This study investigated the relationship between hemoglobin (Hb) level and blood pressure in a Chinese community-dwelling population with normal glucose metabolism. Hb, fasting plasma glucose, glycated Hb A1c, hepatic and renal function, lipid, electrolytes, and anthropometric parameters were measured. Hb level was found to be positively correlated with systolic (SBP; r = 0.075, p < 0.001) and diastolic (DBP; r = 0.272, p < 0.001) blood pressure in the cohort. The relationship was not affected by age, BMI, serum creatinine (Cr), and low-density lipoprotein (LDL) in both males and females. Multivariate stepwise regression showed that age (beta = 0.556, p < 0.001), BMI (beta = 1.107, < 0.001), Hb (beta = 0.082, p < 0.001), Cr (beta = -0.032, p < 0.001), and LDL (beta = 1.023, p < 0.001) were independent factors for SBP, and Hb (beta = 0.168, p < 0.001), BMI (beta = 0.519, p = 0.001), and LDL (beta = 0.331, p < 0.001) for DBP. Hb level is positively associated with both SBP and DBP in a Chinese community-dwelling population with normal glucose metabolism. (c) 2018 S. Karger AG, Basel

Objective To evaluate the effect of intensive hypertension management model for patients with uncontrolled blood pressure in community.Methods Three hundred and seven hypertensive patients,whose blood pressure was not controlled with administration of two or more kinds of antihypertensive drugs,entered in the intensive management program from May 2015 to December 2017.Using calcium channel blockers,angiotensin converting enzyme inhibitors or angiotensin receptor blockers and diuretic as the primary scheme,the medication was adjusted by general practitioners under the guidance of specialists in tertiary hospitals.The "seamless" two-way referral between community and tertiary hospitals was implemented,and the blood pressure control,medication and adverse effects were analyzed.Results Among 307 patients,157 were males (51.1％) and the mean age was (65.0±8.6) years.There were 246 (80.0％)patients with moderate and severe hypertension 44 (14.3％) patients complicated with diabetes,and 63(20.5％) patients having comorbidities,and the patients with high risk or extremely high-risk accounted for 85.0％ (261/307).Through (3.97± 1.21) months (1-6 months) intensive management,systolic blood pressure decreased from (167.56±16.73)mmHg(1 mmHg=0.133 kPa) in the baseline to (132.79±11.24)mmHg (t=33.34,P＜0.01),and diastolic blood pressure from (95.34± 12.59) mmHg to(79.11 ±7.85) mmHg (t=23.67,P＜0.01),blood pressure control rate was 75.6％(232/307).No serious adverse reactions occurred.During the period 42 patients were referral to hospital through green channel with a referral rate of 13.7％,and six patients were diagnosed as secondary hypertension.Angiotensin receptor antagonists and calcium antagonists were the main antihypertensive drugs.After intensive management patients taking three or more antihypertensive drugs increased by 158 and those taking diuretics increased by 116.Conclusions The intensive management model is effective in patients with uncontrolled blood pressure in community.Early use of C+A,A+D,and A+C+D treatment schemes for uncontrolled patients in the community can improve the rate of reaching the target and is safe.

Objectives: Recent guidelines propose a redefinition of hypertension from 140/90 to 130/80 mmHg. This study assesses the impact of the new threshold of hypertension diagnosis on the association of hypertension with target organ damage (TOD). Methods: Health checks were conducted in a community-dwelling population in Shanghai in 2017 (N = 10,826; 43.26% men, age 62.2 ± 12.0 years [range 29–95]). Subclinical TOD indices were quantified in terms of left ventricular hypertrophy (LVH) by electrocardiogram (Sokolow-Lyon standard), estimated Glomerular Filtration Rate (eGFR) and presence of proteinuria. Information on clinical TOD was obtained by questionnaire. Results: Compared to the high threshold (140/90 mmHg), the lower threshold (130/80 mmHg) was associated with variable rates of increased detection of hypertension and TOD: (i) Hypertension: incidence of hypertension for the whole cohort, 29.5% (51.8% to 81.5%) (ii) Subclinical TOD: LVH, 20.8% (65.6% to 86.4% of total of 684); eGFR (30–60 ml/min per 1.73m2, 23.7% (60.9% to 84.6% of total of 553); proteinuria, 23.5% (65.6% to 86.4% of total of 553) (iii) Clinical TOD: chronic kidney disease (eGFR < 30 ml/min per 1.73m2), 3.1% (68.8% to 71.9% of total of 32); diabetes (fasting glucose≥7.0 mmol/l or HbA1C > 7.0%), 24.3% (65.5% to 89.8% of total of 1107); stroke, 26.4% (56.4% to 82.8% of total of 349); chronic heart disease, 28.1% (55.1% to 83.2% of total of 394); acute myocardial infaction,19.5% (69.4% to 88.9% of total of 36). Conclusion: The lower threshold of hypertension of 130/80 was associated with a significantly higher detection rate of clinical and subclinical TOD of approximately 20% compared to the higher threshold of 140/90. In the same cohort, some 15%–20% of TOD was also found below the lower threshold of hypertension.

Objectives: To investigate the relationship between the hemoglobin level and blood pressure in Chinese normal glucose metabolism community dwelling population. Methods: Hemoglobin, fasting plasma glucose, glycated hemoglobin A1c (HbA1c), hepatic and renal functions, lipide, electrolytes basic infomations and anthropometric parameters were measured. Results: The hemoglobin is positively correlated with SBP (r = 0.075, p < 0.001)and DBP (r = 0.272, p < 0.001)in the cohort. The relationship was not effected by age, BMI, Cr, LDL in both males and females. Multivariate Stepwise Regression showed age (β = 0.556, P < 0.001), BMI(β = 1.107, < 0.001),Hb (β = 0.082, P < 0.001), Cr (β = − 0.032, P < 0.001), LDL (β = 1.023, P < 0.001) were independent factors for SBP and Hb (β = 0.168, P < 0.001), BMI (β = 0.519, P = 0.001), LDL(β = 0.331, P < 0.001) for DBP. Conclusion: Hemoglobin level is positively associated with both SBP and DBP in Chinese normal glucose metabolism community dwelling population.

Objectives: To explore hypertension management and effect analysis on treatment flow path in the uncontrolled blood pressure (BP) patients of community health center (CHC). Methods: Hypertensive patients in CHC used simple antihypertension flow path, the preferred medicine was calcium channel blockers (C), angiotensin converting enzyme inhibitors or angiotensin receptor blockers (known as A). BP did not target in 2–4 weeks, general practitioners (GPs) prescribed C and A, or A and diuretic (D) to treat 1 month at least. Bp did not reach the target yet, the patients were referral to department of hypertension. Under the guidance of experts in tertiary hospitals (THs), GPs adjusted treatment protocol, strengthened management, made BP reach the target. The uncontrolled BP patients were referral to THs to make etiological diagnosis, after BP reached the target, they were back to the community to follow-up. Results: Among 307 uncontrolled BP patients, the average age of 157 males were 65.0 ± 8.6 years. Moderate and severe hypertension was 80.0%, 14.3% accompanied by diabetes, and 20.5% merged with clinical diseases. High risk and extremely high-risk patients were 85.0%. Through 3.97 ± 1.21 months intensive management, systolic BP decreased significantly from 167.56 ± 16.73mmHg in the baseline to 132.79 ± 11.24 mmHg, and diastolic BP from 95.34 ± 12.59 mmHg to 79.11 ± 7.85 mmHg (P < 0.0001), BP control rate was 75.6%. 42 patients were referral to superior hospital, the referral rate was 13.7%.6 patients were diagnosed as secondary hypertension. Conclusion: GPs implemented intensive management and made BP reach the target under the guidance of experts were effective management pattern of chronic disease. The uncontrolled BP patients in the communities used simple treatment flow path (C + A or A + D) earlier, the BP control rate was higher.