目的探讨收缩压与缺血性心血管病(ICVD)10年发病危险度对无合并糖尿病和慢性肾脏病老年高血压人群全因死亡的影响。方法采取前瞻性队列研究方法,以首次参加2006-2007、2008-2009年开滦集团健康体检的6372例无合并糖尿病和慢性肾脏病老...目的探讨收缩压与缺血性心血管病(ICVD)10年发病危险度对无合并糖尿病和慢性肾脏病老年高血压人群全因死亡的影响。方法采取前瞻性队列研究方法,以首次参加2006-2007、2008-2009年开滦集团健康体检的6372例无合并糖尿病和慢性肾脏病老年高血压人群为观察对象。进行统一问卷调查、血液生化检查,以全因死亡为终点事件。依据观察对象收缩压值分为4组:收缩压<140 mm Hg(Q1组,n=703)、收缩压140～<150 mm Hg(Q2组,n=1931)、收缩压150～<160 mm Hg(Q3组,n=1472)和收缩压≥160 mm Hg(Q4组,n=2266)。用寿命表法计算各组累积全因死亡率,并采用Cox比例风险模型分析收缩压对全因死亡的影响。根据国人10年内ICVD发病危险简易评分方法,评估观察对象10年ICVD发病危险度,采用Cox比例风险模型探讨10年ICVD发病危险度对全因死亡的影响。结果随访(7.2±1.5)年,4组全因死亡例数和累积全因死亡率分别为128(18.2%)、323(16.7%)、264(17.9%)和458(20.2%)(χ~2=9.8,P=0.02)。以Q2组为对照,Cox比例风险模型分析显示,Q4组全因死亡风险比为1.23(95%CI 1.06～1.44,P<0.05);以Q1组为对照,Q2组10年内ICVD发病为很低危+低危、高危+很高危的全因死亡风险比分别为0.64(0.50～0.83)、1.48(1.05～2.10),P<0.05。校正混杂因素后,未服降压药者(n=3939)以及排除随访时间不足1年的观察对象24例后(n=6348),仅Q4组全因死亡风险增加。结论收缩压≥160 mm Hg无合并糖尿病和慢性肾脏病的老年高血压人群全因死亡风险增加23%。收缩压140～<150 mm Hg组10年ICVD发病低危及以下者全因死亡风险减少36%,高危及以上者全因死亡风险增加48%。展开更多
Type 2 diabetes （T2D） is common in the elderly and more than half of the people with diabetes are over 65 years old. Elderly diabetic patients have a higher frequency of hypertension, coronary artery disease and chr...Type 2 diabetes （T2D） is common in the elderly and more than half of the people with diabetes are over 65 years old. Elderly diabetic patients have a higher frequency of hypertension, coronary artery disease and chronic kidney disease than non-diabetic elderly patients and the risk of these complications increases with patient age, duration of the dia- betes and glycated hemoglobin values. Besides the known classical factors of renal disease progression,展开更多
The burgeoning geriatric population worldwide has resulted in an unprecedented challenge to the cardiology community. Cardiovascular disease is the major cause of morbidity and mortality in the elderly population, but...The burgeoning geriatric population worldwide has resulted in an unprecedented challenge to the cardiology community. Cardiovascular disease is the major cause of morbidity and mortality in the elderly population, but its recognition and management are characteristically confounded by substantial comorbidities, polypharmacy, and other complexities of care, not encountered in younger cardiac patients.展开更多
Objective To assess the relationship between HOMA-estimated insulin resistance and risk fac-tors of cardiovascular disease in the general population. Methods 268 eligible subjects of Pudong ShangGan community, aged 45...Objective To assess the relationship between HOMA-estimated insulin resistance and risk fac-tors of cardiovascular disease in the general population. Methods 268 eligible subjects of Pudong ShangGan community, aged 45-80 years, volunteered to participate in this cross-sectional survey. Fasting insulin was measured by means of a radioimmunoassay. Results Anthropometric parameters ,fasting blood glucose and insulin, increased in a linear fashion across quartiles of HOMA-IR after adjustment for age and sex. HOMA-IR was significantly associated with measures of anthropometry (BMI,r = 0. 30; waist circumference, r =0. 35; and waist-to-hip ratio,r =0.21), fasting (glucose,r =0. 41; insulin,r=0. 71), and cardiovascular risk factors ( cholesterol, r = 0. 23; triglyceride,r = 0. 31; systolic blood pressure,r= 0. 25; and diastolic blood pressure, r = 0. 20; all P < 0. 0001). In logistic regression analysis, odds ratios indicate that individuals with obesity ( high levels of BMI and waist circumference) were more than 4 times likely to have elevated HOMA-IR. With increase of log triglycerides, the risk of having elevated HOMA-IR increased more than 2. 4 times. For increase in systolic and diastolic blood pressure, the likelihood of having elevated HOMA-IR increased >1. 8 times. Conclusion HOMA-IR was significantly and independently associated with risk factors of cardiovascular disease in this study.展开更多
Although emerging studies from high-income countries investigated the relationship between sedentary behavior(SB) and cardiovascular risk,little evidence came from developing countries.Moreover,the benefits of realloc...Although emerging studies from high-income countries investigated the relationship between sedentary behavior(SB) and cardiovascular risk,little evidence came from developing countries.Moreover,the benefits of reallocating time from SB to physical activity(PA) on incident cardiovascular disease(CVD) are unknown.Using three cohorts from the Prediction for Atherosclerotic Cardiovascular Disease Risk in China project,we included 93 110 adults who were free from CVD at baseline.Cox proportional hazards models were used to calculate the hazard ratios(HRs) and 95% confidence intervals(CIs) for CVD,including stroke,coronary heart disease,and CVD death.Isotemporal substitution models were applied to estimate the per-hour effects of replacing SB with PA.After 5.8 years follow-up,3799 CVD cases were identified.A gradient positive association between sedentary time and incident CVD was observed.Relative to those with <5 h/d sedentary time,the multivariable-adjusted HRs(95% CIs) of CVD incidence were 1.07(0.96-1.20),1.27(1.13-1.43) and 1.51(1.34-1.70) for those having 5-<8,8-<10,and> 10 h/d sedentary time,respectively.When participants were cross-classified by SB and moderate to vigorous physical activity(MVPA) level,the CVD risk was highest in those with> 10 h/d SB and <150 min/week MVPA.Among those who reported> 5 h/d sedentary time,per-hour substitution of SB with light,moderate,and vigorous PA reduced incident CVD risk by 5%,6%,and 8%,respectively.The study first found that sedentary time was associated with increased incident CVD risk among Chinese adults and that substitution of SB with PA of any intensity could convey cardiovascular benefits among those with> 5 h/d SB.展开更多
文摘目的探讨收缩压与缺血性心血管病(ICVD)10年发病危险度对无合并糖尿病和慢性肾脏病老年高血压人群全因死亡的影响。方法采取前瞻性队列研究方法,以首次参加2006-2007、2008-2009年开滦集团健康体检的6372例无合并糖尿病和慢性肾脏病老年高血压人群为观察对象。进行统一问卷调查、血液生化检查,以全因死亡为终点事件。依据观察对象收缩压值分为4组:收缩压<140 mm Hg(Q1组,n=703)、收缩压140～<150 mm Hg(Q2组,n=1931)、收缩压150～<160 mm Hg(Q3组,n=1472)和收缩压≥160 mm Hg(Q4组,n=2266)。用寿命表法计算各组累积全因死亡率,并采用Cox比例风险模型分析收缩压对全因死亡的影响。根据国人10年内ICVD发病危险简易评分方法,评估观察对象10年ICVD发病危险度,采用Cox比例风险模型探讨10年ICVD发病危险度对全因死亡的影响。结果随访(7.2±1.5)年,4组全因死亡例数和累积全因死亡率分别为128(18.2%)、323(16.7%)、264(17.9%)和458(20.2%)(χ~2=9.8,P=0.02)。以Q2组为对照,Cox比例风险模型分析显示,Q4组全因死亡风险比为1.23(95%CI 1.06～1.44,P<0.05);以Q1组为对照,Q2组10年内ICVD发病为很低危+低危、高危+很高危的全因死亡风险比分别为0.64(0.50～0.83)、1.48(1.05～2.10),P<0.05。校正混杂因素后,未服降压药者(n=3939)以及排除随访时间不足1年的观察对象24例后(n=6348),仅Q4组全因死亡风险增加。结论收缩压≥160 mm Hg无合并糖尿病和慢性肾脏病的老年高血压人群全因死亡风险增加23%。收缩压140～<150 mm Hg组10年ICVD发病低危及以下者全因死亡风险减少36%,高危及以上者全因死亡风险增加48%。
文摘Type 2 diabetes （T2D） is common in the elderly and more than half of the people with diabetes are over 65 years old. Elderly diabetic patients have a higher frequency of hypertension, coronary artery disease and chronic kidney disease than non-diabetic elderly patients and the risk of these complications increases with patient age, duration of the dia- betes and glycated hemoglobin values. Besides the known classical factors of renal disease progression,
文摘The burgeoning geriatric population worldwide has resulted in an unprecedented challenge to the cardiology community. Cardiovascular disease is the major cause of morbidity and mortality in the elderly population, but its recognition and management are characteristically confounded by substantial comorbidities, polypharmacy, and other complexities of care, not encountered in younger cardiac patients.
基金Supported by the foundation from Shanghai Science and Technology Commission (00HX020)by the foundation from Shanghai Public Administration (99427)
文摘Objective To assess the relationship between HOMA-estimated insulin resistance and risk fac-tors of cardiovascular disease in the general population. Methods 268 eligible subjects of Pudong ShangGan community, aged 45-80 years, volunteered to participate in this cross-sectional survey. Fasting insulin was measured by means of a radioimmunoassay. Results Anthropometric parameters ,fasting blood glucose and insulin, increased in a linear fashion across quartiles of HOMA-IR after adjustment for age and sex. HOMA-IR was significantly associated with measures of anthropometry (BMI,r = 0. 30; waist circumference, r =0. 35; and waist-to-hip ratio,r =0.21), fasting (glucose,r =0. 41; insulin,r=0. 71), and cardiovascular risk factors ( cholesterol, r = 0. 23; triglyceride,r = 0. 31; systolic blood pressure,r= 0. 25; and diastolic blood pressure, r = 0. 20; all P < 0. 0001). In logistic regression analysis, odds ratios indicate that individuals with obesity ( high levels of BMI and waist circumference) were more than 4 times likely to have elevated HOMA-IR. With increase of log triglycerides, the risk of having elevated HOMA-IR increased more than 2. 4 times. For increase in systolic and diastolic blood pressure, the likelihood of having elevated HOMA-IR increased >1. 8 times. Conclusion HOMA-IR was significantly and independently associated with risk factors of cardiovascular disease in this study.
基金supported by the Chinese Academy of Medical Sciences (CAMS) Innovation Fund for Medical Sciences (2019-I2M-2-003, 2017-I2M-1-004)National Key R&D Program of China (2017YFC0211700 and 2018YFE0115300)the National Natural Science Foundation of China (91643208)。
文摘Although emerging studies from high-income countries investigated the relationship between sedentary behavior(SB) and cardiovascular risk,little evidence came from developing countries.Moreover,the benefits of reallocating time from SB to physical activity(PA) on incident cardiovascular disease(CVD) are unknown.Using three cohorts from the Prediction for Atherosclerotic Cardiovascular Disease Risk in China project,we included 93 110 adults who were free from CVD at baseline.Cox proportional hazards models were used to calculate the hazard ratios(HRs) and 95% confidence intervals(CIs) for CVD,including stroke,coronary heart disease,and CVD death.Isotemporal substitution models were applied to estimate the per-hour effects of replacing SB with PA.After 5.8 years follow-up,3799 CVD cases were identified.A gradient positive association between sedentary time and incident CVD was observed.Relative to those with <5 h/d sedentary time,the multivariable-adjusted HRs(95% CIs) of CVD incidence were 1.07(0.96-1.20),1.27(1.13-1.43) and 1.51(1.34-1.70) for those having 5-<8,8-<10,and> 10 h/d sedentary time,respectively.When participants were cross-classified by SB and moderate to vigorous physical activity(MVPA) level,the CVD risk was highest in those with> 10 h/d SB and <150 min/week MVPA.Among those who reported> 5 h/d sedentary time,per-hour substitution of SB with light,moderate,and vigorous PA reduced incident CVD risk by 5%,6%,and 8%,respectively.The study first found that sedentary time was associated with increased incident CVD risk among Chinese adults and that substitution of SB with PA of any intensity could convey cardiovascular benefits among those with> 5 h/d SB.
