Comments on Lu et al. Association between self-reported global sleep status and prevalence of hypertension in Chinese adults: data from Kailuan community. Int. J. Environ. Res. Public Health 2015, 12, 488-503

Comparison of atrial fibrillation in CKD and non-CKD populations: A cross-sectional analysis from the Kailuan study

OBJECTIVES

To compare clinical epidemiological features of atrial fibrillation (AF) in chronic kidney disease (CKD) and non-CKD populations.

METHODS

This study included 88,312 adults aged ≥45 years old from the KAILUAN study. AF was ascertained with a 12-lead electrocardiogram. CKD was defined as an estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m² and/or proteinuria. Participants were categorized into non-CKD (eGFR > 60 mL/min/1.73 m² without proteinuria, n = 66,725) and CKD (n = 21,578) groups. We evaluated the prevalence of AF in both groups, evaluated risk factors for AF using multivariable-adjusted logistic regression analysis.

RESULTS

The prevalence of AF among non-CKD and CKD participants was 0.26% and 1.00%, respectively. Multivariable-adjusted analysis showed that older age (odds ratio [OR]: 1.08, 95% confidence interval [CI]: 1.07-1.10, P < 0.001), smoking (OR: 1.23, 95% CI: 1.07-1.57, P = 0.017), hypertension (OR: 2.14, 95% CI: 1.44-3.17, P < 0.001), diabetes (OR: 1.79, 95% CI: 1.10-2.89, P < 0.001), and larger waist circumference (OR: 1.03, 95% CI: 1.01-1.04, P < 0.001) were significantly associated with AF in the non-CKD group. In the CKD group, older age, smoking, larger waist circumference, reduced eGFR (OR: 0.97, 95% CI: 0.95-0.99, P < 0.001), proteinuria (OR: 2.01, 95% CI: 1.09-3.74, P < 0.001) and raised serum C-reactive protein (1.01, 1.00-1.03, P < 0.001) were significantly associated with AF.

CONCLUSIONS

The prevalence of AF in Chinese adults with CKD is higher than that among those without CKD. Risk factors for AF in non-CKD population were not the same compared with those in CKD population, kidney function and inflammatory markers were associated with the prevalence of AF.

Gender- and age-specific associations between sleep duration and prevalent hypertension in middle-aged and elderly Chinese: a cross-sectional study from CHARLS 2011-2012

OBJECTIVES

The impact of gender and age on the association between sleep duration and hypertension is not well known in Asians. The objective of this study was to analyse gender- and age-specific associations between sleep duration and prevalent hypertension in middle-aged and elderly Chinese.

DESIGN

Secondary analysis of a cohort sample.

SETTING

This study used data from the national baseline survey of the China Health and Retirement Longitudinal Study (CHARLS, 2011-2012), covering 150 counties/districts and 450 villages/resident committees from 28 provinces in China.

PARTICIPANTS

Community-based subjects were drawn from the CHARLS through multistage probability sampling. Overall, this study included 9086 eligible subjects aged 45 years or above.

OUTCOME MEASURES

Self-reported sleep duration was obtained using a structured questionnaire. The mean of three measures of systolic blood pressure and diastolic blood pressure was calculated. By gender and age groups (45-60 years, middle-aged; ≥60 years, elderly), relationships between self-reported sleep duration and prevalent hypertension were examined using logistic regression models to estimate OR and 95% CIs.

RESULTS

Compared with the reference group (≥7 and <8 hours/night), the group who had less sleep (<6 hours/night) had a higher likelihood of hypertension in the whole sample (OR 1.26, 95% CI 1.04 to 1.52). Significant ORs (95% CIs) of hypertension were 1.68 (1.17 to 2.42), 1.69 (1.11 to 2.59) and 2.21 (1.29 to 3.80) for <6, 6-7 (≥6 and <7) and 8-9 (≥8 and <9) hours/night, respectively, in middle-aged men but not women. Interestingly, a significant association was observed between long sleep duration (≥9 hours/night) and hypertension in middle-aged women (OR 1.55, 95% CI 1.02 to 2.35) but not in men.

CONCLUSIONS

Extremes of sleep duration increased the likelihood of prevalent hypertension in middle-aged Chinese depending on gender, suggesting that appropriate strategies for improvement in sleep health are required.