Nomogram-based risk assessment model for left ventricular hypertrophy in patients with essential hypertension: Incorporating clinical characteristics and biomarkers.

Left ventricular hypertrophy (LVH) is a hypertensive heart disease that significantly escalates the risk of clinical cardiovascular events. Its etiology potentially incorporates various clinical attributes such as gender, age, and renal function. From mechanistic perspective, the remodeling process of LVH can trigger increment in certain biomarkers, notably sST2 and NT-proBNP. This multicenter, retrospective study aimed to construct an LVH risk assessment model and identify the risk factors. A total of 417 patients with essential hypertension (EH), including 214 males and 203 females aged 31-80 years, were enrolled in this study; of these, 161 (38.6%) were diagnosed with LVH. Based on variables demonstrating significant disparities between the LVH and Non-LVH groups, three multivariate stepwise logistic regression models were constructed for risk assessment: the "Clinical characteristics" model, the "Biomarkers" model (each based on their respective variables), and the "Clinical characteristics + Biomarkers" model, which amalgamated both sets of variables. The results revealed that the "Clinical characteristics + Biomarkers" model surpassed the baseline models in performance (AUC values of the "Clinical characteristics + Biomarkers" model, the "Biomarkers" model, and the "Clinical characteristics" model were .83, .75, and .74, respectively; P < .0001 for both comparisons). The optimized model suggested that being female (OR: 4.26, P <.001), being overweight (OR: 1.88, p = .02) or obese (OR: 2.36, p = .02), duration of hypertension (OR: 1.04, P = .04), grade III hypertension (OR: 2.12, P < .001), and sST2 (log-transformed, OR: 1.14, P < .001) were risk factors, while eGFR acted as a protective factor (OR: .98, P = .01). These findings suggest that the integration of clinical characteristics and biomarkers can enhance the performance of LVH risk assessment.

Hypertension Screening and Follow-up Management by Primary Health Care System among Chinese Population Aged 35 Years and Above.

OBJECTIVE: To describe hypertension screening and follow-up management among Chinese population aged 35 years and above within the primary health care system. METHODS: Data from 2010 China Chronic Disease and Risk Factor Surveillance System were used. We investigated previous hypertension diagnosis, screening, and follow-up assessments within the primary health care system. The prevalence of self-reported and criterion-based hypertension, screening rates, demographic and socioeconomic characteristics associated with screening, and patterns of follow-up assessments were recorded. The SAS software system was used for statistical analyses. RESULTS: About 17.1% reported a previous hypertension diagnosis. The rate difference between the two measures of prevalence was 27.2%. Among those without self-reported hypertension, 27.7% reported never visiting a clinic during the past 1 year and 60.4% of those attending a clinic reported ever being screened. Younger age group was associated with lower screening proportion; odds ratios of 35-, 45-, 55-, and ⋝65 years were 1.7 (95% CI: 1.5-1.9), 1.5 (95% CI: 1.3-1.7), 1.3 (95% CI: 1.2-1.4), and 1.0, respectively. About 35.1% of the patients had undergone follow-up assessments four or more times during the past 1 year. CONCLUSION: Majority of the Chinese population aged 35 years and above, particularly the less educated, elderly population, and rural residents were unaware of that they were suffering from hypertension. Most patients did not receive enough management services by the primary health care system. Thus, strengthening both the screening and follow-up management is needed.

Prevalence of overweight and obesity and their associations with blood pressure among children and adolescents in Shandong, China.

BACKGROUND: Obesity and high blood pressure (BP) are public health problems all over the world. Some studies have reported a positive association between them in children and adolescents. The purpose of this study was to assess the prevalence of overweight and obesity and their associations with BP among school children and adolescents in Shandong, an important province in eastern China. METHODS: In 2011, we conducted a cross-sectional population-representative survey in Shandong, China. A total of 4 898 children and adolescents aged 6-17 years were randomly selected from 140 counties/districts using a multistage random cluster sampling. Weight, height and BP were measured by a trained physician or pediatrician, and information about age, gender and place of residence was obtained using questionnaires. Obesity and high BP were defined according to age- and gender-specific Chinese reference data for children. RESULTS: A total of 4 898 (100%) children and adolescents provided complete information. The prevalence of overweight, obesity and overweight plus obesity were 10.9%, 8.7% and 19.6%, respectively. Boys were more likely to be overweight or obese than girls (P < 0.05 for overweight; P < 0.001 for obesity). The prevalence of overweight plus obesity was highest among children aged 6-11 years (22.3%). BP and the prevalence of high BP increased with increasing body mass index (BMI). With age and sex adjusted, odds ratios (ORs) for high BP were [OR 2.2;95% CI 1.7-2.8) in overweight and [OR 3.6;95% CI 2.6-4.9] in obese children. CONCLUSION: The representative survey confirms high prevalence of overweight and obesity among children and adolescents in Shandong. Childhood obesity is a strong risk factor for high BP. Intervention programs should be implemented to combat the growing obesity epidemic.

Dietary sodium intake and its impact factors in adults of Shandong province.

Dietary sodium intake and its impact factors in 2 140 adults aged 18-69 years were analyzed. The mean daily sodium intake was 5745.0 (5427.6-6062.5) mg per day, which was higher in males than in females (P<0.01). After having been adjusted for gender, age and urban/city areas, the mean daily sodium intake was significantly higher in participants with a lower education level, drinkers and smokers than in those with a higher education level, nondrinkers and nonsmokers (P<0.01). The dietary sodium intake in adults of Shandong Province is higher than the recommended standards.

Dietary sodium intake: knowledge, attitudes and practices in Shandong Province, China, 2011.

OBJECTIVE: To investigate the knowledge, attitudes and practices (KAP) for dietary sodium intake among adult residents of Shandong Province, China. METHODS: In 2011, we conducted a cross sectional survey among a representative sample of 15,350 adults aged 18 to 69 years using a standardized questionnaire to assess their KAP for sodium. Variation in the KAPs by gender, and residence location were compared using the Chi-square tests. Predictors for the 'intention to' and 'currently taking action to' reduce sodium intake were determined by multivariate logistic regression with adjustment for confounding factors. RESULTS: KAPs for dietary sodium intake among urban residents was generally more favorable than among rural residents. Women were likely to have more favorable KAPs than men. About four fifth of subjects reported that they favored a low sodium diets. However, 31% reported that consumption of less sodium results in less physical strength. Overall, 70% indicated their intention to reduce sodium intake, although only 39 % reported that they had taken action to reduce sodium. Multiple logistic regression analyses indicated that favorable actions to dietary sodium reduction were more likely to occur among those who were aware of the link between sodium and hypertension, and less likely among those who had unfavorable attitudes towards dietary sodium reduction. CONCLUSION: Increasing knowledge levels about the benefits of sodium reduction will be a key success factor for effective sodium reduction initiatives and is linked to favorable behavioral change. Emphasis should be placed on the rural area.

[The status of awareness, treatment and control of hypertension in adult population in Shandong province in 2011].

OBJECTIVE: To identify the status of awareness, treatment and control of hypertension in adult population in Shandong province in China. METHODS: A total of 15 350 representative subjects aged 18 to 69 in Shandong province were selected with multistage stratified and clustered sampling design. Questionnaire investigation and physical examination including measurement of blood pressure, height and weight, were taken for all of them. The prevalence was estimated by weighted SURVEYFREQ model. RESULTS: In Shandong province, 34.5% of the hypertensive patients were aware of their high blood pressure (31.1% in male, 38.5% in female), 27.5% of them were taking antihypertensive medications (24.1% in male, 31.7% in female), and 14.9% of them (13.7% in male, 16.4% in female) were under control for their blood pressure (<140/90 mm Hg). CONCLUSION: The rates of awareness, treatment and control of hypertension in adult hypertensive population in Shandong province, China were low, and it is urgently needed to take steps for intervention and control for hypertension prevention, particularly in rural areas.

[Status and trend of cardio-cerebral-vascular diseases mortality in China: data from national disease surveillance system between 2004 and 2008].

OBJECTIVE: To report the status and trend of cardio-cerebral-vascular disease (CCVD) mortality in China between 2004 and 2008. METHODS: The mortality data from population-based survey of National Disease Surveillance System in 2004 and 2008 were analyzed. This surveillance system is consisted of 161 disease surveillance points (DSPs) located in 31 provinces of China including 64 urban and 97 rural DSPs. The total population of surveillance is over 73 millions and accounted for around 6% of the whole population of China. CCVD included ischemic heart diseases (ICD-10: I05-I09, I11, I20-I27, I30-I52) and cerebral-vascular disease (ICD-10: I60-I69). The status and trend of cardiovascular disease (CVD), cerebral-vascular disease (CD), ischemic heart disease (IHD) and acute myocardial infarction (AMI) mortalities from 2004 to 2008 were analyzed by age, gender, and urban/rural regions. RESULTS: The mortality of CCVD was higher in 2008 (229/100 000) than in 2004 (223.5/100 000), which was decreased in urban region (-11.7/100 000) while increased in rural region (+16.0/100 000). The mortality of CD decreased from 134.8/100 000 (2004) to 128.3/100 000 (2008). Mortality of IHD and AMI increased from 66.1/100 000 and 40.4/100 000 (2004) to 71/100 000 and 45.7/100 000 (2008), which remained stable in urban region (+0.98/100 000 and -1.96/100 000) while significantly increased in rural region (+6.7/100 000 and +9.2/100 000). The mortality rates for CVD, CD and AMI were higher in rural population than that in urban population. The age-standardized mortality rates of CVD, CD and IHD were lower in 2008 than in 2004. The mortality rates of CD and IHD decreased in 40-, 60-, and over 80 age groups (except for IHD) in 2008 than in 2004. However, IHD mortality was significantly higher in age of 80 and over group from 2004 to 2008. There were a net 5.5/100 000 increase, 6.4/100 000 decrease and 4.9/100 000 increase for CCVD, CD and IHD between 2004 and 2008. The mortality rate rise in CCVD was mainly due to the increased mortality of IHD and CD in rural population. The CCVD mortality increased with age and was significantly higher in male than in female population. CONCLUSIONS: Despite decreased mortality in CD, CCVD mortality increased from 2004 to 2008, mainly due to the increased mortality of IHD and AMI in rural population. Enhanced CCVD primary and secondary prevention, particular for stressing on primary prevention, is necessary in China, especially in rural areas. Meanwhile, they will give the greatest contributions for a raise of the healthy life expectancy in China.

The cross-effects of cigarette and betel nut consumption in Taiwan: have tax increases made a difference?

This paper empirically identifies cross-price elasticities of betel nut and cigarette consumption in Taiwan based on the Central Bureau of Statistics demand model. It compares reduction of cigarette consumption as a result of the proposed Betel Nut Health Tax with reduction of betel nut consumption as a result of the Tobacco Health and Welfare Taxes levied in 2002 and 2006, in order to determine which tax is most effective. Results from a simulated comparative analysis indicate that the Betel Nut Health Tax reduces cigarette consumption to a much greater extent than the Tobacco Health and Welfare Taxes reduce betel nut consumption.

2-Amino-4-[1-(2-chloro-phen-yl)-5-methyl-1H-1,2,3-triazol-4-yl]-6-(4-methyl-phen-yl)benzene-1,3-dicarbonitrile.

In the title compound, C(24)H(17)ClN(6), the dihedral angles between the triazolyl ring and its adjacent chlorobenzene and trisubstituted benzene rings are 90.6 (2) and 55.7 (3)°, respectively. The dihedral angle between the trisubstituted ring and the attached tolyl ring of the biphenyl unit is 45.9 (3)°. Intra- and intermolecular N-H⋯N hydrogen bonds are present.

[A case-control study on the relations between insulin resistance and essential hypertension in YI NATIONALITY living in Liangshan, Sichuang Province].

OBJECTIVE: To determine whether insulin resistance (IR) was associated with essential hypertension (EH) in YI nationality living in Liangshan, Sichuang Province. METHODS: A case-control study consisting of 113 YI hypertensives as cases and 156 YI normotensives as controls were conducted to investigate the level of fasting glucose (FG) and fasting insulin (FINS), and insulin resistance index was used as the indicator of IR. RESULTS: It was found that impaired fasting glucose (IFG) and IR were associated with EH significantly among YI migrants, and OR (95% CI) were 3.98 (2.14 approximately 7.42, P < 0.001) and 2.55 (1.35 approximately 4.83, P = 0.004) respectively. Being stratified by sex, both IFG and IR were associated with EH significantly among YI male migrant, and OR were 4.31 (2.01 approximately 9.24, P < 0.001) and 3.14 (1.45 approximately 6.82, P = 0.003) respectively; but only IFG was associated with EH significantly among YI female migrant and OR was 3.46 (1.17 approximately 10.22, P = 0.022). Among YI farmers, both IFG and IR were not associated with EH significantly. The non-conditional logistic regression analysis showed that IR was associated significantly with EH among YI migrants. This was not as same as observed in YI farmers. CONCLUSION: It is likely that IR is the risk factor of EH among YI migrants in our study. However, the association between IR and EH among YI farmers needs some further studies.