Association between very low density lipoprotein cholesterol and cholesterol absorption/synthesis markers in patients with moderate and high risk of coronary heart disease / 中华心血管病杂志

<p><b>OBJECTIVE</b>To evaluate the association between very low density lipoprotein cholesterol (VLDL-C) and cholesterol absorption and synthesis markers in patients with moderate and high risk of coronary heart disease.</p><p><b>METHODS</b>A total 363 statin-naïve patients with moderate and high risk of coronary heart disease were consecutively recruited from two hospitals in Shanxi and Henan provinces between October 2008 and June 2009. A standard questionnaire and physical examination were performed at baseline. Atorvastatin (20 mg/day) was administered to patients for 4 weeks. Venous blood samples after an overnight fast were collected before and after treatment for measuring VLDL-C and cholesterol absorption and synthesis markers. In qualitative analyses, the baseline level of cholesterol absorption and synthesis markers and their reduction after atorvastatin treatment were categorized into 3 tertile groups.</p><p><b>RESULTS</b>(1) Of 363 patients, 283 patients with mean age of (55.43±9.01)years old with complete data were finally analyzed. The median level of baseline VLDL-C was 1.06 (0.65, 1.86) mmol/L. The median level of baseline cholesterol absorption marker (Campesterol) and cholesterol synthesis marker (Lathosterol) was 6.01 (3.78, 9.45) mg/L and 13.46 (8.30, 21.07) mg/L, respectively. (2) Partial correlation analysis and multiple regression showed the baseline level of VLDL-C was positively correlated with Campesterol (r=0.153, P<0.05) but not with Lathosterol(r=0.182, P=0.173). Furthermore, baseline VLDL-C level significantly increased with tertile of the baseline level of Campesterol in the qualitative analyses(P for trend=0.035). (3) Mean reduction in VLDL-C levels was 38.0% after 4 weeks atorvastatin treatment. VLDL-C reduction was positively correlated with Campesterol reduction (r=0.331, P<0.001). VLDL-C reduction significantly increased with the tertile of Campesterol reduction (P for trend=0.032). But this trend was not observed between VLDL-C level and Lathosterol (P for trend=0.798).</p><p><b>CONCLUSION</b>The level of VLDL-C was closely related to cholesterol absorption marker, and further studies are needed to validate if inhibitor of cholesterol absorption (for example by Ezetimibe) could bring about more effective VLDL-C lowering effect in this patient cohort.</p>

Relationship between leukocyte count and risk of hypertension / 中华心血管病杂志

<p><b>OBJECTIVE</b>To observe the association between the leukocyte count and blood pressure value and hypertension risk in a Chinese community-based population.</p><p><b>METHODS</b>A total of 4 188 participants who took part in the baseline examination in 1992 and the follow-up survey in 2007 from the Chinese Multi-Provincial Cohort Study were included in this study. The relationship of leukocyte and blood pressure value and hypertension risk were evaluated by cross-sectional analyses.The prospective association between baseline leukocyte count and blood pressure changes and risk of hypertension were analyzed in 2 954 normotensive individuals at baseline examination.The associations between leukocyte count and blood pressure was evaluated with Spearman's rank correlation analyses and linear regression models,and the associations between leukocyte count and risk of hypertension was evaluated with logistic regression models.</p><p><b>RESULTS</b>(1) The cross-sectional study results showed that the correlation coefficient of leukocyte count and systolic blood pressure and diastolic blood pressure was 0.208 and 0.154 (both P < 0.001), respectively.Multiple linear regression analyses showed that every 1×10(9)/L increment in leukocyte count was associated with 1.41 mmHg (1 mmHg = 0.133 kPa) systolic blood pressure increase (95% CI: 1.20-1.63 mmHg, P < 0.001) and 0.63 mmHg diastolic blood pressure increase (95% CI: 0.51-0.76 mmHg, P < 0.001). Multivariable logistic regression analyses showed that every 1×10(9)/L increment in leukocyte count was associated with a 15% increased risk of hypertension (OR: 1.15, 95% CI: 1.12-1.19, P < 0.001). (2) During 15 years of follow-up, 47.2% (1 394/2 954) normotensive individuals progressed to hypertension. Spearman's rank correlation analyses showed that, the correlation coefficient of leukocyte count and systolic blood pressure change and diastolic blood pressure change was 0.062 (P = 0.003) and 0.102 (P < 0.001), respectively.Multiple linear regression analyses showed that every 1×10(9)/L increment in baseline leukocyte count was associated with 1.03 mmHg systolic blood pressure increase (95% CI: 0.74-1.32 mmHg, P < 0.001) and 0.64 mmHg diastolic blood pressure increase (95% CI: 0.48-0.80 mmHg, P < 0.001). Multivariable logistic regression analyses showed that every 1×10(9)/L increment in leukocyte count was associated with a 9% increased risk of incident hypertension (OR: 1.09, 95% CI: 1.06-1.13, P < 0.001).</p><p><b>CONCLUSION</b>Elevated leukocyte count is associated with increased blood pressure value and hypertension among Chinese community-based population, suggesting that inflammation may participate in the pathogenesis of hypertension.</p>

The epidemiology of out-of-hospital deaths due to acute coronary events in young Beijing adults / 中华内科杂志

Objectives To explore the characteristics of status and different populations of prehospital death associated with acute coronary events among young adults in Beijing.Methods Data of acute coronary events of hospitalization or death were obtained from the Hospital Discharge Information System from Beijing Public Health Information Center and Death Register System from Beijing Center for Disease Control in Beijing.The total case fatality rate of acute coronary events and proportion of prehospital coronary heart disease (CHD) death were compared upon gender,area,occupation and marital status among people aged between 25-45 years old.Results A total of 3489 cases were identified during 2007 to 2009 with acute coronary events ( male:3183,female:306),with a mean age of (40.5 ± 4.3 ) years old.The 3-years' overall mortality was 26.0％,with female's higher than male's (51.0％ vs 23.6 ％,P ＜ 0.05 ) ; and it was higher in rural area than in urban areas (28.9％ vs 22.9％,P ＜0.05).Ninety-five percent of death due to acute coronary events occurred prehospital,with the proportion of 95.2％ in male and 94.2％ in female. Among the people with different occupations, self-employed people had the highest rate of prehospital death.Majority of prehospital deaths (64.8％ ) occurred at home.Conclusion More than 90％ of deaths caused by acute coronary events among young adults aged between 25-45 years old occurred before been admitted into hospital,and the site of prehospital deaths was mainly at home.

The epidemiologic study of hypertension in a Beijing urban population aged 60-74 years / 中华老年医学杂志

Objective To study the prevalence of hypertension in a Beijing urban population aged 6074 years and to analyze the characteristics of hypertension distribution. Methods A(cross-sectional) study was carried out in the population consisting of 1175 people,and data of blood pressure,glucose,lipid and obesity were analyzed. Results (1) The age-adjusted prevalence of hypertension was 60.5% in the Beijing elderly population.About two thirds of the hypertensive cases were taking prescribed medication(60.9%).Only one quarter of hypertension was controlled successfully(23.4%).(2)Compared with 60-64 age group,the prevalences of hypertension of 70-74 age group was increased by 30.3% in man and by 32.1% in women.(3) The prevalence of isolated systolic hypertension in the elderly was 25.0%,accounting for 42.3% of hypertension in the elderly population.(4) Eighty-six percent of all elder hypertensive patients had one and more cardiovascular risk factor and more in addition to hypertension itself. Conclusions High blood pressure is a popular disease of cardiovascular disorders in Beijing elderly population.Isolated systolic hypertension is the main hypertension subtype in the elderly.Most of the elderly hypertension patients combine other cardiovascular disease risk factors.

Study on temporal patterns of stroke onset from community-based cohort in Beijing / 中华流行病学杂志

<p><b>OBJECTIVE</b>To Study the temporal patterns of stroke onset, and to provide insights into the triggers which might cause the acute onset of stroke and to develop preventive strategies.</p><p><b>METHODS</b>Using a 10-year period of the SINO-MONICA-Beijing study cohort a total number of 700 000 people, aged 25 to 74 years was recruited. The diagnostic criteria exactly followed the WHO MONICA project. Date of the week, season and month occurrence of stroke were ascertained. Percentage of stroke onset on date in the week, season and month were calculated. chi(2) test was used to identify the deviation from expected frequencies. Multiple stepwise regression was carried out for multivariate analysis.</p><p><b>RESULTS</b>Most stroke occurred and recurred (chi(2) = 7.02, P = 0.008 in male and chi(2) = 12.32, P = 0.000 4 in female) in winter. The most frequent occurrence on the dates of stroke events were Monday in the urbans and Saturday in the rurals. The finding were confirmed (the stroke occurrence and recurrence positively correlated with season, correlation coefficient 0.032, P = 0.01) by correlation and multiple stepwise regression.</p><p><b>CONCLUSION</b>It was important to find out the circadian variation and the external triggering factors together with unhealthy behaviour of life that would contribute to the prevention and reduction of stroke onset.</p>

Trend analyses in the incidence of acute intracerebral hemorrhage events and acute cerebral infarction events in urban areas in Beijing / 中华流行病学杂志

<p><b>OBJECTIVE</b>To study the trends of incidence on acute intracerebral hemorrhage events and acute cerebral infarction events in the population aged 25 - 74 in urban areas of Beijing from 1984 to 1999.</p><p><b>METHODS</b>In monitoring the trends and determinants in the cardiovascular disease (MONICA) project and subsequent study, acute intracerebral hemorrhage events and acute cerebral infarction events were registered in a standardized way in men and women aged 25 to 74 years from 1984 - 1999.</p><p><b>RESULTS</b>Both intracerebral hemorrhage attack rates decreased but cerebral infarction attack rates increased significantly; The proportion of intracerebral hemorrhage events in stroke events decreased from 42.0% to 16.0% while the proportion of cerebral infarction events in stroke events increased from 55.8% to 81.6%, the changes in incidences of acute intracerebral hemorrhage events and acute cerebral infarction events in various age groups were different.</p><p><b>CONCLUSION</b>Cerebral infarction was the most important risk causing stroke, so prevention of cerebral infarction should be strengthened in the area.</p>