ABSTRACT
BACKGROUND@#Hypertension is associated with stroke-related mortality. However, the long-term association of blood pressure (BP) and the risk of stroke-related mortality and the influence path of BP on stroke-related death remain unknown. The current study aimed to estimate the long-term causal associations between BP and stroke-related mortality and the potential mediating and moderated mediating model of the associations.@*METHODS@#This is a 45-year follow-up cohort study and a total of 1696 subjects were enrolled in 1976 and 1081 participants died by the latest follow-up in 2020. COX proportional hazard model was used to explore the associations of stroke-related death with baseline systolic blood pressure (SBP)/diastolic blood pressure (DBP) categories and BP changes from 1976 to 1994. The mediating and moderated mediating effects were performed to detect the possible influencing path from BP to stroke-related deaths. E value was calculated in the sensitivity analysis.@*RESULTS@#Among 1696 participants, the average age was 44.38 ± 6.10 years, and 1124 were men (66.3%). After a 45-year follow-up, a total of 201 (11.9%) stroke-related deaths occurred. After the adjustment, the COX proportional hazard model showed that among the participants with SBP ≥ 160 mmHg or DBP ≥ 100 mmHg in 1976, the risk of stroke-related death increased by 217.5% (hazard ratio [HR] = 3.175, 95% confidence interval [CI]: 2.297-4.388), and the adjusted HRs were higher in male participants. Among the participants with hypertension in 1976 and 1994, the risk of stroke-related death increased by 110.4% (HR = 2.104, 95% CI: 1.632-2.713), and the adjusted HRs of the BP changes were higher in male participants. Body mass index (BMI) significantly mediated the association of SBP and stroke-related deaths and this mediating effect was moderated by gender.@*CONCLUSIONS@#In a 45-year follow-up, high BP and persistent hypertension are associated with stroke-related death, and these associations were even more pronounced in male participants. The paths of association are mediated by BMI and moderated by gender.
Subject(s)
Adult , Humans , Male , Middle Aged , Blood Pressure/physiology , China/epidemiology , Follow-Up Studies , Hypertension , Risk Factors , StrokeABSTRACT
Objective To investigate the epidemiological characteristics of a family clustering of COVID-19. Methods Field epidemiological survey was conducted. Result Case 1 of the long-term residents from Hubei province was the source of infection of this family clustering. There were 6 cases (from case 2 to case 7) infected in the whole incubation period. The incubation period was more than 14 days for 3 of the second-generation cases. Routes of transmission include respiratory droplets (from case 1 transmitted to case 6, from case 1 to her family members) and closecontact (from case 1 to other cases in her family). All the age groups were generally susceptible, while elderly were easier to progress to critically ill. Besides respiratory symptoms, there were also gastrointestinal symptoms, of which diarrhea was the most common one. Conclusion Family clustering had been an important part for COVID-19 cases.
ABSTRACT
Objective:This study aimed to assess the association between hypertension and carotid plaque in a research population in China.Methods:The subjects of this study were selected from a population undergoing physical examination at the Fourth Medical Center of PLA General Hospital in 2017. We collected information on physical examination, physiological index test, blood pressure indicators were analyzed according as continuous variables (systolic blood pressure, diastolic blood pressure, and pulse pressure) and categorical variables (hypertension and quartile of blood pressure pulse pressure). A multivariate logistic regression model was conducted to estimate the correlation between blood pressure and carotid plaque development.Results:A total of 716 individuals were surveyed, including 321 men (44.8%) and 395 women (55.2%), and the prevalence of hypertension and carotid plaque were 40.9%(293 cases) and 40.4% (289 cases), respectively. The prevalence of carotid plaque was higher in individuals aged ≥60 years, diabetes mellitus, hypertension and increased waist circumference, systolic blood pressure, fasting blood glucose and glycosylated hemoglobin. The prevalence of carotid plaque increased with the increase of the quartile of blood pressure and pulse pressure ( Ptrend<0.05). After adjustment for age, sex, BMI, waist circumference, and total cholesterol, triglyceride, fasting blood glucose, glycosylated hemoglobin, and hemoglobin levels, every 1 mmHg increased systolic blood pressure increases the risk of carotid plaque by 1.4% (95% CI: 1.005-1.024). Compared with the control group, the risk of carotid plaque increased by 86.8% (95% CI: 1.175-2.946) and 84.8% (95% CI: 1.098-3.110) and 119.6% (95% CI: 1.165-4.142) in the group of normal high blood pressure, grade 1 hypertension and grade 2 and grade 3 hypertension, respectively; compared with the control group, the risk of carotid plaque increased by 56.2% in the group of pulse pressure difference≥60 mmHg (95% CI: 1.049-2.326), in which the risk of carotid plaque increased by 73.3% (95% CI: 1.007-2.983) in women with pulse pressure difference≥60 mmHg (1 mmHg=0.133 kPa); in the control group with pulse pressure difference of four categories Q1 (<42 mmHg), the risk of carotid plaque increased by 92.2% (95% CI: 1.173-3.149) and 95.0% (95% CI: 1.147-3.316) in Q3 (50-61 mmHg) and Q4 (≥62 mmHg), respectively. Conclusion:Increased blood pressure or pulse pressure are associated with increased prevalence of carotid plaque. Prevention of elevated blood pressure and pulse pressure might be one of the effective precautions for the prevention of carotid plaque development.
ABSTRACT
Objective@#This study aimed to assess the association between hypertension and carotid plaque in a research population in China.@*Methods@#The subjects of this study were selected from a population undergoing physical examination at the Fourth Medical Center of PLA General Hospital in 2017. We collected information on physical examination, physiological index test, blood pressure indicators were analyzed according as continuous variables (systolic blood pressure, diastolic blood pressure, and pulse pressure) and categorical variables (hypertension and quartile of blood pressure pulse pressure). A multivariate logistic regression model was conducted to estimate the correlation between blood pressure and carotid plaque development.@*Results@#A total of 716 individuals were surveyed, including 321 men (44.8%) and 395 women (55.2%), and the prevalence of hypertension and carotid plaque were 40.9%(293 cases) and 40.4% (289 cases), respectively. The prevalence of carotid plaque was higher in individuals aged ≥60 years, diabetes mellitus, hypertension and increased waist circumference, systolic blood pressure, fasting blood glucose and glycosylated hemoglobin. The prevalence of carotid plaque increased with the increase of the quartile of blood pressure and pulse pressure (Ptrend<0.05). After adjustment for age, sex, BMI, waist circumference, and total cholesterol, triglyceride, fasting blood glucose, glycosylated hemoglobin, and hemoglobin levels, every 1 mmHg increased systolic blood pressure increases the risk of carotid plaque by 1.4% (95%CI: 1.005-1.024). Compared with the control group, the risk of carotid plaque increased by 86.8% (95%CI: 1.175-2.946) and 84.8% (95%CI: 1.098-3.110) and 119.6% (95%CI: 1.165-4.142) in the group of normal high blood pressure, grade 1 hypertension and grade 2 and grade 3 hypertension, respectively; compared with the control group, the risk of carotid plaque increased by 56.2% in the group of pulse pressure difference≥60 mmHg (95%CI: 1.049-2.326), in which the risk of carotid plaque increased by 73.3% (95%CI: 1.007-2.983) in women with pulse pressure difference≥60 mmHg (1 mmHg=0.133 kPa); in the control group with pulse pressure difference of four categories Q1 (<42 mmHg), the risk of carotid plaque increased by 92.2% (95%CI: 1.173-3.149) and 95.0% (95%CI: 1.147-3.316) in Q3 (50-61 mmHg) and Q4 (≥62 mmHg), respectively.@*Conclusion@#Increased blood pressure or pulse pressure are associated with increased prevalence of carotid plaque. Prevention of elevated blood pressure and pulse pressure might be one of the effective precautions for the prevention of carotid plaque development.
ABSTRACT
Objective@#To assess the association and intensity of baseline dyslipidemia with the incidence of carotid plaque in a researchers group in China.@*Methods@#A total of 716 researchers were enrolled in this prospective cohort study. Dyslipidemia was assessed in 2010. Follow-up study on carotid plaque was conducted in 2017.@*Results@#Over 8 years’ follow-up, 289 carotid plaque patients were identified among 716 individuals who did not have carotid plaque at baseline survey, with cumulative incidence of 40.36%. After adjustment of age, gender, BMI, waist circumference, FPG, SBP, DBP, ALT and uric acid, compared with non-dyslipidemia group, HR of carotid plaque for such populations with ≥3 types of dyslipidemia was 1.681 (95%CI: 1.090--2.593).@*Conclusions@#Dyslipidemia might be associated with higher risk of carotid plaque, and population with ≥3 types of dyslipidemia had higher risk for carotid plaque. Prevention of dyslipidemia or reduction of types of dyslipidemia might be one of the effective precautions for prevention of carotid plaque.
ABSTRACT
Objective@#To investigate blood pressure level, hypertension prevalence and control status in the oldest old in China.@*Methods@#A cross-sectional data set of Chinese Longitudinal and Health Longevity Study (CLHLS) in 2014 was used to investigate the blood pressure level and hypertension prevalence and control status in the oldest old.@*Results@#A total of 4 587 elderly people aged ≥80 years were surveyed with mean age (91.3±7.8) years old, including 1 896 males (41.3%). The mean SBP was (139.5±22.0) mmHg, DBP was (79.6±11.8) mmHg, and the pulse pressure difference was (60.0±18.7) mmHg. The prevalence rate of hypertension was 56.5% (95%CI: 55.1%- 58.0%), the awareness rate of hypertension was 52.2% (95%CI: 50.3%-54.1%), the control rate was 11.5% (95%CI: 10.3%-12.5%), and the control rate of those with awareness of hypertension was 22.2% (95%CI: 19.9%-24.4%). Age, gender, BMI, residence place and living area were related to blood pressure level and control status of the oldest old.@*Conclusions@#The blood pressure level and the prevalence of hypertension in the oldest old in China were different from those in developing countries and adults in China, while similar to that in the younger elderly in China. The prevalence rate of hypertension was high and the control rate was low. Age, gender, BMI, residence place and living area were related with blood pressure level, hypertension prevalence and control status.
ABSTRACT
Objective To evaluate the activities of daily living (ADL) and related factors in community elderly people in urban and rural areas of Beijing.Methods A population-based cross-sectional study was conducted in Haidian and Miyun districts of Beijing using two-stage random cluster sampling method between 2011 and 2014.Results A total of 4 499 community elderly people (1 815 males,2 684 females) aged 60-95 years were included in the study.The mean age was (70.3 ±6.7) years.Compared with the participants from urban area,the participants from rural area had lower education level (85.2％ had education level primary school),but higher level of smoking (22.8％) and drinking (43.1％).The ADL disability rate was higher in rural area than in urban area (12.4％ vs.11.8％,P=0.039).And it increased significantly with age (P＜0.05).Multivariate logistic regression showed besides urban-rural difference (P=0.031),age (P=0.013),education level (P=0.015),physical activity (P=0.001) and stroke (P＜0.001) were related factors influencing ADL disability.Conclusions The ADL disability was relatively low in the community elderly people in Beijing,and there was significant difference between rural area and urban area.Older age,lower education level and physical inactivity and stroke were related factors.
ABSTRACT
Objective To evaluate the activities of daily living (ADL) and related factors in community elderly people in urban and rural areas of Beijing.Methods A population-based cross-sectional study was conducted in Haidian and Miyun districts of Beijing using two-stage random cluster sampling method between 2011 and 2014.Results A total of 4 499 community elderly people (1 815 males,2 684 females) aged 60-95 years were included in the study.The mean age was (70.3 ±6.7) years.Compared with the participants from urban area,the participants from rural area had lower education level (85.2％ had education level primary school),but higher level of smoking (22.8％) and drinking (43.1％).The ADL disability rate was higher in rural area than in urban area (12.4％ vs.11.8％,P=0.039).And it increased significantly with age (P＜0.05).Multivariate logistic regression showed besides urban-rural difference (P=0.031),age (P=0.013),education level (P=0.015),physical activity (P=0.001) and stroke (P＜0.001) were related factors influencing ADL disability.Conclusions The ADL disability was relatively low in the community elderly people in Beijing,and there was significant difference between rural area and urban area.Older age,lower education level and physical inactivity and stroke were related factors.
ABSTRACT
Objective To analyze the epidemiological characteristic of New Delhi metallo-β-lactamase (NDM)-1-positive bacteria in China and explore its mechanism of drug-resistance.Methods The published papers from 2010 to 2015 about domestic blaNDM-1 were collected and analyzed according to the bacteria species,regional distribution,NDM-1-positive bacteria,infectious source,drug-resistance spectra and transfer mechanism.Results NDM-1-positive bacteria were isola-ted from 25 provinces (municipalities)in China,Guangdong Province was predominant and accounted for 39.49%(P <0.05).The number of Klebsiella pneumoniae and Enterobacter cloacae were predominant in the NDM-1-positive bacteria (P <0.05).Number of patients under the age of ten and among 60 -80 years which infected by NDM-1-positive bacteria were predominant of all the reported patients(P <0.05).The most kinds of samples and diseases were sputum sample (P <0.05)and pulmonary diseases(P <0.05).NDM-1-positive bacteria which found in China had the lowest resistance to amikacin and tigecycline accounted for 7.69% and 2.33%(P <0.05).Conclusion Antibiotic resistant bacteria with NDM-1 resistant gene have become a global public health problem,and significant difference among age,districts and sources,which need active surveillance and more studies to find how it happens and epidemic in the future.