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Chen R, Xu J, Shang X, Bulloch G, He M, Wang W, Zhu Z. Association between cardiovascular health metrics and retinal ageing. GeroScience 2023:10.1007/s11357-023-00743-3. [PMID: 36930331 PMCID: PMC10400488 DOI: 10.1007/s11357-023-00743-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 01/25/2023] [Indexed: 03/18/2023] Open
Abstract
The study aims to investigate associations between cardiovascular health (CVH) metrics and retinal ageing indexed by retinal age gap. A total of 26,354 participants from the UK Biobank study with available CVH metrics and qualified retinal imaging were included in the present analysis. CVH included 7 metrics (smoking, physical activity, diet, body mass index [BMI], total cholesterol, blood pressure [BP], blood glucose). These were summarized to classify the overall CVH as poor (0-7), intermediate (8-10) or ideal (11-14). Retinal age gap was defined as the difference between biological age predicted by fundus images and chronological age. Accelerated and non-accelerated retinal ageing was defined if retinal age gap was in the upper or lower 50% quantiles of the study population, respectively. Linear and logistic regression models estimated the association of overall CVH and each metric of CVH with retinal age gap respectively. Our results showed that in the fully adjusted model, each one-unit score increase in overall CVH was negatively associated with retinal age gap (odds ratio [OR] = 0.89, 95% confidence interval [CI]: 0.87-0.92, P < 0.001). Compared with poor overall CVH, people with intermediate and ideal overall CVH had significantly lower retinal age gap (OR = 0.76, 95%CI: 0.67-0.85, P < 0.001; OR = 0.58, 95%CI: 0.50-0.67, P < 0.001). Similar associations were found between overall CVH and accelerated retinal ageing. CVH metrics including smoking, BMI, BP, and blood glucose were also significantly associated with higher retinal age gap. Taken together, we found a significant and inverse dose-response association between CVH metrics and retinal age gap, indicating that maintaining healthy metrics especially smoking, BMI, BP, and blood glucose may be crucial to slow down biological ageing.
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Affiliation(s)
- Ruiye Chen
- Department of Ophthalmology, Guangdong Academy of Medical Sciences, Guangdong Provincial People's Hospital, Guangzhou, China.,Centre for Eye Research Australia; Ophthalmology, University of Melbourne, Melbourne, Australia.,Ophthalmology, Department of Surgery, University of Melbourne, Melbourne, Australia
| | - Jinyi Xu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Xianwen Shang
- Department of Ophthalmology, Guangdong Academy of Medical Sciences, Guangdong Provincial People's Hospital, Guangzhou, China.,Centre for Eye Research Australia; Ophthalmology, University of Melbourne, Melbourne, Australia.,Ophthalmology, Department of Surgery, University of Melbourne, Melbourne, Australia
| | - Gabriella Bulloch
- Ophthalmology, Department of Surgery, University of Melbourne, Melbourne, Australia
| | - Mingguang He
- Department of Ophthalmology, Guangdong Academy of Medical Sciences, Guangdong Provincial People's Hospital, Guangzhou, China. .,Centre for Eye Research Australia; Ophthalmology, University of Melbourne, Melbourne, Australia. .,Ophthalmology, Department of Surgery, University of Melbourne, Melbourne, Australia. .,State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China.
| | - Wei Wang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China.
| | - Zhuoting Zhu
- Department of Ophthalmology, Guangdong Academy of Medical Sciences, Guangdong Provincial People's Hospital, Guangzhou, China. .,Centre for Eye Research Australia; Ophthalmology, University of Melbourne, Melbourne, Australia. .,Ophthalmology, Department of Surgery, University of Melbourne, Melbourne, Australia.
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Yang D, Liu M, Willey JZ, Khasiyev F, Tom SE, Rundek T, Cheung YK, Wright CB, Sacco RL, Elkind MSV, Gutierrez J. Physical Activity Is Inversely Associated With Severe Intracranial Stenosis in Stroke-Free Participants of NOMAS. Stroke 2023; 54:159-166. [PMID: 36416126 PMCID: PMC9780184 DOI: 10.1161/strokeaha.122.039660] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Accepted: 09/30/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND Although protective in secondary stroke prevention of intracranial arterial stenosis (ICAS), it is uncertain if the benefits of leisure time physical activity (LTPA) extend to asymptomatic ICAS or extracranial carotid stenosis (ECAS). Therefore, we sought to determine LTPA's relationship with ECAS and ICAS in a stroke-free, race-ethnically diverse cohort. METHODS This cross-sectional study included participants from the magnetic resonance imaging substudy of the Northern Manhattan Study, of whom 1274 had LTPA assessments at enrollment. LTPA was represented continuously as metabolic equivalent score (MET-score) and ordinally as model-based cluster analysis (LTPA-cluster), both based on the same LTPA assessments. We evaluated ECAS sonographically using carotid intima-media thickening and number of carotid plaques. ICAS was assessed with time-of-flight magnetic resonance angiograph and defined as ≥50% or ≥70% stenosis. We applied regression analyses to evaluate the association between LTPA with ECAS and ICAS, adjusting for confounders. RESULTS Of 1274 included participants (mean age 71±9 years; 60% women; 65% Hispanic), the mean MET-score was 10±16 and 60% were in a LTPA-cluster with any activity. Among those with carotid ultrasound (n=1234), the mean carotid intima-media thickening was 0.97±0.09 mm, and 56% of participants had at least one carotid plaque identified. Among those with magnetic resonance angiograph (n=1211), 8% had ≥50% ICAS and 5% had ≥70% ICAS. For ICAS, MET-score was associated with ≥70% ICAS (adjusted odds ratio per unit increase in MET-score [95% CI, 0.97 [0.94-0.99]) but not with ECAS measures (carotid intima-media thickening, adjusted β-estimate per unit increase in MET-score [95% CI], 0.002 [-0.003 to 0.006] or number of plaques, adjusted β-estimate [95% CI], 0.0001 [-0.0001 to 0.0003]). Substituting MET-score with LTPA-clusters replicated the association between ≥70% ICAS and LTPA (adjusted odds ratio per each increased LTPA-cluster [95% CI], 0.83 [0.70-0.99]). CONCLUSIONS In this diverse stroke-free population, we found LTPA most strongly associated with asymptomatic ≥70% ICAS. Given the high-risk nature of ≥70% ICAS, these findings may emphasize the role of LTPA in people at risk for ICAS.
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Affiliation(s)
- Dixon Yang
- Department of Neurology, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Minghua Liu
- Department of Neurology, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Joshua Z Willey
- Department of Neurology, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Farid Khasiyev
- Department of Neurology, Saint Louis University, Saint Louis, MO, USA
| | - Sarah E Tom
- Department of Neurology, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Tatjana Rundek
- Department of Neurology, University of Miami Miller School of Medicine, Miami, FL, USA
- Evelyn McKnight Brain Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Ying K Cheung
- Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Clinton B Wright
- National Institute of Neurologic Disorders and Stroke, Bethesda, MD, USA
| | - Ralph L Sacco
- Department of Neurology, University of Miami Miller School of Medicine, Miami, FL, USA
- Evelyn McKnight Brain Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Mitchell S V Elkind
- Department of Neurology, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Jose Gutierrez
- Department of Neurology, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA
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Yu Y, Dong Z, Li Y, Zhang J, Yin S, Gao X, Wu S. The Cardiovascular and Cerebrovascular Health in North China From 2006 to 2011: Results From the KaiLuan Study. Front Cardiovasc Med 2021; 8:683416. [PMID: 34322527 PMCID: PMC8310945 DOI: 10.3389/fcvm.2021.683416] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 06/07/2021] [Indexed: 11/13/2022] Open
Abstract
Background: The American Heart Association (AHA) defined cardiovascular health in terms of four behaviors (smoking, diet, physical activity, body weight) and three factors (plasma glucose, cholesterol, blood pressure). By this definition, the prevalence of ideal cardiovascular health behaviors and factors is negatively correlated with all-cause mortality and risks of cardiovascular and cerebrovascular diseases and malignancy. We analyzed the trends in cardiovascular and cerebrovascular health behaviors and factors in the population of the KaiLuan study for 2006–2011, reported the results, and provided evidence for prevention. Methods and Results: We calculated the prevalence of cardiovascular and cerebrovascular health behaviors and factors from KaiLuan data for 2006–2007, 2008–2009, and 2010–2011. The prevalence of ideal cardiovascular and cerebrovascular health behaviors and factors is low in the KaiLuan population. Conclusions: The prevalence of ideal cardiovascular and cerebrovascular health behaviors and factors is low in the KaiLuan population. Clinical Trial Registration:http://www.chictr.org/cn/proj/show.aspx?proj=1441, unique identifier: ChiCTR-TNC-11001489.
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Affiliation(s)
- Yao Yu
- Department of Neurology, Peking University People's Hospital, Beijing, China
| | - Zhiyi Dong
- Department of Biomedical Engineering, Stony Brook University, Stony Brook, NY, United States
| | - Yongjie Li
- Department of Neurology, Peking University People's Hospital, Beijing, China
| | - Jun Zhang
- Department of Neurology, Peking University People's Hospital, Beijing, China
| | - Sufeng Yin
- Department of Preventive Medicine, School of Public Health, North China University of Science and Technology, Tangshan, China
| | - Xuguang Gao
- Department of Neurology, Peking University People's Hospital, Beijing, China
| | - Shouling Wu
- Department of Cardiology, Kailuan General Hospital, North China University of Science and Technology, Tangshan, China
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Wang D, Zhang Q, Wang A, Wu S, Zhao X. Ideal Cardiovascular Health Metrics on the New Occurrence of Peripheral Artery Disease: A Prospective Cohort Study in Northern China. Sci Rep 2020; 10:9660. [PMID: 32541812 PMCID: PMC7296034 DOI: 10.1038/s41598-020-66578-6] [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: 09/19/2019] [Accepted: 05/24/2020] [Indexed: 12/20/2022] Open
Abstract
Peripheral artery disease (PAD) is a common atherosclerotic disease which could lead to severe cardiovascular and cerebrovascular events. Previous studies have indicated the ideal cardiovascular health (ICVH) was associated with many atherosclerotic diseases and cardiovascular events. This study aimed to find out the relationship between ICVH metrics and the new occurrence of PAD. We collected information of baseline from 2010 on the seven ICVH metrics (including smoking, body mass index, dietary intake, physical activity, blood pressure, total cholesterol and fasting blood glucose); and assessed PAD by ankle brachial index among the enrolled participants. The relationship between the ICVH metrics and new occurrence of PAD was analyzed using the multivariate logistic regression in 2018. There were 214 participants were diagnosed with the new occurrence of PAD during the follow-up visit. Participants with PAD tend to be older, with a lower level of education and a higher morbidity of hypertension. Among the seven ICVH metrics, BMI seems to be the most sensitive metric to the occurrence of PAD after adjusting the other risk factors (HR (95% CI) = 0.704 (0.529-0.937), P = 0.0163). We further found out as the number of ICVH metric increased, the morbidity of PAD decreased gradually (HR (95% CI) = 0.888 (0.801-0.984), P for trend= 0.0240). There is no difference between different age and gender groups. The ICVH metrics affect the new occurrence of PAD in a Chinese population. It enhances the importance of ideal health behaviors and factors in the prevention of PAD.
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Affiliation(s)
- Dandan Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,China National Clinical Research Center for Neurological Diseases, Beijing, China.,Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China.,Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China
| | - Qian Zhang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,China National Clinical Research Center for Neurological Diseases, Beijing, China.,Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China.,Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China
| | - Anxin Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,China National Clinical Research Center for Neurological Diseases, Beijing, China.,Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China.,Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China
| | - Shouling Wu
- Department of Cardiology, Kailuan Hospital, Tangshan, China.
| | - Xingquan Zhao
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China. .,China National Clinical Research Center for Neurological Diseases, Beijing, China. .,Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China. .,Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China.
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Association of Newly Found Asymptomatic Intracranial Artery Stenosis and Ideal Cardiovascular Health Metrics in Chinese Community Population. Sci Rep 2020; 10:7200. [PMID: 32350306 PMCID: PMC7190703 DOI: 10.1038/s41598-020-63927-3] [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: 12/04/2018] [Accepted: 03/25/2020] [Indexed: 12/28/2022] Open
Abstract
In the general population, there is a strong inverse relationship between the number of ideal cardiovascular health (CVH) metrics and the total incidence of cardiovascular diseases and stroke. However, the prevalence of ideal CVH is extremely low and there are few studies on its association with newly found asymptomatic intracranial arterial stenosis (AICAS). Therefore, we performed this prospective study to assess the relationship between the newly found AICAS and ideal CVH metrics in the Chinese community population. Seven ideal CVH metrics of 3,475 participants in the Asymptomatic Polyvascular Abnormalities Community study (APAC) conducted in China (1,962 men and 1,513 women between the ages of 45 and 75 years) were collected. Based on the occurrence of newly found AICAS, all participants were divided into the AICAS group and non-ICAS group. Prevalence of ideal CVH metrics was compared between the two groups. Logistic regression was used to estimate the association of newly found AICAS with ideal CVH metrics. The result was the number of ideal CVH metrics was strongly associated with age, gender, education levels and family income (each P < 0.0001). Among the seven CVH metrics total cholesterol (TC) was the only one showing significant difference between the newly found AICAS group and non-ICAS group in our 2 years observation. Participants with less ideal CVH metrics (≤3) were associated with significantly higher prevalence of AICAS than those with more (>3) ideal CVH metrics (OR, 1.27; P = 0.045). Furthermore, less (≤3) ideal CVH metrics was markedly associated with higher incidence of AICAS for all participants, younger participants (<60 years) (OR, 1.34; P = 0.046) and men participants (OR, 1.53; P = 0.032) after adjustment for gender, age, education level, family income and stroke history. Thus we conclude that participants with newly found AICAS have high prevalence of total cholesterol status, and Individuals with low ideal CVH metrics (≤3) are associated with significantly higher prevalence of asymptomatic ICAS, especially in high-risk population of young and men participants. Therefore, primordial prevention of stroke should also focus on those high-risk populations.
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Zhang Q, Wang D, Wang A, Zhang S, Pan Y, Li Y, Chen S, Wu S, Wei W, Zhao X. Relationship of ideal cardiovascular health metrics with retinal vessel calibers and retinal nerve fiber layer thickness: a cross-sectional study. BMC Cardiovasc Disord 2018; 18:187. [PMID: 30285640 PMCID: PMC6167817 DOI: 10.1186/s12872-018-0922-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Accepted: 09/17/2018] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Ideal cardiovascular health (CVH) metrics have been found to be associated with subclinical vascular abnormalities. However, the relationship between ideal CVH metrics and retinal vessel calibers and retinal nerve fiber layer (RNFL) thickness in a Chinese population is unknown. METHODS We collected information on the seven ideal CVH metrics among 3376 participants aged 40 years or older from the Asymptomatic Polyvascular Abnormalities Community Study in 2012. Retinal vessel calibers and RNFL thickness were assessed by retinal photography and spectral-domain optical coherence tomography. Multivariable linear models were used to analyze the relationship between ideal CVH metrics and retinal parameters. RESULTS With the decreased number of ideal CVH metrics, central retinal arteriolar equivalents (CRAE) was significantly narrowed and arterio- venous ratio (AVR) significantly decreased (p < 0.0001). While the RNFL thickness and central retinal venous equivalents (CRVE) showed no significant changes with the decreased ideal CVH metrics. Linear regression showed that both CRAE and AVR was positively related with the number of ideal CVH metrics (regression coefficient beta: 0.806, 95% confidence interval (CI): 0.266-1.346 for CRAE (micron); and regression coefficient beta: 0.005, 95% CI: 0.002-0.009 for AVR) after adjusting for age (year), sex = male (n), education (n), average monthly income (¥) and other related risk factors. CONCLUSIONS These findings suggested a clear positive relationship between the number of ideal CVH metrics and CRAE and AVR in Chinese population, supporting the importance of ideal health behaviors and factors in subclinical vascular abnormalities prevention.
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Affiliation(s)
- Qian Zhang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No.6 Tiantanxili, Dongcheng District, Beijing, 100050, China.,China National Clinical Research Center for Neurological Diseases, Beijing, China.,Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China.,Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China
| | - Dandan Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No.6 Tiantanxili, Dongcheng District, Beijing, 100050, China.,China National Clinical Research Center for Neurological Diseases, Beijing, China.,Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China.,Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China
| | - Anxin Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No.6 Tiantanxili, Dongcheng District, Beijing, 100050, China.,China National Clinical Research Center for Neurological Diseases, Beijing, China.,Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China.,Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China
| | - Shufeng Zhang
- Department of Neurology, The General Hospital of Chinese People's Armed Police Forces, Beijing, China
| | - Yuesong Pan
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No.6 Tiantanxili, Dongcheng District, Beijing, 100050, China.,China National Clinical Research Center for Neurological Diseases, Beijing, China.,Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China.,Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China
| | - Yang Li
- Beijing Tongren Eye Center, Beijing Key Laboratory of Ophthalmology and Visual Science, Beijing Tongren Hospital, Capital Medical University, 1 Dong Jiao Min Lane, Beijing, 100730, China
| | - Shengyun Chen
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No.6 Tiantanxili, Dongcheng District, Beijing, 100050, China.,China National Clinical Research Center for Neurological Diseases, Beijing, China.,Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China.,Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China
| | - Shouling Wu
- Department of Cardiology, Kailuan Hospital, Tangshan, 063000, China.
| | - Wenbin Wei
- Beijing Tongren Eye Center, Beijing Key Laboratory of Ophthalmology and Visual Science, Beijing Tongren Hospital, Capital Medical University, 1 Dong Jiao Min Lane, Beijing, 100730, China.
| | - Xingquan Zhao
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No.6 Tiantanxili, Dongcheng District, Beijing, 100050, China. .,China National Clinical Research Center for Neurological Diseases, Beijing, China. .,Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China. .,Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China.
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7
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Ideal Cardiovascular Health Metrics Associated with Reductions in the Risk of Extracranial Carotid Artery Stenosis: a Population-based Cohort Study. Sci Rep 2018; 8:12277. [PMID: 30115933 PMCID: PMC6095842 DOI: 10.1038/s41598-018-29754-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Accepted: 07/17/2018] [Indexed: 01/08/2023] Open
Abstract
The cardiovascular health (CVH) metrics are closely related to the risk of stroke. Extracranial carotid artery stenosis (ECAS) represents an important risk factor for ischemic stroke. The present study aims to explore the longitudinal effect of the baseline CVH metrics on the development of ECAS. Totally 5,440 participants were randomly enrolled in the Asymptomatic Polyvascular Abnormalities Community study from 2010 to 2011. Information regarding the seven CVH metrics was collected at baseline. ECAS was assessed by performing carotid duplex sonography at baseline (2010-2011) and during the follow-up (2012-2013). Finally 3,487 subjects were included, and 976 participants developed ECAS during the 2-year follow-up. The optimum CVH status was associated with a 42% (95% confidence interval: 0.40-0.85) decreased risk of the incidence of ECAS after adjusting for age, sex, weight, education, income, alcohol use, waist-hip ratio, triglycerides, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, uric acid, homocysteine, and C-reactive protein. Ideal physical activity, total cholesterol and fasting blood glucose were independent protective factors of ECAS. In this cohort study, the ideal baseline CVH status was negatively associated with the occurrence of ECAS during the follow-up. This study provides practical insight for further developing effective screening strategies or implementing the best medical treatment.
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Cai B, Peng B. Intracranial artery stenosis: Current status of evaluation and treatment in China. Chronic Dis Transl Med 2017; 3:197-206. [PMID: 29354802 PMCID: PMC5747500 DOI: 10.1016/j.cdtm.2017.09.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Indexed: 01/15/2023] Open
Abstract
Intracranial artery stenosis (ICAS), a common cause of ischemic stroke, is a growing cause of concern in China. Recently, many epidemiological, etiological, pathophysiological, therapy, and diagnostic imaging studies have focused on ICAS, and guidelines and consensus on the diagnosis and treatment of ICAS have been published and updated by domestic experts. Such work is pivotal to our enhanced comprehension, diagnosis, and treatment of ICAS. In this review, we summarize the latest progress in the evaluation and treatment of ICAS in China.
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Affiliation(s)
- Bin Cai
- Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - Bin Peng
- Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
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9
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Sun Y, Wang A, Liu X, Su Z, Li J, Luo Y, Chen S, Wang J, Li X, Zhao Z, Zhu H, Wu S, Guo X. Changes in Proteinuria on the Risk of All-Cause Mortality in People with Diabetes or Prediabetes: A Prospective Cohort Study. J Diabetes Res 2017; 2017:8368513. [PMID: 29090222 PMCID: PMC5635464 DOI: 10.1155/2017/8368513] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Revised: 08/15/2017] [Accepted: 09/07/2017] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Proteinuria has been related to all-cause mortality, showing regression or progression. However, few studies have focused on the relationship between proteinuria changes and all-cause mortality. The main purpose of this paper is to examine the associations between proteinuria changes and all-cause mortality in people with diabetes or prediabetes. METHODS Dipstick proteinuria at baseline and a 2-year follow-up were determined in the participants attending the Kailuan prospective cohort study. Participants were then divided into three categories: elevated proteinuria, stable proteinuria, and reduced proteinuria. Four Cox proportional hazard models were built to access the relations of proteinuria changes to all-cause mortality, adjusting for other confounding covariates. RESULTS A total of 17,878 participants were finally included in this study. There were 1193 deaths after a median follow-up of 6.69 years. After adjusting for major covariates and proteinuria at baseline, mortality risk was significantly associated with elevated proteinuria (hazard ratio (HR): 1.54, 95% confidence interval (CI): 1.33-1.79) and reduced proteinuria (HR: 0.70, 95% CI: 0.55-0.89), compared to those with stable proteinuria. CONCLUSION Proteinuria changes were independently associated with mortality risk in either diabetic or prediabetic population.
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Affiliation(s)
- Yang Sun
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China
| | - Anxin Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Xiaoxue Liu
- Department of Cardiology, Tangshan People's Hospital, North China University of Science and Technology, Tangshan, China
| | - Zhaoping Su
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Junjuan Li
- Department of Nephrology, Kailuan Hospital, North China University of Science and Technology, Tangshan, China
| | - Yanxia Luo
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China
| | - Shuohua Chen
- Department of Cardiology, Kailuan Hospital, North China University of Science and Technology, Tangshan, China
| | - Jianli Wang
- Department of Rehabilitation, Kailuan Hospital, North China University of Science and Technology, Tangshan, China
| | - Xia Li
- Department of Mathematics and Statistics, La Trobe University, Melbourne, Australia
| | - Zhan Zhao
- State Key Laboratory of Transducer Technology, Institute of Electronics, Chinese Academy of Sciences, Beijing, China
- University of Chinese Academy of Sciences, Beijing, China
| | - Huiping Zhu
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China
| | - Shouling Wu
- Department of Cardiology, Kailuan Hospital, North China University of Science and Technology, Tangshan, China
| | - Xiuhua Guo
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China
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Zhang Q, Jiang R, Wang Y, Zhang S, Chen S, Zhang Y, Guo X, Wu S, Zhao X. Relation of Ideal Cardiovascular Health Metrics to Asymptomatic Polyvascular Disease in a Chinese Population. Am J Cardiol 2017; 120:393-398. [PMID: 28599801 DOI: 10.1016/j.amjcard.2017.04.039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2017] [Revised: 04/27/2017] [Accepted: 04/27/2017] [Indexed: 11/17/2022]
Abstract
Atherosclerosis is a systemic disease with manifestations in multiple vascular beds. Ideal cardiovascular health (CVH) metrics relate to cardiovascular and cerebrovascular disease. However, the relation between ideal CVH metrics and asymptomatic polyvascular disease (polyVD) is unknown. We collected information on the 7 CVH metrics among 5,224 participants aged ≥40 years from 2010 to 2011. Intracranial artery stenosis, extracranial artery stenosis, and lower extremity artery disease were detected by transcranial Doppler, duplex sonography, and by calculating ankle-brachial index. Ordinal logistic regression and linear models were used to analyze the relation between ideal CVH metrics and polyVD. PolyVD was identified in 158 (3%) participants. We observed a significant inverse gradient relation between the number of ideal CVH metrics and prevalence of polyVD after adjustment for potential confounders. The adjusted odds ratios and 95% confidence intervals were 0.824 (0.657 to 1.032), 0.641 (0.511 to 0.804), 0.538 (0.423 to 0.684), 0.583 (0.442 to 0.769), and 0.530 (0.348 to 0.808) for those having 2, 3, 4, 5, and 6 or 7 ideal CVH metrics, respectively, compared with those having 0 or 1 ideal CVH metric (p-trend <0.0001). Similarly, a larger number of ideal CVH metrics was associated with a lower prevalence of polyVD in the linear models (adjusted β coefficient -0.030, 95% confidence interval -0.041 to -0.020). Stratification for gender and age yielded consistent results in all subgroups except for women subgroup. In conclusion, we observed a significant inverse gradient association between the number of ideal CVH metrics and prevalence of asymptomatic polyVD.
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Affiliation(s)
- Qian Zhang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, People's Republic of China; China National Clinical Research Center for Neurological Diseases, Beijing, People's Republic of China; Center of Stroke, Beijing Institute for Brain Disorders, Beijing, People's Republic of China; Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, People's Republic of China
| | - Ruixuan Jiang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, People's Republic of China; China National Clinical Research Center for Neurological Diseases, Beijing, People's Republic of China; Center of Stroke, Beijing Institute for Brain Disorders, Beijing, People's Republic of China; Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, People's Republic of China
| | - Yizheng Wang
- Department of Neurorehabilitation, School of Rehabilitation, China Rehabilitation Research Center, Capital Medical University, Beijing, People's Republic of China
| | - Shufeng Zhang
- Department of Neurology, The General Hospital of Chinese People's Armed Police Forces, Beijing, People's Republic of China
| | - Shengyun Chen
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, People's Republic of China; China National Clinical Research Center for Neurological Diseases, Beijing, People's Republic of China; Center of Stroke, Beijing Institute for Brain Disorders, Beijing, People's Republic of China; Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, People's Republic of China
| | - Yaqing Zhang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, People's Republic of China; China National Clinical Research Center for Neurological Diseases, Beijing, People's Republic of China; Center of Stroke, Beijing Institute for Brain Disorders, Beijing, People's Republic of China; Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, People's Republic of China
| | - Xiuhua Guo
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, People's Republic of China
| | - Shouling Wu
- Department of Cardiology, Kailuan Hospital, Tangshan, People's Republic of China.
| | - Xingquan Zhao
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, People's Republic of China; China National Clinical Research Center for Neurological Diseases, Beijing, People's Republic of China; Center of Stroke, Beijing Institute for Brain Disorders, Beijing, People's Republic of China; Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, People's Republic of China.
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11
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Han QL, Wu SL, Liu XX, An SS, Wu YT, Gao JS, Chen SH, Liu XK, Zhang Q, Mao RY, Shang XM, Jonas JB. Ideal cardiovascular health score and incident end-stage renal disease in a community-based longitudinal cohort study: the Kailuan Study. BMJ Open 2016; 6:e012486. [PMID: 27899399 PMCID: PMC5168547 DOI: 10.1136/bmjopen-2016-012486] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVES To investigate an association between ideal cardiovascular health metrics (CVH) and the risk of developing end-stage renal disease (ESRD). SETTING Community of Kailuan in Tangshan/China. PARTICIPANTS We examined in a community-based longitudinal cohort study 91 443 participants without history of stroke or myocardial infarction at baseline in 2006-2007, with a glomerular filtration rate (GFR) ≥15 mL/min at baseline, and who participated in at least 1 of 3 follow-up examinations in 2008-2009, 2010-2011 and 2012-2013. INTERVENTIONS CVH was measured by 7 key health factors (smoking, body mass index, physical activity, healthy dietary score, total cholesterol blood concentration, blood pressure, fasting blood glucose) each of which ranged between 'ideal' (2) and 'poor' (0). With a maximal CVH score of 14, the study participants were divided into categories of <5, 5-9 and 10-14 points. PRIMARY AND SECONDARY OUTCOME MEASURES CHV, incidence of ESRD. RESULTS Incidence of ESRD ranged from 7.06‰ in the lowest CVH category to 2.34‰ in the highest CVH category. After adjusting for age, sex, educational level, income, alcohol consumption and GFR, the lowest CVH category as compared with the highest CVH category had a significantly higher risk of incident ESRD (adjusted HR 2.87; 95% CI 1.53 to 5.39). For every decrease in group number of the cum-CVH score, the risk of ESRD increased by 20% (HR 1.20; 95% CI 1.13 to 1.28). The effect was consistent across sex and all age groups. CONCLUSIONS A low CVH score significantly increased the risk of incident ESRD. Risk factors for cardiovascular events may also be associated with an increased risk for kidney failure.
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Affiliation(s)
- Quan Le Han
- Department of Internal Medicine, Hebei Medical University, Shijiazhuang, China
| | - Shou Ling Wu
- Department of Cardiology, Kailuan Hospital, North China University of Science and Technology, Tangshan, China
| | - Xiao Xue Liu
- Department of Cardiology, Tangshan People's Hospital, North China University of Science and Technology, Tangshan, China
| | - Sha Sha An
- Department of Cardiology, Kailuan Hospital, North China University of Science and Technology, Tangshan, China
| | - Yun Tao Wu
- Department of Cardiology, Kailuan Hospital, North China University of Science and Technology, Tangshan, China
| | - Jing Sheng Gao
- Department of Cardiology, Kailuan Hospital, North China University of Science and Technology, Tangshan, China
| | - Shuo Hua Chen
- Department of Cardiology, Kailuan Hospital, North China University of Science and Technology, Tangshan, China
| | - Xiao Kun Liu
- Department of Cardiovasology, Tangshan Gongren Hospital Affiliated to Hebei Medical University, Tangshan, China
| | - Qi Zhang
- Department of Cardiovasology, Tangshan Gongren Hospital Affiliated to Hebei Medical University, Tangshan, China
| | - Rui Ying Mao
- Department of Cardiovasology, Tangshan Gongren Hospital Affiliated to Hebei Medical University, Tangshan, China
| | - Xiao Ming Shang
- Department of Internal Medicine, Hebei Medical University, Shijiazhuang, China
- Department of Cardiovasology, Tangshan Gongren Hospital Affiliated to Hebei Medical University, Tangshan, China
| | - Jost B Jonas
- Department of Ophthalmology, Medical Faculty Mannheim of the Ruprecht-Karls-University of Heidelberg, Mannheim, Germany
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12
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The Association of Ideal Cardiovascular Health and Atherogenic Index of Plasma in Rural Population: A Cross-Sectional Study from Northeast China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:ijerph13101027. [PMID: 27775583 PMCID: PMC5086766 DOI: 10.3390/ijerph13101027] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/06/2016] [Revised: 10/12/2016] [Accepted: 10/17/2016] [Indexed: 01/12/2023]
Abstract
In 2010, the American Heart Association has proposed a new concept “ideal cardiovascular health” (CVH) based on seven CVH metrics: smoking, body mass index, physical activity, diet score, total cholesterol, blood pressure, and fasting plasma glucose. We aimed to determine the association of CVH with atherogenic index of plasma (AIP), a strong marker for atherosclerosis (AS). This cross-sectional study was conducted in the rural areas of northeast China and 11,113 middle-aged subjects were enrolled. Seven CVH metrics were classified into ideal, intermediate, and poor groups. AIP was calculated as log (TG/HDL) (triglycerides/high-density lipoprotein cholesterol). AIP > 0.21 was classified into the high AIP group and served as dependent variable. All seven CVH metrics were correlated with AIP. A gradient relationship between the number of poor CVH metrics and the prevalence of high AIP existed. Log binomial regression analysis showed that compared to those with five to seven ideal CVH metrics, individuals with four, three, two, one, and no ideal CVH metrics had 1.67, 2.66, 4.00, 5.30 and 6.50 times higher prevalence for high AIP. The subjects with poor CVH status had 2.73 times higher prevalence for high AIP. We found an inversely gradient relationship between the number of ideal CVH metrics and lower prevalence of high AIP.
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13
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Prevalence and Metrics Distribution of Ideal Cardiovascular Health: A Population-based, Cross-sectional Study in Rural China. Heart Lung Circ 2016; 25:982-92. [DOI: 10.1016/j.hlc.2016.02.007] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2015] [Revised: 02/02/2016] [Accepted: 02/09/2016] [Indexed: 11/20/2022]
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14
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Liu X, Cui L, Wang A, Wang X, Song Q, Li S, Shi J, Zhao X, Chen S, Du X, Ji C, Huxley R, Guo Y, Wu S. Cumulative Exposure to Ideal Cardiovascular Health and Incident Diabetes in a Chinese Population: The Kailuan Study. J Am Heart Assoc 2016; 5:JAHA.116.004132. [PMID: 27638783 PMCID: PMC5079052 DOI: 10.1161/jaha.116.004132] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Background It is unclear whether ideal cardiovascular health (CVH), and particularly cumulative exposure to ideal CVH (cumCVH), is associated with incident diabetes. We aimed to fill this research gap. Methods and Results The Kailuan Study is a prospective cohort of 101 510 adults aged 18 to 98 years recruited in 2006–2007 and who were subsequently followed up at 2‐ (Exam 2), 4‐ (Exam 3), and 6 (Exam 4)‐year intervals after baseline. The main analysis is restricted to those individuals with complete follow‐up at all 4 examinations and who had no history of diabetes until Exam 3. Cumulative exposure to ideal CVH (cumCVH) was calculated as the summed CVH score for each examination multiplied by the time between the 2 examinations (score×year). Logistic regression models were used to assess the association between cumCVH and incident diabetes. In fully adjusted models, compared with the lowest quintile of cumCVH, individuals in the highest quintile had ~68% (95% confidence interval [CI] 60‐75) lower risk for incident diabetes (compared with 61% [95% CI 52‐69] lower risk when using baseline CVH). Every additional year lived with a 1‐unit increase in ideal CVH was associated with a 24% (95% CI 21‐28) reduction in incident diabetes. Conclusions Ideal CVH is associated with a reduced incidence of diabetes, but the association is likely to be underestimated if baseline measures of CVH exposure are used. Measures of cumulative exposure to ideal CVH are more likely to reflect lifetime risk of diabetes and possibly other health outcomes. Clinical Trial Registration URL: https://www.chictr.org. Unique identifier: ChiCTRTNC‐11001489.
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Affiliation(s)
- Xiaoxue Liu
- Department of Cardiology, Tangshan People's Hospital, North China University of Science and Technology, Tangshan, China
| | - Liufu Cui
- Department of Internal Medicine, Kailuan Hospital, North China University of Science and Technology, Tangshan, China
| | - Anxin Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
| | - Xizhu Wang
- Department of Cardiology, Tangshan People's Hospital, North China University of Science and Technology, Tangshan, China
| | - Qiaofeng Song
- Department of Cardiology, Tangshan People's Hospital, North China University of Science and Technology, Tangshan, China
| | - Shanshan Li
- Division of Epidemiology and Biostatistics, School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
| | - Jihong Shi
- Department of Cardiology, Kailuan Hospital, North China University of Science and Technology, Tangshan, China
| | - Xiaohong Zhao
- Department of Cardiology, Kailuan Hospital, North China University of Science and Technology, Tangshan, China
| | - Shuohua Chen
- Department of Health Care Center, Kailuan Hospital, North China University of Science and Technology, Tangshan, China
| | - Xin Du
- Department of Cardiology, Kailuan Hospital, North China University of Science and Technology, Tangshan, China
| | - Chunpeng Ji
- Department of Cardiology, Kailuan Hospital, North China University of Science and Technology, Tangshan, China
| | - Rachel Huxley
- School of Public Health, Curtin University, Perth, Australia
| | - Yuming Guo
- Division of Epidemiology and Biostatistics, School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
| | - Shouling Wu
- Department of Cardiology, Kailuan Hospital, North China University of Science and Technology, Tangshan, China
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15
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The Association between Ideal Cardiovascular Health Metrics and Extracranial Carotid Artery Stenosis in a Northern Chinese Population: A Cross-Sectional Study. Sci Rep 2016; 6:31720. [PMID: 27572519 PMCID: PMC5004147 DOI: 10.1038/srep31720] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Accepted: 07/26/2016] [Indexed: 01/05/2023] Open
Abstract
Past epidemiologic studies have indicated that the ideal cardiovascular health (CVH) metrics are associated with a lower risk of cardiovascular diseases (CVDs) and stroke. Carotid artery stenosis (CAS) causes approximately 10% of ischemic strokes. The association between ideal CVH and extracranial CAS has not yet been assessed. In the current study, extracranial CAS was assessed by carotid duplex ultrasonography. Logistic regression was used to analyze the association between ideal CVH metrics and extracranial CAS. A total of 3297 participants (52.2% women) aged 40 years and older were selected from the Jidong community in China. After adjusting for sex, age and other potential confounds, the odds ratios (95% confidence intervals) for extracranial CAS were 0.57 (0.39–0.84), 0.46 (0.26–0.80) and 0.29 (0.15–0.54), and for those quartiles, quartile 2 (9–10), quartile 3 (11) and quartile 4 (12–14), respectively, compared with quartile 1 (≤8). This negative correlation was particularly evident in women and the elderly (≥60 years). This cross-sectional study showed a negative correlation between the ideal CVH metrics and the prevalence of extracranial CAS in northern Chinese adults.
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16
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Liu X, Shi J, Wang A, Song Q, Huang Z, Zhu C, Du X, Zhang Y, Chen S, Wang X, Wu S. Changes in ideal cardiovascular health status and risk of new-onset type 2 diabetes: The Kailuan prospective study. Medicine (Baltimore) 2016; 95:e4571. [PMID: 27559955 PMCID: PMC5400322 DOI: 10.1097/md.0000000000004571] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
The aim of the present study was to investigate the association between the altered ideal cardiovascular health status (ΔCHS) and the risk of developing diabetes mellitus in the Kailuan population of China.We included 50,656 Chinese adults aged 18 years or older (11,704 men and 38,952 women) without baseline diabetes mellitus in this study. Information about 7 individual components of the cardiovascular health metrics during 2006 to 2008 was collected. A ΔCHS score was defined as the changes of ideal cardiovascular health status (CHS) from the year 2006 to 2008. New-onset diabetes was identified based on the history of diabetes, currently treated with insulin or oral hypoglycemic agents, or having a fasting blood glucose concentration ≥7.0 mmol/L during the 2010 to 2011 and 2012 to 2013 surveys. After a mean follow-up period of 3.80 years, a total of 3071 (6.06%) participants developed diabetes mellitus. Cox proportional hazards regression was used to calculate the hazard ratios and 95% confidence intervals for the CHS change and new-onset diabetes.A strong inverse association between the positive CHS changes and lower risks of developing diabetes mellitus was observed. After adjusting for age, sex, alcohol consumption, and other potential confounders, the hazard ratios for new-onset diabetes were 0.73, 0.59, 0.49, and 0.42 (95% confidence interval: 0.37-0.82; P trend <0.001) for those who met ΔCHS = -1, 0, 1, and ≥2, respectively, compared with the participants with ΔCHS ≤-2.The study concluded that the improved CHS was associated with the reduced risk of developing diabetes mellitus in this investigated Chinese population.
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Affiliation(s)
- Xiaoxue Liu
- Department of Cardiology, Tangshan People's Hospital
| | - Jihong Shi
- Department of Cardiology, Kailuan Hospital, North China University of Science and Technology, Tangshan
| | - Anxin Wang
- Department of Neurology, Beijing Tiantan Hospital
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing
| | - Qiaofeng Song
- Department of Cardiology, Tangshan People's Hospital
| | - Zhe Huang
- Department of Cardiology, Kailuan Hospital, North China University of Science and Technology, Tangshan
| | - Chenrui Zhu
- Department of Cardiology, Kailuan Hospital, North China University of Science and Technology, Tangshan
| | - Xin Du
- Department of Cardiology, Kailuan Hospital, North China University of Science and Technology, Tangshan
| | - Ying Zhang
- Department of Ultrasonography, Hospital Affiliated to North China University of Science and Technology
| | - Shuohua Chen
- Department of Health Care Center, Kailuan Hospital, North China University of Science and Technology, Tangshan, China
| | - Xizhu Wang
- Department of Cardiology, Tangshan People's Hospital
- Correspondence: Xizhu Wang, Department of Cardiology, Tangshan People's Hospital, North China University of Science and Technology, Tangshan 063000, China (e-mail: ); Shouling Wu, Department of Cardiology, Kailuan Hospital, North China University of Science and Technology, Tangshan 063000, China (e-mail: )
| | - Shouling Wu
- Department of Cardiology, Kailuan Hospital, North China University of Science and Technology, Tangshan
- Correspondence: Xizhu Wang, Department of Cardiology, Tangshan People's Hospital, North China University of Science and Technology, Tangshan 063000, China (e-mail: ); Shouling Wu, Department of Cardiology, Kailuan Hospital, North China University of Science and Technology, Tangshan 063000, China (e-mail: )
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17
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Gao F, Liu X, Wang X, Chen S, Shi J, Zhang Y, Wu S, Cai J. Changes in Cardiovascular Health Status and the Risk of New-Onset Hypertension in Kailuan Cohort Study. PLoS One 2016; 11:e0158869. [PMID: 27434049 PMCID: PMC4951012 DOI: 10.1371/journal.pone.0158869] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Accepted: 06/23/2016] [Indexed: 12/29/2022] Open
Abstract
American Heart Association cardiovascular health metrics are intimately related to cardiovascular diseases. Acting as a key independent risk factor for high morbidity and mortality of cardiovascular diseases, hypertension and its relationship between health status get urgent attention. While the influence of individual health status changes and the future risk of new-onset hypertension is rarely understood, the present study applied this construct to assess the changes of cardiovascular health status and the morbidity of hypertension in Kailuan cohort study in north China. The Cardiovascular Health Score (CHS) was evaluated by the follow-ups of 2006–2007, 2008–2009, 2010–2011 and 2012–2013. The study population (n = 19381) was divided into 5 groups based on the changes in their CHS score between the first two follow-ups (△CHS) of 2006–2007 and 2008–2009 (≤-2, -1, 0, 1, ≥2). The morbidity of hypertension was collected during 2010–2011 and 2012–2013 follow-ups. Data analysis showed that during a median follow-up of 3.79±0.96 years, morbidity of hypertension had a graded relationship with △CHS. As △CHS scored from low to high, the standardized morbidity of hypertension for all participants were 81.40, 75.47, 68.37, 71.43 and 83.13 per 1000 person-year, respectively. An increased △CHS score of 1 was associated with a 10% decrease in the future risk of new-onset hypertension(HR: 0.90, 95% CI: 0.88–0.92). In conclusion, there was a strong inverse relationship between the incidence of new-onset hypertension and elevation of cardiovascular health metrics. Population-wide prevention, especially the promotion of lifestyle improvements, is critical to reducing the morbidity of new-onset hypertension.
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Affiliation(s)
- Fei Gao
- Department of Opthalmology, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Xiaoxue Liu
- Department of Cardiology, Tangshan People's Hospital, North China University of Science and Technology, Tangshan, China
| | - Xizhu Wang
- Department of Cardiology, Tangshan People's Hospital, North China University of Science and Technology, Tangshan, China
| | - Shouhua Chen
- Department of Health Care Center, Kailuan Hospital, North China University of Science and Technology, Tangshan, China
| | - Jihong Shi
- Department of Cardiology, Kailuan Hospital, North China University of Science and Technology, Tangshan, China
| | - Ying Zhang
- Department of Ultrasonography, Hospital Affiliated to North China University of Science and Technology, Tangshan, China
| | - Shouling Wu
- Department of Cardiology, Kailuan Hospital, North China University of Science and Technology, Tangshan, China
| | - Jun Cai
- Department of Hypertension, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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18
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Risk scores for predicting incidence of type 2 diabetes in the Chinese population: the Kailuan prospective study. Sci Rep 2016; 6:26548. [PMID: 27221651 PMCID: PMC4879553 DOI: 10.1038/srep26548] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2015] [Accepted: 05/04/2016] [Indexed: 12/18/2022] Open
Abstract
Few risk scores have been specifically developed to identify individuals at high risk of type 2 diabetes in China. In the present study, we aimed to develop such risk scores, based on simple clinical variables. We studied a population-based cohort of 73,987 adults, aged 18 years and over. After 5.35 ± 1.59 years of follow-up, 4,726 participants (9.58%) in the exploration cohort developed type 2 diabetes and 2,327 participants (9.44%) in the validation cohort developed type 2 diabetes. Age, gender, body mass index, family history of diabetes, education, blood pressure, and resting heart rate were selected to form the concise score with an area under the receiver operating characteristic curve (AUC) of 0.67. The variables in the concise score combined with fasting plasma glucose (FPG), and triglyceride (TG) or use of lipid-lowering drugs constituted the accurate score with an AUC value of 0.77. The utility of the two scores was confirmed in the validation cohort with AUCs of 0.66 and 0.77, respectively. In summary, the concise score, based on non-laboratory variables, could be used to identify individuals at high risk of developing diabetes within Chinese population; the accurate score, which also uses FPG and TG data, is better at identifying such individuals.
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19
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Qiu J, Zhou Y, Yang X, Zhang Y, Li Z, Yan N, Wang Y, Ge S, Wu S, Zhao X, Wang W. The association between ankle-brachial index and asymptomatic cranial-carotid stenosis: a population-based, cross-sectional study of 5440 Han Chinese. Eur J Neurol 2016; 23:757-62. [PMID: 26787310 DOI: 10.1111/ene.12935] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2015] [Accepted: 11/04/2015] [Indexed: 02/01/2023]
Abstract
BACKGROUND AND PURPOSE Routine screening for asymptomatic cranial-carotid stenosis (ACCS) is controversial and recommendation in clinical practice is vague. The ankle-brachial index (ABI) is reported as a predictor for cardiovascular disease. However, there is a scarcity of data about the association between abnormal ABI and ACCS. A population-based cross-sectional study was conducted to explore the relationship between ABI and ACCS. METHODS A sample of 5440 Chinese adults aged 40-94 years old was recruited from 2010 to 2011. The ABI was measured using a portable Doppler device and ACCS was evaluated by bilateral carotid duplex ultrasound and portable examination devices. A logistic regression model was used to analyse the association between ABI and ACCS after adjusting for potential confounding factors. RESULTS A low ABI was associated with ACCS [odds ratio (OR) 1.95, 95% confidence interval (CI) 1.42-2.67] after adjusting for potential confounders. When the data were stratified by age and sex, the correlation remained statistically significant in the male (OR 2.32, 95% CI 1.60-3.37) and elderly (OR 3.07, 95% CI 1.97-4.78) subgroups compared to the female (OR 1.26, 95% CI 0.67-2.39) and middle-aged groups (OR 1.27, 95% CI 0.77-2.12), respectively. CONCLUSION This study demonstrated that low ABI is a significant risk factor for ACCS in male and elderly Chinese adults.
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Affiliation(s)
- J Qiu
- School of Public Health, Ningxia Medical University, Yinchuan, China
| | - Y Zhou
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - X Yang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Y Zhang
- School of Public Health, Ningxia Medical University, Yinchuan, China
| | - Z Li
- Department of Cardiology, Tangshan People's Hospital, Hebei United University, Tangshan, China
| | - N Yan
- Beijing Municipal Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, China
| | - Y Wang
- Beijing Municipal Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, China
| | - S Ge
- Beijing Municipal Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, China
| | - S Wu
- Department of Cardiology, Kailuan Hospital, Hebei United University, Tangshan, China
| | - X Zhao
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - W Wang
- School of Public Health, Ningxia Medical University, Yinchuan, China.,Beijing Municipal Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, China.,School of Medical Sciences, Edith Cowan University, Perth, WA, Australia
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Yan N, Zhou Y, Wang Y, Wang A, Yang X, Russell A, Wu S, Zhao X, Wang W. Association of Ideal Cardiovascular Health and Brachial-Ankle Pulse Wave Velocity: A Cross-Sectional Study in Northern China. J Stroke Cerebrovasc Dis 2015; 25:41-8. [PMID: 26409715 DOI: 10.1016/j.jstrokecerebrovasdis.2015.08.031] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2015] [Accepted: 08/22/2015] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Brachial-ankle pulse wave velocity (baPWV) is an index for evaluating arterial stiffness and is recognized as an independent predictor of an impending cardiovascular event. Limited large-scale population data are available regarding the relationship between baPWV and the change in ideal cardiovascular health (CVH) status, particularly among Asians. METHODS A random sample of 5199 participants (≥40 years of age; 40% women) was enrolled in a cross-sectional study in China to examine the association between ideal CVH and baPWV. Arterial stiffness was defined as a baPWV of 1400 cm/second or higher. Information on CVH was collected based on the American Heart Association's CVH definition by measuring all 7 components (nonsmoking status, body mass index, physical activity, healthy diet, normal total cholesterol, blood pressure, and fasting blood glucose), with 1 or 0 for each component, and a score from 0 to 7 for each participant. RESULTS A significant and inverse association was found between the ideal CVH score and baPWV (P <.001). The adjusted odds ratios for arterial stiffness prevalence were .17 (95% confidence interval [CI], .11-.26), .26 (95% CI, .19-.35), .42 (95% CI, .32-.52), .54 (95% CI, .42-.69), and .69 (95% CI, .54-.89) for those with CVH scores of 7-6, 5, 4, 3, and 2, respectively, compared with those with a CVH score of 1-0 (P <.001). Similarly graded relationships were observed in different age and gender subgroups (P <.001). CONCLUSION The favorable score of ideal CVH was inversely related to baPWV in Chinese adults, supporting the use of ideal CVH metrics as a useful tool for public health efforts.
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Affiliation(s)
- Na Yan
- Beijing Municipal Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, China
| | - Yong Zhou
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Youxin Wang
- Beijing Municipal Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, China
| | - Anxin Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Xin Yang
- Beijing Municipal Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, China
| | - Alyce Russell
- Systems and Intervention Research Center for Health, School of Medical Sciences, Edith Cowan University, Perth, Western Australia, Australia
| | - Shouling Wu
- Department of Cardiology, Tangshan People's Hospital, Hebei United University, Tangshan, China.
| | - Xingquan Zhao
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
| | - Wei Wang
- Beijing Municipal Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, China; Systems and Intervention Research Center for Health, School of Medical Sciences, Edith Cowan University, Perth, Western Australia, Australia.
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21
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Pilkerton CS, Singh SS, Bias TK, Frisbee SJ. Changes in Cardiovascular Health in the United States, 2003-2011. J Am Heart Assoc 2015; 4:e001650. [PMID: 26396200 PMCID: PMC4599487 DOI: 10.1161/jaha.114.001650] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2014] [Accepted: 07/24/2015] [Indexed: 01/10/2023]
Abstract
BACKGROUND Cardiovascular disease is the leading cause of death in the United States, making improving cardiovascular health a key population health goal. As part of efforts to achieve this, the American Heart Association has developed the first comprehensive cardiovascular health index (CVHI). Our objective was to investigate the changes in CVHI in US states from 2003 to 2011. METHODS AND RESULTS CVHI was examined using Behavioral Risk Factor Surveillance System data between 2003 and 2011 (odd-numbered years). Total CVHI decreased from 3.73±0.01 in 2003 to 3.65±0.01 in 2009. The majority of states (88%) experienced a decline in CVHI and an increase in the prevalence of "poor" CVHI between 2003 and 2009. Among CVHI components, the highest prevalence of "ideal" was observed for blood glucose followed by smoking, whereas the lowest prevalence of "ideal" was observed for physical activity and diet. Between 2003 and 2009, prevalence of "ideal" smoking and diet status increased, while "ideal" prevalence of blood pressure, cholesterol, blood glucose, body mass index, and physical activity status decreased. We observed statistically significant differences between 2009 and 2011, outside the scope of the 2003-2009 trend, which we hypothesize are partially attributable to differences in sample demographic characteristics related to changes in Behavioral Risk Factor Surveillance System methodology. CONCLUSIONS Overall, CVHI decreased, most likely due to decreases in "ideal" blood pressure, body mass index, and cholesterol status, which may stem from low prevalence of "ideal" physical activity and diet status. These findings can be used to inform state-specific strategies and targets to improve cardiovascular health.
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Affiliation(s)
- Courtney S Pilkerton
- School of Medicine, West Virginia UniversityMorgantown, WV
- School of Public Health, West Virginia UniversityMorgantown, WV
- Center for Cardiovascular and Respiratory Sciences, West Virginia University Robert C. Byrd Health Sciences CenterMorgantown, WV
| | - Sarah S Singh
- School of Medicine, West Virginia UniversityMorgantown, WV
- School of Public Health, West Virginia UniversityMorgantown, WV
- Center for Cardiovascular and Respiratory Sciences, West Virginia University Robert C. Byrd Health Sciences CenterMorgantown, WV
| | - Thomas K Bias
- School of Public Health, West Virginia UniversityMorgantown, WV
- Center for Cardiovascular and Respiratory Sciences, West Virginia University Robert C. Byrd Health Sciences CenterMorgantown, WV
- Health Research Center, West Virginia University Robert C. Byrd Health Sciences CenterMorgantown, WV
| | - Stephanie J Frisbee
- School of Public Health, West Virginia UniversityMorgantown, WV
- Center for Basic and Translational Stroke Research, West Virginia University Robert C. Byrd Health Sciences CenterMorgantown, WV
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Zheng X, Jin C, Liu Y, Zhang J, Zhu Y, Kan S, Wu Y, Ruan C, Lin L, Yang X, Zhao X, Wu S. Arterial Stiffness as a Predictor of Clinical Hypertension. J Clin Hypertens (Greenwich) 2015; 17:582-91. [PMID: 25917107 DOI: 10.1111/jch.12556] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2014] [Revised: 01/30/2015] [Accepted: 01/30/2015] [Indexed: 12/01/2022]
Affiliation(s)
- Xiaoming Zheng
- Department of Cardiology; Kailuan Hospital; Hebei United University; Tangshan China
| | - Cheng Jin
- Department of Cardiology; Kailuan Hospital; Hebei United University; Tangshan China
| | - Yeqiang Liu
- Department of Endocrinology; Kailuan Hospital; Hebei United University; Tangshan China
| | - Jing Zhang
- Department of Cardiology; Kailuan Hospital; Hebei United University; Tangshan China
| | - Ying Zhu
- Department of Cardiology; Kailuan Hospital; Hebei United University; Tangshan China
| | - Shuting Kan
- Department of Cardiology; Kailuan Hospital; Hebei United University; Tangshan China
| | - Yuntao Wu
- Department of Cardiology; Kailuan Hospital; Hebei United University; Tangshan China
| | - Chunyu Ruan
- Department of Cardiology; Kailuan Hospital; Hebei United University; Tangshan China
| | - Liming Lin
- Department of Cardiology; Kailuan Hospital; Hebei United University; Tangshan China
| | - Xinchun Yang
- Department of Cardiology; Chaoyang Hospital; Capital Medical University; Beijing China
| | - Xingquan Zhao
- Department of Neurology; Beijing Tiantan Hospital; Capital Medical University; Beijing China
| | - Shouling Wu
- Department of Cardiology; Kailuan Hospital; Hebei United University; Tangshan China
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Dhamoon MS, Dong C, Elkind MSV, Sacco RL. Ideal cardiovascular health predicts functional status independently of vascular events: the Northern Manhattan Study. J Am Heart Assoc 2015; 4:jah3757. [PMID: 25677566 PMCID: PMC4345864 DOI: 10.1161/jaha.114.001322] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND We hypothesized that the American Heart Association's metric of ideal cardiovascular health (CVH) predicts improved long-term functional status after adjusting for incident stroke and myocardial infarction. METHODS AND RESULTS In the prospective, multiethnic Northern Manhattan Study, stroke-free individuals in northern Manhattan aged ≥40 years had annual assessments of the primary outcome of functional status with the Barthel index (BI), for a median of 13 years. Ideal CVH was calculated as a composite of 7 measures, each scored on a scale of 0 to 2. Primary predictors were (1) number of ideal CVH metrics, and (2) total score of all CVH metrics. Of 3219 participants, mean age was 69 years (SD 10), 63% were female, 21% were white, 25% were non-Hispanic black, and 54% were Hispanic. Twenty percent had 0 to 1 ideal CVH metrics, 32% had 2, 30% had 3, 14% had 4, and 4% had 5 to 7. Both number of ideal CVH categories and higher CVH metric scores were associated with higher mean BI scores at 5 and 10 years. 0047 Gradients persisted when results were adjusted for incident stroke and myocardial infarction, when mobility and nonmobility domains of the BI were analyzed separately, and when BI was analyzed dichotomously. At 10 years, in a fully adjusted model, differences in mean BI score were lower for poor versus ideal physical activity (3.48 points, P<0.0001) and fasting glucose (4.58 points, P<0.0001). CONCLUSIONS Ideal CVH predicts functional status, even after accounting for incident vascular events. Vascular functional impairment is an important outcome that can be reduced by optimizing vascular health.
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Affiliation(s)
- Mandip S Dhamoon
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY (M.S.D.)
| | - Chuanhui Dong
- Department of Neurology, Evelyn F. McKnight Brain Institute, Miller School of Medicine, University of Miami, FL (C.D., R.L.S.)
| | - Mitchell S V Elkind
- Department of Neurology, College of Physicians and Surgeons, and Epidemiology, Mailman School of Public Health, Columbia University, New York, NY (M.V.E.)
| | - Ralph L Sacco
- Department of Neurology, Evelyn F. McKnight Brain Institute, Miller School of Medicine, University of Miami, FL (C.D., R.L.S.) Department of Public Health Sciences and Human Genetics, Miller School of Medicine, University of Miami, FL (R.L.S.)
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Yang X, Zhou Y, Liu C, Gao X, Wang A, Guo Y, Li W, Zhao X, Liang W. Homocysteine and carotid plaque stability: a cross-sectional study in Chinese adults. PLoS One 2014; 9:e94935. [PMID: 24736609 PMCID: PMC3988131 DOI: 10.1371/journal.pone.0094935] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2013] [Accepted: 03/21/2014] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND AND PURPOSE This study aimed to explore the possible association of plasma total homocysteine with carotid plaque stability. METHODS A cross-sectional study was conducted from 2010 to 2011. A stratified random sample of 2,919 Chinese participants aged 40 years or older was enrolled. Plasma total homocysteine levels were measured and carotid plaques were evaluated by ultrasonography. Logistic regression model was used to analyze the association of homocysteine levels to the progression of carotid plaque development, while adjusting for demographics and vascular risk factors. RESULTS The mean level of plasma homocysteine in the subjects was 14.9 µmol/l. Along with increase in homocysteine level, the risk of advanced carotid plaque elevated (odds ratio = 1.28; 95% confidence interval = 1.09-1.51) after adjusting for age, sex, and other potential confounders. Stratified by sex, higher homocysteine level was strongly associated with advanced carotid plaque in men (OR = 1.41; 95% confidence interval = 1.17-1.70), but not in women. CONCLUSION The findings suggest that plasma level of homocysteine may be associated with advanced carotid plaque, which constitutes high risks of stroke, in male Chinese adults.
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Affiliation(s)
- Xin Yang
- Department of General Practice, School of General Practice and Continuing Education, Capital Medical University, Beijing, China
| | - Yong Zhou
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Chao Liu
- Department of Neurosurgery, the Second Hospital of Jilin University, Changchun, China
| | - Xiang Gao
- Channing Laboratory, Department of Medicine, Brigham and Women’s Hospital, and Harvard Medical School, Boston, Massachusetts, United States of America
- Department of Nutrition, Harvard University School of Public Health, Boston, Massachusetts, United States of America
| | - Anxin Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Yuming Guo
- Department of Epidemiology and Biostatistics, University of Queensland School of Population Health, Brisbane, Queensland, Australia
| | - Wen Li
- Department of Ultrasound, Kailuan Hospital, Hebei United University, Tangshan, China
| | - Xingquan Zhao
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Wannian Liang
- Department of General Practice, School of General Practice and Continuing Education, Capital Medical University, Beijing, China
- National Health and Family Planning Commission of People’s Republic of China, Beijing, China
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Wang J, Liu L, Zhou Y, Wang C, Hu H, Hoff K, Guo Y, Gao X, Wang A, Wu S, Zhao X. Increased fasting glucose and the prevalence of arterial stiffness: a cross-sectional study in Chinese adults. Neurol Res 2014; 36:427-33. [DOI: 10.1179/1743132814y.0000000345] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Wu J, Chen S, Zhou Y, Wang C, Wang A, Zhang Q, Gao X, Hu H, Wu S, Zhao X. Non-high-density lipoprotein cholesterol on the risks of stroke: a result from the Kailuan study. PLoS One 2013; 8:e74634. [PMID: 24058611 PMCID: PMC3769236 DOI: 10.1371/journal.pone.0074634] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2013] [Accepted: 08/03/2013] [Indexed: 11/18/2022] Open
Abstract
AIMS To prospectively explore the association between non-high-density lipoprotein cholesterol (non-HDLC) and the risks of stroke and its subtypes. METHODS A total of 95,916 participants (18-98 years old; 76,354 men and 19,562 women) from a Chinese urban community who were free of myocardial infarction and stroke at baseline time point (2006-2007) were eligible and enrolled in the study. The serum non-HDLC levels of participants were determined by subtracting the high-density lipoprotein cholesterol (HDLC) from total serum cholesterol. The primary outcome was the first occurrence of stroke, which was diagnosed according to the World Health Organization criteria and classified into three subtypes: ischemic stroke, intracerebral hemorrhage, or subarachnoid hemorrhage. The Cox proportional hazards models were used to estimate risk of stroke and its subtypes. RESULTS During the four-year follow-up, we identified 1614 stroke events (1,156 ischemic, 416 intracerebral hemorrhagic and 42 subarachnoid hemorrhagic). Statistical analyses showed that hazard ratios (HR) (95% Confidence Interval: CI) of serum Non-HDLC level for total and subtypes of stroke were: 1.08 (1.03-1.12) (total), 1.10 (1.05-1.16) (ischemic), 1.03 (0.96-1.10) (intracerebral hemorrhage) and 0.83 (0.66-1.05) (subarachnoid hemorrhage). HR for non-HDLC refers to the increase per each 20 mg/dl. For total and ischemic stroke, the risks were significantly higher in the fourth and fifth quintiles of non-HDLC concentrations compared to the first quintile after adjusting the confounding factors (total stroke: 4(th) quintile HR=1.33 (1.12-1.59); 5(th) quintile HR = 1.36 (1.15-1.62); ischemic stroke: 4(th) quintile HR =1.34 (1.09-1.66); 5(th) quintile HR = 1.53 (1.24-1.88)). CONCLUSIONS Our data suggest that serum non-HDLC level is an independent risk factor for total and ischemic stroke, and that higher serum non-HDLC concentrations are associated with increased risks for total stroke and ischemic stroke, but not for intracerebral and subarachnoid hemorrhage.
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Affiliation(s)
- Jianwei Wu
- Department of Neurology, Beijing TianTan Hospital, Capital Medical University, Beijing, China
| | - Shengyun Chen
- Department of Neurology, Beijing TianTan Hospital, Capital Medical University, Beijing, China
| | - Yong Zhou
- Department of Neurology, Beijing TianTan Hospital, Capital Medical University, Beijing, China
| | - Chunxue Wang
- Department of Neurology, Beijing TianTan Hospital, Capital Medical University, Beijing, China
| | - Anxin Wang
- Department of Neurology, Beijing TianTan Hospital, Capital Medical University, Beijing, China
| | - Qian Zhang
- Department of Neurology, Beijing TianTan Hospital, Capital Medical University, Beijing, China
- Department of Neural Stem Cell Transplantation, The General Hospital of Chinese People's Armed Police Forces, Beijing, China
| | - Xiang Gao
- Channing Laboratory, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts, United States of America
- Department of Nutrition, Harvard University School of Public Health, Boston, Massachusetts, United States of America
| | - Haitao Hu
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - Shouling Wu
- Department of Cardiology, Kailuan Hospital, Hebei United University, Tangshan, China
- * E-mail: (XQZ); (SLW)
| | - Xingquan Zhao
- Department of Neurology, Beijing TianTan Hospital, Capital Medical University, Beijing, China
- * E-mail: (XQZ); (SLW)
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