmundowicz D, Masaki K, Shin C, Kuller LH, Ueshima H, Sekikawa A. Increased Aortic Calcification Is Associated With Arterial Stiffness Progression in Multiethnic Middle-Aged Men. Hypertension 2017; 69:102-108. [PMID: 27821619 PMCID: PMC5145727 DOI: 10.1161/hypertensionaha.116.08459] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2016] [Revised: 09/23/2016] [Accepted: 10/12/2016] [Indexed: 01/11/2023]
Abstract
Arterial stiffness is established as an independent predictor of cardiovascular morbidity and mortality. The objective was to prospectively evaluate association of aortic calcification burden with progression of arterial stiffness in population-based samples of healthy middle-aged men from ERA JUMP cohort (Electron-Beam Computed Tomography and Risk Factor Assessment in Japanese and US Men in the Post-World War II Birth Cohort). Men (n=635) aged 40 to 49 years (207 white American, 45 black American, 142 Japanese American, and 241 Japanese in Japan) were examined at baseline and 4 to 7 years later. Aortic calcification was evaluated from level of aortic arch to iliac bifurcation. Arterial stiffness progression was measured as annual change in brachial-ankle pulse wave velocity. Multivariable-adjusted general linear models were applied to investigate associations of longitudinal change in aortic calcification with arterial stiffness progression in participants overall, as well as in subgroups without or with prevalent aortic calcification at baseline. Annual change in aortic calcification was positively and significantly associated with arterial stiffness progression. In participants with annual changes in aortic calcium score of ≤0, 1 to 10, 11 to 100, and >100, the adjusted means (SD) for the annual change in brachial-ankle pulse wave velocity were 3.8 (2.2), 7.2 (2.2), 12.2 (1.8), and 15.6 (2.6) cm/s, respectively (P for trend <0.01) adjusted for baseline aortic calcification, arterial stiffness, and standard cardiovascular risk factors. Arterial stiffness was associated with the incidence of aortic calcification over the follow-up period among participants without aortic calcification (n=297) and with an increase in aortic calcification among participants with prevalent aortic calcification at baseline (n=388). Our findings suggest aortic calcification may be causally linked to arterial stiffness.
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Affiliation(s)
- Jingchuan Guo
- From the Department of Epidemiology, University of Pittsburgh, PA (J.G., A.V., V.A., E.B.-M., R.W.E., L.H.K., A.S.); Department of Public Health (A.F., N.T., A.K., K.M.) and Center for Epidemiologic Research in Asia (A.K., K.M., H.U.), Shiga University of Medical Science, Japan; Department of Research, Kuakini Medical Center, Honolulu, HI (B.W.); Department of Geriatric Medicine, John A. Burns School of Medicine, University of Hawaii, Honolulu, HI (B.W., K.M.); College of Nursing, Korea University, Seoul, South Korea (J.C.); Department of Environmental Medicine and Public Health, Shimane University, Japan (T.H.); Department of Cardiology, Temple University Hospital, Philadelphia, PA (D.E.); Department of Geriatric Medicine, Kuakini Medical Center, Honolulu, Hawaii (K.M.); and Division of Pulmonary, Sleep and Critical Care Medicine, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, South Korea (C.S.)
| | - Akira Fujiyoshi
- From the Department of Epidemiology, University of Pittsburgh, PA (J.G., A.V., V.A., E.B.-M., R.W.E., L.H.K., A.S.); Department of Public Health (A.F., N.T., A.K., K.M.) and Center for Epidemiologic Research in Asia (A.K., K.M., H.U.), Shiga University of Medical Science, Japan; Department of Research, Kuakini Medical Center, Honolulu, HI (B.W.); Department of Geriatric Medicine, John A. Burns School of Medicine, University of Hawaii, Honolulu, HI (B.W., K.M.); College of Nursing, Korea University, Seoul, South Korea (J.C.); Department of Environmental Medicine and Public Health, Shimane University, Japan (T.H.); Department of Cardiology, Temple University Hospital, Philadelphia, PA (D.E.); Department of Geriatric Medicine, Kuakini Medical Center, Honolulu, Hawaii (K.M.); and Division of Pulmonary, Sleep and Critical Care Medicine, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, South Korea (C.S.)
| | - Bradley Willcox
- From the Department of Epidemiology, University of Pittsburgh, PA (J.G., A.V., V.A., E.B.-M., R.W.E., L.H.K., A.S.); Department of Public Health (A.F., N.T., A.K., K.M.) and Center for Epidemiologic Research in Asia (A.K., K.M., H.U.), Shiga University of Medical Science, Japan; Department of Research, Kuakini Medical Center, Honolulu, HI (B.W.); Department of Geriatric Medicine, John A. Burns School of Medicine, University of Hawaii, Honolulu, HI (B.W., K.M.); College of Nursing, Korea University, Seoul, South Korea (J.C.); Department of Environmental Medicine and Public Health, Shimane University, Japan (T.H.); Department of Cardiology, Temple University Hospital, Philadelphia, PA (D.E.); Department of Geriatric Medicine, Kuakini Medical Center, Honolulu, Hawaii (K.M.); and Division of Pulmonary, Sleep and Critical Care Medicine, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, South Korea (C.S.)
| | - Jina Choo
- From the Department of Epidemiology, University of Pittsburgh, PA (J.G., A.V., V.A., E.B.-M., R.W.E., L.H.K., A.S.); Department of Public Health (A.F., N.T., A.K., K.M.) and Center for Epidemiologic Research in Asia (A.K., K.M., H.U.), Shiga University of Medical Science, Japan; Department of Research, Kuakini Medical Center, Honolulu, HI (B.W.); Department of Geriatric Medicine, John A. Burns School of Medicine, University of Hawaii, Honolulu, HI (B.W., K.M.); College of Nursing, Korea University, Seoul, South Korea (J.C.); Department of Environmental Medicine and Public Health, Shimane University, Japan (T.H.); Department of Cardiology, Temple University Hospital, Philadelphia, PA (D.E.); Department of Geriatric Medicine, Kuakini Medical Center, Honolulu, Hawaii (K.M.); and Division of Pulmonary, Sleep and Critical Care Medicine, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, South Korea (C.S.)
| | - Abhishek Vishnu
- From the Department of Epidemiology, University of Pittsburgh, PA (J.G., A.V., V.A., E.B.-M., R.W.E., L.H.K., A.S.); Department of Public Health (A.F., N.T., A.K., K.M.) and Center for Epidemiologic Research in Asia (A.K., K.M., H.U.), Shiga University of Medical Science, Japan; Department of Research, Kuakini Medical Center, Honolulu, HI (B.W.); Department of Geriatric Medicine, John A. Burns School of Medicine, University of Hawaii, Honolulu, HI (B.W., K.M.); College of Nursing, Korea University, Seoul, South Korea (J.C.); Department of Environmental Medicine and Public Health, Shimane University, Japan (T.H.); Department of Cardiology, Temple University Hospital, Philadelphia, PA (D.E.); Department of Geriatric Medicine, Kuakini Medical Center, Honolulu, Hawaii (K.M.); and Division of Pulmonary, Sleep and Critical Care Medicine, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, South Korea (C.S.)
| | - Takashi Hisamatsu
- From the Department of Epidemiology, University of Pittsburgh, PA (J.G., A.V., V.A., E.B.-M., R.W.E., L.H.K., A.S.); Department of Public Health (A.F., N.T., A.K., K.M.) and Center for Epidemiologic Research in Asia (A.K., K.M., H.U.), Shiga University of Medical Science, Japan; Department of Research, Kuakini Medical Center, Honolulu, HI (B.W.); Department of Geriatric Medicine, John A. Burns School of Medicine, University of Hawaii, Honolulu, HI (B.W., K.M.); College of Nursing, Korea University, Seoul, South Korea (J.C.); Department of Environmental Medicine and Public Health, Shimane University, Japan (T.H.); Department of Cardiology, Temple University Hospital, Philadelphia, PA (D.E.); Department of Geriatric Medicine, Kuakini Medical Center, Honolulu, Hawaii (K.M.); and Division of Pulmonary, Sleep and Critical Care Medicine, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, South Korea (C.S.)
| | - Vasudha Ahuja
- From the Department of Epidemiology, University of Pittsburgh, PA (J.G., A.V., V.A., E.B.-M., R.W.E., L.H.K., A.S.); Department of Public Health (A.F., N.T., A.K., K.M.) and Center for Epidemiologic Research in Asia (A.K., K.M., H.U.), Shiga University of Medical Science, Japan; Department of Research, Kuakini Medical Center, Honolulu, HI (B.W.); Department of Geriatric Medicine, John A. Burns School of Medicine, University of Hawaii, Honolulu, HI (B.W., K.M.); College of Nursing, Korea University, Seoul, South Korea (J.C.); Department of Environmental Medicine and Public Health, Shimane University, Japan (T.H.); Department of Cardiology, Temple University Hospital, Philadelphia, PA (D.E.); Department of Geriatric Medicine, Kuakini Medical Center, Honolulu, Hawaii (K.M.); and Division of Pulmonary, Sleep and Critical Care Medicine, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, South Korea (C.S.)
| | - Naoyuki Takashima
- From the Department of Epidemiology, University of Pittsburgh, PA (J.G., A.V., V.A., E.B.-M., R.W.E., L.H.K., A.S.); Department of Public Health (A.F., N.T., A.K., K.M.) and Center for Epidemiologic Research in Asia (A.K., K.M., H.U.), Shiga University of Medical Science, Japan; Department of Research, Kuakini Medical Center, Honolulu, HI (B.W.); Department of Geriatric Medicine, John A. Burns School of Medicine, University of Hawaii, Honolulu, HI (B.W., K.M.); College of Nursing, Korea University, Seoul, South Korea (J.C.); Department of Environmental Medicine and Public Health, Shimane University, Japan (T.H.); Department of Cardiology, Temple University Hospital, Philadelphia, PA (D.E.); Department of Geriatric Medicine, Kuakini Medical Center, Honolulu, Hawaii (K.M.); and Division of Pulmonary, Sleep and Critical Care Medicine, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, South Korea (C.S.)
| | - Emma Barinas-Mitchell
- From the Department of Epidemiology, University of Pittsburgh, PA (J.G., A.V., V.A., E.B.-M., R.W.E., L.H.K., A.S.); Department of Public Health (A.F., N.T., A.K., K.M.) and Center for Epidemiologic Research in Asia (A.K., K.M., H.U.), Shiga University of Medical Science, Japan; Department of Research, Kuakini Medical Center, Honolulu, HI (B.W.); Department of Geriatric Medicine, John A. Burns School of Medicine, University of Hawaii, Honolulu, HI (B.W., K.M.); College of Nursing, Korea University, Seoul, South Korea (J.C.); Department of Environmental Medicine and Public Health, Shimane University, Japan (T.H.); Department of Cardiology, Temple University Hospital, Philadelphia, PA (D.E.); Department of Geriatric Medicine, Kuakini Medical Center, Honolulu, Hawaii (K.M.); and Division of Pulmonary, Sleep and Critical Care Medicine, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, South Korea (C.S.)
| | - Aya Kadota
- From the Department of Epidemiology, University of Pittsburgh, PA (J.G., A.V., V.A., E.B.-M., R.W.E., L.H.K., A.S.); Department of Public Health (A.F., N.T., A.K., K.M.) and Center for Epidemiologic Research in Asia (A.K., K.M., H.U.), Shiga University of Medical Science, Japan; Department of Research, Kuakini Medical Center, Honolulu, HI (B.W.); Department of Geriatric Medicine, John A. Burns School of Medicine, University of Hawaii, Honolulu, HI (B.W., K.M.); College of Nursing, Korea University, Seoul, South Korea (J.C.); Department of Environmental Medicine and Public Health, Shimane University, Japan (T.H.); Department of Cardiology, Temple University Hospital, Philadelphia, PA (D.E.); Department of Geriatric Medicine, Kuakini Medical Center, Honolulu, Hawaii (K.M.); and Division of Pulmonary, Sleep and Critical Care Medicine, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, South Korea (C.S.)
| | - Rhobert W Evans
- From the Department of Epidemiology, University of Pittsburgh, PA (J.G., A.V., V.A., E.B.-M., R.W.E., L.H.K., A.S.); Department of Public Health (A.F., N.T., A.K., K.M.) and Center for Epidemiologic Research in Asia (A.K., K.M., H.U.), Shiga University of Medical Science, Japan; Department of Research, Kuakini Medical Center, Honolulu, HI (B.W.); Department of Geriatric Medicine, John A. Burns School of Medicine, University of Hawaii, Honolulu, HI (B.W., K.M.); College of Nursing, Korea University, Seoul, South Korea (J.C.); Department of Environmental Medicine and Public Health, Shimane University, Japan (T.H.); Department of Cardiology, Temple University Hospital, Philadelphia, PA (D.E.); Department of Geriatric Medicine, Kuakini Medical Center, Honolulu, Hawaii (K.M.); and Division of Pulmonary, Sleep and Critical Care Medicine, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, South Korea (C.S.)
| | - Katsuyuki Miura
- From the Department of Epidemiology, University of Pittsburgh, PA (J.G., A.V., V.A., E.B.-M., R.W.E., L.H.K., A.S.); Department of Public Health (A.F., N.T., A.K., K.M.) and Center for Epidemiologic Research in Asia (A.K., K.M., H.U.), Shiga University of Medical Science, Japan; Department of Research, Kuakini Medical Center, Honolulu, HI (B.W.); Department of Geriatric Medicine, John A. Burns School of Medicine, University of Hawaii, Honolulu, HI (B.W., K.M.); College of Nursing, Korea University, Seoul, South Korea (J.C.); Department of Environmental Medicine and Public Health, Shimane University, Japan (T.H.); Department of Cardiology, Temple University Hospital, Philadelphia, PA (D.E.); Department of Geriatric Medicine, Kuakini Medical Center, Honolulu, Hawaii (K.M.); and Division of Pulmonary, Sleep and Critical Care Medicine, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, South Korea (C.S.)
| | - Daniel Edmundowicz
- From the Department of Epidemiology, University of Pittsburgh, PA (J.G., A.V., V.A., E.B.-M., R.W.E., L.H.K., A.S.); Department of Public Health (A.F., N.T., A.K., K.M.) and Center for Epidemiologic Research in Asia (A.K., K.M., H.U.), Shiga University of Medical Science, Japan; Department of Research, Kuakini Medical Center, Honolulu, HI (B.W.); Department of Geriatric Medicine, John A. Burns School of Medicine, University of Hawaii, Honolulu, HI (B.W., K.M.); College of Nursing, Korea University, Seoul, South Korea (J.C.); Department of Environmental Medicine and Public Health, Shimane University, Japan (T.H.); Department of Cardiology, Temple University Hospital, Philadelphia, PA (D.E.); Department of Geriatric Medicine, Kuakini Medical Center, Honolulu, Hawaii (K.M.); and Division of Pulmonary, Sleep and Critical Care Medicine, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, South Korea (C.S.)
| | - Kamal Masaki
- From the Department of Epidemiology, University of Pittsburgh, PA (J.G., A.V., V.A., E.B.-M., R.W.E., L.H.K., A.S.); Department of Public Health (A.F., N.T., A.K., K.M.) and Center for Epidemiologic Research in Asia (A.K., K.M., H.U.), Shiga University of Medical Science, Japan; Department of Research, Kuakini Medical Center, Honolulu, HI (B.W.); Department of Geriatric Medicine, John A. Burns School of Medicine, University of Hawaii, Honolulu, HI (B.W., K.M.); College of Nursing, Korea University, Seoul, South Korea (J.C.); Department of Environmental Medicine and Public Health, Shimane University, Japan (T.H.); Department of Cardiology, Temple University Hospital, Philadelphia, PA (D.E.); Department of Geriatric Medicine, Kuakini Medical Center, Honolulu, Hawaii (K.M.); and Division of Pulmonary, Sleep and Critical Care Medicine, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, South Korea (C.S.)
| | - Chol Shin
- From the Department of Epidemiology, University of Pittsburgh, PA (J.G., A.V., V.A., E.B.-M., R.W.E., L.H.K., A.S.); Department of Public Health (A.F., N.T., A.K., K.M.) and Center for Epidemiologic Research in Asia (A.K., K.M., H.U.), Shiga University of Medical Science, Japan; Department of Research, Kuakini Medical Center, Honolulu, HI (B.W.); Department of Geriatric Medicine, John A. Burns School of Medicine, University of Hawaii, Honolulu, HI (B.W., K.M.); College of Nursing, Korea University, Seoul, South Korea (J.C.); Department of Environmental Medicine and Public Health, Shimane University, Japan (T.H.); Department of Cardiology, Temple University Hospital, Philadelphia, PA (D.E.); Department of Geriatric Medicine, Kuakini Medical Center, Honolulu, Hawaii (K.M.); and Division of Pulmonary, Sleep and Critical Care Medicine, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, South Korea (C.S.)
| | - Lewis H Kuller
- From the Department of Epidemiology, University of Pittsburgh, PA (J.G., A.V., V.A., E.B.-M., R.W.E., L.H.K., A.S.); Department of Public Health (A.F., N.T., A.K., K.M.) and Center for Epidemiologic Research in Asia (A.K., K.M., H.U.), Shiga University of Medical Science, Japan; Department of Research, Kuakini Medical Center, Honolulu, HI (B.W.); Department of Geriatric Medicine, John A. Burns School of Medicine, University of Hawaii, Honolulu, HI (B.W., K.M.); College of Nursing, Korea University, Seoul, South Korea (J.C.); Department of Environmental Medicine and Public Health, Shimane University, Japan (T.H.); Department of Cardiology, Temple University Hospital, Philadelphia, PA (D.E.); Department of Geriatric Medicine, Kuakini Medical Center, Honolulu, Hawaii (K.M.); and Division of Pulmonary, Sleep and Critical Care Medicine, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, South Korea (C.S.)
| | - Hirotsugu Ueshima
- From the Department of Epidemiology, University of Pittsburgh, PA (J.G., A.V., V.A., E.B.-M., R.W.E., L.H.K., A.S.); Department of Public Health (A.F., N.T., A.K., K.M.) and Center for Epidemiologic Research in Asia (A.K., K.M., H.U.), Shiga University of Medical Science, Japan; Department of Research, Kuakini Medical Center, Honolulu, HI (B.W.); Department of Geriatric Medicine, John A. Burns School of Medicine, University of Hawaii, Honolulu, HI (B.W., K.M.); College of Nursing, Korea University, Seoul, South Korea (J.C.); Department of Environmental Medicine and Public Health, Shimane University, Japan (T.H.); Department of Cardiology, Temple University Hospital, Philadelphia, PA (D.E.); Department of Geriatric Medicine, Kuakini Medical Center, Honolulu, Hawaii (K.M.); and Division of Pulmonary, Sleep and Critical Care Medicine, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, South Korea (C.S.)
| | - Akira Sekikawa
- From the Department of Epidemiology, University of Pittsburgh, PA (J.G., A.V., V.A., E.B.-M., R.W.E., L.H.K., A.S.); Department of Public Health (A.F., N.T., A.K., K.M.) and Center for Epidemiologic Research in Asia (A.K., K.M., H.U.), Shiga University of Medical Science, Japan; Department of Research, Kuakini Medical Center, Honolulu, HI (B.W.); Department of Geriatric Medicine, John A. Burns School of Medicine, University of Hawaii, Honolulu, HI (B.W., K.M.); College of Nursing, Korea University, Seoul, South Korea (J.C.); Department of Environmental Medicine and Public Health, Shimane University, Japan (T.H.); Department of Cardiology, Temple University Hospital, Philadelphia, PA (D.E.); Department of Geriatric Medicine, Kuakini Medical Center, Honolulu, Hawaii (K.M.); and Division of Pulmonary, Sleep and Critical Care Medicine, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, South Korea (C.S.).
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42
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Increased pulse wave velocity in patients with acute lacunar infarction doubled the risk of future ischemic stroke. Hypertens Res 2016; 40:371-375. [DOI: 10.1038/hr.2016.157] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2016] [Revised: 09/18/2016] [Accepted: 10/03/2016] [Indexed: 12/20/2022]
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