Association between serum apolipoprotein A1 and atrial fibrillation in the Chinese population: a case-control study.

BACKGROUND: The relationship between serum apolipoprotein A1 (APOA1) and atrial fibrillation (AF) is not known. Therefore, we sought to investigate the associations between APOA1 and AF in the Chinese population. METHODS: This case-control study included 950 patients with AF (29-83 years old, 50.42% male) who were hospitalized consecutively in China between January 2019 and September 2021. Controls with sinus rhythm and without AF were matched (1:1) to cases by sex and age. Pearson correlation analysis was performed to investigate the correlation between APOA1 and blood lipid profiles. Multivariate regression models were used to explore the association between APOA1 and AF. The receiver operator characteristic (ROC) curve was constructed to examine the performance of APOA1. RESULTS: Multivariate regression analysis showed that low serum APOA1 in men and women with AF was significantly associated with AF (OR = 0.261, 95% CI: 0.162-0.422, P < 0.001). Pearson correlation analysis indicated that serum APOA1 was positively correlated with total cholesterol (TC) (r = 0.456, p < 0.001), low-density lipoprotein cholesterol (LDL-C) (r = 0.825, p < 0.001), high-density lipoprotein cholesterol (HDL-C) (r = 0.238, p < 0.001), and apolipoprotein B (APOB) (r = 0.083, p = 0.011). ROC curve analysis showed that APOA1 levels of 1.105 g/L and 1.205 g/L were the optimal cut-off values for predicting AF in males and females, respectively. CONCLUSION: Low APOA1 in male and female patients is significantly associated with AF in the Chinese population of non-statin users. APOA1 may be a potential biomarker for AF and contribute to the pathological progression of AF along with low blood lipid profiles. Potential mechanisms remain to be further explored.

Physical activity, sleep disorders, and type of work in the prevention of cognitive function decline in patients with hypertension.

BACKGROUND: Hypertensive patients are likelier to have cognitive function decline (CFD). This study aimed to explore physical activity level, sleep disorders, and type of work that influenced intervention effects on cognitive function decline in hypertensive patients and to establish a decision tree model to analyze their predictive significance on the incidence of CFD in hypertensive patients. METHODS: This cross-sectional study recruited patients with essential hypertension from several hospitals in Shandong Province from May 2022 to December 2022. Subject exclusion criteria included individuals diagnosed with congestive heart failure, valvular heart disease, cardiac surgery, hepatic and renal dysfunction, and malignancy. Recruitment is through multiple channels such as hospital medical and surgical outpatient clinics, wards, and health examination centers. Cognitive function was assessed using the Mini-Mental State Examination (MMSE), and sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). Moreover, we obtained information on the patients' type of work through a questionnaire and their level of physical activity through the International Physical Activity Questionnaire (IPAQ). RESULTS: The logistic regression analysis results indicate that sleep disorder is a significant risk factor for CFD in hypertension patients(OR:1.85, 95%CI:[1.16,2.94]), mental workers(OR:0.12, 95%CI: [0.04,0.37]) and those who perform both manual and mental workers(OR: 0.5, 95%CI: [0.29,0.86]) exhibit protective effects against CFD. Compared to low-intensity, moderate physical activity(OR: 0.53, 95%CI: [0.32,0.87]) and high-intensity physical activity(OR: 0.26, 95%CI: [0.12,0.58]) protects against CFD in hypertension patients. The importance of predictors in the decision tree model was ranked as follows: physical activity level (54%), type of work (27%), and sleep disorders (19%). The area under the ROC curves the decision tree model predicted was 0.72 [95% CI: 0.68 to 0.76]. CONCLUSION: Moderate and high-intensity physical activity may reduce the risk of developing CFD in hypertensive patients. Sleep disorders is a risk factor for CFD in hypertensive patients. Hypertensive patients who engage in mental work and high-intensity physical activity effectively mitigate the onset of CFD in hypertensive patients.

Association between serum albumin levels and paroxysmal atrial fibrillation by gender in a Chinese population: a case-control study.

BACKGROUND: Hypoalbuminemia is linked to the emergence of cardiovascular events. However, there is an unclear association between serum albumin (ALB) and gender in paroxysmal AF patients. This retrospective study aimed to explore the association between ALB levels and paroxysmal AF by gender in a Chinese population. METHODS: This study included patients with paroxysmal AF who were hospitalized consecutively in China from January 2019 to September 2021. Controls with sinus rhythm and without paroxysmal AF were matched (2:1) to cases by gender and age. Pearson correlation analysis was used to study the correlation between ALB and blood lipid profiles, multivariate regression models were performed to investigate the association between ALB and paroxysmal AF. RESULTS: There were 305 patients with paroxysmal AF and 610 patients with controls included in this study. Low ALB in male with AF patients were significantly associated with paroxysmal AF (OR = 0.889, 95% CI 0.832-0.950). ALB was positively correlated with triglyceride (TG) (r = 0.212, p < 0.001), total cholesterol (TC) (r = 0.381, p = 0.002), low-density lipoprotein cholesterol (LDL-C) (r = 0.263, p < 0.001), and high-density lipoprotein cholesterol (HDL-C) (r = 0.329, p < 0.001). CONCLUSION: Low ALB in male patients is significantly associated with paroxysmal AF in a Chinese population. Monitoring for hypoalbuminemia in men might help reduce the incidence of paroxysmal AF.

Retrospective Study from a Single Center to Evaluate the Association Between Sex and Serum Uric Acid Levels in 950 Patients with Atrial Fibrillation.

BACKGROUND The association between patients' serum uric acid (SUA) levels and sex in atrial fibrillation (AF) remains controversial. This retrospective study from a single center in China aimed to evaluate the association between sex and SUA levels in 950 patients with AF. MATERIAL AND METHODS We retrospectively analyzed clinical information of 1913 consecutive hospitalized patients (male/female: 949/964, 68.26±11.02 years). The sample of 950 patients with AF served as the AF group and 963 age- and sex-matched patients without AF with sinus rhythm served as controls. The uricase method was used to determine SUA levels. The analysis of variance, t test, and chi-squared test were performed to analyze clinical baseline data. Pearson correlation analysis was performed to identify interrelationships and multivariate regression analysis was performed to determine the independent risk factor for AF. RESULTS SUA levels in the AF group were significantly higher in both sexes (P<0.05), especially for permanent AF. In patients with AF, SUA levels were positively correlated with serum creatinine (r=0.235, P<0.05) and prealbumin (r=0.129, P<0.05) and were negatively correlated with high-density lipoprotein cholesterol (r=-0.207, P<0.05) and apolipoprotein A1 (r=-0.167, P<0.05). SUA was independently associated with AF after adjusting for confounding factors (OR=1.244, 95% CI: 1.133-1.365, P<0.05). CONCLUSIONS In both sexes, increased SUA was significantly associated with AF. These findings supported the importance of monitoring SUA levels in patients with AF and other cardiac diseases.

Serum Uric Acid Levels in Relation to Atrial Fibrillation: A Case-Control Study.

BACKGROUND Although serum uric acid (SUA) levels have been reported to be associated with atrial fibrillation (AF), the specific associations remain unclear. The purpose of this study was to investigate the potential relationship of serum uric acid levels to atrial fibrillation. MATERIAL AND METHODS We retrospectively analyzed clinical data of 970 consecutive hospitalized patients (M/F, 519/451; age, 64.78±13.49 years). The study included 478 patients with AF, and 492 age-matched patients with sinus rhythm and no history of arrhythmia as a control group. The t test, ANOVA, chi-squared test, or Fisher exact test were performed to analyze clinical baseline data. RESULTS Compared with the control group, patients with AF exhibited higher SUA levels (5.66±1.90 vs 5.35±1.55 mg/dL, P=0.006), especially women (P<0.001). Pearson correlation analysis showed SUA was influenced by A/G, PAB, and APOA1 in patients with AF. Logistic regression analysis showed SUA was associated with AF (total: OR=1.002, 95% CI: 1.000-1.003; women: OR=1.005, 95% CI: 1.003-1.007). After adjustment for clinical related factors for AF, SUA was still associated with AF (total: OR=1.004, 95% CI: 1.002-1.006; women: OR=1.005, 95% CI: 1.002-1.009). Also, elevated SUA was positively correlated with A/G and PAB and negatively correlated with APOA1. There were no significant differences in SUA levels in AF subtypes and complications. CONCLUSIONS Elevated SUA levels were associated with AF, but the independent association was significant only in women. Elevated SUA may promote other AF-related factors and participate in the pathological process of AF.

Erratum: Serum Uric Acid Levels in Relation to Atrial Fibrillation: A Case-Control Study.

The authors requested several labels to be corrected: 1. Lp (a), mg/L should be Lp (a), mg/dL: 2. ALT/AST should be AST/ALT. Reference: Xia Zhong, Huachen Jiao, Dongsheng Zhao, Jing Teng: Serum Uric Acid Levels in Relation to Atrial Fibrillation: A Case-Control Study. Med Sci Monit, 2022; 28: e934007. DOI: 10.12659/MSM.934007.

Autonomic Tone Variations Prior to Onset of Paroxysmal Atrial Fibrillation.

BACKGROUND Variations of heart rate variability (HRV) before paroxysmal atrial fibrillation (PAF) onset are still controversial. We aimed to observe the autonomic tone variations before PAF onset based on HRV analysis. MATERIAL AND METHODS We prospectively investigated 24-h Holter recordings of 60 patients with PAF (M/F: 34/26) and 40 healthy people in sinus rhythm (M/F: 18/12). According to clinical information and Poincare scatter plot, 60 PAF patients were divided into sympathetic group (n=20) and vagus group (n=40). Time domain and frequency domain parameters of HRV were respectively measured before PAF episodes in 3 subgroups. Five time periods were studied using the ANOVA. RESULTS No significant variations were observed for the HRV parameters during 60 minutes preceding PAF in sympathetic group. A significant and linear change in SDNN, RMSSD, PNN50, HF and LF/HF during 60 minutes preceding PAF onset in vagus group. Compared with controls, RMSSD, LF and HF were significantly longer in patients with PAF during 60 minutes before PAF. Comparing sympathetic group and vagus group, we observed the same pattern of autonomic variations with a progressive decrease in LF and HF. A progressive decrease in PNN50 and LF/HF of sympathetic group and a significant increase in PNN50 and LF/HF of vagus group were also observed. CONCLUSIONS Patients with PAF mediated by different autonomic nerves have HRV variations, especially vagus PAF, there was a progressive increase with vagal tone during 60 minutes before PAF onset. The findings may help clinicians better intervene in PAF.

Case-Control Study to Investigate the Association Between Serum Apolipoprotein B/A1 Ratio and Atrial Fibrillation by Sex in 920 Patients from China.

BACKGROUND The serum apolipoprotein B/A1 ratio (APOB/APOA1) has been shown to predict cardiovascular events, whereas the effect of the APOB/APOA1 ratio on atrial fibrillation (AF) is less known. We investigated the association between the APOB/APOA1 ratio and AF by sex in 920 patients from China. MATERIAL AND METHODS We reviewed clinical data on 1840 hospitalized patients, including 920 patients with AF (male/female: 460/460, age: 68.62±10.36 years) and 920 age- and sex-matched patients without AF with sinus rhythm in China between January 2019 and September 2021. Pearson correlation analysis was performed to investigate the correlation between APOB/APOA1 ratio and AF-related metabolic factors. Logistic regression analysis was used to determine the odds ratios (ORs) and 95% confidence intervals (CIs). RESULTS Low serum APOB/APOA1 ratios in male and female patients were significantly associated with AF after adjusting for confounding factors (OR 0.159, 95% CI 0.058-0.432, P<0.05). Serum APOB/APOA1 ratio was positively correlated with triglyceride (TG) (r=0.146, P<0.05) and total cholesterol (TC) (r=0.227, P<0.05) and was negatively correlated with albumin (ALB) (r=-0.128, P<0.05) and prealbumin (PAB) (r=-0.107, P<0.05). There was no significant difference of APOB/APOA1 ratio in different subtypes, complications, and statin use in patients with AF (P>0.05). CONCLUSIONS A low serum APOB/APOA1 ratio in male and female patients from China was significantly related to AF. This finding implies that a low serum APOB/APOA1 ratio may be associated with the causes of AF. Further studies are needed to determine causalities.

A Retrospective Study to Determine the Association Between Serum Albumin Levels and Atrial Fibrillation by Sex in 950 Patients from a Single Center in China.

BACKGROUND It remains unclear whether there is a sex difference in the association between serum albumin (ALB) and atrial fibrillation (AF). This retrospective case-control study from a single center in China aimed to determine the association between serum ALB levels and AF by sex in 950 patients. MATERIAL AND METHODS Data of 950 AF patients and 963 age- and sex-matched non-AF patients with sinus rhythm were collected and analyzed retrospectively. Clinical baseline data were analyzed using the t test or Mann-Whitney U test, analysis of variance (ANOVA), and chi-square test. The interrelationships were determined by Pearson correlation analysis, and multivariate logistic regression analysis was performed to adjust for covariables. RESULTS ALB levels of AF patients were significantly lower in both sexes (P<0.05), especially paroxysmal AF. ALB was positively correlated with total cholesterol (TC) (r=0.359, P<0.05), low-density lipoprotein cholesterol (LDL-C) (r=0.283, P<0.05), and serum apolipoprotein A1 (APOA1) (r=0.429, P<0.05) and was negatively correlated with serum creatinine (SCr) (r=0.129, P<0.05) in patients with AF. We found an independent negative association between ALB levels and AF in men after adjusting for confounding factors (OR=0.889, 95% CI: 0.845-0.934, P<0.05). CONCLUSIONS In patients at a single center in China, low serum ALB levels in male patients were significantly associated with AF. These findings support those from previous studies in other populations and highlight the importance of monitoring and treating the cause of hypoalbuminemia in cardiac patients.

Correlation Between Serum Albumin and D-Dimer Levels in 909 Patients with Non-Valvular Atrial Fibrillation: A Retrospective Study from a Single Center in China.

BACKGROUND D-dimer level can reflect the hypercoagulable state of atrial fibrillation (AF) and predict thromboembolic events. However, no effective indicator associated with D-dimer of AF patients has been found to prevent thromboembolic events in AF. This retrospective study from a single center aimed to investigate the correlation between serum albumin and D-dimer levels in 909 patients with non-valvular AF (NVAF) and 653 subjects in sinus rhythm. MATERIAL AND METHODS A total of 909 NVAF patients and 653 sex- and age-matched sinus rhythm participants were used to compare serum albumin and D-dimer levels. Serum albumin was determined by colorimetry, and D-dimer level was determined by latex-enhanced photoimmunoassay. We analyzed the correlation of serum albumin and D-dimer with NVAF by correlation analysis, logistic regression analysis, and receiver operating characteristic (ROC) curve. RESULTS Albumin (P<0.001) and D-dimer (P<0.001) were significantly associated with NVAF. Among NVAF patients, D-dimer level was negatively correlated with albumin levels (P<0.001), and albumin level was an independent risk factor of abnormal D-dimer level (>0.5 ug/mL), which was also an effective predictor of abnormal D-dimer level (the area under the ROC curve was 0.77, P<0.001), and the optimal cutoff value was 36.95 g/L. CONCLUSIONS Serum albumin and D-dimer levels were significantly associated with NVAF. In NVAF patients, D-dimer level was inversely correlated with albumin levels, and albumin level was an independent risk factor and effective predictor of abnormal D-dimer level. Close examination and supplementation of serum albumin can prevent thromboembolic events, but further clinical research and confirmation are needed.

[Effect of Fuxin Mixture on The 01-AR-cAMP-PKA Pathway of Rats with Heart Failure].

Objective To observe the effect of Fuxin Mixture(FXM) on the ß,-AR(adrenergic receptor) -cAMP(cyclic adenosine monophosphate, cAMP) -PKA ( protein kinase A, PKA) pathway of rats with heart failure. Methods Male Wistar rats were randomly divided into blank control group, captopril group, FXM low dose group, FXM high dose group and model group.Models of CHF were established. After drug intervention for 6 weeks, the left ventricular mass index (LVMI) was analysed, the expression of ß1 - AR mRNA in myocardial tissue was measured,the level of cAMP in rat plasma,the OD value PKA content of spleen tissue homogenate were detected. Results Compared with the blank control group, the LVMI and the cAMP in plasma of model group were increased (P <0. 05), the expression of ß1,-AR mRNA, the OD value of spleen tissue homogenate and PKA were decreased (P <0. 01). Compared with the model group, the LVMI were decreased,and the expression of ß1-AR mRNA were increased in FXM high dose group and captopril group (P <0. 01 , P <0. 05) ; the level of cAMP in plasma of each drug group were decreased (P <0. 01) , the OD value of spleen tissue homogenate and PKA were increased (P <0. 01). Compared with the captopril group, the expression of ß1-AR mRNA, the OD value of spleen tissue homogenate and PKA were decreased, and the LVMI and the cAMP were increased in the FXM low dose group (P <0. 01 , P <0. 05). Compared with the FXM low dose group, the LVMI and the cAMP of FXM high dose group were decreased (P <0. 05), the expression of ß1-AR mRNA, the OD value of spleen tissue homogenate and PKA were increased (P <0. 01). Conclusion FXM could play the role of anti-heart fail- ure through regulating P1-AR-cAMP-PKA pathway.

Association between intensity of physical activity and cognitive function in hypertensive patients: a case-control study.

Previous studies have shown that a higher intensity of physical activity (PA) is associated with a lower risk of cognitive impairment (CI), whereas hypertension is associated with higher CI. However, there are few studies on the association between PA intensity and cognitive function in hypertensive patients. This study investigated the association between PA intensity and cognitive function in hypertensive patients. A total of 2035 hypertensive patients were included in this study, including 407 hypertensive patients with CI and 1628 hypertensive patients with normal cognitive function matched 1:4 by age and sex. The International Physical Activity Questionnaire-Long Form and the Mini-mental State Examination were used to evaluate PA intensity, total metabolic equivalents, and cognitive function in patients with hypertension. Multivariate logistic regression was used to analyze the correlation between PA intensity and CI in hypertensive patients. The Spearman correlation coefficient was used to analyze the correlation between PA intensity and the total score of each component of the MMSE and the correlation between PA total metabolic equivalents and cardiac structure in hypertensive patients. After adjusting for all confounding factors, PA intensity was negatively associated with CI in hypertensive patients (OR = 0.608, 95% CI: 0.447-0.776, P < 0.001), and this association was also observed in hypertensive patients with education level of primary school and below and junior high school and above (OR = 0.732, 95% CI: 0.539-0.995, P = 0.047; OR = 0.412, 95% CI: 0.272-0.626, P < 0.001). The intensity of PA in hypertensive patients was positively correlated with orientation (r = 0.125, P < 0.001), memory (r = 0.052, P = 0.020), attention and numeracy (r = 0.151, P < 0.001), recall ability (r = 0.110, P < 0.001), and language ability (r = 0.144, P < 0.001). PA total metabolic equivalents in hypertensive patients were negatively correlated with RVEDD and LAD (r = - 0.048, P = 0.030; r = - 0.051, P = 0.020) and uncorrelated with LVEDD (r = 0.026, P = 0.233). Higher PA intensity reduced the incidence of CI in hypertensive patients. Therefore, hypertensive patients were advised to moderate their PA according to their circumstances.

A Case Report of Asthma Exacerbation Induced by Excessive Drinking Water.

Excessive water consumption is an extremely rare and potential asthma risk factor with very few cases reported in the literature. Common triggers of asthma include genetic factors, smoking, allergens, and viral respiratory infections. The adult patient with asthma reportedly drank too much water and was unable to get relief from his asthma while hospitalized. The patient's asthma was better controlled with the use of diuretics and control of the patient's fluid intake and output. This case explores asthma induced by excessive drinking of water.

Association of Serum Uric Acid with Non-Valvular Atrial Fibrillation: A Retrospective Study in China.

Purpose: The association between serum uric acid (SUA) and atrial fibrillation (AF) has been widely focused on and studied in recent years. However, the exact association between SUA and AF is unclear, and the effect of gender on the association between SUA levels and AF has been controversial. This study aimed to investigate the association between SUA levels and non-valvular AF (NVAF) and the potential effect of gender on it. Patients and Methods: A total of 866 NVAF patients (463 males, age 69.44 ± 8.07 years) and 646 sex-matched control patients in sinus rhythm, with no history of arrhythmia were included in this study. t-test, ANOVA, and chi-square test were used for baseline data analysis. The receiver operating characteristic curve, logistic regression and Pearson correlation analysis were used for correlation analysis. Results: Compared to controls, NVAF patients exhibited higher SUA (P<0.001). After adjusting for confounders of NVAF, SUA remained significantly associated with NVAF, regardless of gender (OR= 1.31, 95% CI 1.18-1.43, P<0.001). SUA demonstrated higher predictability and sensitivity in predicting the occurrence of female NVAF compared to male (area under the curve was 0.68 (95% CI 0.64-0.72, P<0.001), sensitivity 87.3%), with the optimal cut-off point identified as 5.72 mg/dL. Furthermore, SUA levels correlated with APOA1, Scr and NT-proBNP in NVAF patients. SUA levels varied significantly among NVAF subtypes. Conclusion: High SUA levels were independently associated with NVAF, regardless of gender. SUA exhibited higher predictability and sensitivity in predicting the occurrence of NVAF in females compared to males. High SUA levels may affect other NVAF-related factors and participate in the pathophysiological process of NVAF.

[Chinese herbs for shen invigorating and blood activating activated MMP-9 signaling pathway to mobilize rats' bone marrow EPCs: a molecular mechanism research].

OBJECTIVE: To explore the effect of Chinese herbs for Shen invigorating and blood activating (CHSIBA) on the number of endothelial progenitor cells (EPCs) in the bone marrow and the peripheral blood and the signaling pathway of bone marrow matrix metalloproteinase 9 (MMP-9) of the myocardial infarction (MI) model rats. METHODS: The MI rat model was established by ligation. Thirty successfully modeled rats were randomly divided into the high dose CHSIBA group, the low dose CHSIBA group, and the model group, 10 in each group. Besides, another 10 normal rats were recruited as the blank group. Rats in the high dose CHSIBA group and the low dose CHSIBA group were administered with CHSIBA at 3 g/kg and 1.5 g/kg body weight by gastrogavage (by adding them in 4 mL physiological saline), once daily. Rats in the model group and the blank group were administered with 4 mL physiological saline once daily. The EPCs were collected from the bone marrow and the peripheral blood 4 weeks later. Seven days later the CD34/CD133 phenotype was identified in collected sticking wall cells using flow cytometry. The MMP-9 and water soluble Kit ligand (sKitL) were detected using Western blot. The expressions of vascular endothelial growth factor (VEGF) and stromal cell-derived factor-1alpha (SDF-1alpha) were detected using ELISA. RESULTS: The CD34/CD133 positive rate and the EPC quantity in the bone marrow and the peripheral blood were higher in the high dose CHSIBA group and the low dose CHSIBA group than in the model group (P < 0.05, P < 0.01). Besides, the expressions of VEGF, SDF-1alpha, MMP-9, and sKitL in the bone marrow and the peripheral blood were also higher in the high dose CHSIBA group and the low dose CHSIBA group than in the model group (P < 0.05, P < 0.01). CONCLUSION: CHSIBA could activate MMP-9 signaling pathway, increase its upstream and downstream signal expression levels, and mobilize EPCs in the bone marrow to enter the blood circulation.

Sleep quality and related influencing factors in adult hypertensive patients in Shandong Province, China.

Hypertension is a leading cause of death worldwide. Hypertension is associated with poor sleep quality, which adversely affects physical and mental health, and can increase the incidence rate and mortality of cardiovascular disease, cancer, and depression. This study aimed to investigate the prevalence of the factors related to poor sleep quality in hypertensive patients in Shandong Province, China. This cross-sectional study of adult patients with hypertension from August 2020 to February 2021was conducted in 10 cooperative hospitals in Shandong Province, China. Information was collected in the form of a questionnaire. In this study, Pittsburgh sleep quality index was used to evaluate sleep quality. A multivariate logistic regression model was used to analyze the risk of poor sleep quality. Variables with a P value < 0.05 and a 95% confidence interval (CI) were considered statistically significant. A total of 528 patients with hypertension were included, ranging in age from 31 to 90 years old. The prevalence of poor sleep quality among study participants with hypertension was 319 (60.4%) (95% CI: 0.562-0.646). Female gender (adjusted odds ratios [AOR] = 3.231; 95% CI: 2.194-4.757), stage III blood pressure (AOR = 2.142; 95% CI: 1.108-4.141), mental labor, and labor both physical and mental (AOR = 1.639; 95% CI:1.03-2.611 and AOR = 1.632; 95% CI: 1.030-2.584), unstable marriage (AOR = 3.203; 95% CI: 1.026-9.997) and the very Low-density Lipoprotein (odds ratios = 0.776; 95% CI: 0.649-0.928) were significantly associated with poor sleep quality. This study preliminarily showed that poor sleep quality was a common problem in hypertensive patients, and more than half of the hypertensive patients had poor sleep quality. Poor sleep quality was significantly correlated with gender, hypertension level, occupation, marital status, and the very Low-density Lipoprotein. Considering the negative impact of sleep quality, appropriate strategies should be developed to prevent and treat poor sleep quality in hypertensive patients.

Association between serum uric acid levels and atrial fibrillation in different fasting glucose patterns: A case-control study.

Background: Previous studies have shown both dysglycaemia and hyperuricemia are associated with an increased risk of atrial fibrillation (AF), while the relationship between serum uric acid (SUA) levels and AF in different fasting glucose patterns (FBG) is unclear. Therefore, this study aimed to determine the association between SUA and AF in different FBG patterns. Methods: A total of 1840 patients in this case-control study were enrolled, including 920 AF patients and 920 controls. Patients were divided into three groups according to the different FBG patterns: normoglycemic, impaired fasting glucose (IFG), and diabetes mellitus (DM). Multivariate logistic regression models were performed to evaluate the relationship between SUA and AF in different FBG patterns. Pearson correlation analysis was used to explore the correlation between SUA and metabolic factors. Receiver operating characteristic (ROC) curve models indicated the diagnostic efficiency of SUA for diagnosing AF. Results: SUA was independently associated with AF after adjusting for all confounding factors in different FBG patterns(normoglycemic: OR=1.313, 95% CI:1.120-1.539; IFG: OR=1.386, 95% CI:1.011-1.898; DM: OR=1.505, 95% CI:1.150-1.970). Pearson's correlation analysis suggested that SUA in AF patients was correlated with several different metabolic factors in different FBG patterns (p<0.05). ROC curve analysis showed that SUA in the normoglycemic group combined with CHD and APOB [AUC: 0.906 (95% CI: 0.888-0.923)], in the IFG group combined with CHD and Scr [AUC: 0.863 (95% CI: 0.820-0.907)], in the DM group combined with CHD and SBP [AUC: 0.858 (95% CI: 0.818-0.898)] had the highest AUC for predicting AF. Conclusion: Findings implied a significant association between SUA and AF in different FBG patterns and provide specific models combined with other factors (CHD, APOB, SCr, SBP), which might contribute to the diagnosis of AF.

The Effect of High-Intensity Interval Training on Exercise Capacity in Patients with Coronary Artery Disease: A Systematic Review and Meta-Analysis.

Background: The optimal exercise prescription for coronary artery disease (CAD) remains under debate. The aim of our meta-analysis is to investigate the efficacy of high-intensity interval training (HIIT) versus moderate-intensity continuous training (MICT) of coronary artery disease patients. Methods: Electronic databases were searched from their inception date until October 23, 2021, and the articles include randomized controlled trials. The mean differences and 95% confidence intervals were calculated, and heterogeneity was assessed using the I 2 test. Results: The study standards were met by seventeen studies. The pooled studies included 902 patients. HIIT resulted in improvement in peak oxygen uptake (1.50 ml/kg/min, 95% confidence interval: 0.48 to 2.53, n = 853 patients, and low quality evidence) compared with MICT. There was no discernible difference between the individuals in the HIIT group and the MICT group in terms of systolic/diastolic blood pressure or peak/resting heart rate. Conclusion: This systematic review and meta-analysis reported the superiority of HIIT versus MICT in enhancing peak oxygen uptake in CAD patients.

Association between lean body mass and hypertension: A cross-sectional study of 50 159 NHANES participants.

Increasing attention has been paid to the association between lean body mass (LBM) and hypertension in recent years, but the previous findings have often been contradictory. Therefore, the authors investigated the association between LBM and hypertension through a cross-sectional study in the United States. To investigate the relationship between LBM and hypertension, the authors conducted weighted multivariable logistic regression models. The authors used the restricted cubic spline regression model to determine if there was a nonlinear correlation. In order to locate the inflection point, the authors built a two-part linear regression model using a recursive method. In the full adjustment model, LBM was positively associated with hypertension, with ORs (95% CI) of 1.19 (1.02, 1.38). In the further linear trend test, the ORs (95% CI) for Q2, Q3, and Q4 were 0.76 (0.60, 0.95), 0.62 (0.47, 0.80), and 0.66 (0.48, 0.91), respectively, compared to Q1, which suggested that the association between LBM and hypertension might be non-linear. The authors performed the restricted cubic spline curve to confirm this non-linear relationship and found the inflection point of 43.21 kg with an opposite relationship in which LBM and hypertension exhibited a negative correction of 0.66 (0.50, 0.86) before the inflection point and a positive correlation of 1.20 (1.03, 1.39) after the inflection point. Our study highlighted a non-linear association between LBM and hypertension in the general US population.

A risk prediction model based on machine learning for early cognitive impairment in hypertension: Development and validation study.

Background: Clinical practice guidelines recommend early identification of cognitive impairment in individuals with hypertension with the help of risk prediction tools based on risk factors. Objective: The aim of this study was to develop a superior machine learning model based on easily collected variables to predict the risk of early cognitive impairment in hypertensive individuals, which could be used to optimize early cognitive impairment risk assessment strategies. Methods: For this cross-sectional study, 733 patients with hypertension (aged 30-85, 48.98% male) enrolled in multi-center hospitals in China were divided into a training group (70%) and a validation group (30%). After least absolute shrinkage and selection operator (LASSO) regression analysis with 5-fold cross-validation determined the modeling variables, three machine learning classifiers, logistic regression (LR), XGBoost (XGB), and gaussian naive bayes (GNB), were developed. The area under the ROC curve (AUC), accuracy, sensitivity, specificity, and F1 score were used to evaluate the model performance. Shape Additive explanation (SHAP) analysis was performed to rank feature importance. Further decision curve analysis (DCA) assessed the clinical performance of the established model and visualized it by nomogram. Results: Hip circumference, age, education levels, and physical activity were considered significant predictors of early cognitive impairment in hypertension. The AUC (0.88), F1 score (0.59), accuracy (0.81), sensitivity (0.84), and specificity (0.80) of the XGB model were superior to LR and GNB classifiers. Conclusion: The XGB model based on hip circumference, age, educational level, and physical activity has superior predictive performance and it shows promise in predicting the risk of cognitive impairment in hypertensive clinical settings.