1
|
Fu J, Deng Y, Ma Y, Man S, Yang X, Yu C, Lv J, Wang B, Li L. National and Provincial-Level Prevalence and Risk Factors of Carotid Atherosclerosis in Chinese Adults. JAMA Netw Open 2024; 7:e2351225. [PMID: 38206625 PMCID: PMC10784858 DOI: 10.1001/jamanetworkopen.2023.51225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 11/21/2023] [Indexed: 01/12/2024] Open
Abstract
Importance Epidemiologic studies on carotid atherosclerosis (CAS) based on nationwide ultrasonography measurements can contribute to understanding the future risk of cardiovascular diseases and identifying high-risk populations, thereby proposing more targeted prevention and treatment measures. Objectives To estimate the prevalence of CAS within the general population of China and to investigate its distribution among populations with potential risk factors and variation across diverse geographic regions. Design, Setting, and Participants This multicenter, population-based cross-sectional study used China's largest health check-up chain database to study 10 733 975 individuals aged 20 years or older from all 31 provinces in China who underwent check-ups from January 1, 2017, to June 30, 2022. Main Outcomes and Measures Carotid atherosclerosis was assessed and graded using ultrasonography as increased carotid intima-media thickness (cIMT), carotid plaque (CP), and carotid stenosis (CS). The overall and stratified prevalences were estimated among the general population and various subpopulations based on demographic characteristics, geographic regions, and cardiovascular disease risk factors. Mixed-effects regression models were used to analyze the risk factors for CAS. Results Among 10 733 975 Chinese participants (mean [SD] age, 47.7 [13.4] years; 5 861 566 [54.6%] male), the estimated prevalences were 26.2% (95% CI, 25.0%-27.4%) for increased cIMT, 21.0% (95% CI, 19.8%-22.2%) for CP, and 0.56% (95% CI, 0.36%-0.76%) for CS. The prevalence of all CAS grades was higher among older adults (eg, increased cIMT: aged ≥80 years, 92.7%; 95% CI, 92.2%-93.3%), male participants (29.6%; 95% CI, 28.4%-30.7%), those residing in northern China (31.0%; 95% CI, 29.1%-32.9%), and those who had comorbid conditions, such as hypertension (50.8%; 95% CI, 49.7%-51.9%), diabetes (59.0%; 95% CI, 57.8%-60.1%), dyslipidemia (32.1%; 95% CI, 30.8%-33.3%), and metabolic syndrome (31.0%; 95% CI, 29.1%-32.9%). Most cardiovascular disease risk factors were independent risk factors for all CAS stages (eg, hypertension: 1.60 [95% CI, 1.60-1.61] for increased cIMT, 1.62 [95% CI, 1.62-1.63] for CP, and 1.48 [95% CI, 1.45-1.51] for CS). Moreover, the magnitude of the association between several cardiovascular disease risk factors and increased cIMT and CP differed between the sexes and geographic regions. Conclusions and Relevance These findings suggest that nearly one-quarter of Chinese adults have increased cIMT or CP. The burden of this disease is unevenly distributed across geographic regions and subpopulations and may require different levels of local planning, support, and management. Addressing these disparities is crucial for effectively preventing and managing cardiovascular and cerebrovascular diseases in China.
Collapse
Affiliation(s)
- Jingzhu Fu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
- Meinian Public Health Institute, Peking University Health Science Center, Beijing, China
- Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing, China
| | - Yuhan Deng
- Meinian Institute of Health, Beijing, China
- Department of Social Medicine and Health Education, School of Public Health, Peking University, Beijing, China
- Chongqing Research Institute of Big Data, Peking University, Chongqing, China
| | - Yuan Ma
- Meinian Institute of Health, Beijing, China
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Sailimai Man
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
- Meinian Public Health Institute, Peking University Health Science Center, Beijing, China
- Meinian Institute of Health, Beijing, China
| | - Xiaochen Yang
- Meinian Institute of Health, Beijing, China
- Department of Social Medicine and Health Education, School of Public Health, Peking University, Beijing, China
| | - Canqing Yu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
- Meinian Public Health Institute, Peking University Health Science Center, Beijing, China
- Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing, China
- Peking University Center for Public Health and Epidemic Preparedness & Response, Beijing, China
| | - Jun Lv
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
- Meinian Public Health Institute, Peking University Health Science Center, Beijing, China
- Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing, China
- Peking University Center for Public Health and Epidemic Preparedness & Response, Beijing, China
| | - Bo Wang
- Meinian Public Health Institute, Peking University Health Science Center, Beijing, China
- Meinian Institute of Health, Beijing, China
- Peking University Center for Public Health and Epidemic Preparedness & Response, Beijing, China
| | - Liming Li
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
- Meinian Public Health Institute, Peking University Health Science Center, Beijing, China
- Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing, China
- Peking University Center for Public Health and Epidemic Preparedness & Response, Beijing, China
| |
Collapse
|
2
|
Sun J, Guo F, Ran J, Wu H, Li Y, Wang M, Wang X. Bibliometric and Visual Analysis of Global Research on Taurine, Creatine, Carnosine, and Anserine with Metabolic Syndrome: From 1992 to 2022. Nutrients 2023; 15:3374. [PMID: 37571314 PMCID: PMC10420945 DOI: 10.3390/nu15153374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 07/25/2023] [Accepted: 07/27/2023] [Indexed: 08/13/2023] Open
Abstract
Red meat and animal-sourced protein are often disparaged as risk factors for developing metabolic syndrome, while emerging research has shown the beneficial effects of dietary taurine, creatine, carnosine, and anserine which are all exclusively abundant in red meat. Thus, it is imperative to highlight the available evidence to help promote red meat as part of a well-balanced diet to optimize human health. In this study, a bibliometric analysis was conducted to investigate the current research status of dietary taurine, creatine, carnosine, and anserine with metabolic syndrome, identify research hotspots, and delineate developmental trends by utilizing the visualization software CiteSpace. A total of 1094 publications were retrieved via the Web of Science Core Collection from 1992 to 2022. There exists a gradual increase in the number of publications on this topic, but there is still much room for research papers to rise. The United States has participated in the most studies, followed by China and Japan. The University of Sao Paulo was the research institute contributing the most; Kyung Ja Chang and Sanya Roysommuti have been identified as the most prolific authors. The analysis of keywords reveals that obesity, lipid profiles, blood pressure, and glucose metabolism, as well as ergogenic aid and growth promoter have been the research hotspots. Inflammation and diabetic nephropathy will likely be frontiers of future research related to dietary taurine, creatine, carnosine, and anserine. Overall, this paper may provide insights for researchers to further delve into this field and enlist the greater community to re-evaluate the health effects of red meat.
Collapse
Affiliation(s)
- Jiaru Sun
- Department of Nursing, Xi’an Jiaotong University Health Science Center, 76 Yanta West Road, Xi’an 710061, China;
| | - Fang Guo
- School of Public Health, The University of Hong Kong, 7 Sassoon Road, Pok Fu Lam, Hong Kong, China; (H.W.); (Y.L.)
| | - Jinjun Ran
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China;
| | - Haisheng Wu
- School of Public Health, The University of Hong Kong, 7 Sassoon Road, Pok Fu Lam, Hong Kong, China; (H.W.); (Y.L.)
| | - Yang Li
- School of Public Health, The University of Hong Kong, 7 Sassoon Road, Pok Fu Lam, Hong Kong, China; (H.W.); (Y.L.)
| | - Mingxu Wang
- School of Public Health, Xi’an Jiaotong University Health Science Center, 76 Yanta West Road, Xi’an 710061, China
| | - Xiaoqin Wang
- Department of Nursing, Xi’an Jiaotong University Health Science Center, 76 Yanta West Road, Xi’an 710061, China;
| |
Collapse
|
3
|
Shao J, Li Y, Xia J, Zheng L, Sun Z, Guo C. Trends in ethnic disparities in clinical cardiovascular health among Chinese adults from 2016-2020. Nutr Metab Cardiovasc Dis 2023; 33:749-757. [PMID: 36805193 DOI: 10.1016/j.numecd.2023.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Revised: 01/05/2023] [Accepted: 01/09/2023] [Indexed: 01/15/2023]
Abstract
BACKGROUND AND AIMS Little is known about the long-term trends in ethnic differences in cardiovascular health (CVH) in China in recent years. This study aimed to investigate ethnic differences in CVH and identify long-term trends in China. METHODS AND RESULTS This survey was based on the physical examination data of Tacheng Prefecture in China from 2016 to 2020, and included 1,947,938 physical examination participants aged over 20 years for analysis. The American Heart Association (AHA) criteria were used to evaluate the clinical CVH of the subjects. The time trends from 2016 to 2020 were assessed using a weighted linear regression model stratified by ethnicity. The ethnic groups included Han, Kazakh, Hui, Mongolian, Uyghur, among others. The mean ideal clinical cardiovascular score was highest in Hui and lowest in Uyghur. The scores increased from 5.99 (5.95-6.03) to 6.11 (6.08-6.14) in Kazakh males and from 6.05 (5.99-6.11) to 6.11 (6.06-6.16) in Hui males among participants (Plinear trend < 0.001). The scores for the other groups declined significantly from 2016 to 2020(Plinear trend < 0.05). In the sensitivity analysis, the trend remained unchanged after calculating the body mass index (BMI) cut-off for China. CONCLUSION Clinical CVH differences still exist among different ethnic groups, with a decline in CVH from 2016 to 2020 in all except Kazakh and Hui males. This may indicate a higher incidence and poorer prognosis of cardiovascular disease in the future and can provide guidelines for improving CVH.
Collapse
Affiliation(s)
- Jingan Shao
- Department of Biostatistics and Epidemiology, School of Public Health, China Medical University, Shenyang 110122, China; Department of Cardiology, Shengjing Hospital of China Medical University, Shenyang 110004, China
| | - Yuying Li
- Health Commission of Tacheng Prefecture, Tacheng Prefecture, 834799, China
| | - Jianjiang Xia
- People's Hospital of Tacheng Prefecture, 834799, China
| | - Liqiang Zheng
- Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China.
| | - Zhaoqing Sun
- Department of Cardiology, Shengjing Hospital of China Medical University, Shenyang 110004, China.
| | - Chuanji Guo
- Department of Clinical Epidemiology,Shengjing Hospital of China Medical University, Shenyang 110004, China.
| |
Collapse
|
4
|
Jiang K, He T, Ji Y, Zhu T, Jiang E. The perspective of hypertension and salt intake in Chinese population. Front Public Health 2023; 11:1125608. [PMID: 36875386 PMCID: PMC9981806 DOI: 10.3389/fpubh.2023.1125608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 02/01/2023] [Indexed: 02/19/2023] Open
Abstract
Salt intake is too high nowadays. It has been widely recognized that there is a close relationship between hypertension (HTN) and dietary salt intake. Investigations reveal that long-term high salt intake, mainly sodium intake, induces a relevant increase in blood pressure in hypertensive and normotensive individuals. According to most scientific evidence, a diet with high salt intake in public increases cardiovascular risk, salted-related HTN, and other HTN-associated outcomes. Given the clinical importance, this review aims to present the prevalence of HTN and trends in salt intake in the Chinese population and will comprehensively discuss the risk factors, causes, and mechanisms of the association between salt intake and HTN. The review also highlights the education of Chinese people regarding salt intake and the cost-effectiveness of salt reduction from a global perspective. Finally, the review will emphasize the need to customize the unique Chinese practices to reduce salt intake and how awareness changes people's eating lifestyle and helps adopt diet salt reduction strategies.
Collapse
Affiliation(s)
- Kexin Jiang
- Institute of Nursing and Health, Henan University, Kaifeng, China
| | - Tingting He
- Department of Basic Nursing, Henan Technical Institute, Zhengzhou, China
| | - Yongzhi Ji
- Institute of Nursing and Health, Henan University, Kaifeng, China
| | - Tao Zhu
- Department of Geriatrics, Kaifeng Traditional Chinese Medicine Hospital, Kaifeng, China
| | - Enshe Jiang
- Institute of Nursing and Health, Henan University, Kaifeng, China.,Department of Scientific Research, Scope Research Institute of Electrophysiology, Kaifeng, China
| |
Collapse
|
5
|
Wu J, Gao Y, Malik V, Gao X, Shan R, Lv J, Ning Y, Wang B, Li L. Prevalence and risk factors of MRI-defined brain infarcts among Chinese adults. Front Neurol 2022; 13:967077. [PMID: 36313518 PMCID: PMC9597681 DOI: 10.3389/fneur.2022.967077] [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: 06/12/2022] [Accepted: 09/20/2022] [Indexed: 11/24/2022] Open
Abstract
Background Few studies have explored the prevalence and risk factors of brain infarcts (BI) detected by magnetic resonance imaging (MRI) in China. The purpose was to evaluate the prevalence and risk factors of brain infarcts (BI) detected by magnetic resonance imaging (MRI) in 1.4 million Chinese adults. Methods This was a multicenter cross-sectional study conducted on 1,431,527 participants aged ≥18 years (mean age: 46.4 years) who underwent MRI scans in health examinations from 28 provinces of China in 2018. MRI-defined BI was defined as focal parenchymal lesions ≥3 mm. Multivariable logistic regression analyses were performed to evaluate risk factors associated with MRI-defined BI. Results The age- and sex-standardized prevalence of MRI-defined BI, lacunar and non-lacunar infarcts were 5.79% (5.75–5.83%), 4.56% (4.52–4.60%), and 1.23% (1.21–1.25%), respectively. The sex-standardized prevalence of MRI-defined BI ranged from 0.46% among those aged 18–29 years to 37.33% among those aged ≥80 years. Men (6.30%) had a higher age-standardized prevalence of MRI-defined BI than women (5.28%). The highest age- and sex-standardized prevalence of MRI-defined BI was observed in the Northwest (8.34%) and Northeast (8.02%) regions, while the lowest prevalence was observed in the Southwest (4.02%). A higher risk of MRI-defined BI was associated with being male [odd ratio (OR) 1.17, 95% CI 1.15–1.19], older age (OR per 10-year increments 2.33, 2.31–2.35), overweight (1.12, 1.10–1.14) or obesity (1.18, 1.16–1.21), hypertension (1.80, 1.77–1.83), diabetes (1.24, 1.21–1.26), and dyslipidemia (1.07, 1.05–1.08). Conclusion MRI-defined BI is highly prevalent in China, even among young adults. MRI-defined BI was associated with being male, older age, living in the northern region, and metabolic conditions.
Collapse
Affiliation(s)
- Jing Wu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
| | | | - Vasanti Malik
- Department of Nutritional Sciences, University of Toronto, Toronto, ON, Canada
| | - Xiang Gao
- Department of Nutritional Sciences, The Pennsylvania State University, University Park, State College, PA, United States
| | - Ruiqi Shan
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Jun Lv
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
- Meinian Public Health Institute, Peking University Health Science Center, Beijing, China
| | - Yi Ning
- Meinian Institute of Health, Beijing, China
- School of Public Health, Hainan Medical University, Haikou, China
- Yi Ning
| | - Bo Wang
- Meinian Institute of Health, Beijing, China
- Meinian Public Health Institute, Peking University Health Science Center, Beijing, China
- Bo Wang
| | - Liming Li
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
- Meinian Public Health Institute, Peking University Health Science Center, Beijing, China
- *Correspondence: Liming Li
| |
Collapse
|
6
|
Bae M, Ahmed K, Yim JE. Beneficial Effects of Taurine on Metabolic Parameters in Animals and Humans. J Obes Metab Syndr 2022; 31:134-146. [PMID: 35670160 PMCID: PMC9284575 DOI: 10.7570/jomes21088] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 01/14/2022] [Accepted: 04/13/2022] [Indexed: 11/02/2022] Open
Abstract
Taurine (2-aminoethanesulfonic acid) is a non-essential amino acid mainly obtained through diet in humans. Despite the lack of research on the health effects of taurine in animals and humans, it is widely used as a dietary supplement. Evidence from human and animal studies indicates that taurine is involved in conjugation of bile acids and regulation of blood pressure and has anti-oxidative, anti-inflammatory, and anti-obesogenic properties. Taurine can benefit both human and non-human animal health in multiple ways. However, few interventional and epidemiological studies regarding the beneficial impacts of taurine in humans and other animals have been conducted. Here, we review the evidence from animal and human studies showing that taurine protects against dyslipidemia, obesity, hypertension, and diabetes mellitus.
Collapse
Affiliation(s)
- Minkyung Bae
- Department of Food and Nutrition, Changwon National University, Changwon, Korea.,Interdisciplinary Program in Senior Human Ecology, BK21, Changwon National University, Changwon, Korea
| | - Kainat Ahmed
- Interdisciplinary Program in Senior Human Ecology, BK21, Changwon National University, Changwon, Korea
| | - Jung-Eun Yim
- Department of Food and Nutrition, Changwon National University, Changwon, Korea.,Interdisciplinary Program in Senior Human Ecology, BK21, Changwon National University, Changwon, Korea
| |
Collapse
|
7
|
Prevalence of hypertension and its relationship with altitude in highland areas: a systematic review and meta-analysis. Hypertens Res 2022; 45:1225-1239. [PMID: 35705740 DOI: 10.1038/s41440-022-00955-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 05/12/2022] [Accepted: 05/13/2022] [Indexed: 02/05/2023]
Abstract
This systematic review and meta-analysis synthesized the pooled prevalence of hypertension at high altitudes and explored its correlation with altitude using studies published in Chinese and English from database inception to February 2021. A systematic literature search was conducted among bibliographic databases (PubMed, Embase, and Web of Science) and three Chinese databases (CNKI, VIP, and Wanfang data) to identify eligible studies. A random-effects model was used to calculate the overall pooled prevalence of hypertension. The I2 statistic was used to assess heterogeneity across studies. Random-effects meta-regression was conducted to investigate covariates that may have influenced between-study heterogeneity. The pooled prevalence of hypertension among the general population in high-altitude areas was 33.0% (95% CI: 29.0-38.0%), with high between-study heterogeneity (I2 = 99.4%, P < 0.01). Subgroup analyses showed the pooled prevalence of hypertension in Tibetan individuals was significantly higher than that in non-Tibetan individuals living in the Himalayas and Pamir Mountains (41% vs. 18%). A trend toward an increase in the prevalence of hypertension was found with every 100-m increase in elevation (coefficient: 0.012, 95% CI: -0.001 to 0.025, P = 0.069) only in Tibetan individuals. In addition, in these individuals, we found an increase in mean diastolic BP with each 100-m increase in altitude (coefficient: 0.763, 95% CI: 0.122-1.403, P = 0.025). Our meta-analysis suggests that the pooled prevalence of hypertension among the general population in high-altitude areas is 33.0%. Subjects of Tibetan ethnicity were more prone to developing hypertension at high altitudes. However, a very weak relationship between altitude and the prevalence of hypertension was found only in Tibetan individuals.
Collapse
|
8
|
Zhou Q, Sun J, Wu Z, Wu W, Zhang X, Pan Q, Qi H, Yuan H, Shi H, Cao S, Yang Z, Wang X, Sun L. The older, the less potential benefit for type 2 diabetes from weight control. BMC Geriatr 2022; 22:346. [PMID: 35443612 PMCID: PMC9022304 DOI: 10.1186/s12877-022-02979-8] [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] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 03/25/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Although moderate weight loss improves outcomes of type 2 diabetes mellitus (T2DM) in young and middle-aged adults, there is a lack of high-quality evidence to support the strong relationship between obesity and T2DM in older people. This study aims to investigate whether the association of obesity with T2DM changes with aging. METHODS In this cross-sectional study, we recruited 63,180 Chinses and US subjects from 3 datasets. Subjects were divided into young & middle-aged (≤59 years), young-old (60-75 years), and old-old (≥75 years). Logistic regression was used to determine the odds ratio (OR) and 95% confidence intervals (95% CI) for the association between obesity and T2DM, stratified by common confounders. A sliding-window based algorithm and restricted cubic splines were used to smoothly estimate the changes with aging. RESULTS The OR (95% CI) for the associations between general obesity and T2DM were decreased from the young & middle-aged group (OR, 5.91; 95% CI, 5.33-6.56) to the young-old group (OR, 3.98; 95% CI, 3.56-4.45) and then to the old-old group (OR, 3.06; 95% CI, 2.57-3.66). The trend for this reduced association with aging persisted after stratification by obesity type, region, gender, recruiting time, hypertension, and hyperlipidemia in both Chinese and Americans. We also identified a weakened gender disparity for this association between the young & middle-aged subjects (P for disparity < 0.001) and the old-old group (P for disparity = ~ 0.36). CONCLUSIONS The obesity-T2DM association is clearly reduced with aging, which indicates that the elderly may gain fewer potential benefits in weight lose than the younger patients. Considering this attenuated association, as well as the increased incidence of geriatric syndrome in the elderly, clinicians should comprehensively balance the benefits and side effects of weight loss in geriatric T2DM interventions.
Collapse
Affiliation(s)
- Qi Zhou
- The Key Laboratory of Geriatrics, Beijing Institute of Geriatrics, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital/National Center of Gerontology of National Health Commission, Beijing, 100730, People's Republic of China
| | - Jie Sun
- Graduate School of Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, 100730, People's Republic of China
| | - Zhu Wu
- The Key Laboratory of Geriatrics, Beijing Institute of Geriatrics, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital/National Center of Gerontology of National Health Commission, Beijing, 100730, People's Republic of China
| | - Wenbin Wu
- Geriatrics Department, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, 100730, People's Republic of China
| | - Xianbo Zhang
- Department of Endocrinology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, 100730, People's Republic of China
| | - Qi Pan
- Department of Endocrinology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, 100730, People's Republic of China
| | - Haimei Qi
- Department of Medical and Health, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, 100730, People's Republic of China
| | - Huiping Yuan
- The Key Laboratory of Geriatrics, Beijing Institute of Geriatrics, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital/National Center of Gerontology of National Health Commission, Beijing, 100730, People's Republic of China
| | - Hong Shi
- Geriatrics Department, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, 100730, People's Republic of China
| | - Suyan Cao
- Health Management Center, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, 100730, People's Republic of China
| | - Ze Yang
- The Key Laboratory of Geriatrics, Beijing Institute of Geriatrics, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital/National Center of Gerontology of National Health Commission, Beijing, 100730, People's Republic of China
| | - Xiaoxia Wang
- Department of Endocrinology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, 100730, People's Republic of China.
| | - Liang Sun
- The Key Laboratory of Geriatrics, Beijing Institute of Geriatrics, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital/National Center of Gerontology of National Health Commission, Beijing, 100730, People's Republic of China. .,The NHC Key laboratory of Drug Addiction Medicine, Kunming Medical University, Kunming, 650032, China.
| |
Collapse
|
9
|
Xiao Z, Sun X, Zhaxi D, Zhang F, Ji Y, Cheng T, Li X, Xu X. Distinct Nutrient Intake Style in Inhabitants of Ultra-High-Altitude Areas in North of Tibet, China: A Cross-Sectional Study Based on Newly Developed Tibetan Food Frequency Questionnaires. Front Nutr 2021; 8:743896. [PMID: 35004798 PMCID: PMC8733569 DOI: 10.3389/fnut.2021.743896] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 11/22/2021] [Indexed: 12/13/2022] Open
Abstract
Dietary pattern is quite distinct among the inhabitants of high-altitude areas because of environmental and geographical uniqueness; hence, it is important to investigate this data as accurately as possible. However, very few data are related to these populations up to now. Based on the food frequency questionnaire (FFQ) used in the Chinese population, a revised Tibetan edition was developed with respect to the lifestyle in high-altitude areas. After assessment of validity and reproducibility, a nutrition intake survey was conducted among 1,071 randomly sampled Tibetan people. In addition, the Bland-Altman approach was used to compare the agreement between the two dietary tools. For the reproducibility analysis, intraclass correlation coefficients (ICC) were calculated to examine the agreement of food groups and nutrients from the two FFQs (FFQ1 and FFQ2). Nutrient intake was calculated using food composition tables. For the validity analysis, Pearson's correlation of food groups intakes varied from 0.22 to 0.91 (unadjusted). The correlations of nutrients ranged from 0.24 to 0.76 (unadjusted). In the analysis of reliability, the ICC of food groups varied from 0.27 to 0.70 (unadjusted). The ICC of nutrient intakes ranged from 0.22 to 0.87 (unadjusted). The results of nutritional analysis showed that ~25% of foods consumed frequently were traditional Tibetan foods. However, traditional Han foods were frequently consumed. In addition, the energy, iron, and protein intakes for male or female subjects were close to the Chinese Dietary Nutrient Reference Intake (Chinese DRIs); however, fat and sodium intakes were significantly higher than the Chinese DRIs. Interestingly, lower intakes of other types of nutrition, such as vitamin C were detected in people living in high-altitude areas. Our data indicated that excess consumption of fat and sodium and insufficient intake of vitamin C were common among Tibetan people, as compared with the most Chinese people living in the plateau areas. More investigations are needed to reveal the association between the food intake style and high-altitude endemic diseases.
Collapse
Affiliation(s)
- Zhen Xiao
- Institute of High Altitude Medicine, People's Hospital of Naqu Affiliated to Dalian Medical University, Naqu, China
- Department of Obstetrics and Gynecology, First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Xianzhi Sun
- Department of Epidemiology and Health Statistics, Dalian Medical University, Dalian, China
| | - Duoji Zhaxi
- Institute of High Altitude Medicine, People's Hospital of Naqu Affiliated to Dalian Medical University, Naqu, China
| | - Fan Zhang
- Department of Epidemiology and Health Statistics, Dalian Medical University, Dalian, China
| | - Yuchen Ji
- Department of Epidemiology and Health Statistics, Dalian Medical University, Dalian, China
| | - Tingting Cheng
- Department of Epidemiology and Health Statistics, Dalian Medical University, Dalian, China
| | - Xiaofeng Li
- Department of Epidemiology and Health Statistics, Dalian Medical University, Dalian, China
| | - Xiaoguang Xu
- Institute of High Altitude Medicine, People's Hospital of Naqu Affiliated to Dalian Medical University, Naqu, China
- Department of Neurosurgery, Second Affiliated Hospital of Dalian Medical University, Dalian, China
| |
Collapse
|
10
|
Zhang X, Liao H, Ye R, Li X, Gou Q, Zhang Z, Shi R, Meng Q, Zhuoma Z, Zhang H, Chen X. Assessment and validation of three spot urine assay methods for the estimation of 24-hour urinary sodium excretion in Chinese Tibetan adults living in the mountains. J Clin Hypertens (Greenwich) 2021; 23:1588-1598. [PMID: 34196446 PMCID: PMC8678802 DOI: 10.1111/jch.14312] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Revised: 05/17/2021] [Accepted: 06/03/2021] [Indexed: 02/05/2023]
Abstract
Twenty‐four‐hour urine collection is the gold standard method for the evaluation of salt intake, but it is often impractical in large‐scale investigations, especially in resource‐poor areas. Methods for the estimation of 24‐hour urinary sodium excretion (USE) using a spot urine sample have been established, but have not been validated in Chinese Tibetans. Therefore, the authors aimed to evaluate the Kawasaki, Tanaka, and the International Cooperative Study on Salt, Other Factors, and Blood Pressure (INTERSALT) formulas for the prediction of 24‐hour USE in Chinese Tibetan adults. The authors analyzed the bias, correlation, agreements between estimated values and measured values, and the relative and absolute differences and misclassification at the individual level for the three methods in 323 Tibetan participants from the Ganzi Tibetan Autonomous Prefecture of Sichuan Province, China. The mean biases between the measured values and the estimated 24‐hour USE using the Kawasaki, Tanaka, and INTERSALT methods were 5.4 mmol/day (95% confidence interval [CI]: 0.8–10.1 mmol/day), −40.8 mmol/day (95% CI: −44.6 to −36.9 mmol/day), and −57.1 mmol/day (95% CI: −61.9 to −52.4 mmol/day), respectively. The Pearson correlation coefficients for the relationships between the measured values and the estimated 24‐hour USE were 0.43 (Kawasaki), 0.38 (Tanaka), and 0.27 (INTERSALT), respectively (all p < .01). The intraclass correlation coefficients showed similar patterns to the correlation data: 0.47 for Kawasaki, 0.40 for Tanaka, and 0.27 for INTERSALT (all p < .01). The upper and lower limits of agreement between the measured values and the estimated 24‐hour USE were −92.6 and 81.8 mmol/day for the Kawasaki method, −28.5 and 110.0 mmol/day for the Tanaka method, and −28.4 and 142.7 mmol/day for the INTERSALT method. Compared with the other two methods, the percentage of individuals that were misclassified by using the Kawasaki method was 48.2%, while those for the Tanaka and INTERSAL methods was 72.1% and 75.5%, respectively. However, when an individual's salt intake was higher than 12.8 g/day, the misclassification rates of the Kawasaki, Tanaka, and INTERSALT methods were 20%, 90%, and 97.5%, respectively. Thus, the authors found that the Kawasaki equation may have performed better than the other equations at Chinese Tibetan population level assessment, but none of these equations are suitable for use or perform well at the individual level. A more accurate method of using a spot urine sample to evaluate individual 24‐hour USE for Tibetans is needed.
Collapse
Affiliation(s)
- Xin Zhang
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, Sichuan Province, People's Republic of China
| | - Hang Liao
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, Sichuan Province, People's Republic of China
| | - Runyu Ye
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, Sichuan Province, People's Republic of China
| | - Xinran Li
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, Sichuan Province, People's Republic of China
| | - Qiling Gou
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, Sichuan Province, People's Republic of China
| | - Zhipeng Zhang
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, Sichuan Province, People's Republic of China
| | - Rufeng Shi
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, Sichuan Province, People's Republic of China
| | - Qingtao Meng
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, Sichuan Province, People's Republic of China
| | - Zewong Zhuoma
- Luohuo County Health Bureau, Ganzi Tibetan Autonomous Prefecture, Luhuo, Sichuan Province, People's Republic of China
| | - Hengyu Zhang
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, Sichuan Province, People's Republic of China
| | - Xiaoping Chen
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, Sichuan Province, People's Republic of China
| |
Collapse
|
11
|
The effects of taurine supplementation on obesity, blood pressure and lipid profile: A meta-analysis of randomized controlled trials. Eur J Pharmacol 2020; 885:173533. [DOI: 10.1016/j.ejphar.2020.173533] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 08/26/2020] [Accepted: 08/28/2020] [Indexed: 12/11/2022]
|
12
|
Doğan M, Sabaner MC, Akar AT, Şenel M, Kaşikçi İ, Günal EŞ, Özbay AE, Şarman T, Gobeka HH, Cam Ö. Evaluation of the effect of energy drink consumption on retina and choroid: an optical coherence tomography and optical coherence tomography angiography study. Cutan Ocul Toxicol 2020; 39:295-297. [DOI: 10.1080/15569527.2020.1755977] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Mustafa Doğan
- Faculty of Medicine, Department of Ophthalmology, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
| | | | - Ahmet Tayyip Akar
- Faculty of Medicine, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
| | - Metehan Şenel
- Faculty of Medicine, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
| | - İsmet Kaşikçi
- Faculty of Medicine, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
| | - Emine Şule Günal
- Faculty of Medicine, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
| | - Ahmet Esat Özbay
- Faculty of Medicine, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
| | - Tuğrul Şarman
- Faculty of Medicine, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
| | | | - Özlem Cam
- Department of Ophthalmology, Maltepe University, İstanbul, Turkey
| |
Collapse
|
13
|
Li N, Cai L, Heizhati M, Wang L, Li M, Zhang D, Abulikemu S, Yao X, Hong J, Zou B, Zhao J. Maternal exposure to cold spells during pregnancy is associated with higher blood pressure and hypertension in offspring later in life. J Clin Hypertens (Greenwich) 2020; 22:1884-1891. [PMID: 32815665 DOI: 10.1111/jch.14015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 08/02/2020] [Accepted: 08/04/2020] [Indexed: 12/18/2022]
Abstract
We aimed to investigate whether month of birth is associated with blood pressure (BP) and prevalent hypertension in adults from a region with frost-free days of <150 days and average temperatures - 13°C in winter, Xinjiang, China. We analyzed data for 6158 subjects from several surveys. We divided participants into April to August (n = 2624) and September to March (n = 3534) groups, based on length of maternal exposure to cold months, and analyzed BP, prevalent hypertension, and related factors. Diastolic BP in total subjects and systolic and diastolic BP in male subjects born between April and August were significantly higher than in those born between September and March. In sensitivity analysis, untreated males born between April and August showed significantly higher systolic and diastolic BP than did their counterparts. Subjects born between April and August showed significantly higher prevalence of hypertension (31.3% vs 27.8%, P = .003), and isolated systolic (23.3% vs 20.8%, P = .018) and diastolic hypertension (24.5% vs 21.4%, P = .004), than those born between September and March, which is similar for men. Birth between April and August showed 1.68 (95% CI: 1.06-2.67, P = .027)-fold increased odds for the prevalence of hypertension, independent of gender, age, body mass index, waist circumference, cigarette consumption, alcohol intake, and family history, compared with their counterparts. In conclusion, maternal exposure to cold spells during pregnancy may be associated with the increased risk of hypertension in offspring later in life, particularly among males, suggesting the involvement of maternal cold exposure during pregnancy in offspring hypertension development.
Collapse
Affiliation(s)
- Nanfang Li
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, National Health Committee Key Laboratory of Hypertension Clinical Research, Urumqi, China
| | - Li Cai
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, National Health Committee Key Laboratory of Hypertension Clinical Research, Urumqi, China
| | - Mulalibieke Heizhati
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, National Health Committee Key Laboratory of Hypertension Clinical Research, Urumqi, China
| | - Lin Wang
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, National Health Committee Key Laboratory of Hypertension Clinical Research, Urumqi, China
| | - Mei Li
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, National Health Committee Key Laboratory of Hypertension Clinical Research, Urumqi, China
| | - Delian Zhang
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, National Health Committee Key Laboratory of Hypertension Clinical Research, Urumqi, China
| | - Suofeiya Abulikemu
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, National Health Committee Key Laboratory of Hypertension Clinical Research, Urumqi, China
| | - Xiaoguang Yao
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, National Health Committee Key Laboratory of Hypertension Clinical Research, Urumqi, China
| | - Jing Hong
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, National Health Committee Key Laboratory of Hypertension Clinical Research, Urumqi, China
| | - Bo Zou
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, National Health Committee Key Laboratory of Hypertension Clinical Research, Urumqi, China
| | - Jianxin Zhao
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, National Health Committee Key Laboratory of Hypertension Clinical Research, Urumqi, China
| |
Collapse
|
14
|
Sodium and potassium intakes in the Kazakhstan population estimated using 24-h urinary excretion: evidence for national action. Eur J Nutr 2020; 60:1537-1546. [PMID: 32754796 DOI: 10.1007/s00394-020-02354-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Accepted: 07/27/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE There is strong scientific evidence for reducing sodium and increasing potassium intake to the recommended levels to lower blood pressure and cardiovascular risk, but consumption levels in Kazakhstan are unknown. This study sought to estimate mean sodium and potassium intake using 24-h urine samples and describe dietary knowledge and behavior among adults in Kazakhstan. METHODS In two cross-sectional surveys, the same multi-stage cluster sampling method was used to randomly select participants aged 25-64 years from Almaty City in 2015 and Kyzylorda in 2016. Complete 24-h urine samples were available for 478 participants; 294 in Almaty City and 184 in Kyzylorda (response rates 86% and 54%, respectively) and were weighted for the age and sex distribution of the two regions. RESULTS Weighted mean 24-h urinary sodium excretion was 6782 mg/day (17.2 g salt) (95% CI 6507-7058) in both regions combined, and not significantly different between the regions (P = 0.660). 99% of adults in the two regions combined consumed above the World Health Organization's (WHO) recommended sodium maximum of 2000 mg/day; however, only 15% of adults perceived that they consumed excess sodium. Weighted mean 24-h urinary potassium excretion was 2271 mg/day (95% CI 2151-2391) for the regions combined. CONCLUSION Mean sodium consumption in Kazakhstan was more than triple the WHO's recommended maximum, and mean potassium consumption was below the recommended minimum. National efforts to lower sodium intake and increase potassium intake are needed and would likely prevent ample premature deaths and disease burden.
Collapse
|
15
|
Prevalence, Awareness, Treatment, Control, and Related Factors of Hypertension among Tajik Nomads Living in Pamirs at High Altitude. Int J Hypertens 2020; 2020:5406485. [PMID: 32733702 PMCID: PMC7376436 DOI: 10.1155/2020/5406485] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Revised: 05/27/2020] [Accepted: 06/09/2020] [Indexed: 12/15/2022] Open
Abstract
Background Hypertension is a global problem, for which high-altitude residents exhibit higher burden. Hypertension in Tajik nomads from Pamirs with an average altitude above 4000 m remains less studied. We aimed to determine the prevalence, awareness, treatment, control, and risk factors associated with hypertension among Tajik population in Pamirs. Methods A cross-sectional survey was conducted between August and September 2015 using stratified three-stage random sampling in Taxkorgan county, Pamirs, China. Hypertension is defined as mean systolic and/or diastolic blood pressure (SBP, DBP) ≥140/90 mmHg and/or taking antihypertensive medication within the past two weeks. The prevalence (SBP ≥130 or DBP ≥80 mmHg) was also estimated using the 2017 American College of Cardiology (ACC)/American Heart Association (AHA) High Blood Pressure Guideline. The awareness, treatment, and control of hypertension and associated factors were evaluated. Results Totally, 797 subjects aged ≥18 years were enrolled with 46.3% men and 88.8% nomads with the mean age of 42.3 ± 15.2 years. The prevalence of hypertension was 24.2% (140/90 mmHg), and the prevalence was as high as 40.3%, based on the 2017 ACC/AHA guideline. Overall awareness, treatment, and control of hypertension were 52.8%, 40.9%, and 9.3%, respectively. In multivariate logistic regression, BMI ≥24.0 kg/m2 (OR: 2.41, 95% CI: 1.44–4.04) was a risk factor for prehypertension, and age ≥60 years (OR: 2.04, 95% CI: 1.15–3.61), BMI ≥24.0 kg/m2 (OR: 2.04, 95% CI: 1.15–3.61), and abdominal obesity (OR: 1.87, 95% CI: 1.09–3.22) were risk factors for hypertension. Angiotensin-converting enzyme inhibitors/angiotensin receptor blockers were the most commonly used antihypertensive medication (45.4%) as monotherapy, and 13.6% of treated hypertensive patients used two drugs. Conclusions There is a considerable prevalence of hypertension with low awareness, treatment, and control rates among Tajik nomads in Pamirs, where health programs improving the hypertension status are urgently needed, with the excess weight loss as a strategy.
Collapse
|
16
|
Heizhati M, Wang L, Yao X, Li M, Hong J, Luo Q, Zhang D, Abulikemu S, Wu T, Li N. Prevalence, awareness, treatment and control of hypertension in various ethnic groups (Hui, Kazakh, Kyrgyz, Mongolian, Tajik) in Xinjiang, Northwest China. Blood Press 2020; 29:276-284. [PMID: 32349556 DOI: 10.1080/08037051.2020.1745055] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Purpose: Credible data is scarce in representative population aged ≥18 years, though hypertension is highly prevalent and poorly controlled in population aged ≥30 years in Xinjiang Northwest China. Therefore, we tried to provide data on hypertension status for reference.Materials and methods: We conducted a population-based cross-sectional survey between 2014 and 2015 using stratified multi-stage random sampling as part of a national survey. Hypertension is defined as systolic blood pressure (BP) ≥140 mmHg, and/or diastolic BP ≥90 mmHg and/or taking anti-hypertensive agents. We assessed prevalence, awareness, treatment and control rates of hypertension by rural and urban regions, by gender and by ethnicity, and related factors including agent prescription pattern.Results: Data for 6807 subjects ≥18 years with 79.2% rural and 52.0% women subjects are analyzed. Overall age-adjusted prevalence of hypertension in population aged ≥18 years is 22.2%, and shows no disparity between genders and regions. By ethnicity, the prevalence of hypertension was the highest in Tajik subjects (25.4%), followed by Mongolian (25.3%) and Kazakh (24.8%) subjects and the lowest in Kyrgyz (20.2%) subjects. Of the hypertensives, 55.5% have awareness, 43.9% receive anti-hypertensive treatment, whereas only 14.5% have their BP controlled. In different ethnic groups, the awareness, control and control in treatment rates showed no significant disparities, except for the treatment rate. It was the highest in Kazakh subjects (50.0%) and the lowest in Hui subjects (36.7%). The most common prescribed agent encompassed ACEI/ARBs (41.1%) and calcium channel blockers (30.4%). Over 87.2% of hypertensives were prescribed for single drug regimen.Conclusions: Hypertension is moderately prevalent in Xinjiang, whereas poorly controlled. Standardization of its treatment such as introducing treatment algorithm might be the priorities for future improvement, with healthy life promotion.
Collapse
Affiliation(s)
- Mulalibieke Heizhati
- The Center of Hypertension of the People's Hospital of Xinjiang Uygur Autonomous Region; The Center of Diagnosis, Treatment and Research of Hypertension in Xinjiang, NHC Key Laboratory of Hypertension Clinical Research Urumqi, Xinjiang, China
| | - Lin Wang
- The Center of Hypertension of the People's Hospital of Xinjiang Uygur Autonomous Region; The Center of Diagnosis, Treatment and Research of Hypertension in Xinjiang, NHC Key Laboratory of Hypertension Clinical Research Urumqi, Xinjiang, China
| | - Xiaoguang Yao
- The Center of Hypertension of the People's Hospital of Xinjiang Uygur Autonomous Region; The Center of Diagnosis, Treatment and Research of Hypertension in Xinjiang, NHC Key Laboratory of Hypertension Clinical Research Urumqi, Xinjiang, China
| | - Mei Li
- The Center of Hypertension of the People's Hospital of Xinjiang Uygur Autonomous Region; The Center of Diagnosis, Treatment and Research of Hypertension in Xinjiang, NHC Key Laboratory of Hypertension Clinical Research Urumqi, Xinjiang, China
| | - Jing Hong
- The Center of Hypertension of the People's Hospital of Xinjiang Uygur Autonomous Region; The Center of Diagnosis, Treatment and Research of Hypertension in Xinjiang, NHC Key Laboratory of Hypertension Clinical Research Urumqi, Xinjiang, China
| | - Qin Luo
- The Center of Hypertension of the People's Hospital of Xinjiang Uygur Autonomous Region; The Center of Diagnosis, Treatment and Research of Hypertension in Xinjiang, NHC Key Laboratory of Hypertension Clinical Research Urumqi, Xinjiang, China
| | - Delian Zhang
- The Center of Hypertension of the People's Hospital of Xinjiang Uygur Autonomous Region; The Center of Diagnosis, Treatment and Research of Hypertension in Xinjiang, NHC Key Laboratory of Hypertension Clinical Research Urumqi, Xinjiang, China
| | - Suofeiya Abulikemu
- The Center of Hypertension of the People's Hospital of Xinjiang Uygur Autonomous Region; The Center of Diagnosis, Treatment and Research of Hypertension in Xinjiang, NHC Key Laboratory of Hypertension Clinical Research Urumqi, Xinjiang, China
| | - Ting Wu
- The Center of Hypertension of the People's Hospital of Xinjiang Uygur Autonomous Region; The Center of Diagnosis, Treatment and Research of Hypertension in Xinjiang, NHC Key Laboratory of Hypertension Clinical Research Urumqi, Xinjiang, China
| | - Nanfang Li
- The Center of Hypertension of the People's Hospital of Xinjiang Uygur Autonomous Region; The Center of Diagnosis, Treatment and Research of Hypertension in Xinjiang, NHC Key Laboratory of Hypertension Clinical Research Urumqi, Xinjiang, China
| |
Collapse
|
17
|
Li Y, Teng D, Shi X, Qin G, Qin Y, Quan H, Shi B, Sun H, Ba J, Chen B, Du J, He L, Lai X, Li Y, Chi H, Liao E, Liu C, Liu L, Tang X, Tong N, Wang G, Zhang JA, Wang Y, Xue Y, Yan L, Yang J, Yang L, Yao Y, Ye Z, Zhang Q, Zhang L, Zhu J, Zhu M, Ning G, Mu Y, Zhao J, Teng W, Shan Z. Prevalence of diabetes recorded in mainland China using 2018 diagnostic criteria from the American Diabetes Association: national cross sectional study. BMJ 2020; 369:m997. [PMID: 32345662 PMCID: PMC7186854 DOI: 10.1136/bmj.m997] [Citation(s) in RCA: 751] [Impact Index Per Article: 187.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
OBJECTIVE To assess the prevalence of diabetes and its risk factors. DESIGN Population based, cross sectional study. SETTING 31 provinces in mainland China with nationally representative cross sectional data from 2015 to 2017. PARTICIPANTS 75 880 participants aged 18 and older-a nationally representative sample of the mainland Chinese population. MAIN OUTCOME MEASURES Prevalence of diabetes among adults living in China, and the prevalence by sex, regions, and ethnic groups, estimated by the 2018 American Diabetes Association (ADA) and the World Health Organization diagnostic criteria. Demographic characteristics, lifestyle, and history of disease were recorded by participants on a questionnaire. Anthropometric and clinical assessments were made of serum concentrations of fasting plasma glucose (one measurement), two hour plasma glucose, and glycated haemoglobin (HbA1c). RESULTS The weighted prevalence of total diabetes (n=9772), self-reported diabetes (n=4464), newly diagnosed diabetes (n=5308), and prediabetes (n=27 230) diagnosed by the ADA criteria were 12.8% (95% confidence interval 12.0% to 13.6%), 6.0% (5.4% to 6.7%), 6.8% (6.1% to 7.4%), and 35.2% (33.5% to 37.0%), respectively, among adults living in China. The weighted prevalence of total diabetes was higher among adults aged 50 and older and among men. The prevalence of total diabetes in 31 provinces ranged from 6.2% in Guizhou to 19.9% in Inner Mongolia. Han ethnicity had the highest prevalence of diabetes (12.8%) and Hui ethnicity had the lowest (6.3%) among five investigated ethnicities. The weighted prevalence of total diabetes (n=8385) using the WHO criteria was 11.2% (95% confidence interval 10.5% to 11.9%). CONCLUSION The prevalence of diabetes has increased slightly from 2007 to 2017 among adults living in China. The findings indicate that diabetes is an important public health problem in China.
Collapse
Affiliation(s)
- Yongze Li
- Department of Endocrinology and Metabolism and the Institute of Endocrinology, First Hospital of China Medical University, 155 Nanjing Bei Street, Shenyang, 110001, Liaoning, China
| | - Di Teng
- Department of Endocrinology and Metabolism and the Institute of Endocrinology, First Hospital of China Medical University, 155 Nanjing Bei Street, Shenyang, 110001, Liaoning, China
| | - Xiaoguang Shi
- Department of Endocrinology and Metabolism and the Institute of Endocrinology, First Hospital of China Medical University, 155 Nanjing Bei Street, Shenyang, 110001, Liaoning, China
| | - Guijun Qin
- Division of Endocrinology, Department of Internal Medicine, First Affiliated Hospital, Zhengzhou University, Zhengzhou, Henan, China
| | - Yingfen Qin
- Department of Endocrinology, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Huibiao Quan
- Department of Endocrinology, Hainan General Hospital, Haikou, Hainan, China
| | - Bingyin Shi
- Department of Endocrinology, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shannxi, China
| | - Hui Sun
- Department of Endocrinology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Jianming Ba
- Department of Endocrinology, Chinese PLA General Hospital, Beijing, China
| | - Bing Chen
- Department of Endocrinology, Southwest Hospital, Third Military Medical University, Chongqing, China
| | - Jianling Du
- Department of Endocrinology, First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China
| | - Lanjie He
- Department of Endocrinology, Cardiovascular and Cerebrovascular Disease Hospital of Ningxia Medical University, Yinchuan, Ningxia, P.R. China, 750004
| | - Xiaoyang Lai
- Department of Endocrinology and Metabolism, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Yanbo Li
- Department of Endocrinology, First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Haiyi Chi
- Department of Endocrinology, Hohhot First Hospital, Hohhot, Inner Mongolia, China
| | - Eryuan Liao
- Department of Endocrinology and Metabolism, Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Chao Liu
- Research Centre of Endocrine and Metabolic Diseases, Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Libin Liu
- Department of Endocrinology and Metabolism, Fujian Institute of Endocrinology, Fujian Medical University Union Hospital, Fuzhou, Fujian, China
| | - Xulei Tang
- Department of Endocrinology, First Hospital of Lanzhou University, Lanzhou, Gansu, China
| | - Nanwei Tong
- Department of Endocrinology and Metabolism, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Guixia Wang
- Department of Endocrinology and Metabolism, First Hospital of Jilin University, Changchun, Jilin, China
| | - Jin-An Zhang
- Department of Endocrinology, Shanghai University of Medicine and Health Science Affiliated Zhoupu Hospital, Shanghai, China
| | - Youmin Wang
- Department of Endocrinology, First Hospital of An Hui Medical University, Hefei, Anhui, China
| | - Yuanming Xue
- Department of Endocrinology, First People's Hospital of Yunnan Province, Kunming, Yunnan, China
| | - Li Yan
- Department of Endocrinology and Metabolism, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Jing Yang
- Department of Endocrinology, First Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
| | - Lihui Yang
- Department of Endocrinology and Metabolism, People's Hospital of Tibet Autonomous Region, Lhasa, Tibet, China
| | - Yongli Yao
- Department of Endocrinology, Qinghai Provincial People's Hospital, Xining, Qinghai, China
| | - Zhen Ye
- Zhejiang Provincial Centre for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Qiao Zhang
- Department of Endocrinology and Metabolism, Affiliated Hospital of Guiyang Medical University, Guiyang, Guizhou, China
| | - Lihui Zhang
- Department of Endocrinology, Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Jun Zhu
- Department of Endocrinology, the First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Mei Zhu
- Department of Endocrinology and Metabolism, Tianjin Medical University General Hospital, Tianjin, China
| | - Guang Ning
- Department of Endocrinology and Metabolism and the Institute of Endocrinology, Rui-Jin Hospital affiliated with Shanghai Jiao-Tong University School of Medicine, Shanghai, China
| | - Yiming Mu
- Department of Endocrinology, Chinese PLA General Hospital, Beijing, China
| | - Jiajun Zhao
- Department of Endocrinology, Shandong Provincial Hospital affiliated with Shandong University, Jinan, Shandong, China
| | - Weiping Teng
- Department of Endocrinology and Metabolism and the Institute of Endocrinology, First Hospital of China Medical University, 155 Nanjing Bei Street, Shenyang, 110001, Liaoning, China
| | - Zhongyan Shan
- Department of Endocrinology and Metabolism and the Institute of Endocrinology, First Hospital of China Medical University, 155 Nanjing Bei Street, Shenyang, 110001, Liaoning, China
| |
Collapse
|
18
|
Yan L, Carter E, Fu Y, Guo D, Huang P, Xie G, Xie W, Zhu Y, Kelly F, Elliott P, Zhao L, Yang X, Ezzati M, Wu Y, Baumgartner J, Chan Q. Study protocol: The INTERMAP China Prospective (ICP) study. Wellcome Open Res 2020. [DOI: 10.12688/wellcomeopenres.15470.2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Background: Unfavourable blood pressure (BP) level is an established risk factor for cardiovascular diseases (CVD), while the exact underlying reasons for unfavourable BP are poorly understood. The INTERMAP China Prospective (ICP) Study is a prospective cohort to investigate the relationship of environmental and nutritional risk factors with key indicators of vascular function (BP, arterial stiffness, carotid-intima media thickness) among middle-aged/older men and women. Methods: A total of 839 Chinese participants aged 40-59 years from three diverse regions of China were enrolled in INTERMAP in 1997/98; data collection included repeated BP measurements, 24-hour urine specimens, and 24-hour dietary recalls. In 2015/16, 574 of these 839 persons were re-enrolled along with 208 new participants aged 40-59 years that were randomly selected from the same study villages. Participant’s environmental and dietary exposures and health outcomes were assessed in this open cohort study, including BP, 24-hour dietary recalls, personal exposures to air pollution, grip strength, arterial stiffness, carotid-media thickness and plaques, cognitive function, and sleep patterns. Serum and plasma specimens were collected with 24-hour urine specimens. A follow-up visit has been scheduled for 2020-2021. Discussion: Winter and summer assessments of a comprehensive set of vascular indicators and their environmental and nutritional risk factors were conducted with high precision. We will leverage advances in exposome research to identify biomarkers of exposure to environmental and nutritional risk factors and improve our understanding of the mechanisms and pathways of their hazardous cardiovascular effects. The ICP Study is observational by design, thus subject to several biases including selection bias (e.g., loss to follow-up), information bias (e.g., measurement error), and confounding that we sought to mitigate through our study design and measurements. However, extensive efforts will apply to minimize those limitations (continuous observer training, repeated measurements of BP, standardized methods in data collection and measurements, and on-going quality control).
Collapse
|
19
|
Hirschler V, Gonzalez C, Molinari C, Velez H, Nordera M, Suarez R, Robredo A. Blood pressure level increase with altitude in three argentinean indigenous communities. AIMS Public Health 2019; 6:370-379. [PMID: 31909060 PMCID: PMC6940575 DOI: 10.3934/publichealth.2019.4.370] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2019] [Accepted: 10/08/2019] [Indexed: 11/18/2022] Open
Abstract
Objective To compare blood pressure (BP) levels in three groups of Argentinean Indigenous schoolchildren from similar ethnic backgrounds but living at three different altitudes. Methods A cross-sectional study compared 185 (83 females) children aged 5–14 years from San Antonio de los Cobres (SAC), 3750 m above sea level; 46 (23 females) from Cobres, 3450 m; and 167 (83 females) from Chicoana (CH), 1400 m. Anthropometric and BP measurements were performed. Results The prevalence of overweight/obesity was lower in SAC (6.5% [12]) and Cobres (4.3% [2]) than in CH (24% [24]) (BMI > 85 percentile per CDC norms). Systolic BP increased significantly with altitude: (SAC 86 mm Hg, Cobres 77 mm Hg, and CH 69 mm Hg). Similar results were obtained with diastolic BP (SAC 57 mm Hg, Cobres 51 mm Hg, and CH 47 mm Hg) and with median arterial pressure (MAP) (SAC 67 mm Hg, Cobres 60 mm Hg, and CH 55 mm Hg). Multiple linear regression analyses showed that altitude was significantly and independently associated with children's systolic BP (beta 10.56; R2 = 0.40), diastolic BP (beta 6.27; R2 = 0.25) and MAP (beta 7.69; R2 = 0.32); adjusted for age, sex, and BMI. Conclusions We found that as altitude increased, BP levels increased significantly in indigenous children from similar backgrounds living permanently at different altitudes.
Collapse
Affiliation(s)
| | | | | | - Hernan Velez
- Cardiology, Hospital Materno Infantil, Salta, Argentina
| | | | | | | |
Collapse
|
20
|
Yan L, Carter E, Fu Y, Guo D, Huang P, Xie G, Xie W, Zhu Y, Kelly F, Elliott P, Zhao L, Yang X, Ezzati M, Wu Y, Baumgartner J, Chan Q. Study protocol: The INTERMAP China Prospective (ICP) study. Wellcome Open Res 2019. [DOI: 10.12688/wellcomeopenres.15470.1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Background: Unfavourable blood pressure (BP) level is an established risk factor for cardiovascular diseases (CVD), while the exact underlying reasons for unfavourable BP are poorly understood. The INTERMAP China Prospective (ICP) Study is a prospective cohort to investigate the relationship of environmental and nutritional risk factors with key indicators of vascular function including BP, arterial stiffness, and carotid-intima media thickness. Methods: A total of 839 Chinese participants aged 40-59 years from three diverse regions of China were enrolled in INTERMAP in 1997/98; data collection included repeated BP measurements, 24-hour urine specimens, and 24-hour dietary recalls. In 2015/16, 574 of these 839 persons were re-enrolled along with 208 new participants aged 40-59 years that were randomly selected from the same study villages. Participant’s environmental and dietary exposures and health outcomes were assessed in this open cohort study, including BP, 24-hour dietary recalls, personal exposures to air pollution, grip strength, arterial stiffness, carotid-media thickness and plaques, cognitive function, and sleep patterns. Serum and plasma specimens were collected with 24-hour urine specimens. Discussion: Winter and summer assessments of a comprehensive set of vascular indicators and their environmental and nutritional risk factors were conducted with high precision. We will leverage advances in exposome research to identify biomarkers of exposure to environmental and nutritional risk factors and improve our understanding of the mechanisms and pathways of their hazardous cardiovascular effects. The ICP Study is observational by design, thus subject to several biases including selection bias (e.g., loss to follow-up), information bias (e.g., measurement error), and confounding that we sought to mitigate through our study design and measurements. However, extensive efforts will apply to minimize those limitations (continuous observer training, repeated measurements of BP, standardized methods in data collection and measurements, and on-going quality control).
Collapse
|
21
|
Wang L, Heizhati M, Zhang D, Chang G, Yao X, Hong J, Kamilijiang M, Li M, Li N. Excess weight loss is a vital strategy for controlling hypertension among multi-ethnic population in northwest China: A cross-sectional analysis. Medicine (Baltimore) 2019; 98:e16894. [PMID: 31490374 PMCID: PMC6738997 DOI: 10.1097/md.0000000000016894] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Hypertension is a common global health problem including China. This study aimed to assess the prevalence and awareness of hypertension, and evaluate risk factors associated with hypertension among multi-ethnic population in northwest China using a random sampling cross-sectional data.A cross-sectional survey was conducted between 2014 and 2015 as part of a nationwide survey using stratified four-stage random sampling in Xinjiang. Hypertension was defined as mean systolic blood pressure (SBP) and/or diastolic blood pressure (DBP) ≥140/90 mm Hg and/or taking anti-hypertensive medication. In addition, the prevalence of hypertension (SBP ≥ 130 or DBP ≥ 80 mm Hg) was also estimated according to the 2017 American College of Cardiology (ACC)/American Heart Association (AHA) High Blood Pressure Guideline. Awareness of hypertension was based on self-report. An optimized risk score model was used to assess the risk and determine the predictive power of risk factors on hypertension.Totally 6722 subjects aged ≥18 years were enrolled and prevalence of hypertension was 24.3%, while the prevalence of hypertension based on the 2017 ACC/AHA guideline was approximately twice as high as that based on 2010 Chinese guideline (37.6%). Among individuals with hypertension, 55.5% were aware of their condition. Six potential factors were estimated to be associated with increased risk of hypertension including age, ethnicity, marital status, body mass index (BMI), waistline circumference, and comorbidity. In the analyses of calculated risk score, BMI ≥ 28.0 corresponded to the highest risk score of 23 points. The area under the receiver operation curve for the multivariable prediction model was 0.803 (95%CI: 0.789-0.813).There is a considerable prevalence of hypertension among Xinjiang adults, northwest China; awareness of hypertension is low. Excess weight loss may be a vital strategy for controlling hypertension, particularly if accompanied with other preventive measures in this region.
Collapse
|
22
|
Han W, Wang W, Sun N, Li M, Chen L, Jiang S, Chen Y, Han X. Relationship between 24-hour urinary sodium excretion and blood pressure in the adult population in Shandong, China. J Clin Hypertens (Greenwich) 2019; 21:1370-1376. [PMID: 31350809 PMCID: PMC6771517 DOI: 10.1111/jch.13644] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Revised: 06/20/2019] [Accepted: 06/28/2019] [Indexed: 01/12/2023]
Abstract
The main objective of this study was to determine baseline salt intake levels in a sample of the adult population of Shandong province and to establish the relationship between urinary sodium excretion and blood pressure. A total of 512 participants were recruited, and all the participants provided complete 24‐hour urine collections. Physical assessment and socioeconomic status of participants were collected at the same time. The mean 24‐hour urinary sodium excretion of all subjects was 228.0 ± 127.5 mmol/24 hours. Estimated salt intake was higher in obese subjects (17.6 ± 8.8 g/d) compared with overweight subjects (15.6 ± 8.0 g/d) and those with a normal BMI (13.9 ± 6.8 g/d). Likewise, urinary sodium excretion of hypertensive participants was dramatically higher than that of non‐hypertensive ones, the equivalent of 18.2 ± 9.1 g/d vs 13.3 ± 6.8 g/d. Urinary sodium was significantly associated with SBP (β = 1.08, P = .018) after adjustment for potential confounders. In summary, we found significantly high levels of salt intake in Shandong Province, particularly in obese and hypertension subjects. It is quite important to improve public education about reducing salt intake to control blood pressure among Shandong people.
Collapse
Affiliation(s)
- Weizhong Han
- Department of Cardiology, Shandong Provincial Hospital Affiliated to Shandong University, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Ji'nan, China
| | - Wei Wang
- Department of Cardiology, Shandong Provincial Hospital Affiliated to Shandong University, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Ji'nan, China
| | - Ningling Sun
- Department of Heart Center, Hypertensive Laboratory, Peking University People's Hospital, Beijing, China
| | - Min Li
- Department of Cardiology, Shandong Provincial Hospital Affiliated to Shandong University, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Ji'nan, China
| | - Lianghua Chen
- Department of Cardiology, Shandong Provincial Hospital Affiliated to Shandong University, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Ji'nan, China
| | - Shiliang Jiang
- Department of Cardiology, Shandong Provincial Hospital Affiliated to Shandong University, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Ji'nan, China
| | - Yunchao Chen
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong University, Ji'nan, China
| | - Xiao Han
- Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Ji'nan, China
| |
Collapse
|
23
|
Sun P, Wang Q, Zhang Y, Huo Y, Nima N, Fan J. Association between homocysteine level and blood pressure traits among Tibetans: A cross-sectional study in China. Medicine (Baltimore) 2019; 98:e16085. [PMID: 31277103 PMCID: PMC6635152 DOI: 10.1097/md.0000000000016085] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Studies on hypertension (HTN) in Tibetans who live in high altitude areas are less and whether total homocysteine level (tHcy) is associated with blood pressure (BP) levels or HTN status in Tibetans is unknown.A total of 1486 Tibetans with complete information from a cross-sectional survey conducted in Lhasa Chengguan County of Tibet were included in this study. Demographic data, self-reported history of disease, and life styles were collected using a questionnaire. Blood tHcy, creatinine, fasting plasma-glucose, total cholesterol, triglycerides, and BP were measured with equipment.The median tHcy level of the whole population was 14.60 (13.17-16.50) μmol/L, and the prevalence of HTN was 26.99%. Regression models, adjusted for possible covariates, showed that an average increase of 1 lnHcy (log transformation of tHcy level) was associated with an increase of 3.78 mmHg of systolic BP (SBP, P = .011) and 3.02 mmHg of diastolic BP (DBP, P = .003). The prevalence of HTN, levels of SBP and DBP in the third (OR for HTN: 1.60, P = .026; β for SBP: 3.41, P = .004; β for DBP: 2.57, P = .002) and fourth (OR for HTN: 2.19, P < .001; β for SBP: 5.08, P < .001; β for DBP: 3.09, P < .001) quartile of tHcy level were higher than those in the first quartile.THcy is associated with BP levels and HTN status among Tibetans. Both HTN management and tHcy level should be paid more attention in Tibetans.
Collapse
Affiliation(s)
- Pengfei Sun
- Department of Cardiology, Peking University First Hospital
| | - Qianqian Wang
- Department of Molecular Orthopaedics, Beijing Institute of Traumatology and Orthopaedics
| | - Yan Zhang
- Department of Cardiology, Peking University First Hospital
| | - Yong Huo
- Department of Cardiology, Peking University First Hospital
| | - Nima Nima
- Department of Cardiology, Lhasa People's Hospital, Lhasa, Xizang
| | - Jun Fan
- Department of Cardiology, Jishuitan Hospital, Beijing, China
| |
Collapse
|
24
|
Tong X, Wang X, Wang D, Chen D, Qi D, Zhang H, Wang Z, Lu Z, Li W. Prevalence and ethnic pattern of overweight and obesity among middle-aged and elderly adults in China. Eur J Prev Cardiol 2019; 26:1785-1789. [DOI: 10.1177/2047487319845129] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Affiliation(s)
- Xinyue Tong
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, China
| | - Xiaojun Wang
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, China
| | - Dongming Wang
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, China
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, China
| | - Dajie Chen
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, China
| | - Dong Qi
- Department of Neurology, The Third Hospital of Xingtai, China
| | - Hao Zhang
- Department of Neurology, Rizhao People’s Hospital, China
| | - Zhihong Wang
- Department of Neurosurgery, Shenzhen No. 2 People’s Hospital, Shenzhen University, China
| | - Zuxun Lu
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, China
| | - Wenzhen Li
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, China
| |
Collapse
|
25
|
Lee DS, Jo HG, Kim MJ, Lee H, Cheong SH. Antioxidant and Anti-Stress Effects of Taurine Against Electric Foot-Shock-Induced Acute Stress in Rats. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2019; 1155:185-196. [PMID: 31468397 DOI: 10.1007/978-981-13-8023-5_17] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
In the present study, we evaluated the antioxidant and anti-stress activities of taurine in electric foot-shock stress model rats. Taurine supplementation markedly increased the hepatic glutathione (GSH) levels, compared to the levels in the stress group. In addition, activities of antioxidant enzymes such as catalase (CAT), glutathione peroxidase (GPx) and glutathione-S-transferase (GST) were improved in the taurine-treated group. Plasma cortisol and dehydroepiandrosterone-sulfate (DHEA-S) levels were significantly reduced in the taurine-supplemented group compared to those in the stress group. In contrast, the levels of 5-hydroxytryptamine (5-HT) and 5-hydroxyindoleacetic acid (5-HIAA) were markedly increased in the taurine or betaine-treated group compared to those in the stress group. It may be concluded that taurine produces beneficial effects in the form of antioxidant status and biochemical alterations in foot-shock-induced acute stress in rats.
Collapse
Affiliation(s)
- Dong-Sung Lee
- College of Pharmacy, Chosun University, Dong-gu, Gwangju, Republic of Korea
| | - Hee Geun Jo
- Department of Marine Bio-Food Sciences, Chonnam National University, Yeosu, Republic of Korea
| | - Min Ji Kim
- Department of Marine Bio-Food Sciences, Chonnam National University, Yeosu, Republic of Korea
| | - Hwan Lee
- College of Pharmacy, Chosun University, Dong-gu, Gwangju, Republic of Korea
| | - Sun Hee Cheong
- Department of Marine Bio-Food Sciences, Chonnam National University, Yeosu, Republic of Korea.
| |
Collapse
|
26
|
The prevalence of hyperuricemia and its correlates in Ganzi Tibetan Autonomous Prefecture, Sichuan Province, China. Lipids Health Dis 2018; 17:235. [PMID: 30309357 PMCID: PMC6182831 DOI: 10.1186/s12944-018-0882-6] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Accepted: 10/01/2018] [Indexed: 02/05/2023] Open
Abstract
Background Hyperuricemia is a common and serious public health problem. There has been no broad epidemiological survey of hyperuricemia in China, especially in Tibetan area. This study was therefore investigated the prevalence of hyperuricemia and its correlated factors among people aged 18–85 years in Ganzi Tibetan Autonomous Prefecture, Sichuan Province, China. Methods We carried out a cross-sectional study among 3093 participants in Ganzi Tibetan Autonomous Prefecture using questionnaires in face-to-face interviews, anthropometric measurements and biochemical tests. We included 1416 subjects with complete data including serum uric acid and medical history to analyze the prevalence of hyperuricemia and correlated factors. Hyperuricemia was defined as a fasting serum uric acid level higher than 420 μmol/L in men and 360 μmol/L in women. Results The overall crude prevalence of hyperuricemia was 37.2%, and was greater in men than women (41% vs 34.4%, P = 0.011). The age-adjusted prevalence was 33.0%. Characteristics linked to hyperuricemia were farmers-herdsmen (OR: 1.749, 95% CI: 1.022–2.992), low to moderate education level (low OR:1.57, 95% CI: 1.102–2.237; moderate OR: 1.86, 95% CI: 1.167–2.963), current drinking (OR: 1.795, 95% CI: 1.193–2.702), hypertension (OR: 1.48, 95% CI: 1.091–2.006), higher body mass index (1 unit increase) (OR: 1.116, 95% CI: 1.077–1.156) and higher serum creatinine (1 unit increase) (OR: 1.046, 95% CI: 1.034–1.059). Serum uric acid was positively related to triglycerides and total cholesterol and negatively related to high density lipoprotein cholesterol in all subjects. Hyperuricemia was a risk factor for high triglyceride ((OR: 2.13, 95% CI: 1.156–3.9266) and high total cholesterol (OR: 2.313, 95% CI: 1.364–3.923) in men and for high low-density lipoprotein cholesterol (OR: 2.696, 95% CI: 1.386–5.245) in women. Conclusion There is a high prevalence of hyperuricemia in Ganzi Tibetan Autonomous Prefecture. The government needs to prevent and manage hyperuricemia in this area.
Collapse
|
27
|
Li CL, Wang HJ, Si QJ, Zhou J, Li KL, Ding Y. Association between urinary sodium excretion and coronary heart disease in hospitalized elderly patients in China. J Int Med Res 2018; 46:3078-3085. [PMID: 29756493 PMCID: PMC6134650 DOI: 10.1177/0300060518772222] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Objective This study was performed to evaluate the association between urinary sodium excretion and coronary heart disease (CHD) in hospitalized elderly patients in China. Methods The 24-h urinary excretion specimens of 541 patients were collected, and the serum creatinine concentration and urinary sodium/potassium ratio were measured. Associations were explored by multivariate logistic regression analysis. Results The mean 24-h urinary sodium excretion was 200.4 mmol, corresponding to 11.7 g of salt intake. Both of these values were higher in men than in women. The salt intake of 80- to 89-year-old patients was significantly lower than that of 70- to 79-year-old patients. The 24-h urinary sodium excretion and spot urine Na/K ratios were significantly higher in overweight/obese and hypertensive patients. The 24-h urinary sodium excretion of men who smoked was significantly higher than that of women. The spot urine Na/K ratio was significantly higher in patients with cerebral thrombosis. The urinary Na/K ratio, smoking status, and hypertension were independent risk factors for CHD. Conclusions This cross-sectional survey suggests that the Na/K ratio may better represent salt loading than Na excretion alone in studying the association between sodium intake and CHD. There was no association between sodium and CHD prevalence.
Collapse
Affiliation(s)
| | | | - Quan-jin Si
- Quan-jin Si, Department of Geriatric Cardiology, Chinese PLA General Hospital, 28 Fuxing Road, Beijing 100853, P.R. China.
| | | | | | | |
Collapse
|
28
|
Wassef B, Kohansieh M, Makaryus AN. Effects of energy drinks on the cardiovascular system. World J Cardiol 2017; 9:796-806. [PMID: 29225735 PMCID: PMC5714807 DOI: 10.4330/wjc.v9.i11.796] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Revised: 08/04/2017] [Accepted: 08/15/2017] [Indexed: 02/06/2023] Open
Abstract
Throughout the last decade, the use of energy drinks has been increasingly looked upon with caution as potentially dangerous due to their perceived strong concentration of caffeine aside from other substances such as taurine, guarana, and L-carnitine that are largely unknown to the general public. In addition, a large number of energy drink intoxications have been reported all over the world including cases of seizures and arrhythmias. In this paper, we focus on the effect of energy drinks on the cardiovascular system and whether the current ongoing call for the products' sales and regulation of their contents should continue.
Collapse
Affiliation(s)
- Bishoy Wassef
- Department of Family Medicine, Eisenhower Medical Center, Rancho Mirage, CA 92270, United States
| | - Michelle Kohansieh
- Stern College for Women, Yeshiva University, New York, NY 10016, United States
| | - Amgad N Makaryus
- Department of Cardiology, Northwell Health/Nassau University Medical Center, East Meadow, NY 11554, United States
| |
Collapse
|
29
|
Wang L, Gao P, Zhang M, Huang Z, Zhang D, Deng Q, Li Y, Zhao Z, Qin X, Jin D, Zhou M, Tang X, Hu Y, Wang L. Prevalence and Ethnic Pattern of Diabetes and Prediabetes in China in 2013. JAMA 2017; 317:2515-2523. [PMID: 28655017 PMCID: PMC5815077 DOI: 10.1001/jama.2017.7596] [Citation(s) in RCA: 1233] [Impact Index Per Article: 176.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
IMPORTANCE Previous studies have shown increasing prevalence of diabetes in China, which now has the world's largest diabetes epidemic. OBJECTIVES To estimate the recent prevalence and to investigate the ethnic variation of diabetes and prediabetes in the Chinese adult population. DESIGN, SETTING, AND PARTICIPANTS A nationally representative cross-sectional survey in 2013 in mainland China, which consisted of 170 287 participants. EXPOSURES Fasting plasma glucose and hemoglobin A1c levels were measured for all participants. A 2-hour oral glucose tolerance test was conducted for all participants without diagnosed diabetes. MAIN OUTCOMES AND MEASURES Primary outcomes were total diabetes and prediabetes defined according to the 2010 American Diabetes Association criteria. Awareness and treatment were also evaluated. Hemoglobin A1c concentration of less than 7.0% among treated diabetes patients was considered adequate glycemic control. Minority ethnic groups in China with at least 1000 participants (Tibetan, Zhuang, Manchu, Uyghur, and Muslim) were compared with Han participants. RESULTS Among the Chinese adult population, the estimated standardized prevalence of total diagnosed and undiagnosed diabetes was 10.9% (95% CI, 10.4%-11.5%); that of diagnosed diabetes, 4.0% (95% CI, 3.6%-4.3%); and that of prediabetes, 35.7% (95% CI, 34.1%-37.4%). Among persons with diabetes, 36.5% (95% CI, 34.3%-38.6%) were aware of their diagnosis and 32.2% (95% CI, 30.1%-34.2%) were treated; 49.2% (95% CI, 46.9%-51.5%) of patients treated had adequate glycemic control. Tibetan and Muslim Chinese had significantly lower crude prevalence of diabetes than Han participants (14.7% [95% CI, 14.6%-14.9%] for Han, 4.3% [95% CI, 3.5%-5.0%] for Tibetan, and 10.6% [95% CI, 9.3%-11.9%] for Muslim; P < .001 for Tibetan and Muslim compared with Han). In the multivariable logistic models, the adjusted odds ratios compared with Han participants were 0.42 (95% CI, 0.35-0.50) for diabetes and 0.77 (95% CI, 0.71-0.84) for prediabetes for Tibetan Chinese and 0.73 (95% CI, 0.63-0.85) for diabetes and 0.78 (95% CI, 0.71-0.86) for prediabetes in Muslim Chinese. CONCLUSIONS AND RELEVANCE Among adults in China, the estimated overall prevalence of diabetes was 10.9%, and that for prediabetes was 35.7%. Differences from previous estimates for 2010 may be due to an alternate method of measuring hemoglobin A1c.
Collapse
Affiliation(s)
- Limin Wang
- National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Pei Gao
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Mei Zhang
- National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Zhengjing Huang
- National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Dudan Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Qian Deng
- National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yichong Li
- National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Zhenping Zhao
- National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Xueying Qin
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Danyao Jin
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Maigeng Zhou
- National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Xun Tang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Yonghua Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Linhong Wang
- National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| |
Collapse
|
30
|
Xu J, Chen X, Ge Z, Liang H, Yan L, Guo X, Zhang Y, Wang L, Ma J. Associations of Usual 24-Hour Sodium and Potassium Intakes with Blood Pressure and Risk of Hypertension among Adults in China's Shandong and Jiangsu Provinces. Kidney Blood Press Res 2017; 42:188-200. [PMID: 28494444 DOI: 10.1159/000475486] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Accepted: 01/17/2017] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND/AIMS High sodium intake and low intake of potassium can increase blood pressure (BP) and risk of developing hypertension. Few studies have examined the association between 24-h urinary sodium and potassium excretion and BP or risk of hypertension in China, and most used only a single 24-h urinary sample. METHODS We analyzed data on 2281 participants aged 18-69 years by using two 24-h urinary sodium and potassium excretions from the supplemental baseline survey of the Shandong-Ministry of Health Action on Salt Reduction and Hypertension (SMASH) project. We used measurement error models to estimate usual intakes, multivariable linear regression to assess their association with B P, and logistic regression to estimate the risk of hypertension. RESULTS The average usual intakes of sodium and potassium, and the mean sodium-potassium ratio, were 166.9 mmol/day, 25.3 mmol/day, and 6.8, respectively. All three measures were significantly associated with systolic BP (SBP) and diastolic BP (DBP), with an increase of 1.39 mmHg (95% confidence interval [CI] 0.44─2.34) in SBP and 0.94 mmHg (95% CI 0.34─1.55) in DBP for a 1-standard deviation (SD) (25.6mmol/day) increase in sodium intake, a decrease of 1.42 mmHg (95% CI -2.37─ -0.47) in SBP and 0.91 mmHg (95% CI -1.52─ -0.30) in DBP for a 1-SD (3.4 mmol/day) increase in potassium intake, and an increase of 0.97 mmHg (95% CI 0.36─1.58) in SBP and of 0.65 mmHg (95% CI 0.26─1.04) in DBP per unit increase in the sodium-to-potassium ratio. The adjusted odds ratios comparing the risk of hypertension among adults in the highest with those in the lowest quintile differ significantly for potassium (0.51; 95% CI 0.29─0.88) and sodium-to-potassium ratio (1.40; 95% CI 1.01─1.94). CONCLUSIONS Our results suggested that higher sodium and lower potassium intakes are associated with increased BP and risk of hypertension in the Shandong and Jiangsu adults.
Collapse
Affiliation(s)
- Jianwei Xu
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Xiaorong Chen
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Zeng Ge
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Hao Liang
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Liuxia Yan
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Xiaolei Guo
- Shandong Center for Disease Control and Prevention, Jinan, China
| | - Yongqing Zhang
- Jiangsu Center for Disease Control and Prevention, Nanjing, China
| | - Linhong Wang
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jixiang Ma
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| |
Collapse
|
31
|
Shao S, Hua Y, Yang Y, Liu X, Fan J, Zhang A, Xiang J, Li M, Yan LL. Salt reduction in China: a state-of-the-art review. Risk Manag Healthc Policy 2017; 10:17-28. [PMID: 28260957 PMCID: PMC5328139 DOI: 10.2147/rmhp.s75918] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
Objective This study aimed to reveal the latest evidence on salt reduction initiatives in China in order to identify the contextual cost-effective interventions, as well as the barriers encountered during China’s long march to reach its population salt reduction goal. Background Population-based salt reduction has been considered as one of the most cost-effective strategies in the world for the prevention and control of noncommunicable diseases. China, along with its sustained economic growth, faces increasing burdens from chronic diseases such as cardiovascular and kidney diseases. With policy support and cross-sector collaboration, various salt reduction initiatives have been adopted in China in order to reduce such dietary risk, especially since the beginning of this millennium. Methods This study conducted structured literature reviews in both English and Chinese databases and synthesized the latest evidence on the association of salt intake and health, as well as salt intake among Chinese and population-based salt reduction strategies in China and around the world. Findings Dietary salt restriction has been found to contribute to the reduction of blood pressure among both the normotensives and hypertensives bringing associated reduced disease burdens and great public health benefits. With gender, ethnic, and regional variations, salt intake levels in the population in China are well above the recommended threshold and physiological need. Admittedly, excessive salt intake precipitates the high prevalence of hypertension and cardiovascular disease among the Chinese. Considering that the majority of the dietary salt is added during cooking in China, salt substitutes, salt restriction tools, and health education are the most common salt reduction initiatives with varying levels of effectiveness and acceptability among the Chinese population. Implication Overwhelming evidence is in support of a well-coordinated nationwide salt restriction initiative as a key public health strategy for the prevention and control of hypertension and its related diseases. Orchestrated efforts from the government, industries, academia, health professionals, and the general public are required to achieve China’s long-term goal for salt reduction.
Collapse
Affiliation(s)
- Shuai Shao
- Global Health Research Center, Duke Kunshan University, Kunshan, Jiangsu, China; Duke Global Health Institute
| | - Yechu Hua
- School of Economics, Duke University, Durham, NC, USA
| | - Ying Yang
- Department of Public Health, Wuhan University, Wuhan, Hubei
| | - Xiaojuan Liu
- Department of Biostatistics, School of Public Health, Shandong University, Jinan, Shandong, China
| | - Jingruo Fan
- Depatment of Accounting, School of Business and Management, The Hong Kong University of Science and Technology, Kowloon, Hong Kong
| | - An Zhang
- Department of Statistics and Applied Probability, National University of Singapore, Singapore
| | - Jingling Xiang
- School of Business, Sichuan University, Chengdu, Sichuan
| | - Mingjing Li
- Department of Public Health, School of Public Health and Management, Chongqing Medical University, Chongqing, China
| | - Lijing L Yan
- Global Health Research Center, Duke Kunshan University, Kunshan, Jiangsu, China; Duke Global Health Institute
| |
Collapse
|
32
|
Wang W, Jiang B, Sun H, Ru X, Sun D, Wang L, Wang L, Jiang Y, Li Y, Wang Y, Chen Z, Wu S, Zhang Y, Wang D, Wang Y, Feigin VL. Prevalence, Incidence, and Mortality of Stroke in China. Circulation 2017; 135:759-771. [DOI: 10.1161/circulationaha.116.025250] [Citation(s) in RCA: 1044] [Impact Index Per Article: 149.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Accepted: 12/19/2016] [Indexed: 12/21/2022]
Abstract
Background:
China bears the biggest stroke burden in the world. However, little is known about the current prevalence, incidence, and mortality of stroke at the national level, and the trend in the past 30 years.
Methods:
In 2013, a nationally representative door-to-door survey was conducted in 155 urban and rural centers in 31 provinces in China, totaling 480 687 adults aged ≥20 years. All stroke survivors were considered as prevalent stroke cases at the prevalent time (August 31, 2013). First-ever strokes that occurred during 1 year preceding the survey point-prevalent time were considered as incident cases. According to computed tomography/MRI/autopsy findings, strokes were categorized into ischemic stroke, intracerebral hemorrhage, subarachnoid hemorrhage, and stroke of undetermined type.
Results:
Of 480 687 participants, 7672 were diagnosed with a prevalent stroke (1596.0/100 000 people) and 1643 with incident strokes (345.1/100 000 person-years). The age-standardized prevalence, incidence, and mortality rates were 1114.8/100 000 people, 246.8 and 114.8/100 000 person-years, respectively. Pathological type of stroke was documented by computed tomography/MRI brain scanning in 90% of prevalent and 83% of incident stroke cases. Among incident and prevalent strokes, ischemic stroke constituted 69.6% and 77.8%, intracerebral hemorrhage 23.8% and 15.8%, subarachnoid hemorrhage 4.4% and 4.4%, and undetermined type 2.1% and 2.0%, respectively. Age-specific stroke prevalence in men aged ≥40 years was significantly greater than the prevalence in women (
P
<0.001). The most prevalent risk factors among stroke survivors were hypertension (88%), smoking (48%), and alcohol use (44%). Stroke prevalence estimates in 2013 were statistically greater than those reported in China 3 decades ago, especially among rural residents (
P
=0.017). The highest annual incidence and mortality of stroke was in Northeast (365 and 159/100 000 person-years), then Central areas (326 and 154/100 000 person-years), and the lowest incidence was in Southwest China (154/100 000 person-years), and the lowest mortality was in South China (65/100 000 person-years) (
P
<0.002).
Conclusions:
Stroke burden in China has increased over the past 30 years, and remains particularly high in rural areas. There is a north-to-south gradient in stroke in China, with the greatest stroke burden observed in the northern and central regions.
Collapse
Affiliation(s)
- Wenzhi Wang
- From Department of Neuroepidemiology, Beijing Neurosurgical Institute; Capital Medical University, China (W.W., B.J., H.S., X.R., D.S., Z.C., S.W., Y.Z.); Beijing Municipal Key Laboratory of Clinical Epidemiology, China (W.W., B.J., H.S., X.R., D.S., Z.C.); Beijing Tiantan Hospital, Capital Medical University, Beijing Institute for Brain Disorders, China (Y.J., Yilong Wang, Yongjun Wang); National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease
| | - Bin Jiang
- From Department of Neuroepidemiology, Beijing Neurosurgical Institute; Capital Medical University, China (W.W., B.J., H.S., X.R., D.S., Z.C., S.W., Y.Z.); Beijing Municipal Key Laboratory of Clinical Epidemiology, China (W.W., B.J., H.S., X.R., D.S., Z.C.); Beijing Tiantan Hospital, Capital Medical University, Beijing Institute for Brain Disorders, China (Y.J., Yilong Wang, Yongjun Wang); National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease
| | - Haixin Sun
- From Department of Neuroepidemiology, Beijing Neurosurgical Institute; Capital Medical University, China (W.W., B.J., H.S., X.R., D.S., Z.C., S.W., Y.Z.); Beijing Municipal Key Laboratory of Clinical Epidemiology, China (W.W., B.J., H.S., X.R., D.S., Z.C.); Beijing Tiantan Hospital, Capital Medical University, Beijing Institute for Brain Disorders, China (Y.J., Yilong Wang, Yongjun Wang); National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease
| | - Xiaojuan Ru
- From Department of Neuroepidemiology, Beijing Neurosurgical Institute; Capital Medical University, China (W.W., B.J., H.S., X.R., D.S., Z.C., S.W., Y.Z.); Beijing Municipal Key Laboratory of Clinical Epidemiology, China (W.W., B.J., H.S., X.R., D.S., Z.C.); Beijing Tiantan Hospital, Capital Medical University, Beijing Institute for Brain Disorders, China (Y.J., Yilong Wang, Yongjun Wang); National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease
| | - Dongling Sun
- From Department of Neuroepidemiology, Beijing Neurosurgical Institute; Capital Medical University, China (W.W., B.J., H.S., X.R., D.S., Z.C., S.W., Y.Z.); Beijing Municipal Key Laboratory of Clinical Epidemiology, China (W.W., B.J., H.S., X.R., D.S., Z.C.); Beijing Tiantan Hospital, Capital Medical University, Beijing Institute for Brain Disorders, China (Y.J., Yilong Wang, Yongjun Wang); National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease
| | - Linhong Wang
- From Department of Neuroepidemiology, Beijing Neurosurgical Institute; Capital Medical University, China (W.W., B.J., H.S., X.R., D.S., Z.C., S.W., Y.Z.); Beijing Municipal Key Laboratory of Clinical Epidemiology, China (W.W., B.J., H.S., X.R., D.S., Z.C.); Beijing Tiantan Hospital, Capital Medical University, Beijing Institute for Brain Disorders, China (Y.J., Yilong Wang, Yongjun Wang); National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease
| | - Limin Wang
- From Department of Neuroepidemiology, Beijing Neurosurgical Institute; Capital Medical University, China (W.W., B.J., H.S., X.R., D.S., Z.C., S.W., Y.Z.); Beijing Municipal Key Laboratory of Clinical Epidemiology, China (W.W., B.J., H.S., X.R., D.S., Z.C.); Beijing Tiantan Hospital, Capital Medical University, Beijing Institute for Brain Disorders, China (Y.J., Yilong Wang, Yongjun Wang); National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease
| | - Yong Jiang
- From Department of Neuroepidemiology, Beijing Neurosurgical Institute; Capital Medical University, China (W.W., B.J., H.S., X.R., D.S., Z.C., S.W., Y.Z.); Beijing Municipal Key Laboratory of Clinical Epidemiology, China (W.W., B.J., H.S., X.R., D.S., Z.C.); Beijing Tiantan Hospital, Capital Medical University, Beijing Institute for Brain Disorders, China (Y.J., Yilong Wang, Yongjun Wang); National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease
| | - Yichong Li
- From Department of Neuroepidemiology, Beijing Neurosurgical Institute; Capital Medical University, China (W.W., B.J., H.S., X.R., D.S., Z.C., S.W., Y.Z.); Beijing Municipal Key Laboratory of Clinical Epidemiology, China (W.W., B.J., H.S., X.R., D.S., Z.C.); Beijing Tiantan Hospital, Capital Medical University, Beijing Institute for Brain Disorders, China (Y.J., Yilong Wang, Yongjun Wang); National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease
| | - Yilong Wang
- From Department of Neuroepidemiology, Beijing Neurosurgical Institute; Capital Medical University, China (W.W., B.J., H.S., X.R., D.S., Z.C., S.W., Y.Z.); Beijing Municipal Key Laboratory of Clinical Epidemiology, China (W.W., B.J., H.S., X.R., D.S., Z.C.); Beijing Tiantan Hospital, Capital Medical University, Beijing Institute for Brain Disorders, China (Y.J., Yilong Wang, Yongjun Wang); National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease
| | - Zhenghong Chen
- From Department of Neuroepidemiology, Beijing Neurosurgical Institute; Capital Medical University, China (W.W., B.J., H.S., X.R., D.S., Z.C., S.W., Y.Z.); Beijing Municipal Key Laboratory of Clinical Epidemiology, China (W.W., B.J., H.S., X.R., D.S., Z.C.); Beijing Tiantan Hospital, Capital Medical University, Beijing Institute for Brain Disorders, China (Y.J., Yilong Wang, Yongjun Wang); National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease
| | - Shengping Wu
- From Department of Neuroepidemiology, Beijing Neurosurgical Institute; Capital Medical University, China (W.W., B.J., H.S., X.R., D.S., Z.C., S.W., Y.Z.); Beijing Municipal Key Laboratory of Clinical Epidemiology, China (W.W., B.J., H.S., X.R., D.S., Z.C.); Beijing Tiantan Hospital, Capital Medical University, Beijing Institute for Brain Disorders, China (Y.J., Yilong Wang, Yongjun Wang); National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease
| | - Yazhuo Zhang
- From Department of Neuroepidemiology, Beijing Neurosurgical Institute; Capital Medical University, China (W.W., B.J., H.S., X.R., D.S., Z.C., S.W., Y.Z.); Beijing Municipal Key Laboratory of Clinical Epidemiology, China (W.W., B.J., H.S., X.R., D.S., Z.C.); Beijing Tiantan Hospital, Capital Medical University, Beijing Institute for Brain Disorders, China (Y.J., Yilong Wang, Yongjun Wang); National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease
| | - David Wang
- From Department of Neuroepidemiology, Beijing Neurosurgical Institute; Capital Medical University, China (W.W., B.J., H.S., X.R., D.S., Z.C., S.W., Y.Z.); Beijing Municipal Key Laboratory of Clinical Epidemiology, China (W.W., B.J., H.S., X.R., D.S., Z.C.); Beijing Tiantan Hospital, Capital Medical University, Beijing Institute for Brain Disorders, China (Y.J., Yilong Wang, Yongjun Wang); National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease
| | - Yongjun Wang
- From Department of Neuroepidemiology, Beijing Neurosurgical Institute; Capital Medical University, China (W.W., B.J., H.S., X.R., D.S., Z.C., S.W., Y.Z.); Beijing Municipal Key Laboratory of Clinical Epidemiology, China (W.W., B.J., H.S., X.R., D.S., Z.C.); Beijing Tiantan Hospital, Capital Medical University, Beijing Institute for Brain Disorders, China (Y.J., Yilong Wang, Yongjun Wang); National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease
| | - Valery L. Feigin
- From Department of Neuroepidemiology, Beijing Neurosurgical Institute; Capital Medical University, China (W.W., B.J., H.S., X.R., D.S., Z.C., S.W., Y.Z.); Beijing Municipal Key Laboratory of Clinical Epidemiology, China (W.W., B.J., H.S., X.R., D.S., Z.C.); Beijing Tiantan Hospital, Capital Medical University, Beijing Institute for Brain Disorders, China (Y.J., Yilong Wang, Yongjun Wang); National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease
| |
Collapse
|
33
|
Relationship between urinary sodium with blood pressure and hypertension among a Kazakh community population in Xinjiang, China. J Hum Hypertens 2017; 31:333-340. [PMID: 28054572 DOI: 10.1038/jhh.2016.83] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Revised: 10/02/2016] [Accepted: 10/21/2016] [Indexed: 01/11/2023]
Abstract
Urinary sodium levels are reported to be associated with blood pressure in clinical trials and epidemiology studies. Nevertheless, the public health message of reducing sodium intake in free-living community populations remains under debate. Based on an ongoing prospective study initiated in 2012 with a community-based design in Xinjiang, China, 1668 adults (⩾30 years old) were assessed in the current study for associations between urinary sodium and blood pressure and hypertension in a free-living population of Kazakh people. After excluding 223 people on antihypertensive medication, 1445 participants were analyzed. Second urine samples after waking were used to estimate 24-h urinary sodium excretion, which is a marker for sodium intake. Following analyses, we found that the distribution of systolic and diastolic blood pressures moved upward with increasing quartiles of urinary sodium. After adjusting for age, differences in median systolic blood pressure were 8.5 mm Hg for men and 8.0 mm Hg for women between the top and bottom urinary sodium quartiles, and differences for diastolic blood pressure were 4.7 mm Hg for men and 4.3 mm Hg for women. A significant increased risk for hypertension was observed for the top quartile of urinary sodium after adjusting for age, body mass index, smoking, alcohol consumption, fruit and vegetable consumption, with corresponding odds ratios being 1.61 (95% confidence interval (CI): 1.02-2.54) for men and 1.92 (95% CI: 1.13-3.27) for women. Improving education about reducing salt intake is of particular public importance to reduce blood pressure and the risk for hypertension among the Kazakh people.
Collapse
|
34
|
Turck D, Bresson JL, Burlingame B, Dean T, Fairweather-Tait S, Heinonen M, Hirsch-Ernst KI, Mangelsdorf I, McArdle H, Neuhäuser-Berthold M, Nowicka G, Pentieva K, Sanz Y, Siani A, Sjödin A, Stern M, Tomé D, Van Loveren H, Vinceti M, Willatts P, Aggett P, Martin A, Przyrembel H, Brönstrup A, Ciok J, Gómez Ruiz JÁ, de Sesmaisons-Lecarré A, Naska A. Dietary reference values for potassium. EFSA J 2016. [DOI: 10.2903/j.efsa.2016.4592] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
|
35
|
Aryal N, Weatherall M, Bhatta YKD, Mann S. Blood Pressure and Hypertension in Adults Permanently Living at High Altitude: A Systematic Review and Meta-Analysis. High Alt Med Biol 2016; 17:185-193. [DOI: 10.1089/ham.2015.0118] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Nirmal Aryal
- Department of Medicine, University of Otago, Wellington, New Zealand
| | - Mark Weatherall
- Department of Medicine, University of Otago, Wellington, New Zealand
| | | | - Stewart Mann
- Department of Medicine, University of Otago, Wellington, New Zealand
| |
Collapse
|
36
|
Abstract
With one-fifth of the world's total population, China's prevention and control of cardiovascular disease (CVD) may affect the success of worldwide efforts to achieve sustainable CVD reduction. Understanding China's current cardiovascular epidemic requires awareness of the economic development in the past decades. The rapid economic transformations (industrialization, marketization, urbanization, globalization, and informationalization) contributed to the aging demography, unhealthy lifestyles, and environmental changes. The latter have predisposed to increasing cardiovascular risk factors and the CVD pandemic. Rising CVD rates have had a major economic impact, which has challenged the healthcare system and the whole society. With recognition of the importance of health, initial political steps and national actions have been taken to address the CVD epidemic. Looking to the future, we recommend that 4 priorities should be taken: pursue multisectorial government and nongovernment strategies targeting the underlying causes of CVD (the whole-of-government and whole-of-society policy); give priority to prevention; reform the healthcare system to fit the nature of noncommunicable diseases; and conduct research for evidence-based, low-cost, simple, sustainable, and scalable interventions. By pursuing the 4 priorities, the pandemic of CVD and other major noncommunicable diseases in China will be reversed and the global sustainable development goal achieved.
Collapse
Affiliation(s)
- Yangfeng Wu
- From Peking University School of Public Health and Clinical Research Institute, Beijing, China (Y.W.); The George Institute for Global Health at Peking University Health Science Center, Beijing, China (Y.W.); Boston University Schools of Medicine and Public Health, MA (E.J.B.); and The George Institute for Global Health, Sydney, Australia (S.M.).
| | - Emelia J Benjamin
- From Peking University School of Public Health and Clinical Research Institute, Beijing, China (Y.W.); The George Institute for Global Health at Peking University Health Science Center, Beijing, China (Y.W.); Boston University Schools of Medicine and Public Health, MA (E.J.B.); and The George Institute for Global Health, Sydney, Australia (S.M.)
| | - Stephen MacMahon
- From Peking University School of Public Health and Clinical Research Institute, Beijing, China (Y.W.); The George Institute for Global Health at Peking University Health Science Center, Beijing, China (Y.W.); Boston University Schools of Medicine and Public Health, MA (E.J.B.); and The George Institute for Global Health, Sydney, Australia (S.M.)
| |
Collapse
|
37
|
Hou L, Zhang M, Han W, Tang Y, Xue F, Liang S, Zhang B, Wang W, Asaiti K, Wang Y, Pang H, Wang Z, Wang Y, Qiu C, Jiang J. Influence of Salt Intake on Association of Blood Uric Acid with Hypertension and Related Cardiovascular Risk. PLoS One 2016; 11:e0150451. [PMID: 27042828 PMCID: PMC4820262 DOI: 10.1371/journal.pone.0150451] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2015] [Accepted: 02/12/2016] [Indexed: 11/19/2022] Open
Abstract
Background A relationship of blood uric acid (UA) with hypertension and cardiovascular risk is under debate thus salt intake is hypothesized to contribute to such associations. Methods In this cross-sectional study, stratified cluster random sampling elicited a sample of 1805 Kazakhs with 92.4% compliance. Hypertension and moderate-or-high total cardiovascular risk (mTCR) were defined according to guidelines. Sodium intake was assessed by urinary sodium excretion. Prevalence ratios (PRs) were used to express associations of UA with hypertension and mTCR. Results In the highest tertile of sodium intake in women, the adjusted PRs (95% confidence intervals) of low to high quartiles compared with the lowest quartile of UA, were 1.22(0.78–1.91), 1.18(0.75–1.85), and 1.65(1.09–2.51) for hypertension and 1.19(0.74–1.90), 1.39(0.91–2.11), and 1.65(1.10–2.47) for mTCR (P for trend <0.05). However, these findings were not shown for other sodium intake levels. There were similar results in men. PRs markedly increased with a concomitant increase in UA and sodium intake and there was a significant interaction (P = 0.010) for mTCR with PRs of 1.69(1.10–2.60) for men and 3.70(2.09–6.52) for women in those with the highest compared with the lowest quartile of UA and tertile of sodium intake. Similar findings were shown for hypertension. Conclusions This study implied that a high salt intake may enhance the associations of UA with hypertension and cardiovascular risk.
Collapse
Affiliation(s)
- Lei Hou
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences / School of Basic Medicine Peking Union Medical College, Beijing, China
| | - Mingtao Zhang
- The People’s Hospital of Altay Prefecture, Xinjiang, China
| | - Wei Han
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences / School of Basic Medicine Peking Union Medical College, Beijing, China
| | - Yong Tang
- The People’s Hospital of Altay Prefecture, Xinjiang, China
| | - Fang Xue
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences / School of Basic Medicine Peking Union Medical College, Beijing, China
| | - Shaohua Liang
- The People’s Hospital of Altay Prefecture, Xinjiang, China
| | - Biao Zhang
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences / School of Basic Medicine Peking Union Medical College, Beijing, China
| | - Weizhi Wang
- The People’s Hospital of Altay Prefecture, Xinjiang, China
| | | | - Yanhong Wang
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences / School of Basic Medicine Peking Union Medical College, Beijing, China
| | - Haiyu Pang
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences / School of Basic Medicine Peking Union Medical College, Beijing, China
| | - Zixing Wang
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences / School of Basic Medicine Peking Union Medical College, Beijing, China
| | - Yuyan Wang
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences / School of Basic Medicine Peking Union Medical College, Beijing, China
| | - Changchun Qiu
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences / School of Basic Medicine Peking Union Medical College, Beijing, China
| | - Jingmei Jiang
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences / School of Basic Medicine Peking Union Medical College, Beijing, China
- * E-mail:
| |
Collapse
|
38
|
Wu F, Koenig KL, Zeleniuch-Jacquotte A, Jonas S, Afanasyeva Y, Wójcik OP, Costa M, Chen Y. Serum Taurine and Stroke Risk in Women: A Prospective, Nested Case-Control Study. PLoS One 2016; 11:e0149348. [PMID: 26866594 PMCID: PMC4750934 DOI: 10.1371/journal.pone.0149348] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2015] [Accepted: 01/29/2016] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Taurine (2-aminoethanesulfonic acid), a conditionally essential sulfur-containing amino acid, is mainly obtained from diet in humans. Experimental studies have shown that taurine's main biological actions include bile salt conjugation, blood pressure regulation, anti-oxidation, and anti-inflammation. METHODS We conducted a prospective case-control study nested in the New York University Women's Health Study, a cohort study involving 14,274 women enrolled since 1985. Taurine was measured in pre-diagnostic serum samples of 241 stroke cases and 479 matched controls. RESULTS There was no statistically significant association between serum taurine and stroke risk in the overall study population. The adjusted ORs for stroke were 1.0 (reference), 0.87 (95% CI, 0.59-1.28), and 1.03 (95% CI, 0.69-1.54) in increasing tertiles of taurine (64.3-126.6, 126.7-152.9, and 153.0-308.5 nmol/mL, respectively). A significant inverse association between serum taurine and stroke risk was observed among never smokers, with an adjusted OR of 0.66 (95% CI, 0.37-1.18) and 0.50 (95% CI, 0.26-0.94) for the second and third tertile, respectively (p for trend = 0.01), but not among past or current smokers (p for interaction < 0.01). CONCLUSIONS We observed no overall association between serum taurine and stroke risk, although a protective effect was observed in never smokers, which requires further investigation. Taurine, Stroke, Epidemiology, Prospective, Case-control study, NYUWHS.
Collapse
Affiliation(s)
- Fen Wu
- Department of Population Health, New York University School of Medicine, 650 First Avenue, New York, New York, United States of America
| | - Karen L. Koenig
- Department of Population Health, New York University School of Medicine, 650 First Avenue, New York, New York, United States of America
| | - Anne Zeleniuch-Jacquotte
- Department of Population Health, New York University School of Medicine, 650 First Avenue, New York, New York, United States of America
| | - Saran Jonas
- Department of Neurology, New York University School of Medicine, 462 First Avenue, New York, New York, United States of America
| | - Yelena Afanasyeva
- Department of Population Health, New York University School of Medicine, 650 First Avenue, New York, New York, United States of America
| | - Oktawia P. Wójcik
- Robert Wood Johnson Foundation, Route 1 and College Road East, Princeton, New Jersey, United States of America
| | - Max Costa
- Department of Environmental Medicine, New York University School of Medicine, 57 Old Forge Rd, Tuxedo Park, New York, United States of America
| | - Yu Chen
- Department of Population Health, New York University School of Medicine, 650 First Avenue, New York, New York, United States of America
- * E-mail:
| |
Collapse
|
39
|
Kawamura H, Ozawa Y, Izumi Y, Kasamaki Y, Nakayama T, Mitsubayashi H, Ohta M, Ichimaru Y. Non-dipping blood pressure variations in adult Kazakhs are derived from decreased daytime physical activity and increased nighttime sympathetic activity. Clin Exp Hypertens 2016; 38:194-202. [DOI: 10.3109/10641963.2015.1081216] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|
40
|
Mingji C, Onakpoya IJ, Perera R, Ward AM, Heneghan CJ. Relationship between altitude and the prevalence of hypertension in Tibet: a systematic review. Heart 2015; 101:1054-60. [PMID: 25953970 PMCID: PMC4484261 DOI: 10.1136/heartjnl-2014-307158] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2014] [Accepted: 04/07/2015] [Indexed: 11/17/2022] Open
Abstract
Introduction Hypertension is a leading cause of cardiovascular disease, which is the cause of one-third of global deaths and is a primary and rising contributor to the global disease burden. The objective of this systematic review was to determine the prevalence and awareness of hypertension among the inhabitants of Tibet and its association with altitude, using the data from published observational studies. Methods We conducted electronic searches in Medline, Embase, ISI Web of Science and Global Health. No gender or language restrictions were imposed. We assessed the methodological characteristics of included studies using the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) criteria. Two reviewers independently determined the eligibility of studies, assessed the methodology of included studies and extracted the data. We used meta-regression to estimate the degree of change in hypertension prevalence with increasing altitude. Results We identified 22 eligible articles of which eight cross-sectional studies with a total of 16 913 participants were included. The prevalence of hypertension ranged between 23% and 56%. A scatter plot of altitude against overall prevalence revealed a statistically significant correlation (r=0.68; p=0.04). Meta-regression analysis revealed a 2% increase in the prevalence of hypertension with every 100 m increase in altitude (p=0.06). The locations and socioeconomic status of subjects affected the awareness and subsequent treatment and control of hypertension. Conclusions The results from cross-sectional studies suggest that there is a significant correlation between altitude and the prevalence of hypertension among inhabitants of Tibet. The socioeconomic status of the inhabitants can influence awareness and management of hypertension. Very little research into hypertension has been conducted in other prefectures of Tibet where the altitude is much higher. Further research examining the impact of altitude on blood pressure is warranted.
Collapse
Affiliation(s)
- Cuomu Mingji
- Tibetan Medical College, Lhasa, Tibet & Austrian Academy of Sciences, Vienna, Austria
| | - Igho J Onakpoya
- Nuffield Department of Primary Care Health Sciences, Centre for Evidence-Based Medicine, University of Oxford, Oxford, UK
| | - Rafael Perera
- Nuffield Department of Primary Care Health Sciences, Centre for Evidence-Based Medicine, University of Oxford, Oxford, UK
| | - Alison M Ward
- Nuffield Department of Primary Care Health Sciences, Centre for Evidence-Based Medicine, University of Oxford, Oxford, UK
| | - Carl J Heneghan
- Nuffield Department of Primary Care Health Sciences, Centre for Evidence-Based Medicine, University of Oxford, Oxford, UK
| |
Collapse
|
41
|
Zhao X, Yin X, Li X, Yan LL, Lam CT, Li S, He F, Xie W, Sang B, Luobu G, Ke L, Wu Y. Using a low-sodium, high-potassium salt substitute to reduce blood pressure among Tibetans with high blood pressure: a patient-blinded randomized controlled trial. PLoS One 2014; 9:e110131. [PMID: 25338053 PMCID: PMC4206289 DOI: 10.1371/journal.pone.0110131] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2013] [Accepted: 09/06/2014] [Indexed: 11/18/2022] Open
Abstract
Objectives To evaluate the effects of a low-sodium and high-potassium salt-substitute on lowering blood pressure (BP) among Tibetans living at high altitude (4300 meters). Method The study was a patient-blinded randomized controlled trial conducted between February and May 2009 in Dangxiong County, Tibetan Autonomous Region, China. A total of 282 Tibetans aged 40 or older with known hypertension (systolic BP≥140 mmHg) were recruited and randomized to intervention (salt-substitute, 65% sodium chloride, 25% potassium chloride and 10% magnesium sulfate) or control (100% sodium chloride) in a 1: 1 allocation ratio with three months’ supply. Primary outcome was defined as the change in BP levels measured from baseline to followed-up with an automated sphygmomanometer. Per protocol (PP) and intention to treat (ITT) analyses were conducted. Results After the three months’ intervention period, the net reduction in SBP/DBP in the intervention group in comparison to the control group was −8.2/−3.4 mmHg (all p<0.05) in PP analysis, after adjusting for baseline BP and other variables. ITT analysis showed the net reduction in SBP/DBP at −7.6/−3.5 mmHg with multiple imputations (all p<0.05). Furthermore, the whole distribution of blood pressure showed an overall decline in SBP/DBP and the proportion of patients with BP under control (SBP/DBP<140 mmHg) was significantly higher in salt-substitute group in comparison to the regular salt group (19.2% vs. 8.8%, p = 0.027). Conclusion Low sodium high potassium salt-substitute is effective in lowering both systolic and diastolic blood pressure and offers a simple, low-cost approach for hypertension control among Tibetans in China. Trial Registration ClinicalTrials.gov NCT01429246
Collapse
Affiliation(s)
- Xingshan Zhao
- Department of Cardiology, Beijing Jishuitan Hospital, 4 medical college of Peking University, Beijing, China
| | - Xuejun Yin
- The George Institute for Global Health at Peking University Health Science Center, Beijing, China,
| | - Xian Li
- The George Institute for Global Health at Peking University Health Science Center, Beijing, China,
| | - Lijing L. Yan
- The George Institute for Global Health at Peking University Health Science Center, Beijing, China,
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, United States of America
| | - Christopher T. Lam
- Duke Global Health Institute, Duke University, Durham, North Carolina, United States of America
| | - Shenshen Li
- The George Institute for Global Health at Peking University Health Science Center, Beijing, China,
| | - Feng He
- Department of Cardiology, Beijing Jishuitan Hospital, 4 medical college of Peking University, Beijing, China
| | - Wuxiang Xie
- Department of Epidemiology and Biostatistics, Peking University School of Public Health, Beijing, China
| | - Ba Sang
- Dangxiong People’s Hospital, Tibet, China
| | - Gesang Luobu
- Tibet Autonomous Region People’s Hospital, Tibet, China
| | - Liang Ke
- The George Institute for Global Health at Peking University Health Science Center, Beijing, China,
| | - Yangfeng Wu
- The George Institute for Global Health at Peking University Health Science Center, Beijing, China,
- Department of Epidemiology and Biostatistics, Peking University School of Public Health, Beijing, China
- * E-mail:
| |
Collapse
|
42
|
Jiang J, Zhang B, Zhang M, Xue F, Tang Y, Liang S, Hou L, Wang W, Han W, Asaiti K, Nasca PC, Wang Y, Pang H, Wang Z, Wang Y, Qiu C. Prevalence of conventional cardiovascular disease risk factors among Chinese Kazakh individuals of diverse occupational backgrounds in Xinjiang China. Int J Cardiol 2014; 179:558-60. [PMID: 25466562 DOI: 10.1016/j.ijcard.2014.10.077] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2014] [Accepted: 10/19/2014] [Indexed: 10/24/2022]
Affiliation(s)
- Jingmei Jiang
- Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, Schoolof Basic Medicine, Peking Union Medical College, Beijing, China.
| | - Biao Zhang
- Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, Schoolof Basic Medicine, Peking Union Medical College, Beijing, China
| | - Mingtao Zhang
- The People's Hospital in Altay Region, Xinjiang, China.
| | - Fang Xue
- Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, Schoolof Basic Medicine, Peking Union Medical College, Beijing, China
| | - Yong Tang
- The People's Hospital in Altay Region, Xinjiang, China
| | - Shaohua Liang
- The People's Hospital in Altay Region, Xinjiang, China
| | - Lei Hou
- Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, Schoolof Basic Medicine, Peking Union Medical College, Beijing, China
| | - Weizhi Wang
- The People's Hospital in Altay Region, Xinjiang, China
| | - Wei Han
- Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, Schoolof Basic Medicine, Peking Union Medical College, Beijing, China
| | | | - Philip C Nasca
- School of Public Health, State University of New York at Albany, US
| | - Yanhong Wang
- Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, Schoolof Basic Medicine, Peking Union Medical College, Beijing, China
| | - Haiyu Pang
- Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, Schoolof Basic Medicine, Peking Union Medical College, Beijing, China
| | - Zixing Wang
- Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, Schoolof Basic Medicine, Peking Union Medical College, Beijing, China
| | - Yuyan Wang
- Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, Schoolof Basic Medicine, Peking Union Medical College, Beijing, China
| | - Changchun Qiu
- Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, Schoolof Basic Medicine, Peking Union Medical College, Beijing, China.
| |
Collapse
|
43
|
Zhang JY, Yan LX, Tang JL, Ma JX, Guo XL, Zhao WH, Zhang XF, Li JH, Chu J, Bi ZQ. Estimating daily salt intake based on 24 h urinary sodium excretion in adults aged 18-69 years in Shandong, China. BMJ Open 2014; 4:e005089. [PMID: 25037642 PMCID: PMC4120319 DOI: 10.1136/bmjopen-2014-005089] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE 24 h urinary sodium extretion was used to estimate the daily salt intake of shandong residents aged from 18 to 69 years in China. SETTING 20 selected counties/districts in Shandong stratified by geographic region (Eastern, Central Southern and North Western) and residence type (urban vs rural). PARTICIPANTS Among 2184 randomly selected adults, 2061 provided usable 24 h urine samples. Urine volume <500 mL or male creatinine <3.81 (female creatinine <4.57) are not included in the analysis. RESULTS The mean sodium level excreted over 24 h was 237.61 mmol (95% CI 224.77 to 250.44) mmol. Overall, the estimated mean salt intake was 13.90 g/day (95% CI 13.15 to 14.65). The mean salt intake among rural residents was higher than that among urban residents (14.00 vs 13.68 g; p<0.01). Salt intake in men was higher than that in women (14.40 vs 13.37 g; p<0.01). Approximately 96% of the survey participants had a dietary salt intake of ≥6 g/day. CONCLUSIONS The salt intake in Shandong is alarmingly higher than the current recommended amount (6 g/day). Thus, effective interventions to reduce salt intake levels to combat the increasing burden of non-communicable diseases need to be developed and implemented.
Collapse
Affiliation(s)
- Ji-yu Zhang
- Shandong Center for Disease Control and Prevention, Jinan, China
| | - Liu-xia Yan
- National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jun-li Tang
- Shandong Center for Disease Control and Prevention, Jinan, China
| | - Ji-xiang Ma
- National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Xiao-lei Guo
- Shandong Center for Disease Control and Prevention, Jinan, China
| | - Wen-hua Zhao
- Chinese Center for Disease Control and Prevention, Beijing, China
| | - Xiao-fei Zhang
- Department of Clinical Epidemiology and Biostatistics, Second Affiliated Hospital of Zhejiang University College of Medicine, Hangzhou, China
| | - Jian-hong Li
- National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jie Chu
- Shandong Center for Disease Control and Prevention, Jinan, China
| | - Zhen-qiang Bi
- Shandong Center for Disease Control and Prevention, Jinan, China
| |
Collapse
|
44
|
Xu J, Wang M, Chen Y, Zhen B, Li J, Luan W, Ning F, Liu H, Ma J, Ma G. Estimation of salt intake by 24-hour urinary sodium excretion: a cross-sectional study in Yantai, China. BMC Public Health 2014; 14:136. [PMID: 24507470 PMCID: PMC3921994 DOI: 10.1186/1471-2458-14-136] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2013] [Accepted: 02/04/2014] [Indexed: 11/17/2022] Open
Abstract
Background High levels of dietary sodium are associated with raised blood pressure and adverse cardiovascular health. To determine baseline salt intake, we investigated the average dietary salt intake from 24-hour urinary sodium excretion with a small sample of Yantai adults in the Shandong province of China. Methods One hundred ninety one adults aged 18–69 years were randomly selected from the Yantai adult population. Blood pressure, anthropometric indices and sodium excretion in a 24-hour urine collection were measured. Consumption of condiments was derived from 3-day weighted records. Completeness of urine collections was verified using creatinine excretion in relation to weight. Results The mean Na and K outputs over 24 hours were 201.5 ± 77.7 mmol/day and 46.8 ± 23.2 mmol/day, respectively (corresponding to 11.8 g NaCl and 1.8 g K). Overall, 92.1% of the subjects (96.9% of men and 87.1% of women) had intakes of over 6 g salt (NaCl)/d. The main sources of salt intake from weighed condiments records were from home cooking salt (74.7%) followed by soy sauce (15.0%). Salt intake from condiments and salt excretion were weakly correlated((r = 0.20, p = 0.005).A positive linear correlation between salt intake was associated with systolic blood pressure in all adjusted and unadjusted model (r = 0.16, p = 0.01). Each 100 mmol/day increase in sodium intake was associated with a 4.0 mmHg increase in systolic blood pressure. Conclusion Dietary salt intake in Yantai adults was high. Reducing the intake of table salt and soy sauce used in cooking will be an important strategy to reduce sodium intake among Yantai adults.
Collapse
Affiliation(s)
| | - Maobo Wang
- Yantai Center for Disease Control and Prevention, 264003 Yantai, China.
| | | | | | | | | | | | | | | | | |
Collapse
|
45
|
Du S, Neiman A, Batis C, Wang H, Zhang B, Zhang J, Popkin BM. Understanding the patterns and trends of sodium intake, potassium intake, and sodium to potassium ratio and their effect on hypertension in China. Am J Clin Nutr 2014; 99:334-43. [PMID: 24257724 PMCID: PMC3893725 DOI: 10.3945/ajcn.113.059121] [Citation(s) in RCA: 199] [Impact Index Per Article: 19.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2013] [Accepted: 11/05/2013] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Recent studies have shown inconsistent effects of sodium reduction, potassium intake, and the ratio of sodium to potassium (Na/K ratio) on hypertension and other cardiovascular diseases. Major gaps exist in knowledge regarding these issues in China. OBJECTIVE We analyzed the patterns and trends of dietary sodium intake, potassium intake, and the Na/K ratio and their relations with incident hypertension in China. DESIGN The China Health and Nutrition Survey cohort includes 16,869 adults aged 20-60 y from 1991 to 2009. Three consecutive 24-h dietary recalls and condiment and food weights provided detailed dietary data. Multinomial logistic regression models determined trends and patterns of sodium and potassium intake and the Na/K ratio. Models for survival-time data estimated the hazard of incident hypertension. RESULTS Sodium intake is decreasing but remains double the Institute of Medicine recommendations. Most sodium comes from added condiments. Adults in the central provinces have the highest sodium intake and the most rapid increase in hypertension. Potassium intake has increased slightly but is below half of the recommended amount. The Na/K ratio is significantly higher than the recommended amounts. Recent measurements of high sodium intake, low potassium intake, and high Na/K ratio have strong independent dose-response associations with incident hypertension. CONCLUSIONS Reducing sodium in processed foods, the major public health strategy in Western countries, may be less effective in China, where salt intake remains high. Replacing sodium with potassium in salt to control and prevent hypertension in China should be considered along with other public health and clinical prevention options.
Collapse
Affiliation(s)
- Shufa Du
- Department of Nutrition and Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC (SD, CB, and BMP); the Division for Heart Disease and Stroke Prevention, National Center for Chronic Disease Prevention and Health Promotion, Atlanta, GA (AN); and the National Institute of Nutrition and Food Safety, Chinese Center for Disease Control and Prevention, Beijing, China (HW, BZ, and JZ)
| | | | | | | | | | | | | |
Collapse
|
46
|
Weight reduction in patients with coronary artery disease: Comparison of Traditional Tibetan Medicine and Western diet. Int J Cardiol 2013; 168:1509-15. [DOI: 10.1016/j.ijcard.2013.07.034] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2013] [Accepted: 07/02/2013] [Indexed: 12/19/2022]
|
47
|
Abstract
Background and Purpose—
In 1960s, a stroke belt with high stroke mortality was discovered in the southeast United States. In China, where stroke is the leading cause of death, we aimed to determine whether a focal region of high stroke incidence (stroke belt) exits and, if so, the possible causal and modifiable factors.
Methods—
We systematically reviewed all studies of stroke incidence in China between 1980 and 2010, and included those which met our criteria for a high-quality study. Criteria for a provincial region of high stroke incidence were ranking in the top one third of all provinces for stroke incidence and ranking of more than one third of prefectural regions within the province in the top two sevenths of all prefectural regions for stroke incidence. We also reviewed regional distribution of major vascular risk factors, socioeconomic status, and demographic profiles in China.
Results—
Nine eligible studies provided data on the incidence of stroke in 32 of 34 provincial regions of China (with Hong Kong and Macao as exceptions) and 52% of the 347 prefectural regions. Nine provincial regions (Heilongjiang, Tibet, Jilin, Liaoning, Xinjiang, Hebei, Inner Mongolia, Beijing, and Ningxia) met our criteria for a region of high stroke incidence and constitute a stroke belt in north and west China. The incidence of stroke in the stroke belt was 236.2 per 100 000 population compared with 109.7 in regions outside the belt (rate ratio, 2.16; 95% confidence interval, 2.10–2.22). The mean population prevalence of hypertension and overweight (body mass index, >25) was greater in the stroke belt than that in other regions (15.3% versus 10.3%,
P
<0.001; 21.1% versus 12.3%,
P
=0.013, respectively). The prevalence of hypertension and overweight also correlated significantly with regional stroke incidence (
R
=0.642,
P
<0.001;
R
=0.438,
P
=0.014, respectively, by Spearman rank correlation).
Conclusions—
A stroke belt of high stroke incidence exists in 9 provincial regions of north and west China. The stroke belt may be caused, at least in part, by a higher population prevalence of hypertension and excess body weight. Lowering blood pressure and body weight in the stroke belt may reduce the geographic disparity in stroke risk and incidence in China.
Collapse
Affiliation(s)
- Gelin Xu
- From the Department of Neurology, Jinling Hospital, Nanjing University School of Medicine, Nanjing, Jiangsu Province, China (G.X., M.M., X.L.); School of Medicine and Pharmacology, The University of Western Australia, Western Australia, Australia (G.J.H.); and Stroke Unit, Department of Neurology, Royal Perth Hospital, Perth, Western Australia, Australia (G.J.H.)
| | - Minmin Ma
- From the Department of Neurology, Jinling Hospital, Nanjing University School of Medicine, Nanjing, Jiangsu Province, China (G.X., M.M., X.L.); School of Medicine and Pharmacology, The University of Western Australia, Western Australia, Australia (G.J.H.); and Stroke Unit, Department of Neurology, Royal Perth Hospital, Perth, Western Australia, Australia (G.J.H.)
| | - Xinfeng Liu
- From the Department of Neurology, Jinling Hospital, Nanjing University School of Medicine, Nanjing, Jiangsu Province, China (G.X., M.M., X.L.); School of Medicine and Pharmacology, The University of Western Australia, Western Australia, Australia (G.J.H.); and Stroke Unit, Department of Neurology, Royal Perth Hospital, Perth, Western Australia, Australia (G.J.H.)
| | - Graeme J. Hankey
- From the Department of Neurology, Jinling Hospital, Nanjing University School of Medicine, Nanjing, Jiangsu Province, China (G.X., M.M., X.L.); School of Medicine and Pharmacology, The University of Western Australia, Western Australia, Australia (G.J.H.); and Stroke Unit, Department of Neurology, Royal Perth Hospital, Perth, Western Australia, Australia (G.J.H.)
| |
Collapse
|
48
|
Roysommuti S, Wyss JM. Perinatal taurine exposure affects adult arterial pressure control. Amino Acids 2012; 46:57-72. [PMID: 23070226 DOI: 10.1007/s00726-012-1417-5] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2012] [Accepted: 10/04/2012] [Indexed: 12/13/2022]
Abstract
Taurine is an abundant, free amino acid found in mammalian cells that contributes to many physiologic functions from that of a simple cell osmolyte to a programmer of adult health and disease. Taurine's contribution extends from conception throughout life, but its most critical exposure period is during perinatal life. In adults, taurine supplementation prevents or alleviates cardiovascular disease and related complications. In contrast, low taurine consumption coincides with increased risk of cardiovascular disease, obesity and type II diabetes. This review focuses on the effects that altered perinatal taurine exposure has on long-term mechanisms that control adult arterial blood pressure and could thereby contribute to arterial hypertension through its ability to program these cardiovascular regulatory mechanisms very early in life. The modifications of these mechanisms can last a lifetime and transfer to the next generation, suggesting that epigenetic mechanisms underlie the changes. The ability of perinatal taurine exposure to influence arterial pressure control mechanisms and hypertension in adult life appears to involve the regulation of growth and development, the central and autonomic nervous system, the renin-angiotensin system, glucose-insulin interaction and changes to heart, blood vessels and kidney function.
Collapse
Affiliation(s)
- Sanya Roysommuti
- Department of Physiology, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand,
| | | |
Collapse
|
49
|
Wang LP, Zhao LR, Cui HW, Yan MR, Yang L, Su XL. Association between PPARγ2 Pro12Ala polymorphism and myocardial infarction and obesity in Han Chinese in Hohhot, China. GENETICS AND MOLECULAR RESEARCH 2012; 11:2929-38. [PMID: 22653647 DOI: 10.4238/2012.may.18.13] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Activation of the peroxisome proliferator-activated receptor g (PPARg) improves insulin sensitivity and inhibits atherosclerosis. Whether PPARg2 Pro12Ala polymorphism affects myocardial infarction is not clearly understood. We investigated a possible association of PPARg2 Pro12Ala polymorphism with obesity and myocardial infarction in Han Chinese in Hohhot, Inner Mongolia, China. We included 121 subjects with myocardial infarction and 137 healthy controls in our study. Triglycerides, total cholesterol, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol were measured. The following information was recorded for each subject: age, gender, body height, body weight, systolic blood pressure, and diastolic blood pressure; the body mass index was calculated. PCR-RFLP was used to examine Pro12Ala polymorphism. There were significant differences in clinical characteristics between myocardial infarction patients and healthy controls, except for diastolic blood pressure and triglycerides. The PP, PA/AA genotype frequencies were 88.4 and 11.6% in myocardial infarction patients and 95.6 and 4.4% in controls, respectively (P = 0.031). Individuals with the A allele had a significantly higher risk of myocardial infarction. The A allele was not an independent risk factor for obesity. We conclude that PPARg2 Pro12Ala polymorphisms are associated with increased risk for myocardial infarction in Han Chinese in Hohhot.
Collapse
Affiliation(s)
- L P Wang
- Department of Cardiology of Affiliated Hospital, Inner Mongolia Medical College, Hohhot, China
| | | | | | | | | | | |
Collapse
|
50
|
Liu L, Yin X, Morrissey S. Global variability in diabetes mellitus and its association with body weight and primary healthcare support in 49 low- and middle-income developing countries. Diabet Med 2012; 29:995-1002. [PMID: 22150805 DOI: 10.1111/j.1464-5491.2011.03549.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
AIMS In the absence of any previous global comparison, we examined the variability in prevalence of diabetes mellitus across 49 developing countries, and the associations of diabetes with body weight and primary healthcare support using data from the World Health Survey. METHODS Diabetes mellitus was defined by individuals' self-report of a physician diagnosis of diabetes. BMI is the weight (kg)/the square of the height (m). Healthcare support was assessed using clinical treatment status and whether patients with diabetes followed prescribed behaviour changes to control diabetes. Associations of diabetes with BMI and diabetes treatment status were analysed cross-sectionally. RESULTS A total of 215898 participants were included in the analysis. Age-adjusted prevalence of diabetes ranged from 0.27% (Mali) to 15.54% (Mauritius). Participants who were underweight (BMI <18.5 kg/m(2) ), overweight (BMI 25-29.9 kg/m(2) ) and obese (BMI ≥ 30 kg/m(2) ) were significantly associated with odds of having diabetes as compared with those who were of normal weight (BMI 18.5-24.9 k/m(2) ), with corresponding values of multivariate adjusted odds ratios (95% CI) of 1.15 (1.07-1.24), 1.56 (1.44-1.68) and 2.35 (2.17-2.61), respectively. The overall untreated rate of those with diabetes mellitus was 9.6% in the total sample. Patients with underweight had the highest diabetes untreated rate, followed by those with normal weight, overweight and obesity. CONCLUSION There are significant variations in prevalence of diabetes and primary healthcare support for diabetes across low- and middle-income countries. Aggressively preventing abnormal body weight and improving healthcare support may play a pivotal role in ameliorating the unfavourable epidemic of diabetes in developing countries.
Collapse
Affiliation(s)
- L Liu
- Department of Epidemiology and Biostatistics, Drexel University School of Public Health, Philadelphia, PA 19102, USA.
| | | | | |
Collapse
|