Gender Difference in Circulatory Associated Multi-Morbidity among the Elderly in Rural Southwest China

Aim: This study examined the prevalence of four chronic circulatory system diseases (hypertension, CHD, hyperlipemia, Stroke) and associated multi-morbidity in order to identify the risk factors among the elderly in Yunnan province. Methods: A cross-sectional survey including 2299 consenting adults aged ≥ 60 years from rural places was conducted in 2018. Data of demographic parameters and clinical characteristics were acquired from questionnaire and health examination. Categorical variables were presented as counts and percentages. Multivariable logistic regression analysis was used to analyze the association between individual SES and lifestyle variables and multimorbidity of the four chronic cardiovascular and cerebrovascular diseases. All analyses were conducted with SPSS 17.0 software. Results: Our study suggested that the prevalence of hypertension, CHD, hyperlipemia, Stroke was 57.1%, 4.2%, 5.9% and 5.3%, respectively and the prevalence of multimorbidity was 10.3%. Females had a higher prevalence of family history of chronic cardiovascular and cerebrovascular diseases, obesity, central obesity and illiteracy than males (P < 0.01), whereas males had a markedly higher prevalence of drinking, smoking and good sleeping quality than females (P < 0.01). The family genetic history, obesity, smoking, education, and diabetes were positively and drinking was negatively correlated with the prevalence of circulatory associated multimorbidity in elderly. Interestingly, some of the above associations were only observed in male/female but not the other sex. Conclusions: The prevalence of circulatory disease associated multimorbidity is relatively high among elderly population in rural places of Yunan province and the risk factors are different between females and males.

Exclusive cigar smoking in the United States and smoking-related diseases: A systematic review

BACKGROUND Little information has been published on the risks of cigar smoking.Since 1990 cigar smoking has become more prevalent in the United States.AIM To summarise the evidence from the United States relating exclusive cigar smoking to risk of the major smoking-related diseases.METHODS Literature searches detected studies carried out in the United States which estimated the risk of lung cancer,chronic obstructive pulmonary disease(COPD),heart disease,stroke or overall circulatory disease in exclusive cigar smokers as compared to those who had never smoked any tobacco product.Papers were identified from reviews and detailed searches on MEDLINE.For each study,data were extracted onto a study database and a linked relative risk database.Relative risks and 95%CIs were extracted,or estimated,relating to current,former or ever exclusive cigar smokers,and meta-analysed using standard methods.Sensitivity analyses were conducted including or excluding results from studies that did not quite fit the full selection criteria(for example,a paper presenting combined results from five studies,where 86%of the population were in the United States).RESULTS The literature searches identified 17 relevant publications for lung cancer,four for COPD and 12 for heart disease,stroke and circulatory disease.These related to 11 studies for lung cancer,to four studies for COPD and to eight studies for heart disease,stroke or overall circulatory disease.As some studies provided results for more than one disease,the total number of studies considered was 13,with results from four of these used in sensitivity analyses.There was evidence of significant heterogeneity in some of the meta-analyses so the random-effects estimates are summarized below.As the results from the sensitivity analyses were generally very similar to those from the main analyses,and involved more data,only the sensitivity results are summarized below.For lung cancer,relative risks(95%CI)for current,former and ever smokers were respectively,2.98(2.08 to 4.26),1.61(1.23 to 2.09),and 2.22(1.79 to 2.74)based on 6,4 and 10 individual study estimates.For COPD,the corresponding estimates were 1.44(1.16 to 1.77),0.47(0.02 to 9.88),and 0.86(0.48 to 1.54)based on 4,2 and 2 estimates.For ischaemic heart disease(IHD)the estimates were 1.11(1.04 to 1.19),1.26(1.03 to 1.53)and 1.15(1.08 to 1.23)based on 6,3 and 4 estimates,while for stroke they were 1.02(0.92 to 1.13),1.08(0.85 to 1.38),and 1.11(0.95 to 1.31)based on 5,3 and 4 estimates.For overall circulatory disease they were 1.10(1.05 to 1.16),1.11(0.84 to 1.46),and 1.15(1.06 to 1.26)based on 3,3 and 4 estimates.CONCLUSION Exclusive cigar smoking is associated with an increased risk of lung cancer,and less so with COPD and IHD.The increases are lower than for cigarettes.

The Association between Exposure to Second-Hand Smoke and Disease in the Chinese Population: A Systematic Review and Meta-Analysis

Objective To analyze the association between exposure to second-hand smoke(SHS) and 23 diseases,categorized into four classifications, among the Chinese population.Methods We searched the literature up to June 30, 2021, and eligible studies were identified according to the PECOS format: Participants and Competitors(Chinese population), Exposure(SHS),Outcomes(Disease or Death), and Study design(Case-control or Cohort).Results In total, 53 studies were selected. The odds ratio(OR) for all types of cancer was 1.79(1.56–2.05), and for individual cancers was 1.92(1.42–2.59) for lung cancer, 1.57(1.40–1.76) for breast cancer, 1.52(1.12–2.05) for bladder cancer, and 1.37(1.08–1.73) for liver cancer. The OR for circulatory system diseases was 1.92(1.29–2.85), with a value of 2.29(1.26–4.159) for stroke. The OR of respiratory system diseases was 1.76(1.13–2.74), with a value of 1.82(1.07–3.11) for childhood asthma. The original ORs were also shown for other diseases. Subgroup analyses were performed for lung and breast cancer. The ORs varied according to time period and were significant during exposure in the household;For lung cancer, the OR was significant in women.Conclusion The effect of SHS exposure in China was similar to that in Western countries, but its definition and characterization require further clarification. Studies on the association between SHS exposure and certain diseases with high incidence rates are insufficient.