Evidence regarding how collective exerkines mediate the association between physical activity (PA) and heart failure (HF) risk in older adults with prediabetes and diabetes remains limited. This prospective cohort study enrolled 5,886 older adults with prediabetes or diabetes from community dwellings in Shandong, China, between 2008 and 2011. PA metabolic equivalent task (MET) scores and plasma concentrations of ten exerkines, such as brain-derived neurotrophic factor (BDNF) and interleukin (IL)−6, were evaluated. The new-onset of HF during follow-up served as the outcome. Over a median follow-up of 11.1 years, 615 participants developed HF, with an incidence rate of 9.59 per 1000 person-years. A U-shaped dose-response association emerged between PA MET scores and HF risk. Compared to light PA, moderate and vigorous PA reduced HF risk by 57.0

Train travel trajectories are of interest to various stakeholders, especially for energy-efficient traction control and energy-efficient timetabling. Various single-train models exist to simulate a train’s longitudinal motion, most of which are based on numerical methods. The nonlinearity in the equation of motion limits the use of analytical methods, which have been hampered either by incomplete solutions or by inaccurate linearized solutions. In this work, variational calculus has been used to derive analytical solutions for the longitudinal motion of a train that can cover the entire piecewise regions of traction and braking curves. Then, usingthese analytical solutions, a parametric single-train analytical model has been created. The analytical solutions and the resultant model provide a faster, more efficient approach to developing train travel trajectories. Further, the accuracy of the analytical model has been verified against two numerical single-train models. Finally, four cases have been studied using the analytical model to demonstrate its broad and versatile applicability, which can help to solve both stochastic and deterministic problems.

Purpose To investigate the modifying role of obesity in the association between abnormal glucose metabolism and atrial fibrillation (AF) risk in older individuals. Methods From April 2007 to November 2011, 11663 participants aged ≥60 years were enrolled in Shandong area. Glucose metabolic status were determined using fasting plasma glucose and hemoglobin A1c levels, obesity determined using body mass index (BMI), waist-to-hip ratio (WHR), and visceral fat area (VFA). Obesity-associated metabolic activities were assessed using adiponectin-to-leptin ratio (ALR), galectin-3, and triglyceride-glucose index (TyG). New-onset AF was diagnosed by ICD-10. Results During an average of 11.1 years of follow-up, 1343 participants developed AF. AF risks were higher in those with prediabetes, uncontrolled diabetes, and well-controlled diabetes than with normoglycemia. The hazard ratios were decreased by 14.79%, 40.29%, and 25.23% in those with prediabetes, 31.44%, 53.56%, and 41.90% in those with uncontrolled diabetes, and 21.16%, 42.38%, and 27.59% in those with well-controlled diabetes after adjusting for BMI, WHR, and VFA, respectively. The population attributable risk percentage of general obesity, central obesity, and high VFA for new-onset AF were 10.43%, 34.78%, and 31.30%, respectively. ALR, galectin-3, and TyG significantly mediated the association of BMI, WHR, and VFA with AF risk (all Padj. <0.001). Conclusions Obesity mediates the association between abnormal glucose metabolism and AF risk in older individuals. WHR is an effective modifier than BMI and VFA for moderating the association. ALR, TyG, and galectin-3 mediate the moderating effect of obesity on the association between abnormal glucose metabolism and AF risk.

BACKGROUND Sacubitril/valsartan (S/V) has been shown to be an effective antihypertensive drug combination. However, its therapeutic effects on blood pressure (BP), hemodynamics, and left ventricular (LV) remodeling in resistant hypertension (RHTN) remain unclear. METHODS Eighty-six patients completed this self-control study, during which olmesartan was administered within the first 8 weeks (phase 1), followed by S/V within the second 8 weeks (phase 2), with nifedipine and hydrochlorothiazide taken as background medications. Office BP, echocardiography, and hemodynamics assessment using impedance cardiography were performed at baseline and at the eighth and sixteenth weeks. RESULTS The reduction in office BP was larger in phase 2 than in phase 1 (19.59/11.66 mmHg vs. 2.88/1.15 mmHg). Furthermore, the treatment in phase 2 provided greater reductions in systemic vascular resistance index (SVRI) and thoracic blood saturation ratio (TBR), with differences between the two phases of-226.59 (-1212.80 to 509.55) dyn$s/ cm(5)/m(2) and-0.02 (-0.04 to 0.02). Switching from olmesartan to S/V also significantly reduced E/E', LV mass index, LV end-diastolic volume index, and LV end-systolic volume index (all P < 0.05). Decreases in arterial stiffness, SVRI, and TBR were correlated with changes in indicators of LV remodeling (all P < 0.05). This correlation persisted even after adjusting for confounders including changes in BP. CONCLUSIONS Switching from olmesartan to S/V effectively lowered BP and reversed ventricular remodeling in RHTN. In addition, hemodynamic improvement was also observed. Changes in hemodynamics played an important role in reversing LV remodeling of S/V, and were independent of its antihypertensive effect. (Hellenic Journal of Cardiology 2025;84:51-60) (c) 2024 Hellenic Society of Cardiology. Publishing services by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

ABSTRACT Background Appendicular skeletal muscle mass index (ASMI), a crucial indicator of sarcopenia and estimated glucose disposal rate (eGDR), a surrogate marker of insulin resistance (IR), are associated with the risk of cardiovascular diseases. However, it remains unclear whether the collective effects, including the impact of the temporal progression of ASMI and eGDR, affect atrial fibrillation (AF) risk. This study aims to elucidate the association between the collective effects of ASMI and eGDR and AF risk in the non‐diabetic older population. Methods A total of 8060 non‐diabetic older individuals from a community‐based cohort study were used to prospectively analyse the association between the collective effects of baseline ASMI and eGDR and AF risk. Among them, 7651 were eligible and used for dual‐trajectory analysis of the association between dual trajectory of ASMI and eGDR and AF risk. The temporal development of ASMI and eGDR over time was determined using a dual‐trajectory model. Statistical analyses involved restricted cubic splines and Fine–Gray competing risk models, adjusting for potential confounders. Results In the prospective analysis, the hazard ratio (HR) of AF was 1.762 (95% confidence interval [CI]: 1.528–2.032) in the low ASMI group compared to the normal ASMI group in total participants. Restricted cubic splines analysis demonstrated L‐shaped associations between AF risk and ASMI and eGDR, with inflection points at 7.23 kg/m2 and 7.85 mg/kg/min, respectively. Low ASMI and moderate and low eGDR exhibited a significant interplay for increasing AF risk (HR: 1.290 and 1.666, 95% CI: 1.136–1.464 and 1.492–1.861, respectively, padj. < 0.001). One‐SD increment ASMI and eGDR synergistically reduced AF risk (HR: 0.896, 95% CI: 0.839–0.957, padj. < 0.001). In the dual‐trajectory analysis for total participants, five distinct dual trajectories of ASMI and eGDR were identified. Group 4, characterized by moderate‐stable ASMI and moderate‐stable eGDR, exhibited the lowest incidence of AF (7.03 per 1000 person‐years) and was used as a reference for further analyses. Group 1, characterized by high‐decrease ASMI and high‐decrease eGDR, had the highest AF risk (HR: 2.255, 95% CI: 1.769–2.876, padj. < 0.001), followed by Group 5, with high‐decrease ASMI and low‐stable eGDR (HR: 1.893, 95% CI: 1.491–2.403, padj. < 0.001) when compared to Group 4 after adjustment for potential confounders including baseline ASMI and eGDR. Conclusions The collective effects of ASMI and eGDR are significantly associated with AF risk in the non‐diabetic older population. Collective management of skeletal muscle mass and IR might be a useful and effective management strategy for preventing and controlling AF.

Traction motors, as essential electromechanical energy conversion devices, play a vital role in heavy-haul locomotives. The transition of railway transportation to higher power, higher speeds, and heavier axle loads intensifies dynamic interactions within locomotive traction systems. This shift results in more frequent motor failures, significantly affecting the performance of the traction transmission system. Previous studies have relied on dq -axis motor models, making it challenging to adjust motor parameters to accurately simulate various motor fault types and severities. Consequently, the impact of motor faults on locomotive traction transmission systems has not been thoroughly explored. To address this gap, this paper aims to develop a locomotive dynamics model incorporating the traction transmission system. The model replaces the dq -based motor model with an improved multiple coupled circuit model considering the interaction between the stator and rotor-bearing system. This enables a more precise simulation of the electromechanical dynamic interactions of traction motors within the traction transmission system under varying levels of fault severity. The electromechanical response characteristics and influence laws of the traction transmission system under conditions of broken rotor bars and stator inter-turn short-circuit faults are investigated. The results indicate that broken rotor bars cause low-frequency fluctuations in stator current, pulsating torque, and significant variations in wheel–rail longitudinal forces. An increase in broken rotor bars further amplifies fluctuations in the electromechanical response. Stator inter-turn short circuits result in three-phase current unbalances and elevated amplitudes at specific frequencies. The short-circuit turn ratio exerts a more significant influence on current unbalance than the short-circuit resistance. Under motor faults, the electromechanical coupling effects become weakened. This research provides a theoretical foundation for fault diagnosis in locomotive traction motors.

Purpose Adding an appropriate pre-sag to the geometry of simple catenary systems for electric railways can improve their performance in dynamic interaction with the pantographs of trains operating under them. The value of pre-sag can be obtained by empirical approximation or computationally expensive optimisation. This study aims to define a simple but accurate method to determine a suitable pre-sag without dynamic simulations and to find its limitations. Design/methodology/approach A quasi-static method to determine the ideal value of pre-sag is described based on elasticity variations. It considers variations of the static contact force. The limits of this method are investigated by comparing it to a parametric dynamic simulation study. In the dynamic simulation, an optimal level of pre-sag is identified for each contact force level. The influence of the speed in the dynamic simulation results is expressed in two parameters: the quasi-static influence in the mean contact force and the dynamic influence in the ratio between the vehicle speed and the wave propagation speed in the contact wire. Findings The comparison between the suggested method and the dynamic simulations shows a high consistency up to a speed limit of around 40 % of the wave propagation speed. The best agreement with the dynamic results is achieved by calculating the optimal pre-sag based on the absolute elasticity variation. Practical implications u2013 The simplified approach for determining the pre-sag is valid for low-speed applications, such as suburban railway lines. For these cases, a highly suitable geometry can be obtained with the suggested method, meaning a significantly reduced computational effort. As a case study for this work, the results are applied to a Swedish suburban rail line upgrade case. Originality/value The static uplift force is added as a varied parameter in dynamic simulations. The shift in system behaviour from low to high dynamics is described, and how the benefits from pre-sag are visible and then disappear. The limit value of the low-dynamics regime is identified to be 40 %.

Skeletal muscle mass loss and insulin resistance (IR) are associated with cardiovascular diseases risk. However, it remains unclear whether the combination of skeletal muscle mass loss and elevated IR affects heart failure (HF) risk. Here, we investigate the association between a combination of appendicular skeletal muscle mass index (ASMI) with estimated glucose disposal rate (eGDR) and HF risk in older adults. A prospective analysis and a dual-trajectory analysis were carried out to investigate the association of the combined effect of ASMI and eGDR with HF risk. A total of 11,596 adults aged ≥ 60 years were enrolled from the community for prospective analysis. Among them, 10,489 were eligible for the dual-trajectory analysis. The temporal evolution of ASMI and eGDR was determined using a dual-trajectory model. In the prospective analysis, 1087 individuals developed HF. Restricted cubic splines analysis showed L-shaped associations between ASMI and eGDR and HF risk. HF risk decreased by 32.3

Atherosclerosis (AS) is a chronic disease initiated by vascular endothelial dysfunction, with low shear stress (SS) being a critical inducing factor in this dysfunction. Apoptosis, a form of programmed cell death, is closely associated with AS progression. However, the impact of low SS on endothelial apoptosis and its specific molecular mechanisms remains unclear. Our study revealed that low SS induces apoptosis in endothelial cells and contributes to endothelial dysfunction. Under low SS conditions, miR-330 expression was markedly upregulated, which subsequently targeted and inhibited SOD2 expression, leading to ROS accumulation and oxidative stress. Overexpression of SOD2 under low SS conditions markedly elevated HSP70 expression, contributing to endothelial homeostasis. However, when HSP70 expression was inhibited in the context of SOD2 overexpression, there was a significant increase in pro-apoptotic proteins (BAX and cleaved-caspase-3) and total apoptosis rate, along with a significant reduction in endothelial function markers such as nitric oxide and endothelial nitric oxide synthase. Notably, our experiments indicated no direct interaction between SOD2 and HSP70. Furthermore, inhibiting ROS production significantly raised HSP70 expression, suggesting that SOD2 regulates HSP70 in an indirect process involving ROS. In summary, our findings elucidate that low SS induces endothelial apoptosis and dysfunction through the miR-330/SOD2/HSP70 signaling pathway, providing valuable insights into AS intervention and prevention.

BACKGROUND:Evidence of an association between sarcopenic obesity (SO) and the risk of long-term atrial fibrillation (AF) is lacking, and the underlying involvement of insulin resistance (IR) and inflammation is not clear. METHODS:This community-based prospective cohort study evaluated sarcopenia, obesity, and baseline clinical characteristics in 4321 non-diabetic older adults between 2007 and 2011. Sarcopenia was identified using skeletal muscle mass/body weight (SMM/BW), appendicular lean mass (ALM)/BW, and handgrip strength (HGS), and obesity was identified by fat mass (FM)/BW. The association of sarcopenia and obesity with AF risk was determined by Kaplan-Meier analysis and a Cox proportional hazards model. Interaction analysis, a restricted cubic splines model, mediation analysis, and a Fine-Gray competing-risk model were also used. RESULTS:Over an average of 10.9 years of follow-up, 546 (11.98 per 1000 person-years) participants developed AF. Low SMM/BW, low ALM/BW, low HGS, high FM/BW, sarcopenia and obesity, were significantly associated with an increased AF risk. There was a significant synergistic relationship between sarcopenia and obesity in the increased AF risk [hazard ratio (HR): 2.029, 95 % confidence interval (CI): 1.639-2.512]. Compared with participants without sarcopenia and obesity, AF risk was the highest in those with SO (HR: 2.669, 95 % CI: 2.110-3.377], followed by sarcopenia alone (HR: 1.980, 95%CI: 1.453-2.699) and obesity (HR: 1.839, 95%CI: 1.475-2.292). Mediation analysis found that estimated glucose disposal rate (a surrogate marker of IR), high-sensitivity C-reactive protein, and galectin-3 were mediating factors in the increased AF risk caused by SO, accounting for 34.87 %, 27.56 %, and 21.05 % of the total effect, respectively. CONCLUSIONS:SO significantly increased AF risk in these non-diabetic older individuals. Sarcopenia and obesity not only acted alone but also exhibit had a synergistic relationship to increase AF risk. IR and inflammation mediated the increased AF risk associated with SO.

In railway signalling systems, trackside equipment and signalling devices are controlled by wayside object controllers (OC). With the application of radio communication to wirelessly transmit command control and signals, the cost of cabling and installation has been significantly reduced. However, for non-electrified regional lines in rural areas, dedicated cables are still installed along the track to drive the wayside object controllers, which increases both capital and operational costs. With the development of renewable energy sources (RES) and wayside energy storage systems (ESS), a concept of smart wayside object controllers (SWOC) is proposed, which are autonomous, off-grid and powered by local renewable energy sources to reduce the related costs. To assist future system development, this work develops methods to not only calculate power and energy demand for system configuration but also estimate the life cycle cost in long-term operation. A case study based on a railway test site in Sweden is performed. This study shows that it is sufficient to use 100% local renewable energy sources to power the SWOC, trackside equipment and signalling devices. Compared with the existing system, the SWOC shows a significant cost saving in long-term operation by removing cabling and installation, reducing trackside maintenance and replacing the power supply with renewable energy power sources for decarbonisation. Therefore, the SWOC shows its significant benefits over the existing system from both economical and environmental aspects. In the end, some suggestions for future development and implementation of SWOC are given.

Increased equivalent conicity of wheels because of hollow wear during long-term operation influences the ride comfort performance of Chinese highspeed trains. To investigate the evolution of wheel wear, a high-speed train operating on the Beijing-Shanghai Railway line at maximum operational speed of 350 km/h is monitored over a time of 1.5 years. An MBS based wear calculation software tool of KTH using stochastic simulation inputs has been used for wear prediction, where the vehicle suspension parameters and global structural modes of car-body and bogie frame have been identified using roller rig measurements and dynamic track measurements as well to validate the simulation models. The calculated wear is then validated against measurements by calibrating the wear rate coefficients. The influence of initial conicity on the lateral wear distribution is analyzed. Wheel profiles with lower initial conicities result in significantly less wear but more vibrations which possibly worsen the ride comfort. Increasing the roll-stiffness shows to be an effective way to damp the low frequency vibrations for the low conicity wheel while resulting in low wear. The suspension parameters and initial conicity which give the most stable equivalent conicity evolution and best ride comfort are selected for field tests.

This work applies numerical simulations and a drive cycle perspective for the estimation of wear on rail vehicle collector strips using an existing heuristic wear model. As it is crucial to understand the origin of wear patterns to ensure long service life, the proposed analysis method allows to identify the contribution of each drive stage during operation to the wear pattern and to compare their wear rates against each other. Input data is created by numerically simulating the power intake of a rail vehicle during a drive cycle between two stations and extracting power-speed couples for characteristic drive stages. The dynamic interaction between pantograph and catenary is then simulated using a FE-representation of the catenary and a pantograph modelwith two individually suspended flexible collector strips. Using these transient time signals as input data to the heuristic wear model, the lateral wear distribution along both collector strips can be estimated for each drive stage. Here, a representative run of a Swedish X2 higher speed train is used as a case example. The results show that mechanical wear dominates on average, but that there is a considerable electrical wear intensity, especially during acceleration. This contribution is however relativised by the short distance covered in this stage, and the total wear pattern is dictated by the cruising stage. The wear patterns show high dependence on the evaluated frequency range in the force signal.

Glucose metabolic disorder is associated with the risk of heart failure (HF). Adiposity is a comorbidity that is inextricably linked with abnormal glucose metabolism in older individuals. However, the effect of adiposity on the association between glucose metabolic disorder and HF risk, and the underlying mechanism remain unclear. A total of 13,251 participants aged ≥ 60 years from a cohort study were categorized into euglycemia, prediabetes, uncontrolled diabetes, and well-controlled diabetes. Adiposity was assessed using body mass index (BMI), waist-to-hip ratio (WHR), and visceral fat area (VFA). Adiposity-associated metabolic activities were evaluated using adiponectin-to-leptin ratio (ALR), homeostatic model assessment of insulin resistance (HOMA-IR), and triglyceride-glucose index (TyG). The first occurrence of HF served as the outcome during the follow-up period. A total of 1,138 participants developed HF over the course of an average follow-up period of 10.9 years. The rate of incident HF occurrence was higher in prediabetes, uncontrolled diabetes, and well-controlled diabetes participants compared to that in euglycemia participants. However, the high rates were significantly attenuated by BMI, VFA, and WHR. For WHR in particular, the hazard ratio for incident HF was 1.18 (95

Rail corrugation is a typical rail cyclical disease which often occurs on heavy haul, urban transit, and high-speed railways. Rail corrugation has a significant impact on vehicle dynamic performance, especially on the axle box acceleration. It may cause the bolts of axle box to loosen or break the rail fastener, and even affect the operation of vehicle. Therefore, it is necessary to discover rail corrugation in time and to repair it by rail grinding, which is an important way to improve the safety of the vehicle. A numerical analysis method based on adaptive time-frequency feature extraction is proposed in this paper. First, acceleration sensors are installed on both the left and right side of the axle box. Then the vibration features of the axle box are extracted according to the line mileage segmentation based on the adaptive time-frequency feature extraction method proposed in this paper. Finally, the impact of different wavelength and different section length of rail corrugation is compared using field test data. The test results show that the method proposed in this paper can accurately extract the features of different wavelength and different section length of rail corrugation. Moreover, compared with traditional methods, this method is proven to be strongly adaptive and highly accurate.

The increasing operation speed of high-speed trains allows the pantograph to continuously interact with the catenary over a long distance in a short time, and many new methods have been developed to efficiently calculate its dynamics. However, the existing methods only consider simple catenary systems, which limits their application in high-speed railway systems. In this work, a reduced pantograph–stitched-catenary interaction model is developed to simulate pantograph–stitched-catenary interactions during long-distance travel. Based on the existing reduced catenary model, the stitched catenary system is first considered, where the stitched wire is simplified into a part of the messenger wire supported by two spring-damping elements. The present model is validated by test results and the EN 50318:2018 standard, and it is subsequently used to study the dynamic performance of the pantograph–stitched-catenary system at an overdesigned speed in Sweden. The results show that the proposed model can be seven times faster than the traditional modal superposition method with the same accuracy in a stitched catenary system, and the existing catenary system cannot be operated at an overdesigned speed without increasing the contact wire tension. The present model gives an efficient solution to pantograph–stitched-catenary interaction problems.

To investigate the effect of rosuvastatin on gait and balance disorder progression and elucidate the role of cerebrovascular reactivity (CVR) on this effect. From April 2008 to November 2010, 943 hypertensive patients aged ≥60 years were enrolled from the Shandong area of China. Patients were randomized into rosuvastatin and placebo groups. Gait, balance, CVR, fall and stroke were assessed. During an average 72 months of follow-up, the decreasing trends for step length, step speed, and Berg balance scale scores and the increasing trends for step width and chair rising test were slower in the rosuvastatin group when compared to the placebo group. The hazard ratio of incident balance impairment and falls was 0.542 [95% confidence interval (CI) 0.442-0.663] and 0.532 (95% CI 0.408-0.694), respectively, in the rosuvastatin group compared with placebo group. For CVR progression, the cerebrovascular reserve capacity and breath-holding index were increased and the pulsatility index decreased in the rosuvastatin group, while the cerebrovascular reserve capacity and breath-holding index were decreased, and pulsatility index increased in the placebo group. The changes in gait stability and balance function were independently associated with the changes in the CVR. The odds risks of balance impairment and falls were 2.178 (95% CI: 1.491-3.181) and 3.227 (95% CI: 1.634-6.373), respectively, in the patients with CVR impairment and patients without CVR impairment. Rosuvastatin ameliorated gait and balance disorder progression in older patients with hypertension. This effect might result from the improvement in the CVR. This double-blind clinical trial recruited 943 hypertensive patients aged ≥60 years who were randomly administered rosuvastatin and placebo interventions. The data indicates that rosuvastatin significantly ameliorated the progressions of gait and balance disorders in older hypertensive patients. The cerebrovascular reactivity might play an important mediating role in this amelioration.

Purpose The objective of this study is to investigate the impact of longitudinal forces on extreme-long heavy-haul trains, providing new insights and methods for their design and operation, thereby enhancing safety, operational efficiency and track system design. Design/methodology/approach A longitudinal dynamics simulation model of the super long heavy haul train was established and verified by the braking test data of 30,000 t heavy-haul combination train on the long and steep down grade of Daqing Line. The simulation model was used to analyze the influence of factors on the longitudinal force of super long heavy haul train. Findings Under normal conditions, the formation length of extreme-long heavy-haul combined train has a small effect on the maximum longitudinal coupler force under full service braking and emergency braking on the straight line. The slope difference of the long and steep down grade has a great impact on the maximum longitudinal coupler force of the extreme-long heavy-haul trains. Under the condition that the longitudinal force does not exceed the safety limit of 2,250 kN under full service braking at the speed of 60 km/h the maximum allowable slope difference of long and steep down grade for 40,000 t super long heavy-haul combined trains is 13‰, and that of 100,000 t is only 5‰. Originality/value The results will provide important theoretical basis and practical guidance for further improving the transportation efficiency and safety of extreme-long heavy-haul trains.

Energy and maintenance costs constitute a large part of the recurring cost for railway operation. The vehicle weight impacts both energy consumption and the need for tamping of the track, while curving performance impacts the curving resistance and the wear on wheels and rails. In the project RUN2Rail and further in NextGear, both parts of the EU-funded initiative Shift2Rail, a single axle running gear with composite frame and active wheelset guidance was proposed for metro vehicles.

Objective To investigate the effects of lipid-lowering therapy on endothelial function and mitophagy in the elderly patients with hypertension, and to explore the correlation of endothelial function with mitophagy.Methods A total of 672 patients who took physical examination in Cardiovascular and Cerebrovascular Disease Prevention and Research Center of Shandong Academy of Medical Sciences from April 2015 to November 2017 were selected as the study subjects.According to their blood pressure and plasma lipids and anti-hypertensive and/or lipid-lowering treatments, the participants were divided into hypertension without lipid-lowering group（n=135）,hypertension combined with hyperlipidemia without lipid-lowering group（n=201）,hypertension with lipid-lowering group（n=163）,and hypertension combined with hyperlipidemia and lipid-lowering group（n=173）.Results After two years’ treatment, the systolic and diastolic blood pressure and plasma levels of ET1,DRP1,and Fis1 were decreased, whereas FMD and the plasma levels of NO,PINK1,Parkin, LC3,Mfn1 and OPA1 were increased in all four groups.Compared to the groups without lipid-lowering, the changes of IMT,DRP1,and Fis1 were significant lower, while PINK1,Parkin, LC3,Mfn1,and OPA1 were higher in the groups with lipid-lowering（P＜0.05）.After adjustment for confounders, the changes in PINK1,Parkin, LC3,DRP1,Fis1,Mfn1,and OPA1 were independent influencing factors for the changes in IMT,FMD,ET1 and NO（P＜0.01）.Conclusion Statin lipid-lowering therapy can ameliorate endothelial dysfunction in elderly hypertensive patients by improving mitophagy.