Prevalence of albuminuria and its association with cardiovascular diseases in Chinese residents aged over 35 years / 中华内科杂志

Objective:To investigate the prevalence of albuminuria in Chinese residents aged >35 years and its potential association with cardiovascular disease (CVD).Methods:A total of 34 647 Chinese subjects aged ≥35 years were selected by stratified multi-stage random sampling from 2012 to 2015. Data were collected through questionnaires, physical examinations, and laboratory tests. Albuminuria was categorized into 3 types according to urinary albumin-to- creatinine ratio: normal (<30 mg/g), microalbuminuria (MAU, 30-300 mg/g), and macroalbuminuria (≥300 mg/g). Measurement data were expressed as xˉ±s, and t-tests were used for comparisons between indicators. Qualitative data were expressed as rate or constituent ratio, and the χ2 test or Kruskal-Wallis test was used to examine differences. Logistic regression was used for multivariate analyses. SAS 9.4 software was used for statistical analyses, and P<0.05 was considered statistically significant. Results:The prevalence of abnormal albuminuria was 19.1%; the prevalence was 17.2% for MAU and lower in males (13.8%) than females (20.1%, P<0.01). The risk of CVD was higher among subjects with MAU ( OR=1.23, 95% CI 1.12-1.35) and macroalbuminuria ( OR=1.86, 95% CI 1.50-2.32). When MAU was complicated by hypertension and diabetes mellitus, the CVD risk was 1.76 times higher. Conclusions:The prevalence of MAU is high among Chinese subjects aged 35 years and over. Those with MAU have higher CVD risk, especially those with hypertension and diabetes mellitus.

Summary of the 2022 Report on Cardiovascular Health and Diseases in China / 中华医学杂志(英文版)

Recent decades have seen the remarkable development of China in medical accessibility and quality index, and the application of a number of new advanced cardiovascular technologies benefits more patients. However, according to the Annual Report on Cardiovascular Health and Diseases in China published in this article, which was organized and summarized by National Center for Cardiovascular Diseases, there is still a huge population living with risk factors of cardiovascular diseases (CVD), and the morbidity and mortality of CVD are increasing. It is estimated that there are around 330 million patients suffering from CVD currently, including 245 million of hypertension, 13 million of stroke, 45.3 million of peripheral artery disease, 11.39 million of coronary heart disease (CHD), 8.9 million of heart failure, 5 million of pulmonary heart disease, 4.87 million of atrial fibrillation, 2.5 million of rheumatic heart disease, and 2 million of congenital heart disease. Tobacco use, diet and nutrition factors, physical activity, overweight and obesity, and psychological factors are what affect cardiovascular health, while hypertension, dyslipidemia, diabetes, chronic kidney disease, metabolic syndrome, and air pollution are the risk factors for CVD. In this article, in addition to risk factors for CVD, we also report the epidemiological trends of CVD, including CHD, cerebrovascular disease, arrhythmias, valvular heart disease, congenital heart disease, cardiomyopathy, heart failure, pulmonary vascular disease and venous thromboembolism, and aortic and peripheral artery diseases, as well as the basic research and medical device development in CVD. In a word, China has entered a new stage of transforming from high-speed development focusing on scale growth to high-quality development emphasizing on strategic and key technological development to curb the trend of increasing incidence and mortality of CVD.

Efficacy of superficial temporal artery-anterior temporal artery bypass combined with encephalo-duro-arterio-synangiosis in treatment of moyamoya disease / 中华神经医学杂志

Objective:To investigate the clinical efficacy of superficial temporal artery-anterior temporal artery bypass combined with encephalo-duro-arterio-synangiosis in the treatment of Moyamoya disease.Methods:A total of 42 patients with moyamoya disease, admitted to our hospital from January 2016 to January 2019, were selected and divided into observation group and control group according to surgical management. The patients in the observation group were treated with superficial temporal artery-anterior temporal artery bypass combined with encephalo-duro-arterio-synangiosis, and the patients in the control group were treated with superficial temporal artery-angular gyrus artery bypass combined with encephalo-duro-arterio-synangiosis. The clinical data of these patients were analyzed retrospectively, and the differences of efficacy and safety between the two groups were compared.Results:There was no significant difference in operation time between the two groups ([189.16±21.23] min vs. [179.46±16.95] min, P>0.05). One d after the operation, the patients in both groups were re-examined with CT angiography, and the anastomotic vessels were unobligated. Two patients in the observation group had cerebral infarction in the operative region and one patient in the control group had cerebral infarction in the operative region; no significant difference was noted in the incidence of postoperative complications between the two groups ( P>0.05). The modified Rankin scale (mRS) scores in both groups one month after surgery were significantly decreased as compared with those one d before surgery ( P<0.05); one month after surgery, the mRS scores in observation group (0.13±0.346) were significantly lower than those in the control group (0.42±0.515, P<0.05). Conclusion:The superficial temporal artery-anterior temporal artery bypass combined with encephalo-duro-arterio-synangiosis has definite clinical efficacy in the treatment of moyamoya disease.

New-type stereotaxic apparatus-assisted transfrontal puncture and drainage in treatment of hypertensive intracerebral hemorrhage in the basal ganglia / 中华神经医学杂志

Objective:To investigate the efficacy of new-type stereotaxic apparatus-assisted transfrontal puncture and drainage in the treatment of hypertensive intracerebral hemorrhage in the basal ganglia.Methods:A retrospective analysis was performed on the clinical data of 60 patients with hypertensive intracerebral hemorrhage in the basal ganglia who received disposable new-type stereotaxic apparatus-assisted transfrontal insertion with soft tunnels for hematoma aspiration drainage in our hospital from August 2017 to September 2019. The treatment efficacy was analyzed.Results:All patients were successfully punctured at one time; the puncture surface was 5-6.5 cm on the basement plane, where the hematoma surface was the largest; the puncture angle was 10-14°, and the puncture depth was 9-11.5 cm. Fifteen patients were operated within 6 h of hemorrhage, and the intraoperative hematoma clearance rate was about 25%; 40 patients were operated 6-24 h after hemorrhage, and the hematoma clearance rate was about 20%; 5 patients were operated one-3 d after hemorrhage, and the hematoma clearance rate was as high as 30%. The first postoperative re-check CT showed that 51 patients had ideal position of the drainage tube, 2 were too deep, one was too shallow, 2 were below the position, 2 were above the position, one was inside the position, and one was outside the position. The Glasgow Coma Scale (GOS) scores of the patients on 3 rd d of operation (9.88±3.998) were significantly higher than those of the patients before operation (6.24±3.159, P<0.05). One month after the operation, GOS showed that 20 patients (33.3%) had good recovery, 28 (46.7%) had mild disability, 7 (11.7%) had severe disability, 3 (5.0%) had plant survival, and 2 (3.3%) died. Conclusion:The disposable new-type stereotaxic apparatus-assisted transfrontal puncture drainage is easy to be conducted and practicable with a reasonable design, accurate positioning, minimal surgical traumas and satisfactory curative effect.

Effects of standardized management of hypertension in the workplace for patients with diabetes / 中华健康管理学杂志

Objective:To evaluate the effects of standardized management of hypertension on blood pressure control of hypertension patients with diabetes mellitus in workplace population.Methods:Taking the type and size of workplace into consideration, 61 work sites were selected in different provinces by using epidemiological field trial method. In each selected province, 2-4 work sites with similar economic and medical conditions were chosen, among which 1-3 were designated as the intervention group and the other one as the control group. In total, 443 patients with hypertension and diabetes mellitus were included, with 347 patients in the intervention group and 96 patients in the control group. After training, doctors conducted standardized management for patients in the intervention group for a period of 24 months, following up with them regularly once a month, and recorded changes in blood pressure, risk factors, target organ damage, and treatment, while the control group had no special intervention, and relevant information was collected only at baseline and 24 months. Blood pressure, blood pressure control rate, and blood glucose changes were compared between the two groups.Results:After receiving standardized management of hypertension, the control rate of hypertension for patients with both hypertension and diabetes mellitus in the intervention group increased from 24.2% to 63.7% ( P<0.05) and the participants’ blood pressure also significantly decreased, by 10.2 (11.9-8.4) mmHg (1 mmHg=0.133 kPa) for systolic blood pressure and 7.7 (8.8-6.6) mmHg for diastolic blood pressure ( P<0.05); moreover, the blood glucose also decreased slightly ( P<0.001). In addition, the control rate of blood pressure increased to 63.7% with the increase of management time. In the control group, the control rate of hypertension increased to 46.9% ( P<0.05) and the systolic and diastolic blood pressure decreased by 5.6 (8.9-2.2) and 4.5 (6.6-2.4) mmHg ( P<0.05). Conclusions:The standardized management of hypertension in the workplace can effectively reduce overall blood pressure levels and improve the control rate of hypertension in the working population.

Effects of standardized management of hypertension in the workplace for patients with diabetes / 中华健康管理学杂志

Objective@#To evaluate the effects of standardized management of hypertension on blood pressure control of hypertension patients with diabetes mellitus in workplace population.@*Methods@#Taking the type and size of workplace into consideration, 61 work sites were selected in different provinces by using epidemiological field trial method. In each selected province, 2-4 work sites with similar economic and medical conditions were chosen, among which 1-3 were designated as the intervention group and the other one as the control group. In total, 443 patients with hypertension and diabetes mellitus were included, with 347 patients in the intervention group and 96 patients in the control group. After training, doctors conducted standardized management for patients in the intervention group for a period of 24 months, following up with them regularly once a month, and recorded changes in blood pressure, risk factors, target organ damage, and treatment, while the control group had no special intervention, and relevant information was collected only at baseline and 24 months. Blood pressure, blood pressure control rate, and blood glucose changes were compared between the two groups.@*Results@#After receiving standardized management of hypertension, the control rate of hypertension for patients with both hypertension and diabetes mellitus in the intervention group increased from 24.2% to 63.7% (P<0.05) and the participants’ blood pressure also significantly decreased, by 10.2 (11.9-8.4) mmHg (1 mmHg=0.133 kPa) for systolic blood pressure and 7.7 (8.8-6.6) mmHg for diastolic blood pressure (P<0.05); moreover, the blood glucose also decreased slightly (P<0.001). In addition, the control rate of blood pressure increased to 63.7% with the increase of management time. In the control group, the control rate of hypertension increased to 46.9% (P<0.05) and the systolic and diastolic blood pressure decreased by 5.6 (8.9-2.2) and 4.5 (6.6-2.4) mmHg (P<0.05).@*Conclusions@#The standardized management of hypertension in the workplace can effectively reduce overall blood pressure levels and improve the control rate of hypertension in the working population.

The incidence of hypertension, overweight, and obesity and relationship with cardiovascular events among middle-aged Chinese: 6 years follow-up results / 中华心血管病杂志

Objective@#To identify the incidence of hypertension, overweight/obesity in middle-aged population in China, and explore their impact on cardiovascular events.@*Methods@#From 2009 to 2010, 12 areas were sampled in China, and about 1 000 subjects aged 35 - 64 from each area were enrolled to collect the basic information, physical examination and blood tests were also performed. From 2016 to 2017, data from 8 835 subjects, who completed the 6 years follow-up, were analyzed.Blood pressure and body mass index(BMI) at both baseline and the follow-up, as well as incidence of hypertension, overweight and obesity, were calculated. Cox proportional hazard model was used to investigate the impacts of hypertension, overweight and obesity on cardiovascular events after adjusting confounders.@*Results@#At the end of follow-up, both BMI and systolic and diastolic blood pressure increased significantly compared with the baseline levels (all P<0.001). The cumulative incidence of hypertension, overweight and obesity within 6 years was 39.3%(1 146/2 918), 11.5%(406/3 544) and 4.3%(302/7 025), respectively. Compared with subjects with both normal BMI and blood pressure, people with overweight, obesity, hypertension, overweight with hypertension, and obesity with hypertension faced significantly increased risk of cardiovascular disease (HRs (95%CIs) were 2.394(1.130-5.073), 3.341(1.454-7.674), 6.047(2.978-12.279), 5.808(2.924-11.539) and 8.716(4.391-17.302), respectively, all P<0.05), after adjusting for other confounders.@*Conclusions@#The incidence of overweight, obesity, and hypertension is high in middle-aged people in China. Overweight, obesity and hypertension are associated with significantly increased risk of cardiovascular events during the 6 years follow up.

Effect of comprehensive intervention on hypertension control program in workplaces in China / 中华流行病学杂志

Objective: To evaluate the effect of comprehensive intervention program on hypertension control in workplaces in China. Methods: The study design was a non-randomized controlled trial. First, 20 sub-centers were selected across China, then hypertension patients in 2-4 workplaces were selected as the intervention group, and hypertension patients in 1 comparable workplace selected, as the control group in each sub-center. The comprehensive intervention strategy which integrating workplace primary prevention of cardiovascular diseases and standardized management of hypertension was adopted in the intervention group for at least 2 years. Patients in the control group continued their usual health care, and only baseline data and 2-year data was collected. Analyses were conducted for hypertension patients in 30 stated-owned enterprises (SOEs), including 20 for the intervention group and 10 for the control group. The primary outcome was the control rate ofhypertension while the intervention effect (IE) was estimated by using the formula: differential value of intervention group[rate (mean)]-differential value of control group[rate (mean)]. Results: Overall, 2 622 patients completed the 2-year follow-up, of which 2 055 were in the intervention group and 567 in the control group, respectively. After 2 years of intervention, the IE on the level of SBP and DBP for intervention group and control group were-7.5 and-3.9 mmHg, respectively (P<0.05). BMI decreased by 0.4 kg/m(2), with the regular exercise rate as 36.4% and alcohol consumption rate decreased by 14.0%, respectively (P<0.05). The smoking rate decreased by 6.1% (P>0.05). The overall hypertension control rate was 25.0%, and further subgroup analysis showed that our intervention program was particularly effective for those with high education level (27.6%), white-collar employees (41.9%), and those from SOEs whose affiliated hospital had been separated away (41.9%). Conclusion: The comprehensive intervention program could greatly improve the hypertension control in the workplaces in China.

Effect of comprehensive intervention on hypertension control program in workplaces in China / 中华流行病学杂志

Objective To evaluate the effect of comprehensive intervention program on hypertension control in workplaces in China.Methods The study design was a non-randomized controlled trial.First,20 sub-centers were selected across China,then hypertension patients in 2-4 workplaces were selected as the intervention group,and hypertension patients in 1 comparable workplace selected,as the control group in each sub-center.The comprehensive intervention strategy which integrating workplace primary prevention of cardiovascular diseases and standardized management of hypertension was adopted in the intervention group for at least 2 years.Patients in the control group continued their usual health care,and only baseline data and 2-year data was collected.Analyses were conducted for hypertension patients in 30 stated-owned enterprises (SOEs),including 20 for the intervention group and 10 for the control group.The primary outcome was the control rate ofhypertension while the intervention effect (IE) was estimated by using the formula:differential value of intervention group [rate (mean)] — differential value of control group [rate (mean)].Results Overall,2 622 patients completed the 2-year follow-up,of which 2 055 were in the intervention group and 567 in the control group,respectively.After 2 years of intervention,the IE on the level of SBP and DBP for intervention group and control group were-7.5 and-3.9 mmHg,respectively (P＜0.05).BMI decreased by 0.4 kg/m2,with the regular exercise rate as 36.4％ and alcohol consumption rate decreased by 14.0％,respectively (P＜0.05).The smoking rate decreased by 6.1％ (P＞0.05).The overall hypertension control rate was 25.0％,and further subgroup analysis showed that our intervention program was particularly effective for those with high education level (27.6％),white-collar employees (41.9％),and those from SOEs whose affiliated hospital had been separated away (41.9％).Conclusion The comprehensive intervention program could greatly improve the hypertension control in the workplaces in China.

Equity of outpatient service utilization for hypertensive patients in community / 中南大学学报(医学版)

To analyze the equity of outpatient service utilization for hypertensive patients (HPs) under 3 kinds of social medical insurance, and to explore its influential factors.
 Methods: A total of 8 670 HPs (aged at 15 years old from 28 sub-centers) in 14 provinces were selected. Indirectly standardized method and concentration index were used to analyze the equity of outpatient utilization in HPs, and decomposition analysis was used to explore the impact factors of outpatient treatment among the whole sample population, population with urban employees' basic medical insurance (UEBMI), and population with urban residents' basic medical insurance (URBMI) and new rural cooperative medical systems (NCMS).
 Results: The overall concentration index (CI) for the whole sample population was 0.2378. After the standardizing "need" variable, horizontal inequity (HI) was 0.2360, indicating that the outpatient service of HPs was inequity and that the higher economic level, the more outpatient services received. The decomposition of overall CI results showed that the positive factors for contribution were gross domestic product (GDP) level, retired, UEBMI and URBMI, and the negative factors for contribution were NCMS. The CI of UEBMI, URBMI and NCMS was 0.2017, 0.1208 and 0.0288, respectively; the HI was 0.1889, 0.1215 and 0.0219, respectively. The inequity in UEBMI is the most serious, followed by NRCMS and URBMI. The economic level was the main factor that caused inequity in the outpatient services utilization in three social medical insurance. In addition to the economic level, a common positive factor for the contribution to UEBMI and URBMI was district of residence, and the age was the positive factor to UEBMI as well.
 Conclusion: There are different levels of inequity in the HPs covered by 3 kinds of social medical insurance, and the inequity of UEBMI is the highest one among 3 kinds social medical insurance. The economic level is the main factor that affects the equity of outpatient in the HPs under 3 kinds of social medical insurance.

Association between high-sensitivity C-reactive protein and both cardiovascular, total mortality events in middle-aged Chinese adults / 中华流行病学杂志

Objective: To estimate the association between high-sensitivity C-reactive protein (hs-CRP) and cardiovascular events as well as all-cause mortality events. Methods: During 2009- 2010, out of the 11 623 individuals, 1 000 participants aged 35-64 years, were recruited and divided into 12 age-groups, to have received a study on CVD risk factors. Information on the risk factors of cardiovascular diseases was also collected. Fasting blood sample was gathered for all the participants, with hs-CRP tested. Participants in 7 out of the 12 sites were followed, with 6.21 years (36 075 person-years) as the median follow-up period. Cardiovascular and all-cause mortality events were collected. A total of 6 177 participants had been followed after excluding participants who had baseline infections, or did not take hs-CRP test/physical examination at the baseline. Finally, 5 984 participants were included for analysis. Participants were categorized into three groups based on the hs-CRP (mg/L) values: <1, 1-3 and >3, respectively. Cox proportional hazards regression model was used to analyze the relationships between hs-CRP with cardiovascular events or all-cause mortality events, after adjusting for confounding factors. Results: Mean age of the participants was 50.2 years. The incidence rates of cardiovascular disease events were 3.6/1 000 person-years, 7.1/1 000 person-years,and 10.4/1 000 person-years among three groups and 3.0/1 000 person-years, 5.7/1 000 person-years, 9.1/1 000 person-years for all-cause mortality events, respectively. After adjusting for confounding factors, the hazard risks (HR) for cardiovascular events were 1.33 (95%CI: 0.95-1.84) in the hs-CRP 1-3 mg/L group and 1.76 (95%CI: 1.20-2.60) in the hs-CRP>3 mg/L group when comparing with the hs-CRP<1 mg/L group (trend test P=0.003). The HRs for all-cause mortality events were 1.76 (95%CI: 1.23-2.54) and 2.64 (95%CI: 1.74-4.01) (trend test P<0.001), respectively. Conclusion: Hs-CRP appeared an independent predictor for cardiovascular events and all-cause mortality events.

Association between high-sensitivity C-reactive protein and both cardiovascular, total mortality events in middle-aged Chinese adults / 中华流行病学杂志

Objective To estimate the association between high-sensitivity C-reactive protein (hs-CRP) and cardiovascular events as well as all-cause mortality events.Methods During 2009-2010,out of the 11 623 individuals,1 000 participants aged 35-64 years,were recruited and divided into 12 age-groups,to have received a study on CVD risk factors.Information on the risk factors of cardiovascular diseases was also collected.Fasting blood sample was gathered for all the participants,with hs-CRP tested.Participants in 7 out of the 12 sites were followed,with 6.21 years (36 075 personyears) as the median follow-up period.Cardiovascular and all-cause mortality events were collected.A total of 6 177 participants had been followed after excluding participants who had baseline infections,or did not take hs-CRP test/physical examination at the baseline.Finally,5 984 participants were included for analysis.Participants were categorized into three groups based on the hs-CRP (mg/L) values:＜ 1,1-3 and ＞3,respectively.Cox proportional hazards regression model was used to analyze the relationships between hs-CRP with cardiovascular events or all-cause mortality events,after adjusting for confounding factors.Results Mean age of the participants was 50.2 years.The incidence rates of cardiovascular disease events were 3.6/1 000 person-years,7.1/1 000 person-years,and 10.4/1 000 person-years among three groups and 3.0/1 000 person-years,5.7/1 000 person-years,9.1/1 000 person-years for all-cause mortality events,respectively.After adjusting for confounding factors,the hazard risks (HR) for cardiovascular events were 1.33 (95％CI:0.95-1.84) in the hs-CRP 1-3 mg/L group and 1.76 (95％CI:1.20-2.60) in the hs-CRP＞3 mg/L group when comparing with the hs-CRP＜ 1 mg/L group (trend test P=0.003).The HRs for all-cause mortality events were 1.76 (95％CI:1.23-2.54) and 2.64 (95％CI:1.74-4.01) (trend test P＜0.001),respectively.Conclusion Hs-CRP appeared an independent predictor for cardiovascular events and all-cause mortality events.

Prevalence and Risk Factors of Mitral Regurgitation in the Population Aged ≥ 35 Years / 中国循环杂志

Objective: To explore the prevalence and risk factors of mitral regurgitation (MR) in the population ≥35 years in China in order to provide prevention reference for high risk crowd. Methods: The residents ≥35 years were taken by a stratified multistage sampling method. General information of crowd was collected by predesigned questionnaire and physical examination including life style, disease history, body weight and height. Echocardiography was conducted, fasting blood glucose and blood lipid levels were measured. Results: A total of 28814 subjects were enrolled. The overall MR detection rate was 18.4%, the detection rate in male and female were both 18.4%. The detection rates of moderate and severe MR were 0.3% in the paticipants at (35-50) years, 0.9% at (51-64) years and 2.2% at ≥65 years. MR prevalence showed an increasing trend with aging. Multivariate Logistic regression analysis indicated that age, systolic blood pressure, urban and rural, district, left atrial front and back diameter, left ventricular end diastolic front and back diameter, left ventricular ejection fraction, stroke, atrial fibrillation and heart failure were the risk factors for MR occurrence. Conclusion: MR detection rate was rather high in China. Specific prevention action should be taken for those with theabove risk factors.

Association between the types of obesity and the 10-year-coronary heart disease risk, in Tibet Autonomous Region and Xinjiang Uygur Autonomous Region / 中华流行病学杂志

Objective To investigate the association between types of obesity and the 10-year-coronary heart disease risk in Tibet and Xinjiang of China.Methods Using the multi-stage random sampling method,7 631 participants aged 35 or older were examined under the International Standardized Examination process but with only 5 802 were eligible for analysis,in the 2015-2016 season.Results The prevalence rates of general obesity,central obesity,visceral obesity and compound obesity were 0.53％,12.62％,10.08％ and 42.35％,respectively.Out of all the compound obesity cases,58.65％ (1 441/2 457) of them appeared as having all types of obesity in our study.Risk related to the 10-year-coronary heart disease was higher in men than in women [(3.05 ± 4.14)％ vs.(1.42-2.37) ％,P＜0.000 1.Compound obesity (30.16％) showed the highest proportion on the risk of 10-year-coronary heart disease than central obesity (28.01％),visceral obesity (18.46％) or the general obesity (19.35％).After adjustment for confounding factors,results from the multivariate analysis showed the risk in compound obesity was higher than central obesity,visceral obesity or general obesity and was associated with the highest risk on the 10-year-coronary heart disease (OR=2.889,95％CI:2.525-3.305).People with anomalous BMI and WC seemed to have had the higher risk (OR=3.168,95％CI:2.730-3.677).Conclusions Obesity was popular in the residents of Tibet and Xinjiang areas of China.Men and people with compound obesity (especially both BMI and WC were abnormal) seemed to carry greater risk on the 10-year-coronary heart disease.

Association between body fat percentage, visceral fat index and cardiometabolic risk factor clustering among population aged 35 year old or over, in Tibet Autonomous Region and Xinjiang Uygur Autonomous Region / 中华流行病学杂志

Objective To investigate the association between body fat percentage (BFP),visceral fat index (VFI) and Cardiometabolic Risk Factor Clustering (CRFC),among population aged 35 or older in Tibet and Xinjiang areas.Methods Using the stratified multi-stage random sampling method,7 571 residents aged 35 or above were examined with international standardized examination between 2015 and 2016.Of the eligible 5 643 participants,association of BFP and VFI with CRFC was defined as having two or more of the four risk factors:hypertension,diabetes mellitus,high TG and low HDL-C,at the same time.Logistic regression analysis and receiver operating characteristic (ROC) curve analysis were employed to further explore the relationships.Results The overall prevalence of CRFC among aged 35 and older population in Tibet and Xinjiang areas was 9.78％.BFP and VFI were divided into four groups by quartile.After adjustment for age,gender,race,cigarette smoking,alcohol consumption,education attainments,and altitude of residence,ORs of CRFC seemed to have increased with BFP and VFI.Compared with people having BFP of 5.0％-27.0％,the OR(95％CI) were 1.15(0.86-1.54),1.48(1.05-2.07) and 1.72(1.10-2.68) for the ones who presented 27.1％-31.7％,31.8％-36.6％ and 36.7％-50.0％ of BFP.Compared to people of having 1-6 of VFI,with OR (95％CI) as 1.20(0.81-1.79),1.91(1.30-2.80) and 3.91(2.64-5.77) for the ones having 7-9,10-13 and 14-30 of VFI.Areas under the curve (AUC) of CRFC appeared as 0.55 for BFP and 0.70 for VFI,respectively,with statistically significant difference (P＜0.01).Conclusion Both BFP and VFI levels were closely associated with CRFC while VFI seemed to have a better predictive value than the BFP.

Association between the types of obesity and the 10-year-coronary heart disease risk, in Tibet Autonomous Region and Xinjiang Uygur Autonomous Region / 中华流行病学杂志

Objective To investigate the association between types of obesity and the 10-year-coronary heart disease risk in Tibet and Xinjiang of China.Methods Using the multi-stage random sampling method,7 631 participants aged 35 or older were examined under the International Standardized Examination process but with only 5 802 were eligible for analysis,in the 2015-2016 season.Results The prevalence rates of general obesity,central obesity,visceral obesity and compound obesity were 0.53％,12.62％,10.08％ and 42.35％,respectively.Out of all the compound obesity cases,58.65％ (1 441/2 457) of them appeared as having all types of obesity in our study.Risk related to the 10-year-coronary heart disease was higher in men than in women [(3.05 ± 4.14)％ vs.(1.42-2.37) ％,P＜0.000 1.Compound obesity (30.16％) showed the highest proportion on the risk of 10-year-coronary heart disease than central obesity (28.01％),visceral obesity (18.46％) or the general obesity (19.35％).After adjustment for confounding factors,results from the multivariate analysis showed the risk in compound obesity was higher than central obesity,visceral obesity or general obesity and was associated with the highest risk on the 10-year-coronary heart disease (OR=2.889,95％CI:2.525-3.305).People with anomalous BMI and WC seemed to have had the higher risk (OR=3.168,95％CI:2.730-3.677).Conclusions Obesity was popular in the residents of Tibet and Xinjiang areas of China.Men and people with compound obesity (especially both BMI and WC were abnormal) seemed to carry greater risk on the 10-year-coronary heart disease.

Association between body fat percentage, visceral fat index and cardiometabolic risk factor clustering among population aged 35 year old or over, in Tibet Autonomous Region and Xinjiang Uygur Autonomous Region / 中华流行病学杂志

Objective To investigate the association between body fat percentage (BFP),visceral fat index (VFI) and Cardiometabolic Risk Factor Clustering (CRFC),among population aged 35 or older in Tibet and Xinjiang areas.Methods Using the stratified multi-stage random sampling method,7 571 residents aged 35 or above were examined with international standardized examination between 2015 and 2016.Of the eligible 5 643 participants,association of BFP and VFI with CRFC was defined as having two or more of the four risk factors:hypertension,diabetes mellitus,high TG and low HDL-C,at the same time.Logistic regression analysis and receiver operating characteristic (ROC) curve analysis were employed to further explore the relationships.Results The overall prevalence of CRFC among aged 35 and older population in Tibet and Xinjiang areas was 9.78％.BFP and VFI were divided into four groups by quartile.After adjustment for age,gender,race,cigarette smoking,alcohol consumption,education attainments,and altitude of residence,ORs of CRFC seemed to have increased with BFP and VFI.Compared with people having BFP of 5.0％-27.0％,the OR(95％CI) were 1.15(0.86-1.54),1.48(1.05-2.07) and 1.72(1.10-2.68) for the ones who presented 27.1％-31.7％,31.8％-36.6％ and 36.7％-50.0％ of BFP.Compared to people of having 1-6 of VFI,with OR (95％CI) as 1.20(0.81-1.79),1.91(1.30-2.80) and 3.91(2.64-5.77) for the ones having 7-9,10-13 and 14-30 of VFI.Areas under the curve (AUC) of CRFC appeared as 0.55 for BFP and 0.70 for VFI,respectively,with statistically significant difference (P＜0.01).Conclusion Both BFP and VFI levels were closely associated with CRFC while VFI seemed to have a better predictive value than the BFP.

Detection Rates and Influencing Factors of Atrial Septal Defect and Ventricular Septal Defect Among Live Births in Two Cities of East China / 中国循环杂志

Objective: To investigate the detection rates and inlfuencing factors of atrial septal defect (ASD) and ventricular septal defect (VSD) among neonates in two cities of East China and to provide scientiifc basis for the prevention, diagnosis, treatment and monitor of ASD and VSD. Methods: 2100 newborns with gestational age of at least 28 weeks were recruited consecutively from each city between 2013-09 and 2014-11. Data related to ASD and VSD were collected by questionnaires and echocardiographic screening was conducted within 7 days after birth. Results: A total of 4152 neonateswere examined with gestational age of (39.03 ± 1.29) weeks, among whom 2189 were male infants (52.72%), and age of mother was (26.32 ± 4.10) years old. Detection rates of ASD and VSD were 60.5‰ and 12.8‰ respectively, showing no significant difference between genders (P>0.05). Multivariate logistic regression analysis showed that maternal pre-pregnancy BMI and home decoration were the inlfuencing factors of ASD and maternal drug use in early pregnancy was the inlfuencing factor of VSD among newborns. Conclusions: Detection rates of ASD and VSD among neonates were relatively high in two cities of East China. Early screening is importtant to reduce the incidence of ASD and VSD and improve the prognosis.

Influential factors of treatment cost of antihypertensive drugs for hypertensive patient in community / 中南大学学报(医学版)

OBJECTIVE@#To explore the influential factors of treatment cost of antihypertensive drugs for hypertensive patient in community.@*METHODS@#A total of 220 community health centers (CHCs) from 15 provinces were selected across China in view of geographical location, economic level and previous cooperative experience to implement standardized blood pressure management for hypertensive patients for 1 year, based on guidelines for prevention and control for hypertension in China (2009 Community-based revision). Baseline and follow-up information for each hypertensive patient under the care of these CHCs was collected. A total of 22 683 hypertensive patients in hypertension community standardization management were enrolled in this study. We used multivariate linear regression model to analyze the influential factors of treatment cost of antihypertensive drugs.@*RESULTS@#Cultural degree, regional distribution, medical security system, the blood pressure classification, complications, and treatment options were statistically significant independent variables.@*CONCLUSION@#In hypertension community standardization management, the blood pressure of hypertensive patients should be controlled in advance to reduce the economic burden, , the occurrence of complications should be reduced, and economic factors should also be considered when selecting a treatment option.

Current prevalence rates of overweight, obesity, central obesity, and related cardiovascular risk factors that clustered among middle-aged population of China / 中华流行病学杂志

<p><b>OBJECTIVE</b>To analyze the current prevalence rates of overweight, obesity, central obesity and the clustering of major cardiovascular risks among middle-aged population of China.</p><p><b>METHODS</b>1 000 participants aged 35-64 years in each of the 12 populations under study, were examined with international standardized criteria in 2009-2010. Out of the 11 623 potential respondents, 10 340 of them were eligible for analysis. Current prevalence rates of overweight, obesity and central obesity, and the clustering of major cardiovascular risks were analyzed. Overweight and obesity were defined under the Chinese BMI criteria.</p><p><b>RESULTS</b>The prevalence rates were 38.8% on overweight, 20.2% on obesity and 51.6% on central obesity, respectively. Overall, the prevalence was seen higher in females, in northern part of the country and in urban (P < 0.05). Participants with all of three risk factors (hypertension, diabetes and dyslipidemia) appeared 4.5 times in obese persons than in normal persons but 5.1 times in persons with central obesity.</p><p><b>CONCLUSION</b>About half of middle aged Chinese were under abnormal weight, and most participants in our study were accompanied with cardiovascular risk factors related to obesity. It is of urgent need to develop strategies on prevention and intervention against obesity.</p>