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Objective@#To investigate the impact of change of ideal cardiovascular behavior and related factors on healthy vascular aging(HVA).@*Methods@#This study was a multi-center cross-sectional survey. Six thousand three hundred and sixteen participants who underwent at least 2 healthy examinations from 2006 to 2015 at 11 hospitals, including Kailuan Hospital and so on, and examined brachial-ankle pulse wave velocity (baPWV) during 2010 and 2016, with available information about cardiovascular behavior and factors were included. The cardiovascular health score (CHS) was calculated. Basic CHS was collected from the first examination. The second CHS derived from the healthy examination in the same year of baPWV examination. Change of cardiovascular health score (ΔCHS) was calculated. Participants were defined into 5 groups according to ΔCHS, namely ΔCHS≤-2 (n=2 166), ΔCHS=-1 (n=1 284), ΔCHS=0 (n=1 187), ΔCHS=1 (n=860), and ΔCHS≥2 (n=819). Participants′ characteristics, value of baPWV and proportion of HVA were compared among different groups. Multiple logistic regression analysis was used to investigate the association between ΔCHS and HVA. The ΔCHS was recalculated and included in multiple logistic regression analysis model again after each component of the cardiovascular health metrics was removed separately in order to investigate effects of removal factors on HVA by observing changes in effect values.@*Results@#The percentage of the participants with HVA in the group of ΔCHS≤-2, ΔCHS=-1, ΔCHS=0, ΔCHS=1 and ΔCHS≥2 were 23.3%(505/2 166), 27.8%(357/1 284), 28.7%(341/1 187),31.9%(274/860) and 33.9%(278/819), respectively. After adjustment for age, sex, income, education, alcohol consumption and the basic CHS, a significant positive association between ΔCHS and proportion of participants with HVA was observed (OR=1.50, 95%CI 1.44-1.56). Multiple regression analysis after removing each single cardiovascular behavior or factor showed that the OR value decreased as follow systolic blood pressure (OR=1.04, 95%CI 1.00-1.09), fasting blood glucose (OR=1.14, 95%CI 1.09-1.18), physical exercise (OR=1.16, 95%CI 1.11-1.21), salt intake (OR=1.17, 95%CI 1.12-1.22), body mass index (OR=1.18, 95%CI 1.13-1.23), smoking(OR=1.18, 95%CI 1.13-1.23) and total cholesterol (OR=1.20, 95%CI 1.16-1.24).@*Conclusion@#The improvement of every ideal cardiovascular behavior and factor is associated with the increase of the proportion of HVA population.
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Objective: To explore the relationship between longitudinal trajectory of systolic blood pressure (SPB) and atrial fibrillation (AF) in Kailuan group population. Methods: Our study cohort consisted of 40727 participants with the specific criteria in Kailuan group, Tangshan. SAS Proc Traj procedure was used to identify longitudinal trajectories of SPB throughout 2006-2007, 2008-2009 and 2010-2011. There were 5 longitudinal trajectories generated: Low-stable group,n=10950, Moderate-stable group, n=19158, Moderate-high stable group,n=3713, High-moderate stable group,n=4702 and High stable group,n=2181. Log-rank test was performed to compare AF incidence throughout 2012-2013 and 2014-2015 by physical examination among different groups; Multi Cox regression analysis was conducted to study the relationship among different SBP longitudinal trajectories and AF occurrence. Results:①The mean age of participants was (51.81±11.54) years including 30693 (75.4%) male.②AF occurrence rates in Low-stable, Moderate-stable, Moderate-high stable, High-moderate stable and High stable groups were 0.1%, 0.2%, 0.5%, 0.5% and 0.6% respectively, allP<0.05.③Multi Cox regression analysis presented that with adjusted confounding factors, compared with the patients in Low-stable group, Moderate-high stable, High-moderate stable and High stable SBP longitudinal trajectories were the risk factors for new AF occurrence (HR=7.58, 95% CI 2.08-27.73), (HR=5.30, 95% CI 1.88-14.95) and (HR=8.52, 95% CI 1.96-37.09) respectively, allP<0.05. With excluded history of myocardial infarction/stroke, the sensitivity study showed the similar result with the major research trend. Conclusion: Elevated long trajectory of SPB was the risk factor for new AF occurrence in Kailuan group population.
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Objective: To explore the predictive value of inlfammatory factors on all cause mortality in normal population. Methods: In our prospective cohort study, a total of 83,228 subjects from physical examination of Kailuan group from 2006-07 to 2007-10 were enrolled, nobody had acute inlfammation. The death information was collected once per year and the last follow-up was conducted in 2013-12-31. According to baseline levels, white blood cells (WBC), ratio of neutrophil/lymphocyte ratio (N/L) and C-reactive protein (CRP) were respectively divided into 4 Quartile groups; all cause mortality was compared among different groups and their risks were studied by multi-Cox regression analysis. Results: The average follow-up time was 6.9 years. All cause mortality in Quartile 1, Quartile 2, Quartile 3 and Quartile 4 groups for WBC were 4.2%, 4.5%, 4.5% and 5.0% respectively; for N/L were 3.3%, 3.6%, 4.5% and 6.7% respectively; for CRP were 3.0%, 3.6%, 4.8% and 6.8% respectively. Multi-Cox regression analysis indicated that with adjusted age, gender, waist and other confounders, by elevation of WBC, N/R and CRP, the risks of all cause mortality were increased accordingly, and the risks in Quartile 4 groups were higher than those in Quartile 1 groups as for WBC, it was 1.17-time (95% CI 1.06-1.29);for N/L, it was 1.44-time (95% CI 1.31-1.59); for CRP, it was 1.33-time (95% CI 1.20-1.47) respectively. Conclusion: Elevated WBC, N/R and CRP are independent risk factors for all cause mortality in normal population.
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Objective: To investigate the relationship between long-, short-term systolic blood pressure variability (SBPV) and renal damage in elder population. Methods: Our research was conducted in the 3rd physical examination of healthy population from Kailuan group by cohort study. Cluster sampling was used by 25% ratio in subjects≥60 years of age to monitor their 24-hour ambulatory blood pressure and finally, 2464/3064 participants with inclusion criteria were recruited. SBPV indexes as standard deviation of systolic blood pressure (SSD), variability independent of the mean (VIM), maximum-minimum difference (MMD) and average real variability (ARV) were examined; renal damage indexes as estimated glomerular filtration rate (eGFR) and microalbuminuria (ALBU) were detected. Relationships between different long-term, short-term SBPV indexes and eGFR, ALBU were studied by multi-liner regression analysis. Results:①The mean age of 2464 participants was (67.41 ± 6.05) years including 1667 (67.7%) male and 797 (32.3%) female.②Multi-liner regression analysis indicated that different long-term SBPV indexes were not related to eGFR and ALBU; 24h SBPV in all 4 indexes and day-time SSD, MMD, ARV were negatively related to eGFR; 24h ARV and day-time MMD, ARV were positively related to ALBU; night-time SBPV indexes were not related to eGFR and ALBU.Conclusion: Different short-term SBPV indexes were, at certain point related to eGFR and ALBU
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Objective: To investigate the changes of cardiovascular health indicator and arteriosclerosis in middle and elder population. Methods: A total of 4190 subjects with the average age of (49.78 ± 9.74) years by 3 physical examinations in Kailuan group from 2006 to 2011 were randomly stratiifed for arm ankle arterial pulse wave velocity (baPWV) examination. According to 7 AHA cardiovascular health indicators of non-smoking, normal BMI, active excise, healthy diet, normal cholesterol, blood pressure and fasting blood glucose, each indicator had 3 conditions as ideal, general and poor by scores of 2, 1 and 0 respectively. Based on the 1st and 3rd physical examinations, the changes of cardiovascular health scores (△CHS), the subjects were divided into 8 groups as△CHS≤-4,-3,-2,-1, 0, 1, 2 and△CHS≥3, n=241, 368, 611, 855, 911, 647, 354 and 203 respectively. The impacts of△CHS on baPWV values were studied by liner and Logistic regression analyses. Results: As△CHS increased by △CHS ≤ -4, -3,-2,-1,0,1, 2 and△CHS ≥ 3, the baPWV values were decreased accordingly by cm/s as (1590.78 ± 17.93), (1566.4 ± 14.5), (1552.83 ± 11.25), (1536.59 ± 9.51), (1508.85 ± 9.21), (1499.81 ± 10.93), (1485.92 ± 14.82) and (1475.85 ± 19.57) respectively. Multiple linear regression analysis showed that with adjusted confounding factors, as△CHS increasing 1 score, baPWV increasing 15.58 cm/s (B=15.58, P Conclusion: △CHS was negatively related to baPWV in middle and elder subjects, improving cardiovascular health indicator may decrease arteriosclerosis occurrence.
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Objective To explore the effect of the joint edaravone in early rehabilitation on the prognosis of patients with ischemic stroke.Methods The general branch of Kailuan group of patients with ischemic stroke who were conformed to the 1995 national conference on the 4th cerebrovascular diagnostic criteria with head CT or MRI imaging diagnosis,were collected from January 2012 to December 2014.A total of 324 cases were the first onset,who had been treated with conventional drugs,and were randomly divided into the observation group(edaravone associated with early rehabilitation)and the control group(early rehabilitation)with 162 cases in each group.Patients of the observation group were given venous application of edaravone and received the standardized rehabilitation treatment within 48 hours.The control group were given standard rebabilitation therapy at 2 weeks after attacked.NIHSS and MMSE scores of the two groups of patients were evaluated at the beginning of the rehabilitation course,4 weeks and 12 weeks of the treatments.Results There were no statistically significant difference and the clinial manifestations of the lesion site between the two groups of patients on admission.At the beginning of the rehabilitation,the NIHSS and MMSE score of control group were statistically significant different from that of observation group [NIHSS:(14.8 ±5.3)vs.(16.1 ±5.1),PNIHSS =0.049;MMSE:(15.9 ±6.3)vs.(14.2 ±6.2),PMMSE =0.041].The sec-ond and third evaluation were respectively conducted at 4 weeks[NIHSS:(10.1 ±6.3)vs.(8.2 ±5.7),MMSE:(17.7 ±5.5)vs.(20.9 ±5.9)]and 12 weeks[NIHSS:(6.6 ±4.9)vs.(4.7 ±3.6),MMSE:(21.0 ±4.8)vs. (24.6 ±4.9)].The results of the observation group were significantly better than the control group(P4W NIHSS =0.036,P4W MMSE =0.035;P12W NIHSS =0.006,P12W MMSE =0.003),and the differences were statistically significant. Conclusion Edaravone associated with early rehabilitation can obviously improve the prognosis of patients with ischemic stroke.
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OBJECTIVE:To observe the clinical efficacy and safety of edaravone combined with early rehabilitation in the treat-ment of cerebral hemorrhage,and to provide clinical evidence for rehabilitation management and drug treatment of cerebral hemor-rhage patients. METHODS:168 patients with cerebral hemorrhage,collected from neurology department of our hospital during Jan. 2012 to Dec. 2014,were randomly divided into observation group and control group with 84 cases in each group. Both groups re-ceived routine treatment;observation group was additionally given edaravone intravenously on the basis of routine treatment,and be-gan to receive standardized rehabilitation treatment within 48 hours after the onset of symptom;control group began to receive stan-dardized rehabilitation treatment 2 weeks after the onset of symptom. NIHSS and MMSE score of 2 groups were conducted before re-habilitation treatment,and after 4 and 12 weeks of treatment. RESULTS:There was no statistically significant difference in lesion site and clinical manifestations between 2 groups on admission(P>0.05);both NIHSS and MMSE score of observation group were better than those of control group after 4 and 12 weeks of treatment,there was statistical significance(P<0.05). CONCLUSIONS:Edaravone associated with early rehabilitation can obviously improve the prognosis of patients with cerebral hemorrhage.