Probability of premature mortality due to four chronic diseases in Jiangmen City from 2012 to 2021 / 预防医学

Objective@#To investigate the mortality of malignant tumors, diabetes, cardio-cerebrovascular diseases and chronic respiratory diseases and trends in probability of premature mortality due to these four chronic diseases in Jiangmen City, Guangdong Province from 2012 to 2021, so as to provide the evidence for perfecting the chronic disease control strategy. @*Methods@#The mortality of malignant tumors, diabetes, cardio-cerebrovascular diseases and chronic respiratory diseases among household registered residents in Jiangmen City from 2012 to 2021 were collected from the Guangdong Provincial Population Death Information Registration Management System, and the crude mortality, standardized mortality by the population of the Fifth National Population Census in China in 2000 and probability of premature mortality were calculated. The trends in mortality and probability of premature mortality were analyzed using average annual percent change (AAPC), and whether achieving the targets for the probability of premature mortality due to four chronic diseases in 2025 and 2030 were evaluated.@*Results@#A total of 226 012 deaths occurred due to four chronic diseases in Jiangmen City from 2012 to 2021, and the overall crude mortality and standardized mortality rates were 569.22/105 and 283.29/105, with a reduction in the probability of premature mortality from 15.04% to 12.05% (AAPC=-2.403%, Z=-7.603, P<0.001). The probability of premature mortality due to four chronic diseases decreased from 19.21% to 16.38% in males, and from 10.42% to 7.58% in females (AAPC=-1.893% and -3.085%, Z=-5.262 and -9.811, both P<0.001). The probability of premature mortality due to diabetes appeared a tendency towards a rise (AAPC=2.317%, Z=2.548, P=0.034), and the probability of premature mortality due to cardio-cerebrovascular diseases showed a tendency towards a decline (AAPC=-4.826%, Z=-13.590, P<0.001), while no significant changing trend was seen in the probability of premature mortality due to malignant tumors or chronic respiratory diseases (AAPC=-0.751% and -2.461%, Z=-1.532 and -1.730, P=0.125 and 0.122). The predicted probability of premature mortality due to four chronic diseases was 10.92% in 2025 and 9.66% in 2030 in Jiangmen City, which were both lower than the target (11.21% and 9.81%). @*Conclusions@#The probability of premature mortality due to four chronic diseases appeared a tendency towards a decline in Jiangmen City from 2012 to 2021, which can reach the target in 2025 and 2030. Males should be given a high priority for interventions of chronic diseases, and diabetes control should be reinforced.

Comparison of risk-assessment tools for cardio-cerebrovascular diseases (CVD) in male shipyard workers: a cross-sectional study

BACKGROUND: Periodic revision of assessment tools is essential to ensure risk assessment reliability and validity. Despite the recent revision of the Korea Occupational Safety and Health Agency (KOSHA) 2018, there is no evidence showing that the revision is superior to other cardio-cerebrovascular diseases (CVDs) risk-assessment tools for workplace health management. We conducted a comparative analysis using the Framingham risk score (FRS) as a gold standard to identify the most relevant CVDs risk-assessment tool for workplace health management. METHODS: We included 4,460 shipyard workers who had undergone a workers' health examination during January–December 2016. Risk levels for CVDs were calculated based on the FRS, KOSHA 2013, KOSHA 2017, KOSHA 2018 (2 methods), National Health Screening Program health risk appraisal (NHS HRA) 2017, and NHS HRA 2018. Study participants were categorized into low-risk, moderate-risk, or high-risk groups. Sensitivity, specificity, correlation, and agreement of each risk-assessment tool were calculated compared with the FRS as a gold standard. For statistical analyses, Spearman's rank correlation coefficient and the linearly weighted kappa coefficient were calculated. RESULTS: Sensitivity of the risk assessments was highest in the KOSHA 2018 (health risk appraisal [HRA]). The FRS showed correlation coefficients of 0.354 with the KOSHA 2013, 0.396 with the KOSHA 2017, 0.386 with the KOSHA 2018, 0.505 with the KOSHA 2018 (HRA), 0.288 with the NHS HRA 2017, and 0.622 with the NHS HRA 2018. Kappa values, calculated to examine the agreement in relation to the KOSHA 2013, KOSHA 2017, KOSHA 2018, KOSHA 2018 (HRA), NHS HRA 2017, and NHS HRA 2018 with the FRS, were 0.268, 0.322, 0.352, 0.136, 0.221, and 0.559, respectively. CONCLUSIONS: The NHS HRA 2018 risk calculation method is a useful risk-assessment tool for CVDs, but only when appropriate classification criteria are applied. In order to enhance the risk-group identification capability of the KOSHA guideline, we propose to apply the classification criteria set in this study based on the risk group definition of the 2018 Korean Society of Hypertension guidelines for the management of hypertension instead of the current classification criteria of the KOSHA 2018.

Correlation between ApoE gene polymorphism and cardio-cerebrovascular diseases / 实用医学杂志

Objective To investigate the correlation between apolipoprotein E gene polymorphism and car-dio-cerebrovascular diseases. Methods Gene chip method was used to determine ApoE genotypes in 1427 pa-tients with cardiovascular disease and 450 health controls. Levels of serum lipid were compared. Results The highest genotype frequency of ApoE was ε3/3 in the patient group and control group. The allele frequency of ApoE from high to low wasε3,ε2 andε4. The genotype ofε3/3 in patient group was significantly lower than that in con-trol group(χ2 = 12.562,P 0.05). The level of TCH and LDL-c significantly decreased in patients with E2 genotype,and increased in patients with genotype E4(P 0.05). Positive relationship was found between ApoE geno-type and phenotype of ApoE and LDL-c. Conclusions ApoE gene polymorphism plays an important role in the oc-currence and development of cardio-cerebrovascular diseases.

New strategy for cardio-cerebrovascular diseases: baroreflex activation therapy / 药学实践杂志

The incident number and death toll of cardio-cerebrovascular diseases increase continuously in China.The impairment of arterial baroreflex (ABR) is closely related to the genesis and development of cardio-cerebrovascular diseases (such as hypertension and chronic heart failure).Barostim neoTM (by American CRVx.Inc) can reduce blood pressure and heart rate by electrically stimulating carotid sinus baroreceptors and activating baroreflex.Therefore, it can be used to treat resistant hypertension, heart failure and end-stage renal disease, etc.The mechanism of baroreflex activation therapy (BAT) includes inhibiting sympathetic nervous system and rennin-angiotensin system, and increasing the activity of vagus nerve.Thus it improves baroreflex sensitivity and heart rate variability, and restores the structure and function of key organs.

A nested case-control study in studying the relationship between interleukin-6,endothelin-1, E-selectin and the risk of cardio-cerebrovascular events / 中华流行病学杂志

Objective To investigate the relationship between interleukin-6(IL-6),endothelin-1 (ET-1),E-selectin and the risk of cardio-cerebrovascular events. Methods Based on a cohort study in which 2 589 Mongolians had been followed up for 10 years,a nested case-control study was carried out to analyze the relationship between IL-6, ET-1, E-selectin and the risk of cardio-cerebrovascular events. Logistic regression analysis was used to calculate the odds ratio(OR) and 95%confidence intervals(95%CI). Results The average level of IL-6(7.66 vs. 8.77 pg/ml), ET-1(0.74 vs. 0.75 pg/ml) and E-selectin (17.96 vs. 18.32 ng/ml) were not significantly different between the case and the control groups(P>0.05). Data from the logistic regression analysis showed that IL-6,ET-1 and E-selectin were not significantly associated with the risk of cardio-cerebrovascular events. The multivariable adjusted ORs(95%CI)on the risk of cardio-cerebrovascular events were 0.69 (0.41-1.16),1.10 (0.66-1.85) and 1.19(0.71-2.00) for the participants with IL-6>23.91 pg/ml ,ET-1>1.33 pg/ml and E-selectin>24.43 ng/ml,respectively,compared with those having IL-6≤23.91 pg/ml ,ET-1≤1.33 pg/ml or E-selectin≤24.43 ng/ml. Conclusion Data from our study indicated that the levels of IL-6,ET-1 and E-selectin at baseline were not significantly associated with the risk of cardio-cerebrovascular events in people from Inner Mongolia.

A nested case-control study in studying the relationship between interleukin-6,endothelin-1, E-selectin and the risk of cardio-cerebrovascular events / 中华流行病学杂志

Objective To investigate the relationship between interleukin-6(IL-6),endothelin-1 (ET-1),E-selectin and the risk of cardio-cerebrovascular events. Methods Based on a cohort study in which 2 589 Mongolians had been followed up for 10 years,a nested case-control study was carried out to analyze the relationship between IL-6, ET-1, E-selectin and the risk of cardio-cerebrovascular events. Logistic regression analysis was used to calculate the odds ratio(OR) and 95%confidence intervals(95%CI). Results The average level of IL-6(7.66 vs. 8.77 pg/ml), ET-1(0.74 vs. 0.75 pg/ml) and E-selectin (17.96 vs. 18.32 ng/ml) were not significantly different between the case and the control groups(P>0.05). Data from the logistic regression analysis showed that IL-6,ET-1 and E-selectin were not significantly associated with the risk of cardio-cerebrovascular events. The multivariable adjusted ORs(95%CI)on the risk of cardio-cerebrovascular events were 0.69 (0.41-1.16),1.10 (0.66-1.85) and 1.19(0.71-2.00) for the participants with IL-6>23.91 pg/ml ,ET-1>1.33 pg/ml and E-selectin>24.43 ng/ml,respectively,compared with those having IL-6≤23.91 pg/ml ,ET-1≤1.33 pg/ml or E-selectin≤24.43 ng/ml. Conclusion Data from our study indicated that the levels of IL-6,ET-1 and E-selectin at baseline were not significantly associated with the risk of cardio-cerebrovascular events in people from Inner Mongolia.

Aspirin Usage Based on Evidence for the Prevention of Cardio-Cerebrovascular Disease / 가정의학회지

Aspirin is well known for its central role in preventing cardio cerebrovascular diseases as an antiplatelet agent. However besides its favorable effects, one must also be fully aware of its side effects such as gastrointestinal complications or cerebral hemorrhage. Particularly when prescribing to Koreans, one must be highly cautious, considering the higher prevalence of helicobacter pylori infection and the contribution of hemorrhagic stroke as a major part of cerebral disease in Korean. Currently the guideline for secondary prevention of cardio cerebrovascular diseases is relatively well established, while the consensus for primary prevention is still controversial. The purpose of this paper would be to summarize the evidence of aspirin usage in preventing cardio cerebrovascular diseases, examine the additional factors one must consider, and help primary physician prescribing aspirin appropriately.

Discussion on imbalance of qi and blood as basic pathogenesis of cardio-cerebrovascular diseases / 中华中医药杂志

The physical functions of the heart and brain is based on the sufficiency,fluency and balance of qi and blood. Therefore,the basic pathogenesis of cardio-cerebrovascular diseases should be imbalance of qi and blood. Any causative agent is bound to influence the harmony of qi and blood once it attacks the heart and brain,its evolving laws are qi stagnancy and blood stasis at early stage,subsequent cementation of phlegm and blood stasis,and more qi deficiency and more blood stasis in the end. Regulating qi and activating blood circulation may harmonize qi and blood,balance yin and yang,which should be served as the basic therapeutic method for treating cardio-cerebrovascular diseases.