Intervention effect of health education on the knowledge and awareness of hypertension in primary and secondary school students / 中华全科医师杂志

Objective:To explore the effects of health education on the knowledge and awareness of hypertension in primary and secondary school students.Methods:Twenty seven primary and secondary schools in Emin County of Xinjiang Uygur Autonomous Region were selected in 2014 as study sites; among which 24 schools were randomly assigned as the intervention group and 3 schools were assigned as control group. According to the education methods (classroom teaching, publicity manual, hypertension class reports and the combination of the three) and the frequency of education (1, 2, 3 times per semester), the intervention group were further randomly divided into 12 subgroups with 2 schools in each group. The intervention study was carried out for 3 years.Results:A total 13 402 students were involved in the study, and there were 11 333 students in the intervention group and 2 069 students in the control group. The awareness rates of hypertension concept [41.8% (4 738/11 333) vs. 24.6% (511/2 069), χ 2=154.86, P<0.01], the adverse consequences of hypertension [85.8% (9 735/11 333) vs. 75.4% (1 561/2 069),χ 2=25.80, P<0.01], the hypertension risk factors [84.3% (9 564/11 333) vs. 72.5%(1 501/2 069), χ 2=12.83, P<0.01), and the health behaviors after hypertension [84.9% (9 629/11 333) vs. 67.7%(1 402/2 069), χ 2=187.24, P<0.01] in intervention group were all significantly higher than those in control group. The stratified analysis showed that among students in elementary school, junior high school and high school, there were significant differences in the awareness rate of adverse consequences [94.4% (2 019/2 138) vs. 81.6% (3 829/4 690), 86.2% (3 887/4 505), χ 2=199.31, P<0.01], awareness rate of risk factor [86.8% (1 857/2 138) vs.86.1% (4 038/4 690), 81.4% (3 669/4 505) , χ 2=49.96, P<0.01); and awareness rate of correct behavior [89.9% (1 923/2 138) vs. 86.1% (4 037/4 690), 81.4% (3 669/4 505) χ 2=89.77, P<0.01]. Up to 95.9% (10 868/11 333) students in the intervention group liked the hypertension health education. Conclusion:Based on the school health education curriculum, the intervention measures of hypertension health education are effective, and the awareness rate of hypertension related knowledge among senior high school students is significantly improved.

The intervention effects of prevention and treatment modes of hypertension in people living in agricultural and pastoral areas / 实用医学杂志

Objective To explore an effective mode for the prevention and control of hypertension in agricultural and pastoral areas in Xinjiang by comparing the effect of mode A with that of B in blood pressure-lowering treatment. Methods 1445 patients with hypertension in agricultural and pastoral areas were included in this study. They voluntarily received mode A or B blood pressure-lowering treatment. The changes in heart rate , blood pressure, lipid, and glucose, and the incidences of cardiovascular and cerebrovascular events and adverse events were noted;and the effect of modes A and B was compared. Results 87.07%of the patients chose mode A group, while 12.93%chose mode B. The rate of pressure control was 70.71%in mode A group and 68.75%in mode B group , with no significant statistical difference (P>0.05). In 12th month of treatment, the decreased level of systolic pressure was (19.09 ± 20.33)mmHg in the group with mode A and (14.14 ± 17.85) mmHg in the group with mode B, showing a significant statistical difference between the two groups (P=0.047); and the declined level of diastolic pressure was (11.17 ± 13.23)mmHg and (8.17 ± 11.17) mmHg, respectively, with no significant statistical difference. Conclusion Mode A blood pressure-lowering treatment can effectively control blood pressure in hypertensive patients living in agricultural and pastoral areas in Xinjiang.

Association of GIRK4 gene polymorphisms with essential hypertension in obese ethnics Uygur from southern Xinjiang / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To assess the association of polymorphisms of G protein-coupled inwardly-rectifying potassium channels 4 (GIRK4) gene with essential hypertension in ethnic Uygurs from southern Xinjiang.</p><p><b>METHODS</b>A total of 1194 (461 males and 733 females) Uygur residents aged 30 to 70 and with a body mass index (BMI) over 18.5 kg/m(2) were selected from Hetian region. All of the subjects have received questionnaire survey, physical examination, biochemical analysis and blood pressure measurement. They were divided into hypertensive group and normotensive group. Genotyping by the TaqMan polymerase chain reaction method was performed for 4 common single nucleotide polymorphisms (rs4937391, rs2604204, rs6590357 and rs1122149), and a case-control study was carried out.</p><p><b>RESULTS</b>Genotype distributions of rs4937391, rs2604204, rs6590357 and rs1122149 in both groups were in Hardy-Weinberg equilibrium (P> 0.05). The average systolic blood pressure of CC genotype of rs11221497 single nucleotide polymorphism (SNP)[(132.69± 26.9) mmHg)] was higher than the CG genotype [(127.4± 22.7) mmHg] and GG genotype [(121.1± 26.3) mmHg]. There has a significantly difference in average systolic and diastolic blood pressures between CC and GG genotypes (P< 0.05). A case-control association analysis revealed that the rs11221497 SNP was in association with essential hypertension with the dominant model [P< 0.05, OR= 0.67 (0.49-0.93)]. Haplotype analysis indicated that H6(C-G-C-G) was significantly more common in normotensive group than hypertensive group (P= 0.001).</p><p><b>CONCLUSION</b>The rs11221497 SNP of the GIRK4 gene is associated with essential hypertension in ethnic Uygur population in Xinjiang.</p>

Association of KCNJ5 gene rs3740835(C/A) and rs2604204(A/C) polymorphism with unilateral and bilateral primary aldosteronism / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To assess the association between polymorphisms of rs3740835(C/A) and rs2604204(A/C) in KCNJ5 gene with the susceptibility to unilateral and bilateral primary aldosteronism (PA).</p><p><b>METHODS</b>A total of 1043 subjects were studied, which included 83 unilateral PA patients,142 bilateral PA patients and 818 essential hypertensive(EH) patients. The polymorphism of KCNJ5 gene at rs3740835(C/A) and rs2604204(A/C) position were analyzed with a TaqMan genotyping technique.</p><p><b>RESULTS</b>Frequencies of A allele and AA+AC genotype at rs3740835(C/A) in unilateral PA group were significantly higher than EH group (P < 0.05). However, the above frequencies did not show a statistical significance between bilateral PA group and EH group (P > 0.05). No statistical difference was detected in the distribution of alleles or genotypes at rs2604204 (A/C) between unilateral PA and EH group or between bilateral PA and EH group. Haplotypic frequencies of C-A and A-A in unilateral PA group were significantly higher and lower than EH group, respectively. However, there was no statistical difference in the haplotype distribution between bilateral PA and EH groups.</p><p><b>CONCLUSION</b>Rs3740835(C/A) polymorphism may be associated with unilateral PA but not with bilateral PA. rs2604204(A/C) polymorphism is not associated with either unilateral or bilateral PA. Haplotype C-A and A-A may respectively be susceptibility factor and protective factor for unilateral PA. No haplotype has been found to associate with bilateral PA.</p>

Application of SUSPPUP ratio in patients with primary aldosteronism / 中华内分泌代谢杂志

Objective To assess the effectiveness of the quotient of serum sodium to urinary sodium divided by (serum potassium) 2 to urinary potassium (SUSPPUP) in screening for primary aldosteronism (PA).Methods Among 952 patients with hypertension who had renin activity,aldosterone measurements and concomitant serum and urinary biochemistry data,204 patients were diagnosed as cases of PA and 261 as cases of essential hypertension.Diagnosis of PA was made in accordance with established laboratory criteria including renin activity and aldosterone,plasma aldosterone concentration/plasma renin activity (ARR),and saline loading test.The SUSPPUP ratio with the ARR were compared in two groups.Results The area under the curve of SUSPPUP and ARR was 0.797 and 0.796 respectively according to receiver operating characteristic curve,optimal cutoff of SUSPPUP was 1.0,the sensitivity and specificity of SUSPPUP was 98.9％ and 81％ respectively.Conclusions The SUSPPUP ratio is an inexpensive and rapid tool to assess the extent of mineralocorticoid excess,therefore,SUSPPUP ratio can be applied to screen PA in hypertensive patients.

The association between KCNJ5 gene polymorphism and primary hyperaldosteronism / 中华内分泌代谢杂志

Objective To investigate the association between KCNJ5 gene polymorphism and primary hyperaldosteronism(PA).Methods A total of 248 PA patients and 816 essential hypertension (EH) patients were enrolled in this study,TaqMan assay was used to detect the rs1221497 polymorphism of KCNJ5 gene.Results The genotypes of rs1221497 were in Hardy-Weinberg equilibrium in both PA group and EH group,the genotype frequencies ofGG,GC,CC were 208,39,1 in PA group and 631,177,8 in EH group respectively,the allele frequencies in the two groups were 455,41 and 1 439,193 respectively.The frequencies of GG genotype and G allele in PA group were significantly higher than those in EH group.Logistic regression showed that GG genotype was closely associated with PA after adjusting age.Conclusions GG genotype and G allele may contribute to the occurrence of PA.

Risk factors of decreased glomerular filtration rate in patients with primary aldosteronism / 中华全科医师杂志

One hundred and fifty-six patients with primary aldosteronism(PA)and 189 patients with essential hypertension (EH) were included in this study.The value of estimate glomerular filtration rate (eGFR) was calculated by MDRD equation.The plasma levels of aldosterone,triglycerides,creatinine and fasting glucose were measured.The plasma creatine,24 hour urine albumin excretion in PA patients were higher and eGFR and plasma aldosterone were lower than those in EH patients ( all P ＜ 0.01 ).Multiple regression analysis revealed that the plasma concentrations of aldosterone ( P =0.003 ) and creatinine ( P =0.001 ) were independent predictors of eGFR.

Characteristics of left ventricular structural damage in patients with primary aldosteronism / 中华内分泌代谢杂志

ObjectiveTo investigate the characteristics of left ventricular structural damage in patients with primary aldosteronism(PA).MethodsA total of 438 inpatients with hypertension from January 2007 to June 2010 were screened for PA,and diagnosis was made in 213 PA patients and 225 patients with essential hypertension (EH).The left ventricular structure of all subjects was evaluated according to the results of echocardiographic measurements.Results The duration of hypertension and plasma aldosterone level in patients with PA were significantly higher (P＜ 0.01 ),while the serum potassium and plasma renin activity were significantly lower (P＜0.01 ) than those in patients with EH.The interventricular septum thickness,left ventricular end-diastolic dimension,left ventricular mass index (LVMI),left ventricular end-diastolic volume,and stroke volume in patients with PA were significantly higher than those in EH patients( P＜0.01 ) after the duration of hypertension was corrected.In patients with PA,the prevalence of left ventricular hypertrophy (LVH) was higher than that in EH patients ( 53.1％ vs 33.8 ％,x2 =16.57,P ＜ 0.01 ). Normal left ventricular geometry ( NG ),concentric remodeling ( CCR ),concentric hypertrophy( CCH),and eccentric hypertrophy (ECH) were found respectively in 24.9％,22.1％,22.1％,and 30.9％ of patients with PA.Multiple stepwise regression analysis showed that the seated plasma aldosterone level (β=0.43,P ＜ 0.01 ) and systolic blood pressure (β =0.45,P ＜ 0.01 ) were the main factors that influenced LVMI.The course was the main parameter that influenced relative wall thickness(β=0.011,P＜0.05 ).Conclusion The prevalence of LVH is higher in patients with PA than that in EH patients.The eccentric hypertrophy is the most common left ventricular geometrical pattern in patients with PA.

Analysis of clinical characteristics of 11 cases of extra-adrenal pheochromocytoma / 中华内分泌代谢杂志

e extra-adrenal pheochromocytoma.

Clinical observations of metabolic disturbance in patients with obstructive sleep apnea-hypoventilation syndrome / 中华全科医师杂志

Objectives To investigate the relationship between obstructive sleep apnea hypoventilation syndrome (OSAHS), insulin resistance (IR) and metabolic syndrome (MS), as well as to explore the possible mechanism of MS caused by OSAHS. Methods We recruited 186 hospitalized patients with hypertensions, who were divided into four groups based on their nocturnal polygraphs recordings, 35 as controls (group Ⅰ), 61 with mild (group Ⅱ), 52 with moderate (group Ⅲ) and 38 with severe OSAHS (group Ⅳ). They all underwent measurements including body height, body weight, waist circumference (WC), systolic and diastolic blood pressure (SBP and DBP), serum uric acid, creatinine, fasting plasma glucose, fasting plasma insulin, serum total cholesterol, high-density lipoprotein-cholesterul, low-density lipoprotein-cholesterol and triglyceride. Results One hundred and two patients with OSAHS (67.6 percent) also suffered of MS, 33 (86.8 percent) of them with severe OSAHS. There was no significant difference in age, gender, fasting plasma glucose, total cholesterol, high-density lipoprutein-cholesterul, low-density lipoprotein-cholesterol and triglyceride among the four groups (P>0.05). Body mass index (BMI), WC, ratio of serum uric acid to creatinine and DBP were all significantly higher in patients with severe OSAHS than those in patients with mild and moderate OSAHS and controls (P<0.01). SBP was significantly higher in patients with severe OSAHS than that in those with mild and moderate OSAHS (P<0.01). Insulin resistance was significantly severer in patients with severe OSAHS than that in those with mild OSAHS and controls (P<0.01). Results of multivariate linear regression analysis showed that insulin resistance was correlated with BMI and reversely correlated with minimal blood oxygen saturation, and minimal blood oxygen saturation reversely correlated with WC and ratio of uric acid to creatinine. Condusions Hypoxemia and obesity may promote development of insulin resistance. Patients of hypertension complicated with OSAHS tend to develop MS, particularly in those with severe OSAHS.