The prognostic values of beta-2 microglobulin for risks of cardiovascular events and mortality in the elderly patients with isolated systolic hypertension.

BACKGROUND: The present study aimed to investigate the effects of serum beta-2 microglobulin (B2M) on the risks of major cardiovascular events (MACEs) and all-cause death in Chinese elderly isolated systolic hypertension (ISH) patients without severe renal insufficiency (estimated glomerular filtration rate [eGFR] <30 ml/min/1.73 m2). MATERIALS AND METHODS: Serum B2M concentration, creatinine-eGFR, and blood pressure variability were evaluated in 460 elderly patients (mean age, 82.6 years; 28 women) with ISH in this observational study. The Cox proportional hazard model was adopted to calculate adjusted hazard ratios (HRs) of risk factors for cardiovascular events and all-cause deaths. RESULTS: During a median follow-up period of 37.6 months, 63 patients (13.7%) died, and 65 patients (14.1%) had MACEs. Multivariable analysis showed that the higher serum B2M concentration (B2M ≥0.28 mg/dl) was an independent predictor of increased risk of MACEs (nonfatal acute myocardial infarction, acute heart failure, ischemic stroke, and cardiovascular deaths) and all-cause death (HR: 2.62, 95% confidence interval [CI]: 1.46-4.69, P = 0.001 and HR: 3.40, 95% CI: 1.78-6.48, P < 0.001, respectively) adjusting for other multiple confounders including creatinine-eGFR and cystatin C. In addition, blood pressure variability derived from ambulatory blood pressure measurement was not associated with incidence of MACEs and all-cause mortality (P > 0.05). CONCLUSION: Our data suggest that serum B2M concentration may be individually associated with MACEs and all-cause death in elderly ISH patients without severe renal insufficiency even after adjusted for creatinine-eGFR and cystatin C.

Association between urinary sodium excretion and coronary heart disease in hospitalized elderly patients in China.

Objective This study was performed to evaluate the association between urinary sodium excretion and coronary heart disease (CHD) in hospitalized elderly patients in China. Methods The 24-h urinary excretion specimens of 541 patients were collected, and the serum creatinine concentration and urinary sodium/potassium ratio were measured. Associations were explored by multivariate logistic regression analysis. Results The mean 24-h urinary sodium excretion was 200.4 mmol, corresponding to 11.7 g of salt intake. Both of these values were higher in men than in women. The salt intake of 80- to 89-year-old patients was significantly lower than that of 70- to 79-year-old patients. The 24-h urinary sodium excretion and spot urine Na/K ratios were significantly higher in overweight/obese and hypertensive patients. The 24-h urinary sodium excretion of men who smoked was significantly higher than that of women. The spot urine Na/K ratio was significantly higher in patients with cerebral thrombosis. The urinary Na/K ratio, smoking status, and hypertension were independent risk factors for CHD. Conclusions This cross-sectional survey suggests that the Na/K ratio may better represent salt loading than Na excretion alone in studying the association between sodium intake and CHD. There was no association between sodium and CHD prevalence.

[Changes of sex hormones and risk factors associated with atherosclerosis in old patients with castrated prostatic cancer].

OBJECTIVE: To detect the relationship between changes of sex hormone levels and risk factors for atherosclerosis in old patients with castrated prostatic cancer. METHODS: Two hundred and forty-seven patients, over 65 years old, were divided into three groups: 64 non-prostatic cancer patients (group I), 61 non-castrated prostatic cancer patients (group II) and 122 castrated prostatic cancer patients (group III). Group I and group II served as controls. Testosterone (T), estradiol (E2), luteal hormone (LH), follicle stimulating hormone (FSH), prolactin (PRL), progesterone (P), C-reactive protein (CRP), serum homocysteine (Hcy), glucose (GLU), uric acid (UA), total cholesterol (TC), triglyceride (TG), low density lipoprotein-cholesterol (LDL-C), and high density lipoprotein-cholesterol (HDL), were measured and compared between any two groups. RESULTS: In patients with castrated prostatic cancer, T, E2, and P levels decreased significantly, LH and FSH increased significantly, change of PRL was not significant, E2/T was elevated significantly; levels of CRP, Hcy, GLU, UA, TC, TG and LDL-C increased significantly compared with those in control groups. CONCLUSION: Sex hormone levels were imbalanced significantly after castration in old prostatic cancer patients, and the risk factors for atherosclerosis also increased accordingly. There might be relationship between decreased sex hormone levels and risk factors for atherosclerosis in old male patients.