Associations between serum potassium and sodium levels and risk of hypertension: a community-based cohort study.

OBJECTIVE: Several studies have examined the relationships between dietary potassium and sodium and hypertension, but few have evaluated the association between serum potassium or sodium and risk of incident hypertension. We therefore investigated the associations between serum potassium and sodium and risk of incident hypertension in a Chinese community-based population. METHODS: A total of 839 normotensive individuals without cardiovascular disease from the Chinese Multi-Provincial Cohort Study who took part in the baseline examination in 2007-2008 and the follow-up survey in 2012-2013 were included in this study. Odds ratios (OR) and 95% confidence intervals (95%CI) for baseline serum potassium and sodium in relation to the risk of new-onset hypertension were evaluated using multivariate logistic regression models. RESULTS: During five years of follow-up, 218 (26.0%) individuals progressed to hypertension. Logistic regression adjusting for multiple confounders showed that every 1 mEq/L increment in baseline serum potassium level was associated with a 75% increased risk of hypertension (OR: 1.75; 95%CI: 1.01-3.04; P = 0.04). Compared with adults with serum potassium level of 4.20-4.79 mEq/L, adults with level ≥ 4.80 mEq/L had an 84% increased risk of hypertension (OR: 1.84; 95%CI: 1.14-2.96; P = 0.01). There was no significant association between serum sodium and risk of hypertension (OR: 0.96; 95%CI: 0.89-1.04; P = 0.33). CONCLUSIONS: Baseline serum potassium level, but not baseline serum sodium level, was positively related to the risk of incident hypertension in the Chinese population.

[Impact of gender on lipoprotein-associated phospholipase A2 activity and association with known cardiovascularrisk factors].

OBJECTIVE: To explore the impact of gender on lipoprotein-associated phospholipase A(2) (Lp-PLA(2)) activity and association with known cardiovascular risk factors. METHODS: Participants in this study were recruited from Beijing sub-cohort from the Chinese Multi-provincial Cohort Study (CMCS) database. A total of 1471 participants with complete laboratory data were included in the study (688 male). Lp-PLA(2) activity was determined by colorimetric assay kit.Lp-PLA(2) activity level and correlation between Lp-PLA(2) activity and known risk factors were compared between men and women. RESULTS: (1) Lp-PLA(2) activity was higher in males than in females [(22.73 ± 8.52) nmol·min(-1)·ml(-1) vs.(20.01 ± 8.06) nmol·min(-1)·ml(-1), P < 0.01].(2) Age, waist circumference, systolic blood pressure, diastolic blood pressure and the prevalence of hypertension were higher in males than in females, while total cholesterol, low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C) were higher in females than in males (P < 0.05 or P < 0.01).(3)Pearson correlation showed that Lp-PLA(2) activity was correlated with lipids ( total cholesterol, LDL-C, HDL-C, and triglyceride), blood pressure (systolic blood pressure and diastolic blood pressure), and adiposity associated parameters (waist circumference and body mass index) in males (all P < 0.01) and was correlated with lipid level (total cholesterol, LDL-C, HDL-C, and triglyceride) and age in females( P < 0.05 or P < 0.01). Correlations with variables associated with obesity or blood pressure in females were much weaker than those in males (in females, r = 0.02-0.08; in males, r = 0.10-0.16).(4)After adjustment for age, waist circumference, systolic blood pressure, glucose, LDL-C, HDL-C, triglyceride and high sensitivity C-reactive protein by multiple logistic regression model, Lp-PLA(2) activity was still significantly higher in males than in females (OR = 1.72, 95% confidence interval = 1.34-2.21, P < 0.01). CONCLUSIONS: Lp-PLA(2) activity and association with known cardiovascular risk factors differed in males and females. The gender difference in Lp-PLA(2) activity still presents after adjustment for known cardiovascular risk factors in this cohort.

Use of traditional Chinese medicine in Chinese patients with coronary heart disease.

OBJECTIVE: To study the use of traditional Chinese medicine (TCM) or both TCM and guideline-recommended Western medicine (WM) in Chinese patients with coronary heart disease (CHD). METHODS: A cross-sectional nationwide survey of 2803 CHD outpatients was completed by collecting information, including general demographic data, disease history, and use of drugs (including TCM and WM). RESULTS: Of the 2712 CHD outpatients with complete drug treatment data, only 3.1% received TCM without any WM for CHD, 30.0% received both TCM and WM recommended by current CHD guidelines, and 66.9% received only WM. Patients with a longer history of CHD or with a history of stroke, were more likely to use TCM. However, 90.6% of CHD patients who used TCM also used certain WM. Furthermore, patients who used more types of TCM tended to use much less WM recommended by current guidelines. CONCLUSION: A substantial proportion of Chinese CHD outpatients use both TCM and WM for secondary prevention of CHD. It is important to assess the effect of combined TCM and WM on major clinical outcomes in Chinese CHD patients.

[Association between glucose level and carotid plaque among 50 - 79 year olds from the communities].

OBJECTIVE: To investigate the association between fasting blood glucose levels and the prevalence of carotid plaque in a community-based population of Beijing and to further explore the association between fasting glucose levels concomitant wand other cardiovascular risk factors as well as the prevalence of carotid plaque. METHODS: This study was a part of the Chinese Multi-provincial Cohort Study conducted in the communities of Beijing University in 2007. All the members aged 50 - 79 years from the community were recruited, with 1046 of them qualified as without missing data. Case of diabetes was defined if the fasting glucose level was greater than 7.0 mmol/L or on anti-diabetic drugs. RESULTS: The mean level of fasting glucose was 5.89 mmol/L, and the prevalence of carotid plaque was 56.3%. For the reference on normal levels of fasting glucose, the risk on carotid plaque had an increase along with the increase of fasting glucose levels only under the univariate and multivariate analyses, after adjusting for age. However, the risk on carotid plaque in women was increased when there was an increase on the levels of fasting glucose. Specifically, for the reference on normal levels of fasting glucose, after adjusting for other cardiovascular risk factors, the odds of developing a carotid plaque was more than two folds in diabetic women. When combining the groups of risk factors (normal and abnormal) among the three groups of fasting glucose and assigning the normal level of risk factors concomitant with normal fasting glucose as a reference for both genders, the risk of developing a carotid plaque in diabetic women with abnormal level of risk factors ranked the highest, with statistical significance. When the diabetic patients combined with a decreased levels of HDL but increased levels of LDL, blood pressure, waist circumference, there appeared 2.8-(P = 0.014), 2.7-(P = 0.010), 2.4-(P = 0.013) and 2.1-times (P = 0.031) higher risks of developing carotid plaque than those in the reference group, respectively. CONCLUSION: In this study, the prevalence of carotid plaque driven by increased fasting glucose was different on gender but the difference was only statistically significant in women. There also appeared a joint association of fasting glucose combined with other cardiovascular risk factors on the risk of developing a carotid plaque.

[The epidemiology of out-of-hospital deaths due to acute coronary events in young Beijing adults].

OBJECTIVES: To explore the characteristics of status and different populations of prehospital death associated with acute coronary events among young adults in Beijing. METHODS: Data of acute coronary events of hospitalization or death were obtained from the Hospital Discharge Information System from Beijing Public Health Information Center and Death Register System from Beijing Center for Disease Control in Beijing. The total case fatality rate of acute coronary events and proportion of prehospital coronary heart disease (CHD) death were compared upon gender, area, occupation and marital status among people aged between 25 - 45 years old. RESULTS: A total of 3489 cases were identified during 2007 to 2009 with acute coronary events (male: 3183, female: 306), with a mean age of (40.5 ± 4.3) years old. The 3-years' overall mortality was 26.0%, with female's higher than male's (51.0% vs 23.6%, P < 0.05); and it was higher in rural area than in urban areas (28.9% vs 22.9%, P < 0.05). Ninety-five percent of death due to acute coronary events occurred prehospital, with the proportion of 95.2% in male and 94.2% in female. Among the people with different occupations, self-employed people had the highest rate of prehospital death. Majority of prehospital deaths (64.8%) occurred at home. CONCLUSION: More than 90% of deaths caused by acute coronary events among young adults aged between 25-45 years old occurred before been admitted into hospital, and the site of prehospital deaths was mainly at home.

[Association between high sensitivity C-reactive protein levels in serum and the 5-year-accumulative-risk of diabetes].

OBJECTIVE: To analyze the association between hs-CRP (high-sensitivity C-reactive protein) levels in serum and the 5-year-accumulative-risk of diabetes in a general population. METHODS: Participants were from the cohort of Peking University residential community in the Chinese Multi-provincial Cohort Study (CMCS). Two surveys on cardiovascular risk factors and the measurements of serum hs-CRP levels were conducted in 2002 and 2007, respectively. Individuals with incomplete information and those having infectious diseases at baseline were excluded. A total of 1045 participants aged 45 to 74 years and free of diabetes at baseline were included in this analysis. RESULTS: The age-standardized 5-year accumulative incidence rate of diabetes was 8.8% (male: 9.8%, female: 8.2%) and increased significantly with the level of hs-CRP in both women and men (P<0.01). After adjustment for age, hypertension, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol, triglycerides, fasting glucose, smoking status and central obesity, people with hs-CRP≥3 mg/L had a 3.30 times higher risk of developing diabetes in men and 2.58 times for women when compared to those with hs-CRP<1 mg/L. The areas under the receiver operating characteristic curves of baseline hs-CRP level in predicting the incidence of diabetes were 0.619 (95%CI: 0.536-0.701) in men and 0.667 (95%CI: 0.585-0.749) in women. CONCLUSION: Serum hs-CRP levels could predict the incidence of diabetes, indicating that inflammation might have great importance in the onset of diabetes.

[Relationship between serum non-high-density lipoprotein cholesterol and incidence of cardiovascular disease].

OBJECTIVE: To evaluate the relationship between serum non-HDL-C and incidence of various cardiovascular disease (CVD) in Chinese population aged 35-64 years. METHODS: This prospective study was performed from 1992 to 2004 in 11 provinces of China and the association between baseline non-HDL-C level with the risk of various CVD events was analyzed in 29 937 subjects aged 35-64 years using Cox multivariate proportional hazards regression. CVD events in this study including acute coronary events (ACE), ischemic stroke, hemorrhagic stroke and ischemic cardiovascular disease (ICVD). RESULTS: (1) Adjusted for age, gender, smoking status, diabetes, body mass index and blood pressure, the relative risk of ACE, ischemic stroke and ICVD in groups of non-HDL-C 3.37 - 4.13 mmol/L (130 - 159 mg/dl), 4.14 - 4.91 mmol/L (160 - 189 mg/dl) and ≥ 4.92 mmol/L (190 mg/dl) was 1.24 (0.91 - 1.70), 1.78 (1.25 - 2.53), 2.23 (1.48 - 3.35); 1.34 (1.07 - 1.68), 1.38 (1.04 - 1.83), 1.38 (0.97 - 1.94) and 1.37 (1.12 - 1.63), 1.52 (1.22 - 1.90), 1.70 (1.30 - 2.22), respectively. The risk of hemorrhagic stroke was declined obviously in group > 4.92 mmol/L (190 mg/dl). (2) The correlation between VLDL-C and ACE was the strongest in four CVD events when VLDL-C and LDL-C were joint analyzed, ICVD events ranked the second. The risk for ischemic stroke also borderline increased with increasing VLDL-C and LDL-C (P > 0.05). CONCLUSION: Increased non-HDL-C is associated with increased risk of suffering ACE, ischemic stroke and ICVD and VLDL-C plays a critical role in the development of ICVD events, especially ACS, in middle aged Chinese population.

[Association between the risk factors of cardiovascular diseases and insulin resistance].

OBJECTIVE: To explore the association between risk factors of cardiovascular diseases (CVD) and insulin resistance in a cross-sectional study. METHODS: An investigation on risk factors of CVD was carried out using stratified-random sampling method among 1475 participants in Beijing. Homeostasis model assessment index (HOMA) was calculated to assess the insulin resistance in 1359 non-diabetic subjects aged 25 - 64 years. Insulin resistance was defined as HOMA index (fasting glucose in mmol/L x fasting insulin in mU/L/22.5) in the top quartile of the studied population. RESULTS: The degree of correlation between risk factors and natural logarithm of HOMA index in descending order were glucose, body mass index (BMI), triglyceride (TG), waist circumstance, high density lipoprotein-cholesterol (HDL-C), uric acid, diastolic blood pressure, systolic blood pressure and total cholesterol (TC) (all P < 0.01). After adjusting factors as sex and age, glucose (r = 0.49), BMI (r = 0.44), TG (r = 0.44), waist circumstance (r = 0.41), uric acid (r = 0.33) and HDL-C (r = -0.32), the systolic blood pressure (r = 0.20), diastolic blood pressure (r = 0.18) and TC (r = 0.16) were independently correlated with HOMA index (P < 0.001). Sex (OR = 1.75), low HDL-C (OR = 1.80), hyperuricemia (OR = 2.11), high TG (OR = 2.14) and central obesity (OR = 2.68) appeared to be independently correlated to insulin resistance in multiple logistic regression analysis. CONCLUSION: The risk factors of CVD as low HDL-C, high TG, central obesity and hyperuricemia were independently correlated to insulin resistance.

[Real world use of statins for secondary prevention in patients with high risk coronary heart disease in China].

OBJECTIVE: To observe the real world statins use for secondary prevention in patients with high risk coronary heart disease (CHD) in China. METHODS: Sixty-four hospitals across 31 provinces of China including 32 secondary hospitals and 32 tertiary hospitals were selected for baseline survey. Fifty consecutive outpatients with established history of acute coronary syndrome were recruited in each hospital. Information of these patients including statins use was collected. RESULTS: A total of 2516 high risk CHD outpatients were involved in present report. Mean age of the patients was (65 ± 10) years and 69.4% patients were male. Fifty-seven point nine percent patients were treated with a statin at the time of interview and recommended low-density lipoprotein-cholesterol (LDL-C) target was achieved in 29.8% patients. Percent of statin use and achieving LDL-C goal was significantly higher in male outpatients than in female outpatients. Outpatients admitted in tertiary hospitals were more likely to have achieved their LDL-C targets than those admitted in secondary hospitals. Statin use was more often for patients in South China than patients in North China. The percentage reaching the optimal LDL-C treatment target was the highest in Central China (38.5%) and the lowest in Northeast China (18.5%). At this interview, 68.2% outpatients were prescribed statins and 24.1% prescribed doses of statins were sub-minimal. CONCLUSION: There was a gap between real world statin use and guideline recommendations for secondary prevention in high risk CHD patients in China.

[Association between body mass index and ten-year-accumulative-risk of hypertension].

OBJECTIVE: To explore the association between body mass index (BMI) and ten-year accumulative risk of hypertension. METHODS: A prospective study of relationship between blood pressure and other traditional risk factors was carried out in a cohort with 2115 people aged 35-64 years old involved, in 1992 and 2002. The association between baseline BMI level and a ten-year accumulative risk of hypertension was analyzed. RESULTS: The ten-year accumulative incidence rate of hypertension was 34.8%, and increased with the elevated baseline BMI level in both genders (P < 0.001). Similar changing trends were observed in both age groups of 45-54 year and 55-64 year olds (P < 0.05). Multivariable OR (95% CI) of accumulative incident hypertension in the highest BMI tertile ( > or =28 kg/m2) was 3.569 higher (2.559 to 4.977) when compared to the lowest ( <24 kg/m2n). The ten-year accumulative risk of hypertension increased 17.5% with elevation of baseline BMI level by 1 kg/m2. The ten-year accumulative incidence rate of hypertension was 22.0% in the subjects with normal BMI and 56.3% in those with obesity, both in 1992 and 2002. CONCLUSION: BMI appeared to be an independent risk factor for hypertension, and the risk of incident hypertension increased with elevated BMI level.

[Association between plasma fibrinogen concentration and ten-year change in blood pressure].

OBJECTIVE: To explore the association between plasma fibrinogen (FIB) concentration and ten-year change in blood pressure in Chinese population aged 35 - 64. METHODS: A prospective cohort comprising 2683 subjects was established in Beijing in 1992. Blood pressure (BP) and other traditional cardiovascular risk factors were assessed in 1992 and 2002 respectively, and plasma FIB concentration was measured in 1992. The association of plasma FIB with ten-year change in blood pressure was analyzed. RESULTS: (1) The median concentration of FIB among this population was 3.8 g/L (3.2 - 4.3 g/L), and the percentage of the people with abnormal FIB concentration (FIB > 4.0 g/L) was 33.4% in 1992. The FIB concentration of the females was higher than that of the males (P < 0.01) and the FIB concentration of the hypertensive subjects was significantly higher than that of the non-hypertensive subjects (P < 0.05), however, there was no significant difference in the abnormal FIB rate among different age groups. (2) Compared with the BP levels in 1992, the systolic BP and diastolic BP of this population increased by 10.0 mm Hg and 5.0 mm Hg respectively in 2002. The partial correlation coefficients of baseline FIB concentration with ten-year difference for systolic and diastolic BP were 0.125 (P < 0.01) and 0.047 (P < 0.05) respectively, and the absolute value of 10-year increase of systolic pressure in the subjects with abnormal FIB was significantly higher than that in those with normal FIB (P < 0.01). (3) The BP grade 2002 was higher than the baseline grade in 1992 in 49.6% of the study population. The BP grade increase rate of the subjects with abnormal FIB was 55.3%, significantly higher than that of the subjects with normal FIB (46.8%, P < 0.05). (4) In the population without baseline hypertension the risk of BP grade increase within 10 years in those with abnormal FIB was 1.46 times the risk in those with normal FIB, the multivariable OR (95% CI) was 1.457 (1.201 - 1.768) for those with normal BP and 2.082 (1.422 - 3.048) for those with hypertension. CONCLUSION: Plasma FIB concentration is associated with the BP change. Improvement of high coagulation and high adhesion help control BP, especially in people with hypertension.

[Association between hypertensive left ventricular hypertrophy and cardiovascular events in adult Beijing residents: a cohort study].

OBJECTIVE: To analyze the impact of hypertensive left ventricular hypertrophy (LVH) on cardiovascular events (CVD) in adult Beijing residents. METHODS: CVD risk factor survey was conducted in 7023 Beijing residents aged 25 - 64 by a stratified-random sample design from 1984 to 1993 in three years interval. CVD events were followed up and the association of the hypertensive LVH and risk of CVD and total death was analyzed by multivariable Cox Regression Model. All subjects were followed up to December 2004. RESULTS: There were 211 non hypertensive LVH patients in the cohort and were excluded from the study. (1) There were 2240 hypertensive patients among 6812 subjects on baseline. The total prevalence of LVH was 11.8% (16.1% in male and 7.5% in female). (2) Compared to the group with normal blood pressure and without left ventricular hypertrophy, subjects with hypertensive LVH had significantly higher risk for acute coronary, acute stroke, total CVD and total death rate. The relative risks (RR) were 4.92 (95% CI: 2.3, 10.7), 4.2 (95% CI: 2.6, 7.0), 4.1 (95% CI: 2.6, 6.3) and 3.3 (95% CI: 2.0, 5.3), respectively. (3) Compared to the group with hypertension and without LVH, the group with hypertensive LVH had also significantly higher risk for acute stroke, total CVD and total death rate. The RR were 1.8 (95% CI: 1.1, 2.8), 1.7 (95% CI: 1.2, 2.3) and 1.7 (95% CI: 1.1, 2.7), respectively. (4) The population attribute risks (PAR) of hypertensive LVH to the incidents of acute CHD, acute stroke, total CVD and total death were 13.0%, 11.0%, 10.4% and 7.9%, respectively. CONCLUSIONS: Hypertensive left ventricular hypertrophy was an independent risk factor for long term risk of cardiovascular events and death.

[The association between white blood cell count and 10-year cardiovascular risk in a large Chinese cohort aged 35-64 years].

OBJECTIVE: To evaluate the association between white blood cell count and the risk of cardiovascular diseases (CVD) in subjects aged 35 - 64 years. METHODS: This prospective study was carried out in 11 provinces from 1992 to 2003. The association of baseline white blood cell count and cardiovascular disease occurrence was analyzed in 30 384 subjects aged 35 - 64 years using Cox multivariate proportional hazards regression. RESULTS: (1) Compared with the group of 4.0 - 4.9 x 10(9)/L, multivariate-adjusted relative risk of ischemic cardiovascular disease (ICVD, including coronary heart disease and ischemic stroke) increased continuously in proportion to increased white blood cell count. (2) White blood cell count had different impact on different types of CVD. Positive association was observed between white blood cell count and the risk of ischemic stroke, but the relationship between white blood cell count and the risk of hemorrhagic stroke was not significant. Compared with the referent group (4.0 - 4.9 x 10(9)/L), the risk of coronary heart disease of the group of white blood count > 9.0 x 10(9)/L increased by 70% (RR = 1.71, P < 0.05) and that of ischemic stroke increased by 80% (RR = 1.85, P < 0.01). CONCLUSION: The risk of ICVD and CVD increases continuously in proportion to increased white blood cell count, the white blood cell count might be used to predict future risk of CVD, especially risk for ICVD.

[Predictive value of combined measurements of body mass index and waist circumference for the risk of cardiovascular disease].

OBJECTIVE: To evaluate the predictive value of the combined measurements of body mass index (BMI) and waist circumference (WC) for the risk of cardiometabolic diseases (including diabetes, hypertension, and dyslipidemia) and ischemic cardiovascular disease. METHOD: A total of 30,378 Chinese people from 11 provinces were studied in this prospective study conducted from 1992 to 2003. Multivariable logistic and Cox regression were used respectively to determine the predictive value of WC for cardiometabolic diseases and ischemic cardiovascular disease within each BMI categories. RESULTS: (1) The prevalence of obesity were 10% defined by BMI. Among them, 76.4% had abdominal obesity defined by WC. The prevalence of abdominal obesity was 17.5% by WC categories, and 43.4% of them were classified as obesity by BMI. (2) The prevalence rates of cardiometabolic diseases were higher in individuals with elevated WC within each BMI category. (3) Compared with subjects with normal BMI and WC, the risk of ischemic cardiovascular disease increased by 38% (RR = 1.383, 95% CI 1.083 - 1.765) in overweight subjects with elevated WC and by 57% (RR = 1.570, 95% CI 1.226 - 2.010) in obese subjects with elevated WC. CONCLUSION: Combined measurements of BMI and WC provide a better prediction for the risk of cardiometabolic diseases and ischemic cardiovascular disease.

[Serum triglyceride is an independent risk factor for acute coronary heart disease events in 35 - 64 years old Chinese-Chinese Multi-provincial Cohort Study.].

OBJECTIVE: To evaluate the association between serum triglyceride (TG) and the cardiovascular diseases (CVD) risk in Chinese population. METHODS: A total of 30, 378 men and women aged 35 - 64 years old were recruited in the Chinese-Chinese Multi-provincial Cohort Study (CMCS). The serum TG and other CVD risk factors were measured. All subjects were followed up annually or biannually for acute CVD events from 1992 to 2004. A Cox regression model was established to identify the association between TG and risk of CVD events. RESULTS: The accumulative incidence rate of acute coronary heart disease (CHD) events increased from 62.6/100 000 in the low TG groups to 168.4/100 000 in the high TG group divided by the quartile. TG was identified as an independent risk factor for CHD after adjustment for the confounding risk factors by a Cox regression model. Compared subjects with TG < 0.81 mmol/L, CHD risk increased 81% and 59% in subjects with TG 1.15 - 1.59 mmol/L and TG >/= 1.60 mmol/L, respectively (all P < 0.05). There was no significant association between TG level and the risks of hemorrhagic and ischemic stroke events (P > 0.05). CONCLUSION: Serum TG is an independent risk factor for acute CHD events in Chinese population aged 35 - 64.

[Incidence risk of cardiovascular diseases associated with specific combinations regarding the metabolic syndrome components].

OBJECTIVE: To investigate the risk of cardiovascular diseases (CVD) incidence related to different combinations of the metabolic syndrome (MS) components. METHODS: A total of 30,378 subjects aged 35 to 64 years were recruited from 11 provinces in a Chinese Multi-provincial Cohort Study and followed-up for new CVD) from 1992 to 2004. MS was defined under the new criteria 'Preventive Guideline of Dyslipidemia for Chinese Adults', issued in 2007. CVD incidence rates and relative risks (RR) were estimated by different MS components and by their various combinations. RESULTS: (1) According to the new criteria, the prevalence of MS was 11.8% for Chinese middle-age adults. The prevalence was 12.4% in men,significantly higher than that in women (9.0%). (2) Risk of CVD increased in proportion to the number of MS components after adjusting for other risk factors. If only 1 component was present, elevated blood pressure was the only significant predictor of CVD. When 2 components were present, 5 of the 10 combinations were associated with significantly higher risk. All combinations with > or =3 components (MS) had significant contribution except for those rare traits (<0.5% of the whole sample). Among the 16 combinations of > or =3 components,the feature of "central obesity and elevated blood pressure" was found in all the 7 combinations with the highest risk. CONCLUSION: CVD risk associated with various number and combinations of MS components seemed to be heterogeneous. The clustering of > or =3 disorders, especially those with central obesity and elevated blood pressure could significantly predict the future development of CVD.

[A cross-sectional study on cognitive function and influencing factors in patients with hypertension].

OBJECTIVE: To compare the differences of cognitive functions in patients with hypertension and normotensives, and to analyze the primary influencing factors on cognitive functions. METHODS: This was a cross-sectional study carried out in two community populations of Beijing in 2001. The study subjects consisted of 83 hypertensive individuals aged 50-65 years, who were both stroke and dementia-free, the control group was chosen with 83 normotensives who were matched one by one with hypertensive individuals on age, sex, educational level and occupation. Socio-demographic, behavioral, medical history, and physiological data were collected on all participants through interview and medical examination. A comprehensive and computerized neuropsychological battery was administered. RESULTS: The total score of Basic Cognitive Ability Examination on hypertension (63.62) was worse than that among controls (68.58) with P < 0.01. Mean reaction time of Digit Discrimination of hypertensive (1.25) was longer than controls (1.17) with P < 0.05. The span of Digit Working Memory of hypertensive (4.96) was shorter than controls (5.63) with P < 0.05. The Score of Dual-Word Recognition of hypertensive (12.05) was lower than controls (13.45) with P < 0.01. Educational level, age and hypertension were the primary influencing factors on cognitive function. CONCLUSION: Patients with hypertension performed significantly worse than controls on velocity of perception, working memory and word memory. The findings suggested that the prevention of hypertension could protect cognitive function.

[Relationship between metabolic syndrome and 10-year risk for incident type 2 diabetes mellitus].

OBJECTIVE: To analyze the relationship of metabolic syndrome (MS) and its components at baseline to the 10-year incidence of diabetes mellitus. METHODS: An investigation on cardiovascular disease (CVD) risk factors, including questionnaire survey, physical examination, and laboratory examination, was carried out in the populations of 4154 subjects, aged 35 approximately 64, in 2 communities (Peking University and Capital Iron and Steel Company area) collected by cluster sampling in the year 1992, with a response rate of 82.0%, so as to obtain baseline data. In 2002 a follow-up survey was conducted among these same populations, aged 45 approximately 74 then with a response rate of 70.0%. Complete data were obtained from 2740 subjects during the 2 investigations. The data of 2659 subjects who were diagnosed as without diabetes mellitus type 2 (T2DM) during the baseline survey, 1177 males (44.3%) and 1482 females (55.7%), were analyzed. RESULTS: (1) 112 patients with T2DM were discovered during the follow-up survey with an incidence of 4.2%, the incidence being 5.0% in males and 3.6% in females. (2) The proportions of those with different MS components were higher among the T2DM patients than those without T2DM. The proportion of baseline high fasting glucose was 71.43% among those who were diagnosed as with T2DM during the follow-up survey. Of the MS components high fasting glucose had the highest proportion among the T2DM patients. (3) Adjusted for age and sex, the results using a logistic regression model showed that abdominal obesity, triglycerides and fasting glucose were the independent factors associated with T2DM in addition of blood pressure and HDL cholesterol. Among them, fasting glucose contributed mostly to T2DM with a relative risk (RR) of 7.14 (4.62, 11.03). (4) Compared with those without both MS and high fasting glucose, the relative risk of T2DM for persons with MS but without high fasting glucose was 2.91 times that for those without MS and with normal fasting glucose. CONCLUSION: MS is an independent indicator for incidence of T2DM. Among the MS components, high fasting glucose contributes mostly to T2DM; however, the prediction of MS for T2DM cannot be entirely explained by high fasting glucose. Those without high fasting glucose but with MS should take early intervention measures to prevent the incidence of T2DM.

[A comparison of three diagnostic criterions for metabolic syndrome applied in a Chinese population aged 35-64 in 11 provinces].

OBJECTIVE: To compare the differences of three diagnostic criterions for metabolic syndrome( MS), issued by the National Cholesterol Education Program(NECP), International Diabetes Federation(IDF) and CDS,in a Chinese population aged 35-64 years in 11 provinces. METHODS: A total of 29 564 Chinese resedents aged 35-64 years were recruited from 11 provinces and a survey on cardiovascular risk factors was conducted in 1992. Additionally,3129 participants were added into the study from 1996 to 1999. MS prevalence was calculated according to three definitions and results of MS components distributions and risk factor aggregation were analyzed. RESULTS: (1)The age-adjusted prevalence of MS in Chinese population were 18.7% for ATP III criterion, 14.6% for IDF criterion and 9.0% for CDS criterion,respectively. (2)Seventy-seven point eight percent of the subjects with MS diagnosed by ATP II criterion presented central obesity. Four point six percent of subjects without MS diagnosed by IDF criterion and 11.2% of subjects without MS diagnosed by CDS criterion presented at least 3 risk factors, respectively. (3)Kappa index showed 0.795 for ATPIII criterion and 0.899 for IDF criterion when applied in Chinese population. (4)The shortest distance in ROC curve for forecasting risk factor aggregation of MS was 0.40 in male and 0.34 in female when waist circumferences were 85 cm in males and 80 cm in females respectively. CONCLUSION: ATPIII definition could be used to detect the highest prevalence of MS and the percent of risk factor aggregation among three definitions. The appropriate cut-off points of waist circumference for Chinese were 85 cm for male and 80 cm for female respectively.

[Impact of new criterion of glucose level on the prevalence of impaired fasting glucose and risk of ischemic cardiovascular diseases].

OBJECTIVE: To evaluate the effect of lowering the fasting plasma glucose (FPG) cutoff point for the criterion of impaired fasting glucose (IFG) in the 2003 ADA guideline on the prevalence of IFG and risk of ischemic cardiovascular diseases (ICVD) associated with IFG in Chinese population. METHOD: A prospective study was carried out in 11 provinces from 1992 to 2003. The baseline survey was conducted according to the WHO-MONICA protocol for risk factor surveys. These subjects have been followed-up for coronary heart disease (CHD) and stroke since the baseline survey. The association between baseline FPG and ICVD (CHD and ischemic stroke) events in 30 378 subjects aged 35 - 64 years in the 10-year follow-up period was analyzed. RESULTS: (1) Lowering the criterion for diagnosing IFG to 5.55 mmol/L increased the prevalence of IFG from 6.9% to 21.6% in Chinese population aged 35 - 64 years. (2) As compared with the group of FPG less than 5.55 mmol/L, the prevalence of other traditional CVD risk factors increased in the FPG level of 5.55 - 6.05, 6.11 - 6.94 and 6.99 mmol/L or above. (3) Univariate analysis method showed that the 10-year accumulated incidence and relative risk for ICVD increased with the elevated baseline level of FPG. (4) After adjusting for age and other ICVD risk factors (including hypertension, lipid disorder, smoking and obesity) FPG level of 5.55 - 6.05 mmol/L showed an independently predictive value for ICVD in men (RR = 1.302, 95% CI = 1.021 - 1.660), but not in women (RR = 1.255, 95% CI = 0.887 - 1.776). Hypertension, low HDL-C, smoking (men) and central obesity (women) were more strongly associated with ICVD than glucose status. CONCLUSIONS: The newly defined IFG criterion (FPG 5.55 - 6.94 mmol/L) increased the prevalence of IFG by more than 2 times in Chinese population aged 35 - 64 years. The 10-year accumulated incidence and relative risk for ICVD increased with the elevated baseline level of FPG. The predictive value of hyperglycemia for ICVD was weaker than that of other traditional risk factors. Comprehensive intervention for multiple risk factors clustering should be strengthened to reduce the overall risk of CVD.