Plasma Choline as a Diagnostic Biomarker in Slow Coronary Flow.

AIM: The slow coronary flow (SCF) phenomenon was characterized by delayed perfusion of epicardial arteries, and no obvious coronary artery lesion in coronary angiography. The prognosis of patients with slow coronary flow was poor. However, there is lack of rapid, simple, and accurate method for SCF diagnosis. This study aimed to explore the utility of plasma choline as a diagnostic biomarker for SCF. METHODS: Patients with coronary artery stenosis <40% evaluated by the coronary angiogram method were recruited in this study and were grouped into normal coronary flow (NCF) and SCF by thrombolysis in myocardial infarction frame count (TFC). Plasma choline concentrations of patients with NCF and SCF were quantified by Ultra Performance Liquid Chromatography Tandem Mass Spectrometry. Correlation analysis was performed between plasma choline concentration and TFC. Receiver operating characteristic (ROC) curve analysis with or without confounding factor adjustment was applied to predict the diagnostic power of plasma choline in SCF. RESULTS: Forty-four patients with SCF and 21 patients with NCF were included in this study. TFC in LAD, LCX, and RCA and mean TFC were significantly higher in patients with SCF in comparison with patients with NCF (32.67 ± 8.37 vs. 20.66 ± 3.41, P < 0.01). Plasma choline level was obviously higher in patients with SCF when compared with patients with NCF (754.65 ± 238.18 vs. 635.79 ± 108.25, P=0.007). Plasma choline level had significantly positive correlation with Mean TFC (r = 0.364, P=0.002). Receiver operating characteristic (ROC) analysis showed that choline with or without confounding factor adjustment had an AUC score of 0.65 and 0.77, respectively. CONCLUSIONS: TFC were closely related with plasma choline level, and plasma choline can be a suitable and stable diagnostic biomarker for SCF.

Plasma homocysteine levels are independently associated with alterations of large artery stiffness in men but not in women.

OBJECTIVES: To investigate the associations of the plasma homocysteine levels with the alterations in arterial stiffness in a community-based cohort. The gender differences in these associations were examined. METHODS: We evaluated the relationship between plasma homocysteine levels to three measures of vascular function [carotid-femoral pulse wave velocity (CF-PWV), carotid-ankle PWV (CA-PWV) and heart rate corrected augmentation index (AI)] in 1680 participants (mean age: 61.5 years; 709 men, 971 women) from communities of Beijing, China. RESULTS: In univariate analysis, plasma homocysteine levels was positively related to the CF-PWV (r = 0.211, P < 0.0001) and CA-PWV (r = 0.148, P < 0.0001), whereas inversely associated with AI (r = -0.052, P = 0.016). In multiple linear regression models adjusting for covariants, plasma homocysteine remained positively related to the CF-PWV (standardized ß = 0.065, P = 0.007) in total cases. When the groups of men and women were examined separately, plasma homocysteine remained positively associated with the CF-PWV (standardized ß = 0.082, P = 0.023) in men, whereas the relations between homocysteine and any of the arterial stiffness indices were not further present in women. CONCLUSIONS: In Chinese population, plasma homocysteine levels are independently associated with alterations of large artery stiffness in men but not in women.

Plasma Homocysteine is a Predictive Factor for Arterial Stiffness: A Community-Based 4.8-Year Prospective Study.

The authors investigated whether plasma total homocysteine (tHcy) is a predictive factor for arterial stiffness (carotid-femoral pulse wave velocity [cf-PWV] and carotid-radial PWV) in 1447 patients from a 4.8-year prospective study in Beijing, People's Republic of China. Baseline tHcy showed a significant relationship with follow-up cf-PWV (ß=0.817, P=.015) in a multivariable linear regression analysis. A stepwise logistic regression model showed that baseline levels of tHcy were significantly associated with follow-up cf-PWV in the adjusted models. Furthermore, the baseline tHcy levels showed a significant association with increases in cf-PWV. There was no association between the change in tHcy and increase in PWV. The present study clearly demonstrated an association between tHcy levels and arterial stiffness, indicating that tHcy is an independent predictive factor for arterial stiffness in a community-based population.

[Central pulse pressure but not brachial blood pressure is the predominant factor affecting aortic arterial stiffness].

OBJECTIVE: To investigate the differences in central hemodynamic indices between hypertensive and normotensive subjects and identify the blood pressure index that the most strongly correlate with arterial stiffness and vascular damage markers. METHODS: A cohort of 820 hypertensive patients and 820 normotensive individuals matched for age and gender were enrolled in this study. We measured carotid-femoral and carotid-radial pulse wave velocity (PWV), aortic augmentation index (AIx) and central blood pressures using pulse wave analysis and applanation tonometry. Plasma homocysteine (HCY), high-sensitivity C-reactive protein (hsCRP) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) were also tested in these subjects. RESULTS: In both hypertensive and normotensive subjects, the central systolic blood pressure (SBP) and pulse pressure (PP) were significantly lower than brachial SBP and PP; this PP amplification was significantly lower in the normotensives (9.85∓6.55 mmHg) than in the hypertensives (12.64∓6.69 mmHg), but the amplification ratios were comparable between the two groups. Blood pressure and age were closely related with aortic arterial stiffness. Compared with normotensive subjects, hypertensive subjects had higher carotid-femoral PWV and AIx, and showed significantly lowered PP amplification ratio with age. Central PP was more strongly related to arterial stiffness and vascular damage markers than the other pressure indices. Multivariate analyses revealed that carotid-femoral PWV and aortic AIx were strongly influenced by central PP but not by the mean blood pressure or brachial PP. CONCLUSION: The central PP is a more direct indicator of central arterial stiffness and a better marker of vascular aging than other blood pressure variables. These findings support the use of central blood pressure as a treatment target in future trials.

Association between serum homocysteine and arterial stiffness in elderly: a community-based study.

BACKGROUND: Arterial stiffness and homocysteine are both powerful predictors of cardiovascular disease, especially in older populations. Previous studies have investigated the association of homocysteine with arterial stiffness in human subjects, while the relationship between homocysteine and arterial stiffness in the elderly is still indefinite. The current study examined the association of homocysteine with arterial stiffness in Chinese community-based elderly persons. METHODS: We related serum levels of homocysteine to two measures of arterial stiffness (carotid-femoral pulse wave velocity (PWV) and carotid-radial PWV) in 780 participants (46.3% men, mean age 71.9 years (ranging 65-96 years old)) from two communities of Beijing, China. Arterial stiffness was measured within two days of the time of biomarker measurement. RESULTS: In multiple-adjusted models, homocysteine levels were strongly associated with the carotid-femoral PWV (standardized ß = 0.13, P < 0.001), even after adjustment for classical risk factors of cardiovascular disease. The association is also stronger when the carotid-femoral PWV is elevated above normal, whereas no significant association with homocysteine was observed for carotid-radial PWV. CONCLUSIONS: In Chinese elderly persons, serum homocysteine levels are associated with alterations of aortic stiffness.

[Association between peroxisome proliferator-activated receptor gene single nucleotide polymorphisms and arterial stiffness in adult Chinese population].

OBJECTIVE: To analyze the association between single nucleotide polymorphisms (SNPs) of peroxisome proliferator-activated receptor(PPAR) and arterial stiffness in adult Chinese population (> 50 years). METHODS: Cardiovascular risk factors from participants of Beijing epidemiological investigation were analyzed. Carotid-femoral pulse wave velocity (cfPWV) was measured by Complior system. The subjects were divided into normal arterial stiffness group (cfPWV < 12 m/s, n = 844) and increased arterial stiffness group (cfPWV > 12 m/s, n = 530). Three valid SNPs including rs1053049, rs1800234 and rs8192678 in the PPAR and PPARγC1a gene were genotyped by TaqMan allelic discrimination assays. RESULTS: The age [(67.9 ± 8.8) years vs. (58.0 ± 9.7) years], prevalence of hypertension [71.1% (377/530) vs. 30.5% (257/844)] and diabetes mellitus [21.7% (115/530) vs. 11.0% (93/844)] were all significantly higher in increased arterial stiffness group than in normal group (all P < 0.05). The frequencies of CC, CT and TT type of rs8192678 [CC: 32.2% (272/844) vs. 30.8% (163/530), CT: 48.7% (411/844) vs. 52.1% (276/530), TT: 19.1% (161/844) vs. 17.2% (91/530)], rs1053049 [CC: 55.7% (470/844) vs. 51.3% (272/530), CT: 36.7% (310/844) vs. 39.1% (207/530), TT: 7.6% (64/844) vs. 9.6% (51/530)] and rs1800234 [CC: 88.4% (746/844) vs. 90.4% (479/530), CT + TT: 11.6% (98/844) vs. 9.6% (51/530)] were similar between the two groups. There was also no association between haplotypes and the increased arterial stiffness in this cohort. CONCLUSIONS: In this community-based population, we found that aging, hypertension and diabetes mellitus were associated but SNPs of PPAR and PPARγC1a were not associated with arterial stiffness.

[Relationship between serum N-terminal pro-brain natriuretic peptide and metabolic syndrome: a cross-sectional study].

OBJECTIVE: To explore the relationship between serum N-terminal pro-brain natriuretic peptide (NT-proBNP) and metabolic syndrome (MS). METHODS: A total of 1323 Beijing residents (559 male) were investigated. MS was defined by the modified 2004 Chinese Diabetes Society criteria and 439 cases were diagnosed as MS according to this criteria. Multivariate logistic regression analysis was used to estimate the odds ratios (OR) of MS. Multiple linear regression analysis was performed to analyze the association between NT-proBNP and characteristic variables. RESULTS: NT-proBNP was significantly lower in MS group compared to non-MS group [32.51 (29.17, 36.14) ng/L vs.38.55 (35.73, 41.50) ng/L, P = 0.012] after adjusted for age and gender. NT-proBNP level decreased with the presence of MS components (from 0 to 4 or 5) (45.92, 37.24, 35.40, 31.55 and 33.65 ng/L respectively, P = 0.043 for linear trend). Among the components, groups with larger waist circumference, higher fasting glucose and triglycerides were associated with lower NT-proBNP level. After adjustment for potential confounders, compared with the lowest NT-proBNP quartile, the adjusted odds ratio of the second, third and fourth quartile for having MS were 0.782 (95%CI: 0.544 - 1.122, P > 0.05), 0.709 (95%CI: 0.489 - 1.028, P > 0.05), 0.604 (95%CI: 0.405 - 0.900, P < 0.05), respectively. Multiple linear regression analysis showed that female gender (ß = 0.248, P < 0.001), age (ß = 0.167, P < 0.001), systolic blood pressure (ß = 0.154, P < 0.001) were positively related to NT-proBNP level while waist circumference (ß = -0.082, P = 0.004), diastolic blood pressure (ß = -0.085, P = 0.015), triglycerides (ß = -0.101, P < 0.001), total cholesterol (ß = -0.078, P = 0.004), eGFR (ß = -0.150, P < 0.001) were negatively correlated to NT-proBNP level. CONCLUSION: In this cohort, higher serum NT-proBNP concentration is associated with lower incidence of metabolic syndrome.

Association of glomerular filtration rate with arterial stiffness in Chinese women with normal to mildly impaired renal function.

OBJECTIVE: Both decreased glomerular filtration rate (GFR) and arterial stiffness were considered as risk factors for atherosclerosis. Previous studies have suggested the association between central arterial stiffness and the degree of GFR loss. Whether decreased GFR contributes to peripheral artery stiffness remains controversial. Moreover, data analyzed from a cohort of Chinese women are rare. Our aim was to explore the relationship between GFR and regional arterial stiffness in Chinese women. METHODS: In this cross-sectional study, we randomly recruited 1131 adult women residents with GFR ≥ 60 mL/min per 1.73 m(2) estimated by the Chinese Modification of Diet in Renal Disease equation from three large communities. Central and peripheral arterial stiffness were estimated simultaneously by measuring carotid-femoral pulse wave velocity (PWVcf) and carotid-radial PWV (PWVcr) using a validated automatic device. Augmentation Index at heart rate 75 beats/minutes (AIx-75) was measured by pulse wave analysis as a composite parameter reflecting both large and distal arterial properties. RESULTS: The mean estimated GFR (eGFR) of the study group was 100.05 ± 23.26 mL/minute per 1.73 m(2). Subjects were grouped by tertiles of eGFR level. PWVcf and AIx-75 increased ongoing from the top to the bottom eGFR tertile, while the values of PWVcr were comparable. Both univariate Pearson correlations and multiple stepwise regression analyses showed that eGFR significantly correlated to PWVcf, but not to PWVcr and AIx-75. CONCLUSIONS: In Chinese women with normal to mildly impaired renal function, decreased eGFR affected carotid-to-femoral rather than carotid-to-radial stiffening. This provides rational to conduct future prospective studies to investigate predictors of atherosclerosis in this population.

[Relationship between serum homocysteine and metabolic syndrome: a cross-sectional study].

OBJECTIVE: To explore the relationship between serum homocysteine and metabolic syndrome (MS). METHODS: A cohort with 1680 people involved in a community-based population in Beijing was investigated. Metabolic syndrome was defined by NCEP-ATPIII criteria. Multivariate logistic regression analysis was used to estimate the odds ratios (OR) of MS. Multiple linear regression analysis was performed to analyze the association between Hcy and characteristic variables. RESULTS: Homocysteine was higher in MS population compared to those without MS (17.99 µmol/L vs. 17.18 µmol/L, P=0.007) after adjusted for age and sex. Levels of homocysteine increased with the presence of MS components (from 0 to 4 or 5) (16.71, 16.94, 17.62, 18.20, 17.82 µmol/L respectively, P=0.044 for linear trend). Among the components, groups with larger waist circumference, higher blood pressure and triglycerides showed significantly higher Hcy level than their counterparts. RESULTS: from multiple logistic regression analysis revealed that the highest Hcy quartile (Hcy IV) was significantly associated with MS. Compared with the lowest Hcy quartile (Hcy I), the adjusted odds ratio of having MS in HcyIV was 1.379 (1.005-1.892) after adjusting for age, sex, levels on creatinine/estimated glomerular filtration rate (eGFR)/low-density lipoprotein cholesterol (LDL-C) and uric acid, smoking, alcohol intake and exercise. In the partial correlation analyses, Hcy was positively associated with body mass index (BMI), waist circumsternece, blood pressure, LDL-C, triglycerides (TG), uric acid, serum creatinine, eGFR, but inversely associated with high-density lipoprotein cholesterol (HDL-C) and independently with age and sex. In multiple linear regression analysis, age, male sex, BMI, LDL-C, creatinine and uric acid were found to be independently associated with Hcy level. CONCLUSION: There was an association noticed between the MS using NCEP-ATPIII criteria and the highest quartile level of Hcy in this study. Factors as age and being male, the levels of BMI, LDL-C, creatinine and uric acid were independently associated with the Hcy level.

Associations of plasma homocysteine and high-sensitivity C-reactive protein levels with arterial stiffness in Chinese population: a community-based study.

BACKGROUND: Arterial stiffness increases with age and is also associated with traditional cardiovascular risk factors. Little is known about the relations of homocysteine and high-sensitivity C-reactive protein (hs-CRP) to arterial stiffness in the Chinese community. The aim of the present study was to investigate the association of plasma homocysteine and hs-CRP levels with arterial stiffness in a community-based cohort. METHODS: We related levels of homocysteine and hs-CRP to four measures of arterial stiffness (carotid-femoral pulse wave velocity (PWV), carotid-radial PWV, carotid-ankle PWV and heart rate corrected augmentation index) in 1680 participants from two communities of Beijing, China. Arterial stiffness was measured within two days of the time of biomarker measurement. RESULTS: In univariate analysis, homocysteine was positively associated with the carotid-femoral PWV (r = 0.211, P < 0.0001), carotid-radial PWV (r = 0.120, P < 0.0001) and carotid-ankle PWV (r = 0.148, P < 0.0001), whereas it was inversely related to the augmentation index (r = -0.052, P = 0.016). Hs-CRP was positively associated with the carotid-femoral PWV (r = 0.074, P = 0.001) and carotid-ankle PWV (r = 0.050, P = 0.02). In multiple-adjusted models (R(2) = 0.57), homocysteine levels remained a significant determinant of the carotid-femoral PWV (standardized ß = 0.065, P = 0.007), whereas the association of hs-CRP with measurements of arterial stiffness was not present. CONCLUSIONS: In the Chinese population, plasma homocysteine levels are associated with alterations of aortic stiffness, whereas plasma levels of hs-CRP are not independently related to artery stiffening.

Influence of low high-density lipoprotein cholesterol on arterial stiffening and left ventricular diastolic dysfunction in essential hypertension.

The authors investigated whether high-density lipoprotein (HDL) cholesterol plays a role in arterial stiffening and left diastolic dysfunction in essential hypertension. Carotid arterial stiffness parameter and left ventricular (LV) diastolic function index were evaluated in 217 patients with essential hypertension. The correlations of dyslipidemia, especially low HDL cholesterol, to LV diastolic function and arterial stiffness were investigated in these patients. Arterial stiffness parameter increased with the increasing of E/Em (LV diastolic function index: the ratio of transmitral peak velocity of early filling to peak early diastolic motion velocity of mitral annulus) (r = 0.26, P<.01). In univariate regression analysis, HDL cholesterol was inversely associated with arterial stiffness parameter and E/Em (r = -0.23 and r = -0.27, respectively, P<.01). The association of HDL cholesterol with arterial stiffness and LV diastolic function was observed in both men and women. Triglycerides were weakly correlated with arterial stiffness parameter and E/Em, while low-density lipoprotein and total cholesterol were not. In multiple regression analysis, only low HDL cholesterol was found as an independent predictor for both arterial stiffness and LV diastolic dysfunction. Enhanced arterial stiffness is associated with LV diastolic dysfunction. Low HDL cholesterol may lead to the deterioration of both arterial stiffness and LV diastolic function in patients with essential hypertension.

[Clinical usefulness of carotid arterial wave intensity in noninvasively assessing left ventricular performance in different hypertensive remodeling hearts].

OBJECTIVE: To evaluate wave intensity (WI) on left ventricular (LV) performance in the different hypertensive remolding hearts. METHODS: 105 hypertensive and 98 control subjects were underwent noninvasive evaluation of carotid arterial wave intensity, LV structure and function. RESULTS: (1) There were increasing trends in the levels of blood pressure, LV end-diastolic diameter and LV mass index in the control, normal geometry group, concentric remodeling group, concentric and eccentric hypertrophy group. LV ejection fraction increased in the concentric hypertrophy group and decreased in the eccentric hypertrophy group in which mid-wall fractional shortening showed a decreasing trend. LV diastolic filling pressure presented increased progression accompanied by LV remodeling (P < 0.05). (2) Transient acceleration wave intensity (W1) in hypertensive subjects were higher than that in the control (P < 0.05). Transient deceleration wave intensity (W2) was lower than that in the control (P < 0.05). (3) W1 in the concentric hypertrophy group was higher and lower in the eccentric hypertrophy, compared with that in the control group, normal geometry group and concentric remodeling group (P < 0.05). W2 was lower in concentric hypertrophy group and eccentric hypertrophy group than that in the control, normal geometry group and concentric remodeling group (P < 0.05). CONCLUSION: WI is a noninvasively obtained, clinically useful parameter for evaluation of LV performance.

[The relationship between obesity and microalbuminuria among general population in Beijing area].

OBJECTIVE: To investigate the correlation between microalbuminuria (MAU) and obesity and its indexes, including BMI, waist circumference (WC), and waist-to-hip ratio (WHR), among partial community population in Beijing. METHODS: A total of 2080 subjects who took physical examination in Beijing, including 810 men and 1270 women with a mean age of (50.9 ± 13.1) years, were enrolled. The informed consent has been achieved from each patients. BMI and WHR were calculated based on collected data of height, weight, WC, and hipline. Urine albumin-creatinine ratio (ACR) within the range of 30 - 300 mg/g was classified as MAU. The subjects were divided into normal albuminuria (NAU) group and MAU group. The correlations between MAU and different obesity indexes including BMI, WC and WHR, were analyzed. RESULTS: Among the 2080 subjects, there was a positive correlation between BMI (r = 0.1276, P < 0.01) and ACR, and WC (r = 0.0840, P < 0.01) and ACR. WHR and ACR was irrelevant (P > 0.05). In univariate analysis, there was significant difference in BMI ≥ 28 kg/m(2) (OR = 2.02) and WC ≥ 85 cm (male) or ≥ 80 cm (female) (OR = 1.69) between NAU group and MAU group (P < 0.05). There was no significant difference in BMI 24- < 28 kg/m(2), and WHR ≥ 0.90 (male) or ≥ 0.85 (female) between NAU group and MAU group (P ≥ 0.05). Multivariate logistic regression analysis revealed that BMI (OR = 1.06) was an isolated independent risk factor of MAU from age (OR = 1.01), female (OR = 1.42), systolic blood pressure (OR = 1.01), TC (OR = 1.93) and HDL-C (OR = 0.54). CONCLUSIONS: Obesity is an independent risk factor of MAU among partial community population in Beijing. The correlation between different obesity indexes and MAU also differs.

[Correlations between different obese indexes and arterial stiffness among populations at the community level].

OBJECTIVE: The aim of this study was to investigate the relationship between obesity [measured by body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR)] and arterial stiffness on community populations in Beijing area. METHODS: In a cross-sectional study of 2664 subjects (1379 men and 1285 women) aged (53.19 ± 15.73 years, mean ± standard deviation), BMI, WC, WHR and other cardiovascular risk factors, were measured and carotid-femoral pulse wave velocity (cfPWV) was measured to assess the arterial stiffness. All the data were analyzed with linear correlation analysis, univariate analysis and stepwise regression method to explore the relationship between obese indexes and arterial stiffness. RESULTS: We noticed that a showed the existence of positive correlations between BMI (r = 0.0829, P < 0.01) and cfPWV, WC (r = 0.2659, P < 0.01) and cfPWV, WHR (r = 0.2749, P < 0.01) and cfPWV. In univariate analysis, cfPWV was associated with WC ≥ 85 cm (male) or ≥ 80 cm (female) (P < 0.01), WHR ≥ 0.90 (male) or ≥ 0.85 (female) (P < 0.01). Stepwise regression analysis revealed that WC was an independent risk factor of cfPWV, other than age, gender, systolic blood pressure, HDL-C, OGTT2h etc. CONCLUSION: Our findings indicated that obesity was an independent risk factor of cfPWV, which was an early marker of cardiovascular and renal diseases, among community population in Beijing area. There were different relationships between obesity measurement parameters (BMI, WC, WHR) and cfPWV.

[Evaluation on left ventricular function by non-invasive transient deceleration wave intensity (W2) of carotid artery].

OBJECTIVE: To evaluate transient deceleration wave intensity (W2) of carotid artery on left ventricular diastolic function. METHODS: 40 patients with hypertension and 43 healthy volunteers were enrolled and W2 of carotid artery of the both sides were measured. The parameters of left ventricular diastolic function by traditional and tissue Doppler imaging and NT-proBNP (N-terminal probrain natriuretic peptide) were measured. RESULTS: (1) W2 is not different between two sides of carotid artery. W2 in hypertension was lower than the control, especially in left side(1126 +/- 996 mmHg x m/s3 vs 1690 +/- 1126 mmHg x m/s3, P < 0.01). (2) The correlation of W2 and else parameters were analyzed. There were notably decreasing in left ventricular diastolic function of the hypertensive group than the control, for example, the ratio of peak velocity of early filling of mitral flow to peak early diastolic motion velocity of mitral annulus (E/Em, 9.37 +/- 3.32 vs 7.39 +/- 1.83, P < 0.01) and NT-proBNP (94.6 +/- 48.5 vs 45.2 +/- 13.8, P < 0.01). (3) The correlation analysis showed negative relation between W2 and E/Em (r = - 0.46, P < 0.05) and negative relation between W2 and NT-proBNP (r = -0.21, P < 0.05). CONCLUSION: New carotid W2 by non-invasive technology for hemodynamics is a deserving parameter in early evaluating left ventricular diastolic function.

[Pressure wave reflections and central blood pressure in treated hypertensive subjects].

OBJECTIVE: To investigate the differences in pressure wave reflections and central blood pressure between brachial BP classification and the effect of antihypertensive drugs. METHOD: In 1371 chronically treated hypertensive subjects aged 33 - 87 years [679 males and 692 females, mean age (47.2 ± 11.5) years], radial arterial augmentation index (rAI) and central systolic blood pressure were measured using an automated tonometric method. RESULTS: rAI gradually increased from the subgroup with the lower blood pressure to the higher blood pressure (P < 0.01), for each given brachial value, central systolic blood pressure was lower than the corresponding brachial pressure (P < 0.01). In multivariable linear regression models analysis revealed that the application of angiotensin converting enzyme inhibitor (ß = -0.09, P < 0.05), AT1 receptor blockade (ß = -0.07, P = 0.01), calcium channel blocker (ß = -0.12, P < 0.01) and diuretic (ß = 0.14, P = 0.04) were independent determinants of rAI. Central SBP significantly correlated to the application of ACEI (ß = -0.07, P = 0.02), ARB (ß = -0.08, P = 0.01) and CCB (ß = -0.15, P < 0.05). CONCLUSIONS: In chronically treated hypertensive individuals, tight blood pressure control would be effective in reducing the reflection wave and central BP. Antihypertensive treatment strategies with more beneficial effects on arterial properties are needed.

[Radial augmentation index is associated with cardiovascular risk and arterial stiffness].

OBJECTIVE: To investigate whether radial augmentation index (AI) associates with cardiovascular risk as well as arterial stiffness. METHODS: A total of 4985 subjects, 2417 men and 2568 women, aged 18 - 96 (50.9 ± 14.7) years, were recruited. AI was measured in the left radial artery using tonometry Colin HEM-9000AI. Carotid-femoral PWV (CFPWV) and carotid-radial PWV (CRPWV) were examined by automatic pulse wave velocity (PWV) measuring system. Framingham risk score and Chinese ischemic cardiovascular disease risk score were applied upon subjects without cardiovascular disease to calculate individual cardiovascular risk respectively. RESULTS: Radial AI (rAI) was significantly higher in women than in men[ (83.18 ± 12.36)% vs (71.93 ± 15.22)%, P < 0.01]. Simple correlation analysis showed rAI was significantly correlated to two cardiovascular risk scores or CFPWV and CRPWV. After adjusted for multi-factors, rAI was still significantly correlated to Framingham risk score or Chinese ischemic cardiovascular disease risk score (r = 0.17 and 0.12) in men respectively (P < 0.05), while r were 0.09 and 0.08 in women respectively (P < 0.05). In multivariate analysis, there was a significant association between CFPWV and rAI (r = 0.14 in men, r = 0.10 in women, P < 0.01), whereas the relation ship between CRPWV and rAI was not found. The relationship between rAI and cardiovascular risk or PWV became weaker for those aged above 50 years. CONCLUSION: Augmentation index might be a useful marker of cardiovascular risk and arterial stiffness, which could be more feasible for younger subjects as a tool for risk differentiation.

[Prevalence of microalbuminuria and its related factors among different genders in general population of Beijing].

OBJECTIVE: Microalbuminuria (MAU) is generally defined as an early effective index of cardiovascular disease and renal disease. Our study aims to investigate the prevalence of MAU and its related factors among people living in Beijing. METHODS: In a cross-sectional study, 2080 subjects (810 men and 1270 women) are recruited, with age distribution as 50.87 ± 13.10 years (mean ± standard deviation). Urine albumin-creatinine ratio (ACR) is used to screen for microalbuminuria. All the data is analyzed with multivariate logistic regression method to explore the related factors for MAU. RESULTS: The overall prevalence of MAU in general population of Beijing is 17.50%, with male as 15.43% and female as 18.82% (P < 0.05). Results from the multivariate logistic regression analysis reveal that the independent risk factors of MAU in men are age (OR = 1.02), blood pressure (OR = 1.02), serum creatinine (OR = 1.04), while age (OR = 1.04), systolic blood pressure (OR = 1.02), serum creatinine (OR = 1.08), body mass index (OR = 1.07), total cholesterol (OR = 2.05) in women. The protective factor of MAU in women is HDL-C (OR = 0.44). CONCLUSION: Our findings indicate that the prevalence of MAU in Beijing area is higher than those in other areas in China or abroad. The prevalence in females is higher than that in males (P < 0.05). There is a gender difference in the related factors of MAU.

[Association of risk factors for cardiovascular disease and the rate of glomerular filtration: a cross-sectional study in the population from certain areas of Beijing].

OBJECTIVE: Data from several large prospective studies revealed that a low glomerular filtration rate was independently associated with cardiovascular disease (CVD) events and all-cause mortality in high-risk populations. Much on the association was explained by traditional CVD risk factors. However, findings from population-based studies were scarce and inconsistent. We explored the correlation between risks factors of cardiovascular and chronic kidney disease (CKD) in a general population from certain area of Beijing. METHODS: A population-based cross-sectional survey was conducted during Sep. 2007 to Oct. 2008 in Beijing. Out of 5100 individuals who were selected, 4515 met the inclusion criteria and responded to the investigation. By face to face interview, a questionnaire was used to find out the risk factors of cardiovascular disease. Body height, body weight and blood pressures were measured. Serum creatinine and total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) were detected. Glomerular filtration rate through using the Modification of Diet in Renal Disease equation was estimated. Participants were grouped into three: >/= 90, 60 - 89, < 60 [mlxmin(-1)x(1.73 m(2))(-1)] by eGFR. Univariate and multivariate logistic regression models were used to identify the associated risk factors. RESULTS: Exposure rate of cardiovascular disease risk factors increased along with the decrease of level of eGFR. Data from univariate logistic regression analyses suggested that age, smoking, history of hypertension and diabetes, BMI, SBP, LDL-C and TG were risk factors of CKD while results from multiple logistic regression indicated that age, smoking, hypertension, high level of TG appeared to be independent risk factors of CKD. CONCLUSION: Exposure rate of cardiovascular disease risk factors increased along with the decrease of level of eGFR while age, hypertension, high level of TG and smoking were independent risk factors of CKD.

[Associations and related factors between pulse wave velocity and arterial system and augmentation index measured on different sites in a healthy population].

OBJECTIVE: To explore the associations and related factors between pulse wave velocity (PWV) and arterial system and augmentation index (AI) measured on different sites in a healthy population. METHODS: All subjects were selected from a local community investigation study which included 5116 people living in Haidian District or Daxing District, Beijing, China. A total of 729 healthy subjects [age 17 - 85 years, mean (39.2 ± 12.2) years, 413 men] were included in this study. Carotid-femoral pulse wave velocity (CF-PWV), carotid-radial pulse wave velocity (CR-PWV) and carotid-ankle pulse wave velocity (CA-PWV) were measured using Complior. Pulse wave analysis at the right radial artery was measured and AI was calculated using SphygmoCor device. RESULTS: CF-PWV correlated significantly with CR-PWV or CA-PWV (all P < 0.01) by both Pearson and Partial Correlation analysis adjusted by age, body mass index, waist-hip ratio, systolic blood pressure, diastolic pressure and heart rate. There was no significant correlation between AI and CR-PWV (r = -0.072, P = 0.053) and between AI and CR-PWV (r = 0.024, P = 0.528), AI and CA-PWV (r = 0.068, P = 0.070) while AI was significantly correlated with CF-PWV (r = 0.110, P = 0.003). Multiple stepwise regression analyses showed that age, systolic blood pressure and heart rate were positively while female gender was negatively correlated with CF-PWV. CR-PWV was positively correlated with diastolic blood pressure and negatively correlated with pulse pressure and female gender (R(2) = 0.155). CA-PWV was positively correlated with systolic blood pressure and age while negatively correlated with pulse pressure and female gender. Multiple stepwise regression analysis also demonstrated that AI was positively correlated with age, diastolic blood pressure, low density lipoprotein cholesterol and female gender, and negatively correlated with heart rate, height and serum creatinine level(R(2) = 0.536). CONCLUSIONS: CA-PWV, covering carotid-femoral arterial segment, could partially represent CF-PWV as an indicator of large arterial stiffness. CR-PWV mainly reflects peripheral muscular arterial stiffness and is not suitable to be used interchangeably with CF-PWV or CA-PWV. Component of blood pressure (systolic, diastolic or pulse pressure) may have different influences on CF-PWV, CA-PWV or CR-PWV. AI is affected by multiple factors and poorly correlated with PWV and is not a good indicator for arterial stiffness.