INTRODUCTION:Retirement represents a significant life transition and is associated with individual health outcomes. Previous studies on the health effects of retirement have yielded inconsistent conclusions. This study aimed to estimate the impact of retirement on the body mass index (BMI) and BMI-defined overweight and obesity. METHODS:Between 2012 and 2015, this study included 88,471 public sector participants from the Chinese Hypertension Survey (CHS) while excluding those working in the private sector. By utilizing the fuzzy regression discontinuity design (FRDD), this research evaluated the direct impact of retirement on the BMI, as well as on the overweight and obesity rates. Additionally, the study examined variations in the effects of retirement among groups stratified by sex and educational attainment. RESULTS:The fully adjusted model suggested that retirement did not have a significant impact on the BMI or overweight and obesity rates of the overall population. Notably, retirement significantly impacted the male participants, resulting in an increase in their BMI of 2.18 (95% CI 0.23-4.13), but did not affect the BMI of the female participants. Furthermore, individuals with lower educational backgrounds experienced more pronounced BMI changes upon retirement. CONCLUSIONS:On average, retirement has no significant impact on the BMI and overweight and obesity rates. Retirement leads to an increase in the BMI among men but does not affect that in women. When considering adjustments to existing retirement policies, the differential health effects of retirement across various populations should be taken into account.

Preamble Hypertension is one of the most common chronic dis-eases and the primary risk factor for stroke,myocardial infarction and even cardiovascular death.More than half of the elderly population has high blood pressure.El-derly people are a unique group,and strategies for the prevention,diagnosis,evaluation,and treatment of hy-pertension in elderly individuals differ significantly from those in the general population.

Background: Research on the association between age at menarche and menopause, reproductive lifespan, and the risk of obesity in China is unclear and requires further clarification.Materials and Methods: Data were obtained from the China Hypertension Survey, a cross-sectional study using a stratified multistage random sampling method, conducted from October 2012 to December 2016, with a total of 187,162 women included in the analysis. Logistic regression models and restricted cubic spines were used to estimate the relationship between obesity and age at menarche, age at menopause, and reproductive lifespan.Results: The mean (standard deviation) age at menarche and menopause, and reproductive lifespan were 15.5 (1.8), 48.7 (3.5), and 33.2 (3.9) years, respectively. Age at menarche was negatively related to the risk of obesity (odds ratio [OR]: 0.968; 95% confidence interval [CI]: 0.961-0.975). There was a positive association between age at menopause and the risk of obesity in postmenopausal women (OR: 1.019; 95% CI: 1.014-1.023). Reproductive lifespan was positively related to obesity (OR: 1.020; 95% CI: 1.017-1.025). The restricted cubic spines showed the association between age at menarche, age at menopause, reproductive lifespan, and obesity was nonlinear when fully adjusted.Conclusions: Based on the large nationally representative sample, Chinese women with earlier age at menarche, later age at menopause, and longer reproductive lifespan have a higher risk of obesity.

BACKGROUND:We aimed to evaluate the impacts of short-term daily temperature variability (DTV) on blood pressure (BP) among participants with normotension, prehypertension, and hypertension, respectively, and explore the effects in different climate zones and seasons. METHODS:A representative population sample (n = 397,173) covering the subtropical, temperate continental, and temperate monsoon zones was obtained from the China Hypertension Survey. DTV was calculated as the standard deviation of daily minimum and maximum temperatures during the exposure days. The linear mixed effect regression model was used to estimate the associations between DTV exposure and BP among normotension, prehypertension, and hypertension, respectively, and further stratified analysis was performed by climate zones and seasons. RESULTS:After adjustment for confounders, per interquartile range (IQR) increase in DTV (2.28 °C) at 0-6 days of exposure was associated with an increase of 0.41 mmHg (95 % confidence interval [CI]: 0.07, 0.75) in systolic BP (SBP) and 0.41 mmHg (95 % CI: 0.09, 0.72) in pulse pressure (PP) among hypertensive participants in the subtropical zone. Similarly, DTV exposure was associated with an increase of 0.31 mmHg (95 % CI: 0.06, 0.55) in SBP and 0.59 mmHg (95 % CI: 0.24, 0.94) in PP among prehypertensive participants in the temperate continental zone. Additionally, during the warm season, DTV was positively associated with SBP among populations with prehypertension and hypertension, and with PP among all three populations. CONCLUSION:Short-term DTV exposure was associated with an increase in SBP and PP among hypertensive and prehypertensive participants in the subtropical zone and the temperate continental zone. In addition, positive associations of DTV with SBP and PP were observed among participants with prehypertension and hypertension in the warm season. Comprehensive health education and effective intervention strategies should be implemented to mitigate the effects of temperature variations on BP, particularly among prehypertensive and hypertensive populations.

INTRODUCTION:The health impact of retirement is controversial. Most previous studies have been based on self-reported health indicators or the endpoints of some chronic diseases (e.g., morbidity or mortality), but objective physiological indicators (e.g., blood pressure) have rarely been used. The objective of this study is to elucidate the health effects of retirement on blood pressure, thereby offering empirical evidence to facilitate the health of retirees and to optimize retirement policies.METHODS:From 2012 to 2015, 84,696 participants of the Chinese Hypertension Survey (CHS) were included in this study. We applied the fuzzy regression discontinuity design (FRDD) to identify retirement's causal effect on systolic blood pressure (SBP), diastolic blood pressure (DBP) and pulse pressure. We also explored the heterogeneity in the effects of retirement across different sex and education level groups.RESULTS:Based on the fully adjusted model, we estimated that retirement increased SBP by 5.047 mm Hg (95% CI: -2.628-12.723, P value: 0.197), DBP by 0.614 mm Hg (95% CI: -3.879-5.108, P value: 0.789) and pulse pressure by 4.433 mm Hg (95% CI: -0.985-9.851, P value: 0.109). We found that retirement led to a significant increase in male participants' SBP and pulse pressure as well as a possible decrease in female participants' blood pressure. Additionally, the blood pressure levels of low-educated participants were more vulnerable to the shock of retirement.CONCLUSION:Retirement is associated with an increase in blood pressure level. There is a causal relationship between the increase in blood pressure levels of men and retirement. Policy-makers should pay extra attention to the health status of men and less educated people when adjusting retirement policies in the future.

OBJECTIVES:The aim of this study was to examine the dose-response associations of physical activity with blood pressure (BP) and hypertension risk among Chinese adults. METHODS:Derived from the national community-based China Hypertension Survey database during 2012--2015, a total of 203 108 residents aged at least 18 years were included. Individual-level physical activity was evaluated using a standardized questionnaire, and minutes of metabolic equivalent tasks per week (MET-min/week) were calculated, integrating domain, intensity, frequency, and duration. Multivariable linear and logistic regressions were used to estimate associations of physical activity with BP and hypertension risk, and restricted cubic spline regressions were performed for their nonlinear dose-response relationships. RESULTS:Overall, the median total physical activity (TPA) was 3213.0 MET-min/week and the prevalence of physical inactivity was 14.8%. TPA was negatively associated with BP. Increasing TPA levels was related to a steep decrease in systolic BP, up to approximately 2500 MET-min/week, with more modest benefits above that level of TPA. Higher levels of domain-specific and intensity-specific physical activity were found to be associated with lower BP levels and hypertension risk, except for the association between vigorous-intensity physical activity and systolic BP. We found that TPA within the range of 2000--4000 MET-min/week, a higher frequency and shorter duration were inversely associated with diastolic BP levels. CONCLUSION:Total, domain-specific, and intensity-specific physical activity were inversely related to BP levels, respectively, in a dose-response fashion. Of a given amount, higher-frequency, shorter-duration, and lower-intensity physical activity produced more beneficial effects.

Objective To investigate the detection rate of the increase of inter-arm systolic pressure difference（IASBPD） in people aged ≥35 years in China and the related factors. Methods Stratified multi-stage sampling method was used to randomly select 262 urban and rural residents from 31 provinces, autonomous regions and municipalities. from 2012 to 2015. Simple random sampling method was used to select 16 cities and 17 areas from eastern, central and western regions. A total of 34 121 subjects aged ≥35 years were analyzed after removing the missing information. Data were collected by questionnaire, and blood pressure in both arms was measured by ankle-brachial index meter. All data were analyzed by SPSS 23.0 software. Continuous data were expressed as mean±standard deviation, and compared between groups using F-test if they were normal distribution, and using rank-sum test if not. Categorical data were expressed as frequency, rate or constituent ratio, and were compared using χ~2 test between groups. Multivariate logistic regression was used to analyze the influencing factors of IASBPD increase. Results The detection rates of IASBPD≥10 mmHg and ≥15 mmHg were 16.31% and 7.55%, respectively. Multivariate logistic regression showed that age, family history of hypertension, low high density lipoprotein cholesterol（HDL-C）, hypertension and abdominal obesity were risk factors of IASBPD≥10 mmHg and ≥15 mmHg（all P＜ 0.05）. Conclusions The detection rates of IASBPD≥10 and ≥15 mmHg in Chinese people≥35 years old are 16.31% and 7.55%, respectively, Age, low HDL-C, family history of hypertension, hypertension and abdominal obesity are the influencing factors of IASBPD increase.

Mitochondrial toxicity induced by therapeutic drugs is a major contributor for cardiotoxicity, posing a serious threat to pharmaceutical industries and patients' lives. However, mitochondrial toxicity testing is not incorporated into routine cardiac safety screening procedures. To accurately model native human cardiomyocytes, we comprehensively evaluated mitochondrial responses of adult human primary cardiomyocytes (hPCMs) to a nucleoside analog, remdesivir (RDV). Comparison of their response to human pluripotent stem cell-derived cardiomyocytes revealed that the latter utilized a mitophagy-based mitochondrial recovery response that was absent in hPCMs. Accordingly, action potential duration was elongated in hPCMs, reflecting clinical incidences of RDV-induced QT prolongation. In a screen for mitochondrial protectants, we identified mitochondrial ROS as a primary mediator of RDV-induced cardiotoxicity. Our study demonstrates the utility of hPCMs in the detection of clinically relevant cardiac toxicities, and offers a framework for hPCM-based high-throughput screening of cardioprotective agents.

目的:了解职业人群心血管疾病防治健康素养水平及其影响因素,为提高职工健康素养、改善职工健康状况提供理论依据.方法:利用整群随机抽样的方法,于 2021年 2月—2021年 12月在北京市选择两个工厂的 1 300名在职职工作为研究对象.采用自行设计的心血管疾病防治健康素养调查问卷进行匿名自填式问卷调查,以了解职工的健康素养水平.结果:共有 1 101 名职工参加调查,知识维度题目正确得分率为 96.9%,态度维度题目积极得分率为 90.2%.女性职工心血管疾病防治健康素养知识维度得分及总得分明显高于男性职工(P<0.001),态度维度得分明显低于男性职工(P<0.001);非吸烟职工心血管疾病防治健康素养知识维度得分及总得分明显高于吸烟职工(P<0.001),态度维度得分明显低于吸烟职工(P<0.001);无心血管病家族史职工健康素养态度维度得分明显高于有心血管病家族史职工(P<0.05).多元线性回归分析结果表明,年龄、性别和吸烟是心血管疾病防治健康素养的影响因素.结论:职业人群的心血管疾病防治健康素养水平整体较高,但在疾病基本知识及健康膳食方面还有待提高,需要进一步加大健康知识的宣教和传播力度,提高知识维度素养水平,促进健康行为的养成.

Lay Summary The burden of heart failure (HF) in China is projected to increase further with population ageing. In an effort to reduce the burden, a crucial starting point is to enhance our knowledge of the burden of clinical precursors of HF in the community. Heart failure can be divided into Stage A (at-risk for HF), Stage B (pre-HF), Stage C (symptomatic HF), and Stage D (advanced HF), which is helpful for early identifying people at risk for symptomatic HF and thus implementing interventions. Despite having a high HF burden, knowledge of the prevalence of HF stages in China is limited. We therefore used the data of China Hypertension Survey 2012-15 to evaluate the prevalence of HF stages in the general Chinese population and the specific prevalence by age, sex, and urbanity. Survey weights were calculated based on the 2010 China population census data. A total of 31 494 community-dwelling adults aged & GE; 35 years were included. The prevalence of Stage A was 35.8% (& AP;245.1 million), Stage B 42.8% (& AP;293.1 million), and Stage C 1.1% (& AP;7.5 million). The prevalence of Stages B and C increased with increasing age. Women had lower prevalence of Stage A but higher prevalence of Stage B than men. People from rural area had lower prevalence of Stage A but higher prevalence of Stage B than people from urban. The prevalence of Stage C was similar by sex and urbanity.The burdens of both pre-clinical and clinical HF are high in China.These burdens vary by age, sex, and urbanity. Aims There are no nationwide epidemiological data on heart failure (HF) stages in China. Knowledge of the prevalence of HF stages is crucial for planning HF prevention and management strategies. We aimed to evaluate the prevalence of HF stages in the general Chinese population and the specific prevalence by age, sex, and urbanity. Methods and results This is a cross-sectional study and national representative general population aged & GE; 35 years (n = 31 494, mean age 57.4 years, women 54.1%) were obtained from the China Hypertension Survey. Participants were divided into Stage A (at-risk for HF), Stage B (pre-HF), and Stage C (symptomatic HF). Survey weights were calculated based on the 2010 China population census data. The prevalence of Stage A was 35.8% (& AP;245.1 million), Stage B 42.8% (& AP;293.1 million), and Stage C 1.1% (& AP;7.5 million). The prevalence of Stages B and C increased with increasing age (P < 0.0001). Women had lower prevalence of Stage A (32.6% vs. 39.3%; P < 0.0001) but higher prevalence of Stage B (45.9% vs. 39.5%; P < 0.0001) than men. People from rural area had lower prevalence of Stage A (31.9% vs. 41.0%; P < 0.0001) but higher prevalence of Stage B (47.8% vs. 36.2%; P < 0.0001) than people from urban. The prevalence of Stage C was similar by sex and urbanity. Conclusion The burdens of pre-clinical and clinical HF are high and vary by age, sex, and urbanity in China. Targeted interventions are needed to reduce the high burden of pre-clinical and clinical HF.

Recent decades have seen the remarkable development of China in medical accessibility and quality index, and the application of a number of new advanced cardiovascular technologies benefits more patients. However, according to the Annual Report on Cardiovascular Health and Diseases in China published in this article, which was organized and summarized by National Center for Cardiovascular Diseases, there is still a huge population living with risk factors of cardiovascular diseases (CVD), and the morbidity and mortality of CVD are increasing. It is estimated that there are around 330 million patients suffering from CVD currently, including 245 million of hypertension, 13 million of stroke, 45.3 million of peripheral artery disease, 11.39 million of coronary heart disease (CHD), 8.9 million of heart failure, 5 million of pulmonary heart disease, 4.87 million of atrial fibrillation, 2.5 million of rheumatic heart disease, and 2 million of congenital heart disease. Tobacco use, diet and nutrition factors, physical activity, overweight and obesity, and psychological factors are what affect cardiovascular health, while hypertension, dyslipidemia, diabetes, chronic kidney disease, metabolic syndrome, and air pollution are the risk factors for CVD. In this article, in addition to risk factors for CVD, we also report the epidemiological trends of CVD, including CHD, cerebrovascular disease, arrhythmias, valvular heart disease, congenital heart disease, cardiomyopathy, heart failure, pulmonary vascular disease and venous thromboembolism, and aortic and peripheral artery diseases, as well as the basic research and medical device development in CVD. In a word, China has entered a new stage of transforming from high-speed development focusing on scale growth to high-quality development emphasizing on strategic and key technological development to curb the trend of increasing incidence and mortality of CVD.

Background: Temporal trends and geographical variations in disease burden for diabetes mellitus (DM) and cardiovascular disease (CVD) attributable to high body mass index (BMI) in China have not been fully elucidated.Methods: We estimated deaths and years of life lost (YLLs) for DM and CVD attributable to high BMI by age, sex, year, and region from 2005 to 2018 based on pooled data of 1.25 million adults.Findings: Approximately 497,430 (95% uncertainty interval [UI], 470,5 20-525,720) deaths for DM and CVD were attributable to high BMI in China in 2018, with 453,750 deaths from CVD and 43,700 deaths from DM. Between 2005 and 2018, there was a 17.35% increase in age standardized mortality rate for DM and CVD attributable to high BMI. The high BMI-related DM and CVD YLL rates increased from 127.46 (95% UI 108.70-148 .62) per 100,000 people aged 20-24 years to 5,735.54 (95% UI 4,844.16-6,713.53) per 100,000 people aged R80 years, respectively. The highest age-standardized mortality rate for high BMI-related DM and CVD in northeast, northwest, and circum-Bohai Sea regions of China.Conclusion: The disease burden for DM and CVD attributable to high BMI increased substantially between 2005 and 2018. Urgent measures are required at both national and regional levels for resource mobilization to slow the growing burden.

心血管疾病(cardiovascular disease,CVD)已成为我国居民最主要的危害健康的疾病,也是导致预期寿命受损、因病致贫、因病返贫的主要疾病.近年来,CVD的发病率和患病率持续上升,推算现患人数3.30亿,其中脑卒中1 300万,冠心病1 100万;死亡人数仍在上升,2020年接近450万,农村为45.91％,城市为43.56％[1].同时,CVD治疗总费用持续升高,居各类疾病费用首位,占疾病治疗总费用的17％,相当于0.66％的国内生产总值.

Background:The burden of cardiovascular diseases (CVDs) is on the rise in China, yet a comprehensive and systematic understanding of the temporal trends and distribution of CVD burden attributable to dietary factors across the provinces remains elusive. This study endeavors to provide a comprehensive depiction of the burden of CVDs attributable to dietary risk factors across China's geographical regions from 2002 to 2018. Methods:Data from the China National Nutrition Surveys, the China Chronic Disease and Risk Factor Surveillance, the Hypertension Survey, and the Chinese Centre for Disease Control and Prevention cause-of-death reporting system were used to estimate the intake of dietary factor, the number of deaths, and disability-adjusted life years (DALYs), mortality rate, for ischemic heart disease (IHD), ischemic stroke (IS), hemorrhage and other stroke (HOS) attributable to dietary factors at national and provincial levels in China from 2002 to 2018. Using a comparative risk assessment approach, we estimated the proportion of CVDs burden attributable to suboptimal intake of seven dietary factors, both individually and collectively, among Chinese citizens aged 20 years or older. Finding:The mean consumption of whole grains, soybeans, nuts, vegetables, fruits, red meat, and sugar-sweetened beverages (SSBs) exhibited an upward trend from 2002 to 2018. However, with the exception of red meat and SSBs, the average intake remained below the levels recommended levels outlined in the Chinese national dietary guidelines. Inadequate fruit, whole grain, and vegetables intake were the leading dietary risk factors for IHD, IS and HOS in China, while nuts, soybean and SSB were only associated with IHD mortality. From 2002 to 2018, the number of deaths and mortality rate for CVDs attributable to suboptimal diet among Chinese males were greater than that of females. With increasing age, the diet-related mortality rate for CVDs increased substantially. In 2018, the nationwide mortality rate attributable to diet was found to be 77.9 (95% UI, 77.5-78.1) per 100,000 population for IHD, 34.1 (95% UI, 33.8-34.2) for IS, and 32.8 (95% UI, 32.4-32.8) for HOS. Suboptimal diet was responsible for 16.0 million (95% UI, 13.8-18.4) DALYs and 1137.1 (95% UI, 980.4-1312.3) DALYs per 100,000 population for stroke, and 13.9 million (95% UI, 11.8-16.3) DALYs and 990.2 (95% UI, 841.2-1158.6) DALYs for IHD. Across the provinces of China, in 2018, the highest age-standardized mortality rates of all diet-related deaths were observed in Shandong (92.8 [95% UI, 89.9-93.3]) for IHD, Heilongjiang (38.1 [95% UI, 36.2-38.8]) for IS, and Tibet (68.3 [95% UI, 65.0-70.1]) for HOS. The highest diet related DALYs were observed in Henan (1.4 million [95% UI, 1.2-1.6] for IS, and 1.3 million [95% UI, 1.1-1.5] for IHD). Interpretation:This study provides a comprehensive picture of the geographic variation and temporal trends of the burden of CVDs attributable to dietary risk factors at the national and provincial levels from 2002 to 2018 in China, highlighting the need for geographically targeted intervention strategies to improve the quality of diet and reduce the diet-related burden of CVDs. Funding:National Key Research and Development Program of China (2018YFC1315303), National Natural Science Foundation of China (82103966).

Cardiovascular disease（CVD） has become the leading cause of death and disability in the global population and imposes a significant economic burden on global health systems. Prevalent cases of total CVD nearly doubled from 271 million in1990 to 523 million in 2019, and the number of CVD deaths steadily increased from 12.1 million in 1990,

ObjectiveTo investigate mediating role of blood pressure on the association of body mass index (BMI) with cardiovascular disease (CVD) risk and to provide evidence for control of CVD risk. MethodsUsing stratified multistage random sampling and a self-designed questionnaire, a baseline survey including face-to-face interview, physical examination and laboratory tests were conducted among 15 600 permanent urban/rural residents aged 18 – 69 years during June – September, 2021 in Shandong province; then the residents were followed up to October 11, 2021 through the Cardiovascular Diseases and Mortality Surveillance System to collect the information on the prevalence of CVD. Univariate and multivariate Cox proportional risk regression model was used to analyze the association of body mass index (BMI) with the risk of CVD. The dose-response relationship between BMI and CVD risk was described with restricted cubic splines (RCS). The mediating role of blood pressure on the association of BMI with CVD risk was assessed with sequential test. ResultsOf all the residents at the baseline survey, 89.17% (13 688) were followed up; after excluding those with previous history of coronary heart disease (n = 254) and stroke (n = 115) and those without valid outcome information, 13 268 participants were finally included in the analysis, with a total follow-up of 133 733.79 person-years and a median follow-up period of 10.25 years. By the end of the follow-up among the participants, totally 492 CVD incidences were identified and the CVD incidence density was 367.90/100 000 person-years. The number of CVD incidence was 22，173，183, and 114 among the participants with low-weight, normal-weight, overweight, and obesity, with the corresponding CVD incidence densities (1/100 000 person-years) of 380.08, 285.84, 410.42, and 499.25, respectively. After adjusting for age, gender, education, marital status, annual household income, living area (urban/rural), geographical region of residence (central/southeast/northwest), smoking, alcohol drinking, physical activity, daily salt intake, daily oil intake, and disease history of hypertension, diabetes or dyslipidemia, multivariate Cox proportional risk regression model analysis showed that the participants with overweight were at an increased risk of CVD incidence (hazard risk [HR] = 1.253, 95% confidence interval [95% CI]: 1.014 – 1.548) compared to those with normal weight. Dose-response analysis revealed a J-shaped relationship between BMI and the risk of CVD (χ2overall = 29.87, P overall = 0.004; χ2nonlinear = 7.08, Pnonlinear = 0.069). Mediating effect analysis demonstrated that the direct effect of BMI on CVD incidence risk was 0.038 (Z = 11.644, P < 0.001) and the mediating effect of systolic blood pressure (SBP), diastolic blood pressure (DBP) and hypertension was 0.022 (Z = 12.354, P < 0.001), 0.041 (Z = 10.589, P < 0.001) and 0.133 (Z = 11.506, P < 0.001). The mediating effect percentages of SBP, DBP pressure and hypertension were 36.67%, 51.90% and 77.78%, respectively. ConclusionBlood pressure has a strong mediating effect on the association of BMI with CVD risk. The results suggested that more attention and intervention on the changes of blood pressure need to be promoted among overweight and obesity populations.

Abstract Background To investigate the detection of the increase of interarm systolic pressure difference (IASBPD) in people aged ≥35 years in our country and its related factors. Methods Stratified multistage sampling method was used to randomly select 262 urban and rural residents from 31 provinces from 2012 to 2015. Further, simple random sampling method was used to select 16 cities and 17 rural residents from eastern, central, and western regions. A total of 34,121 subjects aged ≥35 years were analyzed after removing the missing information. Data were collected by questionnaire, and blood pressure in both arms was measured by ankle–brachial index meter. All data were analyzed by SPSS 23.0 software. Continuous data were expressed as mean ± SD. Comparison between groups was performed using t-test if it was normal distribution, and rank-sum test if it was not. Categorical data were expressed as frequency sum rate or constituent ratio, χ2 test was used for comparison of various rates and constituent ratio, and rank-sum test was used for rank data. Multivariate logistic regression was used to analyze the influencing factors of IASBPD increase. Results The detection rates of IASBPD ≥10 and ≥15 mm Hg were 16.31% and 7.55%, respectively. The detection rate of IASBPD ≥10 mm Hg in males was higher than that in females (P < 0.05). Multivariate logistic regression showed that age, family history of hypertension, low HDL-C, hypertension, and abdominal obesity were risk factors for IASBPD ≥10 and 15 mm Hg (all P < 0.05). Conclusions The detection rates of IASBPD ≥10 and 15 mm Hg are 16.31% and 7.55%, respectively, in Chinese ≥35 years old people, and age, low HDL-C emia, family history of hypertension, hypertension, and abdominal obesity are the influencing factors of large differences in interarm blood pressure.

BACKGROUND:Metabolic syndrome (MetS) has emerged as a significant global public health concern. While environmental factors, including PM2.5, have been identified as important risk factors for MetS in the general population, limited studies have investigated their impact on individuals with essential hypertension. Therefore, our study aims to explore the relationship between PM2.5 composition, green space, and their combined effects on MetS among a Chinese essential hypertensive population. METHOD:A total of 20,131 participants diagnosed with essential hypertension from 10 provinces in China were included in this study. Individual level exposure to various environmental factors (including PM2.5, PM2.5 composition, green space and temperature) were evaluated using spatiotemporal models based on satellites data. Participants were defined as MetS according to the definition issued by the International Diabetes Federation. Generalized additive mixed models were used to analyze the individual air pollutants, green space and their interaction on MetS. RESULT:The prevalence of MetS in this population was 44.33%. The adjusted odd ratio (OR) of MetS, with each one unit increase in SO42-, BC and NO3- were 1.077 (1.049, 1.106), 1.126 (1.077, 1.177) and 0.977 (0.958, 0.996) respectively. Additionally, each unit increase of the Normalized Difference Vegetation Index (NDVI) was associated with a decreased risk of MetS (OR: 0.988, 95% CI: 0.984-0.993). In particular, green space was found to mitigate the adverse impacts of PM2.5 on MetS (OR: 0.988, 95% CI: 0.984-0.993). CONCLUSION:Our results suggested that there was a positive association between PM2.5 and its composition (SO42-, BC) with MetS in the essential hypertensive population, while green space might play a protective role. Moreover, green space could effectively weaken the positive relationship between air pollutants and MetS, especially in males and participants younger than 60 years old.

目的 分析高血压、腹型肥胖聚集对心血管病事件的归因疾病负担.方法 选取中国高血压调查中基线数据和队列数据,共纳入22754名35岁及以上无心血管病史的调查对象,于2018年—2019年随访心血管事件.利用Cox比例风险模型对高血压、腹型肥胖聚集与心血管病事件的风险比(HR)和95％置信区间(95％CI)进行分析.基于以上相对危险度,计算归因于高血压、腹型肥胖聚集的心血管病人群归因百分比(PAF),采用Bootstrap方法计算PAF的95％CI.结果 以非高血压、腹型肥胖(-)人群为参照组,高血压、腹型肥胖(+)人群发生心血管病、冠心病和脑卒中的HR(95％CI)分别为1.95[1.64,2.32]、2.15[1.58.2.94]和1.90[1.52,2.39].心血管病归因于高血压、腹型肥胖(+)聚集的PAF(95％CI)为15.45％[10.26％,21.05％],冠心病为18.12％[12.15％,24.40％],脑卒中为14.77％[9.78％,19.60％].结论 加强高血压伴腹型肥胖人群的管理,可降低心血管病的疾病负担.

随着我国人口老龄化和城镇化步伐的加快,心脑血管病的发病率和患病率也在持续上升.心脑血管病共患及带病生存者大大增加,给基层疾病管理带来了巨大挑战.为此,北京高血压防治协会、中国卒中学会高血压预防与管理分会、中国老年保健协会养老与健康专业委员会、中华预防医学会健康生活方式与社区卫生专业委员会共同发起编撰了《基层冠心病与缺血性脑卒中共患管理专家共识2022》[1] ,希望为基层医疗机构开展共病管理提供有效帮助和指导.本文就共识内容作简要解读.