ABSTRACT
Resumo Fundamento A doença cardiovascular (DCV) é uma série de doenças que afetam o coração ou os vasos sanguíneos. Objetivos Avaliar a relação entre os níveis de pressão arterial (PA) definidos pelo American College of Cardiology/American Heart Association (ACC/AHA) de 2017 diretriz e risco de DCV/doença cardiovascular aterosclerótica (DCVA) para pessoas de meia-idade e idosos na China. Métodos Um total de 6.644 pessoas de meia-idade e idosas do Estudo Longitudinal de Saúde e Aposentadoria da China CHARLS (China Health and Retirement Longitudinal Study) foram finalmente incluídas. De acordo com a diretriz ACC/AHA de 2017, todos os indivíduos foram divididos em quatro grupos: PA normal, PA elevada, hipertensão estágio 1 e hipertensão estágio 2. O desfecho deste estudo foi considerado o risco de DCV e DCVA. Modelos de regressão COX univariados e multivariados foram adotados para examinar a relação da classificação de PA ACC/AHA de 2017 com o risco de DCV. Modelos de regressão logística univariada e multivariada foram utilizados para investigar a associação entre os níveis de PA e o risco de DCVA. Foram realizadas análises de subgrupos baseadas em idade, sexo e uso de medicamentos anti-hipertensivos. P<0,05 foi aceito como estatisticamente significativo. Resultados Após ajustar todas as covariáveis, em comparação com pacientes de meia-idade e idosos com PA normal, descobrimos que pacientes com hipertensão estágio 1/2 estavam associados a um maior risco de DCV, separadamente. Simultaneamente, também observamos uma associação positiva entre indivíduos com PA elevada, hipertensão estágio 1, hipertensão estágio 2 e maior risco de DCVA no modelo totalmente ajustado. O resultado das análises de subgrupos indicou que a relação entre hipertensão estágio 1/2 e DCV/DCVA alta foi robusta em diferentes idades e sexos, e participantes sem uso de medicamentos anti-hipertensivos. Conclusão A classificação da PA de acordo com as diretrizes de PA da ACC/AHA de 2017 pode ser aplicada à população chinesa.
Abstract Background Cardiovascular disease (CVD) is a series of diseases affecting the heart or blood vessels. Objectives To assess the relationship between blood pressure (BP) levels defined by the 2017 American College of Cardiology/American Heart Association (ACC/AHA) guideline and CVD/atherosclerotic cardiovascular disease (ASCVD) risk for middle-aged and elderly people in China. Methods A total of 6,644 middle-aged and elderly people from the China Health and Retirement Longitudinal Study (CHARLS) were finally included. According to the 2017 ACC/AHA guideline, all subjects were divided into four groups: normal BP, elevated BP, stage 1 hypertension, and stage 2 hypertension. The outcome of this study was considered as the risk of CVD and ASCVD. Univariate and multivariate COX regression models were adopted to examine the relationship of the 2017 ACC/AHA BP classification with the risk of CVD. Univariate and multivariate logistic regression models were used to investigate the association between BP levels and ASCVD risk. Subgroup analyses based on age, gender, and use of antihypertensive drugs were performed. P<0.05 was accepted as statistically significant. Results After adjusting all covariates, compared to middle-aged and elderly patients with normal BP, we found that patients with stage 1/2 hypertension were associated with a higher risk of CVD, separately. Simultaneously, we also observed a positive association between individuals with elevated BP, stage 1 hypertension, stage 2 hypertension, and higher ASCVD risk in the fully adjusted model. The result of subgroup analyses implied that the relationship between stage 1/2 hypertension and CVD/ high ASCVD was robust in different ages and genders, and participants without using antihypertensive drugs. Conclusion BP classification under the 2017 ACC/AHA BP guidelines may apply to the Chinese population.
ABSTRACT
Objective @#To explore the effects of two hemostatic agents on the bonding strength of different bonding systems in primary tooth dentin.@*Methods @# Seventy-two retained deciduous teeth were randomly selected. Forty-eight teeth were used to construct the microleakage model, the other 24 teeth were cut along the mesial and distal directions and 48 samples were obtained to construct the shear bond strength model. The two experiments were divided into 2 groups. Group A was the total-etch group: A1 (ViscoStat + Spectrum Bond NT); A2 (ViscoStat Clear + Spectrum Bond NT); and A3 (Non + Spectrum Bond NT); Group B was the self-etch group: B1 (ViscoStat + Single bond Universal Adhesive); B2 (ViscoStat Clear + Single bond Universal Adhesive); and B3 (Non + Single bond Universal Adhesive). Microleakage experiments and shear bond strength experiments were carried out respectively and the morphology of the fracture surface was observed by scanning electron microscopy.@* Results @#There was no significant difference in microleakage among groups A1, A2, and A3 (P > 0.05). There was no significant difference in microleakage among groups B1, B2, and B3 (P > 0.05). There was no significant difference in the shear bond strength among groups A1, A2 and A3 (P > 0.05). The shear bond strength of groups B1 and B2 was significantly lower than that of group B3 (P < 0.05). There was no significant difference between groups B1 and B2 (P > 0.05). @*Conclusion@#ViscoStat and ViscoStat Clear had no effect on the marginal integrity of deciduous tooth dentin under the different bonding systems. The two hemostatic agents reduced the shear bonding strength of deciduous tooth dentin under the self-etch adhesive system, but had no effect on the shear bonding strength of deciduous tooth dentin under the total-etch adhesive system.