[Relationship between blood pressure variability and combined cardiovascular events in 5-10 years in hypertensive patients].

OBJECTIVE: To explore the relationship between blood pressure variability (BPV) and combined cardiovascular events in 5-10 years in patients with hypertension. METHODS: A total of 367 hypertensive patients treated in our hospital from January, 2000 to January, 2005 were analyzed, and their BPV was assessed in comparison with 145 normotensive individuals. The hypertensive patients were classified into high BPV group and low BPV group, and the general clinical data and biochemical profiles were compared. The relationship between BPV and combined cardiovascular events of the patients within 5-10 years were explored. RESULTS: Compared with the normotensive individuals, the hypertensive patients showed significantly increased standard deviation and coefficient of variation of 24-h systolic blood pressure (SBP), 24-h diastolic blood pressrue (DBP), daytime SBP, daytime DBP, night-time SBP and night-time DBP (P<0.01). The percentages of drinking, smoking, diabetes and coronary heart disease were significantly higher in patients with high BPV than those with lower BPV (P<0.01 or 0.05); uric acid, homocysteine, urinary protein/creatinine ratio and urinary microalbumin increased more significantly in patients with high BPV (P<0.01 or 0.05). In addition, the combined cardiovascular events in 5-10 years were significantly higher in the patients with higher BPV than those with lower BPV (P<0.01 or 0.05). Logistic multivariate logistic regression analysis showed that alcohol, diabetes, coronary heart disease, uric acid and homocysteine were independent risk factors for cardiovascular events in hypertensive patients (P<0.01 or 0.05). CONCLUSION: In hypertensive patients, BPV is closely correlated with the long-term combined cardiovascular events, and a high BPV is associated with a greater likeliness of combined cardiovascular events.

Expression of Wnt and NCX1 and its correlation with cardiomyocyte apoptosis in mouse with myocardial hypertrophy.

OBJECTIVE: To study the correlation between expression of Wnt and NCX1 and cardiomyocyte apoptosis in mouse with myocardial hypertrophy. METHODS: C57B/16 male mice were given the subcutaneous injection of 1 mg/kg isoprenaline to build the myocardial hypertrophy model. After 14 d of model building, mice were executed by cervical vertebra luxation. The ratio of heart weight/body weight (HW/BW) and heart weight/tibia length (HW/TL) was observed and proved using HE staining that detected the size of cardiomyocytes. 40 male C57B/16 mice were randomly divided into the sham group (normal saline) and model group (isoprenaline), with 20 mice in each group. The terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling was applied to detect the cardiomyocyte apoptosis; while Western blot and immunohistochemistry were employed to detect the expression of Wnt and NCX1. Meanwhile, the correlation between these two proteins and cardiomyocyte apoptosis was explored. RESULTS: Compared with the sham group, the ratio of HW/BW and HW/TL was increased in the model group, as well as the bigger and hypertrophied cardiomyocytes, decreased number and increased apoptosis of cardiomyocytes, and increased positive expression of Wnt3a, Wnt5a and NCX1 in the cardiac muscle tissue. Besides, there was positive correlation between the expression of Wnt and NCX1 and the cardiomyocyte apoptosis. CONCLUSION: The expression of Wnt3a, Wnt5a and NCX1 in mouse with myocardial hypertrophy is increased and positively correlated with the cardiomyocyte apoptosis.

[Central pulse pressure but not brachial blood pressure is the predominant factor affecting aortic arterial stiffness].

OBJECTIVE: To investigate the differences in central hemodynamic indices between hypertensive and normotensive subjects and identify the blood pressure index that the most strongly correlate with arterial stiffness and vascular damage markers. METHODS: A cohort of 820 hypertensive patients and 820 normotensive individuals matched for age and gender were enrolled in this study. We measured carotid-femoral and carotid-radial pulse wave velocity (PWV), aortic augmentation index (AIx) and central blood pressures using pulse wave analysis and applanation tonometry. Plasma homocysteine (HCY), high-sensitivity C-reactive protein (hsCRP) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) were also tested in these subjects. RESULTS: In both hypertensive and normotensive subjects, the central systolic blood pressure (SBP) and pulse pressure (PP) were significantly lower than brachial SBP and PP; this PP amplification was significantly lower in the normotensives (9.85∓6.55 mmHg) than in the hypertensives (12.64∓6.69 mmHg), but the amplification ratios were comparable between the two groups. Blood pressure and age were closely related with aortic arterial stiffness. Compared with normotensive subjects, hypertensive subjects had higher carotid-femoral PWV and AIx, and showed significantly lowered PP amplification ratio with age. Central PP was more strongly related to arterial stiffness and vascular damage markers than the other pressure indices. Multivariate analyses revealed that carotid-femoral PWV and aortic AIx were strongly influenced by central PP but not by the mean blood pressure or brachial PP. CONCLUSION: The central PP is a more direct indicator of central arterial stiffness and a better marker of vascular aging than other blood pressure variables. These findings support the use of central blood pressure as a treatment target in future trials.

Association between serum homocysteine and arterial stiffness in elderly: a community-based study.

BACKGROUND: Arterial stiffness and homocysteine are both powerful predictors of cardiovascular disease, especially in older populations. Previous studies have investigated the association of homocysteine with arterial stiffness in human subjects, while the relationship between homocysteine and arterial stiffness in the elderly is still indefinite. The current study examined the association of homocysteine with arterial stiffness in Chinese community-based elderly persons. METHODS: We related serum levels of homocysteine to two measures of arterial stiffness (carotid-femoral pulse wave velocity (PWV) and carotid-radial PWV) in 780 participants (46.3% men, mean age 71.9 years (ranging 65-96 years old)) from two communities of Beijing, China. Arterial stiffness was measured within two days of the time of biomarker measurement. RESULTS: In multiple-adjusted models, homocysteine levels were strongly associated with the carotid-femoral PWV (standardized ß = 0.13, P < 0.001), even after adjustment for classical risk factors of cardiovascular disease. The association is also stronger when the carotid-femoral PWV is elevated above normal, whereas no significant association with homocysteine was observed for carotid-radial PWV. CONCLUSIONS: In Chinese elderly persons, serum homocysteine levels are associated with alterations of aortic stiffness.

[Association between peroxisome proliferator-activated receptor gene single nucleotide polymorphisms and arterial stiffness in adult Chinese population].

OBJECTIVE: To analyze the association between single nucleotide polymorphisms (SNPs) of peroxisome proliferator-activated receptor(PPAR) and arterial stiffness in adult Chinese population (> 50 years). METHODS: Cardiovascular risk factors from participants of Beijing epidemiological investigation were analyzed. Carotid-femoral pulse wave velocity (cfPWV) was measured by Complior system. The subjects were divided into normal arterial stiffness group (cfPWV < 12 m/s, n = 844) and increased arterial stiffness group (cfPWV > 12 m/s, n = 530). Three valid SNPs including rs1053049, rs1800234 and rs8192678 in the PPAR and PPARγC1a gene were genotyped by TaqMan allelic discrimination assays. RESULTS: The age [(67.9 ± 8.8) years vs. (58.0 ± 9.7) years], prevalence of hypertension [71.1% (377/530) vs. 30.5% (257/844)] and diabetes mellitus [21.7% (115/530) vs. 11.0% (93/844)] were all significantly higher in increased arterial stiffness group than in normal group (all P < 0.05). The frequencies of CC, CT and TT type of rs8192678 [CC: 32.2% (272/844) vs. 30.8% (163/530), CT: 48.7% (411/844) vs. 52.1% (276/530), TT: 19.1% (161/844) vs. 17.2% (91/530)], rs1053049 [CC: 55.7% (470/844) vs. 51.3% (272/530), CT: 36.7% (310/844) vs. 39.1% (207/530), TT: 7.6% (64/844) vs. 9.6% (51/530)] and rs1800234 [CC: 88.4% (746/844) vs. 90.4% (479/530), CT + TT: 11.6% (98/844) vs. 9.6% (51/530)] were similar between the two groups. There was also no association between haplotypes and the increased arterial stiffness in this cohort. CONCLUSIONS: In this community-based population, we found that aging, hypertension and diabetes mellitus were associated but SNPs of PPAR and PPARγC1a were not associated with arterial stiffness.

[Relationship between serum N-terminal pro-brain natriuretic peptide and metabolic syndrome: a cross-sectional study].

OBJECTIVE: To explore the relationship between serum N-terminal pro-brain natriuretic peptide (NT-proBNP) and metabolic syndrome (MS). METHODS: A total of 1323 Beijing residents (559 male) were investigated. MS was defined by the modified 2004 Chinese Diabetes Society criteria and 439 cases were diagnosed as MS according to this criteria. Multivariate logistic regression analysis was used to estimate the odds ratios (OR) of MS. Multiple linear regression analysis was performed to analyze the association between NT-proBNP and characteristic variables. RESULTS: NT-proBNP was significantly lower in MS group compared to non-MS group [32.51 (29.17, 36.14) ng/L vs.38.55 (35.73, 41.50) ng/L, P = 0.012] after adjusted for age and gender. NT-proBNP level decreased with the presence of MS components (from 0 to 4 or 5) (45.92, 37.24, 35.40, 31.55 and 33.65 ng/L respectively, P = 0.043 for linear trend). Among the components, groups with larger waist circumference, higher fasting glucose and triglycerides were associated with lower NT-proBNP level. After adjustment for potential confounders, compared with the lowest NT-proBNP quartile, the adjusted odds ratio of the second, third and fourth quartile for having MS were 0.782 (95%CI: 0.544 - 1.122, P > 0.05), 0.709 (95%CI: 0.489 - 1.028, P > 0.05), 0.604 (95%CI: 0.405 - 0.900, P < 0.05), respectively. Multiple linear regression analysis showed that female gender (ß = 0.248, P < 0.001), age (ß = 0.167, P < 0.001), systolic blood pressure (ß = 0.154, P < 0.001) were positively related to NT-proBNP level while waist circumference (ß = -0.082, P = 0.004), diastolic blood pressure (ß = -0.085, P = 0.015), triglycerides (ß = -0.101, P < 0.001), total cholesterol (ß = -0.078, P = 0.004), eGFR (ß = -0.150, P < 0.001) were negatively correlated to NT-proBNP level. CONCLUSION: In this cohort, higher serum NT-proBNP concentration is associated with lower incidence of metabolic syndrome.

Association of glomerular filtration rate with arterial stiffness in Chinese women with normal to mildly impaired renal function.

OBJECTIVE: Both decreased glomerular filtration rate (GFR) and arterial stiffness were considered as risk factors for atherosclerosis. Previous studies have suggested the association between central arterial stiffness and the degree of GFR loss. Whether decreased GFR contributes to peripheral artery stiffness remains controversial. Moreover, data analyzed from a cohort of Chinese women are rare. Our aim was to explore the relationship between GFR and regional arterial stiffness in Chinese women. METHODS: In this cross-sectional study, we randomly recruited 1131 adult women residents with GFR ≥ 60 mL/min per 1.73 m(2) estimated by the Chinese Modification of Diet in Renal Disease equation from three large communities. Central and peripheral arterial stiffness were estimated simultaneously by measuring carotid-femoral pulse wave velocity (PWVcf) and carotid-radial PWV (PWVcr) using a validated automatic device. Augmentation Index at heart rate 75 beats/minutes (AIx-75) was measured by pulse wave analysis as a composite parameter reflecting both large and distal arterial properties. RESULTS: The mean estimated GFR (eGFR) of the study group was 100.05 ± 23.26 mL/minute per 1.73 m(2). Subjects were grouped by tertiles of eGFR level. PWVcf and AIx-75 increased ongoing from the top to the bottom eGFR tertile, while the values of PWVcr were comparable. Both univariate Pearson correlations and multiple stepwise regression analyses showed that eGFR significantly correlated to PWVcf, but not to PWVcr and AIx-75. CONCLUSIONS: In Chinese women with normal to mildly impaired renal function, decreased eGFR affected carotid-to-femoral rather than carotid-to-radial stiffening. This provides rational to conduct future prospective studies to investigate predictors of atherosclerosis in this population.

[Relationship between serum homocysteine and metabolic syndrome: a cross-sectional study].

OBJECTIVE: To explore the relationship between serum homocysteine and metabolic syndrome (MS). METHODS: A cohort with 1680 people involved in a community-based population in Beijing was investigated. Metabolic syndrome was defined by NCEP-ATPIII criteria. Multivariate logistic regression analysis was used to estimate the odds ratios (OR) of MS. Multiple linear regression analysis was performed to analyze the association between Hcy and characteristic variables. RESULTS: Homocysteine was higher in MS population compared to those without MS (17.99 µmol/L vs. 17.18 µmol/L, P=0.007) after adjusted for age and sex. Levels of homocysteine increased with the presence of MS components (from 0 to 4 or 5) (16.71, 16.94, 17.62, 18.20, 17.82 µmol/L respectively, P=0.044 for linear trend). Among the components, groups with larger waist circumference, higher blood pressure and triglycerides showed significantly higher Hcy level than their counterparts. RESULTS: from multiple logistic regression analysis revealed that the highest Hcy quartile (Hcy IV) was significantly associated with MS. Compared with the lowest Hcy quartile (Hcy I), the adjusted odds ratio of having MS in HcyIV was 1.379 (1.005-1.892) after adjusting for age, sex, levels on creatinine/estimated glomerular filtration rate (eGFR)/low-density lipoprotein cholesterol (LDL-C) and uric acid, smoking, alcohol intake and exercise. In the partial correlation analyses, Hcy was positively associated with body mass index (BMI), waist circumsternece, blood pressure, LDL-C, triglycerides (TG), uric acid, serum creatinine, eGFR, but inversely associated with high-density lipoprotein cholesterol (HDL-C) and independently with age and sex. In multiple linear regression analysis, age, male sex, BMI, LDL-C, creatinine and uric acid were found to be independently associated with Hcy level. CONCLUSION: There was an association noticed between the MS using NCEP-ATPIII criteria and the highest quartile level of Hcy in this study. Factors as age and being male, the levels of BMI, LDL-C, creatinine and uric acid were independently associated with the Hcy level.

Associations of plasma homocysteine and high-sensitivity C-reactive protein levels with arterial stiffness in Chinese population: a community-based study.

BACKGROUND: Arterial stiffness increases with age and is also associated with traditional cardiovascular risk factors. Little is known about the relations of homocysteine and high-sensitivity C-reactive protein (hs-CRP) to arterial stiffness in the Chinese community. The aim of the present study was to investigate the association of plasma homocysteine and hs-CRP levels with arterial stiffness in a community-based cohort. METHODS: We related levels of homocysteine and hs-CRP to four measures of arterial stiffness (carotid-femoral pulse wave velocity (PWV), carotid-radial PWV, carotid-ankle PWV and heart rate corrected augmentation index) in 1680 participants from two communities of Beijing, China. Arterial stiffness was measured within two days of the time of biomarker measurement. RESULTS: In univariate analysis, homocysteine was positively associated with the carotid-femoral PWV (r = 0.211, P < 0.0001), carotid-radial PWV (r = 0.120, P < 0.0001) and carotid-ankle PWV (r = 0.148, P < 0.0001), whereas it was inversely related to the augmentation index (r = -0.052, P = 0.016). Hs-CRP was positively associated with the carotid-femoral PWV (r = 0.074, P = 0.001) and carotid-ankle PWV (r = 0.050, P = 0.02). In multiple-adjusted models (R(2) = 0.57), homocysteine levels remained a significant determinant of the carotid-femoral PWV (standardized ß = 0.065, P = 0.007), whereas the association of hs-CRP with measurements of arterial stiffness was not present. CONCLUSIONS: In the Chinese population, plasma homocysteine levels are associated with alterations of aortic stiffness, whereas plasma levels of hs-CRP are not independently related to artery stiffening.

Chronic kidney disease: an independent risk factor of all-cause mortality for elderly Chinese patients with chronic heart failure.

OBJECTIVE: To evaluate the prognostic value of chronic kidney disease (CKD) in elderly Chinese patients with chronic heart failure (CHF). METHODS: The study consisted of 327 elderly patients with CHF. All-cause mortality was chosen as an endpoint over the median follow-up period of 345 days. Cox regression analysis was used to identify the risk factors of mortality. RESULTS: The median age of the entire cohort was 85 years (60-100 years). The mortality for 168 elderly patients with CHF and CKD (51.4% of entire cohort) was 39.9% (67 deaths), which was higher than the mortality for CHF patients without CKD [25.2% (40/159 deaths)] and the mortality for entire cohort with CHF [32.7% (107/327 deaths)]. The Cox regression analysis showed that old age [hazard ratio (HR): 1.033; 95% confidence interval (95% CI): 1.004-1.064], CKD (HR: 1.705; 95% CI: 1.132-2.567), CHF New York Heart Association (NYHA) class IV (HR: 1.913; 95% CI: 1.284-2.851), acute myocardial infarction (AMI) (HR: 1.696; 95% CI: 1.036-2.777), elevated resting heart rate (HR: 1.021; 95% CI: 1.009-1.033), and decreased plasma albumin (HR: 0.883; 95% CI: 0.843-0.925) were independent risk factors of mortality for elderly patients with CHF. CONCLUSIONS: CKD was an independent risk factor of mortality for elderly Chinese patients with CHF.

[Effect of pioglitazone on hypoxia/reoxygenation injury and protein kinase C expression in neonatal rat cardiomyocytes].

OBJECTIVE: To observe the effect of pioglitazone on hypoxia/reoxygenation injury and the expression of protein kinase C (PKC) in neonatal rat cardiomyocytes. METHODS: Neonatal Sprague-Dawley rat cardiomyocytes in primary culture were treated with pioglitazone or GW9662 for 24 h prior to hypoxia/reoxygenation injury. Cardiomyocyte apoptosis was evaluated with Hoechst33258 staining and the expression of PKC was detected using Western blotting. RESULTS: In the early stage of hypoxia/reoxygenation injury, the apoptosis rates of the cardiomyocytes increased significantly from (0.20∓0.03)% of the control level to (12.22∓1.45)% (P<0.05). Pretreatment with pioglitazone significantly lowered the apoptosis rate of the cardiomyocytes with hypoxia/reoxygenation injury to (8.32∓0.89)%, and this effect was antagonized by GW9662, a specific blocker of peroxisome proliferators activated receptors γ (PPARγ). Pioglitazone did not cause increased expression of PKC in the cardiomyocytes. CONCLUSION: Pioglitazone can ameliorate neonatal rat cardiomyocyte injury induced by hypoxia/reoxygenation partially by activating PPARγ and does not increase the expression of PKC in the cells.

[Correlations between different obese indexes and arterial stiffness among populations at the community level].

OBJECTIVE: The aim of this study was to investigate the relationship between obesity [measured by body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR)] and arterial stiffness on community populations in Beijing area. METHODS: In a cross-sectional study of 2664 subjects (1379 men and 1285 women) aged (53.19 ± 15.73 years, mean ± standard deviation), BMI, WC, WHR and other cardiovascular risk factors, were measured and carotid-femoral pulse wave velocity (cfPWV) was measured to assess the arterial stiffness. All the data were analyzed with linear correlation analysis, univariate analysis and stepwise regression method to explore the relationship between obese indexes and arterial stiffness. RESULTS: We noticed that a showed the existence of positive correlations between BMI (r = 0.0829, P < 0.01) and cfPWV, WC (r = 0.2659, P < 0.01) and cfPWV, WHR (r = 0.2749, P < 0.01) and cfPWV. In univariate analysis, cfPWV was associated with WC ≥ 85 cm (male) or ≥ 80 cm (female) (P < 0.01), WHR ≥ 0.90 (male) or ≥ 0.85 (female) (P < 0.01). Stepwise regression analysis revealed that WC was an independent risk factor of cfPWV, other than age, gender, systolic blood pressure, HDL-C, OGTT2h etc. CONCLUSION: Our findings indicated that obesity was an independent risk factor of cfPWV, which was an early marker of cardiovascular and renal diseases, among community population in Beijing area. There were different relationships between obesity measurement parameters (BMI, WC, WHR) and cfPWV.

[Pressure wave reflections and central blood pressure in treated hypertensive subjects].

OBJECTIVE: To investigate the differences in pressure wave reflections and central blood pressure between brachial BP classification and the effect of antihypertensive drugs. METHOD: In 1371 chronically treated hypertensive subjects aged 33 - 87 years [679 males and 692 females, mean age (47.2 ± 11.5) years], radial arterial augmentation index (rAI) and central systolic blood pressure were measured using an automated tonometric method. RESULTS: rAI gradually increased from the subgroup with the lower blood pressure to the higher blood pressure (P < 0.01), for each given brachial value, central systolic blood pressure was lower than the corresponding brachial pressure (P < 0.01). In multivariable linear regression models analysis revealed that the application of angiotensin converting enzyme inhibitor (ß = -0.09, P < 0.05), AT1 receptor blockade (ß = -0.07, P = 0.01), calcium channel blocker (ß = -0.12, P < 0.01) and diuretic (ß = 0.14, P = 0.04) were independent determinants of rAI. Central SBP significantly correlated to the application of ACEI (ß = -0.07, P = 0.02), ARB (ß = -0.08, P = 0.01) and CCB (ß = -0.15, P < 0.05). CONCLUSIONS: In chronically treated hypertensive individuals, tight blood pressure control would be effective in reducing the reflection wave and central BP. Antihypertensive treatment strategies with more beneficial effects on arterial properties are needed.

[Radial augmentation index is associated with cardiovascular risk and arterial stiffness].

OBJECTIVE: To investigate whether radial augmentation index (AI) associates with cardiovascular risk as well as arterial stiffness. METHODS: A total of 4985 subjects, 2417 men and 2568 women, aged 18 - 96 (50.9 ± 14.7) years, were recruited. AI was measured in the left radial artery using tonometry Colin HEM-9000AI. Carotid-femoral PWV (CFPWV) and carotid-radial PWV (CRPWV) were examined by automatic pulse wave velocity (PWV) measuring system. Framingham risk score and Chinese ischemic cardiovascular disease risk score were applied upon subjects without cardiovascular disease to calculate individual cardiovascular risk respectively. RESULTS: Radial AI (rAI) was significantly higher in women than in men[ (83.18 ± 12.36)% vs (71.93 ± 15.22)%, P < 0.01]. Simple correlation analysis showed rAI was significantly correlated to two cardiovascular risk scores or CFPWV and CRPWV. After adjusted for multi-factors, rAI was still significantly correlated to Framingham risk score or Chinese ischemic cardiovascular disease risk score (r = 0.17 and 0.12) in men respectively (P < 0.05), while r were 0.09 and 0.08 in women respectively (P < 0.05). In multivariate analysis, there was a significant association between CFPWV and rAI (r = 0.14 in men, r = 0.10 in women, P < 0.01), whereas the relation ship between CRPWV and rAI was not found. The relationship between rAI and cardiovascular risk or PWV became weaker for those aged above 50 years. CONCLUSION: Augmentation index might be a useful marker of cardiovascular risk and arterial stiffness, which could be more feasible for younger subjects as a tool for risk differentiation.

[Effects of pioglitazone on mitochondrial membrane potential of neonate rat's myocardial cells after hypoxia/reoxygenation].

OBJECTIVE: To explore the effectiveness and mechanism of pioglitazone on mitochondrial membrane potential of neonate rat's myocardial cells after hypoxia/reoxygenation. METHODS: Primary cultured myocardial cells of neonate Sprague-Dawley rats were pretreated with different concentrations of pioglitazone, pioglitazone's inhibitor and Chelerythrine, an inhibitor of protein kinase C (PKC). Hypoxia/reoxygenation model was established after 24 h of pretreatment. Subsequently, the mitochondrial membrane potential was detected with JC-1 staining under laser confocal microscopy during reoxygenation phase. RESULTS: Compared with the control group, red/green fluorescent ratio of myocardial cells in the H-r model group decreased significantly after hypoxia/reoxygenation (red/green fluorescent ratio reduced from 1.20 +/- 0.05 to 1.13 +/- 0.02, P<0.01 ), and also decreased in 0.1 micromol/ L, 1 micromol/L and 2 micromol/L pioglitazone group (1.11 +/- 0.01, 1.10 +/- 0.01, 1.16 +/- 0.03, P<0.01, respectively). The red/green fluorescent ratio in pioglitazone + GW9662 group (1.12 +/- 0.02) and pioglitazone + Chelerythrine group (1.07 +/- 0.01) were both significantly lower than those in 2 micromol/L pioglitazone group (P<0.01). CONCLUSION: The mitochondrial membrane potential of neonate rat's myocardial cells was descend after hypoxia/ reoxygenation, while pioglitazone can interrupt the process, indicating that the activation may be relevant to peroxisome proliferator-activated receptor gamma (PPARgamma) ligand and PKC pathway.

[Association of risk factors for cardiovascular disease and the rate of glomerular filtration: a cross-sectional study in the population from certain areas of Beijing].

OBJECTIVE: Data from several large prospective studies revealed that a low glomerular filtration rate was independently associated with cardiovascular disease (CVD) events and all-cause mortality in high-risk populations. Much on the association was explained by traditional CVD risk factors. However, findings from population-based studies were scarce and inconsistent. We explored the correlation between risks factors of cardiovascular and chronic kidney disease (CKD) in a general population from certain area of Beijing. METHODS: A population-based cross-sectional survey was conducted during Sep. 2007 to Oct. 2008 in Beijing. Out of 5100 individuals who were selected, 4515 met the inclusion criteria and responded to the investigation. By face to face interview, a questionnaire was used to find out the risk factors of cardiovascular disease. Body height, body weight and blood pressures were measured. Serum creatinine and total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) were detected. Glomerular filtration rate through using the Modification of Diet in Renal Disease equation was estimated. Participants were grouped into three: >/= 90, 60 - 89, < 60 [mlxmin(-1)x(1.73 m(2))(-1)] by eGFR. Univariate and multivariate logistic regression models were used to identify the associated risk factors. RESULTS: Exposure rate of cardiovascular disease risk factors increased along with the decrease of level of eGFR. Data from univariate logistic regression analyses suggested that age, smoking, history of hypertension and diabetes, BMI, SBP, LDL-C and TG were risk factors of CKD while results from multiple logistic regression indicated that age, smoking, hypertension, high level of TG appeared to be independent risk factors of CKD. CONCLUSION: Exposure rate of cardiovascular disease risk factors increased along with the decrease of level of eGFR while age, hypertension, high level of TG and smoking were independent risk factors of CKD.

[Associations and related factors between pulse wave velocity and arterial system and augmentation index measured on different sites in a healthy population].

OBJECTIVE: To explore the associations and related factors between pulse wave velocity (PWV) and arterial system and augmentation index (AI) measured on different sites in a healthy population. METHODS: All subjects were selected from a local community investigation study which included 5116 people living in Haidian District or Daxing District, Beijing, China. A total of 729 healthy subjects [age 17 - 85 years, mean (39.2 ± 12.2) years, 413 men] were included in this study. Carotid-femoral pulse wave velocity (CF-PWV), carotid-radial pulse wave velocity (CR-PWV) and carotid-ankle pulse wave velocity (CA-PWV) were measured using Complior. Pulse wave analysis at the right radial artery was measured and AI was calculated using SphygmoCor device. RESULTS: CF-PWV correlated significantly with CR-PWV or CA-PWV (all P < 0.01) by both Pearson and Partial Correlation analysis adjusted by age, body mass index, waist-hip ratio, systolic blood pressure, diastolic pressure and heart rate. There was no significant correlation between AI and CR-PWV (r = -0.072, P = 0.053) and between AI and CR-PWV (r = 0.024, P = 0.528), AI and CA-PWV (r = 0.068, P = 0.070) while AI was significantly correlated with CF-PWV (r = 0.110, P = 0.003). Multiple stepwise regression analyses showed that age, systolic blood pressure and heart rate were positively while female gender was negatively correlated with CF-PWV. CR-PWV was positively correlated with diastolic blood pressure and negatively correlated with pulse pressure and female gender (R(2) = 0.155). CA-PWV was positively correlated with systolic blood pressure and age while negatively correlated with pulse pressure and female gender. Multiple stepwise regression analysis also demonstrated that AI was positively correlated with age, diastolic blood pressure, low density lipoprotein cholesterol and female gender, and negatively correlated with heart rate, height and serum creatinine level(R(2) = 0.536). CONCLUSIONS: CA-PWV, covering carotid-femoral arterial segment, could partially represent CF-PWV as an indicator of large arterial stiffness. CR-PWV mainly reflects peripheral muscular arterial stiffness and is not suitable to be used interchangeably with CF-PWV or CA-PWV. Component of blood pressure (systolic, diastolic or pulse pressure) may have different influences on CF-PWV, CA-PWV or CR-PWV. AI is affected by multiple factors and poorly correlated with PWV and is not a good indicator for arterial stiffness.

[Possible determinants of the radial augmentation index in 4985 Chinese population].

OBJECTIVE: The augmentation index (AI) derived from central arteries is generally defined as an index of augmentation of central blood pressure in systole derived from the return of pressure waves reflected from the periphery and is an index of arterial stiffness. There is controversy with respect to how to affect AI. METHODS: In a cross-sectional study of 4985 subjects (2417 men and 2568 women) aged 18 - 96 years (50.94 +/- 14.73 years, mean +/- SD), AI was measured in the left radial artery using tonometry Colin HEM-9000AI. RESULTS: Among the subjects, 39.4% were diagnosed as hypertensive, 11.2% as diabetes mellitus, and 48.7% as hyperlipidemia. Stepwise regression analysis revealed that age, diastolic blood pressure, smoking, heart rate, height, waist circumference and fasting blood glucose were independent determinants of radial AI in women;while in men, it was also determined by total cholesterol. Radial AI was significantly higher in women than in men [(83.18 +/- 12.36)% vs. (71.93 +/- 15.22)%, P < 0.01]. CONCLUSION: Our findings indicate that AI is determined by arterial stiffness, distance to the reflection point and reflection coefficient. It is necessary to take into account these confounding factors when assessing AI is used as an index for atherosclerosis.