Risk stratification of atherosclerotic cardiovascular disease in Chinese adults.

OBJECTIVE: This study aims to determine the distribution of observed atherosclerotic cardiovascular disease (ASCVD) incidence in contemporary cohorts in China, and to identify cut-off points for ASCVD risk classification based on traditional criteria and new equations developed by Prediction for ASCVD Risk in China (China-PAR). METHODS: The study populations included cohorts in the China-PAR project, with 34,757 participants eligible for the current analysis. Traditional risk stratification was assessed by using Chinese guidelines on prevention of CVD and hypertension, and 5 risk groups were classified based on these guidelines after slight modification for available risk factors. Kaplan-Meier analysis was conducted to obtain the cumulative incidence of observed ASCVD events for all subjects and sub-groups. The predicted 10-year ASCVD risk was obtained using the China-PAR equations. RESULTS: A total of 1922 ASCVD events were identified during an average follow-up of 14.1 years. According to the group classification based on traditional risk stratification, the observed 10-year risks for ASCVD were 4.61% (95% confidence interval [CI]: 4.11-5.10%) in the moderate-risk group and 8.74% (95% CI: 7.82-9.66%) in the high-risk group. Based on the China-PAR equations for risk assessment of ASCVD, those with predicted risks of <5%, 5-10%, and ≥10% could be classified into categories of low-, moderate-, and high-risk for ASCVD, respectively. CONCLUSION: The findings enable development of a simple method for classification of individuals into low-, moderate-, and high-risk groups, based on the China-PAR equations. The method will be useful for self-management and prevention of ASCVD in Chinese adults.

Effect of elevated total cholesterol level and hypertension on the risk of fatal cardiovascular disease: a cohort study of Chinese steelworkers.

BACKGROUND: Increased blood pressure and elevated total cholesterol (TC) level are the two most important modifiable risk factors of cardiovascular disease (CVD) in the world. Hypertension and hypercholesterolemia co-exist more often than would be expected and whether there is a synergistic impact on fatal CVD between elevated TC and hypertension need to be further examined in Chinese population. METHODS: We conducted a cohort study which recruited 5092 Chinese male steelworkers aged 18 - 74 years in 1974 - 1980 and followed up for an average of 20.84 years. Totally 302 fatal CVD events were documented by the year of 2001. Cox proportional hazards regression models were undertaken to adjust for baseline variables with fatal CVD events as the outcome variable. Additive interaction model was used to evaluate the interaction between elevated TC and hypertension. RESULTS: Hypercholesterolemia and hypertension were significantly associated with an increased hazard ratio (HR) of fatal CVD (1.67 (95%CI 1.18 - 2.38) and 2.91 (95%CI 2.23 - 3.80) respectively. Compared to participants with normotension and TC < 240 mg/dl, the HRs were 1.11 (95%CI 0.56 - 2.21), 2.74 (95%CI 2.07 - 3.64) for hypercholesterolemia and hypertension respectively, and 5.51 (95%CI 3.58 - 8.46) for participants with both risk factors. There was an additive interaction with a 2.65 (95%CI 0.45 - 4.85) relative excess risk (RERI) between hypercholesterolemia and hypertension on CVD. CONCLUSION: We found that the risk of fatal CVD was significantly associated with an additive interaction due to hypercholesterolemia and hypertension besides a conventional main effect derived from either of them, which highlights that the prevention and treatment of both risk factors might improve the individual risk profile thus reduce the CVD mortality.

The effect of total cholesterol on myocardial infarction in Chinese male hypertension population.

OBJECTIVE: Total cholesterol (TC) is an important risk factor for myocardial infarction (MI), but the effect of TC on MI in Chinese male hypertension population has not been well documented. We conducted a prospective cohort study to determine the incidence and relative risk for MI across a wide range of TC levels in Chinese male hypertension population. METHODS: A cohort of 5298 male employees aged 18-74 years recruited from Capital Steel and Iron Company in Beijing of China in 1974-1980 was followed up for an average of 20.84 years. A total of 122 incident MI cases were identified during the period of follow-up. RESULTS: The incidence of MI among participants with elevated TC and those with desirable TC in male non-hypertension population was 137.20 and 63.81 per 100,000 person-years, respectively; and the corresponding incidence in male hypertension population was 279.80 and 130.96 per 100,000 person-years, respectively. After adjustment for important covariables, 10.38%, 16.71%, and 23.80% of MI cases were attributable to hypertension, elevated TC, and hypertension plus elevated TC, respectively. In male hypertension population, the multivariate adjusted hazard ratios of MI were 1.21, 2.39, 3.38, and 3.95 for participants with TC level of 5.17-5.68, 5.69-6.20, 6.21-6.71, and > or = 6.72 mmol/L, compared with those with TC < 5.17 mmol/L. The corresponding population attributable risks were 2.92%, 9.20%, 8.87%, and 9.84%, respectively. CONCLUSION: Elevated TC is an important independent risk factor of MI both in male non-hypertension and hypertension populations. There is a linear association between TC level and MI incidence in Chinese male hypertension population.

Traditional Chinese herb Dihuang Yinzi (DY) plays neuroprotective and anti-dementia role in rats of ischemic brain injury.

AIM OF THE STUDY: Traditional Chinese herb Dihuang Yinzi (DY) is well known to treat neurological diseases by traditional Chinese medical practitioners. This study is to elucidate its neuroprotective and anti-dementia role in ischemic brain injury. MATERIALS AND METHODS: The effects of DY on the pathohistological changes, lactate dehydrogenase (LDH) release, Morris water maze task, expression of synaptophysin (SYP) and extracellular signal-regulated protein kinase (ERK) of hippocampi of rats with ischemic brain injury were investigated. RESULTS: This study showed that DY not only significantly decreased the number of TUNEL-positive cells but also reduced the LDH release of hippocampus of model rat. Morris water maze test showed that the ability of learning and memory of rats dramatically impaired after ischemic brain injury. However, DY ameliorated the impairment of learning and memory of ischemic rats. Furthermore, western blotting and immunohistochemical data showed that the expression of extracellular regulated protein and synaptophysin, which correlates with synaptic formation and function, decreased after ischemic insult. However, DY inhibited the reduction of ERK an SYP expression in a dose-dependent way. CONCLUSION: These results suggest that DY possesses neuroprotective and anti-dementia properties, at least in part, by preventing the loss of neural cells and synapses in ischemic brain injury.

Inhibition of ATP-induced glutamate release by MRS2179 in cultured dorsal spinal cord astrocytes.

It was reported that ATP, an excitatory chemical mediator, exerts its effects by activation of the P2X (ligand-gated cationic channels) and P2Y (G protein-coupled receptors) purinoceptors in the nervous system. In the present work, we used confocal laser scanning microscopy and high-performance liquid chromatography to assess the role of the P2Y1 receptor in ATP-evoked Ca2+ mobilization and glutamate release from cultured dorsal spinal cord astrocytes. ATP (0.01-100 micromol/l) produces a dose-dependent rise in the Ca2+ relative fluorescence intensity in cultured astrocytes. N6-methyl-2'-deoxyadenosine-3',5'-bisphosphate (MRS2179, 0.01-100 micromol/l), a P2Y1-specific antagonist, could dose-dependently inhibit ATP-evoked Ca2+ mobilization. In addition, 100 micromol/l ATP caused glutamate efflux from cultured dorsal spinal cord astrocytes in a time-dependent manner. 100 micromol/l MRS2179 significantly inhibited the glutamate efflux induced by ATP, which suggests that P2Y1 receptor activation is responsible for the ATP-induced glutamate efflux from astrocytes. Taken together, our results demonstrate that P2Y1 receptor plays an important role in modulating the function of astrocytes, which raises the possibility that MRS2179, a potent P2Y1-specific antagonist, may become a potential drug in treating many chronic neurological diseases characterized by astrocytic activation in the nervous system.

P2Y1 receptor-mediated glutamate release from cultured dorsal spinal cord astrocytes.

P2 receptors have been implicated in the release of neurotransmitter and proinflammatory cytokines by the response to neuroexcitatory substances in astrocytes. In the present study, we examined the mechanisms of ADP and adenosine 5'-O-2-thiodiphosphate (ADPbetaS, ADP analogue) on glutamate release from cultured dorsal spinal cord astrocytes by using confocal laser scanning microscopy and HPLC. Immunofluorescence activity showed that P2Y(1) receptor protein is expressed in cultured astrocytes. ADP and ADPbetaS-induced [Ca(2+)](i) increase and glutamate release are mediated by P2Y(1) receptor. Ca(2+) release from IP(3)-sensitive calcium stores and protein kinase C (PKC) activation is important for glutamate release from astrocytes. Furthermore, P2Y(1) receptor-evoked glutamate release is regulated by volume-sensitive Cl(-) channels and anion co-transporter, which open up the possibility that P2Y(1) receptor activation causes the increase of cell volume. Release of glutamate by ADPbetaS was abolished by 5-nitro-2 (3-phenyl propy lamino)-benzoate plus furosemide but was unaffected by botulinum toxin A. These observations indicate that P2Y(1) receptor-evoked glutamate may be mediated via volume-sensitive Cl(-) channel but not via exocytosis of glutamate containing vesicles. We speculate that P2Y(1) receptors-evoked glutamate efflux, occurring under pathological condition, may modulate the activity of synapses in spinal cord.

[Major causes of death among male steelworkers in Beijing: a prospective study].

OBJECTIVE: To evaluate the major causes of death and risk factors among male steelworkers in Beijing. METHODS: The study included 5137 men from the cohort of Beijing Capital Steel and Iron Company. The baseline survey was performed in 1974, 1979 and 1980 and the final follow-up evaluation was made in 2001 with a mean follow-up of 20.8 years. Causes of death were coded according to the Ninth Revision of International Classification of Diseases (ICD-9). The mortality was calculated by person-years of follow-up and age-standardized according to the 2000 census data in China. Cox proportional-hazards models adjusting for risk factors were used to estimate the relative risk of death. RESULTS: There is 760 deaths during follow-up. Age-standardized mortality from all causes was 643.0 per 100,000 person-years. The three leading causes of death were malignant neoplasms (mortality, 231.3 per 100,000 person-years), cerebrovascular diseases (mortality, 139.3 per 100,000 person-years) and heart diseases (mortality, 96.4 per 100,000 person-years). The multivariate-adjusted relative risk of death and the population attributable risk proportion for risk factors were as follow: cigarette smoking (95% CI, 1.174 to 1.765); hypertension (95% CI, 1.370 to 1.904) and hypercholesterolemia (95% CI, 1.057 to 1.537). CONCLUSIONS: Our study indicates that malignant neoplasms, cerebrovascular diseases and heart diseases were major causes of death among male steelworkers. Furthermore, cigarette smoking, hypertension and hypercholesterolemia are leading preventable risk factors for death.

[Recent advances on the study between steroids and brain function].

It is vital for steroid hormones synthesized in the gonad gland, adrenal gland and placenta to the development and physiological metabolism of the body. In particular, its regulatory effect on brain functions has attracted more and more attention, as nearly all the steroid hormones can be synthesized de novo in the brain. This means steroids derived from brain and peripheral gland can modulate the physiology and pathology of the brain reciprocally and importantly on many aspects such as learning and memory, synaptic transmission, neuroprotection, neurodegenerative diseases (especially Alzheimer's disease), emotion, stress, and menstrual-cycle-linked disorders. In the present review, some new advances are summarized.

[Endothelial function evaluation in salt-sensitive normotensive and mild hypertensive subjects and effects of potassium supplement].

OBJECTIVE: Salt-sensitivity plays an important role in essential hypertension and is associated with more severe target organ injury and higher mortality in patients with essential hypertension. However, the pathologic mechanism of salt-sensitivity is poorly understood and endothelial dysfunction might be involved in salt-sensitive hypertension. We, therefore, observed the endothelial function changes by measuring plasma and urine nitric oxide (NO) concentrations in salt-sensitive (SS) normotensive and mild hypertensive subjects underwent various salt loading protocols and the effects of potassium supplement. METHODS: Thirty-nine normotensive and mild hypertensive subjects (< 160/100 mm Hg), aged 16-60, were enrolled and the study protocol is as follows: 3 days baseline investigation, 1 week low-salt loading (3 g/day), 1 week. high-salt loading (18 g/day) and 1 week high-salt loading plus potassium chloride (4.5 g/day). RESULTS: Plasma and urine NO levels were significantly lower in SS (n = 8) subjects at baseline, low-salt and high-salt loading phases compared with salt-resistant subjects (SR, n = 31) and oral potassium supplement to SS subjects with high salt loading significantly increased plasma and urine NO levels. CONCLUSION: Endothelial function is impaired in normotensive and mild hypertensive SS subjects. Oral potassium supplement could improve endothelial function in normotensive and mild hypertensive SS subjects.

A risk score predicted coronary heart disease and stroke in a Chinese cohort.

BACKGROUND AND OBJECTIVE: This article aims to address two issues: first, whether risk scores derived from Caucasian cohorts can accurately predict coronary heart disease (CHD) in a Chinese population; second, derivation and validation of a new risk prediction score for cardiovascular disease (CVD) from a Chinese cohort. METHODS: A cohort of 4,400 male steelworkers (18-74 years old) recruited between 1974-1980 was followed up for an average 13.5 years. A Cox model was used to predict 10 year risk of CHD, ischemic, and hemorrhagic stroke based on blood pressure, age, total cholesterol, body mass index, and smoking status. RESULTS: The prediction rule from the European Recommendations greatly overestimates the risk of CHD in Orientals. The new models had good predictive ability, with the area under receiver operating characteristic curves (AUCs area) in the derivation set being 0.76, 0.72, and 0.82 for CHD, ischemic, and hemorrhagic stroke separately; AUCs in the validation set were equally good, at 0.76, 0.78, and 0.82, respectively. CONCLUSION: The risk stratification rules derived from Caucasian cohorts overestimates the CHD risk in Orientals, and we derive a specific risk stratification rule for CHD, ischemic and hemorrhagic stroke for Chinese men.

[Apolipoprotein B is associated with metabolic syndrome in Chinese pedigrees with familial hyperlipidemia].

OBJECTIVE: To investigate the prevalence of metabolic syndrome (MS) as well as the potential predictors in families with familial combined hyperlipidemia (FCHL), familial hypertriglyceridemia (FHTG), familial hypercholesterolemia (FH) and normolipidemic families in China. METHODS: The prevalence of MS was identified among 70 different families with 560 individuals aged > or = 20, including 43 FCHL families with 379 individuals, 3 FHTG families with 30 individuals, 16 FH families with 102 individuals and 8 normolipidemic families with 49 individuals. Diagnosis of MS was based on the modified criteria of National Cholesterol Education Program, US, substituting body mass index for waist circumference. Multivariate logistic regression was used to analyze the association between MS and different pedigrees. RESULTS: MS was identified in 60.7% of the FCHL patients and 71.4% of the FHTG patients. The prevalence of MS in the family members was 36.7% for the FCHL families, 33.3% for the FHTG families, 17.6% for the FH families, and 16.3% for the normolipidemic families, with an odds ratio (OR) of 2.97 (95% CI 1.29 to 7.07) in the FCHL families compared with in the normolipidemic families. Multivariate logistic regression showed an association between apolipoprotein (apo) B and MS with an OR of 1.05 (1.03 to 1.07) in the FCHL families, an OR of 1.26 (1.03 to 1.55) in the FHTG families, and an OR of 1.07 (1.01 to 1.12) in the FH families, independent of variables such as age, gender, apoA1, and LDL cholesterol, but showed no association in the normolipidemic families (P >0.05). Similarly, apo A1 provided an OR of 0.95 (0.94 to 0.97) in the FCHL families and an OR of 0.94 (0.90 to 0.99) in the FH families, but neither in the FHTG families nor in the normolipidemic families (both P >0.05). CONCLUSION: Apo B may be regarded as a relevant factor in the assessment of MS in FCHL, FHTG and FH families in Chinese. However, this finding needs to be verified by prospective studies in diverse ethnicities and warrants additional studies to elucidate the possible mechanisms linking apoB to MS.

[Pulse pressure and prevalence of stroke and myocardial infarction in Chinese population].

OBJECTIVE: To explore the characteristics of distribution of pulse pressure (PP) in Chinese population and its relationship to major cardiovascular diseases in them. METHODS: Data from the Third National Blood Pressure Survey involved 882,681 subjects aged over 18 in 1991 were reanalysed for the relationship between PP and risks of major cardiovascular diseases, with t-test, chi2 test and logistic regression model. PP is defined as the difference between systolic and diastolic blood pressure. RESULTS: (1) Overall mean PP was (44.61 +/- 13.59) mm Hg for the subjects aged over 18, higher in men [(44.92 +/- 12.72) mmHg] than that in women [(44.34 +/- 14.32) mmHg]. PP increased progressively with age, and its increase accelerated significantly at age over 50 but higher in women than in men. Proportion of the subjects with PP equal to or greater than 60 mmHg was more in those aged 60 or over than that in younger ones. (2) Prevalence of stroke and myocardial infarction (MI) increased with PP and age, whether in the normotensives, or in the hypertensives or in the isolated systolic hypertensives. (3) Results of multivariate logistic regression analysis revealed that risks of stroke in the subjects with PP of (45-59) mmHg, (60-74) mmHg and over 75 mmHg were 1.9, 3.5 and 5 times as in those with PP less than 45 mm Hg, respectively, adjusted for other risk factors, and their risks of myocardial infarction (MI) were 1.2, 1.5 and 1.7 times, respectively. Furthermore, PP was significantly and independently related to the risks of stroke and MI, even adjusted for systolic and diastolic pressures. CONCLUSIONS: Prevalence of stroke and MI increased with the breadth of PP and age. Broader PP may be an important and independent predictor of risks of stroke and MI, especially in the aged people.

Prevalence and magnitude of classical risk factors for coronary heart disease in a cohort of 4400 Chinese steelworkers over 13.5 years follow-up.

BACKGROUND: The incidence and mortality of cardiovascular disease among Orientals are very different than among Caucasians. This study addresses the prevalence and magnitude of classic cardiovascular disease risk factors associated with coronary heart disease (CHD) in an Oriental cohort of at-risk men (blood pressure, total cholesterol, Body Mass Index [BMI] and smoking), compared to Caucasian populations. We also address which blood pressure index (SBP, DBP, mean arterial pressure [MAP] and pulse pressure [PP]) is the best predictor of CHD. METHODS AND RESULTS: A cohort of 5092 male steelworkers (18-74 years old) recruited between 1974-1980 was followed up for an average of 13.5 years. The prevalence of risk factors was lower in Orientals than in Caucasians, except for smoking. The relative risks (RRs) of CHD associated with classic risk factors in this Oriental population were similar to Caucasians, except for blood pressure. The RRs of CHD associated with both SBP and DBP in this Oriental group were higher than in Caucasians; RR of CHD was approximately 3 for each 40 mmHg rise of SBP versus approximately 2 in Caucasians. SBP was the single best predictor for CHD, followed by MAP, and DBP. The population attributable risk (PAR%) for hypertension (140/90 mmHg) was 42.4. CONCLUSION: Our results would indicate that the lower incidence of CHD in Orientals is at least partly due to the lower prevalence of hypertension, hypercholesterolemia, and obesity. The magnitude of the risk associated with these factors is similar to that in Caucasians, except perhaps for a greater risk associated with hypertension. The most predictive BP index for CHD is SBP. These results are based on indirect comparisons only and should be studied further in prospective multi-ethnic cohorts.

[An association of apolipoprotein B with pulse pressure in Chinese pedigrees with familial combined hyperlipidemia].

OBJECTIVE: To investigate the influencing factors of blood pressure phenotypes and the distribution of FDH in FCHL families. METHODS: Forty-two FCHL families with 435 members, 147 consanguine members and 90 members without consanguinity from Beijing area were studied. Eleven of the 42 FCHL families (26.2%) were identified as families with FDH syndrome. Stepwise regression analysis was used to analyze the association between the target variables and blood pressure phenotypes, such as systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), and pulse pressure (PP), of the 237 FCHL members aged 30 to 60 years. RESULTS: The prevalence of dyslipidemic hypertension in the FCHL relatives was significantly higher than that in the spouses (29.9% versus 8.9%, P < 0.01), with an odds ratio of 3.37 (95% CI 1.44 to 8.14). In the FCHL families body mass index (BMI), age and blood sugar were independent contributors to SBP, DBP, and MAP, respectively (all P < 0.05). Age and apolipoprotein B (apoB) were important contributors to pulse pressure (both P < 0.05). CONCLUSIONS: BMI and glucose are significant contributors to different phenotypes of blood pressure. Moreover, apoB is a significant contributor to pulse pressure in FCHL families.

[A 20-year prospective study on risk factors for myocardial infarction of 5,137 men in Capital Steel and Iron Company].

OBJECTIVE: To identify independent risk factors for myocardial infarction (MI) in Chinese men and to develop a model to predict risk profile of an individual suffering MI. METHODS: Study sample included 5 137 men aged 45.2 +/- 7.8 years who came from a cohort in Beijing Capital Steel and Iron Company, based on the three surveys on coronary heart disease conducted in 1974, 1979 and 1980, respectively. Demographic data and other risk factors, such as life style, medical history, blood pressure, total serum cholesterol level (TC), etc. were collected according to the same protocol in 1980. All the participants were followed up for MI in an average period of 20.84 years until 2001. RESULTS: (1) There were 122 cases with MI identified during the period of follow-up, with an incidence of MI 117.4 per 100 000 person-years. Age of more than 50, smoking, higher systolic and diastolic blood pressure (SBP and DBP) levels, higher TC all were identified as important risk factors of MI. (2) Incidence of MI increased with TC. An increment of 0.52 mmol/L of TC significantly increased relative risk of MI by approximately 40% after adjusted for age, blood pressure and smoking. (3) An increment of 20 mm Hg in SBP or 10 mm Hg in DBP associated with a 40% increase in incidence of MI, adjusting for age, TC and smoking. (4) Smoking was the most risky factors for MI. Smokers had 2.3 times risk of MI, after as compared to non-smokers (or its incidence increased by 137%), after adjusting for blood pressure, TC and age, etc. (5) Incidence of MI increased by 20% with increment of five-year of age in those aged over 50 (P < 0.05), after adjusting for blood pressure, TC and smoking. And, (6) finally, based on multivariate logistic and Cox regression analyses, a model containing several risk factors, such as age, blood pressure, TC and smoking, was developed to predict individual's risk for afflicting MI. CONCLUSIONS: Results of this prospective study showed several established risk factors for MI, including age, blood pressure, TC and smoking all as independent predictors of MI in Chinese men. It is clear and rational that intervention and modification of those traditional risk factors can lead to a decrease in coronary events in Chinese population.

[Olfactory ensheathing cells enhance functional recovery of injured sciatic nerve].

OBJECTIVE: To investigate the effect of olfactory ensheathing cells (OECs) on functional recovery after sciatic nerve injury. METHODS: Upon silicone-tubulization of transected sciatic nerve in 30 adult rats. Thirty rats were divided into two groups(SAL group and OECs group); saline and OECs were injected into the silicone chamber in SAL group and in OECs group respectively. The status of functional recovery of injured sciatic nerve was observed by electrophysiological analysis, axon morphometry analysis. RESULTS: In OECs group on the 30th and the 90th days after sciatic nerve transection: 1. The latent period of CMAP shortened by 0.60 ms and 0.56 ms; the nerve conduction velocity promoted by 6.42 m/s and 5.36 m/s; the amplitude enhanced by 3.92 mv and 5.84 mv, respectively; 2. The HRP positive cells in lateral nucleus of spinal anterior horn increased by 11.63% and 25.01%; 3. The number of nerve fibers increased by 1,047/mm2 and 1,422/mm2 and the thickness of myelim sheath increased by 0.43 micron and 0.63 micron, respectively. CONCLUSION: The olfactory ensheathing cells are capable of promoting the functional recovery after peripheral nerve injury.

[Prevalence, awareness, treatment and control of hypertension in Chinese adults].

OBJECTIVE: To identify the prevalence, distribution, current status of awareness and control of hypertension in Chinese adult population. METHODS: A cross-sectional survey was conducted in mainland of China in 2000 - 2001 as a part of work coordinated with InterASIA Program. A total of 15,838 nationally representative subjects aged 35 to 74 were selected with multistage cluster sampling. Measurement of blood pressure was taken for all of them with three readings in a mercuric-column sphygmomanometer after resting for five minutes. Standard structured questionnaire was used to collect their histories and treatment and prevention for hypertension. A case of hypertension was defined as any person with systolic blood pressure equal to or greater than 140 mmHg, or with diastolic blood pressure equal to or greater than 90 mmHg, or being administered with antihypertensive agents. RESULTS: A total of 15,838 adults aged 35 - 74 years were included in this survey. Overall, the prevalence of hypertension was 27.2%, representing 130 million persons with hypertension nationwide as estimated. Age-specific prevalence of hypertension was 10.7%, 26.8%, 38.9% and 50.2% for women and 17.4%, 28.2%, 40.7% and 47.3% for men aged 35 - 44, 45 - 54, 55 - 64 and 65 - 74 years, respectively. Among hypertensive patients, 44.7% were aware of their high blood pressure, 28.2% were taking antihypertensive medication, and 8.1% achieved their blood pressure under control (< 140/90 mm Hg). All these data indicated that percentages of awareness, treatment and control of hypertension increased by 86.2%, 92.6% and 145.4%, respectively in the past ten years, as compared with the data in 1991. CONCLUSIONS: In the past ten years, percentages of awareness, treatment and control of hypertension in Chinese adults increased significantly, who had a relatively high prevalence of hypertension, but lower awareness and much lower percentages of treatment and control of hypertension. It is urgently needed to improve prevention, detection and treatment for hypertension in adults.

[An evaluation on effectiveness of worksite-based intervention for cardiovascular disease during 1974 - 1998 in capital iron and steel company of Beijing].

OBJECTIVE: To explore the feasibility and effectiveness of worksite-based cardiovascular disease (CVD) prevention and control program in urban population of China. METHODS: Worksite-based intervention program was implemented 110 000 employees at Capital Iron and Steel Company of Beijing (CISC) focusing on primary prevention for CVD and control of hypertension. Intervention components comprised of infrastructure setting-up, health education and health promotion, professional training, detection and management of hypertensive patients, and reasonably readjusting their diet structure focusing on salt intake reduction, reducing their overweight, quitting smoking, and restricting alcohol consumption in high-risk population. Changes in level of risk factors, incidence and mortality of stroke and coronary events and their trend were evaluated between the intervention group at CISC and eight simultaneously parallel reference groups in other provinces outside Beijing with population surveillance data. RESULTS: Major risk factors for CVD, including blood pressure, body mass index and serum cholesterol level, decreased relatively in intervention population at CISC during 1974 to 1998, while those in majority of eight parallel reference groups at different provinces of China significantly increased at the same time. Systolic blood pressure (SBP) decreased by 0.8 mm Hg and 4 mm Hg in average for men and women, respectively, and their diastolic blood pressure (DBP) remained the same as baseline for both men and women at CISC, while SBP increased by (2 - 11) mm Hg and (6 - 8) mm Hg in average for men and women, respectively in reference groups, and DBP increased by (2 - 6) mm Hg in average for men in five of eight reference groups, and by (3 - 6) mm Hg for women in four of eight reference groups. Serum level of cholesterol decreased by 0.26 mmol/L in women and slightly increased for men at CISC, and increased by (0.35 - 0.97) mmol/L for men and (0.29 - 1.05) mmol/L for women in all reference groups. Prevalence of overweight increased by 58.7% for men and 11.3% for women at CISC and increased by one to 22 folds in eight reference groups. Awareness of health knowledge improved significantly with an average net reduction of SBP/DBP of (2.5/2.2) mm Hg in the enforced intervention group at CISC than that in general intervention groups. Incidence and mortality rates of stroke decreased by 54.7% and 74.3%, respectively in intervention group at CSIC, but those of coronary events slowly increased with fluctuation. CONCLUSION: Worksite-based comprehensive intervention for CVD prevention and control was feasible and cost-effective in decreasing risk factors for CVD, incidence and mortality rate of stroke in population of urban areas of China.

[The insertion/deletion polymorphism of angiotensin I converting enzyme gene and coronary heart disease--discordant sib pair analysis and transmission/disequilibrium test].

To investigate whether the insertion/deletion polymorphism of the human angiotensin I converting enzyme gene increased the risk of coronary heart disease (CHD) in CHD pedigrees,discordant sib pair analysis (DSP) and transmission/disequilibrium test (TDT) were used. Forty-five CHD pedigrees with at least one CHD patient in the first degree relatives of probands were recruited during Oct. 1998 to Feb. 1999, of which parental genotype known, one or both parental genotype missing was 21.2 and 22 respectively. ACE genotype was measured by PCR technique. Conditional Logistic regression was used to analyze the DSP, and TDT-STDT program 1.1 was used for TDT and STDT. Univariable conditional Logistic regression did not find significant difference of the distribution of three different ACE genotypes in the 106 discordant sib pairs obtained from the 45 pedigrees. After adjusting effects of traditional risk factors of CHD, no significant difference of the distribution was found by multiple Logistic regression model. Neither the TDT for 13 nuclear families or STDT (sib transmission/disequilibrium test) for 24 sibships showed significant difference between the transmitted and untransmitted ACE gene D allele distributions. Our results show that the insertion/deletion polymorphism of ACE gene is not associated or linked with CHD in Chinese population.