[Setting up a risk prediction model on metabolic syndrome among 35-74 year-olds based on the Taiwan MJ Health-checkup Database].

OBJECTIVE: This study aimed to provide an epidemiological modeling method to evaluate the risk of metabolic syndrome (MS) development in the coming 5 years among 35-74 year-olds from Taiwan. METHODS: A cohort of 13 973 subjects aged 35-74 years who did not have metabolic syndrome but took the initial testing during 1997-2006 was formed to derive a risk score which tended to predict the incidence of MS. Multivariate logistic regression was used to derive the risk functions and using the 'check-up center' (Taipei training cohort)as the overall cohort. Rules based on these risk functions were evaluated in the remaining three centers (as testing cohort). Risk functions were produced to detect the MS on a training sample using the multivariate logistic regression models. Started with those variables that could predict the MS through univariate models, we then constructed multivariable logistic regression models in a stepwise manner which eventually could include all the variables. The predictability of the model was evaluated by areas under curve (AUC) the receiver-operating characteristic (ROC) followed by the testification of its diagnostic property on the testing sample. Once the final model was defined, the next step was to establish rules to characterize 4 different degrees of risks based on the cut points of these probabilities, after being transformed into normal distribution by log-transformation. RESULTS: At baseline, the range of the proportion of MS was 23.9% and the incidence of MS in 5-years was 11.7% in the non-MS cohort. The final multivariable logistic regression model would include ten risk factors as: age, history of diabetes, contractive pressure, fasting blood-glucose, triglyceride, high density lipoprotein cholesterol, low density lipoprotein cholesterol, body mass index and blood uric acid. AUC was 0.827(95% CI: 0.814-0.839) that could predict the development of MS within the next 5 years. The curve also showed adequate performance in the three tested samples, with the AUC and 95% CI as 0.813 (0.789-0.837), 0.826 (0.800-0.852) and 0.794 (0.768-0.820), respectively. After labeling the degrees of the four risks, it was showed that over 17.6% of the incidence probability was in the population under mediate risk while over 59.0% of them was in the high risk group, respectively. CONCLUSION: Both predictability and reliability of our Metabolic Syndrome Risk Score Model, derived based on Taiwan MJ Longitudinal Health-checkup-based Population Database, were relatively satisfactory in the testing cohort. This model was simple, with practicable predictive variables and feasible form on degrees of risk. This model not only could help individuals to assess the situation of their own risk on MS but could also provide guidance on the group surveillance programs in the community regarding the development of MS.

Eye care use among rural adults in China: the Handan Eye Study.

PURPOSE: To assess the use of eye care services in a rural population in North China and to analyze the factors associated with underuse of these services. METHODS: In a cross-sectional population-based study, demographic, health and vision-related information including use of eye care services were determined during a face-to-face interview. A single visit to an eye care provider qualified as "use" of eye care services. RESULTS: Of 6612 participants, 754 (11.4%, 95% confidence interval, CI, 8.7-14.1%) had used eye care services. The most common reason cited for not seeing an eye care provider was "no need" (n = 5754). Of the 5754 who thought that there was no need to see an ophthalmologist, 3458 (60.1%) were found to have one or more type of eye disease, including glaucoma (56, 1.0%), cataract (1056, 18.4%), age-related macular degeneration (AMD; 164, 2.9%) and refractive error (3048, 53.0%). Also, 74 (1.3%) and 409 (7.1%) of the 5754 participants had visual impairment (<20/60) according to best-corrected visual acuity and presenting visual acuity, respectively. In a multiple regression model, participants who had glaucoma (adjusted odds ratio, OR, 4.0, 95% CI 3.0-5.4), AMD (adjusted OR 1.6, 95% CI 1.2-2.3) or refractive error (adjusted OR 1.4, 95% CI 1.1-1.8), were more likely to visit an eye care provider. CONCLUSION: A high proportion of the Chinese rural population had never used eye care services although three fifths had eye diseases. Further efforts towards better education of the general population about common eye problems as well as increasing the number of ocular health providers would be necessary in future.

[Association analysis of serum γ-glutamyltransferase with risk of metabolic syndrome in Beijing healthy population].

OBJECTIVE: To study the association of γ-glutamyltransferase (GGT) with the development of the metabolic syndrome (MS). METHODS: Subjects without MS at baseline in Beijing health-checkup database during 2003 and 2010, from MJ Health Management Centers, with complete key variables and at least two records were selected to derive a cohort, after comparison of the median trend, and analysis with Cox regression models and spline regression models, and to study the association of GGT with the development of MS and the dose-response relationship trend. RESULTS: Out of 10 076 (46.20/1 000 person-years) in the cohort, 1 181 subjects developed MS after follow-up of 2.54 years on average. With adjustment for age, gender, cigarette smoking, alcohol intake, physical activity, body mass index, family history of cardiovascular disease, systolic blood pressure, white blood cell count, high-density lipoprotein cholesterol, fasting blood glucose, triglycerides and C-reacted protein in Cox regression model, the hazard ratio for MS in quartiles 4 level of GGT was 1.60(95% confidence interval: 1.18-2.17). After adjustment with the use of spline regression model, the dose-response relationship showed an increasing curve with a degressive slope. The elevated GGT level was associated with an increased risk of MS, but the contribution of GGT augmented less when the GGT level was high. CONCLUSION: The elevated GGT level, an important risk factor and predictor, may be associated with an increased risk of MS.

Prevalence and associations of cataract in a rural Chinese adult population: the Handan Eye Study.

BACKGROUND: Cataract remains the leading cause of blindness and visual impairment in the world and in China. However, data on the prevalence of cataract based on standardized lens grading protocols from mainland China are limited. This paper estimated the age- and gender-specific prevalence and risk factor for cataract METHODS: In a population-based Chinese sample, participants underwent a comprehensive ophthalmic examination, including assessment of cortical, nuclear, posterior subcapsular (PSC) and mixed lens opacities from slit-lamp grading using the Lens Opacities Classification System III. RESULTS: Of the 7,557 eligible subjects, 6,830 took part in the study (90.4% response rate), and 6,544 participants (95.8%, mean age 52.0 ± 11.8 years) had lens data for analyses. The prevalence of any cataract surgery in at least one eye was 0.8% (95% confidence interval [CI], 0.62, 1.06), with similar rates between men and women. The overall prevalence of any cataract or cataract surgery was 20.8% (95% CI, 19.8, 21.8), higher in women than in men after adjusting for age (23.6% vs 17.6%; OR: 1.78; 95% CI: 1.54-2.07). When distinct lens opacity was categorized in each eye as cortical, nuclear, PSC or mixed, based on one randomly selected eye, cortical cataract was the most common distinct subtype (12.3%), followed by mixed (3.2%), nuclear (1.7%), and PSC (0.2%) cataract. The prevalence of all lens opacities increased with age (P < 0.001). After excluding other causes for visual impairment, the proportion of people with best corrected visual acuity <20/60 was 21% among those with PSC, and 12% among those with mixed opacities in the better-seeing eye. In multivariable logistic regression models, myopia was associated with all cataract types, while higher fasting plasma glucose and diabetes were only associated with PSC cataract. CONCLUSIONS: Cataract affects 20% of the population aged 30 years and older living in rural China, with cortical cataract the most common subtype. Risk factors for cataract include myopia and diabetes.

[Estimation on the risk of 5-years obesity development among adults aged 30 - 59, based on the Taiwan MJ Health-checkup Database].

OBJECTIVE: This study aimed to provide an epidemiological modeling in evaluating the risk of developing obesity within 5 years in Taiwan population aged 30 - 59 years. METHODS: After excluding 918 individuals who were observed at baseline, a cohort of 14 167 non-obesity subjects aged 30 - 59 years in the initial year during 1998 - 2006, was formed to derive a Risk Score which could predict the incident obesity (IO). Multivariate logistic regression was used to derive the risk functions, using the check-up center (Taipei training cohort, n = 8104) of the overall cohort. Rules based on these risk functions were evaluated in the left three centers (testing cohort, n = 6063). Risk functions were produced to detect the IO on a training sample using the multivariate logistic regression models. Starting with variables that could predict the IO through univariate models, we constructed multivariable logistic regression models in a stepwise manner which eventually could include all the variables. We evaluated the predictability of the model by the area under the receiver-operating characteristic (ROC) curve (AUC) and to testify its diagnostic property on the testing sample. Once the final model was defined, the next step was to establish rules to characterize 4 different degrees of risk based on the cut points of these probabilities after transforming into normal distribution by log-transformation. RESULTS: At baseline, the range of the proportion of normal weight, overweight and obesity were 50.00% - 60.00%, 26.47% - 31.11% and 5.76% - 7.24% respectively in four check-up centers of Taiwan. After excluding 918 obesity individuals at baseline, we ascertained 386 (2.73%, 386/14 167) cases having IO and 2.66% - 2.91% of them having centered obesity in the four check-up centers respectively. Final multivariable logistic regression model would include five risk factors: sex, age, history of diabetes, weight deduction ≥ 4 kg within 3 months and waist circumference. The area under the ROC curve (AUC) was 0.898 (95%CI, 0.884 - 0.912) that could predict the development of obesity within 5 years. The curve also had adequate performance in testing the sample [AUC = 0.881 (95%CI, 0.862 - 0.900)]. After labeling the four risk degrees, 16.0% and 2.9% of the total subjects were in the mediate and high risk populations respectively and were 7.8 and 16.6 times higher, when comparing with the population at risk in general. CONCLUSION: The predictability and reliability of our obesity risk score model, derived based on Taiwan MJ Longitudinal Health-checkup-based Population Database, were relatively satisfactory, with its simple and practicable predictive variables and the risk degree form. This model could help individuals to self assess the situation of risk on obesity and could also guide the community caretakers to monitor the trend of obesity development.

Prevalence of primary open angle glaucoma in a rural adult Chinese population: the Handan eye study.

PURPOSE: To estimate the prevalence and associations of primary open angle glaucoma (POAG) in a rural population of northern China. METHODS: In a rural county in Handan, China, 6716 adults residing in 13 villages were randomly selected and participated in the study. All participants completed a comprehensive eye examination, including intraocular pressure (IOP), slit-lamp examination, and fundus evaluation. Visual fields were obtained with on glaucoma suspects. RESULTS: Sixty-five persons (1.2%) had POAG, with an adjusted prevalence of 1.0% (95% confidence interval [CI], 0.7% -1.3%) in those aged 40 years and older. Sex was not significantly associated with POAG (P > 0.05). Age (odds ratio [OR], 1.9; 95% CI, 1.4-2.5, for each 10-year increase), IOP (OR, 1.5; 95% CI 1.2-2.0 for each 5-mm Hg increase), axial length (OR, 1.3; 95% CI, 1.1-1.6), and moderate myopia (3.1-6.0 D; OR, 4.7; 95% CI, 1.6-13.5) increased the risk for POAG in multivariate analysis. The mean IOP of persons with POAG was 16.3 ± 3.5 mm Hg, and 90% of them presented with an IOP ≤ 21 mm Hg. Of those with POAG, 4.5% were blind from glaucoma in at least one eye. CONCLUSIONS: Approximately 1% of adults aged 40 years and older living in rural China have POAG. As seen in other populations, increasing age, higher IOP, greater axial length, and having myopia were associated with POAG. Given the rapid aging and myopic shift (acquired myopia) in China's population, POAG is likely to increase in prevalence in the coming decades.

[Study of an adherence rating score system for tuberculosis patients in China].

OBJECTIVE: To develop an adherence rating score (ARS) system specific for tuberculosis (TB) patients. METHODS: A cross-sectional survey of 124 TB patients was conducted to figure out risk factors for adherence to treatment. The step-wise logistic regression models were used for selecting adherence-related variables. ARS was developed based on the weighting scores of the parameters of all the predicted variables in the logistic model. The reliability and responsibility of ARS was evaluated by using external data from an open label randomized controlled trial on 574 TB patients. The patients were grouped as adherence group (247 patients) and non-adherence group (327 patients) based on the predicted ARS. And the non-adherence group was randomized divided into a trail group (146 patients) and a control group (181 patients). The intervention for the trail group was custom health educational material aimed to reduce ARS, while the intervention for control groups was general TB education material, which was routinely used in the current local TB control settings. The cumulative non-adherence rates of the three groups were compared with each other after six-month follow-up period of treatment. RESULTS: The ARS system had 7 items which covered the following domains: disease status, psychology, patients' KAP (knowledge, attitude, and practice), regularly life-style and social supports. The score of ARS was 2.38+/-0.18 (mean+/-SD) for adherence patients, and 4.69 +/-0.20 (mean+/-SD) for non-adherence patients (t=8.52, P<0.01). In the randomized controlled trial, the six months cumulative non-adherence rates ware 24.7% for the trail group and it was 41.4% for the control group(P<0.01); while the six months cumulative non-adherence rates were not statistical significant difference between trail group and adherence group (P>0.05). CONCLUSION: The ARS system was reliability and validity for evaluating the adherence of TB treatment in the stop TB settings in China.

Normal macular thickness measurements using optical coherence tomography in healthy eyes of adult Chinese persons: the Handan Eye Study.

PURPOSE: To describe macular thickness measured by optical coherence tomography (OCT) in healthy eyes of adult Chinese persons. DESIGN: Population-based cross-sectional study. PARTICIPANTS: Chinese adults aged 30+ years who were residents of Handan, North China. METHODS: The Handan Eye Study is a population-based study of eye disease in Chinese persons. Eligible residents underwent a comprehensive ophthalmic examination including OCT (Stratus OCT, Carl Zeiss Meditec Inc., Jena, Germany). Fast macular thickness scans were performed over maculae within 6 mm in diameter, divided into 3 regions (central, inner, and outer, with a diameter of 1, 3, and 6 mm, respectively) and 9 quadrants (1 in the central region and 4 each in the inner and outer regions). Retinal thickness (means and standard deviations) was calculated by OCT mapping software, presented for foveal minimum, central macula (within 1 mm diameter), and inner and outer regions divided by 8 quadrants. MAIN OUTCOME MEASURES: Macular thickness measured by OCT. RESULTS: Of the 6830 participants (90.4% response rate) examined, 2230 eyes of healthy subjects with high-quality OCT scans were selected (32.7% of participants; mean age, 46.4+/-9.9 years, 58.4% were women). The mean foveal minimum, central, inner, and outer macular thicknesses were 150.3 (18.1) microm, 176.4 (17.5) microm, 255.3 (14.9) microm, and 237.7 (12.4) microm, respectively (overall differences, P<0.001). The mean foveal volume was 0.139 (0.014) mm(3), and the mean total macular volume was 6.761 (0.516) mm(3). In the inner region, the nasal quadrant was thinner than the superior and inferior quadrants, and in the outer region, the nasal quadrant was the thickest (P<0.001). Age was positively correlated with foveal (beta coefficient = 3.582) and central macular (beta coefficient = 2.422) thicknesses. The foveal minimum, central, inner, and outer macular thicknesses were significantly greater in men than in women. Fasting plasma glucose was negatively correlated with central macular thickness (2.416 mm reduction per millimole/liter increase in glucose), and axial length was positively correlated with central macular thickness (2.138 mm increase per millimeter increase in axial length). CONCLUSIONS: Normal macular thickness measurements using OCT in a large population-based sample of adult Chinese persons aged 30 to 85 years were generally thinner in the foveal and central macular areas than measurements reported in other populations. Age and axial length were positively correlated with macular thickness.

[Comparison of two diagnostic criteria for metabolic syndrome applied in health check-up population aged 12-19 years in Taiwan].

OBJECTIVE: To compare the differences of two recommended diagnostic criteria for metabolic syndrome (MS) in a health check-up population aged 12-19 years in Taiwan province. METHOD: The study data were supplied by the MJ Health Screening Center, which is a private membership chain clinic with 4 health screening centers around the Taiwan Island and provides periodic health examination to its members. The database included a self-administered questionnaire for health history, asking about demographic, socioeconomic, medical, and lifestyle information, and clinical and laboratory measures for every member. A total of 1629 members (873 boys and 756 girls, respectively) received a health check-up first time at MJ centers were recruited from 2005 to 2006. MS detection rate and agreement rate was calculated according to two definitions, respectively. The distributions of MS components and the aggregation of risk factors were further analyzed. RESULT: (1) The range of age-adjusted detection rate of MS for two definitions were 4.05% (5.84% for boys, 1.98% for girls) and 8.35% (10.42% for boys, 5.95% for girls), respectively. It was 0.94% , 14.20% and 36.59% for criterion I among adolescents who were overweight (BMI over 95th percentile), at risk of overweight (BMI between 85th and 95th percentile) and normal weight (BMI below the 85th percentile), respectively; while 3.61%, 25.93% and 53.66% for criterion II. (2) The range of five MS components were 9.09% (low-HDL-C)-16.39% (high blood pressure) for definition I, while 0.98% (high FBG)-27.13% (high WC) for definition II. (3) Of the total subjects, 2.76%, 1.04% and 0.25% were presented with three, four and five MS risk factors for definition I; while 6.69%, 1.60% and 0.34% for definition II, separately. (4) The most common clinical symptom complex of MS was "obesity, hypertension and low-HDL-C" for criterion I, "high TG, obesity and low-HDL-C" for criterion II. (5) The MS diagnostic criterions of I and II were in moderate accordance with agreement rate of 94.35%, Kappa index was 0.518. CONCLUSION: Our findings reveal that there were relatively large differences in detection and aggregation of risk components on MS when using two recommended definitions, the detection rate of MS in adolescents depends strongly on the parameters chosen and their respective cut-off points. In order to avoid possible relevant under- or over-estimation of the prevalence, it seems advisable that the use of unversally specific cut-off values seems to be more appropriate to give more reliable results.

Refractive errors in a rural Chinese adult population the Handan eye study.

PURPOSE: To describe the prevalence of and risk factors for myopia and other refractive errors in a rural, adult, Chinese population. DESIGN: Population-based, cross-sectional study. PARTICIPANTS: A clustered, random sampling procedure was used to select 7557 Chinese people aged >or=30 years from Handan, China. METHODS: All eligible subjects were invited to undergo a comprehensive eye examination, including standardized refraction. Myopia, high myopia, and hyperopia were defined as a spherical equivalent (SE) in the right eye of more than -0.5 diopter (D), less than -5.0 D, and 0.5 D or more, respectively. Astigmatism was less than -0.5 D of cylinder. Anisometropia was defined as a difference in SE of >1.0 D between the 2 eyes. Only phakic eyes were analyzed. MAIN OUTCOME MEASURES: Myopia and other refractive errors. RESULTS: We included 6491 (85.9% participation rate) eligible subjects in this study. Adjusted to the 2000 China population census, the prevalence rate of myopia was 26.7% (95% confidence interval [CI], 25.6-27.8), hyperopia 15.9 % (95% CI, 15.0-16.8), astigmatism 24.5% (95% CI, 23.5-25.5), and anisometropia 7.7% (95% CI, 7.0-8.4). The prevalence of high myopia was 1.8% (95% CI, 1.5-2.1). Using a multivariate regression model, current smoking (odds ratio [OR], 0.7, 95% CI, 0.5-0.9), hours of reading (OR, 1.2; 95% CI, 1.1-1.4), diabetes (OR, 8.4; 95% CI, 2.2-32.5), and number of family members with myopia (OR, 1.3; 95% CI, 1.1-1.7, for each family member) were associated with myopia in younger persons (30-49 years). High school or higher education (OR, 1.8; 95% CI, 1.1-3.1), diabetes (OR, 1.6; 95% CI, 1.2-2.7), nuclear opacity (OR, 1.7; 95% CI, 1.2-2.3), and number of family members with myopia (OR, 1.5; 95% CI, 1.2-1.9) were risk factors in persons >or=50 years of age. CONCLUSIONS: Myopia affects more than one quarter of rural Chinese persons >or=30 years of age. Myopia is more common in younger people and is associated with different risk factors than in older people.

Prevalence of diabetic retinopathy in rural China: the Handan Eye Study.

PURPOSE: To describe the age- and gender-specific prevalence, characteristics, and severity of diabetic retinopathy (DR) in a rural population in northern China. DESIGN: A population-based cross-sectional study. PARTICIPANTS: A total of 6830 Han Chinese aged 30 years and older from 13 villages of Yongnian County, Handan City, Hebei Province, China. METHODS: All participants underwent a standardized interview, a comprehensive eye examination, and fasting blood glucose testing according to the American Diabetes Association diagnostic criteria (fasting plasma glucose >or=7.0 mmol/l). Retinal photographs obtained after pupil dilation were graded for the presence and severity of DR according to the modified Early Treatment Diabetic Retinopathy Study classification system. MAIN OUTCOME MEASURES: Any DR, retinopathy grades, macular edema, or vision-threatening retinopathy. RESULTS: Of the 6830 eligible individuals participating in the study, 5597 (81.9%) had fasting blood glucose results available. Of these, 387 participants (6.9%) were diagnosed with diabetes mellitus, including 247 subjects with new diabetes mellitus (NDM) and 140 subjects with known diabetes mellitus (KDM). For these, gradable photographs were available for 368 subjects (95.1%). The overall prevalence of DR was 43.1% (95% confidence interval, 38.1-48.4) and was higher in persons with KDM (65.2%) than NDM (33.5%). The prevalence of proliferative DR, macular edema, and vision-threatening retinopathy was 1.6%, 5.2%, and 6.3%, respectively, with 12.1% with KDM having untreated vision-threatening DR. No age- or gender-related differences were present. The prevalence of DR was strongly related to duration of disease. CONCLUSIONS: Our study reports a high prevalence of DR among adults 30 years and older with diabetes in rural China. On the basis of estimates obtained from our study, we projected that in rural China, 21.1 million persons aged 30+ years have diabetes and 9.2 million have DR, including 1.3 million with vision-threatening DR. There is a pressing need for appropriate screening and management of diabetes and its complications in rural China.

Prevalence and associations of epiretinal membranes in a rural Chinese adult population: the Handan Eye Study.

PURPOSE: To determine the prevalence and association of epiretinal membranes (ERMs), as assessed by retinal photography and optical coherence tomography (OCT), in a Chinese population. METHODS: The Handan Eye Study is a population-based study of eye disease in rural Chinese aged 30+ years. Eligible residents underwent a detailed ophthalmic examination including retinal photography and Stratus OCT. ERMs were defined by a combination of retinal photographs and OCT and classified as cellophane macular reflex (CMR) or preretinal macular fibrosis (PMF) based on retinal photographs characteristics. RESULTS: Of the 6830 persons examined, 6565 (96.1%) had gradable retinal photographs and/or OCT. The mean age was 51.7 +/- 11.6 years. ERMs were present in 3.4% (95% CI: 2.9%-3.8%) of participants, bilateral in 20.3% of the cases. CMR was present in 2.2% and PMF in 0.7%, and ERMs were unclassified in 0.5% (detected by OCT only). ERM prevalence was similar in women and men (3.6% vs. 3.1%), strongly associated with increasing age (P for trend < 0.001). After adjustment for age and sex, primary ERM was associated positively with myopia (OR: 1.58, 95% CI: 1.12-2.23) and inversely with current smoking (OR: 0.61, 95% CI: 0.38-0.97, versus never smoked). Best corrected visual acuity was significantly worse in eyes with primary ERMs (mean LogMAR score lower by 0.07, 95% CI: 0.05-0.10) than eyes without ERMs, after adjustment for age, sex, and lens status. CONCLUSIONS: ERMs affect 3.4% of the population 30+ years of age and living in rural China. Idiopathic ERMs were associated with myopia, decreased visual acuity, and inversely associated with smoking.

[Cost-effectiveness analysis on compound anti-hypertensive tablets for primary hypertension].

OBJECTIVE: To compare the cost-effectiveness of two anti-hypertensive therapy regimens, Compound anti-hypertensive tablets and other common anti-hypertensive agents, in the treatment program of Primary Hypertension. METHODS: We conducted a cost-effectiveness analysis based on a community trial. Two communities' primary hypertensive patients were enrolled to receive different therapy drugs: Compound anti-hypertensive tablets (Group A) or other common anti-hypertensive agents (Group B). Blood pressure, medicine used, and adverse drug reactions were observed and recorded for one year, and then cost-effectiveness ratio of the two groups and incremental ratio were calculated. We considered a 30% drug price fluctuating load to make the sensitivity analysis. RESULTS: 2505 cases were enrolled with 1529 cases in group A and 976 cases in group B. The cost-effectiveness ratios were 418.1 and 1057.7 for Group A and B respectively while the incremental cost-effectiveness of Group B vs. Group A was 19 202.2. The results were insensitive to variation in the costs of drugs over clinically reasonable ranges. CONCLUSION: Compound anti-hypertensive tablets appeared to be relatively cost-effective when compared to common drugs for the treatment of primary hypertension.

[Study on the long-term efficacy and safety of medicine named 'Beijing Hypertensive No. 0' in patients with primary hypertension].

OBJECTIVE: To assess the antihypertensive effect and safety on medicine named 'Beijing Hypertensive No. 0' in a three-year treatment of primary hypertension. METHODS: A community-based intervention study was conducted. The antihypertensive effects and adverse events were observed. RESULTS: 4000 patients with primary hypertension were randomly divided into two groups with 1529 patients treated with 'Beijing Hypertensive No. 0' and 976 patients treated with other antihypertensive drugs, among which 946 and 853 patients in the two groups completed the three-year study. After treatment, the systolic blood pressure decreased 13 mm Hg and 7 mm Hg while diastolic blood pressure decreased 8 mm Hg and 4 mm Hg in the 'No. 0' group and controlled group respectively. After three years of treatment, 90.0% and 79.5% in the 'No.0' group and in the control group had reached the BP 'fulfillment criteria', which were much higher than the baseline data. Side effects occurred in 33/1274 (2.6%) cases during three years' treatment with most commonly seen as dizziness, headache, palpitation and weakness. No serious adverse reactions occurred. There were some positive effects after treated by 'No. 0', including 0.13 mmol/L decrease of TC, 0.70 mmol/L decrease of LDL-C and an average 0.12 mmol/L increase of HDL-C. All of these changes were statistically significant. There were also opposite effects as 0.13 mmol/L increase of TG, 0.24 mmol/L increase of K+, and 0.88 mmol/L increase of Na+ on average, which were also statistically significant. CONCLUSION: Compared with the conventional treatment, this treatment of 'Beijing Hypertensive No.0' was more convenient, safe and effective in treating mild to moderate primary hypertension in the community.

[Comparison of five different diagnostic criteria on metabolic syndrome applied during physical check-up programs among population aged 35-74, in Taiwan].

OBJECTIVE: To compare the differences of five diagnostic criteria used for metabolic syndrome (MS), issued by International Diabetes Federation (IDF), the National Cholesterol Education Program (ATP III), America-Heart-Association (AHA), Chinese Medical Association Diabetes Branch (CDS) and The Taiwan Health Bureau (TAIWAN), during a physical check-up program among population aged 35-74 years, in Taiwan. METHODS: A total number of 28 408 people who had received physical checkup program first time at the MJ centers, were recruited from 2005 to 2007. The prevalence of MS and the degree of agreement were both calculated according to the five definitions and the results of MS components. Distributions and risk factor aggregation of the results were also analyzed. RESULTS: According to the five definitions (1) The range of age-adjusted prevalence of MS appeared to be 10.6% (CDS) -23.6%(AHA), and were 13.4% (CDS) -27.6% (AHA) and 8.0% (CDS) -20.5% (IDF) for men and women respectively. (2) The range of five MS components were 22.5% (low-HDL-C) -39.7% (high FPG), with 22.3% of the total subjects presented at least 3 risk factors. In addition, 0% (AHA), 6.7% (TAIWAN), 6.9% (ATP III), 8.9% (IDF) and 14.9% (CDS) of the subjects diagnosed as MS-free, by the five criterions, also appeared of having > or = 3 risk factors. (3) Among all the MS subjects, the proportions of clinical symptom complex, having 5, 4 and 3 MS components were 8.0%, 29.5% and 62.5% respectively. The most common clinical symptoms complex of MS were obesity, hypertension and high FPG. (4) The MS diagnostic criteria of ATP III, AHA and TAIWAN were in good accordance with Kappa index, showing 0.81-0.98 for the three criteria. CDS and IDF were in relatively weak agreement when comparing with other definitions with Kappa index showed as 0.35 and 0.62. CONCLUSION: Our findings revealed big differences in the prevalence and aggregation of risk components on MS, when using the five definitions. We suggested that prospective cohort studies be planned to investigate the impact on cardiovascular disease morbidity and mortality so as to verify whites criterion might be suitable to the population in Taiwan, considering the possible bias.