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Objective:To explore the association between the changes in ideal cardiovascular health (CVH) indices and the renal function.Methods:The retrospective cohort study consisted of 837 Chinese individuals from Department of Health Management in the Third Xiangya Hospital.The general information,anthropometry and blood biochemistry were obtained for all subjects from 2008 to 2014,respectively.The 6-year changes of 7 ideal CVH metrics defined by American Heart Association and the estimated glomerular filtration rate (eGFR) were calculated.Linear regression analysis was used to study the association between the changes in the ideal CVH metrics and eGFR.Covariance analysis was used to compare the levels of changes in eGFR stratified by variations of the ideal CVH metrics.Results:After 6 years' follow-up,we did not find significant difference in ideal cardiovascular health indexes between 2014 and 2008 [(3.3±1.4) items vs.(3.2±1.3) items,respectively] (P＜0.05).However,the eGFR in 2014 was significantly lower than that in 2008 [(99.8±22.7) mL/(min.1.73 m2)vs (104.3±24.9) mL/(min.1.73 m2),respectively] (P＜0.01).After adjusting for age,sex,history of hypertension and diabetes,and history of drug usage (antihypertensive,cholesterol-lowering and blood glucose-lowering medication),the changes in ideal CVH metrics were positively associated with the changes in eGFR (β=0.701,P＜0.01).With the improved change in ideal CVH metrics from ≤-2 points,-1 point,0 point,1 point to ≥ 2 points,the magnitude of decline in eGFR was gradually decreased,with significant difference (F=21.71,P＜0.01).Conclusion:The changes in ideal CVH metrics are an independent risk factor for changes of eGFR.Positive changes in ideal CVH metrics exert a favorable effect on renal function evolution.
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Objective To explore the application value of stepped screening on hypertension with self-report health measurement questionnaire by comparing the accuracy of the different levels of screening. Methods A total of 6 715 subjects with hypertension (average age of 53.47 ± 11.07 years) were selected from those who completed the physical examination in the department of health management in the Third Xiangya Hospital of Central South University for questionnaire survey, routine inspection and special inspection for hypertension. And the patients were divided into four groups based on their hypertension risk levels: the questionnaire survey group, routine inspection group, questionnaire + routine inspection group and questionnaire+routine inspection+special inspection group. The results were compared respectively to calculate the sensitivity, specificity, positive predictive value and coincidence rate of single inspection and joint inspection. Results Nearly 90.00%of the subjects had hypertension associated with the risk factors, while 20.83% of the subjects had hypertension associated with other clinical diseases (the highest percentage was seen in hypertension with diabetes as 14.88%). According to the guidelines of stratification, 3.41% of the patients were at low risk, 23.78% at moderate risk, 47.85% at high risk, and 24.96% at extremely high risk. Sensitivity and specificity of routine inspection were 95.56%and 45.51%in judgment of moderate risk, which became 100.00%and 45.51%after addition of questionnaire survey;as a result, thesensitivity increased. Sensitivity and specificity of routine inspection were 15.03%and 96.28%in judgment of high risk, which became 30.03% and 99.14% after addition of questionnaire survey; as a result, the sensitivity doubled. Sensitivity and specificity of routine inspection were 15.03%and 100.00%in judgment of extremely high risk, and the sensitivity increased to 94.45%after addition of questionnaire survey, while the specificity remained unchanged. Conclusion Addition of questionnaire on the basis of routine physical examination could greatly increase the detection rate of hypertension patients at different risk levels, and increase the sensitivity as well as specificity for detection of moderate risk, high risk and extremely high risk. Therefore, health information and data acquired from the questionnaire and data obtained from the medical inspection equipment are equally important and suggest health management (physical examination) institutions to take questionnaire as a necessary and primary screening in physical examination and chronic disease screening.
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Objectives To estimate the prevalence of the cardiovascular health (CVH) status in south Jiangsu adults. Methods A cross-sectional study was conducted, a total of 11 996 participants that took health examination in hospitals from March 2013 to August 2013 and live in south Jiangsu were selected. Results Totally 136 participants (1.1%) met all 7 ideal CVH metrics;while 27.6%participants met 5 to 7 ideal CVH metrics, women had higher proportion (47.2%) than men (16.9%). The percentage of participants who met 5 to 7 ideal CVH metrics, whether male or female, decreased with increasing age. Ideal total cholesterol (TC) was the most prevalent (72.0%), whereas ideal salt intake was the least (19.9%). The mean (± SD) number of ideal CVH metrics for urban participants was (3.61 ± 1.46), higher than the rural participants (3.45±1.49). Old age, male and residence in rural area were risk factors for ideal CVH metrics≥5. Conclusions The prevalence of ideal CVH was extremely low in South Jiangsu adults, and there were differences in the distribution of ideal CVH metrics across gender and age. To improve CVH, specific promotion and interventions at the population and individual levels should be developed and implemented actively.
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Carotid ultrasound examination is a very mature examination method, it is widely used in clinical diagnosis and health checkup. Carotid ultrasound examination plays an important role in the prediction of the occurrence of cardiovascular disease. However, there are still certain problems in the application of the examination in the domestic health checkup population, which mainly include that the method and the standard are not unified, and the reporting form is not standardized. Carotid ultrasound examination must be standardized as soon as possible.
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Objective To investigate the application value of the self-rated health measurement scale (SRHMS) in health check-up.Method A total of 8 083 health check-up receivers frow Fujian Province underwent SRHMS self-assessment,and the results of the assessment were analyzed by Chi-square test.Result The results of the survey showed that the total prevalence rate of chronic disease was 57.8％ top five were stomach/duodenum diseases (14.57％),hypertension (11.58％),mammary gland disease (8.04％),abnormal blood lipid (7.16％) and prostate disease (6.54％).The proportion of these five kinds of illness was 43.38％.A positive correlation between the prevalence rate of chronic disease and age was found.The difference of the prevalence rate of chronic diseases between each age group was statistically significant (x2=863.816,P=0.000).Those with family history of chronic diseases accounted for 69.27％ and those with history of present illness accounted for 57.83％ (4 674/8 083).Bodily pain,dietary preferences,refined grain intake,lack of exercise,and alcohol drinking was found in 75.03％,60.15％,54.84％,46.07％ and 41.50％ participants.Conclusion The SRHMS could reflect the chronic disease incidence and unhealthy daily habits.
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Objective To develop a conceptual framework for the synopsis of information of health examination reports (HERs) and its style sheet so as to provide a reference for information collection and management in health examination institutions.Methods A conceptual framework for the synopsis of information of HERs and its core data elements were developed based on HERs items from 11 health examination institutions,and a style sheet for the synopsis of information of HERs was then designed.Results The conceptual framework included 4 dimensions (e.g.identification information,health-related information,health exam summary,health evaluation and guidance),16 sub-dimensions,52 core data elements and 25 value domains.The structure and content of the designed sheet were consistent with the dimensions,subdimensions and core data elements of the conceptual framework.Conclusions The developed synopsis of information of HERs could be a feasible solution for structured and standardized representation of clients' health examination information.The selection and filling of some items should be validated and refined in the future.
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Objective To learn the development of Chinese health management centers,and to provide evidence for discipline planning and development goals.Methods A self-designed questionnaire was used to get the information about the size and personnel structure,discipline and scientific research,academic and talent training,informatization and comprehensive service ability of 103 health management centers.Results About 76％ health management centers occupied a land of more than 1000 square meters.Annual health checkup showed an increasing trend year by year (from 39 500 persons per year in 2009 to 52 500 persons per year in 2011).Nearly 54％ health management centers provided health/disease risk assessment services,and only 21％ provided psychological evaluation services.The main challenges for academic activities in these centers were information collection and record,research topic selection and study design,specific training for chorin disease screening and technique skills.Conclusion Sustainable development of health management industry in China may largely depend on discipline construction of health management.
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Objective To establish a model for evaluating risk grade of cardiovascular health in adults undergoing health checkups.Methods Medical record of individuals who took health checkup in 6 heahhcare centers from 2008 to 2010 was retrospectively reviewed.The study populations were then assigned to 3 classes by using Cluster analysis and ANOVA.An assessment model for cardiovascular health was then established by using discriminant analysis method.Results The evaluation model of cardiovascular health was built by using cluster analysis and diseriminant analysis.The model was good and the consistent homology rate was 97.5％.The model was well used for cardiovascular health evaluation in healthcare center (the Kappa value in 2009 and 2010 was 0.446 and 0.415,respectively) and the consistency of the model was good.Conclusions This evaluation model of cardiovascular health could be used for grading and assessing of the level of health management of cardiovascular health.
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Objective To investigate the detection rate of abnormal cardiovascular and metabolic indicators in health check-up populations,and provide evidence for early screening and health interventions for cardiovascular and metabolic diseases.Methods A total of 5578 adults (male 3404 and female 2174) were recruited from a medical institution in Beijing in 2008 and 2010.Cardiovascular and metabolic indicators,including blood pressure,lipid profile and fasting plasma glucose,were tested at baseline and 2 years.Paired t test or paired rank sum test was used for data analysis.Results Detection rate of abnormal blood pressure in 2010 was lower than that in 2008; however,rates of abnormal total cholesterol,low-density lipoprotein cholesterol and fasting plasma glucose were higher in 2010 than in 2008 (t values were 5.378,13.885,3.210,10.401 and 4.355,respectively; all P ＜ 0.05).High-density lipoprotein cholesterol and triglyceride showed no statistically significant difference between 2008 and 2010 (t values were 1.204 and -0.012,respectively; both P ＞ 0.05).Conclusion We have been observing a dynamic change in abnormal cardiovascular and metabolic indicators,based on which effective interventions could be taken to reduce the risk of cardiovascular diseases.
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Objective To study the effects of physical training on baroreflex sensitivity (BRS) by monitoring finger arterial pressure among volunteers who had experienced three-months′ aerobic or anaerobic exercises.Methods A total of 16 healthy men were divided into the aerobic exercise+anaerobic exercise group (group A,n=7) and aerobic exercise group (group B,n=9).Each subject was trained for 12 weeks.Head-up tilt (HUT) table test was performed before and 4,8,and 12 weeks after training.Blood pressure,finger arterial pressure and electrocardiogram (ECG) were compared between the two groups.Results The BRS was significantly increased after training in group A,although no changes were found in group B.Conclusion Three-months′ aerobic exercise+anaerobic exercise seems to enhance the BRS; however,three-months′ aerobic exercise may decrease the BRS.
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Objective To develop a multidimensional self-report health measurement scale for accurate evaluation of health status in Chinese adults. Methods Delphi method was used to select health measurements. Item database was set up based on available questionnaires. A total of 1858 individuals from Beijing, Hebei ,Tianjin, Shanxi and other provinces of China received field pretest. Results A self-report health assessment tool with 90 items was developed, Cronbach a coefficient of which was 0. 669 to 0. 917,split-half reliability 0. 572 to 0. 877, and test-retest reliability 0. 693 to 0. 896. Six factors from exploratory factor analysis accounted for 71.732% total variance,with the common factor＞0.4. Confirmatory factor analysis showed good fit index and construct validity. Conclusion The newly developed self-rated health measurement scale ,which involves six dimensions and 90 items ,shows good reliability and validity.
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Background: The demand for effective intervention for subhealth conditions is growing with increasing numbers of people being in a state of subhealth with a poor quality of life. Future research and evaluation of the treatment methods for subhealth conditions from the perspective of traditional Chinese medicine (TCM) may provide an important direction for developing effective management of these conditions. Objective: To evaluate the efficacy and safety of Xiaopi Yishen herbal extract granules (XPYS-HEG), a compound traditional Chinese herbal medicine for relieving fatigue and promoting a cheerful spirit for the treatment of people with fatigue-predominant subhealth due to liver-qi stagnation and spleen-qi deficiency. Design, setting participants and interventions: A multi-center, randomized, double-blinded, placebo-controlled clinical study was undertaken. The study period was 18 weeks, including 6 weeks for intervention and 12 weeks for follow-up. Participants were recruited from medical center and outpatient clinics of three hospitals in China, i.e. Xiaotangshan Hospital of Beijing, the First Affiliated Hospital of Henan University of TCM and the Affiliated Hospital of Liaoning University of TCM. Two hundred participants who met the criteria of fatigue-predominant subhealth and liver-qi stagnation and spleen-qi deficiency in TCM were allocated randomly to the treatment group (XPYS, n=100) and control group (placebo, n=100). Main outcome measures: The total score of Fatigue Scale-14 (FS-14) was used to evaluate the fatigue status of subjects and the extent of liver-qi stagnation and spleen-qi deficiency syndrome was also recorded. Results: Three cases in the XPYS group withdrew from the trial. There were 200 subjects who entered to full analysis set (FAS) analysis and 197 subjects fitted in the per-protocol set (PPS) analysis. (1) According to the score changes of FS-14, the effectiveness rates in the XPYS and placebo group were as follows: 14.0% vs 9.0% (FAS) and 14.4% vs 9.0% (PPS) for complete remission, 19.0% vs 15.0% (FAS) and 19.6% vs 15.0% (PPS) for obvious effects, 39.0% vs 26.0% (FAS) and 39.2% vs 26.0% (PPS) for effective, and 72.0% vs 50.0% (FAS) and 73.2% vs 50.0% (PPS) for complete efficacy. The efficacy of XPYS-HEG was superior to the placebo statistically (P<0.05). (2) According to the score changes of TCM syndrome, the effectiveness rates in the XPYS group and placebo group were as follows: 1.0% vs 0.0% (FAS) and 1.0% vs 0.0% (PPS) for complete remission, 20.0% vs 7.0% (FAS) and 19.6% vs 7.0% (PPS) for obvious effects, 29.0% vs 24.0% (FAS) and 29.9% vs 24.0% (PPS) for effective, and 50.0% vs 31.0% (FAS) and 50.5% vs 31.0% (PPS) for complete efficacy. The efficacy of XPYS-HEG was superior to that of placebo statistically (P<0.05). (3) The follow-up results at 12 weeks and 18 weeks showed that the efficacy of XPYS-HEG was superior to that of placebo statistically (P<0.05). (4) No adverse effects were found in the XPYS group. Conclusion: It can be concluded that XPYS-HEG is effective and safe for the treatment of people with fatigue-predominant subhealth due to liver-qi stagnation and spleen-qi deficiency.
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Objective Global cardiovascular risk assessment has been incorporated into current Chinese guidelines for the management of hypertension and hypercholesterolemia. The aim of our study is to determine the distribution of 10-year risk for ischemic cardiovascular disease (ICVD) among middle-aged Chinese adults, and to evaluate the usefulness of global risk assessment tools in the primary prevention of ICVD in Chinese population.Methods Simplified prediction tools derived from the USA-PRC Collaborative Study of Cardiovascular Epidemiology cohort were applied to the Chinese Health Examination Database (CHED) 2008. 10-year risk for ICVD was estimated in 461 157 ICVD-free subjects (264 432 male and 196 725 female) aged 35 to 59 years. Results Among the male subjects, 82.4% had a 10-year risk for ICVD of <5%, 14.4% of 5% to 12.1 % and 3.4 of≥12.2%, and in female subjects, 86.7% had a 10-year risk for ICVD of <5%, 12.1% of 5% to 12.0% and 1.2% of ≥12.1 %. All subjects with predicted high level ICVD risk (≥ 12.2% in male or ≥ 12.1% in female) had either remarkably elevated (≥160 tnmHg) blood pressure, significantly increased (≥6.22 mml/L) total serum cholesterol or diabetes.Conclusion Using the currently recommended prediction tools, only very small proportions of middle-aged Chinese men and women who were free of ICVD would be classified into high level risk group. These prediction tools are unlikely to help for the medical intervention decision making in Chinese adult patients with hypertension and/or hypercholesterolemia.
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Objective To explore the use of non-invasive technique for early detection of atherosclerosis in health checkups. Methods A total of 46 824 healthy normotensive volunteers, including 24 879 men and 21 945 women, from 27 physical examination centers were reviewed for their clinical data. Pulse wave velocity (PWV) by age was calculated,and related factors of PWV were analyzed. Results Reference range of PWV was increased with age. Detectable rate of abnormal PWV in men < 60 years was significantly higher than women (P<0.05). Detectable rate of PWV of > 1400 cm/s, > 1700 cm/s or > 2000 cm/s were 34. 5% ,7. 5% and 1.9% Respectively. Correlation analysis showed that PWV was closely related with age and mean systolic blood pressure ( P < 0. 05 ). Conclusion Non-invasive technique for early detection of atherosclerosis and PWV should be useful in physical examinations and cardiovascular disease screening.
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Objective To describe the characteristics of subclinical carotid atherosclerosis in urban or suburban populations to provide support for cardiovascular risk factors monitoring and health management.Methods A population-based cardiovascular epidemiology survey was conducted among 899 urban and 1202 suburban residents in Beijing from October 2002 to September 2007.Carotid plaque.intimamedia thickness(IMT),and lumen diameter were measured in the proximal,distal,and sinus segment of the carotid artery using duplex ultrasound.Arterial tension and the number of plaques were calculated and compared between the two groups.Results Mean common carotid IMT increased with age in both groups (P<0.05,respectively),and among all age groups IMT Was obviously thicker in suburban population than that in urban population (respectively,P<0.05).Independence of gender,the prevalence of plaques increased with age (P<0.05),and the number of plaques was higher in the suburban population than those in urban population in all age groups (P<0.05).However,aaerial tension decreased with age in both groups,especially in the suburban populations (P<0.05).Conclusion With the acceleration of urbanization and aging in China,cardiovascular risk factor monitoring and health management should focus on suburban and elderly populations.