Subtypes of Hypertension and Risk of Stroke in Rural Chinese Adults
|
|
- Sarah Hoover
- 6 years ago
- Views:
Transcription
1 Original Article Subtypes of Hypertension and Risk of Stroke in Rural Chinese Adults Zhaoqing Sun, 1 Xiaodan Han, 1 Liqiang Zheng, 1 Xingang Zhang, 1 Jue Li, 2 Dayi Hu, 2 and Yingxian Sun 1 background Hypertension is a definitive risk factor for stroke. We examined the associations between hypertension subtypes and stroke incidence in rural Chinese adults. methods We conducted a prospective study in a sample of 38,949 rural Chinese adults aged 35 years and free from stroke at baseline. The subtypes of hypertension were defined as isolated systolic hypertension (ISH), isolated diastolic hypertension (IDH), systolic and diastolic hypertension (SDH), and managed hypertension (MHT). The relative risks of stroke with the subtypes of hypertension, compared with normotensive subjects, were estimated using the Cox model after adjusting for age, sex, and other confounders. results The prevalence of hypertension was as follows: SDH = 18.6%, ISH = 10.2%, IDH = 5.8%, and MHT = 0.4%. During a total of 168,023 person-years of follow-up, 858 subjects developed stroke. The incidence rate per 100,000 person-years of overall first-ever stroke was The SDH group was at the highest risk of stroke among all the hypertensive subjects. The hazard ratio was 2.13 (95% confidence interval (CI) = ) for all stroke, 2.74 (95% CI = ) for hemorrhagic stroke, and 1.92 (95% CI = ) for ischemic stroke. conclusions SDH patients warrant the most attention for prevent of stroke. However, ISH and IDH are also independent predictors of stroke. The risk factors for stroke, especially hypertension, were not controlled in the rural population we studied. More aggressive efforts to control the risk factors for stroke in rural areas are needed. Keywords: blood pressure; China; epidemiology; hypertension; rural population; stroke. doi: /ajh/hpt197 Stroke is one of the most common causes of death and a leading cause of long-term disability worldwide. 1 The incidence and mortality of stroke in China are also high, and the burden of stroke is growing in China. Stroke is currently the leading cause of death in China, 2,3 and hypertension is the most important modifiable risk factor for stroke. 4,5 Recent data suggest a rapid increase in the number of cases of hypertension in China, especially in rural areas. 6 8 More than half of the Chinese population lives in rural regions, so any changes in stroke incidence and mortality in rural populations have enormous public health and economic consequences. How to take a useful and scientific public health measure for hypertension and stroke should be in consideration. As we all know, hypertension includes 3 categories isolated diastolic hypertension (IDH), isolated systolic hypertension (ISH), and diastolic with systolic hypertension (systolic diastolic hypertension (SDH)). 9 Several studies have reported a clear relationship between ISH or SDH and stoke However, little data reveal the effects of IDH on the risk of stroke, even though patients with IDH constitute a large portion (14% 24%) of the total hypertensive population. 10,12 Further, IDH patients are less likely to receive clinical attention and treatment than those with ISH or SDH The purpose of this study was to describe the incidence of stroke and subtypes of hypertension and to examine the relationship between hypertension subtypes and the risk of stroke in rural Chinese adults. METHODS Study design and study population The procedures followed were in accordance with ethical standards of the responsible committee on human experimentation of China Medical University. A large-scale, crosssectional survey was conducted from 2004 to 2006 in the rural areas of Fuxin County, Liaoning Province, where there are 35 towns and approximately 640,000 rural people. The study adopted a multistage, stratified clustering sampling scheme that included samples from the northern, southern, western, eastern, and central regions. According to the population, 3 towns were selected from the southern region, 2 Correspondence: Yingxian Sun (sunyingxian@medmail.com.cn). Initially submitted June 14, 2013; date of first revision July 8, 2013; accepted for publication September 29, 2013; online publication October 25, Division of Cardiology, Shengjing Hospital of China Medical University, Shenyang, P.R. China; 2 Heart, Lung and Blood Vessel Center, Tongji University, Shanghai, P.R. China. American Journal of Hypertension, Ltd All rights reserved. For Permissions, please journals.permissions@oup.com American Journal of Hypertension 27(2) February
2 Sun et al. from the eastern region, and 1 town from each of the other 3 regions. Rural villages in the proximity of these towns were selected from different geographic areas. In total, 8 towns and 84 rural villages were selected from these various regions of the country. Exclusion criteria included a history of tumors, congestive heart failure, or pregnancy. We intended that 53,400 subjects aged 35 years should be surveyed; actually, a total of 45,925 people were surveyed between 2004 and 2006, and the response rate was 85%. 6,8 Of the 45,925 subjects at baseline, 3,579 were not included in the follow-up study because study participants contact information was unavailable. Overall, 42,346 participants at baseline were eligible to participate in the follow-up study, 39,845 individuals completed the follow-up, and 38,949 individuals free from stroke at baseline were available for the calculation of disease incidence. Baseline measurement All baseline surveys were conducted by local doctors, who were trained by our research staff. Training was conducted before beginning the study and included the purpose of the research, how to administer the questionnaire, the method of measurement, and the study procedures. A strict test was conducted after the training, and only those who scored perfectly on the test became investigators. Data on demographic variables (age, sex, and ethnicity), smoking status, use of alcohol, information on antihypertensive medications, and history of coronary heart disease (CHD) at baseline were obtained by interviews with a standard epidemiological questionnaire. Alcohol drinking was defined as alcohol consumption of at least 8 grams per week during the last year. 14 Current smoking was defined as smoking at least 1 cigarette every day for at least 1 year. Body weight and height were measured with subjects wearing light clothing and no shoes. Body mass index (BMI) was calculated as the weight in kilograms divided by the height in square meters. Diabetes and lipid disorder were defined according to selfreport. History of CHD at baseline was positive if a CHD was reported during the baseline interview and confirmed by medical records. A detailed description of the methods has been presented elsewhere. 15 A trained and certified observer used an American Heart Association protocol to perform 3 blood pressure (BP) measurements for each participant. The participant rested in a seated position for 5 minutes before the measurements. Participants were advised to avoid alcohol consumption, cigarette smoking, coffee and tea consumption, and exercise for at least 30 min before the measurements. The research staff used a standardized electronic sphygmomanometer (HEM-741C; Omron, Tokyo, Japan) and 1of 4 cuff sizes (pediatric, regular adult, large, or thigh), which was chosen based on each participants s arm circumference. The average of the 3 readings was used for analysis. Subtypes of hypertension were defined according to the baseline systolic BP (SBP), diastolic BP (DBP), and antihypertensive treatment: ISH (SBP 140 mm Hg and DBP < 90 mm Hg); SDH (SBP 140 mm Hg and DBP 90 mm Hg); IDH (SBP < 140 mm Hg and DBP 90 mm Hg) for the participants with or without antihypertensive treatment; managed hypertension (MHT) was defined as BP under control by antihypertensive treatment (SBP < 140 mm Hg and DBP < 90 mm Hg); and normotensive was defined as no history of hypertension and SBP < 140 mm Hg and DBP < 90 mm Hg at baseline. Follow-up data collection The follow-up examination was conducted between July 2010 and October We conducted new home visits with interviews to capture all stroke events. Deaths were identified by hospital records and direct contact with the participant s families using the International Classification of Diseases, Ninth Revision, Clinical Modification. We confirmed that stroke was the cause of death on the basis of autopsy reports, death certificates, medical record abstractions, or information obtained from family members. Stroke was defined according to the World Health Organization MONICA criteria: a sudden onset of focal (or global) disturbance of cerebral function lasting >24 hours (unless interrupted by surgery or death) with no apparent nonvascular cause. 16 The definition included patients presenting with clinical signs and symptoms suggestive of complete stroke, including ischemic stroke, intracerebral hemorrhage stroke, and subarachnoid hemorrhage stroke. A stroke episode that occurred >28 days after the first stroke was considered a recurrent stroke. The classification of ischemic stroke, intracerebral hemorrhage stroke, and subarachnoid hemorrhage stroke was based on clinical presentation, and confirmation by computed tomography or magnetic resonance imaging was required, with reference to the MONICA criteria. Undetermined stroke included all cases that either had not had a computed tomography scan or could not be classified by computed tomography or magnetic resonance imaging scan findings. Although the stroke events included first-ever and recurrent stroke, only firstever strokes were used for analysis. At the conclusion of the study, the endpoint assessment committee, which was blinded to the study participants baseline risk factor information, independently reviewed all materials. Statistical analysis The incidence rate was denoted by case load/100,000 person years. Relative risks (hazard ratio (HR)) and the corresponding 95% confidence intervals (CIs) were derived from Cox proportional hazards regression models for different hypertension subtypes compared with the normotensive group, adjusting for antihypertensive treatment, age, sex, BMI, smoking, drinking, diabetes, lipid disorder, CHD, and/ or SBP. The proportionality assumption was evaluated by scaled Schoenfeld residuals, and the global fit of the models was evaluated by graphically examining the cumulative hazards function relative to the Cox Snell residuals. All analyses were performed with SPSS statistical software version 12.0 (SPSS, Chicago, IL). A two-sided P < 0.05 was accepted as indicating statistical significance. 194 American Journal of Hypertension 27(2) February 2014
3 Hypertension Subtypes and Stroke in rural Chinese RESULTS Baseline date Baseline date is presented in Table 1. The most common subtype of hypertension was SDH (18.6%), followed by ISH (10.2%), IDH (5.8%), and MHT (0.4%). In our population, 20.5% of the participants were taking antihypertensive medication, but only 1.1% of the hypertension patients were under control. All subtypes had more women and older patients compared with the normotensive group, with the exception of the IDH group. Compared with the normotensive group, all hypertension subtypes had a higher mean BMI and a higher prevalence of CHD. All hypertension subtypes also included more patients with lipid disorder and diabetes, with the exception of the IDH group. The differences in drinking and smoking habits between hypertensive and normotensive groups were significant in the IDH and SDH groups. Subtypes of hypertension and the risks of stroke Hypertension subtypes and stroke risks are presented in Table 2. The mean follow-up time was 4.3 years. During 168,023 person-years of follow-up, the total incidence rate of stroke was 5.1 (n = 858), with more cases of ischemic stroke (n = 458) and less cases of hemorrhagic stroke(n = 348); the rest was undetermined stroke (n = 27). We explored the effect of baseline SBP with stroke incidence with univariable Cox regression analysis. We found that there is a direct relationship of SBP and stroke (all stroke: HR = 1.15, 95% CI = ; ischemic stroke: HR = 1.15, 95% CI = ; hemorrhagic stroke: HR = 1.16, 95% CI = ). After adjusting for baseline age, sex, BMI, smoking, drinking, lipid disorder, diabetes, CHD, antihypertensive treatment, the SDH subtype had the highest risk of developing all kinds of stoke (HR = 2.13, 95% CI = ). The same result can be seen in ischemic stroke (HR = 1.92, 95% CI = ) and hemorrhagic stroke (HR = 2.74, 95% CI = ).The IDH group had a slightly higher HR than the ISH group for all kinds of stroke (HR = 1.58, 95% CI = vs. HR = 1.42, 95% CI = ) and for ischemic stroke (HR = 1.97, 95% CI = vs. HR = 1.60, 95% CI = ). When we compared the multivariable models, we added baseline SBP as a covariable to the same models, the associations among hypertension subtypes and stroke are largely attenuated, and significance is no longer observed. Only the SDH group had an increased relative risk of hemorrhagic stroke compared with the normotensive group (HR = 1.63, 95% CI = ). The associations of subtypes of hypertension with the risks of stroke in normal-weight (BMI < 25 kg/m 2 ) and overweight or obese (BMI 25 kg/m 2 ) participants are shown in Table 3. For those with BMI <25 kg/m 2, after adjusting for the confounders mentioned above, the patients with SDH had 2 times the risk of developing any kind of stroke (HR = 2.21, 95% CI = ), 3 times the risk of developing hemorrhagic stroke (HR = 2.97, 95 % CI = ), and 2 times the risk of ischemic stroke (HR = 1.89, 95% CI = ) compared with the normotensive group. The ISH and IDH group showed similar risk on stroke incidence. For those with BMI 25 kg/m 2, only the SDH group ws at higher risk of any kind of stroke incidence compared with the normotensive group. Table 1. Baseline characteristics of study participants Characteristic Normotensive group ISH group IDH group SDH group MHT group Total No. (%) 25,323 (65.0) 3,989 (10.2) 2,256 (5.8) 7,235 (18.6) 146 (0.4) 38,949 Antihypertensive treatment, no. (%) 0 (0) 436 (10.9)* 67 (3.0)* 2,148 (29.7)* 146 (100)* 2,797 (7.2) Age, y, mean ± SD 48.2 ± ± 13.0* 48.8 ± ± 11.4* 54.2 ± 10.3* ± Male, no. (%) 12,776 (50.5) 1,844 (46.2)* 1,216 (53.9) 3,452 (47.7)* 49 (33.6)* 19,337 (49.6) SBP, mm Hg, mean ± SD 121 ± ± 14* 129 ± 7* 164 ± 20* 127 ± 9* ± DBP, mm Hg, mean ± SD 76 ± 8 81 ± 7* 93 ± 5* 100 ± 9* 79 ± 7* ± BMI, kg/m 2, mean ± SD 23.0 ± ± 3.4* 23.6 ± 3.1* 24.1 ± 3.5* 23.9 ± 3.6* ± 3.10 DM, no. (%) 72 (0.3) 26 (0.7)* 9 (0.4) 26 (0.7)* 5 (3.4)* 176 (0.5) Lipid disorder, no. (%) 326 (1.3) 157 (3.9)* 47 (2.1) 608 (8.4)* 19 (13.0)* 1,157 (3.0) Smoking, no. (%) 10,301 (40.7) 1,635 (41.0) 1,004 (44.5)* 3,107 (42.9)* 46 (31.5) 16,093 (41.3) Drinking, no. (%) 7,725 (30.5) 1,146 (28.7) 813 (36.0)* 2,380 (32.9)* 27 (18.5) 12,091 (31.0) CHD, no. (%) 495 (2.0) 223 (5.6)* 70 (3.1)* 584 (8.1)* 36 (24.7)* 1,408 (3.6) Abbreviations: BMI, body mass index; CHD, coronary heart disease; DBP, diastolic blood pressure; DM, diabetes mellitus; IDH, isolated diastolic hypertension; ISH, isolated systolic hypertension; MHT, managed hypertension; SBP, systolic blood pressure; SDH, systolic and diastolic hypertension. *P < 0.05, for t test or χ 2 test, compared with normotensive group. American Journal of Hypertension 27(2) February
4 Sun et al. Table 2. Incidence and relative risk of stroke by subtypes of hypertension Risk of stroke Normotensive group ISH group IDH group SDH group MHT group Total Persons-years of follow up 108,619 17,521 9,587 31, ,023 All stroke Number of cases Incidence per 100,000 person-years , Model 1 Referent 0.353, 1.42 ( ) 0.455, 1.58 ( ) 0.755, 2.13 ( ) 0.174, 1.19 ( ) Model 2 Referent 0.035, 0.97 ( ) 0.374, 1.45 ( ) 0.228, 1.26 ( ) 0.232, 1.26 ( ) Hemorrhagic stroke Number of cases Incidence per 100,000 person years Model 1 Reference 0.228, 1.26 ( ) 0.038,1.04 ( ) 1.007,2.74 ( ) 0.271,1.31 ( ) Model 2 Reference 0.151, 0.86 ( ) 0.042,0.96 ( ) 0.486,1.63 ( ) 0.335,1.40 ( ) Ischemic stroke Number of cases incidence per 100,000 person- years Model 1 Reference 0.467, 1.60 ( ) 0.678, 1.97 ( ) 0.651, 1.92 ( ) 0.219, 0.80 ( ) Model 2 Reference 0.042, 1.04 ( ) 0.591, 1.81 ( ) 0.077, 1.08 ( ) 0.165, 0.85 ( ) Model 1 was adjusted for baseline age, sex, body mass index, smoking, drinking, lipid disorder, diabetes, coronary heart disease, and antihypertensive treatment. Model 2 was adjusted for baseline age, sex, body mass index, smoking, drinking, lipid disorder, diabetes, coronary heart disease, antihypertensive treatment, and systolic blood pressure. Abbreviations: IDH, isolated diastolic hypertension; ISH, isolated systolic hypertension; MHT, managed hypertension; SDH, systolic and diastolic hypertension. 196 American Journal of Hypertension 27(2) February 2014
5 Hypertension Subtypes and Stroke in rural Chinese Table 3. Relative risk of stroke by hypertension subtypes and body mass index Normotensive group ISH group IDH group SDH group MHT group BMI < 25 kg/m 2 All stroke Referent 0.428, 1.53 ( ) 0.408, 1.50 ( ) 0.792, 2.21 ( ) 0.354, 1.43 ( ) Ischemic stroke Referent 0.558, 1.75 ( ) 0.591, 1.81 ( ) 0.637, 1.89 ( ) 0.557, 0.57 ( ) Hemorrhagic stroke Referent 0.234, 1.26 ( ) 0.026, 1.03 ( ) 1.087, 2.97 ( ) 0.755, 2.13 ( ) BM 25 kg/m 2 All stroke Referent 0.088, 0.92 ( ) 0.178, 1.20 ( ) 0.461, 1.59 ( ) 0.635, 0.53 ( ) Ischemic stroke Referent 0.222, 0.80 ( ) 0.413, 1.51 ( ) 0.478, 1.61 ( ) 0.005, 0.99 ( ) Hemorrhagic stroke Referent 0.178, 1.20 ( ) 0.158, 0.85 ( ) 0.650, 1.92 ( ) Adjusted for baseline age, sex, smoking, drinking, lipid disorder, diabetes, coronary heart disease, and antihypertensive treatment. Abbreviations: BMI, body mass index; IDH, isolated diastolic hypertension; ISH, isolated systolic hypertension; MHT, managed hypertension; SDH, systolic and diastolic hypertension. Discussion This study is the first epidemiologic study on stroke to be conducted in the rural region of Liaoning Province since The results showed basic information about the epidemiologic date of hypertension and stroke in rural parts of China. Our study reported that the prevalence of hypertension in the follow-up group was 35.0%. Among hypertensive patients, only 20.5% were taking antihypertensive medication, and 1.1% of patients achieved BP control. SDH was the most common subtype, followed by ISH and IDH. The prevalence differed by age group and the IDH had a significant lower mean age. Our finding was similar to that of recent studies. 12,17 In our study, the incidence rate per 100,000 person years of overall first-ever stroke was Compared with recent stroke studies conducted in Chinese urban centers and Western countries, the incidence of stroke in our study is high. The medical conditions in the rural Chinese region in our study were relatively poor, and risks factors for stroke, especially hypertension, lipid disorder, and diabetes, were uncontrolled. At the same time, people in rural areas acquired Westernized lifestyles and dietary habits in recent years. All the above-mentioned reasons may explain the change. Several recent studies focused on the effect of hypertension subtypes on the risk of stroke. A study of 26,587 Chinese subjects reported that the HRs of stroke were 2.16 for IDH, 2.35 for ISH, and 2.96 for SDH compared with normotensive subjects. 12 The China Hypertension Epidemiology Follow-Up Study reported that the HRs of stroke were 1.85 for IDH, 2.20 for ISH, and 3.74 for SDH among 169,871 participants from China. 13 A Western stroke study reported HRs of stroke were 1.14 for IDH, 1.36 for ISH, and 2.71 for SDH among 3,267 Finnish men. 21 Our results support the findings of other recent studies that showed a significantly stronger association of SDH with all kinds of stroke compared with other subtypes of hypertension. Although most previous studies reported that individuals with ISH had the highest risk of stroke, 10,22,23 considering the population group and decade character, individuals with SDH should receive the most attention for stroke prevention and protection from stroke-related injury. Different from previous studies, when we compared the multivariable models, we added baseline SBP as a covariable to the same model. We found that the associations among hypertension subtypes and stroke are largely attenuated and significance is no longer observed. That the categories do not add much to the BP values themselves may be a useful finding. We will further study this. We observed significant associations between the IDH and ISH groups and the development of ischemic stroke, which is consistent with recent Chinese studies. 12,13 However, in our study, risk for hemorrhagic stroke was not significant in the ISH and IDH groups. This observation might be explained by several factors. First, our study was based on first-term follow-up (4 5 years of follow-up). This short evaluation period may show a lower risk in the ISH and IDH group. 12,24 Second, subjects in the IDH group had a lower mean age, American Journal of Hypertension 27(2) February
6 Sun et al. indicating a shorter duration of hypertension. Finally, we identified only 10 cases of hemorrhagic stroke in the IDH group and 51 cases in the ISH group; the bias introduced by this small sample also may explain the inconsistent results. Our study has several limitations. The main limitation of our study is that the associated clinical conditions were selfreported. This may have underestimated the prevalence of these conditions. This also limited the possibility to evaluate the impact of the associated conditions on the incidence of stroke in a reliable manner. We did not collect atrial fibrillation data for the participants, and this may be reduce the study s power. Also, the size of the MHT sample was small, so we did not observe the expected result. Large sample sizes are needed in the future to confirm the results In conclusion, all of the hypertension subtypes were associated with an increased incidence of stroke. SDH should receive the most attention for stroke prevention and protection from stroke-related injury. Many interrelated effects and risk factors require further study. We observed an unsatisfactory control rate of hypertension in the rural population, and, therefore, a widespread program including diagnosis, monitoring, and treatment of hypertension is critically needed. We believe that a public health strategy that includes educational and environmental interventions could be effective. The medical conditions and healthcare strategies in the rural Chinese population warrant increased attention. Acknowledgments We thank our subjects for their enthusiastic participation. This research was supported by grants from the key technology Research and Development program of Liaoning Province ( ). DISCLOSURE The authors declared no conflict of interest. References 1. Bonita R, Mendis S, Truelsen T, Bogousslavsky J, Toole J, Yatsu F. The global stroke initiative. Lancet Neurol 2004; 3: Thorvaldsen P, Asplund K, Kuulasmaa K, Rajakangas AM, Schroll M. Stroke incidence, case fatality, and mortality in the WHO MONICA Project. Stroke 1995; 26: Huang J, Yu J, Hu D, Wu Y, Lu J, Li Y, Huang Y, Azen SP, Dustin LD, Detrano RC. Major causes of death among men and women in China. N Engl J Med 2005; 353: Kearney P, Whelton M, Reynolds K, Muntner P, He J. Global burden of hypertension: analysis of worldwide data. Lancet 2005; 365: Lopez A, Mathers C, Ezzati M, Jamison D, Murray C. Global and regional burden of disease and risk factors, 2001: systematic analysis of population health data. Lancet 2003; 367: Sun Z, Zheng L, Wei Y, Li J, Zhang X, Zhang X, Liu S, Xu C, Li J, Zhao F, Dong G, Hu D, Sun Y. The prevalence of prehypertension and hypertension among rural adults in Liaoning province of China. Clin Cardiol 2007; 30: Gu D, Reynolds K, Wu X, Chen J, Duan X, Muntner P, Huang G, Reynolds RF, Su S, Whelton PK, He J. Prevalence, awareness, treatment, and control of hypertension in China. Hypertension 2002; 40: Sun Z, Zheng L, Detrano R, Zhang D, Zhang X, Xu C, Li J, Liu S, Li J, Hu D, Sun Y. The accelerating epidemic of hypertension among rural Chinese women: results from Liaoning Province. Am J Hypertens 2008; 21: Kaplan NM, Victor RG. Kaplan s Clinical Hypertension. Lippincott Williams and Wilkins: Philadelphia, PA, Hozawa A, Ohkubo T, Nagai K, Kikuya M, Matsubara M, Tsuji I, Ito S, Satoh H, Hisamichi S, Imai Y. Prognosis of isolated systolic and isolated diastolic hypertension as assessed by self-measurement of blood pressure at home: the Ohasama Study. Arch Intern Med 2000; 160: Strandberg TE, Salomaa VV, Vanhanen HT, Pitkala K, Miettinen TA. Isolated diastolic hypertension, pulse pressure, and mean arterial pressure as predictors of mortality during a follow-up of up to 32 years. J Hypertens 2002; 20: Fang XH, Zhang XH, Yang QD, Dai XY, Su FZ, Rao ML, Wu SP, Du XL, Wang WZ, Li SC. Subtype hypertension and risk of stroke in middle-aged and older Chinese: a 10-year follow-up study. Stroke 2006; 37: Kelly TN, Gu D, Chen J, Huang JF, Chen JC, Duan X, Wu X, Yau CL, Whelton PK, He J. Hypertens subtype and risk of cardiovascular disease in Chinese adults. Circulation 2008; 118: National Institute on Alcohol Abuse and Alcoholism: Health risks and benefits of alcohol consumption. Alcohol Res Health. 2000; 1: Zhang X, Sun Z, Zhang X, Zheng L, Liu S, Xu C, Li J, Zhao F, Li J, Hu D, Sun Y. Prevalence and associated factors of overweight and obesity in a Chinese rural population. Obesity (Silver Spring) 2008; 16: Tunstall-Pedoe H, for the WHO MONICA Project Principle Investigators. The World Health Organization MONICA Project (Monitoring of Trends and Determinants in Cardiovascular Disease): a major international collaboration. J Clin Epidemiol 1988; 41: Huang JF, Wildman RP, Gu DF, Muntner P, Su SY, He J. Prevalence of isolated systolic and isolated diastolic hypertension subtypes in China. Am J Hypertens 2004; 17: Jiang B, Wang WZ, Chen HL, Hong Z, Yang QD, Wu SP, Du XL, Bao QJ. Incidence and trends of stroke and its subtypes in China: results from three large cities. Stroke 2006; 37: Ministry of Health. Chinese Health Statistical Digest Ministry of Health, People s Republic of China: Beijing, Corso G, Bottacchi E, Giardini G, De la Pierre F, Meloni T, Pesenti Campagnoni M, Ponzetti C, Veronese Morosini M. Communitybased study of stroke incidence in the Valley of Aosta, Italy. Carecerebrovascular Aosta Registry: years Neuroepidemiology 2009; 32: Strandberg TE, Salomaa VV, Vanhanen HT, Pitkala K, Miettinen TA. Isolated diastolic hypertension, pulse pressure, and mean arterial pressure as predictors of mortality during a follow-up of up to 32 years. J Hypertens 2002; 20: Nielsen W, Lindenstrom E, Vestbo J, Jenson G. Is diastolic hypertension an independent risk factor for stroke in the presence of normal systolic blood pressure in the middle-aged and elderly? Am J Hypertens 1997; 10: Petrovich H, Curb D, Bloom-Marcus M. Isolated systolic hypertension and risk of stroke in Japanese-American men. Stroke 1995; 26: Fang XH, Longstreth WT Jr, Li SC, Kronmal RA, Cheng XM, Wang WZ, Wu SP, Du XL, Dai XY. Longitudinal study of blood pressure and stroke in over 37,000 people in China. Cerebrovasc Dis 2001; 11: American Journal of Hypertension 27(2) February 2014
ABSTRACT. OBJECTIVE We wanted to determine the incidence of hypertension and its risk factors among rural Chinese adults.
Incidence and Predictors of Hypertension Among Rural Chinese Adults: Results From Liaoning Province Zhaoqing Sun, MS 1 Liqiang Zheng, MS 1 Robert Detrano, MD, PhD 2 Xingang Zhang, MD 1 Changlu Xu, MS 1
More informationHypertension. Hypertension Subtype and Risk of Cardiovascular Disease in Chinese Adults
Hypertension Hypertension Subtype and Risk of Cardiovascular Disease in Chinese Adults Tanika N. Kelly, MPH; Dongfeng Gu, MD, PhD; Jing Chen, MD, MSc; Jian-feng Huang, MD; Ji-chun Chen, MD; Xiufang Duan,
More information290 Biomed Environ Sci, 2016; 29(4):
290 Biomed Environ Sci, 2016; 29(4): 290-294 Letter to the Editor Prevalence and Predictors of Hypertension in the Labor Force Population in China: Results from a Cross-sectional Survey in Xinjiang Uygur
More informationPrevalence of Hypertension in Semi-Urban area of Nepal
ORIGINAL ARTICLE Prevalence of Hypertension in Semi-Urban area of Nepal Koju R*, Manandhar K*, Gurung R*, Pant P*, Bedi TRS* *Department of Internal Medicine, Dhulikhel Hospital KUH ABSTRACT Hypertension
More informationCardiovascular disease is a major public health problem
Original Article Prevalence, Awareness, Treatment, and Control of Hypertension Among Residents in Guangdong Province, China, 2004 to 2007 Bayi Xu, MS; Zhixia Xu, MS; Xiaojun Xu, MS; Qiumao Cai, MS; Yanjun
More informationTHE NEW ARMENIAN MEDICAL JOURNAL DISTRIBUTION, AWARENESS, TREATMENT, AND CONTROL OF ARTERIAL HYPERTENSION IN YEREVAN (ARMENIA)
THE NEW ARMENIAN MEDICAL JOURNAL Vol.5 (2011), Nо 2, p.29-34 DISTRIBUTION, AWARENESS, TREATMENT, AND CONTROL OF ARTERIAL HYPERTENSION IN YEREVAN (ARMENIA) Zelveian P.H. 1, 2, Podosyan G.A. 2 1 Institute
More informationUniversity of Padova, Padua, Italy, and HARVEST Study Group, Italy
University of Padova, Padua, Italy, and HARVEST Study Group, Italy ISOLATED SYSTOLIC HYPERTENSION IN THE YOUNG DOES NOT IMPLY AN INCREASED RISK OF FUTURE HYPERTENSION NEEDING TREATMENT Mos L, Saladini
More informationORIGINAL INVESTIGATION. Prognosis of Isolated Systolic and Isolated Diastolic Hypertension as Assessed by Self-Measurement of Blood Pressure at Home
Prognosis of Isolated Systolic and Isolated Diastolic Hypertension as Assessed by Self-Measurement of Blood Pressure at Home The Ohasama Study ORIGINAL INVESTIGATION Atsushi Hozawa, MD; Takayoshi Ohkubo,
More informationDifferent worlds, different tasks for health promotion: comparisons of health risk profiles in Chinese and Finnish rural people
HEALTH PROMOTION INTERNATIONAL Vol. 16, No. 4 Oxford University Press 2001. All rights reserved Printed in Great Britain Different worlds, different tasks for health promotion: comparisons of health risk
More informationBlood pressure and total cholesterol level are critical risks especially for hemorrhagic stroke in Akita, Japan.
Blood pressure and total cholesterol level are critical risks especially for hemorrhagic stroke in Akita, Japan. Manabu Izumi, Kazuo Suzuki, Tetsuya Sakamoto and Masato Hayashi Jichi Medical University
More informationJoint Impact of Smoking and Hypertension on Cardiovascular Disease and All-Cause Mortality in Japan: NIPPON DATA80, a 19-Year Follow-Up
1169 Original Article Hypertens Res Vol.30 (2007) No.12 p.1169-1175 Joint Impact of Smoking and Hypertension on Cardiovascular Disease and All-Cause Mortality in Japan: NIPPON DATA80, a 19-Year Follow-Up
More information162 Biomed Environ Sci, 2014; 27(3):
162 Biomed Environ Sci, 2014; 27(3): 162-168 Original Article Impact of Cardiovascular Disease Deaths on Life Expectancy in Chinese Population * FAN Jie, LI Guo Qi, LIU Jing, WANG Wei, WANG Miao, QI Yue,
More informationSupplementary Appendix
Supplementary Appendix This appendix has been provided by the authors to give readers additional information about their work. Supplement to: Moran A, Zhao D, Gu D, et al. The Future Impact of Population
More informationPrognostic significance of blood pressure measured in the office, at home and during ambulatory monitoring in older patients in general practice
(2005) 19, 801 807 & 2005 Nature Publishing Group All rights reserved 0950-9240/05 $30.00 www.nature.com/jhh ORIGINAL ARTICLE Prognostic significance of blood pressure measured in the office, at home and
More informationCurrent status on other health effects:
Current status on other health effects: Changes in Cardiovascular Risk Factors after the Great East Japan Earthquake Tetsuya Ohira, MD, PhD. Department of Epidemiology, Fukushima Medical University School
More informationPrevalence, awareness, treatment and control of hypertension in North America, North Africa and Asia
(2004) 18, 545 551 & 2004 Nature Publishing Group All rights reserved 0950-9240/04 $30.00 www.nature.com/jhh REVIEW ARTICLE Prevalence, awareness, treatment and control of hypertension in North America,
More informationFindings- The sample contained participants with a mean age of 55 6 years (SD 9 7), 59 5% of whom were women. 44 7% (95% CI ) of
Prevalence, awareness, treatment, and control of hypertension in China: data from 1 7 million adults in a population-based screening study (China PEACE Million Persons Project) Jiapeng Lu*, Yuan Lu*, Xiaochen
More informationPrevalence of diabetes and impaired fasting glucose in Uygur children of Xinjiang, China
Prevalence of diabetes and impaired fasting glucose in Uygur children of Xinjiang, China J. Zhang 1, Y.T. Ma 1, X. Xie 1, Y.N. Yang 1, F. Liu 2, X.M. Li 1, Z.Y. Fu 1, X. Ma 1, B.D. Chen 2, Y.Y. Zheng 1,
More informationHypertension is a major risk factor for stroke in developed
Prediction of Stroke by Self-Measurement of Blood Pressure at Home Versus Casual Screening Blood Pressure Measurement in Relation to the Joint National Committee 7 Classification The Ohasama Study Kei
More informationARIC Manuscript Proposal # PC Reviewed: 2/10/09 Status: A Priority: 2 SC Reviewed: Status: Priority:
ARIC Manuscript Proposal # 1475 PC Reviewed: 2/10/09 Status: A Priority: 2 SC Reviewed: Status: Priority: 1.a. Full Title: Hypertension, left ventricular hypertrophy, and risk of incident hospitalized
More informationDiastolic hypertension, defined as a diastolic blood pressure
Hypertension Predictors of New-Onset Diastolic and Systolic Hypertension The Framingham Heart Study Stanley S. Franklin, MD; Jose R. Pio, BS; Nathan D. Wong, PhD; Martin G. Larson, ScD; Eric P. Leip, MS;
More informationPre-diagnostic cruciferous vegetables intake and lung cancer survival among Chinese women
Pre-diagnostic cruciferous vegetables intake and lung cancer survival among Chinese women Qi-Jun Wu, Gong Yang, Wei Zheng, Hong-Lan Li, Jing Gao, Jing Wang, Yu-Tang Gao, Xiao-Ou Shu, Yong-Bing Xiang Supplementary
More informationProf. Samir Morcos Rafla Alexandria Univ. Cardiology Dept.
Obesity as a risk factor for Atrial Fibrillation Prof. Samir Morcos Rafla Alexandria Univ. Cardiology Dept. CardioAlex 2010 smrafla@hotmail.com 1 Obesity has reached epidemic proportions in the United
More informationA Study of Prevalence of Hypertension in Employees of Bangalore Metropolitan Transport Corporation (BMTC)
Hamdard Medicus 11 A Study of Prevalence of Hypertension in Employees of Bangalore Metropolitan Transport Corporation (BMTC) Abdul Haseeb Ansari, Mohammed Zulkifle and Mohammed Shakir Department of Tahaffuzi
More informationDepok-Indonesia STEPS Survey 2003
The STEPS survey of chronic disease risk factors in Indonesia/Depok was carried out from February 2003 to March 2003. Indonesia/Depok carried out Step 1, Step 2 and Step 3. Socio demographic and behavioural
More informationOriginal Contributions
Original Contributions Pulse Pressure and Mean Arterial Pressure in Relation to Ischemic Stroke Among Patients With Uncontrolled Hypertension in Rural Areas of China Liqiang Zheng, MD; Zhaoqing Sun, MD;
More informationYOUNG ADULT MEN AND MIDDLEaged
BRIEF REPORT Favorable Cardiovascular Profile in Young Women and Long-term of Cardiovascular and All-Cause Mortality Martha L. Daviglus, MD, PhD Jeremiah Stamler, MD Amber Pirzada, MD Lijing L. Yan, PhD,
More informationcauses, all cancers, lung cancer and other chronic diseases in urban Shanghai.
Original Article Population attributable risks of cigarette smoking for deaths of all causes, all cancers and other chronic diseases among adults aged 40-74 years in urban Shanghai, China Ying-Ying Wang
More informationDietary Sodium Intake and Urinary Sodium Excretion by Age Groups among Urban Dwellers
Dietary Sodium Intake and Urinary Sodium Excretion by Age Groups among Urban Dwellers Associate Professor Dr. Hazreen B Abd Majid Department of Social and Preventive Medicine and Centre for Population
More informationWhy Do We Treat Obesity? Epidemiology
Why Do We Treat Obesity? Epidemiology Epidemiology of Obesity U.S. Epidemic 2 More than Two Thirds of US Adults Are Overweight or Obese 87.5 NHANES Data US Adults Age 2 Years (Crude Estimate) Population
More informationYuqing Zhang, M.D., FESC Department of Cardiology, Fu Wai Hospital. CAMS & PUMC, Beijing, China
What Can We Learn from the Observational Studies and Clinical Trials of Prehypertension? Yuqing Zhang, M.D., FESC Department of Cardiology, Fu Wai Hospital. CAMS & PUMC, Beijing, China At ARIC visit 4
More informationAnalyzing diastolic and systolic blood pressure individually or jointly?
Analyzing diastolic and systolic blood pressure individually or jointly? Chenglin Ye a, Gary Foster a, Lisa Dolovich b, Lehana Thabane a,c a. Department of Clinical Epidemiology and Biostatistics, McMaster
More informationORIGINAL INVESTIGATION. C-Reactive Protein Concentration and Incident Hypertension in Young Adults
ORIGINAL INVESTIGATION C-Reactive Protein Concentration and Incident Hypertension in Young Adults The CARDIA Study Susan G. Lakoski, MD, MS; David M. Herrington, MD, MHS; David M. Siscovick, MD, MPH; Stephen
More informationBiomed Environ Sci, 2016; 29(3): LI Jian Hong, WANG Li Min, LI Yi Chong, ZHANG Mei, and WANG Lin Hong #
Biomed Environ Sci, 2016; 29(3): 205-211 205 Letter to the Editor Prevalence of Major Cardiovascular Risk Factors and Cardiovascular Disease in Women in China: Surveillance Efforts LI Jian Hong, WANG Li
More informationAssociation between multiple comorbidities and self-rated health status in middle-aged and elderly Chinese: the China Kadoorie Biobank study
Song et al. BMC Public Health (2018) 18:744 https://doi.org/10.1186/s12889-018-5632-1 RESEARCH ARTICLE Association between multiple comorbidities and self-rated health status in middle-aged and elderly
More informationOriginal Research Article
A STUDY TO ESTIMATE SUBCLINICAL ATHEROSCLEROSIS IN PATIENTS WITH TYPE 2 DIABETES MELLITUS BY MEASURING THE CAROTID INTIMAL MEDIAL THICKNESS Natarajan Kandasamy 1, Rajan Ganesan 2, Thilakavathi Rajendiran
More information24-uur ambulante bloeddrukmeting versus thuisbloedrukmeting
2017 Dementia 24-uur ambulante bloeddrukmeting versus thuisbloedrukmeting Wat gebruiken in de klinische praktijk? Jan A. Staessen, MD, PhD KU Leuven jan.staessen@kuleuven.be BPM Key messages to be made
More information300 Biomed Environ Sci, 2018; 31(4):
300 Biomed Environ Sci, 2018; 31(4): 300-305 Letter to the Editor Combined Influence of Insulin Resistance and Inflammatory Biomarkers on Type 2 Diabetes: A Population-based Prospective Cohort Study of
More informationBlood Pressure Reduction Among Acute Stroke Patients A Randomized Controlled Clinical Trial
Blood Pressure Reduction Among Acute Stroke Patients A Randomized Controlled Clinical Trial Jiang He, Yonghong Zhang, Tan Xu, Weijun Tong, Shaoyan Zhang, Chung-Shiuan Chen, Qi Zhao, Jing Chen for CATIS
More informationRISK FACTORS FOR HYPERTENSION IN INDIA AND CHINA: A COMPARATIVE STUDY
Health and Population - Perspectives and Issues 37 (1 & 2), 40-49, 2014 RISK FACTORS FOR HYPERTENSION IN INDIA AND CHINA: A COMPARATIVE STUDY FuJun Wang*, V. K. Tiwari** and Hao Wang*** ABSTRACT To identify
More informationStatin therapy in patients with Mild to Moderate Coronary Stenosis by 64-slice Multidetector Coronary Computed Tomography
Statin therapy in patients with Mild to Moderate Coronary Stenosis by 64-slice Multidetector Coronary Computed Tomography Hyo Eun Park 1, Eun-Ju Chun 2, Sang-Il Choi 2, Soyeon Ahn 2, Hyung-Kwan Kim 3,
More informationValidation of the SEJOY BP-1307 upper arm blood pressure monitor for home. blood pressure monitoring according to the European Society of Hypertension
Validation of the SEJOY BP-1307 upper arm blood pressure monitor for home blood pressure monitoring according to the European Society of Hypertension International Protocol revision 2010 Short title: Validation
More informationTherapeutic Lifestyle Changes and Drug Treatment for High Blood Cholesterol in China and Application of the Adult Treatment Panel III Guidelines
Therapeutic Lifestyle Changes and Drug Treatment for High Blood Cholesterol in China and Application of the Adult Treatment Panel III Guidelines Paul Muntner, PhD a,b,, Dongfeng Gu, MD c, Robert F. Reynolds,
More informationPrevalence of cardiovascular disease and risk factors in a rural district of Beijing, China: a population-based survey of 58,308 residents
RESEARCH ARTICLE Open Access Prevalence of cardiovascular disease and risk factors in a rural district of Beijing, China: a population-based survey of 58,308 residents Liu He 1, Xun Tang 1, Yan Song 1,4,NaLi
More informationFolate, vitamin B 6, and vitamin B 12 are cofactors in
Research Letters Dietary Folate and Vitamin B 6 and B 12 Intake in Relation to Mortality From Cardiovascular Diseases Japan Collaborative Cohort Study Renzhe Cui, MD; Hiroyasu Iso, MD; Chigusa Date, MD;
More informationAlcohol consumption and blood pressure change: 5-year follow-up study of the association in normotensive workers
(2001) 15, 367 372 2001 Nature Publishing Group All rights reserved 0950-9240/01 $15.00 www.nature.com/jhh ORIGINAL ARTICLE Alcohol consumption and blood pressure change: 5-year follow-up study of the
More informationAnalysis of risk factors of cardiac metabolic abnormality in patients with hypertension.
Biomedical Research 2017; 28 (14): 6452-6457 Analysis of risk factors of cardiac metabolic abnormality in patients with hypertension. Wang Yong 1, Cheng Jinsong 1, Huang Funing 1, Zhang Jianping 2, Xu
More informationDeclaration of Conflict of Interest. No potential conflict of interest to disclose with regard to the topics of this presentations.
Declaration of Conflict of Interest No potential conflict of interest to disclose with regard to the topics of this presentations. Clinical implications of smoking relapse after acute ischemic stroke Furio
More informationDiet-Related Factors, Educational Levels and Blood Pressure in a Chinese Population Sample: Findings from the Japan-China Cooperative Research Project
559 Original Article Diet-Related Factors, Educational Levels and Blood Pressure in a Chinese Population Sample: Findings from the Japan-China Cooperative Research Project Yukio YAMORI 1, Longjian LIU
More informationAwareness of Hypertension, Risk Factors and Complications among Attendants of a Primary Health Care Center In Jeddah, Saudi Arabia
IOSR Journal of Nursing and Health Science (IOSR-JNHS e-issn: 2320 1959.p- ISSN: 2320 1940 Volume 6, Issue 1 Ver. VIII (Jan. - Feb. 2017), PP 16-21 www.iosrjournals.org Awareness of Hypertension, Risk
More informationGuidelines on cardiovascular risk assessment and management
European Heart Journal Supplements (2005) 7 (Supplement L), L5 L10 doi:10.1093/eurheartj/sui079 Guidelines on cardiovascular risk assessment and management David A. Wood 1,2 * 1 Cardiovascular Medicine
More informationEpidemiology of community pre-hypertensive patients and related risk factors in Chengdu city
Family Medicine and Community Health ORIGINAL ORIGINAL Epidemiology of community pre-hypertensive patients and related risk factors in Chengdu city Xinyun Chen 1, Yafei Yan 1, Fang Qin, Xiaojing Jiang
More informationCardiovascular disease (CVD) is a major cause of morbidity
Epidemiology Serum Total and Lipoprotein Cholesterol Levels and Awareness, Treatment, and Control of Hypercholesterolemia in China Jiang He, MD, PhD*; Dongfeng Gu, MD, MS*; Kristi Reynolds, MPH; Xigui
More informationA pre experimental study to assess the effect of administration of pomegranate juice among prehypertensive men and women aged between 25-45
2015; 1(11): 597-601 ISSN Print: 2394-7500 ISSN Online: 2394-5869 Impact Factor: 5.2 IJAR 2015; 1(11): 597-601 www.allresearchjournal.com Received: 04-08-2015 Accepted: 06-09-2015 Anoop Masih Sandhu Assistant
More informationNomogram of the Relation of Brachial-Ankle Pulse Wave Velocity with Blood Pressure
801 Original Article Nomogram of the Relation of Brachial-Ankle Pulse Wave Velocity with Blood Pressure Akira YAMASHINA, Hirofumi TOMIYAMA, Tomio ARAI, Yutaka KOJI, Minoru YAMBE, Hiroaki MOTOBE, Zydem
More informationSlide notes: References:
1 2 3 Cut-off values for the definition of hypertension are systolic blood pressure (SBP) 135 and/or diastolic blood pressure (DBP) 85 mmhg for home blood pressure monitoring (HBPM) and daytime ambulatory
More informationDirector of the Israeli Institute for Quality in Medicine Israeli Medical Association July 1st, 2016
The differential effect of Atherosclerosis on end organ damage in adult and elderly patients with CVRF: New Algorithm for Hypertension Diagnosis and Treatment R. Zimlichman, FAHA, FASH, FESC, FESH Chief
More informationThe Impact of Smoking on Acute Ischemic Stroke
Smoking The Impact of Smoking on Acute Ischemic Stroke Wei-Chieh Weng, M.D. Department of Neurology, Chang-Gung Memorial Hospital, Kee-Lung, Taiwan Smoking related mortality Atherosclerotic vascular disease
More informationEFFECT OF SMOKING ON BODY MASS INDEX: A COMMUNITY-BASED STUDY
ORIGINAL ARTICLE. EFFECT OF SMOKING ON BODY MASS INDEX: A COMMUNITY-BASED STUDY Pragti Chhabra 1, Sunil K Chhabra 2 1 Professor, Department of Community Medicine, University College of Medical Sciences,
More informationPrevalence, awareness, treatment and control of hypertension in employees of factories of Northern Greece: the Naoussa study
(2004) 18, 623 629 & 2004 Nature Publishing Group All rights reserved 0950-9240/04 $30.00 www.nature.com/jhh ORIGINAL ARTICLE Prevalence, awareness, treatment and control of hypertension in employees of
More informationHYPERTENSION: ARE WE GOING TOO LOW?
HYPERTENSION: ARE WE GOING TOO LOW? George L. Bakris, M.D.,F.A.S.N.,F.A.S.H., F.A.H.A. Professor of Medicine Director, ASH Comprehensive Hypertension Center University of Chicago Medicine Chicago, IL USA
More informationHYPERTENSION; THE ICE BERG
The Professional Medical Journal DOI: 10.17957/TPMJ/15.2930 ORIGINAL PROF-2930 HYPERTENSION; THE ICE BERG 1. Senior Lecturer (Community Medicine). RIHS Islamabad. 2. Assistant Professor, Department of
More informationANTIHYPERTENSIVE DRUG THERAPY IN CONSIDERATION OF CIRCADIAN BLOOD PRESSURE VARIATION*
Progress in Clinical Medicine 1 ANTIHYPERTENSIVE DRUG THERAPY IN CONSIDERATION OF CIRCADIAN BLOOD PRESSURE VARIATION* Keishi ABE** Asian Med. J. 44(2): 83 90, 2001 Abstract: J-MUBA was a large-scale clinical
More informationStudy on occurrence of metabolic syndrome among patients with stroke: a descriptive study
Original article Study on occurrence of metabolic syndrome among patients with stroke: a descriptive study Dr. Mahesh K Savadi*, Dr Manjunatha N** *Assistant Professor, **Post graduate Dept. of General
More information4/4/17 HYPERTENSION TARGETS: WHAT DO WE DO NOW? SET THE STAGE BP IN CLINICAL TRIALS?
HYPERTENSION TARGETS: WHAT DO WE DO NOW? MICHAEL LEFEVRE, MD, MSPH PROFESSOR AND VICE CHAIR DEPARTMENT OF FAMILY AND COMMUNITY MEDICINE UNIVERSITY OF MISSOURI 4/4/17 DISCLOSURE: MEMBER OF THE JNC 8 PANEL
More informationRelationship between cardiovascular risk factors and traditional Chinese constitution in subjects with high-normal blood pressure
World Journal of Cardiovascular Diseases, 2013, 3, 234-238 http://dx.doi.org/10.4236/wjcd.2013.32036 Published Online April 2013 (http://www.scirp.org/journal/wjcd/) WJCD Relationship between cardiovascular
More informationTrends In CVD, Related Risk Factors, Prevention and Control In China
Trends In CVD, Related Risk Factors, Prevention and Control In China Youfa Wang, MD, MS, PhD Associate Professor Center for Human Nutrition Department of International Health Department of Epidemiology
More informationSupplement materials:
Supplement materials: Table S1: ICD-9 codes used to define prevalent comorbid conditions and incident conditions Comorbid condition ICD-9 code Hypertension 401-405 Diabetes mellitus 250.x Myocardial infarction
More informationimproving BP control and related outcomes. Ethn Dis. 2015;25[2]: Key Words: Hypertension, Blood Pressure, African American
APILOT STUDY EVALUATING A COMMUNITY-BASED INTERVENTION FOCUSED ON THE ISHIB IMPACT CARDIOVASCULAR RISK REDUCTION TOOLKIT IN AFRICAN AMERICAN PATIENTS WITH UNCONTROLLED HYPERTENSION Objective: To evaluate
More informationRisk Factors for Ischemic Stroke: Electrocardiographic Findings
Original Articles 232 Risk Factors for Ischemic Stroke: Electrocardiographic Findings Elley H.H. Chiu 1,2, Teng-Yeow Tan 1,3, Ku-Chou Chang 1,3, and Chia-Wei Liou 1,3 Abstract- Background: Standard 12-lead
More informationSupplementary Online Content
Supplementary Online Content Inohara T, Xian Y, Liang L, et al. Association of intracerebral hemorrhage among patients taking non vitamin K antagonist vs vitamin K antagonist oral anticoagulants with in-hospital
More informationSupplementary Online Content
Supplementary Online Content Linderman GC, Lu J, Lu Y, et al. Association of body mass index with blood pressure among 1.7 million Chinese adults. JAMA Netw Open. 2018;1(4):e181271. doi:10.1/jamanetworkopen.2018.1271
More informationA n aly tical m e t h o d s
a A n aly tical m e t h o d s If I didn t go to the screening at Farmers Market I would not have known about my kidney problems. I am grateful to the whole staff. They were very professional. Thank you.
More informationEffects of smoking and smoking cessation on productivity in China
Effects of smoking and smoking cessation on productivity in China Team *Hong Wang; MD, PhD **Heng-Fu Zou; PhD I. Introduction *: Yale University; **: World Bank 1. Aim of Project We will study smoking
More informationΑΡΥΙΚΗ ΠΡΟΔΓΓΙΗ ΤΠΔΡΣΑΙΚΟΤ ΑΘΔΝΟΤ. Μ.Β.Παπαβαζιλείοσ Καρδιολόγος FESC - Γιεσθύνηρια ιζμανόγλειον ΓΝΑ Clinical Hypertension Specialist ESH
ΑΡΥΙΚΗ ΠΡΟΔΓΓΙΗ ΤΠΔΡΣΑΙΚΟΤ ΑΘΔΝΟΤ Μ.Β.Παπαβαζιλείοσ Καρδιολόγος FESC - Γιεσθύνηρια ιζμανόγλειον ΓΝΑ Clinical Hypertension Specialist ESH Hypertension Co-Morbidities HTN Commonly Clusters with Other Risk
More informationAbstract. Introduction
The Ideal Cardiovascular Health Metrics Associated Inversely with Mortality from All Causes and from Cardiovascular Diseases among Adults in a Northern Chinese Industrial City Yan Liu 1., Hong-jie Chi
More informationHeart Disease and Stroke Statistics 2010 Update. 2009, American Heart Association. All rights reserved.
Heart Disease and Stroke Statistics 21 Update Questions on statistics? mailto:nancy.haase@heart.org Audio-visual questions? mailto:david.brentz@heart.org Please keep the red wave and logo attached to these
More informationLiping Liu Dpet. of Neurology and Stroke Center Beijing Tiantan Hospital Capital Medical University
Liping Liu Dpet. of Neurology and Stroke Center Beijing Tiantan Hospital Capital Medical University Disclosures Conflict of interest disclosures: No Disclosures Funding The CHANCE trial is funded by the
More informationmajor public health burden
HYPERTENSION INTRODUCTION Hypertension is one of the major public health burden in the recent times. Hypertension remains a challenging medical condition among the noncommunicable diseases of ever growing
More informationRelationships Between Indices of Obesity and Its Cardiovascular Comorbidities in a Chinese Population
Circ J 2008; 72: 973 978 Relationships Between Indices of Obesity and Its Cardiovascular Comorbidities in a Chinese Population Rui Li, MD ; Wei Lu, MD, PhD ; Jian Jia, MD, MPH*; Shengnian Zhang, MD; Liang
More informationClinical Recommendations: Patients with Periodontitis
The American Journal of Cardiology and Journal of Periodontology Editors' Consensus: Periodontitis and Atherosclerotic Cardiovascular Disease. Friedewald VE, Kornman KS, Beck JD, et al. J Periodontol 2009;
More informationBlood Pressure Targets: Where are We Now?
Blood Pressure Targets: Where are We Now? Diana Cao, PharmD, BCPS-AQ Cardiology Assistant Professor Department of Clinical & Administrative Sciences California Northstate University College of Pharmacy
More informationAn Epidemiological Study of Hypertension and Its Risk Factors in Rural Population of Bangalore Rural District
AJMS Al Ameen J Med Sci (2 012 )5 (3 ):2 6 4-2 7 0 (A US National Library of Medicine enlisted journal) I S S N 0 9 7 4-1 1 4 3 C O D E N : A A J M B G ORIGI NAL ARTICLE An Epidemiological Study of Hypertension
More informationLifestyle and Risk of Hypertension: Follow-Up of a Young Pre-Hypertensive Cohort
605 Research Paper Ivyspring International Publisher International Journal of Medical Sciences 2015; 12(7): 605-612. doi: 10.7150/ijms.12446 Lifestyle and Risk of Hypertension: Follow-Up of a Young Pre-Hypertensive
More informationHypertension Compendium
Hypertension Compendium Circulation Research Compendium on Hypertension The Epidemiology of Blood Pressure and Its Worldwide Management Genetic and Molecular Aspects of Hypertension Hypertension: Renin
More informationPreventing heart disease by controlling hypertension: Impact of hypertensive subtype, stage, age, and sex
Prevention and Rehabilitation Preventing heart disease by controlling hypertension: Impact of hypertensive subtype, stage, age, and sex Nathan D. Wong, PhD, a Gaurav Thakral, BS, a Stanley S. Franklin,
More informationResearch Article Prevalence, Awareness, Treatment, and Control of Hypertension in Romania: Results of the SEPHAR Study
SAGE-Hindawi Access to Research International Journal of Hypertension Volume 2010, Article ID 970694, 6 pages doi:10.4061/2010/970694 Research Article Prevalence, Awareness, Treatment, and Control of Hypertension
More informationPredicting failure to follow-up screened high blood pressure in Japan: a cohort study
Journal of Public Health Vol. 37, No. 3, pp. 498 505 doi:10.1093/pubmed/fdu056 Advance Access Publication August 7, 2014 Predicting failure to follow-up screened high blood pressure in Japan: a cohort
More informationBiostats Final Project Fall 2002 Dr. Chang Claire Pothier, Michael O'Connor, Carrie Longano, Jodi Zimmerman - CSU
Biostats Final Project Fall 2002 Dr. Chang Claire Pothier, Michael O'Connor, Carrie Longano, Jodi Zimmerman - CSU Prevalence and Probability of Diabetes in Patients Referred for Stress Testing in Northeast
More informationTotal risk management of Cardiovascular diseases Nobuhiro Yamada
Nobuhiro Yamada The worldwide burden of cardiovascular diseases (WHO) To prevent cardiovascular diseases Beyond LDL Multiple risk factors With common molecular basis The Current Burden of CVD CVD is responsible
More informationLetter to the Editor. Association of TCF7L2 and GCG Gene Variants with Insulin Secretion, Insulin Resistance, and Obesity in New-onset Diabetes *
814 Biomed Environ Sci, 2016; 29(11): 814-817 Letter to the Editor Association of TCF7L2 and GCG Gene Variants with Insulin Secretion, Insulin Resistance, and Obesity in New-onset Diabetes * ZHANG Lu 1,^,
More informationSelf-Care Behaviors among women with Hypertension in Saudi Arabia
IOSR Journal of Nursing and Health Science (IOSR-JNHS) e-issn: 2320 1959.p- ISSN: 2320 1940 Volume 5, Issue 3 Ver. III (May. - Jun. 2016), PP 52-56 www.iosrjournals.org Self-Care Behaviors among women
More informationTransient Ischemic Attacks and Risk of Stroke in an Elderly Poor Population
Transient Ischemic Attacks and Risk of Stroke in an Elderly Poor Population BY A. M. OSTFELD, M.D., R. B. SHEKELLE, Ph.D., AND H. L. KLAWANS, M.D. Abstract: Transient Ischemic A t tacks and Risk of Stroke
More informationAmong the most common chronic non-communicable
DOI 10. 5001/omj.2013.94 Prevalence and Determinants of Pre-Hypertension among Omani Adults Attending Non-Communicable Disease Screening Program in Primary Care Setting in Sohar City Ali Abdullah Al-Maqbali,
More informationThe investigation of serum lipids and prevalence of dyslipidemia in urban adult population of Warangal district, Andhra Pradesh, India
eissn: 09748369, www.biolmedonline.com The investigation of serum lipids and prevalence of dyslipidemia in urban adult population of Warangal district, Andhra Pradesh, India M Estari, AS Reddy, T Bikshapathi,
More informationRelations of body weight status in early adulthood and weight changes until middle age with metabolic syndrome in the Chinese population
International Journal of Community Medicine and Public Health Zhao L et al. Int J Community Med Public Health. 2017 Nov;4(11):4011-4017 http://www.ijcmph.com pissn 2394-6032 eissn 2394-6040 Original Research
More informationEpidemiologic Measure of Association
Measures of Disease Occurrence: Epidemiologic Measure of Association Basic Concepts Confidence Interval for population characteristic: Disease Exposure Present Absent Total Yes A B N 1 = A+B No C D N 2
More informationBlood Pressure Measurement in SPRINT
Blood Pressure Measurement in SPRINT Karen C. Johnson, MD, MPH, FAHA Vice Chair, SPRINT Steering Committee University of Tennessee Health Science Center, Department of Preventive Medicine For the SPRINT
More information