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J-shaped association between dietary zinc intake and new-onset hypertension: a nationwide cohort study

《医学前沿（英文）》 2023年 第17卷 第1期   页码 156-164 doi: 10.1007/s11684-022-0932-3

摘要： We aimed to investigate the relationship of dietary zinc intake with new-onset hypertension among Chinese adults. A total of 12,177 participants who were free of hypertension at baseline from the China Health and Nutrition Survey were included. Dietary intake was assessed by three consecutive 24-h dietary recalls combined with a household food inventory. Participants with systolic blood pressure ≥ 140 mmHg or diastolic blood pressure ≥ 90 mmHg or diagnosed by a physician or under antihypertensive treatment during the follow-up were defined as having new-onset hypertension. During a median follow-up duration of 6.1 years, 4269 participants developed new-onset hypertension. Overall, the association between dietary zinc intake and new-onset hypertension followed a J-shape (P for non-linearity < 0.001). The risk of new-onset hypertension significantly decreased with the increment of dietary zinc intake (per mg/day: hazard ratio (HR) 0.93; 95% confidence interval (CI) 0.88–0.98) in participants with zinc intake < 10.9 mg/day, and increased with the increment of zinc intake (per mg/day: HR 1.14; 95% CI 1.11–1.16) in participants with zinc intake ≥ 10.9 mg/day. In conclusion, there was a J-shaped association between dietary zinc intake and new-onset hypertension in general Chinese adults, with an inflection point at about 10.9 mg/day.

关键词： dietary zinc intake     new-onset hypertension     general population     CHNS    

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Metabolic hypertension: concept and practice

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《医学前沿（英文）》 2013年 第7卷 第2期   页码 201-206 doi: 10.1007/s11684-013-0264-4

摘要：

Hypertension is a serious public health problem worldwide. More than 60% of the risk factors for hypertension are associated with metabolic disturbances. Metabolic abnormalities increase the risk for hypertension and cause high blood pressure. Improving metabolic disturbances is beneficial for hypertension treatment. Due to the importance of metabolic abnormalities in the pathogenesis of hypertension, we propose a concept of metabolic hypertension. In this review, we discuss and review the clinical types, pathogenesis, risk evaluation and management of metabolic hypertension. Elucidation of the mechanism of metabolic hypertension should facilitate the design of novel pharmacotherapeutics and dedicated antihypertensive manipulations.

关键词： hypertension     cardiometabolic risk factors     metabolic abnormalities    

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Perioperative management for parturients with pulmonary hypertension: experience with 30 consecutive

null

《医学前沿（英文）》 2013年 第7卷 第3期   页码 395-395 doi: 10.1007/s11684-013-0289-8

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A modified chronic ocular hypertension rat model for retinal ganglion cell neuroprotection

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《医学前沿（英文）》 2013年 第7卷 第3期   页码 367-377 doi: 10.1007/s11684-013-0266-2

摘要：

This study aimed to modify a chronic ocular hypertension (OHT) rat model to screen for potential compounds to protect retinal ganglion cells (RGCs) from responding to increased intraocular pressure (IOP). A total of 266 rats were prepared and randomly grouped according to different time-points, namely, weeks 3, 8, 16, and 24. Rats were sedated and eye examination was performed to score as the corneal damage on a scale of 1 to 4. The OHT rat model was created via the injection of a hypertonic saline solution into the episcleral veins once weekly for two weeks. OHT was identified when the IOP at week 0 was≥6 mmHg than that at week -2 for the same eye. Viable RGCs were labeled by injecting 4% FluoroGold. Rats were sacrificed, and the eyes were enucleated and fixed. The fixed retinas were dissected to prepare flat whole-mounts. The viable RGCs were visualized and imaged. The IOP (meanβ±βSD) was calculated, and data were analyzed by the paired t-test and one-way ANOVA. The OHT model was created in 234 of 266 rats (87.97%), whereas 32 rats (12.03%) were removed from the study because of the absence of IOP elevation (11.28%) and/or corneal damage scores over 4 (0.75%). IOP was elevated by as much as 81.35% for 24 weeks. The average IOP was (16.68β±β0.98)βmmHg in non-OHT eyes (n = 234), but was (27.95±0.97)βmmHg in OHT eyes (n = 234). Viable RGCs in the OHT eyes were significantly decreased in a time-dependent manner by 29.41%, 38.24%, 55.32%, and 59.30% at weeks 3, 8, 16, and 24, respectively, as compared to viable RGCs in the non-OHT eyes (P<β0.05). The OHT model was successfully created in 88% of the rats. The IOP in the OHT eyes was elevated by approximately 81% for 24 weeks. The number of viable RGCs was decreased by 59% of the rats in a time-dependent manner. The modified OHT model may provide an effective and reliable method for screening drugs to protect RGCs from glaucoma.

关键词： chronic ocular hypertension     intraocular pressure     retinal ganglion cells     neuroprotection     glaucoma    

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Effectiveness of lifestyle intervention for hypertension in Shanghai communities: Results from the ShanghaiHypertension Detail Management Program

Xin-Jian LI MD, Min-Na CHENG MPH, Yu-Heng WANG MD, Sun MIAO MPH, Zong-Qi ZHANG PhD, Yi-Sheng CHEN MD, Wei LU PhD,

《医学前沿（英文）》 2010年 第4卷 第1期   页码 67-70 doi: 10.1007/s11684-010-0023-8

摘要： A community-based multi-center randomized controlled trial was conducted to evaluate the effectiveness of blood pressure control for hypertension patients in communities in urban Shanghai by integrated intervention. At present, patients (=1395) from four communities have completed follow-up for one year, including the intervention group (=921) and usual care group (=474). The intervention programs included disease management by a care manager. Blood pressure of each patient was measured regularly. Compared with the control group, the net change of mean systolic blood pressure (SBP) was −6.75 (95% CI: −7.79 to −5.71, <0.001) mmHg, mean diastolic blood pressure (DBP) was −4.29 (95% CI: −5.08 to −3.49, <0.001) mmHg, and mean pulse pressure (PP) was −2.46 (95% CI: −3.50 to −1.43, <0.001) mmHg in the intervention group. The net change extent was larger in patients with regular pharmacological treatment than in those with irregular pharmacological treatment or non-pharmacological treatment. The measures of integrated intervention for hypertension patients in communities can lower significantly not only SBP and DBP, but also PP. It is suggested that measures of integrated intervention can decrease the risk of cardiovascular diseases in hypertension patients.

关键词： hypertension     community     pharmacological adherence     control of blood pressure    

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Clinical characteristics of pulmonary hypertension in bronchiectasis

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《医学前沿（英文）》 2016年 第10卷 第3期   页码 336-344 doi: 10.1007/s11684-016-0461-z

摘要：

Pulmonary hypertension (PH), as a complication of bronchiectasis, is associated with increased mortality. However, hemodynamic characteristics and the efficacy of pulmonary arterial hypertension (PAH) therapies in patients with bronchiectasis and PH remain unknown. Patients with bilateral bronchiectasis and concurrent PH were included in the study. Patient characteristics at baseline and during follow-up, as well as survival, were analyzed. This observational study was conducted in 36 patients with a mean age of 51.5 years (range, 17?74 years). The 6 min walking distance was 300.8±93.3 m. The mean pulmonary arterial pressure (PAP) was 41.5±11.7 mmHg, cardiac output was 5.2±1.4 L/min, and pulmonary vascular resistance was 561.5±281.5 dyn·s·cm−5. The mean PAP was>35 mmHg in 75% of the cases. Mean PAP was inversely correlated with arterial oxygen saturation values (r = −0.45, P = 0.02). In 24 patients who received oral PAH therapy, systolic PAP was reduced from 82.4±27.0 mmHg to 65.5±20.9 mmHg (P = 0.025) on echocardiography after a median of 6 months of follow-up. The overall probability of survival was 97.1% at 1 year, 83.4% at 3 years, and 64.5% at 5 years. Given the results, we conclude that PH with severe hemodynamic impairment can occur in patients with bilateral bronchiectasis, and PAH therapy might improve hemodynamics in such patients. Prospective clinical trials focusing on this patient population are warranted.

关键词： bronchiectasis     hemodynamics     pulmonary hypertension    

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Obesity and overweight prevalence and its association with undiagnosed hypertension in Shanghai population

null

《医学前沿（英文）》 2012年 第6卷 第3期   页码 322-328 doi: 10.1007/s11684-012-0204-8

摘要：

The aim of this study was to determine the prevalence of overweight and obese subjects in the Shanghai population of China and its association with undiagnosed hypertension, by taking age, gender and place of residence (urban or suburban) into account. A cross-sectional population-based survey was conducted in 2007. The sample included 13 359 participants aged 15–69 years. Weight, height, and blood pressure were recorded, and information about gender, age and place of residence was obtained. Overweight and obesity prevalence were calculated by the body mass index (BMI) definition recommended by Working Group on Obesity in China (normal weight, 18.5–23.9 kg/m2; overweight, 24–27.9 kg/m2; obesity,≥28 kg/m2). Undiagnosed hypertension was defined by China criteria in accord with that of WHO-ISH (subjects with systolic pressure≥140 mmHg, and/or diastolic pressure≥90 mmHg). Multiple logistic regression analyses were used to assess the association of overweight or obesity with undiagnosed hypertension by adjusting for age, gender and place of residence. The overall overweight, obesity, and undiagnosed hypertension prevalence were 27.6% (95% CI: 26.8–28.4), 6.6% (95% CI: 6.2–7.0), and 15.5% (95% CI: 14.9–16.1), respectively. Compared to normal weight subjects, the odds ratios (OR) for subjects who were overweight and had hypertension was 2.33 (95% CI: 2.10–2.59); that for obesity and hypertension was 4.27 (95% CI: 3.66–4.99). These data suggest that overweight and obesity prevalence and their association with undiagnosed hypertension are high in our study population.

关键词： overweight     obesity     undiagnosed hypertension     prevalence     association    

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Improved control of hypertension following laparoscopic fundoplication for gastroesophageal reflux disease

null

《医学前沿（英文）》 2017年 第11卷 第1期   页码 68-73 doi: 10.1007/s11684-016-0490-7

摘要：

This study aims to determine whether successful laparoscopic fundoplication for gastroesophageal reflux disease (GERD) can improve the control of hypertension. We conducted an observational study of GERD patients with hypertension. The esophageal and gastroesophageal symptoms of these patients were successfully treated with laparoscopic fundoplication, as measured by the reduced GERD symptoms and proton pump inhibitor consumption. A hypertension control scale was used to classify the use of antihypertensive medications and the quality of blood pressure control before and after anti-reflux surgery. Wilcoxon signed-ranks test was used for the statistical analyses. Seventy GERD patients were included in the analysis and followed up for a mean period of 3.5±1.4 years. Prior to surgery, all participating patients were taking at least one class of antihypertensive medication, and 56 patients (80%) had intermittently high blood pressure. After surgery, the mean number of antihypertensive medication classes per patient was significantly reduced from 1.61±0.77 pre-procedure to 1.27±0.88 post-procedure (P?<?0.001). The blood pressure of 48 of the 56 cases (86%) with preoperative intermittent high blood pressure returned to normal post procedure. A total of 50 patients (71%) recorded improvements on the hypertension control scale, with the overall mean score decreasing from 3.1±1.0 pre-procedure to 1.4±1.0 post-procedure (P?<?0.001). Therefore, successful laparoscopic fundoplication may result in better blood pressure control in some hypertensive GERD patients. This result suggests a possible connection between gastroesophageal reflux and hypertension.

关键词： gastroesophageal reflux disease     hypertension     blood pressure     laparoscopic fundoplication    

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Intra-abdominal hypertension is an independent cause of acute renal failure after orthotopic liver transplantation

SHU Ming, PENG Chenghong, CHEN Hao, SHEN Boyong, ZHOU Guangwen, SHEN Chuan, LI Hongwei

《医学前沿（英文）》 2007年 第1卷 第2期   页码 167-172 doi: 10.1007/s11684-007-0031-5

摘要： An independent association between acute renal failure (ARF) and intra-abdominal hypertension (IAH) after liver transplantation has not been established previously. The aim of this retrospective study was to understand the role of IAH as an independent risk factor for ARF in the early postoperative period. This study involved 62 subjects who underwent liver transplantation. Intra-abdominal pressure (IAP) was measured in the first three days after surgery by using the urinary bladder technique. An IAP of at least 20 mmHg per day was defined as IAH. Clinical parameters between group IAH and group NO-IAH were compared in terms of the incidence of ARF, blood creatinine levels, blood urea nitrogen (BUN) levels, urine volume per hour and glomerular filtration gradient (GFG). Hemodynamic variations were recorded in the first three postoperative days between group ARF and group NO-ARF. The perioperative suspected risk factors of ARF were determined for statistical evaluation using correlation coefficients and logistic regression analysis. In group IAH, 45.8% patients developed ARF as against 7.9% in group NO-IAH; GFG was significantly lower at 0 72 h after surgery; and blood creatinine levels, BUN levels, urine volume per hour were significantly different at 24 72 h after surgery compared with group NO-IAH. The patients with ARF were not significantly different from those without ARF in terms of central venous pressure, pulmonary artery pressure and mean arterial pressure (MAP) in the first three postoperative days despite a significant increase in heart rate at 24 72h after operation. Postoperative IAH, intraoperative MAP and intraoperative blood transfusion volume of more than 15 U were found to be independent risk factors for ARF. IAH impaired renal function and was an independent risk factor for ARF after liver transplantation. Routine measurement should be taken to monitor IAP every eight hours postoperatively.
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Clinical characteristics in lymphangioleiomyomatosis-related pulmonary hypertension: an observation on

Xiuxiu Wu, Wenshuai Xu, Jun Wang, Xinlun Tian, Zhuang Tian, Kaifeng Xu

《医学前沿（英文）》 2019年 第13卷 第2期   页码 259-266 doi: 10.1007/s11684-018-0634-z

摘要： Lymphangioleiomyomatosis (LAM) is a rare diffuse cystic lung disease. Knowledge on LAM-related pulmonary hypertension (PH) is limited. This study aimed to analyze the clinical characteristics of LAM with elevated pulmonary artery pressure (PAP) and evaluate the potential efficacy of sirolimus. The study involved 50 LAM patients who underwent echocardiography. According to the tricuspid regurgitation velocity (TRV), these patients were divided into the TRV≤2.8 m/s group and TRV>2.8 m/s group. Both groups comprised 25 females with an average age of 38.6±8.1 and 41.5±8.9 years. In the TRV>2.8 m/s group, the estimated systolic PAP (SPAP) was significantly elevated (52.08±12.45 mmHg vs. 30.24±5.25mmHg, <0.01). Linear analysis showed that SPAP was correlated with forced expiratory volume in 1 s (FEV ), diffusing capacity of the lungs for carbon monoxide, alveolar arterial oxygen gradient (P O ), and 6 min walking distance ( = −0.392, −0.351, 0.450, and −0.591, respectively; <0.05), in which P O was a risk factor for SPAP elevation ( = 0.064, OR= 1.066, <0.05). Moreover, in 10 patients who received sirolimus therapy, SPAP decreased from 57.0±12.6 mmHg to 35.2±11.1 mmHg. The study showed that LAM patients with PH exhibit poor pulmonary function and hypoxemia and may benefit from sirolimus treatment.

关键词： lymphangioleiomyomatosis     pulmonary hypertension     pulmonary function     hypoxemia     sirolimus    

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is associated with the reduced risk of all-cause mortality in COVID-19 among patients with/without hypertension

《医学前沿（英文）》 2022年 第16卷 第1期   页码 102-110 doi: 10.1007/s11684-021-0850-9

摘要： Consecutively hospitalized patients with confirmed coronavirus disease 2019 (COVID-19) in Wuhan, China were retrospectively enrolled from January 2020 to March 2020 to investigate the association between the use of renin–angiotensin system inhibitor (RAS-I) and the outcome of this disease. Associations between the use of RAS-I (angiotensin-converting enzyme inhibitor (ACEI) or angiotensin receptor blocker (ARB)), ACEI, and ARB and in-hospital mortality were analyzed using multivariate Cox proportional hazards regression models in overall and subgroup of hypertension status. A total of 2771 patients with COVID-19 were included, with moderate and severe cases accounting for 45.0% and 36.5%, respectively. A total of 195 (7.0%) patients died. RAS-I (hazard ratio (HR)=0.499, 95% confidence interval (CI) 0.325–0.767) and ARB (HR=0.410, 95% CI 0.240–0.700) use was associated with a reduced risk of all-cause mortality among patients with COVID-19. For patients with hypertension, RAS-I and ARB applications were also associated with a reduced risk of mortality with HR of 0.352 (95% CI 0.162–0.764) and 0.279 (95% CI 0.115–0.677), respectively. RAS-I exhibited protective effects on the survival outcome of COVID-19. ARB use was associated with a reduced risk of all-cause mortality among patients with COVID-19.

关键词： COVID-19     RAS inhibitor     hypertension     all-cause mortality    

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Evaluation of the relative risk of stroke in patients with hypertension using cerebrovascular hemodynamic

HUANG Jiuyi, WANG Guiqing, GUO Jiping, CAO Yifeng, WANG Yan, YANG Yongju, YU Xuehai

《医学前沿（英文）》 2007年 第1卷 第3期   页码 274-278 doi: 10.1007/s11684-007-0052-0

摘要： The relative risk (RR) of stroke in patients with hypertension was evaluated by using synthetic index of cerebrovascular hemodynamics. A total of 7,371 patients with hypertension with ages ≥40 years were selected from a population-based cohort study of the risk factors for stroke. The data on the baseline investigation of risk factors, the determination of cerebrovascular hemodynamic parameters (CVHP), and stroke follow-up were analyzed. The RR of stroke in patients with hypertension was evaluated by CVHP scores. Univariate analysis indicated that hypertension, complicated by other risk factors, had significant statistical association with the onset of stroke. RRs for stroke when hypertension complicated with decrease of hemodynamic scores, heart disease, cigarette smoking and alcohol consumption were 4.93 (95%CI, 3.26–7.45), 1.90 (95%CI, 1.36–2.66), 1.99 (95%CI, 1.42–2.79) and 1.73 (95%CI, 1.19–2.53) respectively. In multivariate analysis, hemodynamic score, age, sex, cigarette smoking, family history of stroke and systolic blood pressure were selected by the Cox regression for inclusion in the final analysis. Among them, the RR of hemodynamic score was highest. The analysis of doseresponse relationships indicated that when the hemodynamic scores in patients with hypertension were lower than 75 points, the RR of stroke at 75, 60, 45, 30 and 15 points were 2.85, 4.43, 4.54, 5.40 and 9.88, respectively. The risk of stroke in patients with hypertension is closely asso ciated with hemodynamic impairment and the hemodynamic score may be used for quantitative evaluation of relative risks of stroke.

关键词： inclusion     quantitative evaluation     cerebrovascular     relative     decrease    

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Crk-associated substrate, vascular smooth muscle and hypertension

TANG Dale

《医学前沿（英文）》 2008年 第2卷 第4期   页码 323-331 doi: 10.1007/s11684-008-0062-6

摘要： Hypertension is characterized by vascular smooth muscle constriction and vascular remodeling involving cell migration, hypertrophy and growth. Crk-associated substrate (CAS), the first discovered member of the adapter protein CAS family, has been shown to be a critical cellular component that regulates various smooth muscle functions. In this review, the molecular structure and protein interactions of the CAS family members are summarized. Evidence for the role of CAS in the regulation of vascular smooth muscle contractility is presented. Contraction stimulation induces CAS phosphorylation on Tyr-410 in arterial smooth muscle, creating the binding site for the Src homology (SH) 2/SH3 protein CrkII, which activates neuronal Wiskott-Aldrich syndrome protein (N-WASP)-mediated actin assembly and force development. The functions of CAS in cell migration, hypertrophy and growth are also summarized. Abelson tyrosine kinase (Abl), c-Src, focal adhesion kinase (FAK), proline-rich tyrosine kinase 2 (PYK2), protein tyrosine phosphatase-proline, glutamate, serine and threonine sequence protein (PTP-PEST) and SHP-2 have been documented to coordinate the phosphorylation and dephosphorylation of CAS. The downstream signaling partners of CAS in the context of cell motility, hypertrophy, survival and growth are also discussed. These new findings establish the important role of CAS in the modulation of vascular smooth muscle functions. Furthermore, the upstream regulators of CAS may be new biologic targets for the development of more effective and specific treatment of cardiovascular diseases such as hypertension.

关键词： Contraction stimulation     phosphatase-proline     molecular structure     discovered     hypertension    

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Status of hyperhomocysteinemia in China: results from the China Stroke High-risk Population Screening Program, 2018

《医学前沿（英文）》 2021年 第15卷 第6期   页码 903-912 doi: 10.1007/s11684-021-0871-4

摘要： A nationwide survey was conducted from October 2018 to September 2019 to assess the prevalence of hyperhomocysteinemia (Hhcy) and its influencing factors in China. A standardized questionnaire was used to collect information. Hhcy was defined as the level of serum homocysteine (HCY) ≥15.0 µmol/L. The H-type hypertension (HHYP) was defined as hypertension with an elevated serum HCY (≥15.0 µmol/L). Finally, 110 551 residents ≥40 years of age from 31 provinces in the mainland of China were included. Overall, the median serum HCY level was 10.9 µmol/L (interquartile range 7.9–15.1). A total of 28 633 participants (25.9%) were defined as Hhcy. The Hhcy prevalence ranged from 7.9% in Shanghai to 56.8% in Tianjin. The data showed that serum HCY levels were associated with age, male gender, cigarette smoking, hypertension, diabetes, ethnicity, endurance in exercise (inverse), and fruit and vegetable intake (inverse). In addition, 15 486 participants were defined as HHYP, and the rate was 14.0%. HHYP was an independent predictor of stroke with an adjusted odds ratio of 1.752 (95% CI 1.338–2.105). The geographical distribution pattern of the Hhcy epidemic reflects dynamic differences, and national strategies should be carried out to further improve the care of patients with Hhcy across China.

关键词： homocysteine     hyperhomocysteinemia     H-type hypertension     Chinese    

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Hypertension in patients with CKD in China: clinical characteristics and management

null

《医学前沿（英文）》 2017年 第11卷 第3期   页码 307-309 doi: 10.1007/s11684-017-0578-8

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标题 作者 时间 类型 操作

J-shaped association between dietary zinc intake and new-onset hypertension: a nationwide cohort study

期刊论文

Metabolic hypertension: concept and practice

null

期刊论文

Perioperative management for parturients with pulmonary hypertension: experience with 30 consecutive

null

期刊论文

A modified chronic ocular hypertension rat model for retinal ganglion cell neuroprotection

null

期刊论文

Effectiveness of lifestyle intervention for hypertension in Shanghai communities: Results from the ShanghaiHypertension Detail Management Program

Xin-Jian LI MD, Min-Na CHENG MPH, Yu-Heng WANG MD, Sun MIAO MPH, Zong-Qi ZHANG PhD, Yi-Sheng CHEN MD, Wei LU PhD,

期刊论文

Clinical characteristics of pulmonary hypertension in bronchiectasis

null

期刊论文

Obesity and overweight prevalence and its association with undiagnosed hypertension in Shanghai population

null

期刊论文

Improved control of hypertension following laparoscopic fundoplication for gastroesophageal reflux disease

null

期刊论文

Intra-abdominal hypertension is an independent cause of acute renal failure after orthotopic liver transplantation

SHU Ming, PENG Chenghong, CHEN Hao, SHEN Boyong, ZHOU Guangwen, SHEN Chuan, LI Hongwei

期刊论文

Clinical characteristics in lymphangioleiomyomatosis-related pulmonary hypertension: an observation on

Xiuxiu Wu, Wenshuai Xu, Jun Wang, Xinlun Tian, Zhuang Tian, Kaifeng Xu

期刊论文

is associated with the reduced risk of all-cause mortality in COVID-19 among patients with/without hypertension

期刊论文

Evaluation of the relative risk of stroke in patients with hypertension using cerebrovascular hemodynamic

HUANG Jiuyi, WANG Guiqing, GUO Jiping, CAO Yifeng, WANG Yan, YANG Yongju, YU Xuehai

期刊论文

Crk-associated substrate, vascular smooth muscle and hypertension

TANG Dale

期刊论文

Status of hyperhomocysteinemia in China: results from the China Stroke High-risk Population Screening Program, 2018

期刊论文

Hypertension in patients with CKD in China: clinical characteristics and management

null

期刊论文