Xiaofan Guo

Epidemiological evidence for the link between sleep duration and high blood pressure: a systematic review and meta-analysis.

OBJECTIVES We aim to assess if the relationship between short or long sleep duration and hypertension is present among adults from epidemiological evidence and to investigate the relationship quantitatively. METHODS We performed a comprehensive search of cross-sectional and longitudinal studies using PubMed and the Cochrane Library through February 2012. Our search was supplemented by reviewing reference lists of original and relevant reviews. After the related data were extracted by two investigators independently, pooled odds ratios (ORs) or relative risks (RRs) were estimated using a random-effects model or a fixed-effects model. Publication bias was evaluated, while sensitivity and meta-regression analyses were performed. RESULTS Twenty-four adult studies met our inclusion criteria, with ages ranging from 18 to 106 years. Twenty-one studies involving 225,858 subjects were included in the meta-analysis. The pooled results from the cross-sectional studies showed that short sleep duration was associated with a greater risk for hypertension (OR, 1.21; 95% confidence interval [CI], 1.09-1.34; P<0.001), and long sleep duration also increased the risk for hypertension (OR, 1.11; 95% CI, 1.04-1.18; P=0.003). There was no evidence of publication bias. Pooled analysis from the longitudinal studies indicated a significant association between short sleep duration and hypertension (RR, 1.23; 95% CI, 1.06-1.42; P=0.005), but an insignificant relationship between long sleep duration and hypertension (RR, 1.02; 95% CI, 0.91-1.14; P=0.732). The effects of sleep duration differed by gender, location of the population, and definitions of short or long sleep duration. Meta regression analysis including seven variables did not find the sources of heterogeneity. CONCLUSIONS Among adults, a U-shaped relationship between habitual sleep duration and hypertension was found at the cross-sectional level. Short sleep duration was associated with a higher risk for hypertension even longitudinally. We must pay more attention to this lifestyle factor.

Association between sleep duration and hypertension among Chinese children and adolescents.

Short sleep duration was reported to be associated with an increased risk of hypertension among adults. The present study aimed to investigate this association in children and adolescents.

Alcohol consumption and cardiovascular diseases in rural China

OBJECTIVES This study aimed to update the current information on alcohol consumption and evaluate the associations between drinking status and cardiovascular diseases in a general population from rural China. METHODS The study examined a total of 11,269 adults using a multi-stage cluster sampling method to select a representative sample of individuals 35years or older. Related medical histories were obtained using a standard questionnaire, and blood biochemical indexes were collected by well-trained personnel. Participants were asked for information about whether they regularly consumed alcohol, their average alcohol consumption per day, and the number of days per month that they consumed alcohol. RESULTS This population consisted of 75.8% non-drinkers, 7.5% moderate drinkers, and 16.7% heavy drinkers. And the mean alcohol consumption per day for the total population was 15.29±0.35g/d (women: 1.0±0.11g/d and men 32.5±0.69g/d, p<0.001). Multivariate logistic regression analysis showed that heavy drinkers had an approximately 1.3-fold and 1.7-fold greater risk for coronary heart disease and hypertension, respectively (OR: 1.252, 95% CI: 1.012 to 1.549; OR: 1.741, 95% CI: 1.519 to 1.994, respectively) compared with that of the non-drinking group. After fully adjusting the data for all variables, the data showed no significant association between moderate alcohol consumption and CHD, HT or ischemic stroke. CONCLUSIONS Alcohol consumption in rural populations is high, particularly in men. Heavy drinking is a risk factor for coronary heart disease and hypertension, but not for ischemic stroke. There was no significant association between moderate alcohol consumption and CHD, HT or ischemic stroke.

Prehypertension Is Not Associated with All-Cause Mortality: A Systematic Review and Meta-Analysis of Prospective Studies

Objectives Quantitative associations between prehypertension or its two separate blood pressure (BP) ranges and cardiovascular disease (CVD) or all-cause mortality have not been reliably documented. In this study, we performed a comprehensive systematic review and meta-analysis to assess these relationships from prospective cohort studies. Methods We conducted a comprehensive search of PubMed (1966-June 2012) and the Cochrane Library (1988-June 2012) without language restrictions. This was supplemented by review of the references in the included studies and relevant reviews identified in the search. Prospective studies were included if they reported multivariate-adjusted relative risks (RRs) and corresponding 95% confidence intervals (CIs) of CVD or all-cause mortality with respect to prehypertension or its two BP ranges (low range: 120–129/80–84 mmHg; high range: 130–139/85–89 mmHg) at baseline. Pooled RRs were estimated using a random-effects model or a fixed-effects model depending on the between-study heterogeneity. Results Thirteen studies met our inclusion criteria, with 870,678 participants. Prehypertension was not associated with an increased risk of all-cause mortality either in the whole prehypertension group (RR: 1.03; 95% CI: 0.91 to 1.15, P = 0.667) or in its two separate BP ranges (low-range: RR: 0.91; 95% CI: 0.81 to 1.02, P = 0.107; high range: RR: 1.00; 95% CI: 0.95 to 1.06, P = 0.951). Prehypertension was significantly associated with a greater risk of CVD mortality (RR: 1.32; 95% CI: 1.16 to 1.50, P<0.001). When analyzed separately by two BP ranges, only high range prehypertension was related to an increased risk of CVD mortality (low-range: RR: 1.10; 95% CI: 0.92 to 1.30, P = 0.287; high range: RR: 1.26; 95% CI: 1.13 to 1.41, P<0.001). Conclusions From the best available prospective data, prehypertension was not associated with all-cause mortality. More high quality cohort studies stratified by BP range are needed.

Association of interleukin-33 gene single nucleotide polymorphisms with ischemic stroke in north Chinese population.

BackgroundIL-33, an IL-1-like cytokine, is a ligand for IL1RL1, which is an important effector molecule of type 2 T helper responses. Although IL-33/IL1RL1 interaction has been suggested to be important in the development of atherosclerosis, genetic influences of the polymorphisms of IL33 in human ischemic stroke are unclear. The aim of this study was to examine whether the single nucleotide polymorphisms in IL33 are associated with ischemic stroke in Northern Chinese population.MethodsWe used a nested case–control study involving 90 ischemic stroke patients and 270 age-matched, sex-matched and blood pressure-matched non-ischemic stroke controls from a rural population and determined the genotypes of four polymorphisms (rs1929992, rs10975519, rs4742170, rs16924159) in IL33 by Snapshot SNP genotyping assays to assess any links with ischemic stroke.ResultsUnivariate analysis showed two single nucleotide polymorphisms (rs1929992, rs4742170) in IL33 were associated with ischemic stroke in additive, dominant, and recessive model. Binary Logistic Regression shows that rs4742170 variation is the most important factor associated with ischemic stroke (adjusted odds ratio (OR) = 1.880, 95% confidence interval (CI) = 1.316-2.686 in an additive model; OR = 2.091, CI = 1.249-3.498 in a dominant model; OR = 2.623, CI = 1.366-5.036 in a recessive model).ConclusionIn this sample of patients, genetic variation of rs4742170 in IL33 is significantly associated with the developing of ischemic stroke.

A Body Shape Index and Body Roundness Index: Two new body indices for detecting association between obesity and hyperuricemia in rural area of China.

OBJECTIVE The first objective was to examine whether A Body Shape Index (ABSI) and Body Roundness Index (BRI) can identify hyperuricemia in rural China. The second aim was to compare the relative strength of association between anthropometric indices and hyperuricemia. METHODS A total of 11,345 participants were involved in this cross-sectional study. Obesity measurements included BMI, WC, WHtR, ABSI and BRI. According to the statistical distribution of serum uric acid (SUA), we split our study population in sex-specific tertiles of SUA. RESULTS After adjusting for confounding variables, BRI (linear regression: 0.170; AUC: 0.641; OR: 1.459) showed more powerful predictive ability for hyperuricemia than BMI (linear regression: 0.151; AUC: 0.630; OR: 1.108), while having a similar predictive power for hyperuricemia as WHtR (linear regression: 0.191; AUC: 0.656; OR: 1.067) and WC (linear regression: 0.209; AUC: 0.658; OR: 1.047) in the female group, but not in the male group. However, ABSI (A) (linear regression: 0.089 for women, 0.121 for men; AUC: 0.589 for women, 0.578 for men; OR: 1.027 for women, 1.034 for men) and ABSI (B) (linear regression: 0.118 for women, 0.121 for men; AUC: 0.607 for women, 0.578 for men; OR: 1.049 for women, 1.034 for men) had the lowest predictive power for hyperuricemia in both sex categories. CONCLUSIONS ABSI, BRI, BMI, WC and WHtR were all significantly associated with hyperuricemia in both sexes. In addition, BRI rather than ABSI showed a superior predictive ability for identifying hyperuricemia than BMI in female and similar capabilities as those of WC and WHtR in the female, but not in the male gender.

Grim status of hypertension in rural China: results from Northeast China Rural Cardiovascular Health Study 2013.

The last study that reported the prevalence of hypertension in rural Northeast China was conducted approximately 10 years ago. We aimed to update the data on the prevalence and epidemiologic features of hypertension in rural Northeast China. This study examined a total of 11,576 adults using a multi-stage cluster sampling method to select a representative sample of individuals 35 years or older. Sitting blood pressure was measured three times for each participant by trained observers using a standardized electric sphygmomanometer after resting for 5 minutes. Related medical histories were obtained using a standard questionnaire, and blood biochemical indexes were collected by well-trained personnel. Prevalence of hypertension was 51.1%; 53.9% for men and 48.7% for women. Among subjects with hypertension, 43.5% were aware of the diagnosis, and 31.2% were taking antihypertensive medications, but only 6% had their blood pressure controlled. Besides traditional risk factors, multiple logistic regression analysis indicated that obesity, diabetes, dyslipidemia, and hyperuricemia were becoming risk factors for hypertension in this rural area.The status of hypertension is grim currently in rural Northeast China. The prevalence of hypertension remains seriously high, while the control rate is still frustratingly low. Obesity, diabetes, dyslipidemia, and hyperuricemia were more likely to be associated with hypertension in this rural area.

Prevalence and awareness of diabetes mellitus among a rural population in China: results from Liaoning Province

To clarify the diabetes prevalence trends among the rural population in northern China.

Visceral Adiposity Index and Lipid Accumulation Product Index: Two Alternate Body Indices to Identify Chronic Kidney Disease among the Rural Population in Northeast China

We aimed to compare the relative strength of the association between anthropometric obesity indices and chronic kidney disease (CKD). Another objective was to examine whether the visceral adiposity index (VAI) and lipid accumulation product index (LAPI) can identify CKD in the rural population of China. There were 5168 males and 6024 females involved in this cross-sectional study, and 237 participants (2.12%) suffered from CKD. Obesity indices included body mass index (BMI), waist circumference (WC), waist-to-height ratio (WHtR), VAI and LAPI. VAI and LAPI were calculated with triglyceride (TG), high-density lipoprotein (HDL), BMI and WC. VAI = [WC/39.68 + (1.88 × BMI)] × (TG /1.03) × (1.31/ HDL) for males; VAI = [WC/36.58 + (1.89 × BMI)] × (TG/0.81) × (1.52/HDL) for females. LAPI = (WC-65) × TG for males, LAPI = (WC-58) × TG for females. CKD was defined as an estimated glomerular filtration rate (eGFR) of less than 60 mL/min per 1.73 m2. The prevalence of CKD increased across quartiles for WHtR, VAI and LAPI. A multivariate logistic regression analysis of the presence of CKD for the highest quartile vs. the lowest quartile of each anthropometric measure showed that the VAI was the best predictor of CKD in females (OR: 4.21, 95% CI: 2.09–8.47, p < 0.001). VAI showed the highest AUC for CKD (AUC: 0.68, 95% CI: 0.65–0.72) and LAPI came second (AUC: 0.66, 95% CI: 0.61–0.70) in females compared with BMI (both p-values < 0.001). However, compared with the traditional index of the BMI, the anthropometric measures VAI, LAPI, WC, and WHtR had no statistically significant capacity to predict CKD in males. Our results showed that both VAI and LAPI were significantly associated with CKD in the rural population of northeast China. Furthermore, VAI and LAPI were superior to BMI, WC and WHtR for predicting CKD only in females.

Prevalence and risk factors of hypertension among pre- and post-menopausal women: A cross-sectional study in a rural area of northeast China

OBJECTIVES The aim of this study was to assess the prevalence and risk factors of hypertension in pre-menopausal women (Pre-MW) and post-menopausal women (Post-MW) and determine whether years since menopause (YSM) is associated with hypertension. METHODS A cross-sectional study was conducted with 6324 women over 35 years of age (2616 Pre-MW and 3708 Post-MW). Questionnaires, measurements and blood biochemical indexes were collected. RESULTS The overall prevalence of hypertension among women in rural northeast China was 48.8%, and it increased with age. Post-MW had a higher prevalence of hypertension than Pre-MW (62.4% vs. 29.7%, P<0.01). After controlling for confounding variables, overweight (OR=1.97, 95% CI: 1.72-2.25), obesity (OR=2.97, 95% CI: 2.30-3.84), diabetes mellitus (OR=2.13, 95% CI: 1.73-2.62), high triglycerides (OR=1.41, 95% CI: 1.20-1.65), and history of cardiovascular diseases in first-degree relatives (OR=1.60, 95% CI: 1.42-1.81) were associated with hypertension in all participants. However, abdominal obesity (OR=1.29, 95% CI: 1.05-1.58) was associated with higher odds among Post-MW only. Hypertension was associated with being postmenopausal (OR=1.22; 95% CI: 1.03-1.46), and the risk of hypertension reached a peak level in the <5-year group (OR=1.29; 95% CI, 1.07-1.57). CONCLUSIONS Postmenopausal status was an independent risk factor for hypertension. The risk of hypertension was highest in Post-MW with <5 YSM and then decreased. Other risk factors of hypertension were body mass index (BMI), abdominal obesity, a family history of cardiovascular disease among first-degree relatives, a personal history of diabetes, and high TG.