A cohort study on the predictive value of factors influencing cardio-cerebro vascular death among people over 40 years of age / 中华流行病学杂志

<p><b>OBJECTIVE</b>To explore the factors influencing cardio-cerebro vascular death events among people over 40 years of age in Shandong area, China.</p><p><b>METHODS</b>Baseline survey was carried out in 1991. A total number of 11,008 adults over 40 years old had been studied in Shandong province. Data on cardiocerebro death was collected. The correlation between influencing factors and cardio-cerebro vascular death events was analyzed by Cox regression model.</p><p><b>RESULTS</b>Totally, 434 cardio-cerebro death events occurred among the 11,008 subjects during the 8-year follow-up study. Cardio-cerebro death events were related to systolic blood pressure, diastolic blood pressure, smoking, stroke history and age. Data from Cox regression analysis showed that the relative risk (RR) for cardio-cerebro vascular death events increased by 2.862 [95% confidence interval (CI): 1.976-4.144] times for those people having stroke history. When systolic blood pressure, diastolic blood pressure increased by every 10 mm Hg, the relative risk for cardio-cerebro vascular death events increased by 1.171 (95% CI: 1.033-1.328), 1.214 (95% CI: 1.044-1.413) respectively. it was found that a 1.239 (95% CI: 1.088-1.553) times higher in smokers than non-smokers on relative risk for cardio-cerebro vascular death events. However, the predictive values of the influencing factors for cardio-cerebro vascular death were different among population of different years of age. The relative risk for cardio-cerebro vascular death events increased by 1.366 (95% CI: 1.102-1.678) times for each 10 mm Hg increase of diastolic blood pressure in 40-59 years old population. However, the effect was taken place by systolic blood pressure in 60-74 years old population,with a relative risk of 1.201 (95% CI: 1.017-1.418) for each 10 mm Hg increase. Age seemed the only significant factor for cardio-cerebro vascular death events on population aged more than 75 years old. Conclusion The predictive values of the risk factors were different among age groups. The different risk factors should be taken care according to the difference of age.</p>

The impact of gender factor on the candidate gene study of essential hypertension / 中华心血管病杂志

<p><b>OBJECTIVE</b>To study the impact of gender factor on the candidate gene study of essential hypertension (EH).</p><p><b>METHODS</b>The polymerase chain reaction (PCR) was performed to analyze the ACE gene I/D polymorphism of hypertensive patients (50 men and 50 women) and normal controls (50 men and 50 women). The investigation was further focused on possible influence of sex proportion on the conclusion of this kind of research.</p><p><b>RESULTS</b>The frequency of DD genotype in male hypertensive patients is significantly higher than that in male normal controls (chi(2) = 6.98, P = 0.004). The frequency of D allele in male EH group is significantly higher than that of male normal controls (chi(2) = 6.87, P = 0.009), while no significant difference was observed for II and ID genotype between male EH group and control group (P > 0.05). For female EH group and normal controls, there were no significant differences in frequency of genotype and allele (P > 0.05), the distribution ratio of DD genotype in male EH group is significantly different from that of female EH group (chi(2) = 4.06, P = 0.044). Furthermore, males with DD genotype in EH group had higher SBP and PP than that of males with II and ID genotype (P < 0.05). However, there was no significant difference in DBP in all three genotypes (P > 0.05). At the same time, there was no difference in SBP, DBP and PP (P > 0.05) between II and ID genotype in male EH group. In female hypertensive patients, there was no significant difference in SBP, DBP and PP between all three genotypes (P > 0.05).</p><p><b>CONCLUSIONS</b>The relationship between DD genotype in male and EH (especially SBP and PP) is closer than any other genotype-EH relationships in both male and female. The gender factor, as a probable confounding factor, can affect many candidate gene studies of essential hypertension including ACE gene I/D polymorphism, and thus biases the conclusion.</p>