Nocturnal hypertension and riser pattern are associated with heart failure rehospitalization in patients with heart failure with preserved ejection fraction.

BACKGROUND: Nocturnal hypertension is reported as a risk factor for cardiovascular disease. This study aimed to explore the potential association between nocturnal hypertension and heart failure (HF) rehospitalization in patients with HF with preserved ejection fraction (HFpEF). METHODS: A total of 538 patients with HFpEF from May 2018 to December 2021 were consequently recruited in this study and followed up until they were readmitted for HF or the end of this study. Cox regression analysis was used to reveal the potential association between nighttime blood pressure (BP) levels, nocturnal hypertension and nocturnal BP patterns and HF rehospitalization. Kaplan-Meier curve was used to assess the cumulative event-free survival rate between groups. RESULTS: There were 537 patients with HFpEF were included in the final analysis. The mean age of the study population was 77.14 ± 8.68 years, and 41.2% of patients were men. After a median follow-up duration of 10.93 (4.19-21.13) months, 176 patients (32.7%) with HFpEF were readmitted for HF. Cox regression analysis had revealed that nighttime systolic BP level [hazards ratio (HR) = 1.018, 95% CI: 1.008-1.028, P = 0.001], nighttime diastolic BP level (HR = 1.024, 95% CI: 1.007-1.042, P = 0.007), nocturnal hypertension (HR = 1.688, 95% CI: 1.229-2.317, P = 0.001) were associated with HF rehospitalization. Kaplan-Meier analysis had demonstrated that patients with nocturnal hypertension had significantly lower event-free survival rate (log-rank P < 0.001). Furthermore, patients with a riser pattern had a higher risk of HF rehospitalization (HR = 1.828, 95% CI: 1.055-3.166, P = 0.031) and lower event-free survival rate (log-rank P = 0.003) than those with a dipper pattern. These findings were also confirmed in patients with HFpEF and hyperuricemia. CONCLUSIONS: Nighttime BP levels, nocturnal hypertension and a riser pattern are independently associated with HF rehospitalization in patients with HFpEF, and prominently in patients with HFpEF and hyperuricemia. Well controlled nighttime BP levels should be emphasized and considered in patients with HFpEF.

Hyperuricemia is associated with atrial fibrillation prevalence in very elderly - a community based study in Chengdu, China.

Hyperuricemia is a risk factor for cardiovascular diseases. However, in very elderly, the relationship between hyperuricemia and the prevalence of atrial fibrillation (AF) is not clear. This study aimed to investigate hyperuricemia and the risk of AF in community very elderly. In this cross-sectional study, 1056 very elderly in community were enrolled. Serum uric acid (SUA) were measured and rest 12-lead electrocardiogram was performed. Multiple logistic regression models were used to explore risk factors for AF in very elderly. Finally, 1038 participants were included in analysis and the mean age of the study participants were 83.6 ± 3.4 years (age range 80-100 years). The mean SUA level was 350.1 ± 84.5 µmol/L. The estimated prevalence of AF was 5.3%, and there was no significant sex difference (5.8% for men and 4.8% for women, p = 0.401). Multiple logistic regression found that participants with hyperuricemia (SUA >416 µmol/L in men and >357 µmol/L in women) had a higher risk (odds ratio: 2.080, 95% confidence interval: 1.103-4.202, P = 0.007) of suffering AF in very elderly Chinese. In conclusion, AF is relatively frequent in this community very elderly Chinese in Chengdu. Hyperuricemia is associated with the prevalence of AF in general very elderly.

Prevalence and risk factors associated with hypertension in the Chinese Qiang population.

Our aim is to investigate the prevalence and risk factors associated with hypertension among the Chinese Qiang population. From September 2012 to March 2013, a cross-sectional study was conducted in urban and rural communities of the Qiang population using multistage cluster sampling. A total of 2676 people aged above 20 years were enrolled in the analysis. Standardized mercury sphygmomanometer was used to measure the blood pressure twice after a 10-minute seated rest, and the average blood pressure was obtained. The hypertension prevalence among the population aged above 20 years was 13.9%, and age-standardized prevalence was 12.3%. Male and female prevalence of hypertension, as well as the prevalence in urban and rural areas, all increased with age. There were no significant differences between males and females and between urban and rural residents. Among hypertensive patients, 44.2% were aware of their hypertension, 38.0% were undergoing antihypertensive treatment, but only 10.5% achieved blood pressure control. Multivariate logistic regression analysis showed that the risk factors of hypertension included age, low income, overweight and obesity, family history of hypertension. The prevalence of hypertension in Chinese Qiang adults is significantly lower than the national level. Awareness, treatment, and control rates of hypertension were low in the Qiang population. Thus, hypertension-related health knowledge should be more aggressively delivered to improve public awareness and the capacity of community health services should be strengthened.

Temporal trends in Prevalence, Awareness, Treatment, and Control of Hypertension from 2000 to 2010 in Chengdu, China.

This study aimed to describe trends in prevalence, awareness, treatment, and control in hypertension in Chengdu from 2000 to 2010. Two community-based cross sectional surveys were conducted among those aged 40-79 years in 2000 (n = 4850) and 2010 (n = 5456). Demographic characteristics, blood pressure (BP) and associated risk factors were examined. Mean systolic and diastolic BP increased from 117.8 ± 33.9 to 132.1 ± 21.2 mmHg (P < 0.001), and 75.3 ± 19.1 to 79.3 ± 11.2 mmHg (P < 0.001) over past decade, respectively. The prevalence of hypertension increased from 27.7 to 29.4% (P < 0.001). Awareness increased from 37.7 to 42.5% (P < 0.001). The overall treatment rate increased from 20.9 to 28.0% (P < 0.0001), while among subjects aware of hypertension, treatment increased from 46.9 to 65.8% (P < 0.001). In hypertensives, control increased from 6.8 to 6.9% (P = 0.6684). Nevertheless, in hypertensives aware and treated, control decreased from 32.5 to 24.3% (P = 0.020). Hypertension prevalence increased in the last decade, while awareness, treatment and control remained considerably low in Chengdu.

Prevalence, awareness, treatment, and control of hypertension among very elderly Chinese: results of a community-based study.

The epidemiologic distribution of hypertension among very elderly Chinese is still not clear. This study aimed to investigate the prevalence, awareness, treatment, and control rate of hypertension among very elderly in Chengdu. From May 2013 to May 2015, a total of 1056 participants from 20 residential communities were sampled. Standard face-to-face interviews, physical examinations, and biochemical analysis were undertaken. Participants had a mean age of 83.6 ± 3.4 years (range: 80-100), and 49.8% were men. Mean systolic blood pressure (BP) and diastolic BP were 146.4 ± 20.6 and 74.1 ± 11.9 mm Hg, respectively, and both of the highest BP levels were among participants aged 80-84 years. Mean pulse pressure was 72.5 ± 17.1 mm Hg, and the highest pulse pressure level was among participants aged 90 years and older. The overall estimated hypertension prevalence was 75.3% (95% confidence interval: 72.6%-77.9%), and among overall participants, 51.9% were aware of their hypertensive condition and 45.5% were treated. However, only 18.1% of hypertensive participants were controlled (BP < 140/90 mm Hg). Among very elderly Chinese in Chengdu, the prevalence of hypertension is predominantly high, whereas awareness, treatment, and control rates are considerably low. Effective primary and secondary prevention strategies are needed.

Hyperuricemia is associated with cardiovascular diseases clustering among very elderly women - a community based study in Chengdu, China.

Cardiovascular epidemiological features among very elderly Chinese are still uncertain. This study aimed to describe the distribution of cardiovascular diseases and sex difference, and investigate potential risk factors for diseases clustering among very elderly Chinese. From May 2013 to May 2015, a total of 1056 very elderly were sampled in this cross-sectional study. Demographic characteristics collection, physical examination and biochemical analysis were performed. Totally, 1038 participants (men: 49.8%) with a median age of 83.0 years (age range: 80.0-100.0 years) were included. In this very elderly group, the prevalences of hypertension, diabetes mellitus, renal dysfunction, hyperuricemia, obesity, visceral obesity, and hypercholesterolaemia were 76.9%, 20.0%, 23.3%, 33.0%, 9.4%, 54.5% and 35.8%, respectively. About 17.5% of very elderly (men vs. women: 15.1% vs 19.8%, p = 0.007) have ≥3 cardiovascular diseases clustering. Logistic analysis found that hyperuricemia (odds ratio 3.850, 95%CI 2.189-6.770) was associated with of cardiovascular diseases clustering among very elderly women. Prevalences of prehypertension, hyperuricemia, visceral obesity and dyslipidaemia are apparent in very elderly women, while diabetes mellitus, renal dysfunction are common in very elderly men. Women are more likely to have ≥3 cardiovascular diseases. Hyperuricemia is associated with cardiovascular diseases clustering among very elderly women.

[Particle Size Distribution and Diffusion for Simulated Cooking Fume].

Studying particle size distribution and dispersion characteristics of cooking oil fume can help to analyze the influence of the particles on indoor air quality and the health of the residents.Electrical low pressure impactor (ELPI) was employed to measure the number and mass concentration of the particles size range of 0.03-10 µm at two different locations in the kitchen space with smoke exhaust on and off,respectively.The cooking particles were mostly located at below 655 nm.The smoke exhaust with open condition could remarkably decrease the kitchen's cooking fume.The number concentration of particles decreased from 2.8×106 cm-3 to 2.3×105 cm-3,and PM2.5(aerodynamics diameter ≤2.5 µm particulate matter) mass concentrations decreased from 85.9 mg·m-3 to 6.2 mg·m-3.The sucking efficiency of smoke exhaust for PM10 was higher than PM2.5.The number concentration of particles could be declined by 65%,and the cooking fume of PM2.5 could be declined by 75% during the diffusion process detected at the area of 3 m far away from the area where cooking took place.The distribution of PM2.5 mass concentration field of oil fume was simulated by computational fluid dynamics.The temperature field distribution of oil fume was monitored by infrared camera,presenting sector diffusion with the temperature decreasing from 70℃ to room temperature.

Angiotensin-converting enzyme inhibitors and angiotensin receptor blockers decrease the incidence of atrial fibrillation: a meta-analysis.

BACKGROUND: There is not a general agreement regarding antiarrhythmic effects on atrial fibrillation (AF) of angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs). This study was to assess whether ACEIs and ARBs could decrease the incidence of AF. MATERIALS AND METHODS: Medline, Embase and Cochrane Library databases were searched for trials reported from 1950 to May 2009. Search terms included 'randomized controlled trial (RCT), controlled clinical trials, random allocation' and medical subject headings that included all spellings of ACEIs and ARBs agents, 'atrial fibrillation' and 'atrial flutter'. Randomized, controlled human trials of ACEIs or ARBs reporting AF were included. Data were extracted independently by two reviewers using a predefined data extraction sheet, including study quality indicators. Meta-analysis and subgroup analyses were carried out with a random effects model. RESULTS: Twenty-one trials including 91,381 patients and 5730 AF events were identified. Overall, ACEIs/ARBs reduced the relative risk (c) of AF by 25%. In primary and secondary prevention, ACEIs/ARBs decreased the incidence of AF by 24% and 27%, respectively. Patients with hypertension (RR: 0·71, 95%CI: 0·54-0·92), patients with chronic heart failure (RR: 0·58, 95%CI: 0·39-0·87) and those with AF (RR: 0·71, 95%CI: 0·52-0·96) benefited from ACEIs/ARBs treatment. CONCLUSIONS: ACEIs/ARBs are effective for primary prevention and secondary prevention of AF. They decrease the incidence of AF especially in patients with hypertension, patients with chronic heart failure and those with AF.

[An epidemiological study of abnormal glucose metabolism and its risk factors among middle and aged population with hypertension in Chengdu area].

OBJECTIVE: To explore the epidemiological status of abnormal glucose metabolism and its influential factors among middle and aged population with hypertension in Chengdu area. METHODS: In 2008, after adopting the methods of stratified cluster sampling, the authors investigated 4685 subjects of the middle and aged population between the age of 40 - 79 in Chengdu urban and rural area by checking blood pressure and oral glucose tolerance test (OGTT). Patients with previously known diabetes mellitus (DM) were only asked to perform fasting glucose and to carry out a questionnaire. Comparison of the prevalence rates of abnormal glucose metabolism in hypertensive and non-hypertensive subjects was carried out. The prevalence rates of isolated impaired glucose tolerance (I-IGT) and isolated postprandial hyperglycemia (IPH) among middle and aged subjects with hypertension were acquired and the influential factors of abnormal glucose metabolism among middle and aged subjects with hypertension were analyzed. RESULTS: The prevalence rate of abnormal glucose metabolism in the hypertensive subjects was obviously higher than that in the non-hypertensive subjects; without using OGTT, 72.9% of the pre-diabetic and 54.4% of the new diagnosed DM patients would remain undiagnosed if fasting plasma glucose detection was used alone. Age, diabetic history of first degree relatives, overweight or obesity were the risk factors for the development of abnormal glucose metabolism among middle and aged male subjects with hypertension in Chengdu area. Exercise training and high education level were the protective factors. Age, diabetic history of first degree relatives, abdominal obesity and hypertriglyceridemia were the risk factors for the development of abnormal glucose metabolism among middle and aged female subjects with hypertension in Chengdu area. CONCLUSIONS: More than 50% of middle and aged subjects with hypertension in Chengdu area has accompanying abnormal glucose metabolism. OGTT easily discloses the abnormal status and should be a routine procedure in the diagnosis of pre-diabetes or DM in such population. Appropriate exercise, learning diabetes-related knowledge to take reasonable lifestyle, and intervention of metabolic factors such as overweight or obesity are advised. Abdominal obesity and hypertriglyceridemia play important roles in leading to abnormal glucose metabolism among middle and aged population with hypertension.

[Development of evaluation tool for the risk level of abnormal glucose metabolism morbidity in middle-aged and elder populations].

OBJECTIVE: To develop the evaluation tool for the risk level of abnormal glucose metabolism morbidity in the middle-aged and elder populations. METHODS: By the stratified cluster sampling method, a survey was conducted in middle-aged and elder populations aged 40 - 70 years old in urban and rural areas of Chengdu during April-November 2008. The parameters included blood pressure, fasting blood glucose, blood glucose after oral administration of 75 g glucose, blood lipid, blood uric acid, height, body weight and waistline, etc. A total of 5205 valid copies of questionnaires were obtained. A discriminant analysis and a multifactorial logistic regression analysis were conducted. The quantitative scoring system was established and the ROC analysis conducted to screen the boundary point of the quantitative scoring system. The discriminant performance of simple scoring model was conducted in 336 subjects for physical examination. RESULTS: The accuracies of discriminant analysis in male and female models were 79.04% and 81.35% respectively. The simple male scoring mode included the following eight parameters: age, physical work intensity, parental history of diabetes mellitus, sibling's history of diabetes mellitus, BMI index, existing abdominal obesity and history of hypertension. The simple female scoring mode included the following eight parameters: age, physical work intensity, physical training, parental history of diabetes mellitus, sibling's history of diabetes mellitus, BMI index, existing abdominal obesity, history of hypertension, number of parturition and history of gestational diabetes mellitus. The ROC AUCs were 0.701 and 0.728 in male and female models respectively. During applications in other populations, the sensitivity and specificity of the male model were 86.86% and 65.12% while those of female model 88.89% and 72.97% respectively. CONCLUSIONS: The newly developed evaluation tool for the risk level of abnormal glucose metabolism morbidity in middle-aged and elder populations is both simple and practical. With an excellent practicability; it may be used to screen abnormal glucose metabolism in middle-aged and elder populations.

[Effect of compound salvia injection on nitrate ester tolerance].

OBJECTIVE: To investigate the effect and mechanism of Compound Salvia injection (CSI) on nitrate ester tolerance. METHODS: Eighty-four patients with coronary heart disease (CHD) were randomly divided into three groups, Group A treated with isosorbide dinitrate (ISD, 15 mg, 4 times per day) alone, Group B with ISD plus CSI and Group C with ISD plus vitamin C. The therapeutic course for all groups was 10 days. The tolerance to nitrate ester and blood pressure were monitored. Before and after treatment, the color Doppler ultrasonic apparatus was used to detect the baseline value of humeral arterial internal diameters (D0), the humeral arterial dilatory response under compression [D1, that is, the flow-mediated vasodilation (FMD)] and the vasodilatory response after sucking of nitroglycerin (D2). And the blood levels of endothelin-1 (ET-1), endothelial nitric oxide synthase (eNOS) mRNA expression were determined. The endothelial-dependent vasodilation (EDD) was expressed by (D1 - D0)/D0 x 100%, and the endothelial-independent vasodilation (EID) was expressed by (D2 - D0)/D0 x 100%. RESULTS: (1) The occurrence rate of nitrate tolerance in Group B and C (28.57% and 35.7%) was lower than that in Group A (64.29%), but insignificant difference was found between the former two. (2) After treatment, blood pressure increased in Group A to the level of pre-treatment, that in Group C also increased but still lower than that of pre-treatment, while insignificant increase was observed in Group B, comparison between Group B and C showed significant difference (P < 0.05). (3) After treatment, EID lowered in Group A, EDD increased in Group B and C (P < 0.05), EDD and EID in Group B and C were higher than those in Group A (P < 0.05), and EDD was higher in Group B than in Group C (P < 0.05). (4) After treatment, ET-1 mRNA expression lowered in Group B, eNOS mRNA expression increased in Group B and C, with significant difference as compared with those before treatment and those in Group A (P < 0.05), and eNOS mRNA expression in Group C was lower than that in Group B (P < 0.05). CONCLUSION: CSI could partially prevent the occurrence of tolerance to nitrate ester, with the effect better than vitamin C, the mechanism might be related with its regulation on eNOS, ET-1 mRNA expression and protection on vascular endothelial function.

[Effect of Xiangdan Injection on mRNA expression of endothelial vaso-active factors of patients with coronary heart disease and blood stasis].

OBJECTIVE: To evaluate the effect of Xiangdan Injection on mRNA expression of the endothelial vaso-active factors of patients with coronary heart disease and blood stasis. METHODS: Fifty-six patients were randomly divided into two groups:twenty-eight patients were treated according to the therapeutic guide for coronary heart disease as the control group and 28 were given the same treatment plus Xiangdan Injection as the treated group. The expressions of ET-1 and eNOS mRNA were examined with RT-PCR before experiment and ten days later. RESULTS: The positive rate of eNOS mRNA of the treated group increased, while the positive rate of ET-1 mRNA of the treated group decreased after ten day's treatment, with significant differences as compared with that before the experiment. Xiangdan Injection up-regulated the eNOS mRNA expression and suppressed the ET-1 mRNA expression. Changes of expression were not observed in the control group. CONCLUSION: Xiangdan Injection improves the endothelial function of patients with coronary heart disease and blood stasis by regulating the expressions of ET-1 and eNOS mRNA.