ABSTRACT
Recent changes in American and European guidelines on the management of arterial hypertension have caused a considerable shift in the landscape of hypertension management. The 2017 American College of Cardiology/American Heart Association/American Society of Hypertension guideline recommends an office visit blood pressure (BP) > 130/80 mmHg as the new threshold for diagnosis of hypertension, and states that the treatment goal for all hypertensive patients should be lowered to < 130/80 mmHg. In contrast, the 2018 European guideline maintains the diagnostic threshold of hypertension at 140/90 mmHg. However, despite their differences in thresholds for diagnosis of hypertension, both guidelines are in agreement that treatment should be considered in patients with BPs in the range of 130 to 139/80 to 89 mmHg if they have high cardiovascular risk. The results from the Systolic Blood Pressure Intervention Trial (SPRINT) study and recent meta-analyses suggest that BP lowering with antihypertensive treatment may be beneficial in reducing cardiovascular event rates in subjects with high-normal BP or stage 1 hypertension according to the new American guideline. However, intensive BP lowering is associated with increased incidence of treatment-associated adverse events, and evidence suggests that BP lowering below 120/70 mmHg increases the risk of cardiovascular events. In this review, we discuss the evidence supporting antihypertensive treatment in subjects with high-normal BP and discuss the specific subgroup of subjects that might benefit from BP lowering.
Subject(s)
Humans , Blood Pressure , Cardiovascular Diseases , Diagnosis , Heart , Hypertension , Incidence , Office Visits , Risk AssessmentABSTRACT
Objective To analyze the status and its factors associated with HIV/AIDS“90-90-90”-treatment-target in Shandong province,China.Methods Data regarding testing,treatment on HIV/AIDS in Shandong province by December 31,2015 was collected.Chi-square test and logistic regression model were used to analyze related factors associated with the “90-90-90”-treatment-target.Results Of the 11 700 estimated HIV/AIDS,61.2％ were diagnosed,of whom 74.4％ had received Highly active antiretroviral therapy (HAART).More than 80％ of the HIV/AIDS on HAART reached the criteria on viral suppression.HIV/AIDS infected by homosexual contacts were less likely to seek for diagnosis (P＜0.05).HIV/AIDS lived in Qingdao city (OR=1.30,95％CI:1.05-1.60),Yantai city (OR=1.53,95％CI:1.02-2.31) and Weihai city (OR=1.96,95％CI:1.07-3.58) were more likely to receive HAART.HIV/AIDS patients that infected through homosexual or (OR=O.12,95％CI:0.06-0.24) or heterosexual contacts (OR =0.13,95 ％CI:0.07-0.26),through injecting drug use (OR =0.08,95％CI:0.03-0.17) or being diagnosed at the custodial institutions (OR=0.29,95％CI:0.21-0.41)were less likely to receive HAART.HIV/AIDS patients who received HAART at medical institutions (OR=1.81,95％ CI:1.05-3.47) were more likely to meet the level of Viral load (VL) suppression.However,those who were infected through homosexual (OR=0.43,95％ CI:0.25-0.75) or heterosexual contacts (OR =0.49,95％CI:0.28-0.81) or diagnosed at the custodial institutions (OR =0.48,95％CI:0.28-0.80) were less likely to meet the criteria set for VL suppression.Conclusions There was a gap between the status of testing/treatment and the target on HIV/AID “90-90-90”-treatment,especially on the target set for testing,in Shandong Province.Both HIV testing and comprehensive care services need to be strengthened.
ABSTRACT
Objective To analyze the status and its factors associated with HIV/AIDS“90-90-90”-treatment-target in Shandong province,China.Methods Data regarding testing,treatment on HIV/AIDS in Shandong province by December 31,2015 was collected.Chi-square test and logistic regression model were used to analyze related factors associated with the “90-90-90”-treatment-target.Results Of the 11 700 estimated HIV/AIDS,61.2％ were diagnosed,of whom 74.4％ had received Highly active antiretroviral therapy (HAART).More than 80％ of the HIV/AIDS on HAART reached the criteria on viral suppression.HIV/AIDS infected by homosexual contacts were less likely to seek for diagnosis (P＜0.05).HIV/AIDS lived in Qingdao city (OR=1.30,95％CI:1.05-1.60),Yantai city (OR=1.53,95％CI:1.02-2.31) and Weihai city (OR=1.96,95％CI:1.07-3.58) were more likely to receive HAART.HIV/AIDS patients that infected through homosexual or (OR=O.12,95％CI:0.06-0.24) or heterosexual contacts (OR =0.13,95 ％CI:0.07-0.26),through injecting drug use (OR =0.08,95％CI:0.03-0.17) or being diagnosed at the custodial institutions (OR=0.29,95％CI:0.21-0.41)were less likely to receive HAART.HIV/AIDS patients who received HAART at medical institutions (OR=1.81,95％ CI:1.05-3.47) were more likely to meet the level of Viral load (VL) suppression.However,those who were infected through homosexual (OR=0.43,95％ CI:0.25-0.75) or heterosexual contacts (OR =0.49,95％CI:0.28-0.81) or diagnosed at the custodial institutions (OR =0.48,95％CI:0.28-0.80) were less likely to meet the criteria set for VL suppression.Conclusions There was a gap between the status of testing/treatment and the target on HIV/AID “90-90-90”-treatment,especially on the target set for testing,in Shandong Province.Both HIV testing and comprehensive care services need to be strengthened.
ABSTRACT
S100A4, a member of S100 superfamily of Ca~(2+)-binding proteins, is a polypeptide containing 101 amino acids. S100A4, which is overexpressed in most tumor cells, plays pivotal roles in growth, invasion and migration of tumor by regulating cell cycle progression, differentiation, apoptosis, invasion and metastasis of cells. This article reviews S100A4′s structure, function and potential application as the new target in the therapy of tumors.