Association of blood pressure classification in young adults using the 2017 ACC/AHA guideline with subsequent all-cause mortality

Background Little is known regarding the association of changes in blood pressure level with risk of allcause and cardiovascular disease(CVD) mortality in young adults. Methods This cohort study from the 1999-2006 National Health and Nutrition Examination Survey(NHANES) consisted of 9977 adults aged from 18 to 40 years by following up until the date of death or December 31, 2015. Participants were categorized by blood pressure readings using the blood pressure classification of the 2017 American College of Cardiology/American Heart Association(ACC/AHA) High Blood Pressure Clinical Practice Guidelines: normal(systolic, <120 mm Hg;diastolic, <80 mm Hg), elevated(systolic, 120-129 mm Hg;diastolic, <80 mm Hg), and hypertension(systolic,≥130 mm Hg;diastolic,≥80 mm Hg). Multivariable Cox proportional hazard models yielded adjusted hazard ratios(HRs) and 95% confidence intervals(CIs) of CVD and all-cause mortality. Results A total of 8356 participants(median age, 26.63 ± 7.01, 3758 women [44.97%]), of whom 265(3.17%) all-cause and 10(0.12%)CVD mortality were observed during a median follow-up duration of 152.96 ± 30.45 months. All-cause mortality incidence rates for normal blood pressure, elevated blood pressure, and hypertension were 172(2.91%), 43(3.52%), and 50(4.10%), respectively. With the normal blood pressure group being a reference, from elevated blood pressure to hypertension group, adjusted HRs for all-cause mortality were 1.24(95% CI, 0.63-2.42) and1.52(95% CI, 0.83-2.80)(P=0.162) after adjustment for potential confounders. Conclusions Among young adults, those with elevated blood pressure and hypertension, compared with those with normal blood pressure before the age of 40, as defined by the blood pressure classification in the 2017 ACC/AHA guidelines, are not significantly associated with increased risk of subsequent all-cause mortality.[S Chin J Cardiol 2019;20(4):201-210]

Genetic climatic regionalization of the Balkan Peninsula using cluster analysis

Sea Level Pressure（SLP） data for the period 1950–2012 at 61 stations located in or around the Balkan Peninsula was used. The main concept is that intra-annual course of SLP represents the best different air masses that are situated over the Balkan Peninsula during the year. The method for differentiation of climatic zones is cluster analysis. A hierarchical clustering technique–average linkage between groups with Pearson correlation for measurement of intervals was employed in the research. The climate of the Balkan Peninsula is transitional between oceanic and continental and also between subtropical and temperate climates. Several major changes in atmospheric circulation over the Balkan Peninsula have happened over the period 1950–2012. There is a serious increase of the influence of the Azores High in the period January–Marchwhich leads to an increase of SLP and enhances oceanic influence. There is an increase of the influence of the north-west extension of the monsoonal low in the period June–September. This leads to more continental climatebut also to more tropical air masses over the Balkan Peninsula. Accordinglythe extent of subtropical climate widens in northern direction. There is an increase of the influence of the Siberian High in the period October–December. This influence covers central and eastern part of the peninsula in October and Novemberand it reaches western parts in December. Thusthe climate becomes more continental.