Current Trends for ST-segment Elevation Myocardial Infarction during the Past 5 Years in Rural Areas of China's Liaoning Province: A Multicenter Study / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Since 2010, two versions of National Guidelines aimed at promoting the management of ST-segment elevation myocardial infarction (STEMI) have been formulated by the Chinese Society of Cardiology. However, little is known about the changes in clinical characteristics, management, and in-hospital outcomes in rural areas.</p><p><b>METHODS</b>In the present multicenter, cross-sectional study, participants were enrolled from rural hospitals located in Liaoning province in Northeast China, during two different periods (from June 2009 to June 2010 and from January 2015 to December 2015). Data collection was conducted using a standardized questionnaire. In total, 607 and 637 STEMI patients were recruited in the 2010 and 2015 cohorts, respectively.</p><p><b>RESULTS</b>STEMI patients in rural hospitals were older in the second group (63 years vs. 65 years, P = 0.039). We found increases in the prevalence of hypertension, prior percutaneous coronary intervention (PCI), and prior stroke. Over the past 5 years, the cost during hospitalization almost doubled. The proportion of STEMI patients who underwent emergency reperfusion had significantly increased from 42.34% to 54.47% (P < 0.0001). Concurrently, the proportion of primary PCI increased from 3.62% to 10.52% (P < 0.0001). The past 5 years have also seen marked increases in the use of guideline-recommended drugs and clinical examinations. However, in-hospital mortality and major adverse cardiac events did not significantly change over time (13.01% vs. 10.20%, P = 0.121; 13.34% vs. 13.66%, P = 0.872).</p><p><b>CONCLUSIONS</b>Despite the great progress that has been made in guideline-recommended therapies, in-hospital outcomes among rural STEMI patients have not significantly improved. Therefore, there is still substantial room for improvement in the quality of care.</p>

Gender disparity in early death after ST-elevation myocardial infarction / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Females with acute myocardial infarction (AMI) have a higher risk of adverse outcomes because of receiving less evidence-based medical care. Our aim was to investigate the gender disparity in early death after ST-elevation myocardial infarction (STEMI) in the current era.</p><p><b>METHODS</b>A total of 1429 consecutive patients with STEMI in the Liaoning district were analyzed. We compared hospital care and cardiac event data by sex for in-patients with acute STEMI within 24 hours of symptom onset.</p><p><b>RESULTS</b>In the emergency reperfusion group (n = 754), in-hospital mortality occurred in 4.2% of the males and 11.2% of the females (P = 0.001). In the non-emergency reperfusion group (n = 675), in-hospital mortality occurred in 13.0% of the males and 22.9% of the females (P = 0.001). Multivariate Logistic regression analysis revealed female sex as an independent risk factor of death for STEMI patients during hospitalization (OR = 1.691, P = 0.007). After controlling for patients who died within 24 hr after admission, female sex was no longer an independent risk factor (OR = 1.409, P = 0.259).</p><p><b>CONCLUSION</b>Female sex was an independent risk factor for in-hospital mortality of STEMI patients, which is explained by an excess of very early deaths.</p>

Significance of terminal QRS distortion on the electrocardiogram in acute inferior myocardial infarction / 中国医师进修杂志

Objective To investigate whether terminal QRS distortion on the electrocardiogram in acute inferior myocardial infarction could be as a standard for the infarct-related artery,through comparing to coronary angiography.Methods Fifty-seven patients with acute inferior myocardial infarction were enrolled,among which,the right coronary artery (RCA) occlusion (RCA occlusion group) was present in 29 cases,and left circumflex coronary artery (LCX) occlusion (LCX occlusion group) was in 28 cases.The changes of electrocardiogram was analyzed in 12 hours after the acute episode.Results The incidence of terminal QRS distortion in leads Ⅱ,Ⅲ,aVF in RCA occlusion group was 44.8％(13/29) and 39.3％(11/28)in LCX occlusion group,and there was no significant difference (P ＞ 0.05).The incidence of terminal QRS distortion in leads V4R-V5R in RCA occlusion group was 17.2％(5/29) and 7.1％(2/28) in LCX occlusion group,and there was no significant difference (P ＞ 0.05).The incidence of terminal QRS distortion in leads V7-V9 in RCA occlusion group was 6.9％(2/29),which was lower than that in LCX occlusion group[53.6％(15/28)],and there was significant difference (P ＜ 0.05).For identifying LCX as the infarct-related artery of acute inferior myocardial infarction,the sensitivity,specificity,positive and negative value in terminal QRS distortion in leads V7-V9 were 53.6％ (15/28),93.1％ (27/29),88.2％ (15/17),67.5％ (27/40).The area under curve of terminal QRS distortion in leads V7-V9 in identifying LCX as the infarct-related artery of acute inferior myocardial infarction was 0.733 (95％ CI 0.599-0.868).Conclusion Terminal QRS distortion in leads V7-V9 may be of diagnostic value in identifying the infarct-related artery in acute inferior myocardial infarction.

Effect of high-dose rosuvastatin loading before percutaneous coronary intervention in female patients with non-ST-segment elevation acute coronary syndrome / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Early loading statin therapy before percutaneous coronary intervention (PCI) is associated with reduced mortality and periprocedural myocardial injury. The aim of this study was to study the effect of rosuvastatin loading therapy before PCI in female patients with non-ST-segment elevation acute coronary syndrome (NSTEACS).</p><p><b>METHODS</b>Consecutive 117 female patients with NSTEACS were randomly assigned to either the group of rosuvastatin loading before PCI (20 mg 12 hours before angioplasty procedure, with a further 10 mg dose 2 hours before procedure, the loading dose group, n = 59) or the no rosuvastatin treatment group before PCI (control group, n = 58). Periprocedural myocardial injury, periprocedural changes of high sensitivity C-reactive protein (hs-CRP), interleukin (IL)-1, IL-6, and tumor necrosis factor (TNF)-a in serum and the incidence of major adverse cardiac events (MACE) 3 months and 6 months later were assessed.</p><p><b>RESULTS</b>The incidence of periprocedural myocardial injury was higher in control group than loading dose group (CKMB: 10.17% vs. 25.86%, P = 0.027; Troponin I: 11.86% vs. 29.31%, P = 0.019). MACE occurred in 1.69% of patients in loading dose group and 12.07% of those in control group 3 months after procedure (P = 0.026), 3.39% vs. 17.24% at 6 months (P = 0.014). The levels of hs-CRP, IL-1, IL-6, and TNF-a in serum were not significantly different between the two groups before PCI, but after PCI they were significantly higher in control group.</p><p><b>CONCLUSIONS</b>High-dose rosuvastatin loading before PCI significantly reduced periprocedural myocardial injury and periprocedural inflammation cytokines release and improved 3-month and 6-month clinical outcomes in female patients with NSTEACS who underwent PCI.</p>

Value of coronary CT angiography in assessment of bifurcation lesions / 中华心血管病杂志

<p><b>OBJECTIVE</b>To evaluate the value of coronary CT angiography in assessment of bifurcation lesions.</p><p><b>METHODS</b>The original image of 79 established and suspected coronary artery disease patients who underwent both coronary CT angiography and conventional artery angiography (CAG) sequentially were included in this analysis. Bifurcation lesions were assessed on primary and secondary vessels with diameter ≥ 2.0 mm, bifurcation lesions were graded according to Chen's classification. CAG was used as golden standard. The sensitivity, specificity, positive predictive value and negative predictive value were calculated. Spearman's test and Kappa test were used to evaluate the correlation and classification identity of the two methods.</p><p><b>RESULTS</b>CAG evidenced 177 bifurcation lesions out of 445 bifurcation vessels and coronary CT detected 168 bifurcation lesions out of 404 bifurcation vessels with satisfactory imaging quality and 390 bifurcation vessels could be analyzed by both CAG and coronary CT. Sensitivity, specificity, positive predictive value and negative predictive value of coronary CT angiography were 94.2%, 94.6%, 90.7%, 96.1%, respectively. The results for the lesions at LM-LAD/LCX + LAD/Mid, LAD/Diag, RCA/PDA were more satisfactory and the sensitivity and specificity were as high as: 97.1% and 94.2%, 95.7% and 89.5%, 92.3% and 98.7%, respectively. There were significant correlations for evaluating the narrow degree of the opening of the bifurcation branch with these two methods (r = 0.799 58, P < 0.01) and for identifying I, II, III type bifurcation lesions (Kappa coefficient = 0.7959, P < 0.01) as well as for identifying the subtype bifurcation lesions (Kappa coefficient = 0.6328, P < 0.01) using the two methods.</p><p><b>CONCLUSION</b>Coronary CT angiography is efficient in identifying the bifurcation lesions and offers a reasonable indication for bifurcation lesion classification.</p>

Impact of high-density lipoprotein levels at hospital admission on the outcome of patients with acute ST-segment elevation myocardial infarction / 中华流行病学杂志

Objective To analyze the impact of high-density lipoprotein cholesterol (HDL-C) levels at hospital admission on the incidence of major adverse cardiovascular events (MACCE) in patients with acute ST segment elevation myocardial infarction (ASTEMI).Methods 1067 patients with ASTEMI who were admitted to the 20 hospitals in Liaoning region and with lipid profile tested within the 24 hours of admission from May 2009 until May 2010,were enrolled.Data on basic demographic,clinical,status on admission and method of treatment were collected.Rate on various medical use and MACCE (cardiovascular death,non-fatal myocardial infarction,revascularization and stoke) were compared between the two groups through follow-up observation.Cox proportional hazard analysis was estimation.Results The median HDL-C level was 1.27 mmol/L,with 587 patients having HDL-C below and 489 patients HDL-C above the median level.The incidence rates of non-fatal myocardial infarction and MACCE at one-year follow-up period,was higher in low HDL-C group (4.8％ vs.0.9％,P＜0.001:23.7％ vs.18.1％,P=0.03,respectively) At one month follow-up,the incidence rate of non-fatal myocardial infarction was higher in low HDL-C group (1.4％ vs.0.0％,P=0.01 ).At six month follow-up,the incidence rates of non-fatal myocardial infarction and MACCE on one-year follow-up was higher in low HDL-C group (2.8％ vs.0.4％,P=0.003; 18.3％ vs.13.7％,P=0.04,respectively).Results from Cox proportional hazards analysis indicated that age ( HR =1.02,95％ CI:1.006- 1.035,P =0.005 ),diabetes (HR =1.05,95％ CI:1.053-2.171,P=0.03 ),HDL-C level ( HR =0.56,95％CI:0.340-0.921,P=- 0.02 ) were significantly related to the incidence of MACCE.Conclusion The incidence rates of one year and six month MACCE (mainly non-fatal myocardial infarction) and one month non-fatal myocardial infarction were significant higher in patients with low than high HDL-C levels at admission while kept on the ascending along with time.Age,diabetes,HDL-C level were independent risk factors related to the incidence of MACCE.

Prospective multi-center study of female patients with ST-elevation myocardial infarction in Liaoning province, China / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>In cardiology, it is controversial whether gender influences prognosis after acute myocardial infarction (MI). We examined the 30-day and 1-year prognosis for female patients with ST-elevation myocardial infarction (STEMI) in Liaoning province, and we analyzed factors that influenced these outcomes.</p><p><b>METHODS</b>This was a prospective, multicenter, observational study in which patient data were collected by questionnaire at the time of diagnosis and at approximately 30 days and 1 year later by telephone inquiries. Patients were diagnosed with STEMI between June 1, 2009 and June 1, 2010 at any of the 20 hospitals that gave treatment representative of current STEMI treatment in Liaoning Province. Unified follow-up questionnaire was used to visit the STEMI patients.</p><p><b>RESULTS</b>We analyzed data from a total of 1429 consecutive patients with STEMI in Liaoning province. Female patients were older (70.0 vs. 60.3, P < 0.001) and were less likely to receive emergency reperfusion therapy than male ones (39.2% vs. 58.0%, P < 0.001). Female gender was associated with higher unadjusted 30-day mortality rates (HR = 2.118, 95%CI: 1.572 - 2.854, P < 0.001) and higher unadjusted 1-year mortality rates (HR = 2.174, 95%CI: 1.659 - 2.848, P < 0.001). Multivariate Cox regression analysis showed that female gender was not an independent predictor of 30-day mortality rates (HR = 1.273, 95%CI: 0.929 - 1.745, P = 0.133) nor of 1-year mortality rates (HR = 1.112, 95%CI: 0.831 - 1.487, P = 0.475).</p><p><b>CONCLUSIONS</b>Women with STEMI appear to be at increased risk of 30-day and 1-year mortality compared with male STEMI patients, but this difference may be explained by older age and less frequent receipt of reperfusion therapy among the women.</p>

The impact of body mass index on the presentation, treatment and clinical outcomes of patients with ST-segment elevated myocardial infarction / 中华流行病学杂志

Objective To analyze the impact of body mass index (BMI) on the presentation,treatment,and clinical outcomes of patients with ST-segment elevated myocardial infarction (STEMI).Methods 1414 patients with STEMI who were admitted to the 20 hospitals in Liaoning region from May 2009 until May 2010 were enrolled.Patients were stratified according to the BMI levels as normal weight group (18.5 kg/m2≤BMI＜24.0 kg/m2) (n＝485),overweight (24.0 kg/m2≤BMI＜28.0 kg/m2) (n＝736),or obesity (BMI≥28.0 kg/m2) (n＝193).Presentation,treatment and mortality during hospitalization,MACCE (cardiovascular death,non-fatal myocardial infarction,revascularization and stroke) were compared between the three groups at 3-month and 1-year follow-up.Results Obesity in patients with STEMI was associated with younger age (P＜0.001),being male (P＜0.001),with diabetes (P＝0.013) or hypertension (P＜0.001) and hyperlipidmia (P＜0.001).A higher prevalence of reperfusion treatment (P ＝ 0.018),mainly percutaneous coronary intervention (PCI) (P＜0.001) was seen during the period of hospitalization.Rates of using other kinds of medicines as well as the mortalities during hospitalization,were similar among the groups with different BMI categories.At 3-month and 1-year follow-up,more use of asprin (3-months:P＝0.018; 1-year:P＝0.002) and β-receptor blockers were seen in the obesity group (3-months:P＝0.025; 1-year:P＝0.030) while the use of other drugs were not significantly different among the three groups.The incidence rates of MACCE were not significantly different among the BMI categories while the cumulative survival rate was similar between obese group and normal weight group.Results from the Cox proportional hazards analysis indicated that factors as age (HR＝1.045,95％ CI:1.028-1.062,P＜0.001),diabetes (HR＝ 1.530,95％ CI:1.107-2.301,P＝0.041),hyperlipidmia (HR＝2.127,95％ CI:1.317-3.435,P＝0.002),urgent PCI (HR＝0.473,95％CI:0.307-0.728,P＝0.001) and the use of β-receptor blockers at 3-months follow-up period (HR＝0.373,95％ CI:0.195-0.713,P＝0.003) were significantly related to the incidence of MACCE at 1-year follow-up period.Conclusion Despite the fact that patients with obesity presented with STEMI at younger age and having received active treatment of reperfusion and medicine,both the 3-month and 1-year outcomes did not show significant difference among the BMI categories.

Onset timing of acute ST segment elevation myocardial infarction in middle-aged and old patients / 中华心血管病杂志

<p><b>OBJECTIVE</b>To compare the differences on onset timing of acute ST segment elevation myocardial infarction (STEMI) in young and aged patients.</p><p><b>METHODS</b>The exact onset time of symptoms was obtained from 1024 consecutive patients with STEMI admitted to our hospital between January 2000 and May 2010. Patients were classified as the middle-aged group [< 65 years old, mean (52.2 ± 8.0) years, n = 536] and old group [≥ 65 years old, (72.2 ± 5.5) years, n = 488], the difference of the onset months, weeks, weekdays and hours between two groups was compared.</p><p><b>RESULTS</b>The high onset timing of STEMI in middle-aged group was October and February, Friday, Saturday and Wednesday, at 10 A.m. and 10 P.m. The high onset timing of STEMI in old group was October, January and March, Friday, Sunday and Monday, at 6 A.m. and 2 A.m. The incidences of STEMI in the old group were significant higher than in the middle-aged group in March (11.89%), on Sunday (15.97%) and Monday (17.42%), at 6 A.m. (6.35%) and 2 A.m. (5.74%) (all P < 0.05) while the onset rate was significant higher in February (9.89%), On Saturday (16.98%), At 8 P.m. (4.86%) and 10 P.m. (5.78%) in the middle-aged group than old group (all P < 0.05).</p><p><b>CONCLUSION</b>The onset timing of STEMI in old patients was significant different from the middle-aged patients suggesting the onset timing of STEMI changes with aging.</p>

Myocardial infarction in a patient with systemic lupus erythematosus and antiphospholipid syndrome / 中华医学杂志(英文版)

This case report we presented aims to report a-31-year-old man with systemic lupus erythematosus (SLE) and antiphospholipid syndrome (APS) who developed myocardial infarction (MI) and also aims to discuss the possible mechanisms. The results showed that traditional risk factors alone do not cause coronary heart disease with SLE, and SLE-related factors influence the atherogenic process. We found that although SLE patients with acute MI benefit from percutaneous coronary intervention (PCI) therapy, it is very important to choose the reasonable antithrombotic strategies in patients with SLE and APS undergoing PCI who require oral anticoagulant therapy.

Efficacy and safety of intravenous levosimendan compared with dobutamine in decompensated heart failure / 中华心血管病杂志

<p><b>OBJECTIVE</b>To compare the efficacy and safety of intravenous levosimendan and dobutamine in patients with decompensated heart failure refractory to conventional medications.</p><p><b>METHODS</b>Patients were recruited into this multicentre, randomised, positive-controlled and parallel-group study to receive either levosimendan or dobutamine therapy. In the levosimendan group, an initial loading dose of levosimendan of 12 microg x kg was infused over 10 min, followed by a continuous infusion of 0.1 microg x kg(-1) x min(-1) for 1 h and then 0.2 microg x kg(-1) x min(-1) for 23 h. In the control group, dobutamine was infused for 1 h at an initial dose of 2 microg x kg(-1) x min(-1) without a loading dose, followed by a continuous infusion of 4 microg x kg(-1) x min(-1) for 23 h. Hemodynamic responses at 24 h were evaluated by echocardiography (in both groups) and Swan-Gans catheter (in the levosimendan group). Clinical assessment was performed to evaluate efficacy and safety of the medications.</p><p><b>RESULTS</b>A total of 225 patients from 12 medical centers were evaluated; 119 assigned to levosimendan and 106 assigned to dobutamine group. The effectiveness rate was 31.9% (38 patients) in the levosimendan group and 17.9% (19 patients) in the dobutamine group (P < 0.01). At 24 h, left ventricular ejection fraction (LVEF) was improved by 6. 4% in the levosimendan group, compared with 4.6% in the dobutamine group (P > 0.05). Stroke volume (SV) was increased by 11.1 ml in the levosimendan group and 2.8 ml in the dobutamine group respectively (P < 0.05). Dyspnea and clinical manifestations improvements were more significant in levosimendan therapy group compared to dobutamine group. There were less adverse effects including hypokalemia, hypotension and ventricular premature beats in the levosimendan group than in the dobutamine group (P < 0.05).</p><p><b>CONCLUSION</b>Levosimendan was well tolerated and superior to dobutamine for patients with decompensated heart failure refractory to conventional medications.</p>

Multi-link Vision and MiniVision stent registry in Asian patients with coronary artery disease: a prospective, multi-center study / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Recent studies have showed that the fine mesh stents are associated with a significant reduction in both clinical and angiographic re-stenosis of the coronary arteries. To maintain a very satisfactory radio-opacity using the stents, Guidant of the USA has designed a new type of bare metal stents (BMS)-Multi-link (ML) Vision/ML MiniVision stents. The clinical outcomes of Asian patients with coronary artery disease (CAD) after implanting the Multi-link Vision or MiniVision stent were investigated in this study.</p><p><b>METHODS</b>An observational, prospective, multi-center, non-randomized post marketing registry was conducted to demonstrate the efficacy of the BMS-ML Vision/ML MiniVision stents. The primary end point of the registry was clinical target lesion revascularization (TLR) at a 6-month follow-up. The major secondary end points included the rate of major adverse cardiac events (MACE) and serious adverse events (SAE) in hospital and at 6 months; and the rate of clinical TLR as a function of the type of angina. A total of 429 Asian people with 449 lesions from 14 centers were selected for this study. The average reference diameter of the lesions was (3.0 +/- 0.5) mm, and the mean length was (15.7 +/- 5.0) mm.</p><p><b>RESULTS</b>The successful rate of the procedure was 99.3%. Twenty-five percent of the lesions were treated by direct stenting without pre-dilation. Eighty-six percent of the lesions were implanted with ML Vision stent. After the 6-month follow-up, the rate of clinical TLR was 1.4%. The MACE, SAE and target vessel revascularization (TVR) were 6.8%, 3.5% and 1.4% respectively.</p><p><b>CONCLUSION</b>The current registry showed the excellent 6-month clinical outcomes of ML Vision/ML MiniVision stents in Asian patients with CAD.</p>

The pro-angiogenesis effect of Pitavastatin in the Klotho gene-knockout mice / 中国应用生理学杂志

<p><b>AIM</b>To discuss the effect of Pitavastatin on angiogenesis in vivo and its mechanism in Klotho heterozygous deficient mice.</p><p><b>METHODS</b>The heterozygous deficient Klotho mice (kl +/-) and wild mice (kl +/+) from the same litter were used to establish the animal model of hind-limb ischemia and grouped into control and Pitavastatin group, respectively. Hind-limb blood flow was evaluated using Laser Doppler perfusion imager (LDPI) before treatment and after operation of hind-limbs. The capillaries in muscle of limbs were counted by means of CD-31 labeled immuno-fluorescence. The phosphorylation of Akt (Protein kinase B) in cells was measured by direct immunohistochemical technique. The expression of vascular endothelial growth factors (VEGFs) in muscle of limbs was assessed using Western blotting.</p><p><b>RESULTS</b>After treatment of Pitavastatin, the blood flow in ischemic limbs of the Kl +/- and wild mice improved obviously, the ratio of blood flow area in ischemic limb to that in non-ischemic limb increased and the density of capillaries increased in ischemic limbs of the Kl +/- and wild mice. Pitavastatin enhanced the phosphorylation of Akt and the expression of VEGF in ischemic limbs of the Kl +/- and wild mice.</p><p><b>CONCLUSION</b>Pitavastatin has the pro-angiogenesis effect in vivo and the VEGF-p-Akt-NO pathway may be involved in the mechanism of the effect of Pitavastatin.</p>

Pitavastatin enhances angiogenesis and perfusion in a murine mode of limb ischemia / 中华心血管病杂志

<p><b>OBJECTIVE</b>We investigated the effects of pitavastatin on angiogenesis and perfusion in C3H/He mice with unilateral hind limb ischemia.</p><p><b>METHODS</b>C3H/He mice treated with saline (n = 15) or pitavastatin (1 mg.kg(-1).d(-1), n = 15) per gavage for 1 week underwent unilateral hind limb ischemia surgery and were treated for another 5 weeks. Hind-limb blood flow was measured by Laser Doppler perfusion imager (LDPI, ischemic/nonischemic limb, %) at baseline, immediately after ischemia and weekly thereafter for 5 weeks. Endpoints included local vessel counts by immunofluorescence, phospho-Akt positive cell counts by immunoenzyme histochemical technique, vascular endothelial growth factors (VEGFs) expression in ischemic limbs by Western blot and serum nitric oxide metabolite (NOx) by chrome dioxide Griess method.</p><p><b>RESULTS</b>Lower extremity perfusion was significantly improved in pitavastatin treated mice vs. controls as measured by LDPI% at 1 week post ischemia and thereafter (P < 0.05). Pitavastatin treatment was associated with significantly increased capillary count [(47 +/- 11) vs. (26 +/- 14)/per high-power field (x 200), P < 0.05] and greater percentage of phospho-Akt positive cells [(6 +/- 1) vs. (2 +/- 0)/per high-power field (x 200), P < 0.05] in ischemic limbs. Serum NOx [(77.3 +/- 21.8) vs. (52.1 +/- 11.2) mol/L, P < 0.05) and VEGF protein expression in ischemic limbs were also significantly increased in pitavastatin group than those in control group.</p><p><b>CONCLUSIONS</b>Pitavastatin enhances angiogenesis and perfusion in CsH/He mice with limb ischemia.</p>

The epidemiological survey of prevalence rate of hypertension in the countryside of Zhangwu county, Liaoning province / 中华流行病学杂志

<p><b>OBJECTIVE</b>To investigate the prevalence state of essential hypertension in the countryside of Zhangwu county, Liaoning province to confirm whether this county is the high prevalence region of essential hypertension.</p><p><b>METHODS</b>Five thousand, two hundred and eight 15-year olds or older were sampled by means of whole population random sampling. Blood pressure was measured and the related risk factors were investigated with the uniform questionnaire. SPSS 10.0 of statistical software was used for data analysis.</p><p><b>RESULTS</b>The standardized prevalence rate of hypertension was 35.0% at this region, 40.0% in male, 32.0% in female. The prevalence rates of hypertension were increased with the increasing of the age in both males and females. There were significant statistically differences in the prevalence rates of hypertension between the different age groups, different countrysides and different villages. The standardized prevalence rate of hypertension were 43.0% the highest and 29.0% lowest respectively in the countryside, with prevalence rates, were 59.4% highest and 26.9% lowest respectively in the village. In all the patients with hypertension, 72.0% having hypertension II, III.</p><p><b>CONCLUSION</b>The countryside of Zhangwu county was a high prevalence region of essential hypertension which was unusual in our country. The reason of this status was still unknown which called for further study.</p>