Background Carotid intimal thickness(IMT),a marker of subclinical atherosclerosis,was widely used for predicting cardiovascular events. Recent studies have shown that inflammation plays a vital role in the development...Background Carotid intimal thickness(IMT),a marker of subclinical atherosclerosis,was widely used for predicting cardiovascular events. Recent studies have shown that inflammation plays a vital role in the development and progression of atherosclerosis. The neutrophil to lymphocyte ratio(NLR)is a new marker of inflammation because it is closely related to cardiovascular,metabolic and inflammatory diseases. However,the relationship between NLR and carotid atherosclerosis is currently unknown. Methods A total of 882 patients underwent blood sampling for neutrophil and lymphocyte counts,serum lipids,total homocysteine(tHcy),and carotid scan by ultrasonography(US)to evaluate abnormalities of carotid wall. Results NLR was found to be statistically significantly higher in the carotid atherosclerosis group(2.0±0.8 vs. 1.7±0.6,P<0.001). The NLR,expressed as both quartiles(odds ratio[OR],2.36;95% confidence interval[CI],1.37 to 3.47;P=0.001)and continuous values(OR,1.83;95% CI,1.43 to 2.33;P<0.001),was significantly associated with a higher risk for carotid atherosclerosis. The optimal NLR cutoff value for detecting carotid atherosclerosis was 1.60 based on receiver operating curve(ROC)analysis with a sensitivity of 64.0% and a specificity of 57.0%. Conclusion NLR is significantly associated with carotid atherosclerosis in newly diagnosed nondiabetic hypertensive patients.展开更多
Background Hypertension is one of the most common chronic diseases which threatens human health. However,epidemic data of hypertension guided by new ACC hypertension guideline is limited. Methods Residents from four c...Background Hypertension is one of the most common chronic diseases which threatens human health. However,epidemic data of hypertension guided by new ACC hypertension guideline is limited. Methods Residents from four cities in urban and country areas were enrolled by the probability proportional to size method in Guangdong province,China. Results A total of 19,031 participants were enrolled. The age-standardized prevalence of hypertension was 32.07% guided by previous guideline and 56.67%guided by the new guideline. Notably,when guided by new guideline,the prevalence of hypertension in younger(15~24 years,313%;25~34 years,270%;35~44 years,186%),lower body mass index(BMI<24 kg/m^2,102%)and high-educated(undergraduates,194%;postgraduates,137%)participants increased more compared to older(55~64 years,47%;65~74 years,33%;75~84 years,23%),obesity(BMI≥28 kg/m^2,46.6%)and low-educated(primary school,42%)participants. Age,gender,alcohol taking,BMI,waist circumference,education,medical insurance and hypertension family history were found to be independent risk factors of hypertension in new guidelines. Conclusions The prevalence of hypertension changed greatly when guided by the new hypertension guideline. When applying the new hypertension guideline,subjects with younger age,lower BMI and high-educated tend to be more susceptible to hypertension compared to traditional high risk population. Further studies are needed to explore indicators that can predict the morbidity of hypertension.展开更多
Background Non-dipping blood pressure(BP)pattern is a potential risk factor contributing to cardiac geometry change.Relationship between BP pattern and left atrium(LA)enlargement besides left ventricle(LV)structural c...Background Non-dipping blood pressure(BP)pattern is a potential risk factor contributing to cardiac geometry change.Relationship between BP pattern and left atrium(LA)enlargement besides left ventricle(LV)structural change is seldom studied.Methods A total of 237 hypertensive and hospitalized adults were enrolled.Left heart chamber parameters were measured by 2-dimensional echocardiography,and BP circadian rhythm was evaluated by 24-hour ambulatory blood pressure monitoring.Night-day ratios of systolic BP(NDR-SBP)were calculated and BP patterns were classified into dippers,reduced-dippers,and risers,which were defined as NDR-SBP<0.9,≥0.9 and<1,≥1,respectively.Multiple logistic regression analyses were performed to identify the factors associated with increased left ventricular end-diastolic internal diameter and left atrial diameter.Results Among enrolled participants,there were 62(26.2%)dippers,136(57.4%)reduced-dippers and 39(16.5%)risers.Briefly,57.8%were male and the mean age was 57.0±13.9 years.Compared to the dippers,both left ventricular end-diastolic diameter(44.4±4.3 mm in dippers,45.5±4.0 mm in reduced-dippers,46.5±4.5 mm in risers,P=0.045)and left atrial diameter(32.7±4.1 mm in dippers,34.3±4.7 mm in reduced-dippers,35.7±4.3 mm in risers,P=0.004)were progressively increased in reduced-dippers and risers.Logistic regression analyses showed that after adjusted for age,male gender,history of diabetes,blood lipid profiles,mean diurnal BP and estimated glomerular filtration rate,the association between increased LV diameter and riser BP pattern was significant(OR:2.621,95%CI:1.030-6.678)while the association between increased LA diameter and riser BP pattern was marginally significant.Conclusions The riser BP pattern is associated with the enlargement of LV and probably that of LA in hypertensive patients independent of 24-hour systolic BP level.展开更多
Background Central aortic systolic blood pressure（CASP） has been shown to be a stronger predictor of target-organ damage and cardiovascular events than brachial systolic blood pressure（BSBP）, but there was no data...Background Central aortic systolic blood pressure（CASP） has been shown to be a stronger predictor of target-organ damage and cardiovascular events than brachial systolic blood pressure（BSBP）, but there was no data about whether CASP can predict prolonged QRS duration more than BSBP. We examined the association of CASP and BSBP with QRS duration in rural community residents. Methods We retrospectively analyzed 490 rural community residents. Standard resting 12-lead ECG and central aortic blood pressure（CABP） were measured noninvasively in all subjects at baseline. The QRS duration was equal to or more than 120 ms being defined as prolonged QRS duration. Results The prolonged QRS duration group showed higher CASP（139.38 ± 11.67 vs. 135.36 ± 16.22, P = 0.031） and BSBP（136.03 ± 6.74 vs. 124.44 ± 13.01, P 〈 0.001） as compared with controls. Multivariate linear regression analysis showed that CASP, BSBP and heart rate were independently affecting QRS duration. Logistic regression analyses showed that CASP（OR 1.057, 95%CI： 1.027, 1.088, P 〈 0.001）and BSBP（OR 1.056, 95%CI： 1.027, 1.086, P = 0.032） were independent predictors of prolonged QRS duration after adjustment for age, sex, body mass index, heart rate. CASP had a better predictive value for prolonged QRS duration than（AUC： 0.793 vs. 0.601, P 〈 0.001） BSBP. Conclusions Our findings demonstrate that both CASP and BSBP are risks for prolonged QRS duration, but CASP can predict prolonged QRS duration better than BSBP.展开更多
基金supported by the Natural Science Foundation of Guangdong Province(No.2015A030313660)the Science and technology Program of Guangdong Province(No.2014B020212008)+2 种基金the Science and Technology Program of Guangzhou(No.201604020143/201604020018/201604020186/201510010254/201803040012)the National Key Research and development Program of China(No.2017FYC1307603/2016YFC1301305)the Medical Science and Technology research Fund of Guangdong Province(No.B2018023)
文摘Background Carotid intimal thickness(IMT),a marker of subclinical atherosclerosis,was widely used for predicting cardiovascular events. Recent studies have shown that inflammation plays a vital role in the development and progression of atherosclerosis. The neutrophil to lymphocyte ratio(NLR)is a new marker of inflammation because it is closely related to cardiovascular,metabolic and inflammatory diseases. However,the relationship between NLR and carotid atherosclerosis is currently unknown. Methods A total of 882 patients underwent blood sampling for neutrophil and lymphocyte counts,serum lipids,total homocysteine(tHcy),and carotid scan by ultrasonography(US)to evaluate abnormalities of carotid wall. Results NLR was found to be statistically significantly higher in the carotid atherosclerosis group(2.0±0.8 vs. 1.7±0.6,P<0.001). The NLR,expressed as both quartiles(odds ratio[OR],2.36;95% confidence interval[CI],1.37 to 3.47;P=0.001)and continuous values(OR,1.83;95% CI,1.43 to 2.33;P<0.001),was significantly associated with a higher risk for carotid atherosclerosis. The optimal NLR cutoff value for detecting carotid atherosclerosis was 1.60 based on receiver operating curve(ROC)analysis with a sensitivity of 64.0% and a specificity of 57.0%. Conclusion NLR is significantly associated with carotid atherosclerosis in newly diagnosed nondiabetic hypertensive patients.
基金the Natural Science Foundation of Guangdong Province(No.2015A030313660)the Science and Technology Program of Guangzhou(No.201803040012/No.201604020143/No.201604020018/No.201510010254/No.201604020186)+3 种基金the Medical Science and Technology Research Fund of Guangdong Province(No.B2018023)the National Key Research and Development Program of China(No.2017FYC1307603/No.2016YFC1301305)the Science and Technology Program of Guangdong Province(No.2017B030314041/No.2014B020212008)the Key Area R&D Program of Guangdong Province(No.2019B020227005).
文摘Background Hypertension is one of the most common chronic diseases which threatens human health. However,epidemic data of hypertension guided by new ACC hypertension guideline is limited. Methods Residents from four cities in urban and country areas were enrolled by the probability proportional to size method in Guangdong province,China. Results A total of 19,031 participants were enrolled. The age-standardized prevalence of hypertension was 32.07% guided by previous guideline and 56.67%guided by the new guideline. Notably,when guided by new guideline,the prevalence of hypertension in younger(15~24 years,313%;25~34 years,270%;35~44 years,186%),lower body mass index(BMI<24 kg/m^2,102%)and high-educated(undergraduates,194%;postgraduates,137%)participants increased more compared to older(55~64 years,47%;65~74 years,33%;75~84 years,23%),obesity(BMI≥28 kg/m^2,46.6%)and low-educated(primary school,42%)participants. Age,gender,alcohol taking,BMI,waist circumference,education,medical insurance and hypertension family history were found to be independent risk factors of hypertension in new guidelines. Conclusions The prevalence of hypertension changed greatly when guided by the new hypertension guideline. When applying the new hypertension guideline,subjects with younger age,lower BMI and high-educated tend to be more susceptible to hypertension compared to traditional high risk population. Further studies are needed to explore indicators that can predict the morbidity of hypertension.
基金supported by the Key Area R&D Program of Guangdong Province(No.2019B020227005)National Key Research and Development Program of China(No.2016YFC1301202)。
文摘Background Non-dipping blood pressure(BP)pattern is a potential risk factor contributing to cardiac geometry change.Relationship between BP pattern and left atrium(LA)enlargement besides left ventricle(LV)structural change is seldom studied.Methods A total of 237 hypertensive and hospitalized adults were enrolled.Left heart chamber parameters were measured by 2-dimensional echocardiography,and BP circadian rhythm was evaluated by 24-hour ambulatory blood pressure monitoring.Night-day ratios of systolic BP(NDR-SBP)were calculated and BP patterns were classified into dippers,reduced-dippers,and risers,which were defined as NDR-SBP<0.9,≥0.9 and<1,≥1,respectively.Multiple logistic regression analyses were performed to identify the factors associated with increased left ventricular end-diastolic internal diameter and left atrial diameter.Results Among enrolled participants,there were 62(26.2%)dippers,136(57.4%)reduced-dippers and 39(16.5%)risers.Briefly,57.8%were male and the mean age was 57.0±13.9 years.Compared to the dippers,both left ventricular end-diastolic diameter(44.4±4.3 mm in dippers,45.5±4.0 mm in reduced-dippers,46.5±4.5 mm in risers,P=0.045)and left atrial diameter(32.7±4.1 mm in dippers,34.3±4.7 mm in reduced-dippers,35.7±4.3 mm in risers,P=0.004)were progressively increased in reduced-dippers and risers.Logistic regression analyses showed that after adjusted for age,male gender,history of diabetes,blood lipid profiles,mean diurnal BP and estimated glomerular filtration rate,the association between increased LV diameter and riser BP pattern was significant(OR:2.621,95%CI:1.030-6.678)while the association between increased LA diameter and riser BP pattern was marginally significant.Conclusions The riser BP pattern is associated with the enlargement of LV and probably that of LA in hypertensive patients independent of 24-hour systolic BP level.
基金supported by the grants from Guangdong Natural Science Foundation(No.2015A030313660)the Technology Project Foundation of Guangzhou(No.2014y2-00140/No.1563000381/201604020186/201604020018)+1 种基金the Technology Project Foundation of Guangdong Province(No.2014B020212008)National Natural Science Foundation of China(No.81300230)
文摘Background Central aortic systolic blood pressure（CASP） has been shown to be a stronger predictor of target-organ damage and cardiovascular events than brachial systolic blood pressure（BSBP）, but there was no data about whether CASP can predict prolonged QRS duration more than BSBP. We examined the association of CASP and BSBP with QRS duration in rural community residents. Methods We retrospectively analyzed 490 rural community residents. Standard resting 12-lead ECG and central aortic blood pressure（CABP） were measured noninvasively in all subjects at baseline. The QRS duration was equal to or more than 120 ms being defined as prolonged QRS duration. Results The prolonged QRS duration group showed higher CASP（139.38 ± 11.67 vs. 135.36 ± 16.22, P = 0.031） and BSBP（136.03 ± 6.74 vs. 124.44 ± 13.01, P 〈 0.001） as compared with controls. Multivariate linear regression analysis showed that CASP, BSBP and heart rate were independently affecting QRS duration. Logistic regression analyses showed that CASP（OR 1.057, 95%CI： 1.027, 1.088, P 〈 0.001）and BSBP（OR 1.056, 95%CI： 1.027, 1.086, P = 0.032） were independent predictors of prolonged QRS duration after adjustment for age, sex, body mass index, heart rate. CASP had a better predictive value for prolonged QRS duration than（AUC： 0.793 vs. 0.601, P 〈 0.001） BSBP. Conclusions Our findings demonstrate that both CASP and BSBP are risks for prolonged QRS duration, but CASP can predict prolonged QRS duration better than BSBP.
