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Sun P, Chen M, Guo X, Li Z, Zhou Y, Yu S, Yang H, Sun G, Zheng L, Sun Y. Combined effect of hypertension and hyperuricemia on ischemic stroke in a rural Chinese population. BMC Public Health 2021; 21:776. [PMID: 33892657 PMCID: PMC8063426 DOI: 10.1186/s12889-021-10858-x] [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: 11/07/2020] [Accepted: 01/22/2021] [Indexed: 12/12/2022] Open
Abstract
Background To investigate the combined effect of hypertension and hyperuricemia to the risk of ischemic stroke in a rural Chinese population. Methods The cross-sectional study was conducted from 2012 to 2013 in a rural area of China. After exclusion for missing data, we finally included 11,731 participants into analysis. Results After adjusting for age, current smoking, current drinking, BMI, TG, HDL-C and eGFR, hypertension was significantly associated with ischemic stroke in men (OR: 2.783, 95% CI: 1.793, 4.320) and in women (OR: 4.800, 95% CI: 2.945, 7.822). However, hyperuricemia was significantly associated with ischemic stroke only in women (OR: 1.888, 95% CI: 1.244, 2.864). After full adjustment, participants with both hypertension and hyperuricemia had 8.9 times higher risk than those without them. Finally, the interaction between hypertension and hyperuricemia was statistically significant only in women rather than in men after full adjustment. Conclusions This study demonstrated the positive correlations between hypertension, hyperuricemia and ischemic stroke. Our study also demonstrated the joint effect between hypertension and hyperuricemia towards ischemic stroke only in women, not in men.
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Affiliation(s)
- Peng Sun
- Department of Ophthalmology, the First Hospital of China Medical University, Shenyang, Liaoning, China
| | - Mengqi Chen
- Department of Cardiology, the First Hospital of China Medical University, 155 Nanjing North Street, Heping District, Shenyang, 110001, Liaoning, China
| | - Xiaofan Guo
- Department of Cardiology, the First Hospital of China Medical University, 155 Nanjing North Street, Heping District, Shenyang, 110001, Liaoning, China.
| | - Zhao Li
- Department of Cardiology, the First Hospital of China Medical University, 155 Nanjing North Street, Heping District, Shenyang, 110001, Liaoning, China
| | - Ying Zhou
- Department of Cardiology, the First Hospital of China Medical University, 155 Nanjing North Street, Heping District, Shenyang, 110001, Liaoning, China
| | - Shasha Yu
- Department of Cardiology, the First Hospital of China Medical University, 155 Nanjing North Street, Heping District, Shenyang, 110001, Liaoning, China
| | - Hongmei Yang
- Department of Cardiology, the First Hospital of China Medical University, 155 Nanjing North Street, Heping District, Shenyang, 110001, Liaoning, China
| | - Guozhe Sun
- Department of Cardiology, the First Hospital of China Medical University, 155 Nanjing North Street, Heping District, Shenyang, 110001, Liaoning, China
| | - Liqiang Zheng
- Department of Clinical Epidemiology, Library, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China
| | - Yingxian Sun
- Department of Cardiology, the First Hospital of China Medical University, 155 Nanjing North Street, Heping District, Shenyang, 110001, Liaoning, China
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Li W, Jin C, Vaidya A, Wu Y, Rexrode K, Zheng X, Gurol ME, Ma C, Wu S, Gao X. Blood Pressure Trajectories and the Risk of Intracerebral Hemorrhage and Cerebral Infarction: A Prospective Study. Hypertension 2017; 70:508-514. [PMID: 28716992 DOI: 10.1161/hypertensionaha.117.09479] [Citation(s) in RCA: 96] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Revised: 04/07/2017] [Accepted: 06/22/2017] [Indexed: 02/06/2023]
Abstract
The association between long-term blood pressure (BP) patterns in community-dwelling adults and risk of intracerebral hemorrhage and cerebral infarction is not well characterized. This prospective study included 79 385 participants, free of stroke, myocardial infarction, and cancer in or before 2010 (baseline). Systolic BP trajectories were identified using latent mixture modeling with data from 2006, 2008, and 2010. Incident cases of intracerebral hemorrhage and cerebral infarction occurred during 2010 to 2014, confirmed by review of medical records, by 3 physicians. We identified 5 distinct systolic BP trajectories during 2006 to 2010. Each of the trajectories was labeled according to their BP range and pattern over time: normotensive-stable (n=26 740), prehypertension-stable (n=35 674), stage 1 hypertension-increasing (n=8215), stage 1 hypertension-decreasing (n=6422), and stage 2 hypertension-stable (n=2334). We documented 1034 incident cases of cerebral infarction and 187 cases of intracerebral hemorrhage. Although the prehypertension-stable trajectory exhibited systolic BP range within the normal range (120-140 mm Hg) during 2006 to 2010, this group had higher stroke risk relative to the normotensive-stable group (<120 mm Hg) (adjusted hazard ratio was 3.11 for intracerebral hemorrhage and 1.99 for cerebral infarction; P<0.001 for both), after adjusting for possible confounders. Individuals in the stage 2 hypertension-stable systolic BP trajectory (175-179 mm Hg) had the highest risk of intracerebral hemorrhage (adjusted hazard ratio was 12.4) and cerebral infarction (adjusted hazard ratio was 5.07), relative to the normotensive-stable group (P<0.001 for both). BP trajectories were associated with the risk of stroke and increasing BP trajectories within the currently designated normal range may still increase the risk for stroke.
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Affiliation(s)
- Weijuan Li
- From the Vanderbilt University Medical Center, Vanderbilt Heart and Vascular Institute, Nashville, TN (W.L.); Department of Cardiology, Kailuan General Hospital, Tangshan, People's Republic of China (C.J., Y.W., X.Z., S.W.); Department of Nutritional Sciences, Pennsylvania State University, State College (C.J., C.M., X.G.); Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (A.V.); Division of Preventive Medicine, Brigham and Women's Hospital, Boston, MA (K.R.); and Stroke Service, Department of Neurology, Massachusetts General Hospital, Boston (M.E.G.)
| | - Cheng Jin
- From the Vanderbilt University Medical Center, Vanderbilt Heart and Vascular Institute, Nashville, TN (W.L.); Department of Cardiology, Kailuan General Hospital, Tangshan, People's Republic of China (C.J., Y.W., X.Z., S.W.); Department of Nutritional Sciences, Pennsylvania State University, State College (C.J., C.M., X.G.); Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (A.V.); Division of Preventive Medicine, Brigham and Women's Hospital, Boston, MA (K.R.); and Stroke Service, Department of Neurology, Massachusetts General Hospital, Boston (M.E.G.)
| | - Anand Vaidya
- From the Vanderbilt University Medical Center, Vanderbilt Heart and Vascular Institute, Nashville, TN (W.L.); Department of Cardiology, Kailuan General Hospital, Tangshan, People's Republic of China (C.J., Y.W., X.Z., S.W.); Department of Nutritional Sciences, Pennsylvania State University, State College (C.J., C.M., X.G.); Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (A.V.); Division of Preventive Medicine, Brigham and Women's Hospital, Boston, MA (K.R.); and Stroke Service, Department of Neurology, Massachusetts General Hospital, Boston (M.E.G.)
| | - Yuntao Wu
- From the Vanderbilt University Medical Center, Vanderbilt Heart and Vascular Institute, Nashville, TN (W.L.); Department of Cardiology, Kailuan General Hospital, Tangshan, People's Republic of China (C.J., Y.W., X.Z., S.W.); Department of Nutritional Sciences, Pennsylvania State University, State College (C.J., C.M., X.G.); Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (A.V.); Division of Preventive Medicine, Brigham and Women's Hospital, Boston, MA (K.R.); and Stroke Service, Department of Neurology, Massachusetts General Hospital, Boston (M.E.G.)
| | - Kathryn Rexrode
- From the Vanderbilt University Medical Center, Vanderbilt Heart and Vascular Institute, Nashville, TN (W.L.); Department of Cardiology, Kailuan General Hospital, Tangshan, People's Republic of China (C.J., Y.W., X.Z., S.W.); Department of Nutritional Sciences, Pennsylvania State University, State College (C.J., C.M., X.G.); Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (A.V.); Division of Preventive Medicine, Brigham and Women's Hospital, Boston, MA (K.R.); and Stroke Service, Department of Neurology, Massachusetts General Hospital, Boston (M.E.G.)
| | - Xiaoming Zheng
- From the Vanderbilt University Medical Center, Vanderbilt Heart and Vascular Institute, Nashville, TN (W.L.); Department of Cardiology, Kailuan General Hospital, Tangshan, People's Republic of China (C.J., Y.W., X.Z., S.W.); Department of Nutritional Sciences, Pennsylvania State University, State College (C.J., C.M., X.G.); Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (A.V.); Division of Preventive Medicine, Brigham and Women's Hospital, Boston, MA (K.R.); and Stroke Service, Department of Neurology, Massachusetts General Hospital, Boston (M.E.G.)
| | - Mahmut E Gurol
- From the Vanderbilt University Medical Center, Vanderbilt Heart and Vascular Institute, Nashville, TN (W.L.); Department of Cardiology, Kailuan General Hospital, Tangshan, People's Republic of China (C.J., Y.W., X.Z., S.W.); Department of Nutritional Sciences, Pennsylvania State University, State College (C.J., C.M., X.G.); Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (A.V.); Division of Preventive Medicine, Brigham and Women's Hospital, Boston, MA (K.R.); and Stroke Service, Department of Neurology, Massachusetts General Hospital, Boston (M.E.G.)
| | - Chaoran Ma
- From the Vanderbilt University Medical Center, Vanderbilt Heart and Vascular Institute, Nashville, TN (W.L.); Department of Cardiology, Kailuan General Hospital, Tangshan, People's Republic of China (C.J., Y.W., X.Z., S.W.); Department of Nutritional Sciences, Pennsylvania State University, State College (C.J., C.M., X.G.); Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (A.V.); Division of Preventive Medicine, Brigham and Women's Hospital, Boston, MA (K.R.); and Stroke Service, Department of Neurology, Massachusetts General Hospital, Boston (M.E.G.)
| | - Shouling Wu
- From the Vanderbilt University Medical Center, Vanderbilt Heart and Vascular Institute, Nashville, TN (W.L.); Department of Cardiology, Kailuan General Hospital, Tangshan, People's Republic of China (C.J., Y.W., X.Z., S.W.); Department of Nutritional Sciences, Pennsylvania State University, State College (C.J., C.M., X.G.); Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (A.V.); Division of Preventive Medicine, Brigham and Women's Hospital, Boston, MA (K.R.); and Stroke Service, Department of Neurology, Massachusetts General Hospital, Boston (M.E.G.)
| | - Xiang Gao
- From the Vanderbilt University Medical Center, Vanderbilt Heart and Vascular Institute, Nashville, TN (W.L.); Department of Cardiology, Kailuan General Hospital, Tangshan, People's Republic of China (C.J., Y.W., X.Z., S.W.); Department of Nutritional Sciences, Pennsylvania State University, State College (C.J., C.M., X.G.); Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (A.V.); Division of Preventive Medicine, Brigham and Women's Hospital, Boston, MA (K.R.); and Stroke Service, Department of Neurology, Massachusetts General Hospital, Boston (M.E.G.).
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