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Yu Y, Peng J, Zhaxi Z, Jimei Q, Shi H, Bai G, Cheng Q, Yang C. Epidemiological features of hypertension in a high-altitude population in Tibet, China: a cross-sectional study. BMC Public Health 2025; 25:1729. [PMID: 40348994 PMCID: PMC12065275 DOI: 10.1186/s12889-025-22792-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2024] [Accepted: 04/14/2025] [Indexed: 05/14/2025] Open
Abstract
BACKGROUND Hypertension is a significant public health challenge in high-altitude areas of Tibet, China. This study aimed to investigate the current epidemiologic status of hypertension in Tibet and to provide insights for enhancing prevention and control strategies in this population. METHODS A cross-sectional study was conducted across seven cities in the Tibet autonomous Region. Using multi-stage stratified cluster sampling, 8,992 residents aged 35-75 were enrolled. Hypertension prevalence, awareness, treatment, control rates, and associated risk factors were analyzed. We conducted descriptive and logistic regression analyses in this study. RESULTS The crude and weighted hypertension prevalence rates were 46.5% and 46.7%, respectively. Stage 2 or higher hypertension accounted for 49.8% of cases. Among hypertensive individuals, 45.2% were aware of their diagnosis, 30.8% received treatment, and only 3.0% achieved blood pressure control. Risk factors included aging, urban residence, alcohol consumption, overweight, obesity, diabetes, and central obesity (all p < 0.05). Monotherapy was used by 94.2% of treated patients, predominantly calcium channel blockers (CCBs). Among CCBs, nifedipine was the most commonly used agent (38.2%), with women more likely to use CCBs and less likely to receive beta-blockers than men (p < 0.05). CONCLUSIONS Hypertension in Tibet is characterized by high prevalence, multifactorial risk, and critically low rates of awareness, treatment, and control. Strengthening primary healthcare infrastructure and targeted health promotion programs are urgently needed to address this burden in high-altitude populations.
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Affiliation(s)
- Yue Yu
- Tibet Autonomous Region Center for Disease Control and Prevention, Lhasa, People's Republic of China
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Jieru Peng
- The Medical Administration Department, School of Medicine, Chengdu Women's and Children's Central Hospital, University of Electronic Science and Technology of China, Chengdu, People's Republic of China
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Zongji Zhaxi
- Tibet Autonomous Region Center for Disease Control and Prevention, Lhasa, People's Republic of China
| | - Quzhen Jimei
- Tibet Autonomous Region Center for Disease Control and Prevention, Lhasa, People's Republic of China
| | - Heng Shi
- Tibet Autonomous Region Center for Disease Control and Prevention, Lhasa, People's Republic of China
| | - Guoxia Bai
- Tibet Autonomous Region Center for Disease Control and Prevention, Lhasa, People's Republic of China.
| | - Qian Cheng
- Department of Gastroenterology, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, People's Republic of China.
| | - Chunxia Yang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, People's Republic of China.
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Wang F, Wei M, Yang N, Wang X. Prevalence, awareness, treatment, control of hypertension among adults inhabited in the coastal area of Tianjin, China. Medicine (Baltimore) 2024; 103:e38676. [PMID: 38941429 PMCID: PMC11466113 DOI: 10.1097/md.0000000000038676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Accepted: 05/31/2024] [Indexed: 06/30/2024] Open
Abstract
Hypertension has long been a worldwide health concern. Our aim was to investigate the prevalence, awareness, treatment, and control rates of hypertension and analyze the factors related to hypertension among adult residents of the coastal areas of Tianjin, China. This was a cross-sectional study. Adults aged 35 to 75 years were selected for the study using cluster random sampling methods. Detailed information was collected via face-to-face surveys and medical checkups. We assessed the rates of hypertension in the total population and sub-populations and used multivariable logistic regression to identify the factors associated with the prevalence and the control of hypertension. In total, 6305 participants aged 55.22 ± 10.37 years were included in this study. Approximately 49.8% (95% confidence interval [CI]: 48.5%-51.1%) of the population had hypertension; the prevalence increased with age and body mass index (all P < .001). Multivariable logistic regression showed that the odds ratio of hypertension was 5.93 times more in participants aged 65 to 75 years than in those aged 35 to 44 (95% CI: 4.85-7.26, P < .001). The odds ratio of hypertension was 3.63 times more in obese participants than in those of normal weight (95% CI: 3.08-4.28, P < .001). Additionally, the awareness, treatment, control, and control under-treatment rates of hypertension were 89.7%, 83.6%, 54.4%, and 60.5%, respectively. Factors associated with having controlled hypertension included sex, body mass index, and dyslipidemia (all P < .01). Our study identified that in the coastal area of Tianjin, China, about half have hypertension, also the region has high rates of hypertension awareness, treatment and control, and more than half of hypertension patients receiving treatment have controlled hypertension.
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Affiliation(s)
- Fenghua Wang
- Center of Clinical Epidemiology, TEDA International Cardiovascular Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China
| | - Maoti Wei
- Center of Clinical Epidemiology, TEDA International Cardiovascular Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China
| | - Ning Yang
- Department of Hypertension, TEDA International Cardiovascular Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China
| | - Xiongguan Wang
- Department of Cardiovascular Medicine, TEDA International Cardiovascular Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China
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Fotouhi F, Shahidi A, Hashemi H, Saffarpour M, Yekta A, Esmaieli R, Esteki T, Derakhshan HB, Khabazkhoob M. Hypertension prevalence in Iran's elderly according to new criteria: the Tehran Geriatric Eye Study. J Diabetes Metab Disord 2023; 22:1489-1498. [PMID: 37975137 PMCID: PMC10638178 DOI: 10.1007/s40200-023-01272-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 07/27/2023] [Indexed: 11/19/2023]
Abstract
Purpose To determine the prevalence of hypertension in a population above 60 years of age and its relationship with demographic and anthropometric factors. Methods A cross-sectional population-based study was conducted in 2019. Using a multistage random cluster sampling, 160 clusters were selected from 22 districts of Tehran. All participants were interviewed to collect demographic, anthropometric, and socioeconomic information. Then, systolic (SBP) and diastolic (DBP) blood pressures were measured under standard conditions twice, 10 min apart. A third measurement was performed if the two measurements showed a difference of ≥ 10 mmHg in SBP or ≥ 5 mmHg in DBP. Hypertension was defined as a SBP > 130 mmHg or a DBP > 80 mmHg (new criteria), being a known case of hypertension, or use of blood pressure lowering medications. Results Of 3791 invitees, 3310 participated in the study (87.3%). The mean age of the participants was 68.25 ± 6.54 years (60-97 years). The prevalence of hypertension was 81.08% (95% CI: 79.57-82.59) in the whole sample; 82.96% (95% CI: 81.02-84.91) in females, and 79.15% (95% CI: 76.6 -81.69) in males. The prevalence of hypertension ranged from 75.47% (95% CI: 72.65-78.29) in the age group 60-64 years to 88.40% (95% CI: 83.71-93.08) in the age group ≥ 80 years. The prevalence of hypertension unawareness was 32.84% (95% CI: 30.82-34.86). The highest and lowest prevalence of hypertension was seen in illiterate subjects (89.41%) and those with a university education (77.14%), respectively. According to the multiple logistic regression analysis, older age, lower education level, obesity and overweight, neck circumference, and diabetes were significantly associated with the prevalence of hypertension. Conclusion A significant percentage of Iranian elderly have hypertension and one of every 3 affected individuals is unaware of their disease. Considering the population aging in Iran, urgent and special attention should be paid to the elderly population. Caring for the elderly, informing families, and using non-traditional screening methods are recommended by families at the first level and policymakers at the macro level.
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Affiliation(s)
- Farid Fotouhi
- Student Research Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Aida Shahidi
- Noor Research Center for Ophthalmic Epidemiology, Noor Eye Hospital, Tehran, Iran
| | - Hassan Hashemi
- Noor Research Center for Ophthalmic Epidemiology, Noor Eye Hospital, Tehran, Iran
| | - Mahshid Saffarpour
- Department of Restorative Dentistry, School of Dentistry, Alborz University of Medical Sciences, Karaj, Iran
| | - Abbasali Yekta
- Department of Optometry, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Roghayeh Esmaieli
- Department of Medical Surgical Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Taraneh Esteki
- Department of Anesthesiology and Operating Room, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Homayoon Bana Derakhshan
- Department of Basic Sciences, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mehdi Khabazkhoob
- Department of Anesthesiology and Operating Room, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Hou C, Zhong Y, Zhang L, Liu M, Yan F, Chen M, Wang Y, Xu P, Su M, Hu C, Di B. Estimating the prevalence of hypertension in 164 cities in China by wastewater-based epidemiology. JOURNAL OF HAZARDOUS MATERIALS 2023; 443:130147. [PMID: 36283217 DOI: 10.1016/j.jhazmat.2022.130147] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 09/12/2022] [Accepted: 10/06/2022] [Indexed: 06/16/2023]
Abstract
Hypertension is the most common chronic non-infectious disease and a severe problem for public health in China. There were 244.5 million people aged over 18 years in China who had hypertension in 2015, and hypertension-related death accounted for more than 25 % of all causes of death in China every year. To monitor the hypertension prevalence in near real-time, a wastewater-based epidemiology (WBE) approach by using metoprolol acid as a biomarker was conducted in 164 cities in China. LC-MS/MS was utilized to quantify metoprolol acid in sewage, and satisfactory method validation results were achieved. The average concentration of metoprolol acid in sewage was 943.1 ± 671.1 ng/L, and the back-calculated consumption of metoprolol based on metoprolol acid was 932.0 ± 390.5 mg/day/1000inh on average, ranging from 76.7 to 3275.7 mg/day/1000inh. The prevalence of metoprolol was estimated to be 0.83 % ± 0.35 %, and the estimated hypertension prevalence in the population aged over 15 years was ultimately assessed to be 28.56 % ± 10.44 % ranging from 14.28 % to 44.28 % and was consistent with the China Hypertension Survey result of 27.9 %. This research demonstrated that estimating hypertension prevalence by WBE with metoprolol acid as a biomarker is feasible in Chinese cities.
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Affiliation(s)
- Chenzhi Hou
- Department of Pharmacy, China Pharmaceutical University, No.24 Tongjiaxiang Road, Nanjing 210009, PR China; China National Narcotics Control Commission-China Pharmaceutical University Joint Laboratory on Key Technologies of Narcotics Control, Nanjing 210009, PR China
| | - Yuling Zhong
- Department of Pharmacy, China Pharmaceutical University, No.24 Tongjiaxiang Road, Nanjing 210009, PR China; China National Narcotics Control Commission-China Pharmaceutical University Joint Laboratory on Key Technologies of Narcotics Control, Nanjing 210009, PR China
| | - Lan Zhang
- Department of Pharmacy, China Pharmaceutical University, No.24 Tongjiaxiang Road, Nanjing 210009, PR China; China National Narcotics Control Commission-China Pharmaceutical University Joint Laboratory on Key Technologies of Narcotics Control, Nanjing 210009, PR China
| | - Muyuan Liu
- Department of Pharmacy, China Pharmaceutical University, No.24 Tongjiaxiang Road, Nanjing 210009, PR China; China National Narcotics Control Commission-China Pharmaceutical University Joint Laboratory on Key Technologies of Narcotics Control, Nanjing 210009, PR China
| | - Fang Yan
- Department of Pharmacy, China Pharmaceutical University, No.24 Tongjiaxiang Road, Nanjing 210009, PR China; China National Narcotics Control Commission-China Pharmaceutical University Joint Laboratory on Key Technologies of Narcotics Control, Nanjing 210009, PR China
| | - Mengyi Chen
- Department of Pharmacy, China Pharmaceutical University, No.24 Tongjiaxiang Road, Nanjing 210009, PR China; China National Narcotics Control Commission-China Pharmaceutical University Joint Laboratory on Key Technologies of Narcotics Control, Nanjing 210009, PR China
| | - Youmei Wang
- China National Narcotics Control Commission-China Pharmaceutical University Joint Laboratory on Key Technologies of Narcotics Control, Nanjing 210009, PR China; National Narcotics Laboratory, Drug Intelligence and Forensic Center of the Ministry of Public Security of the People's Republic of China, Beijing 100741, PR China; Key Laboratory of Drug Monitoring and Control, Ministry of Public Security, People's Republic of China, Beijing 100741, PR China
| | - Peng Xu
- China National Narcotics Control Commission-China Pharmaceutical University Joint Laboratory on Key Technologies of Narcotics Control, Nanjing 210009, PR China; National Narcotics Laboratory, Drug Intelligence and Forensic Center of the Ministry of Public Security of the People's Republic of China, Beijing 100741, PR China; Key Laboratory of Drug Monitoring and Control, Ministry of Public Security, People's Republic of China, Beijing 100741, PR China
| | - Mengxiang Su
- Department of Pharmacy, China Pharmaceutical University, No.24 Tongjiaxiang Road, Nanjing 210009, PR China; China National Narcotics Control Commission-China Pharmaceutical University Joint Laboratory on Key Technologies of Narcotics Control, Nanjing 210009, PR China
| | - Chi Hu
- China National Narcotics Control Commission-China Pharmaceutical University Joint Laboratory on Key Technologies of Narcotics Control, Nanjing 210009, PR China; Department of Pharmaceutical Engineering, School of Engineering, China Pharmaceutical University, Nanjing 211198, PR China.
| | - Bin Di
- Department of Pharmacy, China Pharmaceutical University, No.24 Tongjiaxiang Road, Nanjing 210009, PR China; China National Narcotics Control Commission-China Pharmaceutical University Joint Laboratory on Key Technologies of Narcotics Control, Nanjing 210009, PR China.
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Gu Z, Qu Y, Wu H. The Interaction between Occupational Stress and Smoking, Alcohol Drinking and BMI on Hypertension in Chinese Petrochemical Workers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16932. [PMID: 36554810 PMCID: PMC9779072 DOI: 10.3390/ijerph192416932] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Revised: 12/12/2022] [Accepted: 12/14/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Hypertension is one of the most vital risk factors for cardiovascular diseases, so we wanted to explore the impact of the interaction between occupational stress and smoking, alcohol drinking and BMI on hypertension in Chinese petrochemical workers. METHODS A total of 1488 employees participated. Questionnaires included the value of blood pressure, occupational stress (assessed by the effort-reward imbalance scale), demographic factors and work conditions. Multivariable logistic regression was used to explore related factors, and the interactions between occupational stress and smoking, alcohol drinking and BMI on hypertension were analyzed using an additive model. RESULTS The prevalence of hypertension was 34.3%. Age ≥ 56 (OR = 3.19, 95%CI: 1.841-5.526), male (OR = 1.436, 95%CI: 1.056-1.954), BMI ≥ 25 (OR = 1.86, 95%CI: 1.468-2.346), smoking (OR = 1.52, 95%CI: 1.191-1.951) and alcohol drinking (OR = 1.53, 95%CI: 1.180-1.972), ERI > 1 (OR = 1.50, 95%CI: 1.133-1.960) are risk factors for hypertension, and a higher education level (OR = 0.57, 95%CI: 0.438-0.754) is a protective factor against hypertension. Positive interactions existed between occupational stress and smoking (RERI = 2.134, AP = 0.328, S = 1.635), alcohol drinking (RERI = 2.332, AP = 0.361, S = 1.746) and BMI (RERI = 1.841, AP = 0.340, S = 1.717) on hypertension in petrochemical workers. CONCLUSIONS Age, gender, educational level, BMI, smoking, alcohol drinking and occupational stress are closely related to the risk of hypertension. There are also positive interactions between occupational stress and alcohol drinking, smoking and BMI, which have a certain impact on hypertension.
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Ren Y, Shi J, Qiao Y, Gu Y, Li Y, Liu Y, Cheng Y, Liu Y. Epidemiological status quo of hypertension in elderly population in Changchun, China: a cross-sectional study. BMJ Open 2022; 12:e053086. [PMID: 35354631 PMCID: PMC8968531 DOI: 10.1136/bmjopen-2021-053086] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVES To investigate the epidemiological status quo of hypertension in elderly population in Changchun, China, and provide a reference for the prevention and control strategies of hypertension of elderly population in this region. DESIGN A cross-sectional study, as a part of a comprehensive project in Northeast China, was designed to perform in 10 districts in Changchun. PARTICIPANTS AND SETTING A total of 6846 participants who were ≥60 years old were selected using a random sampling method. MAIN OUTCOME MEASURES The epidemiological status quo of hypertension. RESULTS The prevalence of hypertension in Changchun was 52.6%. Among participants with hypertension enrolled in this study, 87.6% of the participants had been diagnosed with hypertension before the study, 69.1% was taking antihypertensive medications and 66.9% had effective blood pressure control. Obesity, widower/widow, history of diseases and family history of hypertension were risk factors of hypertension (all p<0.05). Participants with obesity, a personal history of heart coronary disease, or a family history of hypertension were susceptible to realising risks of hypertension (all p<0.05). However, participants with diabetes, hyperlipidaemia, or a family history of hypertension were difficult to control blood pressure within the normal range (all p<0.05). In addition, 92.6% participants taking antihypertensive medications used a single medication, and calcium channel blockers was the most commonly used antihypertensive medications in monotherapy. CONCLUSION The rates of awareness, treatment and control of hypertension are greater in Changchun than those in China, indicating that the prevention and control of hypertension in Changchun are effective. However, the prevalence of hypertension in the elderly population in China is lower than that in Changchun, also rendering Changchun a substantial challenge for the supervision of hypertension.
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Affiliation(s)
- Yaxuan Ren
- Epidemiology and Biostatistics, Jilin University School of Public Health, Changchun, Jilin, China
| | - Jikang Shi
- Epidemiology and Biostatistics, Jilin University School of Public Health, Changchun, Jilin, China
| | - Yichun Qiao
- Epidemiology and Biostatistics, Jilin University School of Public Health, Changchun, Jilin, China
| | - Yulu Gu
- NHC Key Laboratory of Radiobiology, Jilin University School of Public Health, Changchun, Jilin, China
| | - Yong Li
- Epidemiology and Biostatistics, Jilin University School of Public Health, Changchun, Jilin, China
| | - Yunkai Liu
- The Cardiovascular Center, Jilin University First Hospital, Changchun, Jilin, China
| | - Yi Cheng
- The Cardiovascular Center, Jilin University First Hospital, Changchun, Jilin, China
| | - Yawen Liu
- Epidemiology and Biostatistics, Jilin University School of Public Health, Changchun, Jilin, China
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Association of AGTR1 A1166C and CYP2C9∗3 Gene Polymorphisms with the Antihypertensive Effect of Valsartan. Int J Hypertens 2022; 2022:7677252. [PMID: 35345577 PMCID: PMC8957473 DOI: 10.1155/2022/7677252] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 01/27/2022] [Accepted: 02/12/2022] [Indexed: 11/20/2022] Open
Abstract
Background The differences in the antihypertensive treatment with angiotensin type II receptor blockers (ARBs) may be attributed to polymorphisms in genes involving drug-targeted receptor and drug metabolism. The present study aimed to investigate whether the antihypertensive effect of the ARB drug valsartan was associated with angiotensin II type 1 receptor (AGTR1) gene polymorphism (A1166 C) and cytochrome P450 enzyme 2C9 (CYP2C9) gene polymorphism (CYP2C9∗3). Methods 281 patients with hypertension who received valsartan monotherapy in the past month were included in this retrospective study. Polymerase chain reaction-melting curve analysis was performed to genotype the AGTR1 and CYP2C9 gene polymorphisms. Based on the systolic blood pressure (SBP) and diastolic blood pressure (DBP) at the time of visit, the patients were divided into well-controlled group (n = 144, SBP/DBP <140/90 mmHg) and poorly controlled group (n = 137, SBP/DBP ≥140/90 mmHg). Results Older age, decreased history of drinking, a higher proportion of mild-to-moderate hypertension, lower alanine aminotransferase levels, and higher high-density lipoprotein cholesterol levels were observed in the well-controlled group than the poorly controlled group. Higher frequencies of the C allele and AC + CC genotype of AGTR1 A1166C were detected in the well-controlled than the poorly controlled patients (P = 0.005 and P = 0.006). After adjustment for demographic and environmental factors, the CC + AC genotype of AGTR1 A1166C was markedly linked to better hypertension control with valsartan treatment compared to the AA genotype (odds ratio: 2.836, 95% confidence interval: 1.199–6.705, P = 0.018). No significant difference was observed in the allele or genotype distribution of CYP2C9∗3 polymorphism between well-controlled and poorly controlled patients. Conclusions The current data suggested that the AGTR1 A1166 C polymorphism may be associated with the antihypertensive effect of valsartan, and carriers with AC and CC genotypes may have a better antihypertensive efficacy response to valsartan treatment.
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Tang N, Ma J, Tao R, Chen Z, Yang Y, He Q, Lv Y, Lan Z, Zhou J. The effects of the interaction between BMI and dyslipidemia on hypertension in adults. Sci Rep 2022; 12:927. [PMID: 35042940 PMCID: PMC8766602 DOI: 10.1038/s41598-022-04968-8] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Accepted: 01/05/2022] [Indexed: 12/04/2022] Open
Abstract
Body mass index (BMI) and dyslipidemia are indicators of human health and are often associated with high blood pressure. In this study,we explored the relationship between BMI or dyslipidemia and the risk of hypertension and further verified the possible interacting influences of BMI with dyslipidemia on the risk of hypertension. The aim is to explore the possible risk factors of hypertension and to provide scientific basis for the prevention and treatment of hypertension. Eligible subjects were selected from a cross-sectional survey in Changsha City, and we collected relevant data and clinical indicators for each participant. Body mass index (BMI) was calculated as weight (kg)/height2 (m2), and divided into four categories according to the Chinese standard. Dyslipidemia is defined according to Chinese guideline. Unconditional logistic regression models were used for dichotomous variables to determine the risk or protective factors of dependent variables. Multivariate Logistic model was used to study the influence of BMI and dyslipidemia on hypertension. The following indicators were used to assess the interaction effects: (1) Relative excess risk due to interaction (RERI); (2) Attributable proportion due to interaction(AP); (3) Synergy index (SI). SPSS software was used for statistical analysis. A total of 2740 eligible participants were enrolled in the cross-sectional study, of which 765 subjects (27.9%) were diagnosed with hypertension. Multivariate Logistic model showed that overweight (OR: 1.70, 95%CI: 1.39–2.09) or obese (OR: 2.60, 95%CI: 1.84–3.66) subjects had a significantly higher risk of hypertension than normal weight people, and underweight was a protective factor for hypertension(OR: 0.52, 95%CI: 0.29–0.93). People with dyslipidemia have a higher risk of hypertension than those with normal lipids (OR: 3.05, 95%CI: 2.36–3.90). In addition,there was a significant potentiating interaction effect between overweight or obesity and dyslipidemia(overweight: RERI (1.91, 95%CI: 0.17–3.66), AP (0.40, 95%CI:0.14–0.66), SI (2.03, 95%CI:1.11–3.74) and obesity: RERI (2.20, 95%CI:1.01–3.40), AP (0.38, 95%CI:0.18–0.58), SI (1.84, 95%CI:1.18–2.89), while no interaction was found between underweight and dyslipidemia. Low body weight is an independent protective factor for hypertension, but overweight, obesity and dyslipidemia are risk factors for hypertension, and dyslipidemia significantly shared interactions with overweight and obesity that influenced the risk of hypertension.
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Affiliation(s)
- Na Tang
- Key Laboratory of Molecular Epidemiology of Hunan Province, School of Medicine, Hunan Normal University, Changsha, 410013, Hunan, China
| | - Jian Ma
- Key Laboratory of Molecular Epidemiology of Hunan Province, School of Medicine, Hunan Normal University, Changsha, 410013, Hunan, China
| | - Rongqin Tao
- Tianxin District Center for Disease Control and Prevention, Changsha, 410009, Hunan, China
| | - Zhijun Chen
- Key Laboratory of Molecular Epidemiology of Hunan Province, School of Medicine, Hunan Normal University, Changsha, 410013, Hunan, China
| | - Yide Yang
- Key Laboratory of Molecular Epidemiology of Hunan Province, School of Medicine, Hunan Normal University, Changsha, 410013, Hunan, China
| | - Quanyuan He
- Key Laboratory of Molecular Epidemiology of Hunan Province, School of Medicine, Hunan Normal University, Changsha, 410013, Hunan, China
| | - Yuan Lv
- Key Laboratory of Molecular Epidemiology of Hunan Province, School of Medicine, Hunan Normal University, Changsha, 410013, Hunan, China
| | - Zelong Lan
- Tianxin District Center for Disease Control and Prevention, Changsha, 410009, Hunan, China.
| | - Junhua Zhou
- Key Laboratory of Molecular Epidemiology of Hunan Province, School of Medicine, Hunan Normal University, Changsha, 410013, Hunan, China.
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Lv Y, Sun Q, Li J, Zhang W, He Y, Zhou Y. Disability Status and Its Influencing Factors Among Stroke Patients in Northeast China: A 3-Year Follow-Up Study. Neuropsychiatr Dis Treat 2021; 17:2567-2573. [PMID: 34393485 PMCID: PMC8357400 DOI: 10.2147/ndt.s320785] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 07/12/2021] [Indexed: 12/21/2022] Open
Abstract
PURPOSE To explore the rate of post-stroke disability and its associated factors in the third year following discharge from inpatient rehabilitation in Northeast China. DESIGN A prospective cohort study. METHODS A total of 522 persons who were hospitalized with a diagnosis of stroke were recruited consecutively between April 2015 and December 2015 and followed for 3 years. The primary outcome was disability, which was assessed using the Modified Barthel Index (MBI), a cutoff score of ≤95 indicates disability. Plausible risk factors of disability were selected from available variables to perform multivariate logistic regression analysis. FINDINGS The proportion of post-stroke patients with disability decreased from 63.8% to 46.7% at 3-year follow-up. The factors associated with post-stroke disability were age, neurological deficits, cognitive function, depression, and social support. CONCLUSIONS/CLINICAL RELEVANCE Disability continues to be a significant issue for individuals after a stroke, and community health workers should perform targeted assessments and interventions to decrease disability, and pay special attention to individuals who are at greatest risk of post-stroke disability.
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Affiliation(s)
- Yumei Lv
- School of Nursing, Harbin Medical University (Daqing), Daqing, Heilongjiang Province, People’s Republic of China
| | - Qiuxue Sun
- School of Nursing, Harbin Medical University (Daqing), Daqing, Heilongjiang Province, People’s Republic of China
| | - Juan Li
- Department of Pneumology, Qingdao Hospital of Traditional Chinese Medicine, Qingdao, Shangdong Province, People’s Republic of China
| | - Wenyue Zhang
- Department of Rehabilitation, People’s Hospital of Daqing, Daqing, Heilongjiang Province, People’s Republic of China
| | - Yudi He
- School of Nursing, Harbin Medical University (Daqing), Daqing, Heilongjiang Province, People’s Republic of China
| | - Yuqiu Zhou
- School of Nursing, Harbin Medical University (Daqing), Daqing, Heilongjiang Province, People’s Republic of China
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Xing L, Tian Y, Jing L, Lin M, Du Z, Sun Q, Dai D, Shi L, Yang Z, Liu S. Status and disparities of diabetes among urban and rural residents aged 40 years and older: insight from a population-based study in northeast China, 2017-2019. J Epidemiol Community Health 2021; 75:800-808. [PMID: 33526514 DOI: 10.1136/jech-2020-213755] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Revised: 11/15/2020] [Accepted: 01/18/2021] [Indexed: 12/21/2022]
Abstract
OBJECTIVES To evaluate the up-to-date epidemiology of diabetes in northeast China. METHODS The cross-sectional study was conducted between September 2017 and March 2019 using a multistage, stratified and cluster random sampling method. 18 796 participants (28.9% urban and 71.1% rural) aged ≥40 years were enrolled. Diabetes and pre-diabetes were diagnosed according to the history, fasting plasma glucose (FPG) and glycosylated haemoglobin A1c (HbA1c) levels. RESULTS The prevalence of diabetes was 17.1%, higher in urban than in rural residents (20.2% vs 15.8%, p<0.001). Meanwhile, the prevalence of pre-diabetes was 44.3%, higher in rural than in urban areas (49.4% vs 31.8%, p<0.001). The overall FPG and HbA1c were 6.10±1.94 mmol/L and 5.59%±1.08%. The FPG level was higher in rural area than in urban areas (6.15±1.83 mmol/L vs 5.97±2.18 mmol/L, p<0.001). Among participants with diabetes, 47.5% were aware of their diabetes condition; 39.5% were taking antidiabetic medications and 36.8% of people had their diabetes controlled. The awareness and treatment rates in rural areas were lower than those in urban areas (47.3% vs 57.5%, 34.4% vs 49.5%, p<0.001). Patients with diabetic, especially those in rural areas, tended to have multiple risk factors including hypertension (71.7%), overweight or obesity (69.6%) and dyslipidaemia (52.8%). CONCLUSION A considerable burden of diabetes was observed in northeast China, with high percentage of untreated diabetes, high prevalence of pre-diabetes, high overall FPG level and multiple uncontrolled risk factors in patients with diabetics. Therefore, region-specific strategies on prevention and management of diabetes should be emphasised.
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Affiliation(s)
- Liying Xing
- Department of Cardiology, The First Hospital of China Medical University, Shenyang, Liaoning, China.,Department of Chronic Disease, Liaoning Provincial Center for Disease Control and Prevention, Shenyang, Liaoning, China
| | - Yuanmeng Tian
- Department of Chronic Disease, Liaoning Provincial Center for Disease Control and Prevention, Shenyang, Liaoning, China
| | - Li Jing
- Department of Chronic Disease, Liaoning Provincial Center for Disease Control and Prevention, Shenyang, Liaoning, China
| | - Min Lin
- Department of Cardiology, Central Hospital of Ben Xi City, Benxi, China
| | - Zhi Du
- Department of Cardiology, The First Hospital of China Medical University, Shenyang, Liaoning, China
| | - Qun Sun
- Department of Chronic Disease, Disease Control and Prevention of Chao Yang City, Shenyang, China
| | - Dong Dai
- Department of Chronic Disease, Disease Control and Prevention of Dan Dong City, Dandong, China
| | - Lei Shi
- Department of Chronic Disease, Disease Control and Prevention of Liao Yang City, Liaoyang, China
| | - Zuosen Yang
- Department of Chronic Disease, Liaoning Provincial Center for Disease Control and Prevention, Shenyang, Liaoning, China
| | - Shuang Liu
- Department of Cardiovascular Ultrasound, China Medical University First Hospital, Shenyang, Liaoning, China
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Wu J, Du X, Lv Q, Li Z, Zheng Z, Xia Y, Tang C, Yao Z, Zhang J, Long M, Hisada M, Wu J, Zhou W, Ma C. A phase 3 double-blind randomized (CONSORT-compliant) study of azilsartan medoxomil compared to valsartan in Chinese patients with essential hypertension. Medicine (Baltimore) 2020; 99:e21465. [PMID: 32769878 PMCID: PMC7505320 DOI: 10.1097/md.0000000000021465] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Azilsartan medoxomil (AZL-M), an angiotensin II receptor blocker, has a well-characterized efficacy and safety profile in patients with hypertension. AZL-M is approved for use in over 40 countries globally; however, it is not yet approved in China. Therefore, a phase 3 registration study to assess the efficacy (antihypertensive effect), safety, and tolerability of AZL-M compared with valsartan in Chinese patients with essential hypertension was undertaken. METHODS This multicenter, double-blind, randomized, 8-week phase 3 study compared AZL-M with valsartan in Chinese patients aged ≥18 years with essential hypertension. Endpoints included change from baseline to week 8 in trough sitting clinic systolic blood pressure (scSBP) and ambulatory blood pressure monitoring parameters. RESULTS Overall, 612 patients (mean age, 57.1 years; 57.5% male) were randomized to AZL-M 80 mg (n = 209), AZL-M 40 mg (n = 199), or valsartan 160 mg (n = 204). Baseline mean scSBP was similar in all groups (157.9-158.5 mm Hg). The mean reduction in trough scSBP from baseline to week 8 was significantly greater with AZL-M 80 mg than with valsartan (-24.2 vs -20.6 mm Hg; P = .010), and noninferior with AZL-M 40 mg versus valsartan (-22.5 vs -20.6 mm Hg; P = .184). Mean reduction in 24-hour mean systolic blood pressure (n = 257) was significantly greater with both AZL-M 80 mg (-17.0 mm Hg; P < .001) and AZL-M 40 mg (-14.7 mm Hg; P = .014) than with valsartan (-9.4 mm Hg). Treatment-emergent adverse events had similar incidence (52.8%-56.5%) across the treatment groups and were generally mild or moderate. Dizziness was the most frequent treatment-related treatment-emergent adverse events (AZL-M 80 mg, 1.9%; AZL-M 40 mg, 1.5%; valsartan, 1.0%). The safety and tolerability of AZL-M were comparable with valsartan. CONCLUSIONS AZL-M was noninferior to valsartan at the 40-mg dose and superior to valsartan at the 80-mg dose in reducing trough scSBP, and showed acceptable safety-consistent with the AZL-M safety profile in other populations-in Chinese adults with hypertension. TRIAL REGISTRATION NUMBER NCT02480764.
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Affiliation(s)
- Jiahui Wu
- Department of Cardiology, Beijing Anzhen Hospital, Beijing
| | - Xin Du
- Department of Cardiology, Beijing Anzhen Hospital, Beijing
| | - Qiang Lv
- Department of Cardiology, Beijing Anzhen Hospital, Beijing
| | - Zhanquan Li
- Department of Cardiology, People's Hospital of Liaoning Province, Liaoning
| | - Zeqi Zheng
- Department of Cardiology, the First Affiliated Hospital of NanChang University, Jiangxi
| | - Yong Xia
- Department of Cardiology, the Affiliated Hospital of Xuzhou Medical College
| | - Chengchun Tang
- Department of Cardiology, Southeast University, Zhongda Hospital, Jiangsu
| | - Zhuhua Yao
- Department of Cardiology, Tianjin People's Hospital, Tianjin
| | - Jun Zhang
- Department of Cardiology, Hebei Cangzhou Central Hospital, Hebei
| | - Mingzhi Long
- Department of Cardiology, Nanjing Medical University Affiliated 2nd Hospital, Jiangsu, China
| | - Michie Hisada
- Global Patient Safety Evaluation, Takeda Development Center Americas, Inc., Deerfield, IL
| | - Jingtao Wu
- Statistics and Quantitative Sciences, Takeda Development Center Americas, Inc., Cambridge, MA, USA
| | - Wei Zhou
- Clinical Science, Takeda Development Center Asia, Pte. Ltd., Shanghai, China
| | - Changsheng Ma
- Department of Cardiology, Beijing Anzhen Hospital, Beijing
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12
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Zheng R, Liu Y, Hao Z, Liao H, Xiao C. Clinical Characteristics and Prognosis of Young Patients with Coronary Heart Disease. Med Sci Monit 2020; 26:e922957. [PMID: 32608384 PMCID: PMC7346752 DOI: 10.12659/msm.922957] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Background The objective of this study was to investigate the clinical characteristics and prognosis of coronary heart disease (CHD) in young patients. Material/Methods We included 972 CHD patients (≤50 years old) with coronary artery stenting who were prospectively enrolled and followed for 1 year. Clinical characteristics, risk factors, and predictors of outcomes were evaluated. Results The prevalence of current smoker, hypertension, diabetes mellitus, dyslipidemia and positive family history of CHD were 18.9%, 34.3%, 14.5%, 4.4%, and 44.2%, respectively. Most of the patients underwent coronary stenting due to stable angina (48.8%) and unstable angina (UA; 48.1%). After 1-year follow-up, 64 patients (6.6%) experienced clinical outcomes and the most common event was UA (n=56). Compared to patients without clinical outcomes, those with outcomes were more likely to be male, have higher systolic blood pressure, more likely to have hypertension and diabetes mellitus, and more likely to be presented as unstable angina. Multivariate regression analysis showed only age (hazard ratio [HR]: 1.12 and 95% confidence interval [CI]: 1.07–1.26), smoking (HR: 1.15 and 95% CI: 1.06–1.23), presence of hypertension (HR: 1.19 and 95% CI: 1.13–1.31), and diabetes mellitus (HR: 1.16 and 95% CI: 1.09–1.28), more vessels with stenosis (HR: 1.27 and 95% CI: 1.20–1.48) and presented with acute coronary syndrome (HR: 1.35 and 95% CI: 1.21–1.55) were independently associated with clinical outcomes. Conclusions Most of the young (≤50 years of age) CHD patients had poor management of risk factors and better controlling these risk factors would be helpful for the primary and secondary prevention of premature CHD in Guangdong province.
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Affiliation(s)
- Ruyi Zheng
- Department of Cardiology, The Third People's Hospital of Huizhou, Huizhou, Guangdong, China (mainland)
| | - Yan Liu
- Department of Cardiology, The Third People's Hospital of Huizhou, Huizhou, Guangdong, China (mainland)
| | - Zirui Hao
- Department of Endocrinology, The Third People's Hospital of Huizhou, Huizhou, Guangdong, China (mainland)
| | - Huocheng Liao
- Department of Cardiology, The Third People's Hospital of Huizhou, Huizhou, Guangdong, China (mainland)
| | - Chun Xiao
- Department of Cardiology, The Third People's Hospital of Huizhou, Huizhou, Guangdong, China (mainland)
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Yu B, Jin S, Wang C, Yan S, Zhou X, Cui X, Tang Z, Luan Q, Guo Y, Bian Z, Li L, Chen Z, Na L. The association of outdoor temperature with blood pressure, and its influence on future cardio-cerebrovascular disease risk in cold areas. J Hypertens 2020; 38:1080-1089. [PMID: 32371798 PMCID: PMC7614986 DOI: 10.1097/hjh.0000000000002387] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVES To explore whether lower outdoor temperature increases cardio-cerebrovascular disease risk through regulating blood pressure and whether indoor heating in winter is beneficial to prevent cardio-cerebrovascular disease in cold areas. METHODS We analyzed the data of 38 589 participants in Harbin from the China Kadoorie Biobank (CKB) during 2004-2008, with an average of 7.14-year follow-up. Linear regression analysis was performed to estimate the relationship between outdoor temperature and blood pressure. Cox regression analysis and logistic regression analysis were used to analyze the association of blood pressure with cardio-cerebrovascular event risk. Mediation analysis was performed to explore the role of blood pressure in the association between outdoor temperature and cardio-cerebrovascular events risk. RESULTS There was an increase of 6.7 mmHg in SBP and 2.1 mmHg in DBP for each 10 °C decrease in outdoor temperature when outdoor temperature was higher than 5 °C. There was an inverse association between outdoor temperature and cardio-cerebrovascular event morbidity. The increases in blood pressure and cardio-cerebrovascular event morbidity were attenuated in months when central heating was fully provided. Participants with hypertension have higher risks of cardio-cerebrovascular disease (hazard ratio 1.347; 95% CI 1.281--1.415), CVD (hazard ratio 1.347; 95% CI 1.282--1.416), MACE (hazard ratio 1.670; 95% CI 1.560--1.788) and stroke (hazard ratio 1.683; 95% CI 1.571--1.803). Mediation analysis demonstrated that the association between outdoor temperature and cardio-cerebrovascular events risk was potentially mediated by blood pressure. CONCLUSION Temperature-driven blood pressure potentially mediates the association between outdoor temperature and cardio-cerebrovascular events risk. Indoor heating in winter is probably beneficial to cardio-cerebrovascular disease prevention by inhibition of blood pressure increase.
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Affiliation(s)
- Bo Yu
- Department of Chronic Disease, Harbin Nangang District CDC, Harbin, China
| | - Shanshan Jin
- Department of Nutrition and Food Hygiene, Public Health College, Harbin Medical University, Harbin, China
- Collaborative Innovation Center for Biomedicine, Medical Technology College, Shanghai University of Medicine & Health Sciences, Shanghai, China
| | - Chi Wang
- Department of Chronic Disease, Harbin Nangang District CDC, Harbin, China
| | | | - Xue Zhou
- Heilongjiang Provincial CDC, Harbin, China
| | | | - Zhen Tang
- Harbin Nangang District CDC, Harbin, China
| | - Qing Luan
- Department of Chronic Disease, Harbin Nangang District CDC, Harbin, China
| | - Yu Guo
- Chinese Academy of Medical Sciences, Beijing, China
| | - Zheng Bian
- Chinese Academy of Medical Sciences, Beijing, China
| | - Liming Li
- Department of Epidemiology, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Zhengming Chen
- Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Lixin Na
- Collaborative Innovation Center for Biomedicine, Medical Technology College, Shanghai University of Medicine & Health Sciences, Shanghai, China
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Ni Y, Müller P, Ji Y. Bayesian Double Feature Allocation for Phenotyping with Electronic Health Records. J Am Stat Assoc 2019; 115:1620-1634. [PMID: 38111606 PMCID: PMC10727496 DOI: 10.1080/01621459.2019.1686985] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Revised: 10/04/2019] [Accepted: 10/17/2019] [Indexed: 10/25/2022]
Abstract
Electronic health records (EHR) provide opportunities for deeper understanding of human phenotypes - in our case, latent disease - based on statistical modeling. We propose a categorical matrix factorization method to infer latent diseases from EHR data. A latent disease is defined as an unknown biological aberration that causes a set of common symptoms for a group of patients. The proposed approach is based on a novel double feature allocation model which simultaneously allocates features to the rows and the columns of a categorical matrix. Using a Bayesian approach, available prior information on known diseases (e.g., hypertension and diabetes) greatly improves identifiability and interpretability of the latent diseases. We assess the proposed approach by simulation studies including mis-specified models and comparison with sparse latent factor models. In the application to a Chinese EHR data set, we identify 10 latent diseases, each of which is shared by groups of subjects with specific health traits related to lipid disorder, thrombocytopenia, polycythemia, anemia, bacterial and viral infections, allergy, and malnutrition. The identification of the latent diseases can help healthcare officials better monitor the subjects' ongoing health conditions and look into potential risk factors and approaches for disease prevention. We cross-check the reported latent diseases with medical literature and find agreement between our discovery and reported findings elsewhere. We provide an R package "dfa" implementing our method and an R shiny web application reporting the findings.
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Affiliation(s)
- Yang Ni
- Department of Statistics, Texas A&M University
- Department of Statistics and Data Sciences, The University of Texas at Austin
| | - Peter Müller
- Department of Mathematics, The University of Texas at Austin
| | - Yuan Ji
- Department of Public Health Sciences, The University of Chicago
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15
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Song H, Feng D, Wang R, Yang J, Li Y, Gao J, Wang Z, Yan Z, Long C, Zhou J, Feng Z. The urban-rural disparity in the prevalence and risk factors of hypertension among the elderly in China-a cross-sectional study. PeerJ 2019; 7:e8015. [PMID: 31850155 PMCID: PMC6916758 DOI: 10.7717/peerj.8015] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Accepted: 10/09/2019] [Indexed: 01/14/2023] Open
Abstract
Introduction This study aimed to assess the prevalence of hypertension and to explore the disparities of its risk factors among urban and rural elderly. Method Data of hypertensive patients were collected from the China Health and Retirement Longitudinal Study (CHARLS) 2015. Stratified sample households were selected from 450 villages or communities of 150 counties from 28 provinces. Multivariable logistic regression was performed to analyze the factors correlated with hypertension. Results Prevalence of HBP was 47.6% (95% CI [45.2%-50.1%]) in total and it was close between urban and rural population (48.6% vs 47.2%). Factors associated with HBP were different between urban and rural areas. In urban areas, hypertension was significantly associated with literacy and diabetes in both genders, high BMI level and smoke quitters in males, and physical activity and dyslipidemia in females. In rural areas, hypertension was significantly associated with older age, higher BMI level in both males and females, and dyslipidemia in males. Conclusions The prevalence are about the same among urban and rural residents, but their risk factors vary from each other. Disparity in the risk factors between urban and rural population should be taken into consideration for further intervention.
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Affiliation(s)
- Hongxun Song
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Hubei Province, People's Republic of China, Department of Health Management, Wuhan, Hubei, China
| | - Da Feng
- School of Pharmacy, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, Hubei, China
| | - Ruoxi Wang
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Hubei Province, People's Republic of China, Department of Health Management, Wuhan, Hubei, China
| | - Jian Yang
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Hubei Province, People's Republic of China, Department of Health Management, Wuhan, Hubei, China
| | - Yuanqing Li
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Hubei Province, People's Republic of China, Department of Health Management, Wuhan, Hubei, China
| | - Junliang Gao
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Hubei Province, People's Republic of China, Department of Health Management, Wuhan, Hubei, China
| | - Zi Wang
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Hubei Province, People's Republic of China, Department of Health Management, Wuhan, Hubei, China
| | - Ziqi Yan
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Hubei Province, People's Republic of China, Department of Health Management, Wuhan, Hubei, China
| | - Chengxu Long
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Hubei Province, People's Republic of China, Department of Health Management, Wuhan, Hubei, China
| | - Jiawei Zhou
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Hubei Province, People's Republic of China, Department of Health Management, Wuhan, Hubei, China
| | - Zhanchun Feng
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Hubei Province, People's Republic of China, Department of Health Management, Wuhan, Hubei, China
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Gai Z, Wang Z, Zhang L, Ma J, Zhu Q. Paeonol protects against hypertension in spontaneously hypertensive rats by restoring vascular endothelium. Biosci Biotechnol Biochem 2019; 83:1992-1999. [PMID: 31362597 DOI: 10.1080/09168451.2019.1648203] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
ABSTRACT
The present study focused on the effect of paeonol, one of the main components of Guizhi Fuling Pill, on blood pressure, cerebral blood flow, and vascular endothelium injury in spontaneously hypertensive rats to provide theoretical basis for the treatment of hypertension. After treatment with paeonol, the mean arterial pressure (MAP) of LSHRT and HSHRT rats decreased gradually with the prolongation of treatment time. The systolic blood flow velocity (Vs), diastolic blood flow velocity (Vd) and mean blood flow velocity (Vm) were significantly increased after paeonol treatment (p < 0.05). Paeonol effectively improved the blood pressure and increased the cerebral blood flow velocity in spontaneously hypertensive rats. This may be related to the fact that paeonol reduced the blood viscosity and the oxidative stress and improved the antioxidant capacity. Moreover, paeonol protected vascular endothelial cells and reduced vascular endothelial injury in spontaneously hypertensive rats.
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Affiliation(s)
- Zhonghui Gai
- Department of Heart Disease, Yantai Hospital of Traditional Chinese Medicine, Yantai, Shandong, China
| | - Zhenxing Wang
- Department of Encephalopathy, Yantai Hospital of Traditional Chinese Medicine, Yantai, Shandong, China
| | - Lei Zhang
- Department of Heart Disease, Yantai Hospital of Traditional Chinese Medicine, Yantai, Shandong, China
| | - Jun Ma
- Department of Heart Disease, Yantai Hospital of Traditional Chinese Medicine, Yantai, Shandong, China
| | - Qiao Zhu
- Department of Heart Disease, Yantai Hospital of Traditional Chinese Medicine, Yantai, Shandong, China
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Xing L, Jing L, Tian Y, Lin M, Du Z, Yan H, Ren G, Dong Y, Sun Q, Liu S. Urban-Rural disparities in status of hypertension in northeast China: a population-based study, 2017-2019. Clin Epidemiol 2019; 11:801-820. [PMID: 31564985 PMCID: PMC6731973 DOI: 10.2147/clep.s218110] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2019] [Accepted: 08/13/2019] [Indexed: 11/23/2022] Open
Abstract
Background To investigate the status of hypertension and related risk factor disparities between urban and rural areas of northeast China. Methods A multi-stage, stratified, and cluster random sampling method was used to conduct the cross-sectional survey in Liaoning Province in 2017-2019. Finally, included 18,796 participants (28.9% urban, 71.1% rural) aged ≥40 years. The prevalence and control rate of hypertension were estimated based on Chinese hypertension guidelines and the 2017 American College of Cardiology/American Heart Association (ACC/AHA) guidelines. Results The mean age of the population was 60.4±9.9 years, and 61.0% were women. The overall prevalence of hypertension was 56.8%. Compared to urban areas, hypertension was more prevalent, but the awareness, treatment, and control rates were lower in rural areas (59.2 vs 50.2, 52.5% vs 47.0%, 46.9% vs 34.9%, and 11.4% vs 3.7%, P<0.001, respectively). Multivariate regression analysis identified that the lack of exercise (odds ratio (OR), 1.24; 95% confidence interval (CI), 1.10-1.38) in rural areas, whereas overweight/obesity (OR, 2.01; 95% CI, 1.79-2.27) and alcohol consumption (OR, 1.20; 95% CI, 1.01-1.41) in urban areas were specific risk factors for hypertension, besides common risk factors. Under the 2017 ACC/AHA guidelines, the prevalence of hypertension was 80.6% (urban 76.6%, rural 82.2%), increased 1.4-fold compared with the current Chinese guidelines, with increased rates of 27.9% in urban areas and 25.7% in rural areas. Conclusion A highly diverse prevalence for hypertension was found between urban and rural areas in northeast China. Region-specific strategies targeting the prevention and management of hypertension should be highlighted.
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Affiliation(s)
- Liying Xing
- Department of Cardiology, The First Hospital of China Medical University, Shenyang 110001, People's Republic of China.,Department of Chronic Disease, Liaoning Provincial Center for Disease Control and Prevention, Shenyang 110005, People's Republic of China
| | - Li Jing
- Department of Chronic Disease, Liaoning Provincial Center for Disease Control and Prevention, Shenyang 110005, People's Republic of China
| | - Yuanmeng Tian
- Department of Chronic Disease, Liaoning Provincial Center for Disease Control and Prevention, Shenyang 110005, People's Republic of China
| | - Min Lin
- Department of Cardiology, Central Hospital of Ben Xi City, Ben Xi, Liaoning, People's Republic of China
| | - Zhi Du
- Department of Cardiology, The First Hospital of China Medical University, Shenyang 110001, People's Republic of China
| | - Han Yan
- Department of Chronic Disease, Liaoning Provincial Center for Disease Control and Prevention, Shenyang 110005, People's Republic of China
| | - Guocheng Ren
- Department of Disease Control and Preventive, Central Hospital of Chao Yang City, Chaoyang, Liaoning, People's Republic of China
| | - Yingna Dong
- Department of Disease Control and Preventive, Central Hospital of Chao Yang City, Chaoyang, Liaoning, People's Republic of China
| | - Qun Sun
- Department of Chronic Disease, Disease Control and Prevention of Chao Yang City, Chaoyang, Liaoning, People's Republic of China
| | - Shuang Liu
- Department of Cardiovascular Ultrasound, The First Hospital of China Medical University, Shenyang, Liaoning, People's Republic of China
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Prevalence, awareness, treatment, and control of hypertension and their determinants: Results from the first cohort of non-communicable diseases in a Kurdish settlement. Sci Rep 2019; 9:12409. [PMID: 31455810 PMCID: PMC6711962 DOI: 10.1038/s41598-019-48232-y] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Accepted: 07/25/2019] [Indexed: 12/21/2022] Open
Abstract
Hypertension is a public health issue in Iran. The study aimed to estimate the prevalence, awareness, treatment, and control of hypertension, and to explore their determinants among 10,040 Kurdish adults from Ravansar Non-Communicable Disease (RaNCD) cohort study in Iran. Univariate, and multivariate analyses were used for statistical analysis. Prevalence of hypertension was 15.7%. Among hypertensive patients, awareness, treatment, and control of hypertension were 80.7%, 73.2%, and 53.3%, respectively. In multivariate analysis, significant associations were found between awareness and female sex, older age, being married rather than being single, literacy, living in rural areas, having family history, and comorbidities, with a higher probability for those who had both diabetes and dyslipidemia. Being married, living in rural areas, being ex-smokers, having less physical activity and individuals who had diabetes and dyslipidemia had higher odds of receiving treatment. Being female had a statistically significant association with the control of hypertension. The Kurdish population had higher awareness, with a greater proportion of treated, and controlled patients compared to populations included in previous studies for the last 20 years in Iran. With the continuing health promotion programs in Iran, it is expected to observe a lower prevalence of hypertension, higher awareness and greater number of treated individuals with controlled hypertension.
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Li X, Wei Y, Wang Z. microRNA-21 and hypertension. Hypertens Res 2018; 41:649-661. [PMID: 29973661 DOI: 10.1038/s41440-018-0071-z] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2017] [Revised: 01/11/2018] [Accepted: 01/29/2018] [Indexed: 12/12/2022]
Abstract
Hypertension, a multifactorial disease, is a major risk factor for the development of stroke, coronary artery disease, heart failure, and chronic renal failure. However, its underlying cellular and molecular mechanisms remain largely elusive. Numerous studies have shown that microRNAs (miRNAs) are involved in a variety of cellular processes, including cellular proliferation, apoptosis, differentiation, and the development of diseases. microRNA-21 (miR-21), a conserved single-stranded non-coding RNA that is composed of approximately 22 nucleotides, is one of the most intensively studied miRNAs in recent years, and it can regulate gene expression at the post-transcriptional level. miR-21 is expressed in many kinds of tumors and in the cardiovascular system, and it plays an important role in the occurrence and development of cardiovascular diseases. In recent years, more and more evidence indicates that miR-21 plays an important role in hypertension. This article reviews the source, function, and altered levels of miR-21 in hypertension and the role of miR-21 in the pathogenesis of hypertension and target organ damage (TOD). The potential role of miR-21 as a new target for predicting and treating hypertension is also explored.
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Affiliation(s)
- Xiao Li
- Department of Hypertension, Beijing Anzhen Hospital, Capital Medical University, 100029, Beijing, China
| | - Yongxiang Wei
- Department of Otolaryngology Head and Neck Surgery, Beijing Anzhen Hospital, Capital Medical University, 100029, Beijing, China.
| | - Zuoguang Wang
- Department of Hypertension, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung, Blood Vessel Diseases, 100029, Beijing, China.
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