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  • Kang, Yuting  (4)
  • Wang, Xin  (4)
  • Zhang, Zugui  (4)
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  • 1
    In: The Journal of Clinical Hypertension, Wiley, Vol. 22, No. 4 ( 2020-04), p. 623-630
    Abstract: The purpose of this study was to assess the association of blood pressure (BP) measurements with the risk of cardiovascular disease (CVD) and examine whether central systolic BP (CSBP) predicts CVD better than brachial BP measurements (SBP and pulse pressure [PP]). Based on a cross‐sectional study conducted in 2009‐2010 with follow‐up in 2016‐2017 among 35‐ to 64‐year‐old subjects in China, we evaluated the performance of non‐invasively predicted CSBP over brachial BP measurements on the first CVD events. Each BP measurement, individually and jointly with another BP measurement, was entered into the multivariate Cox proportional‐hazards models, to examine the predictability of central and brachial BP measurements. Mean age of participants (n = 8710) was 50.1 years at baseline. After a median follow‐up of 6.36 years, 187 CVD events occurred. CSBP was a stronger predictor for CVD than brachial BP measurements (CSBP, 1‐standard deviation increment HR = 1.49, 95%CI: 1.31‐1.70). With CSBP and SBP entering into models jointly, the HR for CSBP and SBP was 1.28 (1.04‐1.58) and 1.22 (0.98‐1.50), respectively. With CSBP and PP entering into models jointly, the HR for CSBP and PP was 1.51 (1.28‐1.78) and 0.98 (0.83‐1.15), respectively. For subgroup analysis, the association of CSBP with CVD was stronger than brachial BP measurements in women, those with hypertension and obesity. In the middle‐aged Chinese population, noninvasively estimated CSBP may offer advantages over brachial BP measurements to predict CVD events, especially for participants with higher risk. These findings suggest prospective assessment of CSBP as a prevention and treatment target in further trials.
    Type of Medium: Online Resource
    ISSN: 1524-6175 , 1751-7176
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2020
    detail.hit.zdb_id: 2058690-5
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  • 2
    In: Journal of the American Heart Association, Ovid Technologies (Wolters Kluwer Health), Vol. 8, No. 6 ( 2019-03-19)
    Abstract: Data regarding the metabolic risk factors clustering on the risk of left ventricular diastolic dysfunction ( LVDD ) are lacking among people living at high altitude and under hypoxic conditions. In this study, we explored the association between metabolic risk factor clustering and LVDD among the Tibetan population of China. Methods and Results We conducted a cross‐sectional survey in a representative sample of 1963 Tibetans in 2014 to 2016. Grading LVDD was based on recommendations for the evaluation of LV diastolic function by echocardiography (2009). The prevalence of LVDD among 1963 participants (mean age: 51.51 years, 41.11% male) was 34.39%. Odds ratios (95% CI ) of LVDD for the 1, 2, and 3 to 5 risk factors clustering were 1.45 (0.96–2.17), 2.68 (1.8–3.98), and 2.9 (1.9–4.43), respectively ( P for trend 〈 0.001). The association between metabolic risk factors clustering and LVDD was much more pronounced in the middle‐aged group than in the elderly ( P for interaction=0.0170). High altitude was one of the major independent risk factors for LVDD ; however, habitation altitude had no significant effect on the association between metabolic risk factors and LVDD ( P for interaction=0.1022). The multivariable dominance analysis indicated that abdominal obesity, hypertension, and elevated blood glucose were the significant contributors to LVDD . Conclusions There was a significant positive association between the metabolic risk factor clustering number and LVDD among a population living at high altitude, especially in middle‐aged adults. However, habitation altitude itself has no significant effect on the association between metabolic risk factors and LVDD .
    Type of Medium: Online Resource
    ISSN: 2047-9980
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2019
    detail.hit.zdb_id: 2653953-6
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  • 3
    Online Resource
    Online Resource
    Ovid Technologies (Wolters Kluwer Health) ; 2019
    In:  Circulation: Cardiovascular Quality and Outcomes Vol. 12, No. Suppl_1 ( 2019-04)
    In: Circulation: Cardiovascular Quality and Outcomes, Ovid Technologies (Wolters Kluwer Health), Vol. 12, No. Suppl_1 ( 2019-04)
    Abstract: Background: In 2017, the American College of Cardiology (ACC) and the American Heart Association (AHA) published guidelines on the diagnosis and treatment of high BP (blood pressure) in adults. The impact of clinic outcome and economy need to be estimated for adopting the guidelines in China. Methods: Data from a nationally representative sample in China were analyzed. The prevalence and treatment were calculated based on the criteria of the 2017 ACC/AHA and 2010 Chinese guidelines among participants aged ≥35 years old. Direct medical costs, as well as the averted disability adjusted of life years (DALYs) and cost saving from cardiovascular disease (CVD) events prevented by controlling hypertension, were also estimated. Results: The prevalence and treatment rate of hypertension was 32.0% and 43.4% according to the 2010 Chinese guidelines. Based on the 2017 ACC/AHA guidelines, another 24.5% of the adult population (estimated 168.1 million) would be classified with hypertension; of which about 32.1 million hypertensive patients would need to be pharmaceutically treated to reach the current treatment rate of 43.4% ( Table 1 ). As a result, an additional 288.1 billion Chinese currency Renminbi (RMB) of direct medical cost will be required for the lifetime. The new guidelines would reduce lifetime costs by 22.77 billion RMB, while preventing 1,292,881 DALYs lost due to CVD events ( Table 2 ). Conclusions: Application of the 2017 AHA/ACC guidelines in China will substantially increase the prevalence of hypertension and produce a large increase of therapy costs, although it would prevent CVD events and save DALYs. The newly released 2018 Chinese Blood Pressure Management Guidelines defined normal BP as systemic BP 〈 140/diastolic BP 〈 90 mm Hg.
    Type of Medium: Online Resource
    ISSN: 1941-7713 , 1941-7705
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2019
    detail.hit.zdb_id: 2453882-6
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  • 4
    In: Journal of Hypertension, Ovid Technologies (Wolters Kluwer Health), Vol. 38, No. 5 ( 2020-05), p. 829-838
    Type of Medium: Online Resource
    ISSN: 0263-6352 , 1473-5598
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2020
    detail.hit.zdb_id: 2017684-3
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