[Relationship between the ideal cardiovascular health behaviors and factors and newonset heart failure].

Objective: To explore the relationship between the ideal cardiovascular health behaviors and factors and newonset heart failure. Methods: It was a prospective cohort study. People who attended the 2006-2007 physical examination of Kailuan Group Company and with complete data of cardiovascular behaviors and related factors were eligible for this study. A total of 95 167 participants who were free of valvular heart diseases, congenital heart diseases and a prior history of heart failure were included. Basic cardiovascular health score (CHS) of each participant was calculated. Participants were divided into 3 groups according to CHS. Group 1:CHS<8 (n=26 640), Group 2:8≤CHS<10 (n=35 230), Group3:CHS≥10 (n=33 297). The general clinical data and laboratory test results were collected. The outcome was defined as the first occurrence of heart failure at the end of followup(December 31, 2016). Cox regression model was used to determine the association between baseline CHS and the risk of newonset heart failure. Results: After a median followup of 10.3 years, the incidence of newonset heart failure in the group of CHS<8,8≤CHS<10,CHS≥10 were 2.7%(729/26 640), 1.8%(651/35 230) and 1.1%(360/33 297),respectively. After adjustment for age, sex, history of myocardial infarction, history of atrial fibrillation, income, alcohol consumption, education and the use of antihypertensive, cholesterol-lowering, glucose-lowering medications, compared with the group of CHS<8, the Cox regression model showed that HRs of the group of 8≤CHS<10 and CHS≥10 were 0.68 (95%CI 0.61-0.75), 0.49 (95%CI 0.43-0.55), respectively. Cox regression analysis after removing each single cardiovascular behavior or factor showed that the HR value range ability was as follows:systolic blood pressure(HR=0.78,95%CI 0.74-0.82), body mass index(HR=0.78,95%CI 0.74-0.82), fasting blood glucose (HR=0.77,95%CI 0.73-0.81), total cholesterol(HR=0.76,95%CI 0.72-0.80), physical exercise(HR=0.72,95%CI 0.69-0.76), smoking(HR=0.75,95%CI 0.71-0.79) and salt intake(HR=0.73,95%CI 0.69-0.77). Conclusion: CHS is negatively associated with the risk of newonset heart failure, and there is a dose-response relationship between the two indexes.

[Predictive value of C-reactive protein in emerging non-alcoholic fatty liver disease].

Objective: To investigate the predictive value of C-reactive protein (CRP) in emerging non-alcoholic fatty liver disease (NAFLD). Methods: A prospective cohort study was performed. A total of 101510 employees of Kailuan Group Company who underwent physical examination from July 2006 to October 2007 were enrolled as study subjects. The employees with a history of drinking, fatty liver disease, myocardial infarction, stroke, and malignant tumors and incomplete data were excluded. Finally 25843 employees were enrolled in the cohort study. According to the baseline CRP level, these employees were divided into CRP < 1 mg/L group, CRP 1-3 mg/L group, and CRP > 3 mg/L group. The detection rate of emerging NAFLD was compared between groups, and the multivariate logistic regression model was used to analyze the risk of NAFLD in each group. Results: With the increasing CRP level, age, systolic pressure, diastolic pressure, waist circumference, body mass index, fasting blood glucose, total cholesterol, serum uric acid, and the proportion of male patients tended to increase (P< 0.01). The detection rate of emerging NAFLD was 24.6% in the CRP < 1 mg/L group, 29.6% in the CRP 1-3 mg/L group, and 30.6% in the CRP > 3 mg/L group (χ 2= 92.10,P< 0.01). The results of the logistic regression analysis showed that after the confounding factors such as age, sex, and waist circumference were corrected, the risk of NAFLD in the CRP 1-3 mg/L group and CRP > 3 mg/L group was 1.09 (95%CI1.01-1.17) and 1.24 (95%CI1.13-1.35) times that in the CRP < 1 mg/L group. Conclusion: CRP is the independent risk factor for the development of NAFLD.

[Impact of combined systolic blood pressure and body mass index on the risk of new-onset atrial fibrillation].

OBJECTIVE: To observe the impact of combined systolic blood pressure and body mass index (BMI) on the risk of new-onset atrial fibrillation. METHODS: The participants who participated the health examination between July 2006 and October 2007 at Kailuan medical group and had no history of atrial fibrillation were selected as the observation cohort.The second, the third and the fourth health examination were conducted between July 2008 and October 2009, July 2010 and October 2011, July 2012 and October 2013, respectively.The participants were stratified by 3 systolic blood pressure levels (≤120, 120-140, ≥140 mmHg (1 mmHg=0.133 kPa))×3 BMI levels (≤24, 24-28, ≥28 kg/m(2)) at baseline.The combined effect of systolic blood pressure and BMI on the risk of new-onset atrial fibrillation was analyzed by multiple Cox regression analysis. RESULTS: A total of 99 206 participants were recruited and 88 715 participants were included in the final analysis after excluding participants who had new-onset valvular atrial fibrillation or lost to follow-up.A total of 265 participants developed atrial fibrillation during the 5.6 years follow-up.The incidence of atrial fibrillation increased with the BMI and systolic blood pressure, the incidence of new onset of atrial fibrillation was significantly higher in the group with systolic blood pressure≥140 mmHg and BMI≥28 kg/m(2) than the group with systolic blood pressure≤120 mmHg and BMI≤24 kg/m(2)(1.15/1 000 person-year vs. 0.25/1 000 person-year). Multiple Cox regression analysis showed that participants in the group with systolic blood pressure≥140 mmHg and BMI≥28 kg/m(2) carried 2.08 (95%CI 1.18-3.67) times higher risk for atrial fibrillation than the group with systolic blood pressure≤120 mmHg and BMI≤24 kg/m(2) after adjustment for age, gender and other confounders at baseline. CONCLUSION: Participants with systolic blood pressure≥140 mmHg and BMI≥28 kg/m(2) are at high risk for new onset of atrial fibrillation.

[Association between the cardiovascular health score and new-onset atrial fibrillation].

OBJECTIVE: To observe the association between the cardiovascular health score and new-onset atrial fibrillation. METHODS: A total of 95 026 participants who participated the health examination between July 2006 and October 2007 at Kailuan group and without history of atrial fibrillation were selected as the observation cohort. The second, the third and the fourth health examination were performed between July 2008 to October 2009, July 2010 to October 2011, July 2012 to October 2013, respectively.A total of 85 028 participants were included in the final analysis after excluding participants who had new-onset valvular atrial fibrillation and participants lost to follow-up. The participants were divided into 4 subgroups by cardiovascular health score at baseline according to the definition of AHA and cardiovascular health scoring system, namely group of 0-6 points (n=11 103), 7-8 points (n=24 487), 9-10 points (n=32 556), and 11-14 points (n=16 882). The incidence of atrial fibrillation in each subgroup was observed, and the association between cardiovascular health score and risk of new-onset atrial fibrillation was analyzed using multiple Cox regression analysis. RESULTS: A total of 254 participants developed atrial fibrillation during the median of (5.6±1.4) years follow-up. The total incidence of new-onset atrial fibrillation was 0.53/1 000 person-year. The incidence of atrial fibrillation was 0.69/1 000 person-year, 0.60/1 000 person-year, 0.56/1 000 person-year, and 0.30/1 000 person-year, respectively in 0-6 points, 7-8 points, 9-10 points, and 11-14 points subgroups, respectively(P<0.01). After adjustment of age, gender, education level, income, drink, history of myocardial infarction, history of stroke, serum uric acid and C reactive protein level, multiple Cox regression analysis showed that one health score point increase was related to 8% reduction of new onset atrial fibrillation(HR=0.92, 95%CI 0.86-0.99, P<0.05). Compared with the group of 0-6 points group, the risk of atrial fibrillation in the group of 11-14 points group was reduced by 49% (HR=0.51, 95%CI 0.31-0.83, P<0.01). CONCLUSION: The risk of new-onset atrial fibrillation is reduced in proportion to increase of cardiovascular health score. Clinical Trail Registry: Chinese Clinical Trail Registry, ChiCTR-TNRC-11001489.