Objectives: Health check-ups constitute an essential part of China's primary health care policy and a key measure for health screening and risk assessment for elderly people with hypertension and chronic diseases. The role of health check-ups in reducing the incidence of cardiovascular and all-cause mortality remains controversial. This study aimed to investigate the relationship between health check-ups and cardiovascular and all-cause mortality in elderly individuals with hypertension. Study design: Retrospective cohort study. Methods: This study included 625,279 elderly participants with hypertension. Associations of regular and irregular health check-ups with cardiovascular disease related (CVD-related) mortality, all-cause mortality and non-CVD-related mortality were tested via the inverse probability of treatment weighting (IPTW) matching and Cox proportional hazard models. Adjusted hazard ratios (HRs) and 95 % confidence intervals (CIs) were estimated for mortality. Results: A total of 625,279 participants completed health assessments. During a median follow-up of 5.43 years, 45,927 CVD-related deaths and 25,519 non-CVD-related deaths were recorded. After IPTW, regular health checkups were significantly associated with reduced CVD-related mortality and all-cause mortality (HR: 0.442, 95 % CI: 0.434-0.450; and HR: 0.441, 95 % CI: 0.435-0.448, respectively). An even stronger association between regular health check-ups and reduced CVD-related mortality was observed in participants with diabetes (HR: 0.40, 95 % CI: 0.39-0.42, P for interaction 60.001), dyslipidaemia (HR: 0.43, 95 % CI: 0.42-0.44, P for interaction 60.001) and a high risk or very high risk of hypertension (HR: 0.41, 95 % CI: 0.40-0.42, P for interaction 60.001). Conclusions: Regular health check-ups may be associated with reductions in CVD mortality and all-cause mortality in the elderly population with hypertension, especially in individuals with diabetes, dyslipidaemia and a high risk or very high risk of hypertension.

Abstract Wearable devices for BP measurement as an emerging technology for closer monitoring BP and achieving better BP control monitoring. However, the accuracy of wearable devices needs to be systematically validated and analyzed. This study aims to compare wearable device readings for BP measurement with those from cuff sphygmomanometers in prospective clinical studies, therefore, to determine whether wearable devices provide reliable and portable BP monitoring. The Web of Science, MEDLINE, Embase, Cochrane Library, and PubMed databases were searched from January 1, 1952 to October 8, 2021. Data were compiled from 21 articles comprising 897 participants. There was no significant difference between systolic and diastolic readings for wearable devices and cuff sphygmomanometers, with a combined mean difference of 0.58 mmHg (95% CI, -0.35 to 1.51; n = 21; I²=0%, P = 0.22) for SBP and − 0.33 mmHg (95% CI, -1.50 to 0.85; n = 19; I²=56%, P = 0.58) for DBP. The subgroup analysis showed that BP readings of wearable devices lower than cuff sphygmomanometers at the wrist site (-1.85mm Hg, 95% CI, -2.75 to -0.95; n = 11; I² = 10%, P༜0.05). Wearable device measurement for BP is comparable to the readings of cuff sphygmomanometers. Although the accuracy still should be improved, wearable device measurement may be a reliable and convenient approach for daily BP monitoring to improve BP control.

BACKGROUND:Tertiary lymphoid organs (TLOs) are ectopic lymphoid organs developed in nonlymphoid tissues with chronic inflammation, but little is known about their existence in different types of vascular diseases and the mechanism that mediated their development. METHODS:To take advantage of single-cell RNA sequencing techniques, we integrated 28 single-cell RNA sequencing data sets containing 5 vascular disease models (atherosclerosis, abdominal aortic aneurysm, intimal hyperplasia, isograft, and allograft) to explore TLOs existence and environment supporting its growth systematically. We also searched Medline, Embase, PubMed, and Web of Science from inception to January 2022 for published histological images of vascular remodeling for histological evidence to support TLO genesis. RESULTS:Accumulation and infiltration of innate and adaptive immune cells have been observed in various remodeling vessels. Interestingly, the proportion of such immune cells incrementally increases from atherosclerosis to intimal hyperplasia, abdominal aortic aneurysm, isograft, and allograft. Importantly, we uncovered that TLO structure cells, such as follicular helper T cells and germinal center B cells, present in all remodeled vessels. Among myeloid cells and lymphocytes, inflammatory macrophages, and T helper 17 cells are the major lymphoid tissue inducer cells which were found to be positively associated with the numbers of TLO structural cells in remodeled vessels. Vascular stromal cells also actively participate in vascular TLO genesis by communicating with myeloid cells and lymphocytes via CCLs (C-C motif chemokine ligands), CXCL (C-X-C motif ligand), lymphotoxin, BMP (bone morphogenetic protein) chemotactic, FGF-2 (fibroblast growth factor-2), and IGF (insulin growth factor) proliferation mechanisms, particularly for lymphoid tissue inducer cell aggregation. Additionally, the interaction between stromal cells and immune cells modulates extracellular matrix remodeling. Among TLO structure cells, follicular helper T, and germinal center B cells have strong interactions via TCR (T-cell receptor), CD40 (cluster of differentiation 40), and CXCL signaling, to promote the development and maturation of the germinal center in TLO. Consistently, by reviewing the histological images from the literature, TLO genesis was found in those vascular remodeling models. CONCLUSIONS:Our analysis showed the existence of TLOs across 5 models of vascular diseases. The mechanisms that support TLOs formation in different models are heterogeneous. This study could be a valuable resource for understanding and discovering new therapeutic targets for various forms of vascular disease.

Background and aims Acute myocardial infarction (AMI) is divided into left ventricular myocardial infarction (LVMI) and right ventricular myocardial infarction (RVMI) according to the regions of myocardial ischemic necrosis. Clinical characteristics, treatment strategies, and prognosis differences between isolated RVMI and LVMI have not been well characterized. This study aimed to explore this difference of patients with isolated RVMI and LVMI. Methods This retrospective cohort study included 3,506 patients hospitalized with coronary angiography diagnosed type 1 myocardial infarction (MI). Characteristics of admission and treatment strategies were compared in patients with isolated RVMI and LVMI. COX proportional hazards models with and without inverse probability of treatment weighting (IPTW) adjustment were performed to estimate the difference in all-cause and cardiovascular mortality between the two groups. Results In this retrospective study, we found the frequency of isolated RVMI was significantly lower in the population than that of isolated LVMI (406 (11.6%) vs 3,100 (88.4%)). Patients with isolated RVMI have similar age, sex, and comorbidities to the patients with isolated LVMI. However, patients with isolated RVMI have lower heart rate and blood pressure, but higher rates of cardiogenic shock and atrioventricular block. It is noteworthy that patients with isolated RVMI are more likely to be complicated with the multivessel lesion. Patients with isolated RVMI have lower risk of all-cause mortality (HR 0.36; 95% CI [0.24–0.54], p < 0.001) and cardiovascular mortality (HR 0.37; 95% CI [0.22–0.62], p < 0.001) than patients with isolated LVMI. Conclusions This study showed that patients with isolated RVMI and LVMI have similar baseline characteristics. However, the clinical manifestations were different in the isolated RVMI and LVMI patients. This study revealed a better prognosis of isolated RVMI patients compared to isolated LVMI, which indicates the ischemic region could be considered in AMI risk stratification models for better assessment of risk for adverse clinical events.

Background and aims: This study aimed to explore the profile of multimorbidity phenotype clusters and their discrepancy in mortality and the efficiency of combined interventions on blood pressure, glucose and lipid in each cluster.Methods: Fine and Gray competing risk regression models and Kaplan-Meier curves were used to assess the association between multimorbidity and mortality and rehospitalization. Fine and Gray competing risk regres-sion models and subgroup analyses were used to estimate the relations between combined interventions and mortality.Results: Three distinct multimorbidity clusters were observed: Class 1 named severe class, Class 2 termed moderate class, and Class 3 named mild class. Competing risk regression models revealed that patients in Class 1 have the greatest burden of mortality and rehospitalization compared to Class 3 after confounder adjustment, with HRs 1.43 (95% CI 1.30-1.56, P < 0.001) and 2.97 (95% CI 2.74-3.21, P < 0.001), respectively. The patients in Class 2 have moderate risk of mortality and rehospitalization compared to Class 3 after confounder adjust-ment, with HRs 1.41 (95% CI 1.30-1.52, P < 0.001) and 2.39 (95% CI 2.23-2.56, P < 0.001), respectively. Furthermore, we found that combined interventions on blood pressure, glucose and lipid simultaneously could further benefit on survival compared to each individual intervention or two in combine.Conclusions: This study found that multimorbidity among patients with CHD was common and increased the risks of death and rehospitalization. Three multimorbidity clusters that were significantly associated with death and rehospitalization were identified. Simultaneous intervention on blood pressure, glucose and lipid level may further benefit CHD patient in survival.