Urine albumin excretion and related factors in patients with essential hypertension / 心血管康复医学杂志

Objective:To study urine albumin excretion (UAE) and its related factors in patients with essential hyper‐tension (EH) .Methods :A total of 113 EH patients without significant target organ damage were enrolled as EH group ,while another 92 healthy subjects were regarded as healthy control group .Ratio of morning urinary albumin to creatinine was measured and regarded as UAE index .Plasma homocysteine (Hcy) ,serum uric acid ,creatinine , blood urea nitrogen ,blood glucose ,blood lipids etc .levels were measured ,and compared between two groups Re‐sults:Compared with healthy control group ,there were significant rise in UAE ,body mass index (BMI) ,waist hip ratio ,blood pressure ,pulse pressure ,heart rate ,plasma levels of triglyceride (TG) ,low density lipoprotein choles‐terol (LDL‐C) ,serum uric acid and Hcy (P<0.05 or <0.01) ,and significant reduction in level of high density lip‐oprotein cholesterol (HDL‐C) in EH group ( P=0.001) .Pearson correlation analysis indicated that lgUAE was pos‐itively correlated with lgTG (r=0.257 ,P=0.015) and estimated glomerular filtration rate (eGFR ,r=0.284 ,P=0.007) ,and inversely correlated with lg creatinine (r= -0.277 ,P=0.008) in healthy control group ,while in EH group ,lgUAE was positively correlated BMI (r=0.231 ,P=0.014) ,lgTG (r=0.200 ,P=0.034) and lgHcy (r=0.244 , P=0.009) .Muti-factor gradual regression analysis indicated that lg TG (β=0.265 ,P=0.001) and lg Hcy (β=0.170 , P=0.012) were independently positively correlated with lg UAE , R2 =0.112.Conclusion:UAE level significantly rises in EH patients ,and it′s significantly positively correlated with plasma levels of TG and Hcy .

Plasma homocysteine levels are independently associated with alterations of large artery stiffness in men but not in women / 老年心脏病学杂志（英文版）

Objectives To investigate the associations of the plasma homocysteine levels with the alterations in arterial stiffness in a commu-nity-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 (standardizedβ=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 (standardizedβ=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.

Association between arterial stiffness and risk of coronary artery disease in a community-based population / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Arterial stiffness is well known as an important risk factor for coronary artery disease. In this study, we aimed to investigate the association between carotid-ankle pulse wave velocity (caPWV) and risk of coronary artery disease (CAD), and the interaction between pulse wave velocity (PWV) and other potential risk factors of CAD.</p><p><b>METHODS</b>A community-based cross-sectional study was conducted for subjects living in Beijing, China. We collected 213 subjects with coronary artery disease and 1 266 subjects without CAD between September 2007 and January 2009 in a community center of Beijing. A multivariate Logistic regression analysis was carried out to assess the odds ratios of factors related to CAD.</p><p><b>RESULTS</b>We found CAD subjects were more likely to have a higher body massindex (BMI), fasting glucose, uric acid, low-density lipoprotein (LDL) cholesterol, high-sensitivity Creactive protein (hs-CRP), carotic-femoral pulse wave velocity (cfPWV) and caPWV (P < 0.05), and CAD subjects had a significantly lower HDL cholesterol levels (P < 0.05). Moreover, the proportion of hypertension in CAD subjects was significantly higher than non-CAD subjects. The multiple Logistic regression analysis showed that hypertension, higher uric acid, hs-CRP, cfPWV and caPWV levels significantly increased the risk of CAD, with ORs (CI) of 1.47 (1.25-1.74), 1.17 (1.01-1.26), 1.35 (1.10-1.67), 1.15 (1.09-1.19) and 1.07 (1.01-1.15), respectively. Higher HDL cholesterol was significantly associated with reduced risk of CAD, with ORs (CI) of 0.58 (0.40-0.83). In addition, cfPWV had significant association with age, hypertension, LDL cholesterol, with Pearson's coefficients of 0.166, 0.074, and 0.030, respectively.</p><p><b>CONCLUSIONS</b>cfPWV and caPWV are independently associated with significant CAD, and cfPWV has significant correlation with age and hypertension. cfPWV and caPWV may be used as a practical tool for predicting the risk of CAD.</p>

Association between high-sensitivity cardiac troponin T and N-terminal pro-brain natriuretic peptide in a community based population / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>N-terminal pro-B-type natriuretic peptide (NT-proBNP) and high-sensitivity cardiac troponin T (hs-cTnT) are excellent biomarkers for detecting heart failure and subclinical myocardial injury. However, it remains unclear whether subclinical myocardial injury is associated with NT-proBNP elevation in a community based population.</p><p><b>METHODS</b>In a community based study, levels of hs-cTnT and of NT-proBNP were determined in 1 497 participants older than 45 years. The lower detection limit of the hs-cTnT assay used in the present study was 0.003 ng/ml. The association of hs-cTnT levels and NT-proBNP levels was analyzed.</p><p><b>RESULTS</b>When the subjects with undetectable (<0.003 ng/ml), intermediate (0.003-0.014 ng/ml), and elevated (≥0.014 ng/ml) levels of hs-cTnT were compared (r = 0.175, P < 0.001), a strong association between the hs-cTnT levels and NT-proBNP levels was observed (β = -0.206, P < 0.001; β = -0.118, P < 0.001, respectively). In multivariable analyses, older age and hs-cTnT were positively and independently associated with NT-proBNP levels (β = 0.341, P < 0.001; β = 0.143, P < 0.001, respectively), and male gender and the levels of eGFR were inversely and independently associated with NT-proBNP levels. When the subjects with normal or elevated NT-proBNP were analyzed separately, the hs-cTnT level was not an independent predictor for the NT-proBNP level in the normal NT-proBNP group, whereas the hs-cTnT level was the only independent predictor for NT-proBNP level in the elevated NT-proBNP group (β = 0.399, P < 0.01).</p><p><b>CONCLUSIONS</b>In this community based population, NT-proBNP elevation was common. In addition to female gender and older age, subclinical myocardial injury indicated by the hs-cTnT level was another important factor in NT-proBNP elevation.</p>

Serum uric acid level and diverse impacts on regional arterial stiffness and wave reflection

Both increased arterial stiffness and hyperuncaemia are associated with elevated cardiovascular risks. Little is known about the relations of serum uric acid [UA] level to regional arterial stiffness and wave reflection. The aim of the study was to investigate the gender-specific association of serum UA and indices of arterial function in a community-based investigation in China. Cross-sectional data from 2374 adults [mean age 58.24 years] who underwent routine laboratory tests, regional pulse wave velocity [PWV] and pulse wave analysis measurements were analyzed in a gender-specific manner. None of the participants had atherosclerotic cardiovascular disease, chronic renal failure, systemic inflammatory disease, gout, or were under treatment which would affect serum UA level. Men had higher serum UA level than women. Subjects with hyperuricaemia had significantly higher carotid-ankle PWV in both genders [P< 0.05], and the carotid-femoral P W [PWVc-f] was higher in women [P< 0.001] while the augmentation index was marginally lower in men [P = 0.049]. Multiple regression analysis showed that serum UA was an independent determinant only for PWVc-f in women [beta = 0.104, P = 0.027] when adjusted for atherogenic confounders. No other independent relationship was found between UA level and other surrogates of arterial stiffness. Serum UA levels are associated with alterations in systemic arterial stiffness that differ in men and women. Women might be more susceptible to large vascular damage associated with hyperuricaemia

Association of glomerular filtration rate with arterial stiffness in Chinese women with normal to mildly impaired renal function / 老年心脏病学杂志（英文版）

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 m2 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 m2. 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.

The relationship between obesity and microalbuminuria among general population in Beijing area / 中华内科杂志

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 30-300mg/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/m2 ( 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/m2, 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.

Radial augmentation index is associated with cardiovascular risk and arterial stiffness / 中华内科杂志

Objective To investigate whether radial augmentation index (AI) associates with cardiovascular risk as well as arterial stiffness.MethodsA 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.ResultsRadial 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 Framing, ham 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.ConclusionAugmentation 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.

Relationship between Left Ventricular Remodeling and Systolic Function Assessed by Left Ventricular Mid-wall Fractional Shortening / 中国康复理论与实践

@#Objective To investigate the correlation between left ventricular remodeling and systolic function by mid-wall fractional shortening(mFS).Methods 51 cases of hypertension and 47 cases of healthy volunteers were enrolled and systolic parameters were measured as ejection fraction(EF), fractional shortening(FS) and mFS. Acorrding to left ventricular remodeling parameteres inclulding LVMI and RWT, hypertension group was divided into four subgroups. The correlation among these parameters were analyzed.Results Thicker left ventricular wall and lower mFS in patient with hypertension compaired with those in controll (P<0.05). There were negative correlation between mFS and RWTr=-0.42, P<0.05) and positive correlation between mFS and LVMI r=-0.67, P<0.01).Conclusion mFS is a valuable parameter compared with traditional parameteres such as EF and FS. There is a linear association between parameteres of ventricular remodeling and systolic function assessed by mFS in early stage of hypertension.

Arterial Stiffness and Diastolic Function in Primary Hypertension / 中华高血压杂志

Objective To study the relationship between arterial compliance and diastolic dysfunction in essential hypertensive patients.Methods Fifty-one treated hypertensive patients and 47 normotensive controls were enrolled.Arterial stiffness was assessed by vascular e-TRACKING technology of ultrosonic.Tissue Doppler echocardiography combined with conventional Doppler echocardiography was used for assessment of left ventricular diastolic function and peak late diastolic velocity of mitral flow.The ratio of E/A,Em/Am and E/Em were measured.Results Compared with normotensive controls,hypertensive patients have increased arterial sclerosis index(?) [(10.5?3.8) vs control(8.1?3.4),P