Association of marital status with cognitive function in Chinese hypertensive patients: a cross-sectional study.

PURPOSE: The aim of this study was to evaluate the association of marital status with cognitive function and to examine the potential effect modifiers in Chinese hypertensive populations. METHODS: A total of 9,525 adult Chinese hypertensive patients were enrolled in this cross-sectional study. Cognitive function, as the dependent variable in our study, was assessed by the Chinese version of the Mini-Mental State Examination (MMSE). We adjusted for potential confounding factors in multiple linear regression models to examine the relationship of marital status with cognitive function. In addition, we divided the population according to sex to explore whether there were sex-specific differences. RESULTS: Among the 9,525 study participants, the mean (SD) age for men was 63.5 (10.3) years, and the mean MMSE score was 24.9 ± 5.0, whereas for women, the mean (SD) age was 63.8 (9.3) years, and the mean MMSE score was 19.4 ± 6.4. Unmarried persons had lower scores on the MMSE and lower subscores in each of the cognitive domains. A stronger correlation between marital status and a lower MMSE score was statistically significant in men (unmarried men: ß = -1.55; 95% CI: -1.89, -1.21) but not women (unmarried women: ß = -0.22; 95% CI: -0.56, 0.12; p interaction = 0.006). Compared to men who were widowed or divorced, never married men were more likely to have lower MMSE scores (ß = -2.30, 95% CI -3.10,-1.50; p < 0.001). CONCLUSIONS: Our study demonstrated that being unmarried is an extremely important but neglected social risk factor for cognitive function. Sex was a strong effect modifier: being unmarried was correlated with a higher risk of cognitive decline than being married in Chinese hypertensive men, especially among older men, but this correlation was not observed among women. Moreover, never married men showed poorer cognitive function than those who were divorced or widowed.

Association of Sleep Duration, Midday Napping with Atrial Fibrillation in Patients with Hypertension.

Objective: This study aimed to assess the associations of sleep duration, midday napping and the risk of atrial fibrillation (AF) in patients with hypertension. Methods: We conducted a cross-sectional study enrolling 11,524 hypertensive participates from the Chinese Hypertension Registry Study. Information on sleep duration and midday napping were obtained by a self-administered questionnaire. Multivariate logistic regression analyses were performed to estimate odds ratio (OR) and 95% confidence intervals (CIs) for the risk of AF. Results: Compared with sleeping 6 to ≤8 hours/night, those reporting shorter sleep duration (≤5 hours/night) had a greater risk of AF (OR 1.95; 95% CI 1.28-2.95) in the fully adjusted model, while longer sleep (≥9 hours/night) was not significantly associated with the risk of AF. Compared with nonhabitual nappers, nappers had a higher risk of AF (OR 1.28; 95% CI 1.03-1.60) in the fully adjusted model. Moreover, we observed significant joint effects of sleeping ≤5 hours/night and nap (OR 2.13; 95% CI 1.09-4.14) on the risk of AF after adjusting for confounding factors. Conclusion: Short sleep duration and midday napping were independently and jointly associated with higher risks of AF in patients with hypertension.

Association Between Body Mass Index and All-Cause Mortality in a Prospective Cohort of Southern Chinese Adults Without Morbid Obesity.

Objective: This prospective study examined the relationship between body mass index (BMI) and all-cause mortality in Chinese adults without morbid obesity. Methods: We prospectively examined the relationship between BMI and all-cause mortality in 12,608 Southern Chinese adults with age ≥35 years who participated in the National Key R&D Program from 2013-2014 to 2019-2020. Cox proportional hazards models were used to examine the association between BMI and all-cause mortality. Results: The prevalence of being underweight, normal weight, overweight and having moderate obesity was 7.36%, 55.83%, 28.51% and 8.31%, respectively. A total of 683 (5.65%) deaths occurred during a median follow-up period of 5.61 years. The Cox proportional hazards models indicated that a continuous BMI level was negatively associated with all-cause mortality [adjusted-hazard ratio (HR) per 1 kg/m2 increase: 0.96, 95% CI 0.93 to 0.98, p < 0.001]. Furthermore, the HRs of all-cause mortality in the underweight, overweight and moderate obesity groups were 1.31 (1.05, 1.64), 0.89 (0.73, 1.08) and 0.64 (0.44, 0.92), respectively in the confounder model relative to the normal weight group. Survival analysis further confirmed this inverse association of the four BMI categories with mortality. Conclusion: BMI was negatively associated with all-cause mortality in southern Chinese adults without morbid obesity. Compared to the normal weight category, adults in the moderate obesity category had lower all-cause mortality, whereas being underweight was associated with increased all-cause mortality.