Hypersensitive C-reactive protein as a potential indicator for predicting left ventricular hypertrophy in elderly community-dwelling patients with hypertension.

BACKGROUND: The aim of this study was to investigate the relationship between Hypersensitive C-reactive protein (hs-CRP) and left ventricular hypertrophy (LVH) in elderly community-dwelling patients with hypertension. METHODS: A cross-sectional study was conducted, involving the recruitment of 365 elderly hypertensive residents ≥ 65 years of age from five communities. The participants were divided into two groups: an LVH group (n = 134) and a non-LVH group (n = 231), based on the left ventricular mass index (LVMI) determined by echocardiography. Spearman correlation analysis was used to assess the relationship between hs-CRP and LVH. Univariate and Multivariate analysis was performed to detect variables associated with LVH. The diagnostic value of hs-CRP for LVH was expressed as the area under the receiver operating characteristic (ROC) curve. RESULTS: The incidence of LVH in elderly hypertension patients in the community was 36.7%. The hs-CRP levels were significantly higher in subjects with LVH compared to those without LVH (1.9 [0.8, 2.9] vs. 0.7 [0.4, 1.4], P = 0.002). Spearman correlation analysis demonstrated a positive correlation between hs-CRP and LVMI (r = 0.246, P < 0.001), as well as with IVST (r = 0.225, P < 0.001) and LVPWT (r = 0.172, P = 0.001). Among elderly hypertensive residents in the community, the cut-off value of hs-CRP for diagnosing LVH was 1.25 mg/L (sensitivity: 57.5%; specificity: 78.4%), and the area under the ROC curve for hs-CRP to predict LVH was 0.710 (95%CI: 0.654-0.766; P < 0.001). In the final model, hs-CRP ≥ 1.25 mg/L (OR = 3.569; 95%CI, 2.153-5.916; P<0.001) emerged as an independent risk factor for LVH. This association remained significant even after adjusting for various confounding factors (adjusted OR = 3.964; 95%CI, 2.323-6.765; P < 0.001). CONCLUSIONS: This community-based cohort of elderly hypertensive individuals demonstrates a strong association between hs-CRP levels and the presence of LVH. The hs-CRP ≥ 1.25 mg/L may serve as an independent predictor for LVH in hypertensive subjects and exhibit good diagnostic efficacy for LVH.

Knowledge, attitude and behaviour of general practitioners in Shanghai during the pandemic of COVID-19: a cross-sectional study.

OBJECTIVES: To understand the knowledge, attitude and behaviour of general practitioners (GPs) towards COVID-19 and to provide evidence for improved prevention and control measures against the pandemic. STUDY DESIGN: A cross-sectional study was conducted with 1018 GPs in Shanghai from 21 February to 2 March 2020 using the WeChat platform. METHODS: Stratified random cluster sampling was performed according to the regional division of urban, urban-rural fringe and rural areas. This study used a self-designed mobile questionnaire. The questionnaire collected information on knowledge, attitudes and behaviours regarding COVID-19 prevention and control. RESULTS: A total of 989 questionnaires were declared valid. The average scores of GPs' knowledge, attitude and behaviour towards COVID-19 were 6.14±1.42 (range 0-10), 13.59±4.42 (range 0-25) and 7.82±1.53 (range 0-10), respectively. Multiple linear regression analysis showed that the knowledge score of male GPs was lower than that of female GPs (p=0.002). In addition, the 'attitude' score of female GPs was higher than that of male GPs (p=0.004). The 'behaviour' score of GPs in urban areas was lower than that of GPs in urban-rural fringe areas (p<0.001). The higher the knowledge score, the higher the behavioural score was observed to be (p<0.001). CONCLUSIONS: The scores of knowledge, attitude and behaviour of Shanghai GPs towards COVID-19 were limited at the beginning of the COVID-19 outbreak. As a hopeful measure, the early implementation of proper training programmes for GPs in times of crisis will contribute to disease control and prevention. Lessons learnt from the current pandemic will hopefully help GPs handle similar future challenges and potential novel pandemics.

Knowledge and behaviour of community residents' face mask-wearing during the COVID-19 pandemic: a cross-sectional study in Shanghai, China.

OBJECTIVES: COVID-19 is an infectious disease spreading through respiratory droplets. Using a face mask correctly is one of the essential preventive measures. We launched a survey to discover the current face mask-wearing problems for better prevention and control of the pandemic. SETTING/PARTICIPANTS: A cross-sectional study was conducted with 1240 residents in Shanghai during 18-28 February 2020. Stratified random sampling was adopted in the urban area, urban-rural fringe area and rural area. A mobile self-designed questionnaire was used. MAIN OUTCOME MEASURES: Analysis of the demographic and sociological factors influencing residents' face mask type selection, disposable surgical mask-wearing behaviour, replacement time and the storage method for reuse of disposable surgical masks. RESULTS: The accuracy of residents' face mask type selection was rated 41.61% (513/1233), and that of urban-rural fringe residents, low-education residents, elderly residents, were low, respectively (p<0.001). 96.67% of residents always wore face masks in crowded public places. Multiple-factor analysis showed that region, gender and education level were the influencing factors for entirely fitting the disposable surgical mask to the face. Region was an influencing factor for not touching the mask's external surface while wearing or removing it. Education level was an influencing factor for recognising the external and inner mask surface, upper and lower edge of a disposable surgical mask. The accuracy of the mask replacement time was 25.63% (316/1223). It was low with elderly, low-education residents, respectively (p<0.001).The accuracy of residents' storage method for reuse of disposable surgical mask was 3.81% (47/1233), and region, age and education level were influencing factors. CONCLUSIONS: Shanghai residents recorded a high rate of wearing face masks. Selection of an appropriate type of face mask, disposable surgical mask-wearing behaviour, replacement time and storage method for reuse of disposable surgical masks should be particularly emphasised in future behaviour change interventions.