Health-Related Quality of Life and Its Related Factors in Survivors of Stroke in Rural China: A Large-Scale Cross-Sectional Study.

Background: Stroke is a major health threat and the leading cause of mortality and disability in China. The aims of this study were to identify the possible influencing factors of health-related quality of life (HRQoL) and its domain-specific contents in stroke patients in rural areas in China. Methods: A total of 1,709 stroke patients aged 36-79 years from the baseline data of Henan Rural Cohort study (n = 39,259) were included in the cross-sectional study. The Chinese version of the European Quality of Life Five Dimension (including mobility, self-care, usual activities, pain/discomfort, and anxiety/depression) Five Level Scale (EQ-5D-5L) and visual analog scale (VAS) were used to evaluate HRQoL in stroke patients. Tobit regression models, generalized linear models and binary logistic regression models were constructed to determine potential influencing factors of the EQ-5D utility index, as well as influencing factors of each domain and VAS score. Results: The mean utility index and VAS scores of stroke patients were 0.885 (SD, 0.204), and 68.39 (SD, 17.31), respectively. Pain/discomfort (PD, 35.2%) and mobility (MO, 30.4%) were the most frequently reported issues. Regression models revealed that illiterate; a low monthly income; low physical activity intensity; and diabetes, anxiety, depression, or poor sleep quality were significantly associated with lower utility index and VAS scores among stroke patients. In addition, patients with stroke who were older, female, drinking, smoking, and consuming a high-fat diet, had a higher BMI, and lived with a stroke for a longer time, were also significantly associated with different dimensions of the EQ-5D. Conclusion: Patients with stroke in rural areas in China had a low HRQoL. Factors associated with the EQ-5D utility index as well as each domain and VAS score, need to be considered by health providers in rural areas. Patients with stroke in rural areas need to be included in national basic public medical services and managed systematically by medical institutions.

The association between the dietary pattern in abdominal obesity based on visceral fat index and dyslipidaemia in the Henan Rural Cohort Study.

The present study aimed to explore the association between dietary patterns in abdominal obesity obtained by reduced-rank regression (RRR) with visceral fat index (VFI) as a dependent variable and dyslipidemia in rural adults in Henan, China. A total of 29538 people aged 18-79 were selected from the Henan Rural Cohort Study. RRR analysis was used to identify dietary patterns; logistic regression analysis and restricted cubic spline regression models were applied to analyze the association between dietary patterns in abdominal obesity and dyslipidemia. VFI was used as a mediator to estimate the mediation effect. The dietary pattern in abdominal obesity was characterized by high carbohydrate and red meat intake and low consumption of fresh fruits, vegetables, milk, etc. After full adjustment, the highest quartile of dietary pattern scores was significantly associated with an increased risk of dyslipidemia (OR: 1·33, 95 % CI 1·23-1·44, Ptrend < 0·001), there was a non-linear dose-response relationship between them (Poverall-association < 0·001, Pnon-lin-association = 0·022). The result was similar in dose-response between the dietary pattern scores and VFI. The indirect effect partially mediated by VFI was significant (OR: 1·07, 95 % CI 1·06-1·08). VIF explained approximately 53·3 % of odds of dyslipidemia related to the dietary pattern. Abdominal obesity dietary pattern scores positively affected VFI and dyslipidemia; there was a dose-response in both relationships. Dyslipidemia progression increased with higher abdominal obesity dietary pattern scores. In addition, VFI played a partial mediating role in relationship between abdominal obesity dietary pattern and dyslipidemia.

Health-related quality of life and its related factors in coronary heart disease patients: results from the Henan Rural Cohort study.

The aims were to identify the possible influencing factors of health-related quality of life (HRQoL) and its domain-specific scores in patients with coronary heart disease (CHD). A total of 1247 patients with CHD from the Henan Rural Cohort Study (n = 39,259) were included in this study. The Chinese version of the European Quality of Life Five Dimension Five level scale (EQ-5D-5L) and Visual Analogue Scale (VAS) were used to evaluate HRQoL in patients with CHD. Tobit regression, generalized linear models and binary logistic regression were applied to determine the potential factors influencing the EQ-5D utility, as well as each domain, and the VAS. CHD patients had lower per capita monthly actual income, and higher rates of diabetes mellitus, stroke, anxiety and poor sleep quality, which significantly decreased EQ-5D index and VAS scores. In addition, sex, older age, education, not having a spouse, ever drinking alcohol, a high-fat diet, physical activity, hypertension and depression affected the various domain-specific EQ-5D scores in CHD patients. CHD patients in rural areas have a lower HRQoL. Factors associated with the EQ-5D index, including each domain, and the VAS need attention. CHD patients in rural areas need to be managed systematically.

Association of Serum Glucocorticoids with Various Blood Pressure Indices in Patients with Dysglycemia and Hypertension: the Henan Rural Cohort Study.

OBJECTIVE: To our knowledge, no definitive conclusion has been reached regarding the relationship between glucocorticoids and hypertension. Here, we aimed to explore the characteristics of glucocorticoids in participants with dysglycemia and hypertension, and to analyze their association with blood pressure indicators. METHODS: The participants of this study were from the Henan Rural Cohort study. A total of 1,688 patients 18-79 years of age were included in the matched case control study after application of the inclusion and exclusion criteria. Statistical methods were used to analyze the association between glucocorticoids and various indices of blood pressure, through approaches such as logistic regression analysis, trend tests, linear regression, and restricted cubic regression. RESULTS: The study population consisted of 552 patients with dysglycemia and hypertension (32.7%). The patients with co-morbidities had higher levels of serum cortisol ( P = 0.009) and deoxycortisol ( P < 0.001). The adjusted odds ratios (and 95% confidence intervals) for dysglycemia with hypertension were 1.55 (1.18, 2.04) for the highest tertile of Ln-cortisol compared with the lowest tertile. Additionally, the highest Ln-deoxycortisol levels were associated with increased prevalence of dysglycemia with hypertension by 159% (95% confidence interval: 122%, 207%). CONCLUSIONS: Serum deoxycortisol was positively correlated with systolic blood pressure, pulse pressure, mean arterial pressure, mean blood pressure, and mean proportional arterial pressure. Glucocorticoids (deoxycortisol and cortisol) increase the risk of hypertension in people with dysglycemia, particularly in those with T2DM.

Body mass index, abdominal fatness, and hypertension incidence: a dose-response meta-analysis of prospective studies.

Despite the established relationship of obesity to hypertension, the question as to whether there is a linear association between these two morbidities is unanswered. To quantitatively evaluate the relationship between obesity and hypertension, we carried out a dose-response meta-analysis of studies that looked at the relationship of different adiposity measures to hypertension. We searched PubMed, Embase, and Web of Science databases for articles published before 27 June 2017. A random-effects model was used to pool relative risks and 95% confidence intervals. Restricted cubic spline analysis was used to model the relationship. A total of 59 studies were included. Fifty-seven cohort studies with 125,071 incident cases among 830,685 participants were included in the analysis of body mass index and hypertension with the summary relative risk for per 5-unit increment in body mass index of 1.50 (95% confidence interval: 1.40-1.59). We found that the risk of hypertension in the body mass index analysis was greater in populations where the baseline body mass index was <25 kg/m2. The summary relative risk for a 10-cm increase in waist circumference was 1.25 (95% confidence interval: 1.19-1.32) and per 0.1-unit increase in waist-to-hip ratio was 1.27 (95% confidence interval: 1.18-1.37). This meta-analysis suggests that in normal range of obesity indexes, as lean as possible may be the best suggestion to prevent hypertension incidence.

Resting heart rate and the risk of hypertension and heart failure: a dose-response meta-analysis of prospective studies.

BACKGROUND: Studies on the relationship of resting heart rate to the risks of hypertension and heart failure have been inconsistent, and the question as to whether there is a linear association between them is unanswered. OBJECTIVE: To evaluate this possible relationship, we carried out a dose-response meta-analysis of studies that looked at risks associated with resting heart rate and hypertension or heart failure. METHODS: We searched PubMed, Embase, CNKI and WanFang databases for articles published before 15 June 2017. A random-effect model was used to pool relative risks and 95% confidence intervals. Restricted cubic spline analysis was used to model the resting heart rate-hypertension and heart failure risk association. RESULTS: We identified 13 and 17 cohort studies for hypertension and heart failure, respectively. The risk for each disease, respectively, increased by 11% relative risk: 1.11 (95% confidence interval: 1.07-1.15) and 19% relative risk: 1.19 (95% confidence interval: 1.13-1.25) for each 10 beats-per-minute increment in resting heart rate. The relationship between resting heart rate and hypertension or heart failure was consistent in most subgroup analyses except for gender subgroups, with no significant association observed in the women subgroup. The results provide no evidence of a nonlinear association of elevated resting heart rate with hypertension and heart failure risk. CONCLUSION: Resting heart rate shows a linear positive association with the incidence of hypertension and heart failure.

Maternal Lead Exposure Induces Down-regulation of Hippocampal Insulin-degrading Enzyme and Nerve Growth Factor Expression in Mouse Pups.

Lead exposure is a known potential risk factor for neurodegenerative diseases such as Alzheimer's disease (AD). Exposure to lead during the critical phase of brain development has been linked with mental retardation and hypophrenia in later life. This study was aimed to investigate the effects of lead exposure of pregnant mice on the expressions of insulin-degrading enzyme (IDE) and nerve growth factor (NGF) in the hippocampus of their offspring. Blood samples were collected from the tail vein, and after anesthetizing the pups, the brain was excised on postnatal day 21. Lead concentrations were determined by graphite furnace atomic absorption spectrophotometry, and the expressions of IDE and NGF were determined by immunohistochemistry and Western blotting. Results showed that the reduction in IDE and NGF expression in the hippocampus of pups might be associated with impairment of learning and memory and dementia induced by maternal lead exposure during pregnancy and lactation.

[Effects of Songling Xuemaikang Capsule on ambulatory blood pressure in treatment of essential hypertension: a single-blind randomized controlled trial].

OBJECTIVE: To explore the effects of Western medicine including Ca(2+) channel antagonist and angiotensin-receptor antagonist combined with Songling Xuemaikang Capsule (SXC), a compound traditional Chinese herbal medicine for calming liver and suppressing liver yang, on blood pressure indexes derived from 24-hour ambulatory blood pressure monitoring (ABPM), and to evaluate the effects and stability of SXC in lowering blood pressure. METHODS: Seventy patients with essential hypertension of grade 2 or grade 3 were randomly assigned to routine group and SXC group. There were 35 cases in each group. The patients in the routine group were administered with 2.5 mg levoamlodipine and 40 mg telmisartan once daily, and 1.5 g SXC was administered orally to the patients in the SXC group three times daily besides levoamlodipine and telmisartan treatment. They were all treated for two weeks. Twenty-four-hour ABPM, trough to peak ratio and smoothness index were measured before and after the treatment. RESULTS: Twenty-four-hour, day and night average systolic blood pressure (SBP) and 24-hour, day and night SBP load in the two groups were lowered as compared with before treatment (P < 0.05). The effects of Western medicine combined with SXC on blood pressure depression were better than those of Western medicine (P < 0.05). Western medicine combined with SXC had a significant influence on diastolic blood pressure (DBP) as compared with Western medicine (P < 0.05). The heart rate in the SXC group was reduced as compared with before treatment and the routine group (P < 0.05). Trough to peak ratio in SXC group was higher than that in the routine group, while there was no significant difference in smoothness index between the two groups. Morning surge in blood pressure in the two groups was improved as compared with before treatment (P < 0.05), and there was a significant difference in morning surge in blood pressure between the two groups (P < 0.05). CONCLUSION: Western medicine combined with SXC has long-lasting effects in lowering heart rate and blood pressure, especially for SBP and SBP load. SXC plus Western medicine also has an inhibition effect on morning surge in blood pressure.

[Relationship between microalbuminuria and cognition in primary hypertension patients].

OBJECTIVE: To study the relationship between microalbuminuria and cognitive impairment in primary hypertensive patients. METHODS: A total of 200 hypertensive patients were included in this study. Blood pressure, body height and weight, total cholesterol, triglyceride, fasting plasma glucose, 2 hour-postprandial blood sugar, insulin level and urine protein were measured. Microalbuminuria and urine creatinine were determined in patients without proteinuria. The risk stratification of hypertension was evaluated. The cognitive function and calculate scores were tested by the Mini Mental State Examination (MMSE) and patients were divided into two groups: > 24-scores were classified as normal cognition group, < or = 24-scores as impaired cognition group. RESULTS: Among the 200 hypertensive patients, proteinuria was detected in 25 patients. There was no significant difference in the cognitive function between patients with and without proteinuria (P > 0.05). There were significant differences on age, educational level, occupation, smoking, history of coronary heart disease, history of cerebrovascular disease, the risk stratification of hypertension, microalbuminuria/creatinine ratio, postprandial insulin level, cholesterol and diastolic blood pressure between normal cognition function group and impaired cognition function group (all P < 0.05). Multivariate logistic regression analysis showed that microalbuminuria, educational level and the risk stratification of hypertension were significantly correlated to cognition impairment (all P < 0.05). CONCLUSIONS: Educational level, the risk stratification of hypertension and microalbuminuria are associated with cognitive impairment in this patient cohort.