ABSTRACT Mucin‐1 was reported be correlated with organ fibrosis. Pulse pressure amplification (PPA) was a marker of arterial stiffness. We investigate the association of serum mucin‐1 (CA15‐3) concentration with peripheral and central blood pressure and PPA in untreated Chinese patients. The study participants were outpatients who were suspected of hypertension, but had not been treated with antihypertensive medication for at least two weeks. Serum mucin‐1 (CA15‐3) concentration was measured by the enzyme‐linked immunosorbent assay method. PPA was the brachial‐to‐aortic pulse pressure ratio. The 1761 participants included 916 (52.0%) women, and 578 (32.8%) participants with clinic hypertension. Mean (±standard deviation [SD]) age was 51.3±10.6 years. After adjustment for confounders, higher serum mucin‐1 (CA15‐3) concentration was significantly associated with higher peripheral and central systolic and diastolic blood pressure ( p ≤0.009) and lower PPA ( p = 0.037). Among 428 participants with a PPA equal or greater than 130% at baseline, 185 progressed to be a lower PPA (<130%) during a median follow‐up of 4.65 years. Hazard ratio expressed the relative risk of lower PPA per 1 SD increment in the log transformed serum mucin‐1 (CA15‐3) concentration was 1.22 ( p = 0.027). In women but not in men, the risk of lower PPA was significantly higher with increased baseline serum mucin‐1 (CA15‐3) concentration ( p for interaction 0.015). Higher circulating mucin‐1 (CA15‐3) concentration was independently associated with higher peripheral and central blood pressure and lower PPA in untreated Chinese patients. It also correlated with the progression of arterial stiffness as indicated by a lower PPA, especially in women.

The incidence of acute-onset autoimmune hepatitis (A-AIH) is increasing, yet diagnosis remains challenging, especially in patients with recent hepatotoxic drug exposure. The clinical presentations of A-AIH and drug-induced autoimmune-like hepatitis (DI-ALH) at onset are often indistinguishable, complicating timely diagnosis. We conducted a three-center retrospective study in China, screening patients with acute liver injury, hepatotoxic drug exposure, and autoimmune features. Patients were ultimately classified as DI-ALH if they achieved sustained remission after culprit drug cessation, or as A-AIH if they relapsed. We compared baseline demographics, laboratory indices, immunological profiles, liver histology, and established AIH diagnostic criteria. We developed and independently validated a multivariable logistic regression model to improve discrimination between A-AIH and DI-ALH. Of 458 patients screened, 238 met inclusion criteria and constituted the final cohort (94 A-AIH and 144 DI-ALH). Compared to DI-ALH, A-AIH showed significantly higher IgG levels, lower platelet counts, and higher autoantibody titers. Histologically, A-AIH exhibited more severe portal inflammation, interface hepatitis, fibrosis, and rosette formation. The discriminatory capacity of the 2022 and 2008 histological criteria was limited and comparable (AUC 0.62 vs. 0.59, p = 0.616). The Dx-AID score, incorporating platelet count, IgG, autoantibodies, and histological features, achieved high diagnostic accuracy in both the derivation cohort (AUC 0.84, 95

Metabolic dysfunction-associated steatotic liver disease (MASLD) is highly prevalent among patients with cardiovascular disease but remains underrecognized in routine cardiology practice. To address the limited prospective evidence on its progression and clinical impact, we established the CHAIN cohort, a prospective multicenter study enrolling approximately 15 000 adults undergoing coronary evaluation across 40 tertiary hospitals in China. Baseline assessment includes comprehensive cardiometabolic profiling and vibration-controlled transient elastography for evaluation of liver fibrosis and steatosis. Participants will undergo long-term follow-up with repeated liver assessments every 6-12 months. Primary outcomes include liver-related events and major adverse cardiovascular events, while secondary outcomes include longitudinal changes in liver fibrosis and steatosis and their associations with cardiometabolic risk factors and clinical outcomes. This cohort will provide longitudinal evidence to support risk stratification and integrated heart-liver management in cardiovascular care.

Introduction: Biological rather than chronological age (C-age) drives deviation from healthy aging. This study aimed to identify a plasma metabolomic signature indicative of age-related cardiovascular risk (pMTB-age) predicting vascular morbidity and mortality. Methods: Nuclear magnetic resonance identified 38 plasma metabolites in two population cohorts: the Flemish cohort examined as discovery (N = 719 [2005–2010]) and internal replication cohort (N = 580/719 [2009–2013]) and the external replication Spanish Hortega cohort (N = 811 [2001]). Results: The trained model (pMTB-age), relating C-age to the plasma metabolome derived by elastic net regression, included 18 metabolites (six amino acids) and explained from 28.6% to 22.9% of C-age in the discovery and replication data. Feature importance of the retained metabolites derived by SHapley Additive exPlanation showed large interindividual variability in the relation between C-age and pMTB-age. In Flemish and Spanish, cardiovascular risk factors were significantly associated with C-age, pMTB-age, and pMTB-age uncorrelated from C-age (pMTB-age-R). In Flemish (median follow-up 12.3 years) and Spanish (18.8 years), mortality and cardiovascular complications correlated with C-age and pMTB-age. In Flemish, cardiac endpoints (hazard ratio [95% CI] 1.28 [1.00–1.63]) and its components kept significance in relation to pMTB-age-R. The pathway analysis revealed overrepresentation of glycine, serine, and threonine. Conclusions: pMTB-age is a multidimensional biomarker, which identifies individuals with accelerated vascular aging with high precision and combined with the pathway analysis highlights the role of amino acids in vascular disease. Therefore, pMTB-age can guide risk stratification and the personalized and timely prevention and treatment tailored to an individual’s unique pMTB-age profile.

BACKGROUND/AIMS:Diabetic retinopathy (DR) is a major ocular complication of diabetes mellitus. While artificial intelligence (AI)-based DR screening tools have gained widespread adoption, most research focuses on comparing AI performance with human, with limited attention to AI's role as assistants. This study evaluates the impact of AI-assisted decision-making on DR diagnosis and grading based on colour fundus photographs (CFP) and ultra-widefield fundus (UWF) images. METHODS:A total of 224 retinal images were analysed by 21 ophthalmologists and primary care physicians (PCPs) in China. Participants independently diagnosed and graded DR based on CFP and UWF images. After a 1-week interval, they repeated the task with AI assistance. Diagnosis accuracy was compared with a gold standard before and after AI assistance. Incremental costs and accuracy improvements were assessed using generalized estimating equations (GEE) models. RESULTS:AI assistance significantly improved DR diagnosis accuracy for both CFP and UWF images. For CFP, accuracy increased from 79.90% to 85.68% for PCPs, 81.19% to 88.69% for ophthalmic residents and 81.41% to 88.05% for ophthalmic attendings. Similar improvements were observed for UWF, with accuracy rising from 83.62% to 89.66% for residents and from 81.31% to 88.98% for attendings. GEE analysis revealed an incremental cost of 4.79 units and an accuracy improvement of 0.35 units with AI assistance. CONCLUSION:AI assistance shows potential in improving the accuracy of DR diagnosis and grading. Despite the associated costs, AI enables ophthalmologists to achieve superior diagnosis, facilitating earlier DR detection and treatment.

Background:The incidence of insulin resistance, as determined by estimated glucose disposal rate (eGDR), is associated with various morbidities. The relationship between eGDR and chronic liver diseases remains to be explored. This study examined the association between eGDR and the risk of future metabolic dysfunction-associated steatotic liver disease (MASLD), cirrhosis, liver cancer, and liver-related mortality. Method:We analyzed data from UK Biobank participants with no history of liver diseases. We calculated the eGDR values for each participant and divided them into four quartile groups based on these values. The primary outcome was MASLD, whereas the secondary outcomes included cirrhosis, liver cancer, and liver-related mortality. We estimated hazard ratios (HRs) and 95% confidence intervals (CIs) using Cox proportional hazard regression models. We used restricted cubic splines models to detect potential non-linear relationships. Results:This study included data from 290,397 UK Biobank participants who had no history of liver diseases, and the magnetic resonance imaging (MRI)-derived liver proton density fat fraction (PDFF) analysis included 25,810 individuals. Over a median follow-up period of 15.69 years, we identified 3,926 cases of MASLD, 1,553 cases of cirrhosis, 167 cases of liver cancer, and 120 cases of liver-related mortality. After adjusting for multiple variables, higher eGDR levels were significantly associated with a lower risk of MASLD (HR: 0.91, 95% CI: 0.90-0.93), cirrhosis (HR: 0.89, 95% CI: 0.86-0.92), and liver cancer (HR: 0.91, 95% CI: 0.83-1.00). Comparing participants between the lowest and highest quartiles (Q1 and Q4) of eGDR, Q4 had a 47% lower risk of MASLD (HR: 0.53; 95% CI: 0.45-0.63), with similar results for cirrhosis. Moreover, high eGDR levels were associated with a low risk of MASLD based on MRI-derived liver PDFF > 5% (odds ratio: 0.98, 95% CI: 0.97-0.98). Conclusion:We found a significant inverse correlation between eGDR and MASLD, cirrhosis, and liver cancer. Incorporating eGDR into clinical decision-making can improve the long term follow-up of patients with MASLD.

Purpose:Stroke remains a leading cause of death and disability worldwide, with carotid intima-media thickness (IMT) and carotid plaque being significant predictors of cerebrovascular diseases. Despite the established correlation between carotid IMT and stroke, the specific factors influencing IMT in populations with unstable plaques are not well understood. This study aimed to identify the influential factors affecting carotid IMT in individuals with asymptomatic (without prior cardiocerebrovascular events) unstable plaques and to explore sex-specific differences. Methods:Participants were recruited from 2713 patients who underwent carotid ultrasonography in Tianjin Jixian between 2019 and 2020. A total of 1070 individuals met the inclusion criteria, which required the presence of at least one unstable carotid plaque and no significant renal function abnormalities. Clinical and biochemical assessments were conducted, and carotid ultrasonography was performed to evaluate the IMT and plaque characteristics. Statistical analyses, including univariate and multiple linear regression analyses, were used to identify factors influencing IMT. Results:The study included 1070 patients with asymptomatic unstable plaques, comprising 616 males (57.6%) and 454 females (42.4%), with a mean age of 65.35 ± 7.75 years. Multivariate linear regression analysis confirmed that age (β = 0.247, P < 0.001), diabetes mellitus (β = 0.070, P = 0.046), and creatinine (β = 0.075, P = 0.036) were significant predictors of IMT in the overall population. In males, significant predictors included age (β = 0.209, P < 0.001), creatinine (β = 0.103, P = 0.010), and fasting plasma glucose (β = 0.086, P = 0.028). In females, significant predictors included age (β = 0.293, P < 0.001), diabetes mellitus (β = 0.113, P = 0.011), and smoking (β = 0.132, P = 0.003). These results emphasize the importance of considering sex-specific factors in the assessment and management of carotid atherosclerosis. Conclusion:These findings highlight the critical need for personalized approaches in reducing the risk of cerebrovascular diseases and improving patient outcomes. Among patients with asymptomatic unstable carotid plaques, male individuals need to focus more on renal function, while female requires more vigorous smoking cessation efforts.

We investigated the blood pressure (BP) lowering efficacy of two dual antihypertensive therapies, the amlodipine/benazepril and benazepril/hydrochlorothiazide combinations, according to sodium sensitivity risk (SSR) as assessed by ambulatory BP monitoring (ABPM). In a multi-center, randomized, actively-controlled, parallel-group trial, patients with a clinic systolic/diastolic BP of 140 to 179/90 to 109 mmHg while on benazepril 10 mg daily monotherapy, received 24-week antihypertensive treatment with amlodipine/benazepril 5/10 mg (n = 213) or benazepril/hydrochlorothiazide 10/12.5 mg (n = 212). SSR was assessed with two 24-h ABPM parameters, BP dipper status at night and 24-h mean heart rate. The amlodipine/benazepril combination, compared with benazepril/hydrochlorothiazide combination, showed greater BP lowering effect in 304 patients with low/intermediate SSR, but smaller BP lowering effect in 121 patients with high SSR, with significant (P ≤ 0.046) interaction for 24-h, daytime and morning systolic BP. Indeed, in comparison with the benazepril/hydrochlorothiazide group, 24-h and daytime systolic BP reductions in the amlodipine/benazepril group were 4.19 and 5.17 mmHg, respectively, greater in patients with low/intermediate SSR, while morning systolic BP reductions was 10.8 mmHg smaller in patients with high SSR. Similar trends were observed for the other systolic BP measurements and diastolic BP measurements, although statistical significance was not attained (P ≥ 0.069). Sensitivity analysis in 367 patients with sustained hypertension was confirmatory. In conclusion, the antihypertensive treatment effect of the amlodipine/benazepril and benazepril/hydrochlorothiazide combinations was dependent on SSR as assessed by ABPM, with the former combination being more efficacious in patients with low/intermediate SSR, but less efficacious in patients with high SSR.

Objective: The aim of this study was to evaluate the accuracy of the CONTEC08A oscillometric upper-arm blood pressure (BP) monitor for BP measurement in adults according to the International Organization for Standardization (ISO) 81060-2:2018 and amendment (Amd)1:2020 standard. Methods: Eighty-five subjects (male 40 and female 45) were recruited to fulfill the age, sex, BP, and cuff distribution criteria of the ISO standard in the general population, and had a mean age of 40.2 years. The same arm sequential BP measurement method was used with three differently sized cuffs for the arm circumference ranging from 18 to 26 cm (small), 22-32 cm (medium), and 22-43 cm (large), respectively, for the test device, and two differently sized cuffs for the arm circumference <= 32 cm (standard) and >32 cm (large), respectively, for the mercury sphygmomanometer. Results: Two hundred and fifty-five comparison pairs were obtained for analysis. For validation criterion 1, the mean +/- SD of the differences between the test device and reference SBP/DBP readings was 1.1 +/- 6.7/3.0 +/- 5.3 mmHg. For validation criterion 2, the SD of the averaged SBP/DBP differences between the test device and reference BP per subject was 5.63/4.68 mmHg. Conclusion: The automated upper-arm BP monitor CONTEC08A has passed the requirements of the ISO Universal Standard in the general population, and can be recommended for BP measurement in adults.

Background: Uncertainties persist regarding the optimal management of acute onset of autoimmune hepatitis, including the use of corticosteroids. This study aimed to compare the effectiveness and safety of rapid versus slow corticosteroid tapering in acute onset of AIH. Methods: A multicenter study involving patients with acute AIH was conducted. We defined acute AIH as an acute presentation (<30 days) with AIH and exhibiting no evidence of pre-existing liver diseases. Initially, corticosteroid treatment and overall outcomes were reported. Subsequently, the role of corticosteroid tapering rate in modifying outcomes across subgroups was investigated. For patients with an initial corticosteroid dose of 20 mg/ day or higher, we further classified patients into rapid tapering group (duration until dose of prednisone <20 mg/day <3 weeks) and slow tapering group (duration until dose of prednisone <20 mg/day >= 3 weeks). Adverse events were defined as any of the following events, progression (e.g., acute icteric AIH progression to AS-AIH or AIH-ALF, AS-AIH progression to AIH-ALF, non-cirrhotic progression to cirrhosis, compensated cirrhosis progression to decompensation), LT, and liver-related death. Results: This retrospective cohort study enrolled 237 patients, with 109 presenting acute icteric AIH, 97 with acute-severe AIH (AS-AIH), and 31 with AIH-acute liver failure (ALF). Among patients with acute icteric AIH, slow tapering significantly improved adverse outcome-free survival compared to rapid tapering (99 % vs. 71 %, P < 0.0001). Similarly, in AS-AIH patients, slow tapering resulted in notably higher adverse outcome-free survival rates compared to rapid tapering (92 % vs. 54 %, P < 0.001). Slow tapering independently predicted fewer adverse events (OR 0.144; 95 % CI 0.037-0.562; P = 0.005). However, in AIH-acute liver failure (ALF) patients, tapering rate did not significantly affect adverse outcome-free survival (38 % vs. 50 %, P = 0.590). Overall, there were no significant differences in osteoporosis or infection occurrence between tapering groups in the entire acute AIH cohort. Conclusion: A slow corticosteroid tapering reduced adverse outcomes in acute exacerbation of AIH patients, particularly in acute icteric AIH and AS-AIH.

In the present analysis, we investigated the association between alcohol consumption and ambulatory blood pressure (BP) control in male patients after 8 weeks of antihypertensive therapy with two dihydropyridine calcium channel blockers. The study participants were hypertensive (clinic systolic/diastolic BP of 140-179/90-109 mmHg and 24-hour ambulatory systolic/diastolic BP ≥ 130/80 mmHg) patients enrolled in a randomized controlled trial and treated with amlodipine 5–10 mg or nifedipine gastrointestinal therapeutic system (GITS) 30–60 mg once daily. Alcohol consumption was classified as non-drinkers and drinkers. Non-dipping was defined as a BP drop from daytime to nighttime <10 Alcohol drinkers had higher nighttime systolic and diastolic blood pressure than non-drinkers at baseline. Clinic blood pressure-guided antihypertensive treatment was insufficient in changing the non-dipping to dipping pattern in alcohol drinkers with sustained clinic and ambulatory hypertension.

Background & Aims: In this study, we aimed to evaluate the incidence, predictors, and prognostic significance of recompensation in autoimmune hepatitis (AIH)-related decompensated cirrhosis following immunosuppressive therapy (IST). Methods: We retrospectively analyzed patients with AIH at first decompensation. Recompensation, defined using modified Baveno VII criteria, required clinical resolution (≥12 months without ascites, variceal bleeding, or hepatic encephalopathy, with liver function restored to Child-Pugh A) along with aetiological suppression (complete biochemical response under IST). Predictors of recompensation were identified using multivariate regression, and survival outcomes were compared among compensated, recompensated, and non-recompensated groups. Results: A total of 258 patients with AIH-related decompensated cirrhosis were included (median follow-up: 47 months, IQR 28-75). Clinical resolution was achieved by 124 patients (48.1%), while 68 patients (30.9% of 220 treated with IST) met criteria for recompensation. Predictors of recompensation included ascites as the only complication (hazard ratio [HR] 14.40, 95% CI 4.17-49.64, p <0.001), lower IgG levels (HR 0.90, 95% CI 0.89-0.96, p <0.001), higher bilirubin levels (HR 1.04, 95% CI 1.00-1.08, p = 0.030), and higher platelet counts (HR 1.01, 95% CI 1.00-1.01, p = 0.039). Patients achieving recompensation experienced a significantly reduced risk of liver transplantation or death (HR 0.07, 95% CI 0.01-0.50, p = 0.009), with survival outcomes comparable to those of compensated patients. Conclusions: Recompensation was achieved in approximately one-third of patients with AIH-related decompensated cirrhosis undergoing IST, leading to markedly improved transplant-free survival. Predictors of recompensation included having ascites as the sole complication, lower IgG levels, higher bilirubin levels, and higher platelet counts. Impact and implications: The predictors and long-term prognostic implications of recompensation in patients with autoimmune hepatitis (AIH)-related decompensated cirrhosis remain unclear. This study demonstrates that recompensation is achievable in patients with AIH-related decompensated cirrhosis and is associated with significant long-term benefits, including improved survival and reduced transplantation needs. We identified ascites (as the sole decompensating event), lower IgG levels, higher bilirubin levels and higher platelet counts as independent predictors of recompensation. These findings can be used by clinicians to identify the patients most likely to benefit from immunosuppressive therapy.

Insulin resistance (IR) has been associated with incident frailty. However, the precise association between the estimated glucose disposal rate (eGDR) and the development of frailty remains insufficiently understood. We hypothesized that a lower eGDR, indicating greater IR, would be associated with a higher risk of developing frailty and with accelerated frailty progression across cohorts. This study aimed to systematically investigate and clarify this association. Data were obtained from three prospective cohorts: the China Health and Retirement Longitudinal Study (CHARLS), the English Longitudinal Study of Ageing (ELSA), and the Health and Retirement Study (HRS). Frailty was assessed using the Rockwood Frailty Scale. Baseline eGDR, changes in eGDR, and cumulative eGDR from baseline to the most recent survey wave, as well as the frailty index for each survey year, were evaluated. Logistic and Cox regression models were used to examine the association between eGDR and incident frailty. To assess frailty progression over time, we applied linear mixed-effects models and evaluated potential nonlinear trends. In addition, K-means clustering was conducted as an exploratory analysis to describe heterogeneity in longitudinal eGDR trajectories. A total of 7,666 participants were included from CHARLS (female: 51

Background: Patients with chronic kidney disease (CKD) possess a pronounced risk for cardiovascular events. A noninvasive left ventricular pressure-strain loop (LV-PSL) has recently been introduced to detect subtler changes in cardiac function. This study aims to investigate the value of LV-PSL for quantitative assessment of myocardial work (MW) in patients with CKD. Methods: Seventy-five patients with CKD were enrolled retrospectively (37 patients with CKD Stages 2-3, and 38 patients with CKD Stages 4-5), and 35 healthy volunteers were included as controls. All subjects underwent transthoracic echocardiography. LV-PSL analysis was performed to estimate LV MW and efficiency. Global work index (GWI), global constructive work (GCW), global wasted work (GWW), and global work efficiency (GWE) were obtained by echocardiography, and the differences among the groups were compared. Results: There was a significant increase in GWW and reduction in GWE in patients with CKD compared to normal controls (p < 0.05). No significant difference in GWI and GCW was observed among the three groups. Multiple linear regression revealed that increased GWW was significantly associated with age, serum creatinine, and systolic pressure, and decreased GWE was associated with age, serum creatinine, and GLS. Conclusion: LV-PSL can be used for noninvasive quantitative assessment of MW in patients with CKD, providing a new sensitive approach for the clinical assessment of myocardial function.

None of the spironolactone trials in heart failure (HF) assessed the blood pressure (BP) responses to exercise, while conflicting results were reported for exercise capacity. In the HOMAGE trial, 527 patients at increased HF risk were randomized to usual treatment with or without spironolactone (25-50 mg/day). The current substudy included 113 controls and 114 patients assigned spironolactone, who all completed the incremental shuttle walk test at baseline and months 1 and 9. Quality of life (QoL) was assessed by EQ5D questionnaire. Between-group differences (spironolactone minus control [Δs]) were analyzed by repeated measures ANOVA with adjustment for baseline and, if appropriate, additionally for sex, age and body mass index. Δs in the pre-exercise systolic/diastolic BP were -8.00 mm Hg (95% CI, -11.6 to -4.43)/-0.85 mm Hg (-2.96 to 1.26) at month 1 and -9.58 mm Hg (-14.0 to -5.19)/-3.84 mm Hg (-6.22 to -1.47) at month 9. Δs in the post-exercise systolic/diastolic BP were -8.08 mm Hg (-14.2 to -2.01)/-2.07 mm Hg (-5.79 to 1.65) and -13.3 mm Hg (-19.9 to -6.75)/-4.62 mm Hg (-8.07 to -1.17), respectively. For completed shuttles, Δs at months 1 and 9 were 2.15 (-0.10 to 4.40) and 2.49 (-0.79 to 5.67), respectively. Δs in QoL were not significant. The correlations between the exercise-induced BP increases and the number of completed shuttles were similar in both groups. In conclusion, in patients at increased risk of developing HF, spironolactone reduced the pre- and post-exercise BP, but did not improve exercise capacity or QoL.

Hypertension and atrial fibrillation are closely related. However, hypertension is already prevalent in young adults, but atrial fibrillation usually occurs in the elderly. In the present analysis, we investigated incident atrial fibrillation in relation to new-onset hypertension in an elderly Chinese population. Our study participants were elderly (≥65 years) hypertensive residents, recruited from community health centers in the urban Shanghai (n = 4161). Previous and new-onset hypertension were defined as the use of antihypertensive medication or elevated systolic/diastolic blood pressure (≥140/90 mmHg), respectively, at entry and during follow-up on ≥ 2 consecutive clinic visits. Atrial fibrillation was detected by a 30-s single-lead electrocardiography (ECG, AliveCor® Heart Monitor) and further evaluated with a regular 12-lead ECG. During a median of 2.1 years follow-up, the incidence rate of atrial fibrillation was 7.60 per 1000 person-years in all study participants; it was significantly higher in patients with new-onset hypertension (n = 368) than those with previous hypertension (n = 3793, 15.76 vs. 6.77 per 1000 person-years, P = 0.02). After adjustment for confounding factors, the hazard ratio for the incidence of atrial fibrillation was 2.21 (95% confidence interval 1.15–4.23, P = 0.02) in patients with new-onset hypertension versus those with previous hypertension. The association was even stronger in those aged ≥ 75 years (hazard ratio 2.70, 95% confidence interval 1.11–6.56, P = 0.03). In patients with previous hypertension, curvilinear association (P for non-linear trend = 0.04) was observed between duration of hypertension and the risk of incident atrial fibrillation, with a higher risk in short- and long-term than mid-term duration of hypertension. Our study showed a significant association between new-onset hypertension and the incidence of atrial fibrillation in elderly Chinese. In an elderly Chinese population with previous and new-onset hypertension, we found that the new-onset hypertension during follow-up, compared with previous hypertension, was associated with a significantly higher risk of incident atrial fibrillation. In patients with previous hypertension, curvilinear association was observed between duration of hypertension and the risk of incident atrial fibrillation, with a higher risk in short- and long-term than mid-term duration of hypertension.

OBJECTIVE To investigate three features of dietary cooking oil intake, namely, the consumption, cooking style, and composition of fatty acids in relation to several cardiometabolic measurements in an elderly Chinese population. METHODS The elderly (≥ 65 years) participants for this study were recruited from two community health centers in the urban area of Shanghai. A questionnaire was administered to collect information on dietary oil consumption (low, medium and high) and cooking styles (fry or stir-fry vs. others) and the composition of fatty acids (poly-unsaturated vs. mono-unsaturated). The cardiometabolic measurements included anthropometry, blood pressure, fasting plasma glucose and serum lipids. RESULTS The 1186 study participants had a mean age of 70.9 ± 5.4 years. The mean dietary oil consumption was 35.0 g/d, being low (< 25 g/d), medium (25–49 g/d) and high (≥ 50 g/d) in 485,467 and 234 participants, respectively. The proportion of the fry or stir-fry cooking style and oils rich in mono-unsaturated fatty acids was 30.4% and 27.4%, respectively. Both before and after adjustment for sex, age, current smoking and alcohol intake, dietary oil consumption was significantly (P ≤ 0.02) and positively associated with the prevalence of treated hypertension and fasting plasma glucose concentration. With similar adjustments as above and additional adjustment for dietary oil consumption, the fry or stir-fry cooking style was significantly (P ≤ 0.048) and positively associated with body mass index, but inversely with systolic and diastolic blood pressure and serum low-density lipoprotein cholesterol, and the dietary intake of oils rich in mono-unsaturated fat acids was significantly (P ≤ 0.02) and positively associated with diastolic blood pressure, serum triglycerides, total cholesterol and low-density lipoprotein cholesterol, and the prevalence of hypertriglyceridemia and hypercholesterolemia. CONCLUSIONS This study showed that both the consumption and composition of fatty acids of the dietary oils mattered with regard to several cardiometabolic measurements in an elderly Chinese population.

Abstract Background Hypertension is a leading risk factor for disability and deaths worldwide. Evidence indicates that alpha-mangostin(α-MG) can reduce blood pressure and improve target organ damage. Nonetheless, its pharmacological targets and potential mechanisms of action remain inadequately elucidated. Method We used SwissTargetPrediction to identify α-MG’s drug targets and DisGeNET, GeneCards, CTD, and GEO databases for hypertension-related targets, and then determined antihypertensive therapeutic targets of α-MG by intersecting these targets. GO functional enrichment analysis, KEGG pathway analysis, and disease association analysis were conducted using the DAVID database and R package “clusterprofile”, visualized with Cytoscape software. The binding affinity of α-MG to identified targets was confirmed through molecular docking using Autodock Vina v.1.2.2 software. The impact of α-MG on target genes was validated using an Angiotensin II-induced hypertensive mouse model and RT-qPCR. Results A total of 51 potential antihypertensive therapeutic targets for α-MG were identified by intersecting 109 drug targets with 821 disease targets. Furthermore, 10 cellular component terms, 10 disease terms, and the top 20 enriched biological processes, molecular functions, and KEGG pathways related to α-MG’s antihypertensive effects were documented. Molecular docking studies indicated a strong binding affinity of α-MG with the HSP90AA1 domain. In Ang II-induced hypertensive mice aorta, treatment with α-MG effectively reversed the aberrant mRNA expression of TNF, HSP90AA1, NFKB1, PPARG, SIRT1, PTGS2, and RELA. Conclusion Our analyses showed that TNF, HSP90AA1, NFKB1, PPARG, SIRT1, PTGS2, and RELA might be α-MG’s potential therapeutic targets for hypertension, laying groundwork for further investigation into its pharmacological mechanisms and clinical uses.