332例高血压病患者中医体质类型构成比调查分析

目的:探讨高血压病患者的体质特点及高血压病发病的体质因素。方法:按照中医体质研究要求建立纳入病例标准,选择本院中风科门诊及住院的高血压病患者332例,按照《中医体质分类与判定》标准录入,分析各种中医体质类型的构成比。结果:中医体质类型按痰湿质、阴虚质、血瘀质、阳虚质、气虚质、湿热质、气郁质、平和质、特禀质从高到底分布,所占比例分别为19.58%、18.37%、13.55%、12.05%、10.84%、9.94%、7.53%、4.52%、3.61%。结论:痰湿质、阴虚质为高血压病患者的主要中医体质类型。

初发2型糖尿病强化治疗的血压和血糖及血脂变化

目的:比较初发2型糖尿病强化治疗与常规治疗的血糖和血脂及血压控制情况。方法:160例初发糖尿病患者按照入组时间顺序分成2组(先收集常规治疗组80例,再收集强化治疗组80例),治疗前检测空腹血糖(FBG)、糖化血红蛋白(HbA1C)、血压、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白-C(LDL-C)和谷丙转氨酶(ALT)及谷草转氨酶(AST)。常规治疗组予门诊常规治疗,强化治疗组定期检测血压和血糖及血脂,对未达标患者调整治疗方案,直至血压和血糖及血脂达到治疗标准。6个月后再次检测相关指标,比较2组各观察指标的差异。结果:6个月时强化治疗组TC和LDL-C,与常规治疗组比较均有明显降低(P<0.05)。结论:2型糖尿病强化干预治疗在控制血糖的同时能使血脂得到进一步控制。

Meta-analysis of the Use of ACEI for Inhibiting Albuminuria in Diabetic Patients

Aim To examine whether AER(albumin excretion rate) in normotensive diabeticpatients can be effectively inhibited by ACEI. Methods Literature on randomized controlled trials ofACEI for inhibiting AER in normotensive diabetic patients was searched. The electronic databasesretrieved were Medline (1980 ― 2003), Embase database (1980 ― 2000), Cochrane Library, CL( 1980 ―2004), CBMdisc( 1980 ― 2002), and IPA( 1980 ― 2002). Seven studies were chosen. Data werecombined by Revman 4.2. Results: The pooled effect of change in AER is - 56.31 μg·min^(-1)) [ -81.96, -30.66] (P<0.0001). According to the analysis of subgroups, the pooled effects of 1 - 5 yearsare - 11.97 μg·min^(-1)[-22.04, -1.89] (P = 0.02), -28.01 μg·min^(-1)[-34.50, -21.52](P<0.00001), -43.24 μg·min^(-1) [ -57.15, -29.32] (P< 0.00001), -61.65 μg·min^(-1)[77.77,-45.54] (P< 0.00001), and -98.41 μg·min^(-1)[-162.02,-34.79] (P = 0.002). Regarding progression toclinincal proteinuria as end-point, the pooled Peto OR =0.27 [0.18,0.40] (95% CI), P < 0.00001.According to the analysis of subgroups, the pooled effects of 2 and 5 years are Peto OR = 0.30[0.18,0.51] (P<0.00001) and Peto OR=0.25 [0.13, 0.50](P<0.0001). Publication bias is small.Conclusion In normotensive diabetic patients, ACEI inhibits AER effectively and reduces theprobability of progression of microalbuminuria to clinical proteinuria.

Epigenetics of epithelial Na^+ channel-dependent sodium uptake and blood pressure regulation

The epithelial Na^＋ channel （ENaC） consists of α, β, γ subunits. Its expression and function are regulated by aldosterone at multiple levels including transcription. ENaC plays a key role in Na^＋ homeostasis and blood pressure. Mutations in ENaC subunit genes result in hypertension or hypotension, depending on the nature of the mutations. Transcription of αENaC is considered as the rate-limiting step in the formation of functional ENaC. As an aldosterone target gene, αENaC is activated upon aldosterone- mineralocorticoid receptor binding to the cis-elements in the αENaC promoter, which is packed into chromatin. However, how aldosterone alters chromatin structure to induce changes in transcription is poorly understood. Studies by others and us suggest that Dot1a-Af9 complex represses αENaC by directly binding and regulating targeted histone H3 K79 hypermethylation at the specific subregions of αENaC promoter. Aldosterone decreases Dot1a-Af9 formation by impairing expression of Dot1a and Af9 and by inducing Sgk1, which, in turn, phosphorylates Af9 at S435 to weaken Dot1a-Af9 interaction. MR attenuates Dot1a-Af9 effect by competing with Dot1a for binding Af9. Af17 relieves repression by interfering with Dot1a-Af9 interaction and promoting Dot1a nuclear export. Af17^-/- mice exhibit defects in ENaC expression, renal Na^＋ retention, and blood pressure control. This review gives a brief summary of these novel fndings.

Hyponatremic hypertensive syndrome-a retrospective cohort study

AIM To ascertain the frequency of hyponatremic hypertensive syndrome （HHS） in a cohort of children with hypertensive emergency in a tertiary pediatric hospital.METHODS A retrospective review was undertaken among children with hypertensive emergency admitted in our tertiary children hospital between June 2014 and December 2015 with an aim to identify any children with HHS. Three children with HHS were identifed during this period.RESULTS The 3 patients with HHS presented with hypertensive emergency. They were initially managed with Labetalol infusion and thereafter switched to oral anti-hypertensives （combination of Nifedipine sustained release, Hydralazine and Beta Blocker）. All 3 were diagnosed to have unilateral renal artery stenosis. One child was lost to follow up, whereas the other 2 underwent renal angioplasty which was followed with normalization of blood pressure.CONCLUSION Despite activation of renin angiotensin axis secondary to renal artery stenosis, these groups of children have significant hyponatremia. Renal re-vascularisation pro-duces excellent results in most of them.

Cold dialysis and its impact on renal patients' health:An evidence-based mini review

Chronic renal disease is associated with advanced age,diabetes,hypertension,obesity,musculoskeletal problems and cardiovascular disease,the latter being the main cause of mortality in patients receiving haemodialysis(HD).Cooled dialysate(35 ℃-36 ℃) is recently employed to reduce the incidence of intradialytic hypotension in patients on chronic HD.The studies to date that have evaluated cooled dialysate are limited,however,data suggest that cooled dialysate improves hemodynamic tolerability of dialysis,minimizes hypotension and exerts a protective effect over major organs including the heart and brain.The current evidence-based review is dealing with the protective effect of cold dialysis and the benefits of it in aspects affecting patients' quality of care and life.There is evidence to suggest that cold dialysis can reduce cardiovascular mortality.However,large multicentre randomized clinical trials are urgently needed to provide further supporting evidence in order to incorporate cold dialysis in routine clinical practice.

Clinical analysis of surgical treatment of portal hypertension

AIM： To review the experience in surgery for 508 patients with portal hypertension and to explore the selection of reasonable operation under different conditions. METHODS： The data of 508 patients with portal hypertension treated surgically in 1991-2001 in our centers were analyzed. Of the 508 patients, 256 were treated with portaazygous devascularization （PAD）, 167 with portasystemic shunt （PSS）, 62 with selective shunt （SS）, 11 with combined portasystemic shunt and portaazygous devascularization （PSS＋PAD）, 9 with liver transplantation （LT）, 3 with union operation for hepatic carcinoma and portal hypertension （HCC＋PH）. RESULTS： In the 167 patients treated with PSS, free portal pressure （FPP） was significantly higher in the patients with a longer diameter of the anastomotic stoma than in those with a shorter diameter before the operation （P〈0.01）. After the operation, FPP in the former patients markedly decreased compared to the latter ones （P〈0.01）. The incidence rate of hemorrhage in patients treated with PAD, PSS, 55, PSS＋PAD, and HCC＋PH was 21.09% （54/256）, 13.77 （23/167）, 11.29 （7/62）, 36.36% （4/11）, and 100% （3/3）, respectively. The incidence rate of hepatic encephalopathy was 3.91% （10/256）, 9.58% （16/167）, 4.84% （3/62）, 9.09% （1/11）, and 100% （3/3）, respectively while the operative mortality was 5.49% （15/256）, 4.22% （7/167）, 4.84% （3/62）, 9.09% （1/11）, and 66.67% （2/3） respectively. The operative mortality of liver transplantation was 22.22% （2/9）. CONCLUSION： Five kinds of operation in surgical treatment of portal hypertension have their advantages and disadvantages. Therefore, the selection of operation should be based on the actual needs of the patients.

Pre-treatment considerations in childhood hypertension due to chronic kidney disease

Hypertension （HTN） develops very early in childhood chronic kidney disease （CKD）. It is linked with rapid progression of kidney disease, increased morbidity and mortality hence the imperative to start anti-hypertensive medication when blood pressure （BP）is persistently 〉 90th percentile for age, gender, and height in non-dialyzing hypertensive children with CKD. HTN pathomechanism in CKD is multifactorial and complexly interwoven. The patient with CKD-associated HTN needs to be carefully evaluated for co-morbidities that frequently alter the course of the disease as successful treatment of HTN in CKD goes beyond life style modification and anti-hypertensive therapy alone. Chronic anaemia, volume overload, endothelial dysfunction, arterial media calcifcation, and metabolic derangements like secondary hyperparathyroidism, hyperphosphataemia, and calcitriol deficiency are a few co-morbidities that may cause or worsen HTN in CKD. It is important to know if the HTN is caused or made worse by the toxic effects of medications like erythropoietin, cyclosporine, tacrolimus, corticosteroids and non-steroidal anti-infammatory drugs. Poor treatment response may be due to any of these co-morbidities and medications. A satisfactory hypertensive CKD outcome, therefore, depends very much on identifying and managing these co-morbid conditions and HTN promoting medications promptly and appropriately. This review attempts to point attention to factors that may affect successful treatment of the hypertensive CKD child and how to attain the desired therapeutic BP target.

Proteomic analysis of the serum in patients with idiopathic pulmonary arterial hypertension

Idiopathic pulmonary arterial hypertension(IPAH) is a rare disease of unknown etiology.The exact pathogenesis of pulmonary arterial hypertension is still not well known.In the past decades,many protein molecules have been found to be in-volved in the development of IPAH.With proteomic techniques,profiling of human plasma proteome becomes more feasible in searching for disease-related markers.In present study,we showed the protein expression profiles of the serum of IPAH and healthy controls after depleting a few high-abundant proteins in serum.Thirteen spots had changed significantly in IPAH com-pared with healthy controls and were identified by LC-MS/MS.Alpha-1-antitrypsin and vitronectin were down-regulated in IPAH and may be valuable candidates for further explorations of their roles in the development of IPAH.

Clinicopathological spectrum of snake bite-induced acute kidney injury from India

AIM To study the clinico-pathological spectrum of snake bite-induced acute kidney injury(AKI).METHODS A retrospective study of patients admitted at Indira Gandhi Medical College Hospital,Shimla with snake bite-induced AKI from July 2003 to June 2016.Medical records were evaluated for patient's information on demographic,clinical characteristics,complications and outcome.Outcomes of duration of hospital stay,requirement for intensive care unit support,treatment with dialysis,survival and mortality were analyzed.The survival and non survival groups were compared to see the difference in the demographic factors,clinical characteristics,laboratory results,and complications.In patients subjected to kidney biopsy,the findings of histopathological examination of the kidney biopsies were also analyzed.RESULTS One hundred and twenty-one patients were diagnosed with snake bite-induced AKI.Mean age was 42.2 ± 15.1 years and majority(58%) were women.Clinical details were available in 88 patients.The mean duration of arrival at hospital was 3.4 ± 3.7 d with a range of 1 to30 d.Eighty percent had oliguria and 55% had history of having passed red or brown colored urine.Coagulation defect was seen in 89% patients.The hematological and biochemical laboratory abnormalities were:Anemia(80.7%),leukocytosis(75%),thrombocytopenia(47.7%),hyperkalemia(25%),severe metabolic acidosis(39.8%),hepatic dysfunction(40.9%),hemolysis(85.2%) and rhabdomyolysis(68.2%).Main complications were:Gastrointestinal bleed(12.5%),seizure/encephalopathy(10.2%),hypertension,pneumonia/acute respiratory distress syndrome(ARDS) and disseminated intravascular coagulation(9.1% each),hypotension and multi organ failure(MOF)(4.5% each).Eighty-two percent patients required renal replacement therapy.One hundred and ten(90.9%) patient survived and 11(9.1%) patients died.As compared to the survival group,the white blood cell count(P = 0.023) and bilirubin levels(P = 0.006) were significant higher and albumin levels were significantly lower(0.005) in patients who died.The proportion of patients with pneumonia/ARDS(P = 0.001),seizure/encephalopathy(P = 0.005),MOF(P = 0.05) and need for intensive care unit support(0.001) was significantly higher and duration of hospital stay was significantly shorter(P = 0.012) in patients who died.Kidney biopsy was done in total of 22 patients.Predominant lesion on kidney biopsy was acute tubular necrosis(ATN) in 20(91%) cases.In 11 cases had severe ATN and in other nine(41%) cases kidney biopsy showed features of ATN associated with mild to moderate acute interstitial nephritis(AIN).One patient only had moderate AIN and one had patchy renal cortical necrosis(RCN).CONCLUSION AKI due to snake bite is severe and a high proportion requires renal replacement therapy.On renal histology ATN and AIN are common,RCN is rare.

Adherence to pharmacological and non-pharmacological treatment of frail hypertensive patients

Objective To investigate the relationship between frailty syndrome （FS） and adherence to pharmacological and non-pharmacological treatment for hypertension. Methods The study included 100 patients diagnosed with hypertension and treated with one or more hypotensive drugs. Results Frail patients obtained low scores （4.1 ± 2.0） for adherence to pharmaceutical treatment of hypertension, while non-frail patients obtained moderate scores （6.1 ± 2.1）. Non-frail patients had higher scores in two out of four domains of the Health Behavior Inventory （HBI）： positive mental attitudes （3.6 ± 0.4 vs. 3.2 ± 0.5; P = 0.006） and health practices （3.6 ± 0.5 vs. 3.2 ± 0.5; P 〈 0.03）; as well as higher global scores （HBI raw score）： 83.3 ±10.6 vs. 77.3 ± 9.5; P 〈 0.03. Multiple regression analysis showed that frailty syndrome （FS） was a statistically significant independent determinant of worse adherence to pharmacological treatment （β= -0.27; P 〈 0.001） and health behaviors （β = -0.10; P = 0.036）. Education was a statistically significant independent determinant of better adherence to pharmacological treatment （β = 0.82; P = 0.012）, while net income positively affected health behaviors as measured by the HBI （β = 0.39; P = 0.046）. Conclusions FS is a significant independent factor contributing to worse adherence to pharmacological and non-pharmacological treatment of hypertension. Better education significantly improves patients＇ adherence to the prescribed pharmacological treatment, while a good financial standing evidenced by high net income is a determinant of better adherence to health-related behaviors recommended in hypertension treatment.

Power Spectral Analysis of Heart Rate Variability of Driver Fatigue

This investigation was to evaluate the driving fatigue based on power spectral analysis of heart rate variability (HRV) under vertical vibration. Forty healthy male subjects (29.7±3.5 years) were randomly divided into two groups, Group A (28.8±4.3 years) and Group B (30.6±2.7 years). Group A (experiment group) was required to perform the simulated driving and Group B (control group) kept calm for 90 min. The frequency domain indices of HRV such as low frequency (0.04 0.15 Hz, LF), high frequency (0.150.4 Hz, HF), LF/HF together with the indices of hemodynamics such as blood pressure (BP) and heart rate (HR) of the subjects between both groups were calculated and analyzed after the simulated driving. There were significances of the former indices between both groups (P<0.05). All the data collected after experiment of Group A was observed the remarkable linear correlation (P<0.05) and parameters and errors of their linear regression equation were stated (α=0.05, P<0.001) in this paper, respectively. The present study investigated that sympathetic activity of the subjects enhanced after the simulated driving while parasympathetic activities decreased. The sympathovagal balance was also improved. As autonomic function indictors of HRV reflected fatigue level, quantitative evaluation of driving mental fatigue from physiological reaction could be possible.

Meta-analysis of effects of obstructive sleep apnea on the renin-angiotensinaldosterone system

Background Obstructive sleep apnea （OSA） is the most common cause of resistant hypertension, which has been proposed to result from activation of the renin-angiotensin-aldosterone system （RAAS）. We meta-analyzed the effects of OSA on plasma levels of RAAS components. Methods Full-text studies published on MEDL1NE and EMBASE analyzing fasting plasma levels of at least one RAAS component in adults with OSA with or without hypertension. OSA was diagnosed as an apnea-hypopnea index or respiratory disturbance index 〉 5. Study quality was evaluated using the Newcastle-Ottawa Scale, and heterogeneity was assessed using the 12 statistic. Results from individual studies were synthesized using inverse variance and pooled using a random-effects model. Subgroup analysis, sensitivity analysis, and meta-regression were performed, and risk of publication bias was assessed. Results The meta-analysis included 13 studies, of which 10 reported results on renin （n = 470 cases and controls）, 7 on angiotensin II （AnglI, n = 384）, and 9 on aldosterone （n = 439）. AnglI levels were significantly higher in OSA than in controls [mean differences = 3.39 ng/L, 95% CI： 2.00-4.79, P 〈 0.00001], while aldosterone levels were significantly higher in OSA with hypertension than OSA but not with hypertension （mean differences = 1.32 ng/dL, 95% CI： 0.58-2.07, P = 0.0005）. Meta-analysis of all studies suggested no significant differences in aldosterone between OSA and controls, but a significant pooled mean difference of 1.35 ng/mL （95% CI： 0.88-1.82, P 〈 0.00001） emerged after excluding one small-sample study. No significant risk of publication bias was detected among all included studies. Conelusions OSA is associated with higher AnglI and aldosterone levels, espe- cially in hypertensive patients. OSA may cause hypertension, at least in part, by stimulating RAAS activity.

Influence of age on prevalence rates of chronic complications of hospitalized aged patients with hypertension -- analysis of 17,682 cases

Objective To understand the relationship between age and chronic complications in hospitalized aged patients with hypertension, to provide evidence for hypertension prevention and control. Methods To retrospectively analyze the clinical and laboratory data on 17,682 patients with essential hypertension during Jan 1 s,, 1993-Dec 12th, 2008 in PLA general hospital. Results 1） Among all of the inrolled cases, those aged 60-64 account for 27.87%, 65-69 years group account for 26.55%, 70-74 years group accounted for 23.96%, 75-79 years group accounted for 14.14%, 80-84 years group accounted for 5.26%, 85-89 years group accounted for 1.69%, 〉 90 years accounted for 0.41%. 2） The prevalence rate of chronic complications in 60-69 years group were 31.3-31.2% for diabetes and,22.6-27.0% for cerebrovascular disease, 9.5-11.1% for myocardial infarction, 6.7-9.1% for heart failure, 5.8-6.0% for renal dysfanction 4.9-6.8% for atrial fibrillation, 0.1-0.3% for multiple organ dysfunction syndrome （MODS） in the elderly（P 〈0.05 ）. 3） The first four complications of hypertension were diabetes（33.5%）, cerebrovascular disease （31.9%）, myocardial infarction（13.2%） and heart failure（12.3%） in 70-74 years group （P〈0.05）, cerebrovascular disease （42.8%）, diabetes （32.8%）, heart failure （16.5%） and myocardial infarction（15.9%） in 75-79 years group （P〈0.05）, cerebrovascular disease （45.4%）, diabetes （35.0%）, heart failure （21.1%） and myocardial infarction（l 5.9%） in 80-84 years group （P〈0.05）, cerebrovascular disease（42.5%）, diabetes （35.8%）, heart failure （23.1%） and renal dysfanction （17.7%） in 85-89 years group（P〈0.05 ）,and cerebrovascular disease （45. 2%）, heart failure（31.5%） , diabetes （26.0%） and renal dysfanction （20.5%） in patients more than 90 years group （P〈0.05）. Conclusions The prevalence rate and kinds of chronic complications in hospitalized aged patients with hypertension were changed with the increasing age, and the first kind of complication is cerebrovascular disease. It is of more importance to prevent the occurrence of renal dysfanction and heart failure in those hypertension patients who were more than 80 years old.

Spectral Analysis of Blood Pressure Variability as a Quantitative Indicator of Driving Fatigue

The quantitative detector of driver fatigue presents appropriate warnings and helps to prevent traffic accidents.The aim of this study was to quantifiably evaluate driver mental fatigue using the power spectral analysis of the blood pressure variability (BPV) and subjective evaluation. In this experiment twenty healthy male subjects were required to perform a driving simulator task for 3-hours. The physiological variables for evaluating driver mental fatigue were spectral values of blood pressure variability (BPV)including very low frequency (VLF), low frequency (LF),high frequency (HF). As a result, LF, HF and LF/HF showed high correlations with driver mental fatigue but not found in VLF. The findings represent a possible utility of BPV spectral analysis in quantitatively evaluating driver mental fatigue.

Why hypertension is good new and preeclampsia bad news-demonstrating the failure of prevention

Hypertensive disorders in pregnancy continue to be an intriguing and potentially lethal complication in humans and some other primates. In a simplistic way the current hypothesis is that the genesis of preeclampsia starts at 12 to 14 wk gestation with failure of trophoblast invasion in the spiral arteries, resulting in some degree of hypoxemia in the placenta. The hypoperfused placental tissue starts to secrete variable amounts of angiogenic and antiangiogenic factors which eventually cause endothelial damage all over the pregnant women's body with one of the many signs of preeclampsia as the clinical endpoint. For some incomprehensible reason a major interest has existed for decades concerning the early prediction of preeclampsia, most commonly tested using uterine artery Doppler(the earlier the better) and various serum markers, alone or in combination. Any new model for detection has been welcomed enthusiastically, although nothing has changed in the outcome of women presenting with preeclampsia.

Statins role in cancer prevention and development-recent meta-analyses

The therapeutic indications of 3-hydroxy-3-methylgl-utaryl-coenzyme A （HMG-CoA） reductase inhibitors （statins） include hypercholesterolaemia and the pre-vention of cardiovascular events. Statins are well toler-ated and beyond their unambiguous positive cardio-vascular effects there are a steadily increasing number of pleiotropic actions emerging. In this regard, growth inhibition, apoptosis, anti-infammatory and immuno-modulatory actions have been attributed to statins. The anti-proliferative effects have been the basis for massive preclinical investigations to elucidate a func-tional role for statins in carcinogenesis and tumor cell growth. However, preclinical and clinical studies are conflicting, although there is accumulating evidence that statins are capable to suppress and decrease the incidence and recurrence of some human cancers. Giv-en the fact that statins are well tolerated they might also have some impact in combinations with conven-tional and targeted chemotherapy. While synergism has been shown for many combinations in vitro this does not hold true yet in the clinics. Here we review the rational behind usage of statins in oncological set-tings. Positive effects have been observed in patients with melanoma and cancers from the breast, colon, prostate, lung, liver and hematologic tissues. However, substantial evidence from clinical studies is still weak and confounded by several factors, which are inherent in the study design. The majority of the studies are ob-servational or of retrospective nature. Defnitely, there is substantial need for larger, prospective randomized, placebo-controlled trials. Finally, we conclude that statins at the current status of evidence should not be recommended in the prevention or during progression of any cancers, however, individual statins may have benefcial effects in specifc tumor subgroups.

Mutational analysis of KCNJll in Chinese elderly essential hypertensive patients

Objective To compare the distribution ofKCNJll polymorphisms between elderly Chinese population with and without hypertension. Methods We examined the mutation of KCNJll gene by directly sequencing. Data for the present study were obtained from 250 hypertensive subjects （60 to 83 years old） as well as 250 normotensive subjects （60 to 86 years old）. Results We found nine different mutations in KCNJ11, including six novel mutations （1131M, L1471, L147V, L147L, Q235H, G245C）. None of the novel mutations were found in the normotensive subjects, and all the residues were conserved in other species. These sequence variants in Chinese population indicate the diversity of the human library and the complexity of hypertension. Conclusions The consistent finding of our present study provided a basis for the development of new strategies to diagnosis and treat hypertension in the elderly.

Glycemic and blood pressure control in older patients with hypertension and diabetes： association with carotid atherosclerosis

Backgroud Numerous studies have confirmed the effectiveness of slowing the progression of atherosclerosis by blood pressure （Bp） control in patients with hypertension and several studies also showed the efficacy of intensive glycemic control in decreasing progression of carotid intima-media thickness （CIMT） in patients with type 1 and type 2 diabetes. However, few studies have compared the relative importance of glycemic w＇. Bp control in patients with diabetes and hypertension. We aimed to investigate the association between Bp and glycemic control and subclinical carotid atherosclerosis in older patients with hypertension and type 2 diabetes. Methods In a cross-sectional study, B-mode high-resolution ultrasonography of the carotid artery was performed in 670 subjects （508 males and 162 females） aged 60 years or over who had self-reported hypertension and diabetes but no history of coronary heart disease or stroke. Subjects were categorized by their systolic blood pressure： tight control, 〈 130 mmHg; usual control, 130-139 mmHg; or uncontrolled, 〉 140 mmHg, and by their hemoglobin Alc （HbAlc） level： tight control, 〈 6.5%; usual control, 6.5%-7.5%; or uncontrolled, 〉 7.5%, respectively. Results The mean CIMT was 8.20 ±0.11 mm, and carotid plaque was found in 52.5% （352/670） subjects. Overall, 62.1% of the subjects had subclinical carotid atherosclerosis, defined as having either carotid plaque or elevated CIMT （≥ 1.1 ram）. The mean CIMT was significantly different between Bp control categories （7.60 ± 0.09 mm, 7.90 ±0.08 mm, and 8.60 ± 0.12 mm, respectively, P = 0.03） but not between glycemic control categories （8.20± 0.10 mm, 8.1 ±0.08 mm, and 8.40 ± 0.14 ram, respectively, P = 0.13） using ANCOVA analysis. Multivariable logistic regression adjusting for potential confounding factors showed that usual or uncontrolled Bp control were associated with having carotid plaque （OR = 1.08 and OR=1.42, respectively）, or elevated CIMT [Odd ratio （OR） = 1.17, 95% confidence interval （CI） 1.04-2.24, and OR = 1.54, 95% CI 1.36-2.96, respectively compared to tight Bp control; but did not show glycemic control as independent predictor of either having carotid plaque or elevated CIMT. Conclusions In older patients with hypertension and diabetes, blood pressure control, but not glycemic control is associated with subclinical carotid atherosclerosis.