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OBJECTIVE@#To investigate the association between current and former smoking and the risk of mortality in elderly Chinese men.@*METHODS@#Our study participants were elderly (≥ 60 years) men recruited in a suburban town of Shanghai. Cigarette smoking status was categorized as never smoking, remote (cessation > 5 years) and recent former smoking (cessation ≤ 5 years), and light-to-moderate (≤ 20 cigarettes/day) and heavy current smoking (> 20 cigarettes/day). Cox proportional hazards models and restricted cubic splines were used to examine the associations of interest.@*RESULTS@#The 1568 participants had a mean age of 68.6 ± 7.1 years. Of all participants, 311 were never smokers, 201 were remote former smokers, 133 were recent former smokers, 783 were light-to-moderate current smokers and 140 were heavy current smokers. During a median follow-up of 7.9 years, all-cause, cardiovascular and non-cardiovascular deaths occurred in 267, 106 and 161 participants, respectively. Heavy current smokers had the highest risk of all-cause and non-cardiovascular mortality, with an adjusted hazard ratio (HR) of 2.30 (95% CI: 1.34-4.07) and 3.98 (95% CI: 2.03-7.83) versus never smokers, respectively. Recent former smokers also had a higher risk of all-cause (HR = 1.62, 95% CI: 1.04-2.52) and non-cardiovascular mortality (HR = 2.40, 95% CI: 1.32-4.37) than never smokers. Cox regression restricted cubic spline models showed the highest risk of all-cause and non-cardiovascular mortality within 5 years of smoking cessation and decline thereafter. Further subgroup analyses showed interaction between smoking status and pulse rate (≥ 70 beats/min vs. < 70 beats/min) in relation to the risk of all-cause and non-cardiovascular mortality, with a higher risk in current versus never smokers in those participants with a pulse rate below 70 beats/min.@*CONCLUSIONS@#Cigarette smoking in elderly Chinese confers significant risks of mortality, especially when recent former smoking is considered together with current smoking.
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Objective • To investigate the prevalence and related factors of abnormal four-limb blood pressure difference in elderly people in Shanghai. Methods • From 2016 to 2018, the elderly aged 60 years and over in Zhaoxiang Town, Qingpu District, Shanghai were selected by cluster sampling. General data was collected. Height, body mass, and blood pressure were measured. Fasting venous blood was taken for routine blood test, blood glucose, blood lipids, serum creatinine and other biochemical indicators. Four limb blood pressures were measured simultaneously by Vascular Profiler-1000 device, from which ankle-brachial index, inter-arm systolic pressure difference and inter-ankle systolic pressure difference were calculated. Multivariate Logistic regression was used to analyze the related factors of abnormal four-limb blood pressure difference. Results • A total of 4 090 subjects were enrolled with an average age of (68.5±7.6) years, of which 44.6% were males. The people with hypertension and diabetes mellitus accounted for 60.1% and 8.6%, respectively. The prevalence of ankle-brachial index≤ 0.90, inter-arm systolic pressure difference≥ 15 mmHg (1 mmHg=0.133 kPa) and inter-ankle systolic pressure difference≥ 15 mmHg were 2.7%, 1.9%, and 8.4%, respectively. After incorporating age, sex, body mass index (BMI), smoking, drinking, hypertension, diabetes mellitus, total cholesterol and triacylglycerol, the results of multiple Logistic regression analysis showed that age and hypertension were the related factors of the three indicators for abnormal four-limb blood pressure difference. The related factors of ankle-brachial index ≤ 0.90 also included diabetes mellitus, total cholesterol and smoking; the related factors of inter-arm systolic pressure difference≥ 15 mmHg also included BMI; the related factors of inter-ankle systolic pressure difference≥ 15 mmHg also included BMI and diabetes mellitus. Conclusion • Abnormal four-limb blood pressure difference is prevalent among the elderly in Shanghai, of which old age, hypertension, diabetes, dyslipidemia, obesity and smoking are risk factors.
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Objective The Augmentation index(AI)is an indicator of pulse wave reflections.To under- stand the validity of AI in the elderly,we studied the determinants of AI in an elderly population.Methods All subjects older than 70 years living in Zhaoxiang Town,Qingpu District,Shanghai were recruited.Pulse wave a- nalysis at the left radial artery was performed by using Omron HEMg000AI device.The augmentation index (AI)adjusting for a heart rate of 75 beats/min was used for statistical analysis.Results One thousand two hun- dred eighty-six participants included 761(59 %)women,and 815(63 %)hypertensive patients with average age 76.3 years participate the study.Women had a significant higher AI than men(90.3% versus 85.8%,P